303. Hulk, drying clothes, ulcer skin lesions
Qi Jing seemed to have answered an ordinary call, and only Huang Xinghua was talking to him. But at the other end of the phone, his voice came out through the receiver and then amplified through the microphone, and it was reaching the ears of dozens of director-level bosses at the same time.
Although Qi Jing also felt that his voice was a bit strange, he thought that the other party was calling for a long distance and thought it was a call quality problem, so he didn't care much.
At this time, Huang Xinghua was standing by the podium, holding Qi Jing's resume and various materials in his left hand, and pressing a domestic parasite magazine with his right hand, and the pages happened to turn to Qi Jing's article.
Just before making this call, dozens of nationally renowned infectious diseases, dermatology, endocrine and immune experts in the consultation lecture hall were still making differential diagnosis for Professor Lin Zhixing who was far away in Africa.
But the discussion that lasted for a whole morning was deadlocked, and no one could come up with a reasonable diagnosis that could convince others.
It was only at this time that Huang Xinghua was willing to listen to other people's opinions. Cai Ping, who knew her senior brother, seized the opportunity, stepped forward and gave Qi Jing to the front desk again.
The directors usually look very good to patients and are kind-hearted, but they are competitors, and no one will easily show weakness in their respective fields.
What's more, the reinforcements moved in this time were actually hospitalized, and even their practice certificates were just enough to take the exam.
"Aid to Africa is a country. More and more people will go to Africa in the future. But the domestic understanding of African infectious diseases is too little. Now there are younger generations who are willing to fill the gap. Isn't that good?" This is Cai Ping's original words. After all, who would be bored to study a disease that does not exist in her own country at all.
Even if I have this intention, I don’t even have a living case at hand, and there is no corresponding antibody detection capability in the laboratory.
How to do a test? How to differentiate and diagnose? Perhaps someone will think of the CDC at this time, but even ten years later, the CDC coverage is still limited.
They can manage some rare infections in China and some common infections that are prevalent among various countries.
But for the rare infections in distant countries, I have never seen them before, so I can only watch them and have no choice but to do anything.
It was not until the microbial gene sequencing was gradually improved that it was thoroughly investigated. The reason was the reason Cai Ping said, but it would eventually feel a little uncomfortable when it was implemented in everyone's heart.
In order to make the professors here feel better, Huang Xinghua suggested using the three questions he asked as a stepping stone to test the strength of this inpatient doctor.
After all, when he came to these people, he also used the same plan, which was fair. The topics were carefully selected by Huang Xinghua after he worked hard to study foreign infectious disease journals over the years.
According to his requirements, as long as one question can be answered, it means that there are many studies on the diagnosis and treatment of rare infectious diseases, and there is a ticket to consult.
If you can answer two questions, you can be considered a true veteran in infectious diseases. According to Huang Xinghua's understanding, the country at this level will not exceed double digits.
The only one who can answer all three questions is in his memory. Huang Yuhuai was sent to work in Africa three times, and each time he had to stay in the local area for 2-3 years.
Over the years, the old man has devoted his entire life to infectious diseases. No one in the country can match his knowledge and clinical work experience.
The first question was on the Hulk. In fact, it was not just Qi Jing. The first reaction of the others who were asked was all confused.
The Hulk was released in 2003 and has seen it many people. What impressed me the most was its bright green skin, a irritable temper and unparalleled destructive power.
For those who are not satisfied with their work and life, there is nothing more comfortable than watching a popcorn movie while enjoying the visual impact of violence.
Qi Jing has no interest in movies, especially those superpower movies with lasers running around and bursting out special effects.
Of course, Marvel's popularity is there, and the Hulk has never seen it, but he still has some understanding of the character's character.
"Actually, it's okay if you haven't seen it. Just know it's green." Huang Xinghua was not interested in whether Qi Jing was watching the movie. He said that the title of the movie was just to lead to his own question.
"If you see a patient's eyes in the hospital are green, what do you think is wrong with him?"
