Chapter 712 – Gregory's Lecture on Diagnostics
One day five years ago.
Outside the entrance of the teaching building of Tokyo Women's Medical University, a girl who looks like a junior high school is standing under a tree, as if waiting for someone.
"Are you looking for me?" Suddenly, a slight smile of inquiry came to her ears.
"Ahh The girl was startled by the voice behind her, and then looked at the boy who suddenly appeared beside him with a rather surprised look.
"I shouldn't be late, right?" The boy had a faint smile on his face, and at the same time glanced at the girl's chest, which was still slightly bulging despite being covered by his shirt.
"What are you looking at?" The girl's eyes were very sharp, and she immediately saw the boy's gaze.
"Ah, no!" The boy busily explained. "Well, I just subconsciously glanced in the direction of the transmitter - you don't seem to have taken it off?"
"Well, I think this badge is pretty good, so I stayed," the girl looked up again, looking at the badge pinned to the chest of her shirt. "Anyway, yours has been cracked, and I'm also down, so it's not a big problem for me to wear it."
Laughing at each other, the two walked into the school building - of course, neither of them was a student at this university, especially a teenager who could not have been a student at a university that had not started admitting male students until graduate school.
But they did get permission to take classes here.
……
"I ......" The boy looked a little uneasy as he walked into the classroom through the door at the back of the classroom. Wouldn't it be too conspicuous if we sat in front? One look should tell you that we are still children......"
"......" The girl stood in place, thought for a moment, and finally nodded. Okay, I'll sit in the back with you, okay? ”
"Uh-huh......" The boy sat down in the last chair next to him, relieved - behind him, the girl also breathed a sigh of relief.
This is a diagnostic course, that is, a course to train triage doctors, so that people can basically understand how to deal with patients with simple diseases in the shortest possible time, so as to reduce the work pressure of experienced doctors.
But the content of this lesson is obviously a little different.
"Your teacher is sick today, so I'm going to take his class to do a ...... for you Small lectures – don't worry, the bill is out of school. Gregory sat down on a chair in front of the podium, looking in the direction of the thousand feathers, and said at the same time. Let me start with my question – there are three people who come to the clinic and they all say that their legs hurt, what is wrong with them? ”
"It's usually a muscle strain, and the standard coping procedure should be to put him on bed rest and apply a warm compress to the painful area." A front-row schoolgirl replied.
"Well, that's usually the case," Grigory seemed pleased with the answer. "Statistically speaking, more than half of all leg pain comes from muscle pain – usually from over-exercising, 12% from varicose veins caused by pregnancy, and the rest is mostly caused by traffic accidents. In this way, the three of them have six legs, three of them were injured by excessive jogging, two legs were damaged by a car, and the other leg was pregnant, and the diagnosis was completed! ”
There was a good-natured laugh in the classroom, and the student scratched his head in shame.
"What do patients do when they get sick?" A male student asked—apparently, he was a graduate student.
"I don't know." Gregory shrugged.
"Didn't ask about the medical history?" The male student was stunned.
"Of course I did, but the problem is that we don't know what they're doing, only what they say they're doing." Grigory explained. "Patient A, we can call him Uncle Farmer, he said that he was repairing a fence and suddenly felt a pain in his leg. Patient B, Sonorous Rose, suddenly felt pain while pounced on the ball while playing volleyball. And patient C, let's call him handsome, was injured while playing golf. ”
"In the next two hours, one of these three patients will be dying, and one more will be kicked out for coming here just to get the pleasure of the anesthetic, can you guess which one?"
"Uh......" the male student apparently intended to guess. It should be that handsome guy, right? Uncle Farmer and Sonorous Rose are both manual workers, and over-administration of anesthetics should affect their motor function......"
"Calm down, I haven't even said anything about the symptoms," Gregory said, glancing at him. "Don't make judgments before observing your condition, otherwise you may harm others and yourself - then I will play the role of Uncle Farmer first, and you will ask me about my condition."
"When did it happen?" The male student was obviously very familiar with how to ask a pain patient to get the procedure.
"I walked up to the fence about half a mile from the farmhouse and suddenly it started to hurt." Grigory replied.
"Is there any trigger that can be found?"
No, I don't know anything.
"Can you describe the pain? How much area is covered? ”
"It hurts from the ankle up."
"What is the severity, 1 is the lightest and 10 is the heaviest?"
"I'm not too good to say, but at least I haven't been in pain enough to cry out, so I thought...... 4? ”
"How long?"
"All the time." Gregory said this, looking at the male student, expecting if he could ask for something of his own that was outside of the standard procedure.
"Is there a family history?" The male student did ask the question that came to mind after thinking about it, but ......
"Yes, of course, yes, but a family history of leg pain? This is rare, and there should only be bone cancer, osteogenesis imperfecta and multiple myeloma, and the patient does not have it at home. ”
While the male student was silent, the female student from before spoke up again. "Maybe it's a blood disease? We should be able to do a blood count (CBC) and a D-dimer test (to check for fibrinolysis), and then we can do another PET scan...... No, I guess MRI might have a better view of vascular problems. ”
"Yes, yes," Grigory nodded. "Then the patient died, thank you for your diligent autopsy."
"Huh?" The schoolgirl was stunned. "But...... If we hadn't done these tests, we wouldn't have known what disease he had! ”
"Of course we know what ails him," Gregory said with a sigh. "Don't you think the easiest way is to look at the patient's leg?"
"You didn't say—ah, we didn't ask......" The male student showed a look of sudden realization.
"Yes," Grigory nodded. "He has a wound on his leg."