After Liu Li calmed down and thought about these things, she felt panic and regret. As an obstetrician, she was more afraid of not being able to see the big problem with the patient than being criticized. The nature of obstetrics is one corpse and two lives.
She was sweating profusely and wiped her forehead with a tissue.
The waiter brought the dishes to the table. The doctors had no appetite and were busy studying the patient's medical records.
"It cannot be said that this orthopedic outpatient doctor was completely unaware. Give her an electrocardiogram test." Cui Shaofeng said as he turned to the next page of the examination report.
Cervical spondylosis is not obvious, so check whether the patient has coronary heart disease. The patient is in his fifties, and coronary heart disease is common in clinical practice at this age. Among the atypical symptoms of coronary heart disease, pain may radiate to the upper limbs.
The electrocardiogram showed no obvious abnormalities. Then, something else happened at home. The daughter fell ill. This is how illness works. If a person is busy with work and family affairs, they will be more tolerant of minor physical ailments. In addition, the doctor said that there was nothing wrong with the initial examination. The patient went to Beidu No. 3 Hospital for treatment and did not mention cervical spondylosis. Liu Li and the previous obstetrician and gynecologist were completely unaware of this.
The patient came for IVF and had all kinds of tests done again. The electrocardiogram was done again, and there was no problem. The cardiac ultrasound also showed no problem.
There is one thing that the doctor needs to pay attention to.
"Her blood pressure was already high before." Cui Shaofeng emphasized the point again.
...
...
In her early fifties, her family is a high-asset family, she has overnutrition, and her blood lipids and high blood pressure are too "normal". The patient has atherosclerosis. When she was treated in the obstetrics and gynecology department, she tried her best to take lipid-lowering drugs and regulate blood pressure. After her blood pressure stabilized, she could do IVF. After pregnancy, she stopped taking all kinds of medicines, including antihypertensive drugs. Until recently, her blood pressure went up again, and she was prescribed antihypertensive drugs.
After repeated scrutiny of the patient's medical records, it was determined that the test results did not match the patient's clinical symptoms, and the root cause could not be explained. The next step would definitely be to issue a more targeted test order.
When Tan Kelin saw the tests his cousin was going to prescribe for the patient, he criticized her again: "Why are you prescribing a cardiac ultrasound and electrocardiogram for her? What's the point of checking her blood lipids?"
These examinations have been done several times, and the patient certainly does not want to undergo the same examinations over and over again.
Let's talk about blood lipid test. High blood lipid is the pathological basis of various diseases. Lowering blood lipid is a combined treatment for many diseases. It tries to slow down the further development of the disease from the etiology and pathology. It takes a long time to take effect and has little effect on emergency treatment of severe diseases. This patient has always had high blood lipid. You can't find much results if you test it again. If you are afraid that the patient has a critical disease, why do you prescribe this blood lipid test?
"This..." Liu Li frowned. It was not easy for a young doctor to open his mind.
Are there any tests that may not be detected by electrocardiogram and cardiac ultrasound and may be missed?
"She is a pregnant woman. A CT scan cannot be performed unless it is a critical moment. She definitely would not want to have a CT scan," said Liu Li.
Do pregnant women do CT scans? You can imagine that, especially CT scans of the waist and abdomen, are not allowed.
"Why did you give her a CT scan?"
The electrocardiogram and cardiac ultrasound could not find anything, so we had to do a CT scan. This should be Liu Li's clinical thinking. If this machine doesn't work, try another one.
Come on, this cousin is really a technically confused person. I guess she has lost all knowledge except obstetrics and gynecology.
Tan Kelin glanced at his old classmate and said: Do you know?
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