This Doctor is Great

"After potassium supplementation, it became more serious?"

Zhang Luojia, Zhou Mo and others were surprised.

"That's right, it's getting worse, and the skin of the lower limbs began to show obvious tenderness, and at the same time, the hands were numb..."

"?????"

This time, Zhou Mo and others were confused!

"In other words, the patient's muscle weakness is not some kind of hypokalemia periodic paralysis?"

"Yes, ruled out."

Brother Zhang Mingyu said: "After excluding hypokalemia, I arranged a further examination for the patient, MRI of the spine and lumbar spine, in order to rule out the compression of the spine and lumbar nerves by tumors and other lesions, resulting in weakness in the upper and lower limbs..."

"And the final inspection results showed nothing unusual."

"Then I also did a B-ultrasound of the thyroid to see if there was any lesion that caused abnormal secretion of hormones and low potassium...but nothing abnormal was found."

Zhang Luojia, Zhou Mo, and Li Dongmei fell into deep thought.

"What kind of sickness is this?"

Huang Zhichao, a scumbag, also fell into deep thought, pretending to think: "What is the disease?"

Brother Zhang Mingyu said: "The biggest trouble now is that the patient has not found the cause of the disease, but his condition has worsened, his limbs are sluggish, numb, and weak... and what is more serious is that it has spread to the face, causing facial paralysis."

"Besides, the most serious problem is that the patient coughed up sputum with difficulty half an hour ago...I'm afraid that at this time, there may be something wrong with his heart..."

Obviously, the patient in front of him is definitely muscle weak.

The heart has cardiac muscles, and muscle weakness will also spread to the heart. At that time, the heart may stop beating directly, resulting in the death of the patient.

These are all Dr. Zhang Mingyu's worries.

Zhang Luojia said to Zhou Mo: "Xiao Mo, you are from the Department of Cardiology, and you can show patients about heart problems."

Zhou Mo nodded: "Okay."

To Senior Brother Zhang Mingyu: "Is there a B-ultrasound machine?"

Brother Zhang Mingyu nodded: "Yes...but do you know how to use it?"

Looking at Zhou Mo with surprise.

B-ultrasound should not be used by ordinary doctors, right? Zhou Mo is so young.

Zhou Mo nodded: "I have studied it in my heart."

Cardiac muscle weakness is not a professional term, but heart failure is, that is, heart failure. The inspection is very simple, just look at the ejection value. If the value is too bad, there must be a problem.

not long,

The B-ultrasound machine came over.

Zhou Mo re-adjusted the parameters, scanned the patient's heart, and quickly got the result: blood ejection was poor (considering high blood pressure).

"It should be heart failure..."

Zhou Mo told everyone about the data, then analyzed it, and came up with the result.

Zhang Mingyu: "So, I am also anxious now, but I can't find the reason... Sister, have you thought of anything?!"

He looked at Zhang Luojia expectantly.

Zhang Luojia fell into deep thought. There was nothing wrong with it. It was muscle weakness and low potassium. However, after potassium supplementation, instead of reducing it, it aggravated it.

This disease is a bit strange.

Li Dongmei was also thinking.

Huang Zhichao pretended to be thinking.

Zhang Luojia suddenly said: "Have you checked, is it "Guillain-Barré Syndrome"? "

"Guillain Barre Syndrome"

The symptoms of this patient are somewhat similar.

The specific manifestations of "Guillain-Barré Syndrome" are muscle weakness and numbness, which are peripheral nerve inflammation, which may be related to autoimmunity. Patients may also have fatigue and poor appetite. Because of nerve inflammation, there will be numbness, Weakness and other manifestations, and in some severe cases, even paralysis and respiratory failure.

It matches the patient's condition very well.

However, this is the Department of Neurology. Obviously, the doctors are no strangers to "Guillain-Barré Syndrome", and they must have checked it long ago. .

Sure enough, Zhang Mingyu shook his head: "We also considered this at the beginning, and performed cerebrospinal fluid puncture, extracted it, and finally confirmed that it is not Guillain-Barré Syndrome."

Then, Senior Brother Zhang Mingyu said: "We also checked for polio and myasthenia gravis... none of them..."

It can be said,

Neurology takes almost all diseases into consideration.

All checked.

But neither is the end result! !

"etc!!"

