Chapter 1539: with translation of chapter title

They only whispered a couple of sentences to each other and then stopped talking.

It was a mess around; who knows if there were any patient's family members. Besides, just hearing what the Emergency Rescue Service doctor said, we couldn't determine the exact situation then.

It's just speculation, not something to count on. But if someone acts self-righteously, brags about it, and the patient's family hears it, the doctors below could run into trouble.

Do your job well and don't cause trouble for others; that's the most basic principle for doctors.

Fortunately the patient has woken up, so there's nothing to worry about.

Zhou Litao called the patient's family to ask about the situation in detail. Zheng Ren listened for two minutes, then stepped over and asked, 'Last evening, what medication did the patient take?'

"Uh..." the patient's family member froze, trying hard to think.

"Zheng Lao Ban, what are you doubtful about?"

Zheng Ren saw the family member go to the luggage to look for the medicine box, then whispered: 'Patients with hyperthyroidism usually have a fast heart rate; oral propranolol lowers the heart rate. It's recommended in all major guidelines, can inhibit the conversion of T4 to T3, and is the first-choice drug.'

However, high-dose beta-blockers can weaken catecholamine effects, inhibit glycogen breakdown, reduce hepatic glucose output and gluconeogenesis, also inhibit fatty acids, lower blood glucagon levels, and thus reduce glucose production.

In other words, taking too much of this drug can cause low blood sugar.

"I understand," Zhou Litao said immediately.

Actually, Zheng Ren just mentioned it, and Zhou Litao immediately thought of that.

After all, he's not an endocrinology doctor, so Zhou Litao isn't very familiar with the fact that beta-blockers can cause low blood sugar.

But if Zheng Ren weren't there, he probably wouldn't miss it either. With Zheng Ren present, he pointed them in the right direction and sped up the process of taking the medical history.

Sure enough, the family member came over with the propranolol medicine box.

Because the patient's condition was not serious and their activity was normal, there was no family member accompanying them. This morning, clinical staff said that last evening the patient's heart rate was fast, and after taking the oral medication there was no obvious improvement within 30 minutes, so the dosage was increased again.

Since things had settled, seeing that the patient was fine, Zhou Litao had the emergency internal medicine doctor write an order for emergency observation admission.

Let's observe for a while first, then we'll talk.

It's just hyperthyroidism, but we can't admit the patient.

After finishing up, Zhou Litao called Zheng Ren to his duty room.

"Zheng Lao Ban, your eyes are sharp—have you worked in endocrinology?" Zhou Litao took out a pack of Zi Yun cigarettes, and Su Yun looked down on him.

"No, not long ago I encountered a similar patient in Xianggang, but it wasn't hyperthyroidism." Zheng Ren said offhandedly.

Su Yun glanced at Zheng Ren; this answer is also too unserious, right.

Hypoglycemia refers to a reduction in blood glucose concentration, ultimately leading to symptoms and signs including impaired brain function.

Clinical manifestations range from behavioral changes, fatigue, mental confusion to seizures and loss of consciousness, i. e., functional brain failure.

Therefore, many hypoglycemia patients are often misdiagnosed as epilepsy, or even depression and mania.

Qin Lu's condition, including mania, is actually related to hypoglycemia, but at the time he seemed to have noticed it at a glance.

This guy, sneaky and furtive, is really unpleasant to look at.

Too bad no matter what I do, I can't catch up to him. I really want to find an opportunity to give him a good dressing-down; Su Yun smoked a cigarette and thought to himself.

"By the way, Manager Zhou, how did you determine low blood sugar?" Zheng Ren asked.

"When the patient arrives, I just feel something's off." Zhou Litao laughed: "Wanting to sleep with the night-shift nurse, hitting on girls—you wouldn't do that so blatantly in front of others in the ward, would you? There must be a problem."

Actually, Zheng Ren just mentioned it, and Zhou Litao immediately thought of that.

Zheng Ren smiled and said nothing.

Zhou Litao asked doubtfully: "Could it also be related to the nurses?"

"He was holding the hand of the ICU head nurse, saying they should go out for drinks together tonight." Su Yun burst out laughing.

"And then what?" Zhou Litao also had a keen interest in gossip.

Working as an inpatient chief in the emergency department, listening to some gossip is just a way to find joy in hardship.

"Later, when the condition stabilized a bit, he was kicked out of the ICU." Su Yun laughed.

The conditions are different, but the symptoms are similar.

"Zheng Lao Ban, what's the story with the patient you mentioned from Xianggang?"

"There's a plaque on one of the arteries supplying the pancreas; intermittent changes in flow cause abnormal insulin secretion. He's a bit more advanced than those two patients—it's not nonsense, but something he virtually imagined having experienced." Zheng Ren briefly described Qin Lu's condition.

"Tsk tsk." Zhou Litao silently noted down the case Zheng Ren mentioned.

Although one might never encounter a similar patient in a lifetime, if one does, having even a faint mental impression or memory at least reduces the chances of misdiagnosis or missed diagnosis.

"Manager Zhou, if the patient isn't hypoglycemic, what are you planning to check?" Zheng Ren continued asking.

"Hyperthyroid patients presenting with psychiatric symptoms could be due to electrolyte imbalance, impending thyroid storm, hypoglycemia, or autoimmune encephalitis. Checking blood sugar is the most convenient; the patient's drowsy symptoms are similar. If not, we check each possibility one by one." Zhou Litao has solid fundamentals; just as Zheng Ren finished asking, he added offhandedly.

Zheng Ren thought, "912" means deep foundation. An inpatient chief in the emergency department is actually this capable.

As for these hyperthyroidism matters, aside from thyroid surgery and endocrinology departments, doctors in other specialties find it hard to know the details.

The role of specialty is right here, but where there are benefits there are also drawbacks; the more one focuses on a particular direction, the less one knows about diseases in other departments.

"Zheng Lao Ban, you're truly all‑talented, impressive." Zhou Litao said with a smile, "What should I pay attention to with this patient?"

"Yeah, wanting to eat as much as you like is really deadly." Zhou Litao said, "Zheng Lao Ban, when are you planning to do a live‑streamed surgery for a patient with Ge Xie disease?"

"I don't know; if there are no problems, the sooner the better." Zheng Ren said.

"I've watched your live‑streamed surgery; you did a really good job." Zhou Litao felt a bit envious.

One would rather go into surgery and be a surgeon than work in the emergency department.

But back then, a single misstep led to lifelong regret; young and inexperienced, they were tricked into coming to the emergency department.

Nowadays, kids are getting smarter and smarter; few go into medicine after graduation, let alone work in emergency care.

The more Zhou Litao thought about it, the gloomier his future prospects seemed.

These days, kids are getting smarter and smarter, but few pursue a medical career after graduation, let alone work in the emergency department.

The more Zhou Litau thought about it, the gloomier his future seemed.

How great it would be to be like Zheng Lao Ban.

These are still bearable; the key is that Zheng Lao Ban is highly skilled, and he even has a girlfriend!

Having a girlfriend doesn't even count; he can even hand him the instruments during surgery.

Sigh... Zhou Litao let out a long sigh.

Zheng Ren and Su Yun were just about to leave when suddenly they heard a rapid succession of hurried footsteps coming from the hallway.