Chapter 369 Lu Chen’s Teachings

Lu Chen adapted very quickly to the endocrinology department.

After all, he had rotated through two departments and was not the rookie who had just come to the hospital.

Some interns in Min Ling's group were also all under Lu Chen's command. They helped measure blood sugar and blood pressure, and then did an electrocardiogram.

Lu Chen would also give lectures to the interns in the group and harvest a wave of gratitude points.

Although he can now intermittently obtain a large number of gratitude points through Luo Xueya's popular science videos on Bilibili.

However, Lu Chen found that the gratitude points obtained in this way are not only limited to daily acquisition, but also at most twice a month!

Because after the third video of him and Luo Xueya was released, the system popped up a prompt-the gratitude points obtained through this method this month have reached the upper limit!

Therefore, in daily life and work, if there is an opportunity to obtain gratitude points, Lu Chen will not miss it.

"Brother, the examination results of the girl who came yesterday are out!"

As soon as he arrived at the department the next day, an intern in the group handed Lu Chen a check list.

This is a cardiac ultrasound examination report.

Color Doppler ultrasound of the heart showed: mild prolapse of the anterior leaflet of the mitral valve and mild to moderate regurgitation, and enlargement of the left heart.

Lu Chen frowned, this heart ultrasound is a big problem!

Valve prolapse, moderate regurgitation, and enlargement of the left heart.

Changes in the structure of the heart mean that the patient's disease has a long time limit!

It is easy to understand that at the beginning of the disease, the size and structure of an organ will not change half of the time.

Only the damage accumulated over time can make the organ larger or smaller.

"Junior sister, are the results of other tests out?" Lu Chen looked back at the intern.

Liu Binsong nodded slightly: "Well, some blood test results are out."

Lu Chen immediately turned on the computer and entered the test result query interface.

In the patient's blood routine, white blood cells are normal, hemoglobin is 107g/L ↓, platelets are 37CV7CH22.7↓, MCHC:297↓...

Lu Chen looked through the patient's current test results and quickly found all the abnormal indicators.

"Brother, what disease does this little girl have?" Liu Binsong asked in a low voice.

Lu Chen shook his head slightly: "It's hard to tell for the time being, and there are still many test results that haven't come out yet."

Seeing the curiosity on the face of the junior sister, Lu Chen smiled and said a few more words.

"However, her hypertension is definitely likely to be secondary. First of all, we need to differentiate hypertension from obesity. We need to complete the cortisol rhythm and low-dose dexamethasone experiments. It is best to keep urine cortisol, after all, blood is easily affected; we also need to complete the medullary hormone test to rule out pheochromocytoma."

"Then continue to complete the relevant examinations of blood vessels and heart, rule out the high blood pressure caused by vascular stenosis and malformation, and finally do RASS and adrenal CT enhancement."

"If you can check the hydroxylase set, it would be better to check whether the individual is masculine."

"..."

Lu Chen's description was very detailed, and he didn't care whether the junior sister could understand it, and he said it all at once.

"Congratulations, I received a thank you value +1 from Liu Binsong!"

Although it was only a little thank you value, but a mosquito is meat no matter how small it is.

Liu Binsong blinked and looked at Lu Chen.

The senior brother seemed very powerful, but she didn't understand most of what he said.

It didn't matter if she didn't understand, she wrote it all down in her little notebook.

"Let's go, let's go see the patients again." Lu Chen said.

Before the ward rounds, Lu Chen and Liu Binsong went to see the patients first.

There were many ward rounds, as long as the patient's condition could be discovered in time, it was very necessary.

"We may have to do a few more tests today." Lu Chen said to the girl's mother.

"Okay, I'll listen to you." The girl's mother was sensible and cooperated with Lu Chen's diagnosis and treatment process.

Although the girl's condition seemed to be more difficult, Lu Chen was very confident that he could solve it as long as the family members cooperated.

...

The early handover was over, and it was time for ward rounds.

Lu Chen found that there was one thing special about the cardiology department and the endocrinology department, that is, there were a lot of patients!

Not to mention that the entire cardiology department had a total of eight areas, and there were many extra beds!

The number of doctors in each ward, if graduate students and regular trainees were not counted, was far less than the normal doctor-patient ratio.

There were many patients and few doctors.

Junior doctors are busy every day, and most of the patients are mild cases, not many difficult and severe cases.

For example, in the endocrinology department, most of the patients in the department are diabetic patients, who come to the hospital to regulate their blood sugar.

Many of these patients can be treated in the outpatient clinic.

"Lu Chen, although the patients in our endocrinology department are not as urgent as those in the cardiology department, it is not easy either." Min Ling said to Lu Chen with a smile.

"It's really not easy at all!" Lu Chen smiled bitterly.

Before I came to the endocrinology department, I thought it was an easy place.

But what I didn't expect was that each doctor was in charge of a lot of beds.

Lu Chen only needed to take care of four beds in the cardiology department, but in the endocrinology department, he had to take care of six to eight beds.

The workload has almost doubled!

"Being a doctor, no department is easy!" Min Ling shook her head.

...

During the morning rounds, I found the little girl who came yesterday.

Min Ling communicated with the patient's family at the bedside, and then asked everyone in the group: "Can any of you tell me about the differential diagnosis of this patient?"

Min Ling's question naturally went beyond Lu Chen.

Because she knew that Lu Chen must know the answer, she was mainly the other interns in the inspection team.

Three of the four interns in the group, except Liu Binsong, immediately lowered their heads.

Min Ling was also from her student days, so she said, "Let Xiao Liu talk about it."

When Liu Binsong heard this, he lowered his head and looked at the small book in his hand.

She remembered the little knowledge points that senior brother Lu Chen told her in the morning.

Liu Binsong paused, glanced secretly at Lu Chen beside him, and then whispered: "The diagnosis of this patient cannot be determined yet, because there are still many test results that have not been released."

"Then tell me what you know so far." Min Ling smiled.

"Yes." Liu Binsong nodded, "First of all, the patient's high blood pressure must be considered a secondary possibility. First, we need to differentially diagnose high blood pressure and obesity, and improve cortisol rhythm and low-dose dexamethasone experiments... "

Lu Chen on the side smiled helplessly as soon as he heard Liu Binsong's first sentence.

Good guy, this junior sister repeated exactly what she told her that morning...

When Min Ling heard Liu Binsong's answer, she looked surprised.

Liu Binsong has been in the endocrinology department for two weeks. Why didn't she realize that she could have such clinical thinking before?

"If you can check the hydroxylase, UU Reading www.uukanshu.net would be better to check if the individual is masculine." Liu Binsong secretly glanced at Lu Chen again and whispered, "Teacher Min, I said It’s over.”

"Very good, very good!" Min Ling nodded slightly, "It seems that you have worked hard when you went back! The rest of you must learn from Xiao Liu!"

The other three interns in the group nodded, but they were all confused.

Everyone’s level has always been about the same!

Why did Liu Binsong suddenly stand out from the crowd? !

At this time, another prompt popped up on Lu Chen's system panel.

"Congratulations, I received a +1 thank you from Liu Binsong!"

Lu Chen smiled secretly in his heart, this junior sister is not bad, but she is still thinking about herself at this time.

I just hope that she won’t become like Junior Sister Yao Jie in the future. After the two of them got acquainted, they didn’t give much thanks to themselves!