Chapter 2050: 1979 Suspected Feigned Illness (Weapon Row 01 Extra 4)

"Huh?" Su Yun blew a mouthful of smoke onto Yu Zong's face without any courtesy, "Sounds like there's something big going on."

Zheng Renye was also curious.

"The patient's eldest son is Director Liu's friend, and he's currently staying in the VIP ward," Yu Zong said, "So the patient falls under my responsibility."

This is because they're not at ease with other team-leading professors; Director Miao had an incident, a new director was appointed, and there's likely some behind-the-scenes power struggle.

This Director Liu just came up, his foundation isn't very solid either; pondering such matters could fill a whole day.

However, Zheng Ren had no interest in these matters at all; he cared about what kind of hematuria would worry Yu Zong.

Hematuria is usually caused by inflammation, stones, or tumors.

Something that would trouble Yu Zong certainly wouldn't be that simple. As for some common factors, Zheng Ren didn't consider them either. This matter is likely quite complex, perhaps caused by some rare disease.

"Explain the situation," Su Yun asked from the side.

"The patient shows no significant positive signs; before hospitalization, the old man was still managing the daily operations of a listed company."

"Oh? Quite wealthy. A listed company, tsk tsk." Su Yun praised.

"Taking the medical history, you need to focus," Lin Yuan said.

"How am I not focused? This is part of the past medical history." Su Yun said disdainfully, "Do you know how many people one has to meet daily managing a listed company? How much alcohol consumed in a month? Is the listing via direct IPO or via a shell purchase?"

""

"Don't make a fuss, listen to Yu Zong." Zheng Ren felt a bit annoyed; not only was Su Yun nagging, but now there was another opponent who wasn't a match, and he talked even more.

"The patient self-reported hematuria for half a month before admission; outpatient urinalysis showed occult blood (+++), protein (+++); abdominal ultrasound: liver slightly enlarged, right hepatic vein dilated, spleen enlarged, small amount of peritoneal fluid. Urinary system ultrasound: prostate hyperplasia with stones."

"At the time, we considered whether it might be nephrotic syndrome or urinary tract tuberculosis."

"Urinary protein greater than 3.5 g/d; plasma albumin below 30 g/L—neither of these is present, right?" Lin Yuan asked.

"Listen carefully to the medical history, don't interrupt." Su Yun said disdainfully.

Zheng Ren felt a bit headache.

"Hmm, none of those, and tuberculosis was also considered negative." Yu Zong replied cautiously, unsure of the background of the new long-legged beauty in the medical team.

Daring to argue with Yun Ge'er is not something an ordinary person can do.

"Yu Zong, continue speaking, don't mind those two." Zheng Ren pondered.

"Serum tumor markers: normal range; multiple urine smears for acid-fast bacilli: negative; chest X-ray: right pleural thickening, calcification; ECG: sinus rhythm, normal ECG; lower abdominal CT: inferior vena cava fully and its branches dilated, hepatic vein tributaries limited dilation; small amount of ascites."

"Wait, the chest X-ray shows pleural thickening? Does the patient have any history of this?" Zheng Ren cut off Yu Zong's train of thought.

"No, I asked in detail. I also felt something was off with the chest X-ray, so I ordered a CT for the patient. The chest CT shows pleural thickening with adhesion and calcification, and the pericardial wall slightly thickened."

"Let's look at the images in a moment," Zheng Ren said.

"What are you suspecting?" Su Yun, not arguing with Lin Yuan, calmed down and pondered, asking.

"Hard to say; we still need to rule out whether the hematuria is due to congestive heart failure, but only a small amount of calcification wouldn't cause heart failure. Moreover, from Yu Zong's description we can infer the old man's physique is fairly good, so he wouldn't have such severe congestive heart failure." Zheng Ren analyzed.

"Hmm, Zheng Lao Ban is right, the patient's physique is quite good." Yu Zong said, "Before admission, it was said he could still play table tennis for two hours."

"I..." Su Yun exclaimed, "How old is the patient?"

"72."

Definitely not congestive heart failure, Zheng Ren concluded.

Heart failure results from ventricular pumping or filling dysfunction, where cardiac output cannot meet the body's metabolic needs, leading to inadequate tissue and organ perfusion, accompanied by pulmonary and/or systemic congestion; it is the clinical syndrome of various heart diseases progressing to a severe stage.

Generally, when this occurs, the patient has already reached the point of being beyond cure.

Yet being able to play table tennis for two hours the day before makes it impossible to consider congestive heart failure.

"Let's first take a glance at the images," Zheng Ren said.

"I'll look for them." Yu Zong opened the computer in his duty room and began searching for the patient's images.

Zheng Ren pondered the patient's condition in his mind: not a tumor, not stones, not... what then could it be?

"Yu Zong, what do you think it is?" Su Yun asked.

"I see the old man every day, but when I visited yesterday and today, I always felt he was feigning illness." Yu Zong didn't hesitate and directly voiced his honest thought.

"Hematuria?" Su Yun and Lin Yuan asked simultaneously, puzzled.

"It could be drug-induced hematuria from oral medication." Zheng Ren said, "Since Yu Zong currently has no other diseases to consider, we should add this possibility."

"And then?" Lin Yuan asked.

"Have you never seen insurance fraud?" Su Yun looked at Lin Yuan with disdain; seeing her clueless expression, he knew she was a novice, only knowing how to analyze from the condition, not yet evolved to consider human nature.

Yu Zong pulled up the images and then made room for a seat.

Zheng Ren didn't stand on ceremony either, plopped down, and began scrolling the mouse wheel.

Looking frame by frame, pondering bit by bit, Zheng Ren grew increasingly confused.

The patient's imaging data was just as Yu Zong had introduced earlier, not much to see. Definitely not a tumor; the liver had a minor issue, and portal vein pressure didn't appear high either.

Normally, there shouldn't be continuous hematuria.

"Yu Zong, why do you suspect the old man is feigning illness?" Zheng Ren asked.

"His physique is too good; I can't find a reasonable explanation for the hematuria." Yu Zong said, "Once I went on rounds, the old man went to the restroom; I wanted to observe his urination, but he just flushed it away with water."

"It's just a personal hygiene issue, what's there to see?" Lin Yuan questioned doubtfully, "If you want to look, just check a urinalysis and you'll know."

"Lin Yuan, that's not how it works." Zheng Ren said calmly, "What Yu Zong said still makes sense, but Yu Zong, have you found any aminopyrine, phenytoin sodium, rifampicin, phenol red, or similar medications around the patient?"

Yu Zong shook his head.

"Also, that's not right; if it were drug-induced, how would the urinalysis show red blood cells?" Lin Yuan seized on a loophole and asked.

"Just dab a bit of fingertip blood, the kind used for glucose testing. Making red blood cells appear in the urine is quite simple." Zheng Ren continued looking at the images, light and shadow passing over, so focused.

Lin Yuan froze for a moment.

"Do we really have to go through all this trouble? Even dripping fingertip blood into the urine for the urinalysis... but upon further thought, it really could be possible."

"Aside from critically ill patients in the ICU, urine is self-collected by the patient. Wanting to tamper with it presents ample opportunity."