"She went to have an ultrasound to check her appendix and it was fine. If there were any problems with the urinary system and gynecology, the ultrasound didn't find any problems. Later, when I pushed my hand below the navel to the ** area, she felt uncomfortable and had a pulling pain." Xie Wanying reported her thoughts, "I suddenly remembered that this area seemed to be related to the urachal ureter. If it is done by ultrasound, it must be shown. Just like what the teacher said, unless the scan is done at that area, doctors generally won't suspect this place. If it is too small, ureteral stones are very small and within 1 cm may be missed by ultrasound. Only CT can confirm the diagnosis. I finally suggested that she do a CT scan of this area to see what is going on."
"How long did you spend palpating her?" Professor Li asked. As an old professor, he knew that the patient's symptoms were too subtle to be felt, and he was curious about how the intern could have found out the problem.
"I massaged her for about half an hour." Xie Wanying recalled and estimated the time she last examined the patient.
Only interns have the time and energy to slowly ponder the abdomen during a half-hour physical examination, because they are curious about learning. Clinical doctors rely on experience and quickly complete the palpation and form a habit. If you palpate for a long time, the patient will doubt your skills. Medical students will not be questioned, because the patient knows that you are a student.
After hearing this, a group of doctors could only smile bitterly.
Having said that, even if medical students are not questioned by patients, there are very few medical students who have the patience to repeat the actions during the physical examination to figure out the patient's condition, let alone those who can actually figure out the parts that their clinical predecessors missed during the process.
Such medical students are not only not able to rely on perseverance, but also need to have a solid foundation. Rare diseases are not closely related to intelligence and talent, but the foundation is more important. Because rare diseases are often hidden in the corners of medical research, doctors need to remember them at any time, which is quite a test of a doctor's comprehensive grasp of the basics.
"The fact that you were able to think of the urachal area when you were palpating shows that you have learned anatomy very well." Professor Li praised his student sincerely from the bottom of his heart.
Xie Wanying should have been very excited to be praised by the old professor, but she shook her head and said matter-of-factly: "I can think of it not only because of anatomy, but also because of the relationship between histology and embryology and pathology."
...
...
Professor Li and his group of doctors should think about it: Oh, that’s right.
If we don’t understand rare diseases like this caused by partial degeneration of the human body, we will forget them even if they are mentioned in anatomy. This is because histology studies the process of differentiation, development and growth of the human body structure.
In fact, in anatomy, the urachus is rarely mentioned. This place basically degenerates into the median umbilical ligament in infancy. It has become a ligament, so there is no need to dissect it. In rare cases, it is difficult to keep a specimen. The anatomy room of the medical school does not have such patient specimens, but the specimen room of the hospital may have them.
Xie Wanying is unlikely to tell about another deep-seated reason. Before her rebirth, she focused on studying pathology. To learn pathology well, one must first master histology and embryology.
"How many points did you get in the embryology exam?" the seniors asked her excitedly.
Xie Wanying was reluctant to brag in front of everyone, so she hesitated.
Gao Zhaocheng turned around and asked her two classmates: "How many points did she get in the exam?"
"Well - full marks." Lin Hao answered, because the squad leader Yue Wentong was a taciturn person and would not speak first.
"How many points did you take?"
"Eighty-something."
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