Doctor: It's reasonable to perform surgery on yourself.

"Do you know how valuable Dr. Xu's time is?" Wang Fan said angrily.

"It's none of my business. Aren't you doctors supposed to see patients?"

Liu Susu gave Wang Fan an encouraging look. Just as she was about to speak, Xu Qiu stopped them.

They still have too little experience dealing with this kind of patients.

Xu Qiu said lightly: "If you don't cure the disease, how can you realize your ambitions?"

"Tsk, I'm better than you stupid people when I'm sick!"

"Do you think it's just a fever and it will pass after a while? Dr. Wang has already made the first diagnosis, and he can't see any clues, which means that this disease may be very troublesome. In other words, if it's not cured, you may die."

"Do you think you can scare me? Die, die, people die, birds fly to the sky, God is jealous of talents, and dying early just means that God is jealous of my talent!"

"Well, but if you die, the achievements you could have made will be taken away by others. Are you willing to give your reputation to others?"

Wei Ding's voice suddenly paused, and there was a trace of fear on his face.

Click——

The examination bed made a sound, and Wei Ding turned back silently without saying a word.

But his attitude was already very clear.

Xu Qiu didn't waste time and quickly examined the patient.

Liu Susu and others were surprised.

Just a few words to get it done?

Dr. Xu's ability to communicate with patients is also unique...

Wei Ding's parents also showed an expression of disbelief.

Xu Qiu sighed softly in his heart.

In fact, communication skills are one aspect of this matter.

The most important thing is Xu Qiu's identity and status.

Wei Ding, a cynical person, is most afraid of peers who are better than him and whose achievements are beyond his reach.

Xu Qiu said these words to provoke him, but from another perspective, it also gave Wei Ding a sense of satisfaction that "I was affirmed by the boss."

Whenever Wang Fan used the same rhetoric, he would provoke Wei Ding to resist more strongly because of his insufficient status.

It's like the general manager patting an employee on the shoulder and saying "work hard", and the old man who guards the door saying "work hard", the effect is completely different.

...

After the examination, Xu Qiu locked on several problems.

First, muscle weakness level 4.

Level 5 is normal muscle strength, and level 3 means that the limbs can be lifted off the bed, but Xu Qiu will lose strength immediately when he slightly stretches out his hand to block it, that is, there is no resistance.

And Wei Ding is caught between the two. He can resist resistance and walk on the ground, but his muscle strength level is lower than that of normal people.

After careful examination, the eyelids are not drooping, the pupils are very sensitive to light, but there is no abnormality in eye movement.

In terms of limb muscle strength.

There are no major problems with the central axis muscles such as raising the head and bending the waist.

The proximal muscle strength of the upper and lower limbs, that is, the muscles controlled by the shoulder girdle muscles, has decreased.

The distal muscle strength, forearms, calves and wrists are the least ideal.

"Fever, why is there a fever?"

Xu Qiu's attention skipped myasthenia and fell on fever.

According to the medical history, Wei Ding has had a fever for more than a week.

The body temperature is not high, the highest is only 39 degrees, which is even a bit cold for emergency doctors who are used to seeing extremely high fevers above 40 degrees.

During the fever, the patient also had intermittent chills and shivering.

Xu Qiu also did a physical examination, and there were no problems with the physical examination and heart and lung auscultation.

The patient's heart rate, blood pressure and other vital signs are also very stable.

Except for fever and myasthenia, there is no problem.

"What tests have you done?" This was said to Wang Fan.

Wang Fan quickly stood up: "Brother Xu, I originally arranged blood and CT, but the patient did not cooperate..."

"Do it again."

After Xu Qiu finished speaking, he glanced at Wei Ding on the bed, who just closed his eyes and did not make any more resistance.

"Order PCT and C-reactive protein.

"And brain CT. "

Xu Qiu added.

Clinical intuition told him that this disease should be related to the central nervous system.

…

After finishing an operation, it was almost time to get off work.

On the desk, there was a check list sent by Shi Lian.

Weiding.

B-type natriuretic peptide was slightly elevated, which may be related to heart failure, pulmonary embolism, hyperthyroidism, renal failure, etc.

Myoglobin was also elevated, reaching 199.30, far exceeding the normal value of 28~72.

The clinical significance of this is complicated.

If the patient has symptoms such as chest pain and chest tightness, and with increased myoglobin, it may be acute myocardial infarction;

If there is a history of trauma or strenuous exercise, acute muscle damage often occurs, and polymyositis, rhabdomyolysis, etc. should be considered.

Other symptoms include fatigue, nausea, decreased urine, edema, etc., and they must be combined with urine routine and renal function to diagnose acute and chronic renal failure.

However, the trouble is that in addition to fever, the patient There doesn't seem to be anything worth noting!

Other tests, PCT, C-reactive protein, etc. are not high, white blood cells are normal, there are some abnormal indicators in the blood routine, but this has no clinical significance, normal people will also have many problems when doing blood routine.

"Teacher, can you see anything?" Shi Lian tiptoed.

Before Xu Qiu came, she had read the patient's report, and there were quite a few abnormal data on it.

For example, the D-dimer was quantitatively high, and the fibrin degradation products were also slightly increased...

However, she could not judge any disease from these test data, and there was not even a direction for diagnosis.

This is the biggest difference between medical students and doctors.

In the eyes of the former, all kinds of diseases are limited to rules and regulations, and they are checked if they meet the requirements.

Doctors look at the whole picture.

Shi Lian is concerned about the increase of D-dimer, but in Xu Qiu's eyes, this isolated slight increase is meaningless.

"Low albumin and poor nutrition." Xu Qiu gave a conclusion.

From these laboratory tests, he can only see these two problems.

Even, this is not a problem.

It is likely related to Wei Ding's fever for nearly a week.

"Where is the CT?" Xu Qiu asked.

Shi Lian pulled out a small bag from the bottom, took out the report and the image film, "There are three tests, cranial CT, chest CT and abdominal CT."

"Yes."

Xu Qiu quickly found valuable abnormalities.

There are small flakes of low-density shadows in the left basal ganglia, and the density is similar to that of cerebrospinal fluid...

This is a softening focus in the brain!

In short, it is a cystic softening lesion formed after various destructive lesions occur, causing necrosis and softening of brain tissue and filling with cerebrospinal fluid.

This is also the reason why its density is similar to that of cerebrospinal fluid.

There are many causes that can lead to softening lesions, including cerebral hemorrhage, cerebral infarction, circulatory insufficiency, encephalitis and brain trauma.

"If it is a softening lesion in the brain, it will be very troublesome."

Xu Qiu narrowed his eyes slightly.