The Enhanced Doctor

Chapter 1290: Chapter 1290: Trouble Caused by Habit

"Teacher Liu, the blood test results are out. Blood sugar and sodium are a bit low, calcium is somewhat high, other items are normal."

Xu Yino ran over, breathless, holding the freshly issued blood test report.

"This is a bit troublesome. The lack of energy might be caused by low blood sugar, right? The low sodium could be due to poor diet caused by low blood sugar?" Liu Banxia said.

Chen Hongyang and Wang Huan also frowned.

"But what about the high blood calcium? Although the elevated value isn’t much, it is high. Is there an issue with the parathyroid gland? Hyperfunction?" Liu Banxia continued.

He directly gave the judgment because he had dealt with a patient with elevated calcium levels before. That patient had a problem with the parathyroid gland, unable to metabolize calcium normally in the body.

"It’s somewhat reliable. Should we check the parathyroid gland? Ultrasound or CT?" Wang Huan asked.

"Ultrasound, push the mobile ultrasound over, let’s examine the child directly by the examination bed," Chen Hongyang said.

"I think it’s doable. Also, we should consider the twitching symptoms. Initially, I thought maybe it was due to low blood calcium causing muscle cramps, now it seems it’s not the case," Chen Xuehai also spoke up.

"Yes, that’s a problem. Do you still think there might be some issues in the brain affecting the endocrine system?" Chen Hongyang asked.

Chen Xuehai nodded, "If it’s a coma induced by low blood sugar, there shouldn’t be such severe twitching, right? Should we do a head CT?"

"Yes, that’s possible. Anyway, CT is non-invasive. We’ll first use ultrasound to check the parathyroid and then do a CT," Liu Banxia said.

They reached consensus again and called everyone over to push the mobile ultrasound for the examination.

After listening for a while, Xu Yino hurriedly ran back to inform everyone of the latest situation.

"That’s the situation. The big bosses have chosen these two directions. The parathyroid gland and organic changes in the head affecting the endocrine system. What are your thoughts?" Xu Yino asked.

"Do you think there’s a possibility of encephalitis or meningitis?" Su Wenhao asked.

"There isn’t a high fever reaction, but twitching symptoms may only be caused by so many reasons, right? Or some parasites?"

"Well... the big bosses plan to keep the examination conservative for the child," Xu Yino said.

"If we head in this direction, we’ll have to do a lumbar puncture for the child. It’s an invasive examination. If nothing is found, the child’s parents might become very anxious."

"So, let’s wait for the results. Low blood sugar, low blood sodium, high blood calcium, the difference in values isn’t very large, it’s somewhat unclear," Liu Yiqing said.

"What about you guys? Any thoughts?" Xu Yino asked Huang Bo and others.

The group shook their heads in unison.

These are the possibilities, and the big bosses also considered some intracranial problems. Currently, there’s no new idea.

"Alright, I’ll go and gather more information," Xu Yino said and ran to the treatment room.

At this time, Liu Banxia and the others were also seriously conducting the ultrasound.

Even though heart ultrasound requires calling someone from above to help observe, this ultrasound doesn’t need that. If none of the four of them find anything, calling the ultrasound doctor wouldn’t make a difference.

"A bit tricky, we’ve done it twice, right? Dr. Chen, you do it once, and Brother Wang does it once more, to avoid missing anything," Liu Banxia said.

"It’s pretty tough. I was also meticulous earlier, scanning very slowly," Chen Hongyang said with a bitter smile as he took the probe.

Although he didn’t hold any expectation, he still meticulously examined again.

After his examination, Wang Huan went on stage next.

The results were the same; no abnormalities were found.

"For caution, let’s also do a CT here," Liu Banxia said.

"Sounds good, maybe it’s too small and wasn’t scanned," Chen Xuehai nodded.

"Xu Yino, take someone to push the child for examination. Just say it’s my instruction, expedite, head and parathyroid CT," Liu Banxia said.

"Alright, pushing right over," Xu Yino replied quickly.

This will provide first-hand information, perhaps helping in their competition with the big bosses.

"She seemed to have run off earlier, when did she return?" Wang Huan asked.

"Who knows, she’s always curious about the conditions we’re consulting on," Liu Banxia casually replied.

"Since the parathyroid gland is fine, the remaining issue might be intracranial conditions? Hypothetically, I mean hypothetically, if CT also shows nothing, what examination should we do next?"

