The Enhanced Doctor

Chapter 1239: Chapter 1239: Travel History Is Crucial

(Thanks to Wang Lintai1 and Zi Lian Shi Jiu Shou for their monthly ticket support)

"How are the two patients from yesterday doing?"

Early the next morning, Liu Banxia gathered the team at the emergency center.

"My patient showed reduced muscle weakness and lowered blood pressure after potassium supplementation. We just finished a blood draw," Xu Yino said.

"My patient hasn’t shown any changes and had a good night. However, her husband’s blood test results also didn’t show anything significant, just a slightly elevated white blood cell count," Liu Yiqing said.

"Along with symptoms like headache and muscle aches, I suspect he might have contracted some virus, although he reported no mosquito bites."

Liu Banxia nodded, "So, what’s your inclination for Xu Yino’s patient?"

"Teacher Liu, does checking the book count?" Xu Yino asked with a smile.

"Of course, as long as it helps diagnose the patient’s condition, any method is fine," Liu Banxia said.

"Hehe, if the patient’s thyroid function is also fine, it might be Liddle Syndrome. It resembles primary aldosteronism, primarily presenting as hypertension and hypokalemia," Xu Yino said.

"The pathogenesis is the activation of sodium channels in renal tubular epithelial cells, leading to the outward flow of potassium ions, repeated absorption of sodium ions, and excessive potassium ion excretion in the distal renal tubules, resulting in increased urinary potassium, decreased blood potassium, and increased blood sodium."

"However, we also need to check if it’s a result of thyroid dysfunction. Once thyroid dysfunction is ruled out, I’d bet on it being this disease with some confidence."

"Clap clap clap..."

Liu Banxia led the applause.

"Oh dear, I just read about it from literature, it’s not something I came up with myself, I’ve never heard of this disease before, it really is a rare disease," Xu Yino said with some embarrassment.

"I just mentioned, regardless of the reason or method, as long as you can diagnose, it’s commendable. I’ll reward you with half a pig’s trotter at noon," Liu Banxia said.

"Although you’ve found some materials, your extended knowledge on this disease isn’t very clear. It’s quite dangerous and can easily lead to sudden death in people."

"In the past, many patients with this condition may have died suddenly without a diagnosis, but the diagnosis rate has increased in recent years, which should get our attention."

"So in the future, when we encounter patients with hypokalemia accompanied by hypertension, we need to consider this possibility. This disease is actually easy to misdiagnose."

"Because after we supplement potassium for the patient, there will be some improvement. But if we don’t address the high sodium, it’s as if we’ve solved nothing, only relieved the symptoms."

"Later, administer a sodium channel blocker like Amiloride to this patient, as her thyroid ultrasound is negative with a low likelihood of issues."

"Understood,"

Xu Yino quickly responded.

Although not entirely diagnosed, symptomatic treatment is possible.

According to yesterday’s references, this disease is untreatable; it can only be managed by continuously monitoring electrolyte levels with timely medication adjustments.

"We already have a direction for this patient, so let’s not discuss it further. Once the test results are out, we can continue the discussion," Liu Banxia continued.

"Let’s discuss the pregnant patient. What’s her condition? And what’s her husband’s situation? Her husband’s symptoms developed slower but became more severe."

"Teacher Liu, the blood culture hasn’t returned positive yet," Liu Yiqing said.

"This is crucial information, mark it," Liu Banxia said seriously.

"Teacher Liu, that’s unfair," Liu Yiqing said, frustrated.

"Exactly. Our routine virus screening ran all night with no positive results, indicating either there’s nothing, and it’s just a cold, or the virus is unique," Liu Banxia said.

"Given the current situation, we can only explore. Observe the pregnant patient closely, especially for convulsive reactions; protective measures must be ready if it occurs again."

"As for her husband, we should also keep an eye on him and provide symptomatic treatment. I’ve arranged for someone to come for specialized testing soon."

With that, Liu Banxia turned to leave.

But the team wasn’t ready to let him go. Xu Yino quickly blocked the door, spreading her arms wide.

"What’s this? Blocking my way with ICU, IP, IQ cards? Leave me a passcode?" Liu Banxia teased.

"Teacher Liu, be serious, we’re diagnosing the patient’s condition. Do you have a hypothesis?" Xu Yino asked.

