I’ve seen a lot of couples.
But one of them is deep in my memory.
Patient Ms. Rowe, senior manager of a company department, 40 years old, should have lived happily ever after, but has changed over time.
On that day, the family brought Ms. Rowe to the emergency, where she was in a state of emergency, and was still in a stable condition.
Upon enquiry, I learned that Ms. Rowe’s experience had been very hard.
Here’s the thing.
The previous morning, Ms. Rowe had suddenly told her husband that she had been followed.
The husband is angry and afraid when he hears his wife being followed.
Being followed in broad daylight is certainly not a good thing.
What if someone tries to kill his wife?
The next part of his wife’s story is more confusing and suspicious.
She said, you know how I knew that someone was following me, because I had super powers, and I heard someone whispering to me in a thousand miles, saying someone was peeking at me on the corner…
His wife’s words have made him very worried and a little scared.
Superpower? What’s this all about?
Is this still the wife she knows?
I thought it was over. I didn’t think two days later, my wife told him the same thing again.
And other colleagues in the company contacted him quietly to tell him that his wife’s behaviour in the company over the past few days was strange and confusing.
For example, when you speak to walls for no reason or reason, there is one person who laughs and panics.
My husband’s got a big head. Shit, this is a problem.
He stopped working and drove his wife to a nearby hospital to see what happened to her.
The doctor who visited briefly asked about the situation and learned that patients were delusional and hallucinating, and soon introduced them to the psychiatric clinic.
As soon as the psychiatrist looked at it, she said that Ms. Rowe had a vision, analysed it carefully, had a skull CT, diagnosed schizophrenia.
It’s like a thunderbolt for a couple.
How come there’s schizophrenia all of a sudden?
Ms. Rowe ‘ s husband was incomprehensible and, although helpless, had to accept reality.
Doctors say there may be some connection to genetics, genetics, stress at work, etc.
The overall reasons are unknown.
In order to eliminate the mutated pathologies of the skull, such as the brain tumor, the doctor recommended that the skull MRI continue to be developed, with the result that Ms. Rowe had no head tumor.
So, schizophrenia is original.
The so-called original hair, i.e. the cause of the disease is unknown, or at least the specific disease that explains the symptoms is not found for the time being, is treated as it is.
The doctor gave Ms. Rowe an anti-psychiatric drug, which worked well.
After Ms. Rowe had taken her medication, there had been much less eccentric behaviour than to say that she had superpowers, that she would not speak to the walls, let alone be followed.
But after taking her medication, Ms. Rowe’s mental condition was a little weak, and she was asleep all day, feeling bored.
Stop talking about work, even ordinary family life is incompetent and incapable of spirituality.
This is a disaster.
The husband broke his heart.
Several hospitals and specialized psychiatric hospitals have run around, all of which consider the wife to be schizophrenic and provide some medication.
When the doctor said the disease could not be cured, the husband’s mood was not so bad.
Couples of years have suddenly changed so badly.
But he was also prepared to share his wife’s suffering.
Just the night before her departure for Beijing, Ms. Rowe ‘ s condition had suddenly increased.
She’s at home crying and laughing, talking nonsense and even the tendency to self-harm.
That scared her husband.
He quickly called 120 to the emergency.
That was the first time I saw this patient.
My first impression of the patient is a crazy woman.
Her hair is messy, her face is cold, her eyes are numb.
I’ve had any emergency, but I’ve had my first schizophrenia.
I didn’t have much experience in dealing with this disease at the time, and I was whispering.
The treatment of such patients in the middle of the night is a headache.
But as soon as I see the red eyes of the patient’s husband, everything fades away.
I also know that the worst of all is not me, but the husband of the deceased patient.
He has fully and clearly endured what happened before him, and he has told me what happened before.
I greeted the nurses, sent the patients to the rescue room, routinely connected to EKC, tied cuffs, measured blood pressure…
I didn’t expect the patient to be safe and quiet.
I thought she would have taken up the roof of the emergency department, and had the nurse have prepared a tranquilizer, a fluorine needle, etc., and had to inject them directly into the veins at all times to calm down quickly.
The patient ‘ s husband said that the patient had a sudden increase in his condition, that he was very angry at home and that it would be better to come to the hospital.
