Rebirth of Medicine Practices the World

"Yes, yes, too, so my appetite has become very bad."

"After you got sick, did you feel like you had a fever?"

"Well, there really is."

"Have you ever taken your temperature before?"

"Yes, my body temperature is very special."

"Oh, why is it so special?"

"I had a fever and headache when I had a cold. I went to the hospital and the nurse took my temperature, which was only 36.5 degrees. Later, I recovered from the cold and I didn't feel like I had a fever anymore. I took my temperature again and it was only 35.9 degrees."

"You mean, under normal circumstances, your body temperature is 36 degrees or below?"

"Yes, it is true. Once it exceeds 36.5 degrees, I feel particularly uncomfortable. I have encountered this situation several times."

"Okay, I understand. You said your hands and feet are weak. Do you feel that you have less strength than before?"

"Hmm... How should I put it? I don't have the strength. When doing housework at home, I can do what I used to do now. I just feel very sleepy and get tired easily."

"You said you have joint pain, does it hurt when you move, or does it also hurt when you sit quietly or fall asleep?"

"It hurts when I move, but not so much when I sit still or lie down."

"Have you ever had 'pig's gills' since you got sick? (Yingzhou people like to call mumps 'pig's gills')."

"Oh, it really happened, and more than once. Sometimes, after giving birth on the left side, the right side comes next, which is very uncomfortable. By the way, I often have ulcers in my mouth. I also went to the dental department, and they prescribed me

I took vitamin B2, but the effect was very poor.”

"Are you still menstruating now?"

"Yes, and on time."

"Is your period different now than before?"

"When Dean Lin asked me this, I really felt a little different. I felt that the amount was less, especially before menstruation, and it seemed that it was not as moist as before." Women of this age no longer have the problem of being shy.

"I'm asking you a very private question, but you don't have to answer it. Since you became ill, have you and your husband had the same sexual intercourse as before?" Lin Lin leaned down and asked softly in the patient's ear.

"It's different, it's completely different, it hurts, it's burning. Now, I don't dare to let him touch me." The patient was surprised, how come every question asked by Dean Lin was so pertinent.

"Are your teeth okay?"

"I feel a little sore recently, but it's okay to bite things."

"Okay, let me do a check-up for you." After Lin Lin finished speaking, she performed a physical examination on the patient.

This time, Lin Lin asked Ding Feng for a flashlight and a tongue depressor, and carefully inspected the patient's oral condition. Lin Lin found that the patient's teeth had begun to turn black, but the condition was not very serious.

Lin Lin also carefully examined the patient's oral mucosa and found several ulcers and the mouth seemed dry, which was consistent with what the patient said.

The neurological examination was basically consistent with what Ye Xiu reported. The patient's skin appeared dry and slightly desquamated. The tendon reflexes of the limbs were weakened and there were no pathological reflexes.

"Okay, thank you for your cooperation. Let's go back and discuss it and give you a clear answer." Lin Lin's words gave the patient confidence and also made the doctors present feel pressured.

"What's going on? Could it be that Dean Lin already knows the patient's diagnosis?" Zhuo Yiming and Ye Xiu were thinking almost at the same time.

Lin Lin washed her hands and returned to the doctor's office to sit down.

"Let's start, let's start the discussion with Dr. Ma's patients, and let everyone express their opinions." Lin Lin immediately asked everyone to start the discussion.

Ma Shuiyuan started to speak, but there was nothing new.

"I think the characteristic of this patient's condition is very prominent, that is, episodic symptoms."

"In terms of age, the patient is very young and does not have underlying diseases such as cerebrovascular disease, such as high blood pressure, diabetes, hyperlipidemia, etc."

"So, I think this patient's diagnosis is symptomatic epilepsy. The type of epileptic seizure is most likely to be absence seizure or atonic seizure."

"Although the current treatment is ineffective, can we consider switching to other anti-epileptic drugs?"

"I also agree with Dr. Ma's opinion. There is nothing new to add." Li Yun'e couldn't think of any more possibilities.

"I still maintain the point of view from the last discussion. The patient has episodic symptoms, but her episodic symptoms are mainly weakness. In other words, the patient's brain disease is a destructive disease, and

It’s not an irritant lesion.”

"So, I think the patient's diagnosis should be Tia, not epilepsy." Zhuo Yiming still did not change his opinion.

"I also agree with Teacher Zhuo. This patient is most likely to have TIA. As for the reason, it is still difficult to find out."

"Although she does not have a basic disease of cerebrovascular disease, are there some other diseases that we have not discovered yet that can cause TIA?" Ding Feng also agreed with Zhuo Yiming's opinion and put forward her own thoughts.

.

"I also agree with Teacher Zhuo's opinion. Although the patient has episodic symptoms and is very young, the patient's symptoms have not improved after anti-epileptic treatment. On the contrary, they continue to worsen."

"So, I think in another direction, does the patient have Tia? If so, what is the reason?"

"Based on the information at hand, it is still not possible to diagnose the cause of the disease I mentioned. Therefore, the next step is whether it is necessary to further improve some related examinations."

"Should we stop anti-epileptic drugs before perfecting the treatment? After all, we have been using them for such a long time. According to the principles of anti-epileptic drug use, this time is enough to see whether the drugs are effective."

Liu Yulan's speech made Lin Lin's eyes light up. He could not have imagined that Liu Yulan had made such great progress.

"Yes, it seems that everyone has had a full discussion about this patient, and the two views are clearly distinct. In fact, this is a good phenomenon, indicating that everyone has reviewed the information and thought deeply."

"Let me tell you my opinion. This patient has the following characteristics." After Lin Lin praised her, she went directly to the topic.

"First, the patient is a female and very young."

"Second, the patient's symptoms are mainly episodic limb weakness and slurred speech."

"Third, the onset time is not long, and it has a tendency to become more and more frequent."

"Fourth, the patient has been taking contraceptive pills for a long time."

"Fifth, the nature of the patient's work determines that she must remain seated for a long time."

"Back to the patient's diagnosis. I think the patient's clinical manifestations clearly tell us that all her symptoms are destructive symptoms of the nervous system, not irritating symptoms. On this point, I agree with Zhuo

Teacher’s opinion.”