468. Contest
[He has been shutting down the phone and probably is still busy. Have you found someone?]
【...】
[Why don't you answer the phone? Is there a job?]
【...】
[Mr. Han, you answer the phone. It’s not a single call. You are not a doctor...]
I don’t know how many times it was that I felt the vibration from my palms, but the man sitting in the corner of the auditorium of Dan Medical University finally lowered his head and opened the screen of his phone. After turning on the news, he couldn’t help but look up and looked at the stage a few more times, smiled slightly, tapped the keyboard with his fingers, and replied:
【Finally found, we are having a meeting at the Dan Medical University】
【Oh, just find it, I have sent a message to him about your situation, and you can have a good talk after the meeting]
[Well, Xiao Yuan has worked hard, thank you very much when you have time]
Xiao Yuan... and thank me...
A chill broke out from behind Yuan Tianchi, and he couldn't help but tremble slightly. He tightened his pajamas, quickly put down his phone, and fell into deep thought: What's the big trouble I've had this year? I just ran into Qi Jing, why did he deal with this person again?
He didn't expect that he was helping Qi Jing find a house, so why did he find such a guy? When he thought of being an introduction to them, he felt so upset, and he didn't know whether it would be a good or a bad thing to let these two guys meet together.
Fortunately, the other party didn't want him to intervene, so Yuan Tianchi felt relieved, and the big rock in his heart finally fell to the ground.
There was Yuan Tianchi who was temporarily at ease. The man below the stage also put away his cell phone and listened to the discussion meeting carefully. However, Ma Liming on the stage looked like a mouse tied to an iron frame, with hot charcoal fire behind him, and surrounded by onlookers.
Public executions continue.
At 6:12, the emergency doctor came to the patient's house and quickly sent him to the hospital after judging his or her myocardial infarction. At 6:17, the ambulance arrived at the gate of the emergency department of the Third People's Hospital, and the patient was sent to the emergency room.
"Teacher Ma, is this patient a myocardial infarction?"
"Don't call me Teacher Ma." Ma Liming held the edge of the podium with one hand and pretended to be calm, "I can't afford this title."
Even though Xiao Wansong and Qi Jing were put on the stage together, he still had the idea of leaving.
This platform is like an exhibition hall. Qi Jing just wants to show him his embarrassment to others. Now he will feel better after leaving. Even if Xiao Wansong embarrasses him behind his back, the final trouble will be the conclusion of the examination.
Alas, I was worried that the conclusion of the emergency center would affect the promotion, otherwise I would not have thought of them at all!!
In fact, with his current weight in the Third Hospital, it is still a matter of whether the promotion will be damaged. But his reputation will become bad. As long as he doesn't show his face, who will know who, time will naturally stand on his side.
But now...
Not only did he show his face, his name was made public, but his hospital was made public. If he just left like this, it would be too much for him to be out of here. Besides, he would be relieved to leave his voice in Qi Jing's hands.
Thinking of this, he would be grateful to Qi Jing's arrangement, and at least gave him a chance to defend and refute. Otherwise, with this guy's bad character, he might have added fuel to the point, and this bad reputation would probably be his lifelong success.
We must fight.
"The patient has chest pain, and a decrease in blood pressure indicates a decrease in cardiac stroke volume. Severe myocardial infarction can be considered." Ma Liming said, "This type of patient must be sent to the hospital as soon as possible."
"It's just chest pain." Qi Jing laughed twice, reminded him and asked, "I wonder if there is any other basis for Teacher Ma besides chest pain? Or is it that way Teacher Ma determined?"
Ma Liming raised his eyebrows and found that he was waiting for him here: "I just doubt that I need to make further clear consultation, but there is only a brief medical history here and there is no family member. I really..."
"Oh, family members." Qi Jing immediately interrupted him, tidied up his clothes, and pointed at him, "I'll be a family member."
"Oh? It turns out that I'm testing."
"After all, it is for medical students to see. It is very abstract to avoid and strengthen the places, and it is better to do them all." Qi Jing responded with a smile, then lowered his posture again, "I would like to ask Teacher Ma to help me."
Hypocritical! Liar! I said I would let me go if I didn’t help you?
Ma Liming had no choice but to respond, and then asked again according to what he asked before: "I need to ask if the patient has a history of long-term hypertension."
"The patient does have a history of hypertension." Qi Jing looked down at the medical history records.
"That's all. I have a history of chest pain and hypertension. Even if myocardial infarction is not legal, I'm at least highly suspicious." Ma Liming felt that what he said was fine, "You should know when you go to the internal medicine emergency department to improve the electrocardiogram."
After hearing this, Qi Jing had no reaction and looked up at him: "Teacher Ma won't ask the patient if he has controlled his blood pressure?"
"this......"
"Having a history of hypertension does not mean that the patient has hypertension. I hope everyone can remember this." Qi Jing warned everyone in the audience and said, "The patient was diagnosed with hypertension ten years ago, but they were taking the medicine stably, and his blood pressure has been maintained at around 120/75, which is very stable."
Although Qi Jing said that he had no other intentions, he was not as good as a slap in the face to refute it to such an extent, which made the atmosphere on the scene very awkward.
Ma Liming was identified with a problem. Seeing that many people in the audience began to whisper, they were naturally unwilling to be outdone: "Even if the blood pressure is normal, they will suffer from myocardial infarction. There is no regulation that you must have high blood pressure."
"The reason is this, but if you want to say that..." Qi Jing nodded and replied, "Well, Teacher Ma asked the patient if he had a history of hypertension just now, wasn't that a nonsense?"
Ma Liming was stunned. He just opened his pocket and stuffed him in. How could anyone bully people like this?
