Rebirth of Medicine Practices the World

"Since it is a devastating symptom, this patient should not have epilepsy, but a neurological deficit in the ischemic area caused by episodic and transient ischemia in the brain."

"The patient does not have hypertension, nor does he have a history of underlying cerebrovascular diseases such as diabetes. Therefore, when looking for the cause, I hope to find a cause and then use monism to explain all the symptoms and signs of this patient, and even explain her

test result."

"The patient was young, had a sudden onset, and had frequent attacks. Therefore, I identified the cause as cardiogenic."

"Based on the patient's medical history and long-term use of birth control pills, I think the patient is likely to have a type of heart disease that is easily overlooked but is very common: patent foramen ovale."

"This patient's symptoms are most likely caused by small emboli coming from the lower limbs or pelvic cavity, entering the brain through the patent foramen ovale, thereby causing an ischemic attack in the brain."

"The formation of these emboli is directly related to the patient's long-term use of contraceptive pills, and indirectly related to the nature of the patient's work. If these two conditions are not changed, the patient's condition will be difficult to control."

"So, the next step is to improve the cardiac ultrasound examination. Of course, for this ultrasound examination, when we write the examination sheet, we must clearly write down the direction of our diagnosis, so that the doctor in the B-ultrasound room can carry out relevant tests in a targeted manner.

Check. After all, some small, patent foramen ovale are not easy to detect if you don’t pay attention."

"If the patient's conditions permit, it is best to do another head magnetic resonance examination to see if there are any new changes, such as the formation of focal low-signal areas in the brain."

"As for treatment, anticoagulant treatment can be given first. Secondly, the serious relationship must be clearly explained to the patient and she should stop taking birth control pills immediately."

"After the follow-up examination results come out, if the foramen ovale is indeed patent, we can seek the patient's opinion before deciding whether to perform surgical treatment."

When Lin Lin was analyzing, the entire office was very quiet, and you could hear a needle drop.

Everyone present, including Zhuo Yiming, did not expect that Lin Lin's mind would jump so fast, tracing the cause of the disease to the heart and the unclosed foramen ovale.

This is a disease that everyone knows, but no one has ever thought of. When Lin Lin said it, Zhuo Yiming nodded frequently.

"Let's take a look. Do you have any other comments or good suggestions?" Lin Lin asked.

"Dean Lin's thinking is beyond our reach. I think Dean Lin's analysis is very reasonable and I agree with it," Zhuo Yiming said.

Seeing that no one said anything, Lin Lin turned to another patient.

"Doctor Ye, come here, your patient, you speak first." Lin Lin called Ye Xiu's name.

"This is a female patient with a subacute onset and progressive development. Her main symptoms are numbness and weakness in her limbs."

"From the neurological examination, the skin of the patient's limbs is relatively dry and has mild desquamation, which is consistent with changes in peripheral nerve damage."

"In addition, the patient's muscles were slightly relaxed, the tendon reflexes disappeared symmetrically, and the pathological signs were negative, which is also consistent with peripheral nerve damage."

"So, this patient's local diagnosis is multiple peripheral nerve injury. Qualitative diagnosis, I consider multiple peripheral neuropathy."

"In terms of treatment, although it is peripheral nerve damage, although most peripheral nerve damage can be recovered through appropriate treatment, it also takes time. Therefore, I think the patient should still maintain the original treatment plan.

"Ye Xiu's analysis is logically correct.

"Well, that's a good analysis. Do you have any questions about this patient?"

"Yes, at the beginning, I only had one question, which was the patient's joint pain, which I couldn't explain clearly. Just now, when Dean Lin asked about the medical history, the patient mentioned fever. According to the patient, her body temperature during hospitalization

, it is indeed a low-grade fever. This is a new question, and I can’t explain it.”

"Okay, Dr. Ye is good." Lin Lin admired Ye Xiu's performance very much.

"Doctor Ye must be good, she is your junior sister." Ding Feng interrupted.

"Oh, really? Why didn't I know?" Lin Lin was very surprised.

"It was arranged by the Human Resources Department. I didn't know either. I thought you knew."

"Not surprising, I am not in charge of the human resources department. Looking back, I have to thank the human resources department for recruiting a good candidate for our neurology department. Okay, continue."

"I agree with Dr. Ye. This patient must have peripheral nerve damage. As for qualitative diagnosis, it is indeed not easy." Liu Yulan was obviously not prepared for this patient.

"I agree with Dr. Ye's point of view on the positional diagnosis of this patient. In terms of qualitative diagnosis, I am thinking about it. When President Lin asked about the medical history just now, the patient said that her stomach was very poor. If so, will it be like what President Lin did before?

A patient diagnosed with vitamin b12 deficiency is a disease caused by b12 deficiency?" Li Yun'e still remembers that patient.

"When I made rounds, the diagnosis I considered was the same as Dr. Ye's analysis. However, what Dr. Li said just now makes sense. President Lin's questioning of the medical history may be the cause of this patient's disease." Zhuo

Yiming also agreed with Li Yun'e's opinion.

"I have no new opinions. I agree with Teacher Zhuo and Teacher Li." Ding Feng had a hunch that this patient was definitely not diagnosed as such. However, with the depth and breadth of her knowledge, it was indeed impossible to conduct in-depth analysis.

"Although this patient's diagnosis is clear, it will be very rewarding for everyone." Lin Lin said as soon as she opened her mouth that this patient's diagnosis was very clear, attracting everyone's attention.

"Let me tell you what characteristics this patient has." Lin Lin continued.

"First, this is a 45-year-old middle-aged woman. The onset is insidious, progressive, and the main complaint is numbness and weakness in the limbs."

"Second, after the patient became ill, he mainly had fever, anorexia, and dry mouth. Please note that this patient's dry mouth is very obvious."

"Imagine that a person who likes bubble biscuits very much is now afraid of bubble biscuits. This is because there is no or very little saliva secretion and he is unable to eat. This is very abnormal."

"Third, the patient has a special symptom, which is the frequent occurrence of mumps, and on both sides. We must pay attention to this, which will be helpful in the diagnosis of this disease."

"Fourth, the characteristic of the patient's joint pain is that it hurts when moving and decreases or disappears when stationary."