"Did I have to do a differential diagnosis?"
“Not all.”
"The patient came to the emergency department?" Huang Xinghua didn't expect him to ask this question. He didn't know how to answer for a while, so he did a circle of Tai Chi and threw the question back: "It's outpatient clinic, in fact, the outpatient clinic doesn't matter. You can say whatever you think." In fact, Cai Ping had asked the ophthalmologist in her hospital, but she didn't know about it after asking.
The first reaction of the deputy high school senior who was asked was: What is green eyes? Can people still have green eyes?
Is it a fool? This feeling will last for a long time until after calming down, when you think of Huang Xinghua's infectious background, there is only one answer that can be thought of: Pseudomonas aeruginosa.
Anyone who has dealt with Pseudomonas aeruginosa knows that when Pseudomonas aeruginosa is cultivated on the culture medium, the pyogenic enzyme they produce will turn the original white culture medium into grass green.
This has also become a symbol of this bacteria, and even used the color directly on its naming. Qi Jing paused, straightened his thoughts in his mind, and said, "There are a lot of things to say, let me drink water first." As soon as he finished speaking, before Huang Xinghua could speak, the entire consultation report hall echoed the sound of drinking water tons to tons tons. After filling his stomach with water, Qi Jing began to say, "If it is green eyes, then I will first consider the infection of Pseudomonas aeruginosa." After saying the judgment, he began to talk about the effect of pseudomonas aeruginosa, which made the big men in the audience nod frequently.
These contents cannot be learned in textbooks. It is good that a resident who has just graduated for one year can speak so deeply.
However... Qi Jing turned around 180 degrees after he finished speaking, completely overturning the previous statement: "But this green is not caused by Pseudomonas aeruginosa, but a fluorescent staining technique for examining the cornea. This staining will only make the defective cornea appear green and can diagnose corneal lesions." Speaking of this, some communication gradually appeared in the audience.
Inertial thinking naturally thinks of infection and lesions. Who can guess the focus of Huang Xinghua’s question is on examination technology.
It is a question of reversely hindering the possibility of disease through inspection techniques. Just setting up a card in the middle and most people are stuck.
Huang Xinghua really didn't expect Qi Jing to have such a reserve of knowledge. Now that he is still hot, he will naturally continue to ask: "What kind of disease is it?"
"It's better to infect it." Qi Jing replied,
"As for which microorganism is infected, I asked Professor Huang before, whether the patient is going to the outpatient clinic or the emergency department. If it is an emergency, it should be Pseudomonas aeruginosa. Because the corneal defect caused by Pseudomonas aeruginosa is very serious, it can often cause irreversible blindness within one day from the onset of the disease." Huang Xinghua nodded after hearing this: "What if it is an outpatient clinic?"
"Most of the patients who visit the outpatient clinic do not develop that fast." Qi Jing thought for a while and said,
"If it is chronic, there will be more microorganisms, and the typical one is Amoeba Protozoa. You can ask the patient if he has a history of improper wear contact lenses. If so, the probability of Amoeba Protozoa will be very high." There is not much time to consider, nor is there any
Procrastination words such as "Yeah, ahhh" are carried out layer by layer, and are neat and neat.
"Ah, by the way, I forgot to say it." Qi Jing laughed twice and added,
"If it is amoeba protozoa, it should be anamoeba. Corneal scrapers can be used for culture and then microscopic examination. There are 8 types of protozoa that can cause anamoeba keratitis. As for which one, there is no way to test it in China, so you can only send American cdc for it..."
"Okay." Huang Xinghua interrupted Qi Jing's words as he looked at the awkward look of the professors in the audience.
"Enough, if you continue, you will have no idea." Listening to the long speech coming from the phone receiver, Huang Xinghua and the professors realized why Qi Jing had to drink water before.
Qi Jing didn't reserve much about this question, and basically said everything he knew: "Then this question..."
