When doctors have a simulated operating room

The old man was very happy.

"What's wrong, Dean? You look very happy this morning?"

Zhang Yi followed Qian Zhenggang's line of sight and sat on the chair in the office.

Qian Zhenggang looked at Zhang Yi kindly and said:

"There were too many people in the meeting yesterday, so it was inconvenient to talk to you about this. I'll talk to you alone today."

"Okay, just tell me straight?"

"Haha, I came to you to give you a raise."

Zhang Yi raised his eyebrows when he heard it: "Really? How much?"

Although I know that the salary of regular trainees will not be that high.

But since the dean said so.

Why don't you show him an expectant expression and cooperate?

"Two hundred thousand annual salary!"

Qian Zhenggang smiled and gestured to Zhang Yi.

"Two hundred thousand?!"

Zhang Yi's little heart was a little frightened.

It seems that he didn't expect it to be this number? ?

He thought it would increase to a base salary of five thousand plus commission at most!

However, a salary of two hundred thousand per year is comparable to that of the deputy director of some idle departments in Tianhe City, a third-tier city!

Zhang Yi really didn't expect this salary.

"Yes, two hundred thousand!" Qian Zhenggang repeated it again for fear that Zhang Yi didn't believe it.

In fact, Qian Zhenggang had been struggling for a long time over the issue of raising Zhang Yi's salary.

Zhang Yi hasn't verified it yet.

But he is better than most attending doctors in terms of technology and all aspects.

He is even on par with some department heads.

In addition, he has been invited to perform surgery by the provincial hospital many times.

Qian Zhenggang is worried that people from the provincial hospital will come to poach him!

So, it's better to strike first.

What do young people want to do when they come out to work?

Isn't it just for those little things outside of their body?

So, if the salary is raised to the right level, there is no need to worry about Zhang Yi changing jobs~

Zhang Yi was also very happy to hear this salary.

This kind of treatment is unique in the whole hospital.

An annual salary of 200,000 yuan is about 16,000 yuan a month.

In Tianhe City, this is quite good.

No, not only good, but also very good in the blind date market.

"Thank you Dean Qian for your appreciation, I will work hard in the hospital."

Zhang Yi bowed slightly to Qian Zhenggang to show his gratitude.

Qian Zhenggang was also very satisfied, and after praising Zhang Yi a few more words, he let Zhang Yi go back to the department.

...

Emergency Department, today Chen Fang and Zhang Yi are sitting in the emergency clinic.

As soon as he returned to the clinic, Chen Fang asked curiously:

"What did Dean Qian tell you? Why did he ask you to go to him so early in the morning?"

Zhang Yi showed a mysterious smile:

"Salary increase."

Chen Fang immediately shed tears of envy:

"Oh my God, how much did you get?"

Zhang Yi did not respond directly and only said: "Guess."

Chen Fang pursed his lips, knowing that it was not easy to say such things, so he did not ask any more questions.

The patient came in after the patient was called.

It was a male high school student wearing the uniform of Tianhe No. 2 Middle School. He walked in weakly.

His mother was beside him.

"Where do you feel uncomfortable?" Zhang Yi asked.

While asking, he glanced at the high school student's whole body.

There was no problem with the vascular access, the bones, the brain development, and the physiological development.

But, there was something wrong with the thyroid gland in the neck.

Could it be hyperthyroidism?

Chen Fang saw that the boy seemed very weak, so she immediately brought a stool for him.

The boy didn't say anything, so his mother quickly replied:

"Doctor, my son has been acting strangely for the past three months! His legs and feet are always numb and he can't even raise his hands during class..."

"Wow... Doctor, I searched on Baidu, and it said that this disease seems to be ALS or Parkinson's? It can't be true, right?"

"What should I do? My son is only in the second year of high school..."

As the boy's mother spoke, her eyes gradually turned red.

Zhang Yi handed her a piece of paper:

"Family member, please stop crying and explain the child's problem first."

Then he asked: "Do you usually have a situation where you can't get out of bed after waking up from a nap?"

The boy's mother was thinking, and the boy nodded quickly:

"Yes... It happens often... It feels like a ghost is pressing on the bed."

"Do you have convulsions when you feel weak in your limbs?"

The boy shook his head: "No..."

"Have you lost weight recently?"

The boy shook his head: "I don't know..."

The boy's mother nodded suddenly: "It seems so! I still had some fat on my face a few months ago. Now that you ask me, I think I have lost some weight."

"Diarrhea

?”

The boy nodded: "I poop, often."

Now, Zhang Yi has almost determined what the problem is.

Hyperthyroidism, plus weakness in the limbs, a blood potassium and electrocardiogram test will basically confirm the diagnosis.

Zhang Yi tapped the keyboard in front of the computer and wrote down the examination list.

Chen Fang glanced at the family members and then at Zhang Yi.

He was a little confused.

What's going on?

What happened?

Why do you look like you know what's going on after asking a few questions?

Zhang Yi saw Chen Fang's puzzled eyes and explained:

"The child's neck is a little swollen, not obvious, and an electrocardiogram, hyperthyroidism and blood potassium test can basically confirm the diagnosis. "

This sentence woke up Chen Fang again.

He knew!

It's hyperthyroidism hypokalemia periodic paralysis!

No wonder the child's limbs are weak.

If it's ALS, there will be tremors and muscle atrophy at the same time as paralysis.

This child developed paralysis symptoms three months ago, but there is no muscle atrophy at present.

Can walk and talk.

In addition, the neck is slightly swollen, thin, and the limbs are paralyzed and weak.

The above symptoms are very close to hyperthyroidism hypokalemia periodic paralysis.

If it is really hyperthyroidism hypokalemia periodic paralysis, potassium must be supplemented quickly.

This disease mostly occurs in adolescents, with the highest incidence rate between 7-21 years old.

First of all, why does hyperthyroidism cause hypokalemia?

Because hyperthyroidism can reduce thyroid hormones and cause sodium-potassium ATPase dysfunction.

Excessive potassium in the blood is transferred to the cells, resulting in transfer hypokalemia.

In addition, hyperthyroid patients will also have elevated blood sugar. Once blood sugar is high, it will stimulate β cells to secrete a large amount of insulin, which will accelerate the sugar metabolism process.

In this way, it can also promote the transfer of potassium ions outside the cells into the cells, causing abnormal blood potassium distribution and hypokalemia. .

Then there is hyperthyroidism which can cause diarrhea.

Long-term diarrhea can also cause a certain loss of blood potassium.

Once the blood potassium in the human body is low, it will cause symptoms such as muscle weakness, fatigue, and dizziness.

In this way, it forms hypokalemic periodic paralysis caused by hyperthyroidism.

Hypokalemia is still very dangerous.

It is easy to cause respiratory muscle weakness, leading to suffocation.

It is also easy to cause heart function disorders and sudden death.

But it is easy to treat.

Just take potassium supplements.

Swish.

Write a prescription and go for examination.

The family members helped the boy to go for the examination.

… …

Come back half an hour later.

Take a look at the checklist.

Electrocardiogram: U wave increases and merges with T wave.

This is a typical electrocardiogram manifestation of hypokalemia.

Blood potassium: 2.4mmol/L (normal 3.5-5.5mmol/L)

If it is lower than 3.5, it is hypokalemia.

Five thyroid function tests: five red arrows pointing upward, all positive.

Blood sugar: 10.1mmol/L (fasting 3.9-6.1mmol/L)

This can be confirmed.

"Your child does not have ALS, but hyperthyroidism and hypokalemia periodic paralysis."