I spoke to a patient.
There’s red on the lower lip and on the upper cheek.
The biggest, actually has almost 1 cm.
I can’t believe it’s full of rashes.
Large like nail caps, small grains of rice, thick sacks.
Me and the intern who was there, he was so tight…
That time I was on duty, it was a weekend.
As a result, patients are crowded into emergency cases.
Two of these women are students at local universities.
One was a patient and the other was a roommate who accompanied him.
The patient said that he wanted me to prescribe some medicine to get her better and that the day after tomorrow there was a singing competition, which could not affect her.
I was so busy.
There are lots of abdominal pains and chest pains.
There’s only one intern down there.
It’s hard to deal with her mouth ulcer.
I told her to get some watermelon cream and stuff to spray.
And it’s not an emergency. There’s no need for an emergency.
She said that no dental consultations would be held or there would be no emergency cases.
Looking at her face in a hurry, I knew that she could not be persuaded to leave the emergency room and could even be confused, time-consuming and cost-effective.
I asked her if the ulcer was sore that she was going to be given some mouthwash to take her back for oral cleaning.
The ulcer of the mouth is like this, and it’ll heal itself in seven or eight days.
I’m surprised she told me that the ulcer didn’t hurt, but it was just a little uncomfortable.
If it wasn’t for the singing competition, it wouldn’t have come to the emergency.
And she’s got mouthwash in a pharmacy before, watermelon frost and so on, and it’s not working well.
That’s weird.
It wasn’t on fire, and the intern next to me went on to say something.
She then shared her experience with the patients, saying which store had the cool tea and would have waited two days.
The patient said that the tea was too much to use.
The intern would like to share some more, and I quickly stopped her.
The patient is not on fire, there’s no such thing as a burning mouth ulcer.
Besides, there’s no “fire” diagnosis in our textbooks.
Of course, I told her the following sentence with a small voice and the patient could not hear it.
I examined the mouth of the patient and found that there were a number of elliptical red scabs inside her lower lip and in her upper cheeks, partly ulcer.
The biggest one is about a centimeter. It looks scary.
No wonder she said it would affect singing.
This big ulcer doesn’t hurt?
I can’t believe it.
Patients say it’s a little painful at first, but soon it doesn’t feel much, mainly because they feel the ulcer, they feel alien and they don’t feel comfortable singing.
I’ve been thinking for a while, trying to give her something to drink, and I don’t have an idea.
This oral ulcer is unusual, first, because of its size, and secondly, because of its pain and duration.
My brain is flying fast, and I think of several possibilities.
But because of the lack of evidence and the fact that it’s not an emergency, I think we should let the patient go to the orals again tomorrow.
At this point, the intern doctor came up with a cold line that looks like the mouth ulcer of the previous AIDS patient.
I’m sweating.
The words AIDS can’t be said in front of patients and their friends.
But I can’t blame the intern in front of the patient, so I’m going to say it’s not necessarily AIDS, and there’s a lot of ulcer.
Fungi infections, viral infections, autoimmune diseases, etc. can be caused.
Obviously, my words do not comfort.
How can it be AIDS?
Her roommates were also helpful in saying food can eat, can’t talk or anything, and the doctor would have scared the patient to death if he didn’t care.
Apparently, she was not satisfied with what the intern had just said.
I’m complaining, too. This little girl is really, like, talking out of her head.
AIDS is a very special sexually transmitted disease, and virtually all patients are resistant to their involvement with AIDS, especially when there are outsiders.
Even if the patient had AIDS, it must not be known to unrelated third parties.
The patient’s roommate is a third person who has nothing to do with it.
No wonder patients are so angry.
The intern said it was just a bit like it, not necessarily.
I don’t think she’s happy.
But what the intern said happened to me.
With a mind that does not want to cause any more trouble, I gave the patient some mouthwash and vitamins, and then told her to take a good look at her mouth in two days’ time, perhaps for some tests.
But the patient is not happy and says he can do whatever he wants to do today, and tomorrow is too late.
She means the singing contest.
She still wants me to be able to check something, not push it to tomorrow’s orals, use whatever it takes, and it’s easier.
These mouthwash will help, I tell her.
She said that she used several brands of saliva, that it was not very helpful, that she had to do a check, and that she was willing to cooperate with them.
In that case, I don’t have much to say. I’ll take a blood sample and I’ll check it out.
