Chapter 228 complex

All that you can ask is almost done.

This female patient named Chen Xiuya has a complicated condition.

Considering that the patient had vomited blood, he could not be discharged from the hospital and had to stay in the hospital for observation.

But the patient does not know what the disease is at present, so he cannot be sent to the inpatient department for hospitalization.

“Call a consultation…”

“In addition, do some basic examinations, blood routine, liver and kidney function, electrolytes, coagulation function…”

soon,

Zhou Mo called various departments and came to diagnose.

Lungs, coughs, and hemoptysis are called thoracic surgery.

Joint pain, called rheumatology.

Soon, the thoracic surgeon came.

“It may be tuberculosis, so it is necessary, starting today, try to keep sputum every two or three hours and send it to the laboratory for culture to see if there are acid-fast bacilli…”

“If you still cough up blood, it’s best to have a bronchoscopy, by the way, a chest CT to see what’s going on.”

“Yes, doctor.”

“Ah?” At this time, the patient bounced, “CT? I heard that the CT radiation is a bit large. I have recently lost my hair with old age. Will it worsen the hair loss? Can I use X-rays?”

Women, always attach great importance to hair.

Zhou Mo shook his head: “It’s better to have a direct CT. It’s much clearer than a chest X-ray. Even if you do it with an X-ray, you’ll still need a CT for the diagnosis…”

Hearing this, Miss Chen could only agree.

The CT results are the fastest, and the pictures are produced on the spot.

· Chest CT results came out.

·The lungs are white, which means there is some inflammation in the lungs.

but,

CT showed pneumonia, which was not particularly serious.

But it can be explained: fever, chills, dry cough, limb pain and fatigue.

But coughing up blood is a little hard to explain.

Soon,

The blood test results came out.

A very strange phenomenon has occurred.

The white blood cell count is 2.8

Reduced!

A normal white blood cell count is 4-10!

Zhou Mo: “…”

Zhang Mei: “…”

Confused.

what happened?

Pneumonia, shouldn’t it be an increase in white blood cells?

How can it be lowered?

At this time, Zhou Mo thought of a possibility: “Teacher, some critically ill patients, especially those with severe infection, whose immune level has been suppressed, the white blood cell count may not increase but decrease.”

“Moreover, the patient, Miss Chen, has lost her hair for more than 2 months. It is possible that her condition is more serious than we thought!”

“Not just pneumonia.”

Teacher Zhang Mei thought for a while and nodded, “It’s possible.”

Currently,

Consider severe pneumonia infection

Consider whether there is a possibility of blood system diseases, such as leukemia, because leukemia can cause low white blood cells.

but,

Still can’t explain the joint pain problem.

The two continued to look down.

Then…

Zhou Mo was shocked!

“Teacher, look, platelets!”

· Platelets, platelets 76!

Platelets, the normal value of the human body, is 100-300…

If it is less than 100, it is called “thrombocytopenia”!

What is the function of platelets?

Coagulation!

With fewer platelets, it is naturally easier to bleed!

With such a small number of platelets, it is no wonder that the patient coughs up blood. Coupled with a severe cough, it is really easy to break the blood vessels in the lungs and cause bleeding.

but,

Why do platelets decrease?

what is the reason?

Zhou Mo thought of “serious infection”, which inhibited the production of platelets.

In addition, will there be blood system diseases?

Like leukemia? Lymphoma?

“If you want to determine leukemia, you have to do a bone marrow aspirate…”

“If you want to confirm lymphoma, you need to do a CT of the whole body again…”

Zhou Mo shared his thoughts with Teacher Zhang Mei.

“Can…”

“Would you like to call the oncology department for a consultation?”

“Can.”

Zhou Mo called and asked the oncologist to come over.

Zhou Mo: “Do you usually have night sweats?”

Night sweats are one of the typical symptoms of lymphoma.

Patient: “No…”

In addition, there are thin…

Zhang Mei and Zhou Mo observed the patient Chen Xiuya, who was well-proportioned and not thin…

Lymphoma can be temporarily ruled out.

Teacher Zhang Mei: “The infection is so serious, first use antibiotics to suppress the inflammation…”

Zhou Mo: “Yeah.”

in addition,

Zhou Mo suggested: “The cause has not been found yet, so it is best to do all the tests.”

“A set of rheumatism immunity, infection markers, tumor markers… It is best to do it again… Bone marrow aspiration, CT…”

Teacher Zhang Mei agreed.

at this time,

The patient’s parents are present.

After Zhou Mo told the patient’s parents once,

“Is it that serious?”

“That’s what it’s thinking at the moment, so so many checks are needed.”

“Hey, the hospital really spends a lot of money every time I come here.”

“That’s right, it’s a few thousand out again.”

“But, if you don’t do it, you can’t do it…”

“Hey…”

Zhou Mo listened next to him and couldn’t help but smile bitterly.

For some diseases, it is natural to treat them empirically. For example, for diarrhea, a blood routine is usually drawn, and fluid replacement is sufficient. It doesn’t cost much, just under 100. However, if the diarrhea has complicated symptoms, it will be a little more troublesome, the inspection will be more, and the cost will be higher, unless you do not want to find the cause and treat the symptoms rather than the root cause.

Although the parents were rambling, they signed it without hesitation. UU Reading www.uukanshu.com

When Zhou Mo returned to the hospital bed, Zhang Mei couldn’t help frowning.

“teacher…”

“There seems to be something wrong with her condition. She has a fever and her spirits don’t seem to be very good… I don’t know if her condition is progressing.”

“Then do the inspection quickly… I’ve got the signature.”

“it is good.”

The two did not dare to neglect.

Get your blood drawn!

All checks!

Money can’t be saved!

At this time, the doctor of rheumatology and immunization also came.

However, after the rheumatology and immunization department’s consultation and physical examination, there was no diagnosis.

“Let’s do a rheumatism test…”

The rheumatologist only made this decision and went back to work on the ward.

Then, an hour later, the effect of the medication was not obvious.

The patient, Chen Xiuya, still has a fever, and the fever is even higher. The dry cough is more severe. The pain in the limbs and joints has not improved, and the pain is even worse.

Halfway through, he coughed up blood.

This time, Zhou Mo, Teacher Zhang Mei and some nurses saw it with their own eyes, and they were quite sure that it was indeed coughing up blood.

soon,

Except that the bone marrow biopsy has not been done yet, and the results of rheumatism immunity are relatively slow, all the test results have come out.

But nothing special was found.

Zhou Mo and Zhang Mei didn’t find any problems, and the patient’s condition didn’t seem to be “red”, so they went to rescue other patients.

After more than an hour,

The patient’s parents suddenly found Zhou Mo,

“Doctor, I don’t know if I should tell you something…”

“It’s natural to say…” Zhou Mo said seriously.

“My daughter seems to have some rashes on her chest and back. I don’t know if it’s a problem…”

“?!!”

Zhou Mo was taken aback.

This situation has never been mentioned before.