Professor Coent said a word to directly raise the tension in the venue. No one would have thought that a case seminar would evolve into a promotion competition for survival of the fittest. Only now these young doctors realized why they had to bring paper and pen to write diagnostic answers.

"Searching out 3/4 of the people is a bit strict." Xu Jiakang was completely excited, "I hope it is some common diseases in China."

As he spoke, he looked at Qi Jing.

After getting along these days, he has seen some of Qi Jing's strengths, but it is the first time he has participated in serious diagnosis. The time he brought goods at the airport is more inclined to reasoning and guessing, and desiccant is just a gap in knowledge reserves. The two have never really fought each other, and now it is a good opportunity.

"There are so many people in the classroom, what if someone cheats?" Qi Jing looked at the young doctors crowded around him and said in confusion.

Xu Jiakang frowned: "Why is your entry point different from others..."

"Since you have to screen so many people and are not afraid of cheating, the cases you give are definitely not simple," Qi Jing explained. "Don't think about common cases, it's impossible."

At this time Coent put on the slide:

This is a patient admitted to the University of Washington Affiliated Medical Center in the middle of the night a few days ago. He was sent to the emergency room due to mild fever, emotional excitement, and muscle spasms. He was treated with an intern and a training doctor. After some routine examinations, he believed that it was a minor brain infection caused by the virus.

The family doctor asked the patient and learned that the patient's family had herpes simplex before, which may have caused mild encephalitis after cross-infection.

Further cerebrospinal fluid examinations cannot be performed at night and the diagnosis cannot be made. However, the symptoms are mild. After obtaining the consent of the superior doctor, sedatives such as lying agents such as lycne and pethidine are first given to control the symptoms of convulsions on the patient's central nervous system.

"Use dullydin?" Xu Jiakang obviously couldn't understand. In China, this drug has been strictly restricted in use. "Isn't it a bit too much?"

"The situation at home and abroad is different." Qi Jing hinted without saying anything.

After the doctor left, unexpectedly, the patients who used sedative drugs became more excited. Because more than 30 patients in the emergency room were too busy, the two doctors did not see the patient again, but asked the nurse to further inject haloperidol and tied them with protective restraint belts.

Qi Jing sounded something was wrong.

Not only him and Xu Jiakang, but even so many young doctors around him felt that there was something wrong: "I was even more excited after using Du Lengding..."

But since it was Coent said it himself, it was naturally true. They only expressed doubts and no one interrupted him.

Under the interaction of haloperidol and the restraint belt, the patient finally fell asleep. However, when a nurse measured the temperature as usual the next morning, the situation turned sharply. The patient's body temperature was as high as 41℃, blood pressure was 190/100, and heart rate was 145.

Extremely high body temperature, blood pressure and heart rate indicate that a serious lesions have occurred in the patient's body. The doctor tried to take emergency measures and lower his temperature as soon as possible.

But one hour later, the patient died of cardiac arrest.

The patient only spent one night in the hospital, and his symptoms changed from light to severe in his sleep, which is really sad.

The cases are not complicated, but there are not many tips given. Only a very small number of people who can start writing just after listening to it. Most of the others are waiting and watching, thinking that Professor Coent should have some later.

Sure enough, before he could speak, a foreign doctor below asked in poor English: "Do you have a detailed medical history of the patient? Can you show us the test report?"

"The detailed medical history is very limited," Coent explained. "As for the examination report, it indicates that there is a possibility of viral infection. Since the body temperature is only 37.8℃, I hope to observe for one night and wait for the next day before further examination."

"Are there any reports of laboratory biochemical examinations before death?"

"Yes." Coent turned another page, "It suggests that metabolic acidosis and liver and kidney function are very poor."

Having said that, as the prompts increased, the sound of writing began to sound from the audience. Some doctors came with each other and friends would also whisper between them. Coent did not say much about this, but just took a sip of the drink and sat at the podium waiting for them to deliver the answer to their hands.

"In five minutes, I will hand in your answer sheet, and I will judge your stay or not on the spot."

Xu Jiakang thought for a while and started writing. Although Coent did not say that he could not discuss with each other, he still hoped to think independently and compete with Qi Jing in a fair manner.

Since he heard Qi Jing show off his desiccant, he has been thinking about how to "revenge". This case discussion may become the key to his goal to win back the game. At that time, he may feel secretly happy when he sees Qi Jing being kicked out of the classroom.

"Why are you laughing secretly there?" Qi Jing asked softly.

"No, nothing." Xu Jiakang quickly put away his smile at some point and looked at Qi Jing with a stern face, "Why haven't you written the answer yet? Time is very tight."

"No, no hurry."

For Qi Jing, this case discussion topic is a little simpler. I have encountered several cases in more than ten years of emergency work. The symptoms of the case given by Coent this time are very typical.

Mild symptoms include low fever and nervous system muscle tremors and convulsions, while severe symptoms can cause ultra-high fever, hypertension tachycardia, delirium, muscle stiffness and hypertonicity.

It is possible that just a light pat on the knee, the strong knee reflex will cause continuous spasms around the knee for several minutes.

Perhaps there are very few internal emergency departments in general hospitals, and it takes some specific conditions to cause this condition. However, it can be encountered frequently in the medication standards of anesthesia and psychiatric departments, which are already clear contraindications for drug compatibility.

But Professor Coente specifically hid the history of medication, and even if a doctor asked a question in the audience, he did not answer. Obviously, the results of the discussion were not the focus.

For him, what is important is the process, or the idea before diagnosis.

Diagnostic ideas include many types, and the simplest one is to doubt the diagnosis based on the symptoms of the patient.

For emergency doctors, information acquisition is often very limited, and it is very likely to be misdiagnosed by relying solely on known information. At this time, you need to classify and match the symptoms in the brain, and then ask for some key medical history in a targeted manner.

For example, if Qi Jing writes down the answer and sends it to him now, he is likely to be killed by Coent.

He needs to write clearly that he suspects that the patient has a special history of medication. After asking, if there is indeed a history of medication, he will be diagnosed. If the history of medication is denied, it may be...
Chapter completed!