I Can See Health

   Chapter 206 Clear the fog

   Seeing the system prompt, Lu Chen's heart was extremely shocked.

   It turns out that the system can not only receive thank you points, but also receive clinical thinking insights!

   And at this moment, he gave a book of clinical thinking skills directly.

   Although it is only a primary skill book, it is enough for Lu Chen now.

  This clinical thinking skill book, if you want to measure it with a gratitude value, it will definitely surpass all the current skill books and skill cards.

   This is also a skill that all doctors dream of.

  Lu Chen is just a "rookie" who has just entered the clinic. Perhaps his knowledge of cardiovascular medicine is not bad, but when it comes to other departments, his knowledge reserve is somewhat stretched!

With the thought of   , Lu Chen immediately used this "Clinical Thinking Skills Book".

   After using the skill book, he didn't feel any difference.

   However, according to the previous method of using the system skill book, this is not to directly instill various knowledge, but requires him to practice.

  So, Lu Chen turned his attention back to the case in front of him.

  …

   "Are there any other teachers with a different diagnosis, or any good advice on the current treatment plan?"

  Wang Peng stood on the podium and looked around the crowd.

   In this discussion so far, although there are many opinions, not many are more reliable.

   Among them, the HHT diagnosed by Mr. Xu Zhonghuang is one of the more reasonable diagnoses to solve the patient's gastrointestinal bleeding.

  However, how should the patient's myocardial infarction and cerebral infarction be explained?

   Everyone in the audience whispered, but no one stood up to speak.

  Lu Chen has been immersed in the clinical thinking skills book, which brought him insights.

   When he reviewed the case, he saw something different from before.

   The patient's thrombosis and bleeding, these two contradictory symptoms, seem to be separated, but is there any internal connection?

  Lu Chen turned his head to look at Li Yao, who was beside him, and said softly, "Teacher, you said, if you use monism to explain all of the patient's conditions, will there be any connection between the patient's cerebral infarction, myocardial infarction, and gastrointestinal bleeding?"

   Li Yao was stunned when she heard Lu Chen's words, and then fell into deep thought.

  Thrombosis and bleeding, two completely opposite things, how can they be related?

   If it was what other students said, she might not care so much.

   But this came from Lu Chen's mouth, and Li Yao couldn't help but take it to heart.

  …

   "If there is no teacher to continue to speak, then this whole school discussion will be over, thank you..."

   Before Wang Peng's words were finished, Li Yao suddenly stood up.

   Wang Peng's words were forced back.

   "Director Li, do you... have other opinions?"

   Everyone passed the microphone to Li Yao's hands.

  Li Yao smiled slightly, "Because I have some ideas, or some tips from my students, I will just say a few words."

   "Mr. Li, please speak." Wang Peng smiled.

   Everyone in the room automatically ignored Li Yao's "hint from the student".

  Li Yao looked down at Lu Chen next to her, and then said slowly.

   "Based on the medical history, physical examination, and related test results, the possibility of paradoxical embolism cannot be ruled out."

  Li Yao just stood up when Lu Chen opened his notebook again.

   "Paradoxical embolism, what is this?"

  Lu Chen had some doubts in his heart.

   This is another new knowledge point!

   "Paradoxical embolism, also known as paradoxical embolism and singular embolism."

  It refers to the thrombus in the venous system and the right atrium from the right heart system into the left heart system through the communication in the heart, causing arterial embolism in the heart, brain, kidney and peripheral blood vessels.

   Common causes of paradoxical embolism: ventricular septal defect, patent ductus arteriosus, atrial septal defect, pulmonary arteriovenous malformation and patent foramen ovale, the most common of which is patent foramen ovale.

At this time, Director Yang of the third area of ​​the heart said slowly: "Director Li, we have just considered the diagnosis of this contradictory embolism, but the transesophageal ultrasound examination did not find any cardiac chambers such as patent foramen ovale. Internal shunt disease, so these should be ruled out."

   Everyone looked at Li Yao in unison, the director of the eight districts in his heart could not just give this explanation

   They pricked up their ears and wanted to hear what other explanations Li Yao could give.

   And Li Yao still had a faint smile on her face.

   "Intracardiac shunt disease has been ruled out. Is pulmonary arteriovenous malformation ruled out?"

   Director Yang shook his head when he heard this: "This disease is relatively rare, and we have not considered it for the time being."

  Li Yao smiled and continued: "Then leave the pulmonary arteriovenous malformation alone. Tell me about the HHT that Director Xu Zhonghuang just mentioned."

   Everyone here is not sure why.

   Regarding HHT, Mr. Xu Zhonghuang just now made it very clear.

  What is Li Yao doing?

  Only when Xu Zhonghuang heard Li Yao's words, he frowned at first, then his face was stunned, revealing a hint of surprise!

   "Pulmonary artery malformation and HHT?!"

   He looked up at Li Yao, who was talking, with a hint of admiration in his eyes.

   At this time, Li Yao's words continued to come from his ears.

"HHT, as we all know, this disease is a hereditary disease caused by abnormal development of the blood vessel wall. This disease occurs in young and middle-aged people and can be affected by both men and women. The typical lesions are bright red on the skin and mucous membranes. Or purplish-red capillaries or dilation of small blood vessels, resulting in skin and mucous membrane bleeding or gastrointestinal bleeding."

   After listening to Li Yao's words, everyone was even more puzzled.

   She did not talk about new viewpoints, but told the characteristics of HHT again.

   "Director Li, we all know about your HHT." Wang Peng said on stage.

   "Then do you know what the pathophysiology of HHT is?" Li Yao asked with a smile.

   "Ah? This..." Wang Peng was stunned.

   He is a cardiologist, how does he know the pathophysiology of HHT!

  Li Yao smiled and said: "HHT, its basic pathological changes are incomplete smooth muscle of arterioles and venules, and the surrounding matrix lacks elastic tissue."

   "The earliest morphological abnormality is post-capillary dilation of venules. With the dilation of the venules, the venules curl into a mass, and finally, the capillaries connecting the arterioles and venules disappear, and the arterioles are directly connected to the venules."

   "This is the reason for the formation of arteriovenous fistulas. If this morphological change occurs in the blood vessels of the lungs, it is a pulmonary vascular malformation - a pulmonary arteriovenous fistula!"

   Before Li Yao's words were finished, Director Yang from the three districts in his heart was the first to react.

   "HHT, first causes hemorrhage, and then causes pulmonary artery malformation. Pulmonary arteriovenous fistula will form thrombus, and the thrombus will reach the coronary artery and cerebrovascular of the patient's heart along with the blood circulation, causing myocardial infarction and cerebral infarction!"

   Therefore, myocardial infarction, cerebral infarction, and digestive tract will appear in one patient!

   That's all for now.

   Everyone here is a doctor from a top-level tertiary hospital, and they understood it instantly.

   One HHT, causing all the chain reactions of the patient!

  Lu Chen finished listening to Teacher Li Yao's explanation.

   As if the layers of fog were cleared away, there was a feeling of being drenched and dizzy!

   "Congratulations, received clinical insights!"

The    system beep sounded again, but this time, no skill book was received.

   One more chapter

   (end of this chapter)