This Doctor is Great

Although Zhou Mo really wanted to beat up the patient Chen Zhongxin, he held back after thinking about it.

Judging from what the patient Chen Zhongxin said, "I feel like I don't have much energy for running a long time ago", the patient's anemia has been going on for a long time.

Zhou Mo: "Is your stool usually black, or what color?"

Black feces, in addition to eating black and red pigmented fruits (such as cherries, blueberries, etc.), may cause black, most of the other reasons are blood in the stool.

When the upper part of the stomach bleeds (stomach, duodenum, jejunum, ileum), and then passes through the long digestive tract (about one to two days), after being pulled out, the stool is black.

If the stool is red, it means bleeding from the second half of the digestive tract: eg colon, rectum, steel door (harmony).

(The class represents the boss, give me a picture of the digestive system?)

(The dividing point of the upper and lower gastrointestinal tract in medicine is between the duodenum and jejunum.)

Patient Chen Zhongxin: "Most of the time it is green and yellow."

Gastrointestinal bleeding was ruled out.

Zhou Mo: "Do you have any medical history? For example, sickle cell anemia, thalassemia, or favism, or family history, is there anyone who is anemic..."

The patient Chen Zhongxin hesitated for a moment: "My uncle seems to have fava bean disease. Is this related to anemia..."

Zhou Mo suddenly became serious.

Favism is hemolytic anemia.

"Hemolysis": Red blood cells rupture, and hemoglobin escapes, which is called red blood cell lysis, or hemolysis for short.

Favism is a type of glucose-6-phosphate dehydrogenase deficiency. In patients lacking this enzyme, the red blood cells are very unstable, which manifests as hemolytic anemia after eating broad beans, but the specific mechanism of hemolysis is unknown (not studied).

In addition, favism is a genetic disease.

Zhou Mo became serious: "Have you eaten broad beans recently?"

Chen Zhongxin shook his head again and again: "I haven't eaten...

Zhou Mo asked: "What about fans, Doubanjiang..."

These are likely to have broad bean ingredients.

Chen Zhongxin nodded this time: "Yes...and I really like bean paste."

The answer seems to be found.

Bean paste, trigger faba bean disease hemolytic anemia.

However, this is just a guess. Since he has already been hospitalized, he should do all the tests that should be done.

correct,

Zhou Mo thought of another thing.

When I just had the B-ultrasound, I seemed to smell a smell of mothballs, which is the kind of mothballs that are kept in the closet to repel insects, and the smell is relatively strong.

Zhou Mo remembered that mothballs were related to broad bean disease.

Although it is nonsense, mothballs are not broad beans, but there are "naphthalene" ingredients in mothballs, which have a certain chance of causing hemolysis of faba bean disease.

(Because the mechanism of faba bean disease has not been studied, it cannot be falsified. However, in some cases and experience, it is believed that mothballs can cause faba bean disease hemolytic anemia.)

In other words, the probability that favism is the culprit is not small.

Zhou Mo: "I'll give you an examination later to see if you have "broad bean disease"..."

Chen Zhongxin: "It's not right, I eat bean paste since I was young, and it's fine."

"No problem when I was a child doesn't mean there's no problem now..." Zhou Mo said: "And the checkup is not very expensive, and you don't want to be so anemic all the time. For a major event like your heart disease, you don't need to save this money ,Right……"

Chen Zhongxin nodded.

really.

They all have a heart attack, and save a lot of money.

at this time,

The nurse has returned to the Department of Cardiology with plasma from the blood bank.

Replenishing fluid and replenishing blood, relieve anemia first.

Zhou Mo suddenly thought of a question, and asked, "By the way, do you have hemorrhoids?"

Chen Zhongxin hesitated for a moment, then shook his head: "No!"

Zhou Mo noticed his hesitation and realized that the problem was not that simple, so he said seriously: "I am a doctor and I am treating your illness, so I hope you will not hide me."

"I..." Chen Zhongxin hesitated, and finally said, "I have hemorrhoids for more than a year."

"..."

Zhou Mo wanted to scold, 'Why didn't you say it earlier', but he held back in the end.

hemorrhoid,

Basically, the steel door has blood circulation disorder, varicose veins, steel door rectal mucosa edema, and some tissues around the steel door continue to proliferate, thus forming hemorrhoids.

It says it's not serious, but sometimes it's very serious.

(Class representative boss, do you want a picture of hemorrhoids? Book friends should feel sick (Devil Laugh · jpg))

"Does your stool sometimes contain blood?"

"meeting."

"Why didn't you just say that?"

The patient blushed, and probably felt too embarrassed to tell the doctor about it.

"I'll ask the doctor from the anorectal department to come over and show you..."

As for the anorectal department, Zhou Mo didn't study it, so he couldn't help patients diagnose it.

...

Diagnosis, over.

At present, the patient is suspected to be: anemic heart disease.

Cause of anemia: favism, or bleeding from hemorrhoids

Therefore, the examination prescribed is the g6pd project for broad bean disease, and a doctor from the anorectal department is invited to come for consultation.

end diagnosis,

Senior Brother Chen Bing gave Zhou Mo a thumbs up: "If it was me just now, I might not have diagnosed it so quickly as you. I guess I would have to ask a doctor from the Department of Gastroenterology for consultation... You are already better than me in this regard."

Zhou Mo said modestly: "The next department I rotate is Gastroenterology, so I studied it in advance."

Senior Brother Chen Bing: "That's amazing."

Huang Yiming, who was next to him, secretly hid back with a guilty conscience.

It's over!

The next department I'm in is also gastroenterology, but I didn't study it at all!

Lax!

No, I can't hold back Brother Mo, after all, I am Brother Mo's right-hand man!

Zhou Mo asked Senior Brother Chen Bing: "By the way, Senior Brother, do you know any doctors in the anorectal department? Call for a consultation? If possible, it may not necessarily be a surgery."

Brother Chen Bing took out his mobile phone: "There is someone I know better, send him a message now."

soon,

The other party replied: "It's noon, wait for me!"

Senior Brother Chen Bing: "Thank you."

Turning off the phone, he said to Zhou Mo and Huang Yiming with a smile:

"Do you know how my friend chose the anorectal department?"

Weird smile.

Zhou Mo and Huang Yiming were curious. After all, the anorectal department deals with feces, so I'm afraid there won't be too many doctors there.

Senior Brother Chen Bing smiled and said, "Once, he had dinner with several old doctors in the hospital, so he asked which department in the hospital earned the most money. Some said surgery, some said orthopedics, and some said it was dentistry."

"At this time, a respected old director of the hospital said: Fart! The ophthalmology department makes the most money!"

"So he finally chose the anorectal department."

Zhou Mo, Huang Yiming, and the nurse who eavesdropped at the nearby nurse station: "..."

brother,

This thread is a bit old!

Senior Brother Chen Bing: "There are many jokes about anorectal surgery, one of which is: Even if she is the goddess in the eyes of many men, anorectal surgery can get rid of her second fat."

...