Qi Jing knew that he couldn't handle this question, but he couldn't achieve the effect after just being so cold, so he simply gave him a briefing and changed his question: "I want to ask, how does Teacher Ma define chest pain?"
After two round-trip contests just now, everyone could hear his voice-over, which was "persecution" by Teacher Ma.
Perhaps, even Teacher Ma himself has to put quotation marks on this question.
If you consider it from the perspective of medical students, the "chest" of chest pain is a word that locks the anatomical area, and chest pain is a kind of pain in the chest and its surroundings, which is easy to understand.
But in the eyes of clinicians, chest pain should correspond to diseases.
The chest and abdomen are two major areas of the human body's torso. As long as the pain falls here, it cannot be a simple problem.
Acute abdominal symptoms are very headache, both internal and external. They cover more than 50 kinds of symptoms, and everyone will have a headache when they see them. Chest pain involves fewer organs, but once they encounter it, it is likely to be a heart-to-pulmonary problem, and the severity is only high or low.
Therefore, relying on patients toward myocardial infarction does have statistically certain basis, and secondly, it is due to the experience of Ma Liming, a cardiologist.
"Chest pain..."
This is a subject involved in diagnosis and internal medicine. It is a must-take in the exam, but once you enter the clinical practice and are influenced by your own junior college, differential diagnosis will move closer to your own department.
"Chest pain considers myocardial infarction, aortic aneurysm, pericarditis, aortic dissection..." Ma Liming thought for a while and realized that lung factors should also be taken into account, "There are also pneumonia, pleuritis, pulmonary embolism, lung cancer..."
Qi Jing did not respond and looked at him.
Ma Liming immediately realized what he had missed and frowned: Chest pain, what else could cause chest pain???
Ah, by the way, I am thinking about deep-seated organs and forgetting my skin.
"There are shingles!" he explained with a smile. "Shingles can be infected all year round, but it will be a little more in winter, and it is more likely to appear in the elderly. Whether it is time, age or pain symptoms, it is easy to get confused with myocardial infarction."
“Not bad.”
Qi Jing first affirmed his statement, immediately changed the subject and continued to ask: "I don't know where the so-called 'chest' for chest pain is? "
"Breast? Isn't it here..."
Ma Liming didn't realize the problem at first, so he drew a circle on his chest with his fingers. The range was nothing more than the area of his heart, but when his fingertips touched the heart and was about to sway it down, Ma Liming suddenly thought of something.
Yes, the chest and abdomen are already connected, and chest pain must be distinguished from abdominal pain. However, the patient covered the ground is very subtle. Although he was talking about chest, it would be no big problem if he mistakenly thought that the upper abdomen.
"Is this the problem?"
Ma Liming immediately thought of this. Although this point is fatal, there is still room for remedy: "I know what you mean is that I missed the identification of the patient's pain area. But what I want to say is that as an emergency doctor, I still consider more severe cases, just to save my life. Sometimes, for speed, I can only discard accuracy."
"Yes, it lost the accuracy, which gave the doctors in the hospital mistakenly misleads it, and finally affected the patients' participation in other treatment methods."
Qi Jing smiled and repeated what he did, and then took out some new materials, "You don't have a belly, just weave Yali::"
The chest and abdomen are two major areas of the human body's torso. As long as the pain falls here, it cannot be a simple problem.
Acute abdominal symptoms are very headache, both internal and external. They cover more than 50 kinds of symptoms, and everyone will have a headache when they see them. Chest pain involves fewer organs, but once they encounter it, it is likely to be a heart-to-pulmonary problem, and the severity is only high or low.
Therefore, relying on patients toward myocardial infarction does have statistically certain basis, and secondly, it is due to the experience of Ma Liming, a cardiologist.
"Chest pain..."
This is a subject involved in diagnosis and internal medicine. It is a must-take in the exam, but once you enter the clinical practice and are influenced by your own junior college, differential diagnosis will move closer to your own department.
"Chest pain considers myocardial infarction, aortic aneurysm, pericarditis, aortic dissection..." Ma Liming thought for a while and realized that lung factors should also be taken into account, "There are also pneumonia, pleuritis, pulmonary embolism, lung cancer..."
Qi Jing did not respond and looked at him.
Ma Liming immediately realized what he had missed and frowned: Chest pain, what else could cause chest pain???
Ah, by the way, I am thinking about deep-seated organs and forgetting my skin.
"There are shingles!" he explained with a smile. "Shingles can be infected all year round, but it will be a little more in winter, and it is more likely to appear in the elderly. Whether it is time, age or pain symptoms, it is easy to get confused with myocardial infarction."
“Not bad.”
Qi Jing first affirmed his statement, immediately changed the subject and continued to ask: "I don't know where the so-called 'chest' for chest pain is? "
"Breast? Isn't it here..."
Ma Liming didn't realize the problem at first, so he drew a circle on his chest with his fingers. The range was nothing more than the area of his heart, but when his fingertips touched the heart and was about to sway it down, Ma Liming suddenly thought of something.
Yes, the chest and abdomen are already connected, and chest pain must be distinguished from abdominal pain. However, the patient covered the ground is very subtle. Although he was talking about chest, it would be no big problem if he mistakenly thought that the upper abdomen.
"Is this the problem?"
Ma Liming immediately thought of this. Although this point is fatal, there is still room for remedy: "I know what you mean is that I missed the identification of the patient's pain area. But what I want to say is that as an emergency doctor, I still consider more severe cases, just to save my life. Sometimes, for speed, I can only discard accuracy."
"Yes, it lost the accuracy, which gave the doctors in the hospital mistakenly misleads it, and finally affected the patients' participation in other treatment methods."
Qi Jing smiled and repeated what he did, and then took out some new materials, "You don't have a belly, just weave Yali::"
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But in the eyes of clinicians, chest pain should correspond to diseases.
Chapter completed!