Chapter 343: Reviewing the Exam Paper (Part 1)

Very quickly, one after another, the renowned members of the Expert Group appeared.

Zhou Tianbo did not leave; he shamelessly followed behind She Yong, greeting every member of the Expert Group, while in his heart, he kept pondering over Ji Xiang, who had caused the system to trigger an alarm.

It must be that there is a problem with the electronic grading system; Zhou Tianbo leaned toward this conclusion.

"Professor Zhou, you wouldn't really be here to check the scores of that Standardized Training Student named Ji Xiang, would you?" She Yong asked when he found a moment with no one around.

"Young Master, I am indeed here to check his scores," Zhou Tianbo admitted. "I knew he could score at least 480, but I didn't expect it to be a perfect score."

"It must be that the system has malfunctioned. With the current Practicing Physician Examination questions, especially the pile of multiple-choice questions at the end where the answers are all ambiguous, let alone a Standardized Training Doctor, even if you were to go and answer them again, it's hard to say if you could reach 550," She Yong said.

Zhou Tianbo took a deep breath.

Soon, twelve experts sat down in the small conference room of the National Health Commission.

"Respected teachers, the system triggered an alarm, so I had to trouble you all to come and re-verify. I am truly sorry," She Yong said politely first.

"What is the score?" one person asked.

"A perfect score."

"!!!"

"!!!"

The room full of veteran experts all widened their eyes as they looked at She Yong.

"So, I must trouble you all," She Yong said. "I have already re-verified it once according to the standard answer key, and it is indeed correct. Please take a look, teachers."

The veteran experts were not displeased; life was mundane, and such major events rarely occurred.

They began to review the questions and finalize the correct answers.

In Zhou Tianbo's view, the single-choice questions at the beginning had no difficulty, and there should be ambiguity in the multiple-choice questions toward the end.

But!

The Expert Group began to discuss the thirty-eighth question.

"Who wrote question thirty-eight?" an old expert said with dissatisfaction.

Zhou Tianbo hurriedly found question thirty-eight on the Young Master's computer.

The question stem was a medical history—female, 38, patient sought treatment locally seven days ago due to sudden upper abdominal pain; upon admission, serum amylase was significantly elevated, urine amylase was elevated; after being transferred to our hospital, she had low urine output for 2 days; currently, serum amylase is basically normal, and urine amylase is slightly elevated.

Urine protein (+), urine glucose significantly elevated, no pyuria. (Clinical requirement: fasting and no water, patient's condition is special, did not drink Contrast Agent). Supplement: kidney volume approximately 12x7x5 CM3.

Next was the upper abdominal Fubu CT image.

The options included Cerebral Infarction, Cardiogenic Sudden Death, Acute Pancreatitis, etc.

Isn't this a giveaway question? Zhou Tianbo thought to himself after seeing the answer and combining it with the patient's medical history.

Both serum and urine amylase are high, so if it's not Acute Pancreatitis, what else could it be?

He was not a doctor in the Digestive Medicine Department or Hepatobiliary and Pancreatic Surgery, and he couldn't understand the upper abdominal Fubu CT, so he didn't look at it.

If it were him answering the question, he would definitely choose Acute Pancreatitis directly.

"Let me share my view," an old man with white hair and beard tapped the table.

The others looked up at him.

Zhou Tianbo recognized him; this was the retired old director of Hepatobiliary and Pancreatic Surgery from the Beijing Tumor Hospital, and his opinion should be representative.

"The patient's abdominal pain symptoms, combined with elevated amylase, suggest a high probability of pancreatitis.

Regarding the Fubu CT, one should note the full pancreatic tail, unclear pancreatic head space, and the enlarged kidney adjacent to the pancreas;

One should note that the patient's bilateral kidneys are both enlarged on the CT, which is the cause of the low urine output; the gallbladder is full, and the presence of stones cannot be ruled out; it may be the cause of the pancreatitis; there appears to be mucosal thickening in the posterior abdominal wall near the pylorus, and Chronic Gastritis cannot be ruled out.

