I Can See Health

"There are two minutes left. Candidates please pay attention to the exam time and avoid overtime!"

"One more minute!"

"Thirty seconds left!"

"The first room, the exam is over!"

"..."

When Lu Chen came out of the first room, he was a little confused.

He was still not 100% sure about the diagnosis of this patient.

He could only tell what he thought was the most likely diagnosis!

In this exam question, the two most important inspection reports are missing.

That is the result of coronary angiography or aortic CTA!

However, if you take out these two inspection report sheets directly, there is no need to take the exam.

"Now it just depends on luck..."

Lu Chen shook his head slightly. He just noticed that when he told his answer, the female examiner on the side had no expression at all.

He simply couldn't judge whether he was correct from the examiner's microexpression.

…

All four candidates stood at the door.

Outside the corridor, the middle-aged examiner shouted loudly: "All candidates will be postponed to the next ward."

Lu Chen walked into the second ward.

In this second ward, a young girl lies.

The color on her head is red too!

"Start the consultation and physical examination!"

After Lu Chen heard the examiner's order, he immediately began to consult.

"The patient is female, twenty-three years old."

"Main complaint: Headache for 3 days. Hospital admission."

"...Physical examination: blood pressure 220/130 mmHg..."

"This second patient's condition seems to be much simpler than the first one." Lu Chen thought to himself.

For young female patients with elevated blood pressure, secondary hypertension should be considered first.

Hypertension is divided into two types based on its causes.

Essential hypertension has an unknown cause and cannot be cured, requiring lifelong medication.

Secondary hypertension, high blood pressure caused by other factors, is the only type of hypertension that can be cured.

After sorting out his thoughts, Lu Chen said in a deep voice: "The patient's current diagnosis: the cause of secondary hypertension needs to be ruled out. It is recommended to complete the four items of hypertension, cortisol, catecholamines, and adrenal gland CT."

These examination items that need to be improved are all examinations to determine the cause of secondary hypertension.

The examiner nodded and also took out the relevant test sheets and inspection sheets.

Lu Chen carefully took the report sheet and studied it carefully.

"Four items of high blood pressure are normal."

"Cortisol is normal."

"Catecholamines are normal."

"The contrast-enhanced CT scans of the adrenal glands and renal blood vessels are all normal!"

"The heart ultrasound is normal!"

"..."

All laboratory tests and inspection reports are all normal!

"Is this essential hypertension?"

A question arose in Lu Chen's mind.

But the patient is so young and has no family history of hypertension. Is it considered essential hypertension?

The exam time passed by minute by minute.

The examiner continued to remind: "Candidates please improve the diagnosis and treatment methods again."

Lu Chen couldn't make up his mind again.

On the face of it, continued hypertension appears to have been ruled out.

But when Lu Chen looked at the patient on the bed, he still felt that something was not right!

"Last thirty seconds to answer!"

"..."

When Lu Chen walked out of the second ward, he already had deep doubts about himself.

Who came up with these exam questions?

It is completely out of the scope of undergraduate knowledge. Even if a doctor with rich clinical experience is asked, he may not be able to answer it correctly.

…

The exam is still going on.

Lu Chen walked into the third room.

The patient in this room is an old woman.

And the color on her head is also red!

From the physical examination and consultation to the final diagnosis and treatment, Lu Chen did not dare to have any contempt.

Fortunately, the case this time did not exceed Lu Chen's expectations.

The old lady was a typical patient with chronic heart failure. From diagnosis to treatment, Lu Chen thought he had answered perfectly.

"call……"

After walking out of the third room, Lu Chen breathed a sigh of relief.

This third case gave him a little confidence, and now he had at least a glimmer of certainty.

"Dear candidates, please note that there is only the last ward left!"

Gently push open the door of the last ward.

There was a young man sitting on the ward. He looked just like a normal person.

His face was red, and his energy and posture were all normal.

Lu Chen concentrated his attention and saw that the color on his head was green!

The colors on the heads of the patients in the first three wards are all red, but only the color on the heads of the last patient is green!

Green represents health.

Could it be said that this young man is not sick?