After reading the medical records he gave me, hearing about all the symptoms before the patient, together with what I had seen, including the skull image film brought by my family, and the diagnosis of schizophrenia by the patient, should be a minor problem.
But I’ve been a little worried, and I can’t say anything for a while, and I think it’s probably not that simple.
Of course, a schizophrenia alone is enough for me. It’s not easy, but I think she might be a little more complicated, maybe intuitive.
Maybe it’s not intuition, it’s vigilance.
The emergency doctor died hundreds of times without a little vigilance instinct.
Schizophrenia is not fatal, but if it is caused by problems with other organs, it can be in minutes.
Hepatic cerebral disease, urinary-toxic cerebral disease, etc.
I also shared these concerns with the patient’s husband.
Anyway, get into the rescue room and get an E.C.I.
Then I asked Dr. Phoe to get a neurologist to see it. It was supposed to be a psychiatrist, but at night the psychiatrist was off duty, only neurologists were involved, and it was not a bad thing to find someone else.
Blood pressure measurements, 210/100 mmHg.
Oh, no, no, no, no, no, no, no, no.
That’s my concern again.
Patients have no history of hypertension, but blood pressure at this high must be abnormal.
If the patient’s agitated now, this hypertensive blood pressure can be explained by stress and anxiety.
But now the patient is relatively quiet, so the blood pressure is abnormal.
And the patient looks fat, he has a big face, he’s the kind of guy who can get three heights, and he can’t take it lightly.
I am particularly worried about brain hemorrhages, brain infarction and other brain-vascular accidents, and I have looked at the muscle strength of the patient ‘ s limbs, his muscle tension, etc., but not so much, but I think that the muscle strength of the patient is too small to shake her hand.
Probably hungry. The patient ‘ s husband told me that his wife had not eaten much in the last few days.
I’m sorry.
Naturally, my family will not know, and at this point my brain is moving rapidly, thinking about possibilities.
The most frequent cases of mental disorders in our emergency care are urea, liver, pulmonary brain diseases, which must be taken as soon as possible, with a liver function, kidney function and blood and gas analysis.
Also, the skull C.T. is necessary because of the increased condition, the high blood pressure, the lower muscles of the limbs, the more reassuring to be a skull.
I said to the patient’s husband, “Well, it’s a little more reassuring at this point, even though it’s done before. I’m sorry.
The patient’s husband didn’t hesitate to say everything to me.
Well, that’s what I like about family, co-operation, time-saving, no mess.
Shortly after, the nurse measured the patient ‘ s body temperature and said he had a fever, which he received.
That’s strange. The fever, in most cases, means infection. Where is it?
The most common cases are respiratory infections, so I gave the patient a double lung.
The left lung seems to be a little wet, as we have said before, and the presence of a wet voice means that there’s liquid seeping in the bronchial, and the sound that comes from scratching bubbles when the air comes in and out of the pipe is wet.
I looked at the patient’s breath, a little rush.
“Does the patient cough or cough these days? I asked her husband.
“None. He denied that he had been with the patient for days and had never seen cough or cough.
It’s just a bad appetite, not much to eat.
“It cannot be ruled out that the patient suffers from lung infections, pneumonia, which can lead to fever, hysteria in the lungs and respiratory aversion. Even pneumonia can induce or exacerbate mental symptoms. I told him.
In fact, I’m not very good at mental illness, but it is assumed that if there is an acute infectious disease, such as a lung infection, there is a real risk that the patient will exacerbate the already existing disease, schizophrenia.
“The skull, the chest, the CT did it together. I said:
“Okay. The family is happy.
Before doing CT, I ordered the nurse to take blood, perform routine tests and then push the patient to the CT room.
We still have sedatives on the way, and if the patient gets upset or doesn’t cooperate, I’ll give her a shot.
CT’s done, everything’s fine.
You can see it on the spot, with no head problems, no bleeding, no tumors.
It is true that there are some problems with the lungs and some inflammation with the left lung, which may explain the problems of the patient ‘ s fever, wet lingo and respiratory bias.
“The patient has pneumonia. I told my family.
But it’s not serious.
What I didn’t realize was that the patient had just returned to the rescue room and suddenly had a convulsion, which scared me.
Patients suddenly close their teeth, convulsions on their hands, and their faces panic, as if they saw something terrible.