Combined with the medical history, consider the possibility of Chronic Bile Reflux; furthermore, Acute Pancreatitis leading to Renal Failure is often related to Systemic Inflammatory Response Syndrome; in this case, consider the pancreatic lesion involving the kidneys. The patient's Inferior Vena Cava is thickened; whether there is concurrent heart insufficiency."

"Therefore," the old man paused, emphasizing his tone, "if I were to choose, I would choose Cardiogenic Sudden Death."

"Boom~~~" A burst of noise erupted in the small Demonstration Room.

Zhou Tianbo was somewhat bewildered.

If it were him answering this question, Pancreatitis would be the first choice, and renal insufficiency would be the second; in any case, he would never choose Cardiogenic Sudden Death.

However, the old expert's analysis was logical and sound, leaving no room for Zhou Tianbo to say "no."

"Sun Lao, the standard answer is Cardiogenic Sudden Death; do you also think it is correct?" another person asked.

"Hmm, I have seen similar patients," the old man said, somewhat displeased. He said in a deep voice, "The medical record wasn't even provided in full, just one image plus a brief medical history. Is this an exam? This is making things difficult for people!"

"For this kind of question, if I show it to my Doctor of Philosophy students, the probability of them choosing the wrong answer is probably over 80%."

"!!!"

"Forget it," the old man shook his head. "The answer on the re-verified test paper is correct; I am saying that this question itself is problematic. It is too difficult, the difficulty has already exceeded the syllabus, and clinically... heh, if you don't believe me, let the directors of the various large Grade A Tertiary Hospitals in the Imperial Capital take a look; I estimate not many would be able to answer it correctly."

Indeed, his words were very fair.

"This candidate must have guessed it right," one person smiled. "Since the answer is not a problem, let's continue."

Zhou Tianbo's heart was thumping; he vaguely felt that this matter seemed different from what he had imagined.

He knew clearly that Ji Xiang definitely did not guess it right.

That young man... why was his clinical experience so rich!

The attitude of the Expert Group had clearly become rigorous and serious.

If not for Sun Lao's detailed explanation just now, everyone present would likely have been misled by that question.

Whoever wrote the questions is truly bored enough.

Because the Expert Group consisted of top-tier experts, once they became serious, some "trap" questions also quickly had correct answers.

The answers were no different from the standard answers on the test paper, and Ji Xiang's test paper re-verification was passing bit by bit.

No matter how difficult the questions the question-setter found in the question bank, or how many traps were dug in the question stems, Ji Xiang could find the correct answer.

Soon, they reached the long-form questions at the end.

Soon, disputes appeared once again.

This is a discussion question: a Patient suspected of having a cerebral infarction was admitted for treatment, but the Family Member refused Thrombolysis, missing the optimal window.

The Patient's left upper limb muscle strength was grade 0, and the left lower limb muscle strength was grade I.

At the time, treatment was administered with Aspirin, Atorvastatin, Low Molecular Weight Heparin, Edaravone, and other medications; after 2 days of treatment, the Patient's limb muscle strength improved temporarily, with both left upper and lower limb muscle strength reaching grade IV.

Afterward, the condition fluctuated, so Low Molecular Weight Heparin was discontinued, and Clopidogrel was added for dual antiplatelet therapy.

A neck and cranial CTA was performed, and the results showed occlusion of the right carotid artery and right vertebral artery, occlusion of the origin of the left internal carotid artery, and severe stenosis at the origin of the left vertebral artery.

However, during the Carotid Artery Stent Surgery, the Patient suddenly developed a severe Allergic Reaction.

The Patient suffered cardiac and respiratory arrest, but was successfully resuscitated afterward.

The question arises—what medication or procedure is considered to have caused the Patient's Allergic Reaction?

(End of chapter)