In addition, Lu Chen was a little surprised that this patient was also connected to an electrocardiogram monitor.

This point made Lu Chen dare not relax at all.

This skills test has given him too many "surprises".

Start the consultation and physical examination.

"Male patient, thirty years old."

"Main Complaint: Intermittent palpitations for 1 year, which recurred for half an hour."

"Every time the symptoms of heart palpitations occur suddenly, then they stop suddenly. Cardiopulmonary and abdominal examinations are all negative!"

This time the examiner did not rush for Lu Chen to make a diagnosis, but instead took out an electrocardiogram from the patient's attack.

"Interpret this electrocardiogram to diagnose and treat the patient."

Lu Chen picked up the electrocardiogram and began to study it carefully.

"The rhythm is regular and the heart rate is fast, about 160 beats/minute."

"No P wave is seen, the QRS wave is normal. Retrograde P wave can be seen."

Lu Chen quickly browsed the entire electrocardiogram.

This is a typical electrocardiogram of paroxysmal supraventricular tachycardia!

Paroxysmal supraventricular tachycardia is a cardiac arrhythmia.

Patients with organic heart disease, which can be seen in normal people and patients, can be completely cured by radiofrequency ablation!

This is also one of the few diseases that can be cured in cardiovascular medicine.

Lu Chen also had doubts.

Why does the system determine that the color of patients with "paroxysmal supraventricular tachycardia" is green?

When paroxysmal tachycardia occurs, the heart rate will rise to about 160 beats per minute.

A normal heart rate is 60-100 beats/minute!

When the heart rate reaches 160 beats/min, it can cause heart failure, myocardial infarction, and even sudden death!

So even if the color of this young man is not red, it should at least be yellow!

It’s definitely not green anyway!

Just as Lu Chen was thinking, the ECG monitor next to the bed suddenly sounded an alarm!

"woo woo woo woo……"

The alarm sound was a bit harsh, and Lu Chen immediately looked at it intently.

The heart rate actually reached 164 beats!

The waveform on the monitor looks the same as the electrocardiogram in my hand.

This is paroxysmal supraventricular tachycardia!

But what made him a little strange was that the examiner beside him didn't make any move and didn't feel nervous at all.

And the color of this patient’s head is still green!

A glint flashed in Lu Chen's eyes, and he made his own judgment in his mind.

This patient is a fake patient!

There is absolutely no way he is a real patient!

The waveform of supraventricular tachycardia in ECG monitoring was most likely recorded before!

"Doctor, I'm a little flustered..."

The young man suddenly covered his chest and frowned.

Your acting is too fake. Lu Chen was speechless.

A person with a heart rate of 160 beats/min does not look so relaxed!

However, if you should cooperate with your performance, you still have to cooperate.

"Are the symptoms the same as the previous attacks?" Lu Chen asked quickly.

"Yeah, same thing." The young man nodded, "Then what should we do?"

Lu Chen smiled and said, "Don't worry, you are having paroxysmal supraventricular tachycardia."

"Next, you do these moves with me."

"Okay, doctor."

The first choice for supraventricular tachycardia is not drug treatment, but stimulating the vagus nerve to stop the onset of supraventricular tachycardia!

"Hold your breath and then exhale forcefully."

"Irritation of the pharynx causing nausea."

"Massage the carotid sinus. First try the right side for 10 seconds. If it doesn't work, try the left side for 10 seconds. Do not apply pressure on both sides at the same time."

"Press the eyeballs first to the right and then to the left, no more than 10 seconds each time."

"..."

After this series of vagus nerve stimulation methods, the heart rate on the ECG monitor began to slowly decrease!

From 160 to 140, then to 110, and finally stabilized at 90!

If he hadn't known that this was a fake patient, Lu Chen might have been a little complacent.

The success rate of stopping the onset of supraventricular tachycardia by stimulating the vagus nerve is actually not very high.

Lu Chen only saw one case during his internship.

"Thank you doctor, I'm not panicking anymore." The young man looked "excited".

Lu Chen smiled slightly.

The system does not increase the gratitude value, nor does the system completion degree!

Your thanks are too fake!