In the middle of the night, if this happens at home, it may scare the patient ‘ s family enough.
I calmed down very quickly, and my head was just about to get the nurse to stop the convulsions and the patient stopped smoking for less than five seconds.
It’s really a rush to stop.
As a result, the patient became weaker.
Lying in a rescue bed, breathing up and down, breathing out.
Fortunately, the vital signs are still stable, and I’m relieved.
The neurologist came, looked at the skull, gave the patient a simple neuropsychological examination, thought it was not a brain hemorrhage or a brain infarction, but could do a skull MRI.
Because MRI and C.T. are different, and M.I. can see things that C.T. can’t see, like, an acute brain infarction period or a tiny tumour stove.
“But she had a skull MRI the other day, and there was no problem. The patient’s family interrogates.
The neurologists hesitated and said, “There’s no problem with this, not now. I’m sorry.
Yes, as I just told my family, this time of year.
For safety reasons, it would be better to do an MRI, to remove brain infarction or other nervous system problems.
Since there is no neurological specialty for the time being, the patient is in the emergency section for the time being, and the psychiatrist will see it tomorrow.
At that point, Dr. Fupé reported that the patient’s blood had been extracted, and that the other thing was that potassium was particularly low, with only 1.8mmol/L (normal 3.5-5.5).
And that’s, as I expected, 1.8 is very, very low potassium blood.
“Why? I asked Dr. Frédéré.
“Perhaps it’s because of the poor appetite and the low food. Dr. Pepe replied, “The rules are correct.”
This is also the most obvious reason that can be found at this point, after all, the family says that the patient has not eaten anything in the last few days.
Dr. Frieder’s analysis is correct, at least for the moment, and we’ve got some potassium chloride for the patient.
We need to get the potassium blood back to safe levels as soon as possible. 1.8mmol/L is too dangerous, and there is a real possibility that the patient’s heart rate will stop.
To understand that potassium ion and sodium ion are key ions for the functioning of the heart cell, and that they can affect heart electrical activity and can cause cardiac disorders.
“Several potassium haemorrhagic conditions can lead to a cardiac arrest, with one news story in the previous months, one patient dying the night after the surgery and an autopsy finding the patient to be severely potassium haemorrhagic. I’m sorry.
I told Dr. Frépé. Those are the lessons of blood.
In addition, the convulsion of the patient may also be related to low potassium blood.
“The patient has not done an EKG since he entered the room, and must do one. I told Dr. Frepe.
This low blood potassium, look at the EKG. Dr. Friede can also take this opportunity to see the characteristics of the EKG for persons with low potassium blood.
Dr. Frieder is excited, and he’s farting off the EKG.
When a patient is connected to an electrodes, it is necessary to lift up the patient ‘ s crotch, which brings my heart into it.
When the patient’s legs were lifted, Dr. Phube wrinkled his head, tried to say something, but then he stopped and looked at me.
I’m here to watch and see it all.
I smiled and said to Dr. Fupé, “The patient’s leg is a good match for a surgeon. I’m sorry.
I’m down on the sound, and it’s probably just us. It’s the patient’s privacy.
Dr. Pepe smiled. The patient was a woman, and it’s confusing to have hair so long.
It’s not really long, it’s probably a little smaller than the average man, but shouldn’t a woman’s calves be smooth?
But soon I couldn’t laugh, and I thought of a terrible thing.
Dr. Frépé saw me with a serious look and thought he was wrong about the electrocardiogram.
But repeatedly, yes, that’s how it’s connected.
“It’s not about EKG,” I said to him, “Look at the patient’s face, like what? I’m sorry.
“The patient’s face is full, ducky face. Dr. Pepe also answered my questions honestly.
I’d really like to strangle him.
“That’s not what I’m asking. I’m saying that face, clinically, you can think of something. I’m about to pee.
Dr. Pepe couldn’t touch his head, didn’t know what I wanted to ask and smiled at me.
I looked at him for nothing. “Do you think there’s any doubt that the patient’s face is so round that he’s fat and has long legs? I’m sorry.
Dr. Freiper went out of his mind and suddenly came up with the phrase, “The full moon face.” I’m sorry.
Full Moon Face is a medical professional term. It means that some patients have turned their faces round, like a round moon, so they call them full moon faces.
