This Doctor is Great

Zhou Mo: "Use your 3m for me. There is something wrong with my new patient. My stethoscope doesn't work very well..."

When Huang Yiming heard this, he immediately agreed: "Yes, yes..."

Then he returned to the duty room, took out his Littmann 3200 baby, and handed it to Zhou Mo.

Zhou Mo was about to take it over.

"Wait..." Huang Yiming suddenly shrank his hand, "Zhou Mo, you can use my stethoscope, but you show me this patient..."

Zhou Mo smiled: "No problem..."

Huang Yiming was immediately happy: "Thank you!"

Zhou Mo: "Is there a manual?"

Huang Yiming wondered: "Why do you need a manual, don't you just listen to the sound?"

Zhou Mo rolled his eyes: "Your stethoscope costs more than 7,000 yuan, so just listen to the sound? Don't you know that it has its own analysis function?"

Huang Yiming pouted: "Who can understand that ghost, I just listen to the sound anyway..."

Zhou Mo's mouth twitched.

A horse-rider, a treasure bought for more than 7,000 yuan, in the hands of Huang Yiming, a big dog, just to listen to a voice...

"You really have money to burn..."

"It's only more than 7,000. Is it so difficult that I can still use it as an ancestor?"

Huang Yiming said indifferently, but he also went back and took out the manual, most of which are in English.

Zhou Mo opened it and looked at it.

If it was in the past, Zhou Mo might have struggled to read so much English. But recently, he has been brushing too many papers. With the help of the system, his English level has been improved by 100 times. It is easy to read this manual.

It took 20 minutes,

Zhou Mo read the manual and then debugged it.

At this time, the nurse girl took the initiative to talk to Huang Yiming, and the chat was in full swing.

"Let's go, let's go to the ward again..."

Zhou Mo got up and walked into the ward.

Huang Yiming followed.

Suddenly, the nurse called out from behind: "Brother Ming, there is a movie called "The Lion Squinting", do you want to watch it together..."

Huang Yiming: "I don't like it, change it!"

Nurse girl: "Why don't you watch Manslaughter 2..."

Huang Yiming was excited: "Okay!"

…

ward,

Zhou Mo asked Huang Yiming quietly, "You're going to get off the list..."

Huang Yiming was excited: "That's my charm!"

Zhou Mo: "Didn't you say that whoever gets off the bill first is the dog?"

Huang Yiming is proud: "Single is a dog..."

Zhou Mo: "..."

Coming to bed 29…

Zhou Mo auscultated the heart sounds of female patient Li Haiyan for the third time.

This time, the yellow-haired youth looked at Zhou Mo with a strange look.

He felt as if two horns had grown on his head.

Zhou Mo placed the stethoscope on the fifth intercostal space on the left midclavicular line again.

As soon as you put it in your ear, you can feel the difference in this stethoscope!

What a great noise reduction!

Is this a treasure of more than 7,000 yuan?

Cow!

At this time, Zhou Mo finally heard the sound of his heart, it was indeed wrong!

The mitral valve hears a systolic murmur!

Listening to the third and fourth intercostal spaces on the left sternal border, I found that there was also a murmur in the aortic valve!

A thought jumped out of Zhou Mo's mind.

Vegetation!

Vegetation, commonly seen in bacterial endocarditis, systemic lupus erythematosus, endocrine diseases or Behcet's disease.

The patient in front of me may have bacterial endocarditis...

The endocardium is the innermost layer of the heart and includes the heart's valves and the walls of the atria and ventricles.

When bacteria enter the blood, they travel around the body with the blood. When the valve is inflamed or damaged as it flows through the heart, bacteria can stay there, grow and multiply and cause the valve to become inflamed.

When patients suffer from bacterial endocarditis, they usually have fever, and it is a long-term fever, mostly irregular fever, moderate or high fever.

This corresponds exactly to patient Li Haiyan's repeated fever for a week.

in addition,

Bacterial neoenditis has another characteristic: vegetations.

Inflammation on the valve and in the defect may eventually lead to the formation of vegetations.

As for the patient in front of him, Li Haiyan, with Zhou Mohua's super clinical experience of listening to heart sounds that he quickly accumulated in 2 hours, he immediately heard that there was a problem with the mitral valve, and felt a subtle murmur. Zhou Mo recommended it as a vegetation.