At this time,

Zhou Mo suddenly had a flash of inspiration, thinking of the previous cases, he had written about the difference between potassium chloride and potassium citrate.

Is it possible——

The Difference Between Potassium and Magnesium!

"Senior Brother Zhang, have you checked your blood magnesium?"

Zhang Luojia, Li Dongmei, and Huang Zhichao all looked over.

"Ah?" Brother Zhang Mingyu was stunned for a moment: "Blood magnesium? No... only blood sodium and blood potassium were checked..."

Zhou Mo said: "Let's check it... I think there may be a problem with blood magnesium..."

Zhang Mingyu was stunned.

He seems to have figured it out! !

Yes, blood magnesium!

Forget about this!

Zhou Mo continued: "Although you have already supplemented potassium, because the renal tubules absorb potassium, you need a sodium-potassium pump, and the sodium-potassium pump needs the assistance of magnesium ions..."

Speaking of this, Zhang Luojia also understood.

clap your hands!

That's right! Blood magnesium!

It's really possible!

Li Dongmei and Huang Zhichao: "..."

Fuck, I don’t understand, what should I do?

Li Dongmei was at a loss.

Huang Zhichao showed an expression of "I understand"!

Magnesium is one of the most abundant cations in the body. The adult human body contains 0.823-1.234 mol of magnesium, of which 50% exists in the bone, 45% in the intracellular fluid, and 5% in the extracellular fluid. Liver, kidney and muscle contain more magnesium.

In the intracellular fluid, the content of magnesium is second only to potassium, ranking second!

So it's also a very important item.

Zhou Mo continued: "If the patient has hypomagnesemia, because of the lack of magnesium, the patient simply supplements potassium, which may lack the assistance of magnesium ions, and potassium supplementation becomes ineffective..."

"Even if potassium is supplemented all the time, the concentration of potassium may become too high, but it cannot be used..."

Brother Zhang Mingyu clapped his hands: "It makes sense! Why didn't I think of it?"

upset!

And then non-stop.

"Check serum magnesium now!!"

He had a strong hunch that serum magnesium might be the ultimate answer!

...

Naturally, Zhang Luojia, Zhou Mo and others could not wait for the results of serum magnesium in the Department of Neurology.

Back to Gastroenterology first.

on the way

Li Dongmei and Huang Zhichao once again expressed their admiration and admiration for Zhou Mo.

Huang Zhichao said in his heart, "The boss is the boss!"

Li Dongmei: "I am a majestic student, but I have turned into a salted fish during this period of time. I can only call 666... ​​No, I have to work harder!"

Back to the department,

Zhou Mo made something,

half an hour later,

The neurology department called and the results of the blood magnesium test came out.

— Low blood magnesium!

Did not run away!

The reason for the patient's muscle weakness is definitely this!

"Brother Mo is awesome!!"

At this moment, Huang Zhichao, who was older than Zhou Mo, couldn't help calling Zhou Mo 'Brother Mo'!

Huang Yiming: "????"

Worth!

Who is this guy?

Grab my top horse position?

Huang Yiming sent a WeChat message to Zhou: "Brother Mo, treat you to dinner tonight!"

Zhou Mo: "Okay, but Senior Brother Chen Bing also asked me out, do you want to go together? (Hey expression)"

Huang Yiming: "Let's go together! My treat!"

Zhou Mo: "Is it convenient?"

Huang Yiming: "Why is it inconvenient? I haven't eaten with Senior Brother Chen Bing for a long time!"

At this time,

A message was sent out in the group.

——"Shocked! 38,000 in 3 days! The mortuary of the No. 1 Hospital in the Imperial City was accused of charging exorbitant funeral expenses. Family members: 600 for the dead!"

I want to code two chapters today, but the situation in Baiyun has changed suddenly.

(The book friend guessed that I was in Baiyun, afraid of being sent a knife, trembling (dog head to save life))

Today, a very large area was sealed off at once, and the situation is estimated to be very serious.

In the morning, I was doing nucleic acid, buying rice, vegetables, and oil... I didn't get it done until the afternoon.

The vegetable market has already started looting, and the price of vegetables in some stores has soared. I bought 4 large bags of rice, and I was sweating~~

The CDC said this time it may be more serious.

Hey, hope it gets better soon!

...

I will update twice tomorrow, absolutely no problem!

Sorry book friend!