Full moon faces are usually found in patients with long-term sugar cortex hormones, a very critical hormone that is essential for maintaining normal functioning of the human body.
However, excessive need, such as treatment for diseases such as asthma, lupus and slow-retarded lungs, can cause problems with the whole body protein and fat ratio.
People get fat and feel like buffalo.
But the limbs become relatively small, and the face becomes round, which is the full moon face.
I think it’s a good idea that Dr. Frépé could introduce the concept of full moon face.
Because I thought so myself.
For the time being, it is impossible to determine whether the patient is obese or has a full moon face.
“This full moon face has anything to do with the patient’s condition? The blogger says:
“It’s big, big. “What kind of disease is the most common in a full moon face?” I’m sorry.
“Kuthin Syndrome. Dr. Frédéré said:
The problem was difficult because it was a priority, whether it was a medical practitioner or a study.
But it was a test, and he had not actually seen a full moon face in clinical terms, much less the Kuchin syndrome.
What’s the Kuchin syndrome?
There’s a gland on top of our kidneys called adrenal.
Two light yellows are adrenaline.
The adrenal gland is an endocrine gas organ capable of excreting many and many very critical hormones, one of which is called sugary cortex hormones.
Certain pathologies cause a series of clinical symptoms, including full moon faces, buffalo backs, high blood sugar, low potassium blood, obesity, high blood pressure, etc., when the adrenal gland is overstretched.
To put it white, the Cuchin syndrome is a clinical syndrome caused by excessive adrenal glucose hormones.
“If the patient is really a Kuchin syndrome, then it’s possible to explain the patient’s low potassium haemorrhage. I told Dr. Frepe.
Such low levels of potassium blood are not only due to bad appetite, but may also be due to adrenal cortex problems.
The adrenal cortex circulates a lot of hormones, some of which can lead to low potassium blood.
“As the teacher says, the patient’s blood pressure can also be explained? Dr. Pepe’s brain is also spinning.
“Yes, but it’s not the scariest thing, it’s the scariest thing…” I sold a key, looked at Dr. Frepe and waited for him to answer.
Dr. Pepe did not disappoint me, but answered the question and said, “The worst part is that the mental symptoms of the patient may have been caused by the Kuchin syndrome.” I’m sorry.
Yeah, that’s what worries me the most.
It is also a very bold assumption.
The patient has been diagnosed with schizophrenia in several hospitals, and I am an emergency doctor who suddenly has other ideas, which must be described as a very bold assumption.
If the patient is really a Kuchin syndrome, then there is a mass of sugary cortex hormones, which in the brain are fully psychotic, some are depression, some are manic and some are schizophrenic.
I have seen one case of this type of patient, who was treated for schizophrenia until finally diagnosed, suffering from suffering and suffering from prosecution.
My brain is moving rapidly, with mental symptoms, full moon face, long legs, high blood pressure, low potassium haematosis, obesity (buff’s back) and a lot of acne in my body.
The more I get excited, the more I think about it, the more I think about it, the more I think about it. Unfortunately, I didn’t see it right at first.
The previous psychiatrists are also believed to be missing.
I went out and asked my family if the patient had long-term oral sugar-coated hormones, whether the patient had diseases such as asthma, lupus, slow lung and kidney inflammation, and whether there was long-term oral.
My family’s been asked, and I’ve been told, “Didn’t you say that my wife was in good health? I’m sorry.
I realized that I was out of my mind, and I slightly adjusted my mind.
Yes, the more common reason for the patient if he is a Cuchin syndrome is oral hormonal, but it is not the drug that is most common, but the patient itself has problems, such as tumours in the adrenal gland of the patient and the tumour cell madness of glucose hormonal hormonal hormones, which causes the Cuhin syndrome.
There may also be a problem with the patient ‘ s acoustic structure, which is a neuropsychological structure of the brain, and which is capable of excreting a lot of hormones, among which is a hormone called adrenal cortex hormone, which is an adrenal adrenal function that promotes adrenal gland glucose hormones.
This adrenal cortex hormone increases if the patient has a pituitary tumour and naturally stimulates the adrenal gland more, leading to an increase in sugar cortex hormonal tumours, leading to the Coutin syndrome.
