When doctors have a simulated operating room

The blood pressure of Zhao Xiaolong was measured at the beginning, and it was not until the blood pressure was measured that it was measured.

How do high blood pressure and low blood pressure come about?

Because catecholamine can secrete α receptors that constrict blood vessels and β receptors that dilate blood vessels.

Whether the patient has high blood pressure or low blood pressure depends on which type of catecholamine is secreted.

It feels quite hegemonic.

If I tell you to have a high blood pressure, you have to have a high blood pressure. If I tell you to have a low blood pressure, you have to have a low blood pressure!

That's why Zhao Xiaolong's blood pressure was measured below the normal value at the beginning, giving people a symptom of impending shock.

In fact, these are all scams of "catecholamines".

Use sleight of hand to confuse the audience, so that the doctor mistakenly believes that the patient has heart failure, kidney failure, low blood pressure, myocardial damage, etc.

It just so happens that these symptoms are very similar to myocarditis.

Most doctors find it difficult to identify the cause of the disease at the first time of rescue.

Therefore, a small number of patients with fulminant myocarditis or even acute myocardial infarction must die of pheochromocytoma.

After sorting out the cause and effect, Zhang Yi raised his head and said firmly: "This person does not have fulminant myocarditis. The cause is not in the heart, but in the kidney! This person has a tumor in the kidney! And it is very likely to be a pheochromocytoma! Do a blood and urine catecholamine test!"

The people around looked at Zhang Yi in surprise.

Ah? ?

Isn't it myocarditis?

How did it suddenly become a tumor again? ?

And it is such a rare pheochromocytoma.

Hmm?

Pheochromocytoma? !

Don't say...

The symptoms of pheochromocytoma do have the symptoms of myocarditis.

But it doesn't prove that he has pheochromocytoma? ?

The nurse was stunned for a moment, and after two seconds she came back to her senses and quickly drew blood and urine.

Who cares what disease he has?

Just do what Zhang Yi says.

The doctors around, including the two apprentices, were still thinking carefully about why Zhang Yi suddenly changed his diagnosis.

Except for the doctor in the ultrasound department.

He opened his mouth in surprise, and goose bumps crawled all over his arms!

Oh my God!

How did Zhang Yi know that this person had a tumor? ! ?

He had just checked and found that the patient's left kidney echo was uneven, and there was an unknown tumor with a diameter greater than one centimeter.

He just wanted to report the results to everyone! !

Zhang Yi actually saw it? ?

He said the results before he, the examiner? ?

Tsk tsk tsk...!

It's amazing!

Zhang Yi is so awesome!

After a long pause, the goose bumps on the ultrasound doctor's body slowly disappeared.

"Yes... Doctor Zhang, this person... does have a tumor. I found an unknown tumor with a diameter of about one centimeter in his left kidney."

The next second, everyone around showed a shocked expression.

"Really?!? Is it really a tumor?? An unknown tumor on the kidney?"

"Damn? Is it true? Let me see!"

The last second they were still wondering if what Zhang Yi said was correct, and whether the cause of this person's illness was myocarditis or a tumor.

Unexpectedly.

The next second, the ultrasound doctor gave the answer!

If the ultrasound has confirmed that a tumor has appeared in the kidney, then combined with the other clinical examination results...

Then there is indeed only one possibility, pheochromocytoma.

It can combine so many symptoms together, and it is so similar to myocarditis, and there is also a tumor in the kidney.

That is definitely pheochromocytoma!

"Doctor Zhang, you are amazing. How can you know the result faster than the ultrasound doctor?"

"Yes, Master, how did you see it? Can you teach us?"

When the two apprentices looked at Zhang Yi, their eyes were almost filled with hearts.

Zhang Yi is simply too awesome!

He is the only idol in their lives~!

Facing the admiration of the people around him, Zhang Yi seemed particularly calm.

He pointed to the examination sheet and said:

"I saw it with my eyes."

The two apprentices and the other two doctors: - -!

Who doesn't know how to see with their eyes? !

The problem is that we can't see it with our eyes, so we ask you!

Then we heard Zhang Yi's simple explanation:

"First of all, this examination sheet has already indicated that the patient has symptoms of renal failure.

Our initial speculation was fulminant myocarditis, right? Then in general, fulminant myocarditis is likely to affect renal failure in a short period of time.

It is viral myocarditis.

So the results are out. Look at his blood routine and blood picture results.

Why didn't the lymphocytes increase? If this person has a viral infection, then the lymphocytes will definitely increase, but this person doesn't.

Looking at the white blood cells, the white blood cell index is not high, and the neutrophil increase is still the main one, which does not meet the symptoms of fulminant myocarditis.

There are also the results of B-type natriuretic peptide and D-dimer.

Although one of these two is a test for heart failure and the other is a test for thrombosis.

But...

B-type natriuretic peptide can also detect renal failure.

And D-dimer is also a must-check item for tumor patients.

When these two indexes increased, I immediately thought, could the patient not have myocarditis? ?

But if it's not myocarditis, what is it?

What kind of disease is this with symptoms so similar to myocarditis?

So I considered tumors, and the only tumor with this possibility is pheochromocytoma!

Of course, these points I mentioned are easy to overlook if you don't look carefully.

Including myself, I missed it just now.

But how can I say it, this disease comes on too quickly, just as dangerous as fulminant myocarditis.

Let's do a good job of rescue, help the patient stabilize his blood pressure, and see if he can go to the operating room later.

If he can go to the operating room, at least he can have surgery to remove the tumor, so that he still has a chance to survive.

If not... we have done our best. "

After listening to Zhang Yi's analysis, everyone benefited a lot!

What Zhang Yi said was right.

They just looked at these test results and thought that this person had myocarditis.

They even wanted to treat it as acute myocardial infarction at the beginning.

After all, clinically, especially in their emergency department, there are too many patients with myocardial infarction and myocarditis.

When the weather gets cold, the elderly with myocardial infarction are sent to the hospital by ambulance almost every day.

There is also myocarditis. In recent years, the incidence of myocarditis has not only been increasing, but the age of onset has also been getting younger. The younger the patients are.

These are the common diseases that everyone sees in the emergency room every day.

It is rare to encounter a rare disease like pheochromocytoma.

So for a while, no one would consider this direction.

Only Zhang Yi.

He actually thought of the possibility of this disease.

It is worthy of being Zhang Yi.

How much medical knowledge does he have in his mind? ?

Just when a few people wanted to continue to flatter Zhang Yi.

The patient's heart rate is not good again!

This time it is not reduced, but directly ventricular fibrillation!