Chapter 2161: with translation of chapter title

2086 If it were you, what would you do?

On the way, Zheng Ren called Zhou Litao.

He briefly described the patient's condition that had been sent over, and instructed Zhou Litao that if there were no other judgments, to first give a shot of diazepam.

Under normal circumstances, when encountering similar patients, doctors dare not directly inject a shot of diazepam.

There had been a patient with low blood sugar agitation before; after a shot of diazepam, the person became still, but the blood sugar continued to drop.

If the blood sugar drops to a certain limit, it could endanger the patient's life.

Similarly, for patients with abdominal pain, to avoid pain, administering analgesics is contraindicated.

Zheng Ren gave his instructions, and Zhou Litao, on his end, obeyed and left.

A shot of diazepam basically settles the diagnosis; the rest is just waiting for the electromyography side to go on shift and do a more thorough examination.

"Boss, if that guy isn't sick, practicing mechanical dance to this extent would be too awesome!" Su Yun still marveled.

"Impossible, several movements clearly violate the common sense of biomechanics; they can't be trained just by practice." Zheng Ren said.

"Tsk, still feel it's a pity."

The two went to the community hospital while talking, taking a look.

The patients here are all stable; the resident doctors are diligent.

They also knew that the lecture fee had already reached 800,000 Ou; moreover, it was only the lecture fee, not yet involving Zheng Lao Ban's hands-on teaching.

Even if it's teaching, reportedly it's all Yun Ge'er doing the lecturing, with Zheng Lao Ban not even showing his face.

Although they were still on small-class duty in Di Du, they dared not have any complaints.

Even most doctors think that helping out here for half a year, and when leaving being able to get a surgery from Zheng Lao Ban, is already a blessing.

After leaving the community hospital, Zheng Ren and Su Yun discussed the matter of the doctors here taking turns going to 912.

Zheng Ren wasn't interested in administrative work; after a few remarks, he listlessly pushed all these tasks onto Su Yun to do.

Su Yun didn't mind either; he remained immersed in that guy's weird and bizarre 'posture,' occasionally making some movements as if having a spasm.

Unfortunately, even he could not imitate it at all.

The two came directly from the community hospital to the 912 emergency department; seeing Zhou Litao standing by the resuscitation bed observing, they walked in.

"Zheng Lao Ban, Yun Ge'er, you're here." Zhou Litao said with a smile, "The patient has already fallen asleep, and the muscle spasms have disappeared."

"Mm, let's do the examination after work." Zheng Ren saw the patient asleep, starting to snore, limbs soft and limp, like a normal person, and he also felt relieved.

"What examinations are we doing?"

"It's the inpatient department doing the examination, and they didn't let you do it." Su Yun said, "Send it to rheumatology and immunology."

"..." Zhou Litao also remembered Su Yun saying that if he didn't understand something, he would send it to rheumatology and immunology.

Regarding stiff person syndrome, he had no concept; fortunately Zheng Lao Ban arrived, and he wouldn't let slip any chance, hurriedly pulling Zheng Lao Ban to his own duty room.

From the cabinet he took out a box of Jiuwu Zhizun, and Zhou Litao handed it to Zheng Ren and Su Yun.

"Hey, Manager Zhou, you're corrupt?" Su Yun smirked, taking a cigarette and holding it in his mouth.

"Nowhere, nowhere." Zhou Litao waved his hands repeatedly, "This stuff is too expensive; I can't enjoy it. It's not like seeing Yun Ge'er you all smoke this cigarette, so I bought a box, specially prepared for the two of you."

Zhou Litao didn't even want to smoke a single one, put the cigarette back, took out his own, lit it for Zheng Ren and Su Yun, then asked: "Zheng Lao Ban, how did you make the judgment?"

"If I hadn't called, how would you have judged?" Zheng Ren didn't answer, but instead turned the question back.

"At first glance I ruled out tetanus; looking at the patient's condition, I estimate it's not a central nervous system issue, after all he's conscious. He's just terrified to death, his speech a bit unclear." Zhou Litao struggled to recall what he had just seen of the patient's condition.

Because Zheng Lao Ban had already called, the first reaction was Zheng Lao Ban's, not his own.

Now looking back, Zhou Litao feels that if this patient fell into his hands, he'd probably have to struggle a long time before getting a correct diagnosis.

"Do a CT, nuclear magnetic resonance, a bit of screening." Zhou Litao then said, "It could also be Isacs-Mertens syndrome."

"Don't spout nonsense, Isacs-Mertens syndrome is also called muscular stiffness-dwarfism-diffuse bone disease. You see muscle tremors and stiffness and just lean on that? Your bilateral pupils are dilated; where did you see dwarfism?"

Su Yun directly spat back without hesitation.

"Actually, I interfered with Manager Zhou's judgment." Zheng Ren chuckled, "I estimate the patient was sent directly; Manager Zhou's first judgment should have been organophosphate poisoning."

Then Zhou Litao suddenly realized.

Recalling the situation at that time, if Zheng Lao Ban hadn't called, I would definitely have thought it was organophosphate poisoning.

Acetylcholine excessively accumulates and stimulates at the neuromuscular junction of skeletal muscle, causing fasciculations in the face, eyelids, tongue, limbs, and whole-body skeletal muscle, even leading to generalized muscle rigidity spasms.

Such nicotinic-like symptoms are so obvious; although you can't smell anything on the patient, there's this hurdle in the mind, always needing to waste a lot of time to make a clear diagnosis.

Although it won't cause any delay, just checking one by one, it's still not as refreshing as Zheng Lao Ban directly giving the diagnosis.

"It's fine, push a shot of atropine in and you'll know it's not." Zheng Ren smiled, "It won't delay the patient's diagnosis and treatment, rest assured."

Still, Zheng Lao Ban was understanding, giving him a way out.

"Yun Ge'er, should we really send the patient to rheumatology and immunology?" Zhou Litao asked.

The work in the emergency department is tough; if you send the patient to an unrelated department, although the inpatient doctors will eventually have a consultation and not delay the patient's diagnosis and treatment, in others' minds it will leave an impression that you can't see patients.

"Mm, under normal circumstances, giving a shot of diazepam daily and gradually tapering off, the patient can improve. Treatment with benzodiazepine drugs is the clinical first choice."

"If not, using chloral hydrate enema also works; let the patient sleep a bit more then send it over." Su Yun said, "Sleeping here isn't a big deal either."

"But..." Zhou Litao hesitated, saying, "It seems the treatment has nothing to do with rheumatology and immunology; rather, it looks like a neurology disease."

"Pretty much the same." Su Yun laughed heartily, "Like the patient from yesterday's hospital-wide consultation, the boss gave a 1.0g shock dose of cyclophosphamide. Stiff person syndrome treated with cyclophosphamide also works; you say it's not a rheumatology and immunology disease, then what is it?"

「……」 Translate: "\"... \"\" So: 【55】 "..."

This is also too simplistic and brutal, and somewhat forced.

However, many disease classifications in clinical practice are unclear, especially some rare diseases.

According to Zhou Litao's idea, this patient should be sent to neurology, but Yun Ge'er all think it should go to rheumatology and immunology; then just send it, and I won't have any other thoughts.

Not knowing how to treat illness is also Yun Ge'er not knowing how to treat.