The red dot is the pituitary. It’s only a little bit, but it’s huge.
I think I’m going to take you around.
Just one simple example.
The human brain has a structure called the pituitary, which is able to act on the adrenal gland.
If we compare the adrenaline to an employee, the protege is the leader.
Leadership is able to control staff, as is the adrenaline control, which is the upper part of the adrenal gland.
Now the employee did something bad, either by himself (on the adrenal gland tumour) or by the head.
What did the employee do? It’s just a hit and bust!
I’m such a metaphor. Dr. Frédée immediately understood.
The family also seems to understand nodes.
“How do you identify the patient as Kuchin syndrome?” Dr. Freud asked.
It’s very simple, it’s the level of the hormone in the blood of a blood sample, and it’s the level of a 24-hour urine hormonal metabolite.
If both levels are high, this means that the patient has a large amount of sugary cortex hormone in his blood, which basically can be assumed to be the result of an excessive adrenal gland, because it is the only one (the adrenal gland) that can be distributed.
Once again, I communicated with my family, informing them that there was a risk of mental disorders, not necessarily schizophrenia, caused by endocrine diseases.
It’s not until the endocrinologists and psychiatrists see it tomorrow.
Listen to me, the patient’s family almost cried.
The diagnosis of schizophrenia is beyond the reach of ordinary people.
The pathology of their lives has changed completely for this disease.
But I’m not sure, and I’m just guessing that there’s no conclusive evidence of the symptoms of the patient.
Although I can tell the truth, everything depends on auxiliary tests, and if I say it wrong, it’s a little out of order.
So I went on to explain, “My analysis is just a possibility, not necessarily accurate. I’m sorry.
I also do not want him to have too much hope, otherwise disappointment will be greater.
Fortunately, the patient spent the night safe.
The next morning, at 8 a.m., I had the nurse extract the patient’s blood cortisol (a hormone from adrenal gland) and chose 8 a.m. because it was a peak at that time.
After the blood was pumped, contact was made with the Endocrinology Section, and when the Endocrinologist came, he felt like the Kuchin syndrome and received further treatment from the Endocrinology.
After going to the endocrinology, the patient’s mind is much better.
Endocrinologists have found more meaningful signs, such as the discovery of patients with low skin, which is also an expression of the Kuchin syndrome.
Endocrinologists have improved a number of examinations, mainly on hormones.
The result is that the cortisol in the patient’s blood has really increased, and the cortisol metabolites have increased significantly in 24 hours of urine, which suggests that the patient’s adrenal glands are really problematic.
The amount of these hormones in the patient ‘ s blood is excessive, and they can cause mental disorders.
It can now be made clear that the employees did bad things.
Was it an employee who did a bad thing on his own or a bad thing on his head?
The endocrinologists believe that the latter is highly probable, because the adrenal cortex hormone (ACTH) is also elevated in the blood. The hormone is adrenaline and is known by name to be used to stimulate adrenal genre hormones, which is evidence of the leadership that instigates employees to do bad things.
Why do we have to separate them?
This relates to those responsible and to the means of treatment.
In the case of an employee ‘ s own bad behaviour (the adrenal gland itself with tumours and tumour cells with excessive hormones), the cure is to remove the tumor.
And if it was the leadership who instigated the work of the employees (the protege with the tumor, the excessive hormonal hormonal stimulation of the adrenal genre), then the treatment should be to remove the leader, to cut off the tumour from the skull, rather than to punish the average worker, the so-called captors first.
The endocrinologists again placed the brain with the patient, MRI, in an attempt to see more clearly.
There’s no reason why a patient should have a prognosis, otherwise ACTH wouldn’t be this high.
However, several video doctors have repeatedly looked at the film, and the patient is really free of tumours, and the pituitary is really free of tumours, not at all.
That’s weird.
How come the logic is so good that it doesn’t support it?
It was discovered that employees had been instigated to do bad things, but the investigation now found that the leaders were innocent, innocent and innocent.
What’s going on?
“Don’t forget, we have a second-in-command. The blogger says: “Perhaps it was the vice head who instigated the employees? I’m sorry.
That’s a possibility, though it’s a small one.
Of course, we know that pituitary tumours are the most common perpetrators of the Kuchin syndrome, but there are some rare cases of tumours in other parts of the body.
