Zhou Yewu looked at the clouds outside the window in a daze.

"This cloud is surprisingly white..." he murmured to himself.

He looked at Zhou Ling quietly again and found that she was still dealing with the case on her own.

Could it be that this beam was formed like this?

Zhou Yewu sighed long and thought to himself: "Where is the cloud white, it is clearly my white, the idiot white."

"I haven't finished speaking just now, don't get me wrong. I told you not to call me senior sister. I just want you to call me my name directly, or you can call me Ling directly." Zhou Ling seemed to remember something and quickly explained to Zhou Yewu.

oh……

I see.

Zhou Yewu breathed a sigh of relief. If this was the case, it would be much better.

But why not call me a senior?

Zhou Yewu's eyes became a little slow and thoughtful.

"If you call me senior sister, I will look like I am very old, and we are colleagues, so it would be great to just call my name." Zhou Ling smiled carelessly.

Zhou Yewu stared at Zhou Ling's side face and began to daze. While thinking about how there was such a good-looking face in the world, he thought that it was actually good not to call his senior sister...

"Altar?" Zhou Yewu tried to call her.

Zhou Ling nodded with a smile, "Well, I like you calling me that."

Zhou Yewu suddenly didn't dare to look at Zhou Ling anymore, so he turned his head to look at the computer in front of him.

Open the electronic medical record again... and take a look at Gu Xiaosheng's medical record again!

"Do you think this 12-bed patient may be a problem with other systems?" Zhou Yewu preached.

Zhou Ling said lightly: "You just thought of it."

Zhou Yewu said softly, "Ah".

Sure enough, Zhou Ling had already had his own diagnosis for Gu Xiaosheng in bed 12, but he just didn't say it out.

Zhou Yewu pondered for a moment, and he could think of many differential diagnosis of cough, which was too many.

For example, heart failure in the cardiovascular system, bronchiolitis in the respiratory system, and general infections, pharyngitis in the ENT department...

Anyway, there are many kinds and a wide variety, which makes Zhou Yewu a little difficult to make a conclusion for a while.

Zhou Ling reminded at this time: "This patient, Director Chen may be too busy. Is there any missed examination?"

Zhou Yewu refreshed the new doctor's orders again and looked carefully, but was still confused.

All the tests that the respiratory specialist should have have, and even the lung function has been completed. What else is missing?

It's not really a system problem!

Zhou Yewu hammered his chest with a small fist. It was really difficult to see a patient. The patients in the respiratory department also had diseases in other systems.

It is said that he is a specialist and has specialized in his profession, but what is the difference between this kind of discipline and a general practitioner now? No matter what department, he must analyze all the problems of the system!

Zhou Yewu had no passion to analyze Gu Xiaosheng's condition? Because the main complaints like cough seem too ordinary and there are no other special symptoms? Then, it will be quite difficult to diagnose differentially in this way.

"You can consider the symptoms of the digestive tract." Zhou Ling reminded.

Digestive tract?

cough……

Zhou Yewu rolled his eyes and thought quickly in his mind.

"Gasoesophageal reflux disease?" He looked at Zhou Ling? It seemed to be waiting for her answer.

Zhou Ling finished the second case, but he was still 5 short of 7 cases that Ah Chang had to submit.

Although she was completely out of time? She still spoke to help Zhou Yewu determine the cause of the patient's cough.

She would not tell him the answer directly, because this would not allow a person to truly grow.

"Do you know the cause of cough caused by gastroesophageal reflux?" she asked.

In fact, Zhou Yewu can immediately think of gastroesophageal reflux, which has already made Zhou Ling look at him with admiration. Although the things are simple? But it is very good to connect them quickly with the prompts!

"The mechanism of gastroesophageal coughing involves micro-acupuncture, esophageal-bronchial reflex, esophageal motor dysfunction, autonomic dysfunction and airway neurogenic inflammation, etc.? There are even studies that airway neurogenic inflammation caused by esophageal-bronchary reflex plays a major role... and then in addition to gastric acid, a few patients are also related to bile reflux." Zhou Yewu answered quickly.

If it is really a cough caused by gastroesophageal reflux, then Gu Xiaosheng must have some clues about digestive tract symptoms!

When Zhou Yewu thought of this, he ran into the ward directly.

After a while, he ran back and forth happily.

She looked at Zhou Ling and said excitedly: "I just asked Gu Xiaosheng how his stomach is? Is there any acid reflux or something? Guess what?"

Zhou Ling said softly, "Yeah".

Zhou Yewu suddenly touched his head? What are you guessing?

Zhou Ling must have learned through some details that Gu Xiaosheng is likely to have gastroesophageal reflux disease. Is this thanks to her reminder? Zhou Yewu can connect the patient with gastroesophageal reflux disease.

"He has a long history of stomach disease and often wakes up in the morning? He feels bitter in his mouth." Zhou Yewu said.

Actually, this is already very obvious? The bitter mouth is caused by acid reflux in the stomach!

"Then I'll give him some gastric motivation drugs and proton pump inhibitors? This time the cough should be relieved." Zhou Yewu quickly gave a doctor's advice.

Zhou Ling reminded again: "Don't forget the auxiliary examination."

It was only at this time that Zhou Yewu understood why Zhou Ling asked herself if she was missing any auxiliary examination. The missing examination was gastroscopy!

Zaoli said that if you have a long-term cough like this and have a history of gastric disease, you should contact the patient to sign an examination consent form and then have a gastroscopy.

Or monitor the ph!

In addition to gastroscopy, isn’t it good to have 24ph esophageal monitoring?

Zhou Yewu quickly added all these examinations to the doctor's orders to clean up the mess left by Chen Riyuan.

As expected, without Chen Riyuan, there will always be mistakes in dealing with patients. If Chen Riyuan is there, Gu Xiaosheng must have been directly seen by Chen Riyuan during the rounds.

Repeated cough caused by "bronchial asthma gastroesophageal reflux" seems simple, but it is easy to ignore the cause of the cough, and may even be discharged from the hospital and go home directly.

"Thank you for your advice." Zhou Yewu bowed and bowed to Zhou Ling.

Although Zhou Ling was busy sorting out the cases, he couldn't help but laugh.

"Gu Xiaosheng's problem has been solved. Anyway, the next thing is to quickly adjust your lifestyle, use proton pump inhibitors or h2 receptor antagonists, gastrokinesis-enhancing drugs, etc.," said Zhou Yewu.

After saying that, he didn't forget to look at Zhou Ling, "Well? Show me that I don't miss anything."

"No, it's very excellent. Your handling is already at the textbook level." Zhou Ling quipped.

"But the treatment time for gastroesophageal reflux like this requires more than 3 months, and it usually takes 2 to 4 weeks to show the efficacy. A few patients with severe reflux who fail to treat internal medicine must also consider anti-reflux surgery. I don't know how I will explain to Gu Xiaosheng later." Zhou Yewu was a little helpless.
Chapter completed!