"The answer is good." Huang Xinghua made a gesture to his phone and asked for his opinions from the audience very democratically.
The feedback he gave was not unexpected. Most people were very rational and agreed with his decision. Being able to answer this question shows that Qi Jing has a deep understanding of Amoeba and bacterial infection.
Even if I have never seen it clinically, I should read foreign journals often, and they are very rare infectious diseases journals.
With this level, Huang Xinghua is willing to give Qi Jing a green light. However, the green light will be green, and the remaining two questions must be completed.
This is a competency test, which has a strong guiding significance for the subsequent consultation. Huang Xinghua's tone softened at this time, and even his name changed: "Xiao Qi, there are two more questions in the next." Qi Jing naturally didn't care, and the question just now did arouse his interest.
The question setting has a novel perspective, which seems to be a diagnostic question, but it sets traps in the most important places. If it weren't for the fact that many parasites had a special liking for the eyes, his ophthalmic knowledge wouldn't have been so rich.
"Director Huang ask." If the situation of the first question just now can be seen in China, then the second question is about real African life.
Unless you have been to Africa or are particularly familiar with the local situation, you will never answer this question: "In Africa, why can't you dry the washed clothes?" Everyone in the audience expressed their expressions after hearing this: Yes, that's the question!
The most inexplicable question among the three questions is simply confused. When facing this question, they are basically self-deprecating. In addition to making fun of it, some answers that the weather is not good and it is rainy. Some answers that the rainy season has passed, some answers that the wind and sand are too strong, some answers that will be gnawed into slag by locusts, and some answers that are too sun-fading... Anyway, how to spoof, Huang Xinghua never said the correct answer until the end.
"Oh, I know this." Qi Jing's answer refreshed their cognition again.
"To prevent myiasis." In just one sentence, it became the best answer that Huang Xinghua can receive these days.
For him, this was simply an unexpected surprise. Even though he was excited, he couldn't help but continue to ask why.
"Because in the area south of the Sub-Saharan Desert, there are many larvae of flies that can pierce the skin and penetrate into the skin directly." Qi Jing said,
"The most common ones are the anthropophilic flies. Female worms lay eggs on outdoor clothes, 200-300 at a time. After hatching, larvae will easily penetrate into human skin without pain or itching. After the maggots mature in 1-2 weeks, they will crawl out by themselves." This is no longer a matter of reading a journal, and it is not an exaggeration to say that they have been to Africa before.
"How did you know so clearly?" Huang Xinghua was a little disbelief.
"Oh, I just said that my mother went to Africa to provide assistance." Qi Jing once again gave Xiao Yu the shield.
"She often told me about these things when she was a child." Huang Xinghua forgot about this: "Then you should know how to prevent it?"
"If it is really sunbathed outside, then take it back and burn it with an iron. The insect eggs are not resistant to high temperatures." Qi Jing explained,
"It's quite simple to deal with, because small holes will be left after drilling into the skin, and you can completely remove them with surgical tweezers. Of course, you can also wait. When they mature, they will leave the skin, and there will be no harm to the body except the wound." The answers of the two major paragraphs surprised others secretly.
The difficulty of the question is obvious to all, but the child on the phone answered so happily. Thinking about the way he was asked, he could judge the difference.
If their respective titles are blocked, the only criterion is only the question and answer. At least in Lin Zhixing's medical records, they have lost their right to speak.
"Don't forget to disinfect and prevent infection!" Unexpectedly, an old man's voice came from the receiver. Qi Jing nodded repeatedly and echoed: "Well, you must prevent secondary infection after taking the insect."
"Why is the current sound and echo of your phone so loud?"
“The long-distance signal is bad.”
"Oh." Wang Ting nodded, took two sips of tea and didn't say more. Qi Jing smiled and asked Huang Xinghua: "Director Huang, is this answer passed?"
"Well, from the answer, almost perfect score." Huang Xinghua's face was still not full, but there was an extremely complex mentality deep inside.
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Chapter completed!