These tumours can also be transmitted to ACTH, which can also act on the adrenal gland, leading to an excessive adrenal hormonal effect, causing cuchin syndrome.
We call it an alien acth syndrome, so called an alien, which means it’s not perpendicular.
“The killer is not a leader, but a deputy leader. The metaphor is more appropriate. “The doctor at the senior level says, “Hey, hey, hey.
“Let’s make a chest CT, maybe this is the albino tumor in the lungs. I’m not sure what I’m talking about.
“Pneumonia was seen in earlier films. The young doctor is confused.
“Don’t worry, when the pneumonia is under control, we’ll review the chest CT, and maybe the tumor will surface. I’m sorry.
“You know, the vast majority of albino acth syndrome comes from lung tumors. Many early lung tumours are covered by pneumonia. We have to be confident. “The senior physician is full of confidence.”
As a matter of fact, after five days of anti-infection treatment, a review of chest enhancement CT saw a significant reduction in left pneumonia, whereas the original location could be found in several knots.
Maybe these knots are tumours in the lungs.
Everyone agrees.
But whether it’s a tumor or a common inflammation no one dares to draw conclusions until they get the pathology tissue.
“Then take the pathology. I am not sure what I’m talking about.
Just a few knots are closer to the chest, and CT-led pulmonary punctures are able to extract a small percentage of the tissue for pathology.
On that day, the patient ‘ s family signed the consent letter. Push to the CT room, do a pulmonary biopsy.
The process of waiting for pathological results is painful.
The superior physician said he wasn’t afraid. It was probably a tumor. It was definitely a tumor.
It’s coming out. It’s really tumor, lung cancer.
The news is both happy and frightened for patients and their families.
It is gratifying to note that patients do not really appear to be schizophrenic, but rather tumour-celled hormones that stimulate the adrenal gland, which produces excessive sugary cortex hormones, and the mental symptoms of the brain and the Coutine syndrome.
As long as it’s not schizophrenia, it’s clear.
But fear is that the patient is diagnosed with lung cancer.
Lung cancer is not good either.
Breast surgeons were invited to assess lung cancer, as there was a relatively large number of tumour cookers and it appeared that there had been a shift, and later a tumour surgeon.
As you can see, you have performed surgery to remove part of the lung of the tumor, and you have also done lymphomy cleaning. A genetic test was also performed and a target drug was prepared.
God finally pitys Ms. Rowe.
The surgery went well.
After the operation, there is a corresponding target-oriented drug.
Although lung cancer is diagnosed, lung cancer does not always mean terminal illness, does not mean certain death, is actively treated and many cases are treated well.
“At least it’s better than schizophrenia. The patient’s husband says:
Post-operative review of the relevant hormone levels has dramatically decreased to normal levels.
Many people can’t believe it, but that’s what happened. Life is sometimes better than television.
Upon discharge, the patient’s mental state returned to normal and there was no more schizophrenia.
In fact, the patient had symptoms a few years ago, but he didn’t care.
This is also a neurotic person whose full moon face and buffalo back take time to do so in months to a year.
People are supposed to be fat, their faces are round and ugly, and normal people should go to the hospital, but they’re not. They think it’s middle-aged.
The couple are still talking about finding the former psychiatrists, asking them for some fruit, and then thinking about it. It’s not easy for them to survive.
Classroom:
What does schizophrenia diagnosis need to be noticed?
The diagnosis of schizophrenia must begin with the elimination of a body disease, with additional examinations, without fear of being examined, and with the co-operation of the patient.
The purpose of the examination was to remove the mental disorder caused by the body disease, which, like the patient, was eventually found to be the result of an endocrine anomaly caused by lung cancer.
What about lung cancer?
If it was early lung cancer, it would have been curable if it had been able to be fully surgically removed.
Meso-term and end-stage lung cancer is also not without treatment, and now, in addition to the classic methods of surgery, chemotherapy, evaporation, and so forth, can be tried.
Don’t be discouraged with lung cancer, see more doctors, see what they say, see if there’s a target drug that can be taken, and it’s not too expensive now. A lot of it’s in the health insurance, and it’s worth a few hundred bucks a month. Record number: YXA15Q398PMYAX843pCNxNy
I don’t know.
Keep your eyes on the road.