Once this infective endocarditis was introduced,

Then a new process of rational derivation of the condition came out:

Infective endocarditis - reduced heart pumping efficiency (valves are like doors and windows, doors and windows are broken, and naturally the pumping efficiency is reduced) - reduced blood pumping efficiency leads to low blood pressure - the heart starts to pump blood hard - acute heart failure - lungs Edema - crackles + shortness of breath...

(Acute heart failure, cardiac function decline, no way to pump blood with high power, resulting in blood accumulation in the pulmonary circulation, excess blood will enter the alveoli, causing pulmonary edema, the existence of pulmonary edema, will seriously affect the patient's oxygen uptake ability, and then hypoxia , shortness of breath, wheezing...)

this time,

It's all out!

Zhou Mo felt a burst of excitement!

Me, does this count as an independent diagnosis of a patient?

"How's it going?" Huang Yiming couldn't help asking with an excited look on seeing Zhou Mo.

"I seem to have found the cause!"

"What's the cause?"

"I heard a mitral valve murmur, and I guessed it was a vegetation, which means that the patient may have infective endocarditis..."

Zhou Mo explained his derivation in detail.

Huang Yiming looked suspicious: "Impossible, right? Can vegetation be heard with a stethoscope?"

Zhou Mo was proud: "This is my strength!"

Huang Yiming shook his head: "I don't believe it... I'll listen..."

Then he picked up the stethoscope and prepared to lean over the hospital bed to auscultate the patient Li Haiyan...

The boyfriend next to him was a little angry at first, and thought that young doctors like Zhou Mo were ignoring and wiping. But hearing Zhou Mo just described a series of reasoning processes about his illness, he felt very reasonable, and he immediately dispelled this doubt.

Therefore, her boyfriend did not stop Huang Yiming from trying to auscultate.

Huang Yiming placed the stethoscope on the patient's frontal area of ​​Li Haiyan's heart...

Zhou Mo reminded: "The location of the mitral valve is in the fifth intercostal space on the left midclavicular line..."

Huang Yiming: "Oh..."

Fang Quan location…

I heard...

Then, Huang Yiming felt lonely, and couldn't hear the mitral valve murmur that Zhou Mo was talking about.

Huang Yiming looked suspicious: "Are you sure?"

Zhou Mo is very sure: "I'm sure there is a noise, it should be a vegetation... Forget it, there is no need to worry about these..."

Zhou Mo looked at his watch. UU reading www.uukanshu.com

15:20…

"It's time for a cardiac ultrasound..."

Zhou Mo said to the female patient, "The vegetations produced by infective endocarditis I mentioned earlier can be photographed with a cardiac ultrasound, so if there is any, just watch the cardiac ultrasound later..."

"Let's go, now go to the B ultrasound room, I'll go with you..."

Zhou Mo wanted to try to see if he could learn how to use a color Doppler by observing and learning how to use a color Doppler.

…

After 30 minutes…

Ultrasound room.

"Ding... You watched a "Colouric Ultrasound Diagnosis Process", you understood 100% of the essence, and your hands-on ability has been improved accordingly, and you will remember it forever!"

In Zhou Mo's ear, a system prompt sounded.

At this moment, countless experiences flooded into my mind...

Zhou Mo is delighted!

"It's actually possible!"

At this time, the ultrasound teacher said: "It has been confirmed that the patient's mitral valve and tricuspid valve have vegetations... It will take 10 minutes for the report to be detailed, you have to wait..."

Zhou Mo: "Thank you, teacher."

Then he took the patient and left the ultrasound room.

Zhou Mo was very excited. On the one hand, he independently diagnosed a patient, and on the other hand, he learned the relevant operation experience of cardiac color Doppler ultrasound.

At the same time, Zhou Mo admired the deputy director Zhang of the emergency department.

Big cow!

Deputy Director Zhang must have also heard the growth of the patient's heart, and then arranged to send the patient to the Cardiology Department.

Awesome!

…

Now that the cause has been found, the next step is medication.

Zhou Mo contacted Senior Brother Chen Bing.

.