"Why do you say that?" Liu Banxia asked.

"You mentioned arranging specialized testing," Xu Yino said.

"That’s just my perspective, the actual situation might not be exactly that," Liu Banxia said.

"Still, you need to tell us what it might be," Xu Yino said.

The others were equally persistent; they couldn’t just let him off the hook.

"So, you all were somewhat negligent. Now I ask you, if we want to diagnose these two patients, what clue do we have?" Liu Banxia asked.

"Uh... it would be the travel history of the patient’s husband, right? He went to India, and it’s very likely he contracted the virus there. The sanitary conditions there are much worse compared to our country," Liu Yiqing said.

"Then what?" Liu Banxia continued to ask.

Liu Yiqing blinked. Then what next?

The others were also a bit confused, not knowing what ought to come next.

After a moment of thought, Xu Yino took out her phone and started searching.

In less than three minutes, her face fell, and she showed her phone to her companions.

"Better late than never. I’ll head downstairs first. You should also get ready to see the patients," Liu Banxia said, leaving with his hands behind his back.

"This person... this person is too infuriating," Liu Yiqing muttered.

"What can we do? Although we knew to consider the patient’s travel history, we didn’t think to check what kind of epidemic diseases might have recently occurred there," Xu Yino said with a wry smile.

"When you go downstairs, ask the patient’s husband if he ever lived in Rajasthan. That place recently had a Zika virus outbreak."

Liu Yiqing wrinkled her nose, "But I already asked the patient, and he hasn’t been bitten by any mosquitoes. Even if he went, it shouldn’t matter, right?"

"Silly girl, this disease is not only transmitted through mosquito bites; it can also be spread through sexual contact," Xu Yino said.

"Did you forget about our sleeping sickness patient? Oh... how could I be so stupid? Last time with the valley fever patient, I only made the connection after researching the news there. This time, why didn’t I think of it?"

"It’s not just you; we described it in the group chat too, but only the low-potassium patient had a possible diagnosis. As for the other two patients, we still have nothing."

"If it really is this virus, it would become very troublesome," Su Wenhao said.

"Isn’t it not a big deal? The transmission routes of this disease are limited, and severe symptoms are rare. Symptomatic treatment should be enough," Xu Yino said.

"It doesn’t affect adults much, but it has great implications for pregnant women. The information indicates that after infection with this virus, the fetus might develop microcephaly."

Upon hearing Su Wenhao’s words, everyone fell silent, and the atmosphere became somewhat heavy.

Although current research hasn’t established a definitive causal relationship, past data shows pregnant women infected with the Zika virus have a high probability of their fetuses developing microcephaly.

And this patient cares a lot about the baby. If it truly is an infection, should they keep the baby or not?

"Let’s not dwell on it; let’s first ask the patient about his travel whereabouts. Didn’t Teacher Liu also say that examinations are necessary?" Miao Rui said.

"From this patient’s situation, the travel history is indeed very important. But why didn’t we think to look into it more thoroughly, instead of just guessing what diseases might be possible there?"

"So we’re still quite far from the big boss. Despite us being so many, we can’t compare to him alone. It’s indeed a bit frustrating," Xu Yino said.

"What can we do? We need to continue working hard," Li Hao said.

Speaking about this matter, it indeed was somewhat discouraging.

Just a little bit more, and we could have matched the big boss’s speed. Even a small victory would have been something, so why did we overlook it?

We clearly knew the importance of travel history, but didn’t know to delve deeper into it.

For them, this incident was indeed a minor setback.

After all, unlike checking indicators combined with other symptoms to aid diagnosis, no deep medical knowledge was required.

Yet still falling behind the big boss, even missing such a good opportunity.

Honestly, Xu Yino now feels the reward of pig trotters at noon doesn’t seem so appetizing anymore. She would rather have discovered it herself and then reward the big boss with pig trotters.

"Let’s strive harder in the future. Our minds need to be more meticulous," Xu Yino said.

"In fact, I remind myself every day, yet I’m still careless. We don’t know if it really is the Zika virus, but if it is, it’s truly worrying," Huang Bo said.

"There’s nothing we can do about it; illnesses truly don’t pick their patients. If you’re not careful, it’ll find you," Liu Yiqing said.

Bringing this up, everyone’s mood turned somewhat somber. After all, this involved an unborn baby.

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