Chapter 261 Diagnosis of difficult blood cases

"Please pay attention to the doctor who has registered for the blood disease application and announce the competition rules first. We will give the basic information of the patient, and then the contestants will submit an examination application based on their initial diagnosis. The scoring rules are as follows, and each additional routine examination application is added.

One point is deducted, CT, nuclear magnetic field, and advanced biochemical examination applications, two points are deducted for each additional item. If the diagnosis direction is correct, 1 to 5 points will be added.

For example, if the initial diagnosis direction is correct, 1 point will be added, and the second diagnosis direction will be correct, 2 points will be added. If the diagnosis direction is always correct, a total of 5 points can be added.

The diagnosis result is completely correct, and it is 30 points.

For every missed diagnosis, 10 points will be deducted. The misdiagnosis will be counted as zero points.

The correct treatment plan is 20 points.

If the treatment plan is incorrect, points will be deducted based on the possible treatment consequences. For example, if the surgical plan is incorrect and the patient is disabled, 10 points will be deducted. If the patient dies, 20 points will be deducted.

If the medication causes the patient's condition to worsen, 5 points will be deducted, 10 points will be deducted for the patient's death, and 20 points will be deducted for the patient's death."

The rules of the entire competition are formulated based on clinical practice.

There is only one purpose, and the patient's cause is detected and cured at the lowest cost.

What tests a doctor's comprehensive diagnosis and treatment ability in all aspects.

This is just the first competition event, so strict.

This also made Li Jingsheng look forward to this skill competition.

What doctors fear most is to work behind closed doors.

He can take this opportunity to learn how doctors from more than 170 hospitals in and outside the province diagnose and treat various diseases.

This will be of great benefit to his future clinic visits.

"If the contestants answer the questions incorrectly, non-competitors present can also answer the questions. You can turn on the tablet computer on the desk, enter the name of the hospital, personal name, ID number, and mobile phone number verification, and then you can participate in the answer. If you take it, please take it.

If you get a high score, you can be regarded as participating in the competition and you are eligible to obtain trophy and certificates of honor."

The prize money is not attractive in this kind of event.

The doctors present were all elite, and even if they got the first place, the bonus was only 500 yuan.

I believe few doctors can appreciate it.

What is really valuable are trophys and certificates of honor.

This will become a reference for future evaluation of outstanding talents, promotions and professional titles.

It has a high gold content.

The competent departments and the Western Medical Association are recognized.

"In fact, even if non-participants do not participate in the competition, they can enter their personal information to bind the tablet on the desk to facilitate answering questions during the next event. Or watch the correct answer at that time."

The examiner's words rang again.

Everyone started operating the tablet computer on the desk one after another.

Qiaobang Hospital is really rich.

Even if a tablet is only counted as one thousand five, so many are still an astronomical figure.

Li Jingsheng had a try mentality and bound it according to the prompts.

As soon as the binding is completed, a flashing red box will automatically appear.

Current answer.

Click to display the patient's basic information immediately.

It's really very convenient.

High technology changes people's lives and brings great convenience.

Patient information: Xu Moumou, 54 years old, male, sat at home watching TV at 9 o'clock in the evening and found purple patches on his skin. Later, he saw that the purple patches had not dissipated. He was frightened and went to the hospital for treatment.

The patient is usually healthy and has suffered from sore throat, fever, and headache two days ago. He has taken painkiller tablets and spiromycin.

After taking the medicine, the condition improved, the headache was relieved, the body temperature returned to normal, and the pain in the pharyngeal did not improve.

The next night after taking the medicine, I found tiny subcutaneous blood spots on the face, limbs, waist, back, chest and other parts.

After that, it gradually became bigger and became purple spots.

Before the patient was admitted to the hospital, he felt soreness in both knee joints and lower limb muscles.

When he was admitted to the hospital, his body temperature was 36.7 degrees, his blood pressure was 105/75mmhg, his heart and lungs were normal, his consciousness was clear, and hemorrhagic spots could be seen on the skin.

The size of blood spots varies, with a diameter of between one millimeter and two centimeters.

It is scattered throughout the body, with the most limbs and fewer torso.

Hemorrhage points and ecchymosis can be seen in the oral mucosa.

After checking the abdomen, I found tenderness around the umbilical cord and no muscle tension.

No redness and swelling on both knees.

This is the basic information given.

After reading this, Li Jingsheng couldn't help but think of the ITP disease he received a few days ago. The little boy was suffering from bleeding and was thrombocytopenia.

The initial symptoms of this patient are a bit like a cold. After taking the medicine, the body temperature dropped and his head no longer hurts.

As for the pain in the pharynx, this is normal.

The sore throat usually doesn't recover so quickly.

The mouth, pharynx, and nasal cavity are all special, the environment is humid and there are mucous membranes. Inflammation or abscesses occur, and it takes more time to recover.

Anyway, it doesn't cost money to participate in the competition.

He tried to click on the blood to apply.

1 point will be deducted immediately.

I didn't expect to be so smart, so I set the scoring rules.

Points are deducted for examinations to prevent doctors from applying for examinations by blindly.

Some hospitals are very relaxed in the management of examination applications and even encourage doctors to prescribe more examinations. In this case, the doctor's diagnosis habits will be damaged.

Because there is no supervision, the doctor directly prescribes a lot of examinations regardless of the patient's condition.

I wish every patient had a full set of examinations.

In fact, this is not only a loss of medical ethics, but also a serious waste of medical resources.

If a patient undergoes an extra examination, the time required to queue will increase significantly.

It is common to draw blood and queue for half an hour.

It is also normal to take a color ultrasound and queue for half an hour or even longer.

It can be imagined that the patient is dragging his sick body, queuing here and there, constantly struggling, and he cannot get timely and effective treatment.

After a day of hard work, the doctor may have gotten off work before the examination was completed.

This kind of doctor who prescribes examinations is very shameful.

There was no consideration for the patient at all.

To put it bluntly, the patient has become an ATM in their eyes. After the examination is opened, the patient only pays the money. As for the patient's life or death, it has nothing to do with the doctor.

In medical procedures, if an accident occurs during the patient's examination, or the condition worsens and endangers his life, the doctor has the obligation to rescue him and does not need to bear responsibility.

There were hospitals who once made big news because of similar medical ethics.

The patients are already in critical condition, but in order to take group photos, the doctors leave the patients there and leave them alone without anyone taking care of them.

In the end, the patient died because of untimely rescue.

The angry family took the hospital to court.

In the end, the doctors and nurses who neglected their duties were punished as they deserved, but the patients' lost lives could never come back.

What is left to your loved ones is eternal sadness.

In this skill competition, points will be deducted for every examination application prescribed by the doctor, and 2 points will be deducted for unconventional examinations and tests.

Li Jingsheng thought it was very good.

That should be.

A truly wise doctor must first make his own judgment, and then issue a corresponding examination application to verify whether his judgment is correct.

After Li Jingsheng ordered a blood routine application, the result was immediately released.

Hemoglobin is the first data he needs to look at, 176g/L.

Leukocytes 21.9 times the power of ten to nine liter.

Neutral lobular nucleus accounts for more than 80%.

Platelet 82 remains at the power of ten to nineteen per liter.
To be continued...