Zhou Yewu looked at the patient's grandson's panicked expression and realized that he was a little too much.

How to say, as a doctor, you should be more patient with patients.

He adjusted his state and continued to answer the last question.

Isn’t it just scleroderma? Is it still difficult to get me?

"Scroderma is common in women aged 20 to 50. It shows symmetric stiffness in the early edema stage. Neck knee joint pain and synovitis of the joints are easily confused with rheumatoid arthritis. However, scleroderma has self-limiting nature in the early stage. The swelling will often subside after a few weeks, and Raynaud syndrome is present, which is conducive to the diagnosis of the disease."

After Zhou Yewu finished speaking, he added, "Renault's syndrome is a syndrome that causes the onset of pale fingers or foot fingers, purple and then turns to flushing due to cold or emotional excitement."

At this time, the patient's grandson seemed to have to speak.

Zhou Yewu's face turned and turned pale.

The old man also coughed slightly, as if he was timidating his grandson not to play around anymore.

"The doctor is here for consultation, not my attending doctor, so don't waste his time." The old man said angrily.

Now it finally became quiet!

You can continue consultation!

Zhou Yewu just wanted to ask the old man about some medical history, but the damn ward door was opened all of a sudden!

My day...

Who the hell is affecting me?

Zhou Yewu turned around and took a look.

It’s Bai Hong coming!

Her face turned slightly red, and Zhou Yewu stared at her, "I'm here to see if you need any help."

Zhou Yewu said depressedly: "Do you have a tablet?"

It turned out that he only spent a few minutes reading the 17-bed patient in the respiratory department office, so many books on the test sheet were still a little confused.

Bai Hong said "Oh", immediately took out the tablet computer for the rounds from his pocket and respectfully handed it to Zhou Yewu.

This looks very similar to the picture of Zhou Yewu handing Chen Riyuan the tablet on weekdays!

He felt inexplicably funny.

This senior sister of Gui San is also dull and doesn’t ask anything, just treating him as a resident in the respiratory department!

"What is the password?" Zhou Yewu took the password and found that the tablet was still locked.

What's abominable is that there is a password?

What a broken habit this is! Does it mean that the tablets of the rheumatism and immunology department are not used by surgical departments?

Bai Hong said "ah" and apologized: "Sorry, this is the tablet brought by the director's own home. He set up a password, the password is 120120!"

Zhou Yewu murmured softly: "Your director's password is really special, ambulance number..."

Bai Hong also smiled awkwardly. Zhou Yewu was definitely not the first to say about this. Many doctors who came to consult before said so at the same time.

Unlock the password! Work will start.

Zhou Yewu quickly checked the patient's indicators.

After admission, the Rheumatology and Immunology Department conducted detailed examinations on the patients and could see almost all the corresponding blood sheets in their rheumatology specialist.

The patient's vascular subtraction is currently 54mm/h, and the CRP reexamination is 54mg/l, both of which are higher than the normal range, indicating inflammation.

"Hla-b27, anti-cyclic citrulline peptide antibody, anti-nuclear antibody, and immunity are all negative." Zhou Yewu read the report while whispering.

Negative means normal. In clinical practice, positive means not the normal range!

"B ultrasound showed no abnormally enlarged lymph nodes in the peritoneum, and multiple lymph nodes on both sides of the neck, armpits, and inguinal tissue were accessible." Bai Hong also began to talk about the patient's ultrasound report.

Zhou Yewu nodded. To be honest, he was not enough to master the specialized diseases of the rheumatism and immunology department to reach a very easy-to-use level. His eyes fell on Bai Hong.

Isn’t there a rheumatism and immunity specialist in front of you?

Why not use it and waste resources!

Zhou Yewu then pretended to be idle and said: "From the current results, rheumatoid arthritis can be basically ruled out, which doesn't seem to be a connective tissue disease. The patient's immunoglobulin has significantly increased, and it seems that he is suspected of myeloma again... What do you think about this issue?"

Zhou Yewu definitely has no answer to this question.

He looked at Bai Hong, hoping to get a satisfactory answer from her.

Consultation is also a learning process.

Bai Hong looked at the patient in bed 17 and his face was calm, "I did lumbar puncture for the patient, and the results showed no abnormalities. The qualitative test of urinary-Zhou's protein was negative. The urinary κ light chain and urinary λ light chain were both normal. The blood κ light chain and blood λ light chain were also within the normal range. Myeloma can basically be ruled out."

Bai Hong’s foundation is really good!

Zhou Yewu's doubts were answered.

But there is still a problem!

Zhou Yewu asked, "Then how do you treat patients?"

Bai Hong took back the tablet in Zhou Yewu's hand, opened the doctor's order, and said, "After exams, I still returned to vasculitis, so in the treatment, we used 40mg of Arthur Dragon Needle once a day, and 10mg of Thunder Vine in 3 times a day."

Hormone treatment! There is no problem with this!

Because the course of the patient's illness in bed 17 was scattered and a lot of content was missing, Zhou Yewu said curiously: "So did the patient's symptoms change later?"

Bai Hong recalled the story and quickly said: "During the treatment period, the patient always said that his left hip was painful and radiated to his left thigh. Moreover, the patient still had fever, and the heat may be disturbed by hormones, so it fluctuated greatly, and the body temperature could reach a maximum of 39.5℃."

"We also performed a plain lumbar lumbar vertebrae MRI scan on the patient as usual. The results showed degenerative lumbar vertebrae, inflammatory changes in l5/s1 end plate, l2/3, l3/4, l4/5, l5/s1 intervertebral disc degeneration and gamut. Since the patient's fever cannot rule out bacterial infection, we added ceftazidime."

Lumbar spine degeneration often occurs in middle-aged and elderly people after the age of 50. It is related to long-term chronic strain and is also related to bad working habits and sitting postures in daily life.

As for ceftazidime, the third generation of cephalosporin, it can cover most bacterial infectious diseases! The so-called symptomatic treatment also reflects a very high level of antibiotics. Different antibiotics will be used for different positive and negative bacteria, and then for different stages of the same infection, the rules for the use of lifting ladders!

This is the meaning of lumbar vertebrae segment. There are 5 lumbar intervertebral discs, namely l1~2, l2~3, l3~4, l4~5, l5~s1.

This patient has problems with the five lumbar segments!

Zhou Yewu thought that the patient had been treated with antibiotics and sighed, "So have any new discoveries on the patient's physical signs?"

Bai Hong's eyes now had a hint of surprise!

"I didn't expect that your respiratory doctors also have a lot of knowledge about the diseases in our rheumatism and immunology department." Bai Hong said with a smile. It is difficult for doctors in other internal medicine departments to pay attention to changes in patients' physical signs, and pay more attention to symptoms and test reports.
Chapter completed!