"Not much left, right? Except for lumbar puncture to check cerebrospinal fluid, and broad tumor marker screening. For the child’s parents, these two exams would be stressful," Wang Huan said.

"Indeed, the stress for them is from this," Chen Hongyang said.

"Sigh... I don’t even know if something went wrong during my consultation." Liu Banxia said helplessly.

"But it was just a routine consultation, and it was only a superficial second-degree burn, not that serious. To minimize the child’s fright, I even used etomidate."

"Dr. Chen, a 5 mg dose isn’t a lot for this child, right? It’s unlikely to be a drug reaction from the etomidate."

Chen Hongyang nodded, "5 mg isn’t much, and if it were a drug sensitivity reaction, it wouldn’t be so stable now."

"It shouldn’t have anything to do with the child’s burns either. I’m still a bit worried; I’ll go follow up in the CT room." Liu Banxia said.

The other three had no other plans, so they decided to go together.

Arriving at the CT room, the young patient was still waiting.

Even if it’s urgent, they have to wait for the previous patient to finish before going in.

"Doctor, is it really a disease in the brain?" the child’s father asked.

"We can’t say for sure yet, but there are no issues with his thyroid or parathyroid glands. Our current inclination is that there’s a problem with the endocrine system, which is why we decided to perform a head CT." Liu Banxia explained patiently.

"Doctor, please take care of our child and find out what’s wrong. How did he suddenly become unwell with such low blood pressure?" the child’s mother said.

Faced with the anxious parents, Liu Banxia didn’t know how to console them. He walked to the diagnostic bed and looked at the young patient lying down.

"Hmm?"

After a couple of glances, Liu Banxia involuntarily made a sound.

Although it wasn’t loud, Xu Yino next to him caught it clearly.

"What’s up?" Chen Xuehai, also standing nearby, asked.

"Hold on, let me check the child’s body surface first." Liu Banxia said, with a hint of tension in his voice.

He leaned over and removed the sock from the child’s uninjured foot. The skin on the child’s foot was somewhat dark and had a few small white spots mixed in.

Not only did he notice it, but Chen Xuehai and the others did as well.

After this discovery, the other three came over to help Liu Banxia with the examination.

Wang Huan checked the waistband of the child’s pants, Chen Hongyang examined the child’s mouth carefully, and Chen Xuehai grabbed the child’s hand and inspected it closely.

Xu Yino felt a bit frustrated because this situation indicated that the "Demon King" team had already made a very valuable discovery.

But her small team was still in the dark.

"Sigh... Can we make a diagnosis now? What medication should be used?"

After completing the examination, Liu Banxia sighed.

"100 mg hydrocortisone, it’s likely adrenal insufficiency." Wang Huan stated.

"Later, we’ll do blood tests for plasma cortisol, plasma ACTH, and aldosterone, and add a urine aldosterone test to be thorough."

"Xu Yino, no need for the CT; take him back for medication first." Liu Banxia said.

Even though she was still somewhat confused, with Liu Banxia’s medical advice, Xu Yino had to rush to execute it.

"Doctor, was a diagnosis made?" the child’s father asked, somewhat conflicted.

He wanted to follow his child but also wanted to consult with Liu Banxia to understand.

"Almost, the child is likely experiencing an acute adrenal crisis phase. He already has adrenal insufficiency, which explains the lethargy, low blood pressure, low blood sugar, and low blood sodium symptoms." Liu Banxia explained.

"Typically, his condition would progress slowly; that is, his adrenal function issue would deteriorate gradually."

"But the sedative etomidate I administered today has a side effect, which can amplify the adrenal insufficiency, causing the crisis symptoms."

"Although there is no confirmed diagnosis yet, we shouldn’t be far off. We supplemented with hydrocortisone as a hormone replacement, and by expanding the volume and raising blood sugar levels, there should be no issue."

"Additionally, the child now needs to be admitted to the hospital, and this situation requires adjustment for two to three days. Once the child is stable, we’ll proceed with further examinations to identify the exact cause."

The child’s father didn’t fully understand, but he was sure that there was a direction for his son’s condition.

His mood became more relaxed; a diagnosis meant that treatment was possible.

"This is all my habitual fault; I’m used to using etomidate. If I had used ketamine, the child wouldn’t have been at such risk." After the child’s father left, Liu Banxia said.

"I think using it was good. Had the crisis gone unrecognized and not corrected in time, what would have happened if it occurred at home?" Chen Hongyang countered.

Although the reasoning was valid, Liu Banxia’s guilt didn’t lessen in the slightest.

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