In addition, I asked the intern doctor to call the patient’s roommate out of the room and to reassure the outside patients.
Then I’ll ask the patient alone and get ready for a quick decision.
I asked her if there was a history of impure sex.
She doesn’t know what impure sex is.
I explained to her that I had sex with people who might have sexually transmitted diseases (including AIDS, syphilis, sturgeon, etc.), such as an unprotected one-night stand.
If they are men, they also include prostitution.
I’ll be as gentle as I can.
She was straight up when she answered me, no.
I asked her if there was a boyfriend. Do you have sex?
She hesitated to say yes.
I continue to ask, is there a protection measure for every sexual life, a condom?
She didn’t understand. She asked me why. How would it help to treat oral ulcer?
I told her frankly that this oral ulcer was not like a normal oral ulcer.
The common, most common, oral ulcer, called a relapse Aphrodisiac ulcer, called a relapse oral ulcer, a relapsed anesthesia, etc., has happened to almost everyone.
However, this oral ulcer is characterized by a clear sense of burning, which does not reach it and usually recovers itself in 10 or 8 days, rarely more than two weeks.
Her oral ulcer has been in place for two weeks and is far from signs of recovery.
More importantly, it doesn’t hurt at all, which means it’s not just ulcer, inflammation.
There are several diseases I can think of.
One is AIDS, just mentioned by the intern, and the other is oral tuberculosis.
There is also a white clad disease or other self-immunizing diseases, which are not good.
The most dangerous of these is AIDS.
I spoke to her and she was staring.
AIDS is mostly sexually transmitted, so I ask her whether she has unprotected sex.
In fact, no matter how she answers me, I decided to give her an AIDS test, because the history is not always reliable.
She said she didn’t wear a condom twice.
Only twice, the rest is gone.
And it’s all taking place during pregnancy.
In that case, we have to look at the anti-AIDS body, and if the result is negative, the sooner we can get out in the afternoon. If the result is positive, then it is different.
I said it couldn’t be ruled out that her boyfriend had problems and then sexually infected her.
She doesn’t understand. Says her boyfriend is clean. How can she have AIDS?
No symptoms. Everything’s fine.
I solemnly told her that all AIDS patients had no apparent symptoms in the first years of the virus, which was called a no-symptomatic period.
There is no way to judge whether or not a person is an AIDS patient.
Only at an advanced stage of the disease, due to low levels of physical immunity, viruses, bacteria and the like can enter, and there can be various infections, including oral infections, lung infections and infections of the digestive system.
Listen to that. She looked pale when she arrived.
I realized that that sentence might have frightened her, and quickly changed it to say that I had only routinely excluded AIDS, not necessarily.
And that’s when I thought of another crucial question.
That is: when did the patient’s first unprotected act happen?
I told her to think about it, to be honest.
Her lips were shaken, say, about a few months ago.
I’m relieved to hear that.
“Then you’re not AIDS. I told her.
A person infected with HIV (HIV) first goes through an acute period, which lasts approximately 2-4 weeks, during which heated, headaches, nausea, vomiting, diarrhoea, joint pains, rashes, lymphoma swollen ulcers should not be so obvious.
After an acute period, which would have lasted for several years, after which the real AIDS phase would have been reached, the body would have completely collapsed, including serious oral ulcer.
If patients have had unprotected sex only a few months ago, even if they are likely to be infected with HIV, they are now at most in a non-symptomatic period, which does not make it so obvious that oral ulcer appears.
After my explanation, her eyes finally shined.
I’m sorry, too, that I didn’t ask for any more details in my medical history to get her a few minutes like a needle and a panic.
If I had asked the relevant questions earlier, I would not have come close to AIDS.
But if it wasn’t AIDS, then what caused her such a serious oral ulcer?
Is it oral tuberculosis, white slugs, syphilis?
I’ve been through all of these, and I’m still reminiscent.
Both AIDS and syphilis are sexually transmitted diseases that can lead to ulcer in the sick population.
In particular, syphilis, with a syphilis spiral, the patient has rashes and oral, nasal, genital mucous membranes, etc.
Especially in the genitals, there will be a hard-and-down larvae.
The so-called hard-down ulcer refers to the ulcer of the genital mucus, which is pain-free and the ulcer of the mouth is pain-free.
More critically, the patient has just said that for the first time in a few months there was unprotected contact.
Assuming that the other side is syphilis, there is a real risk that it will cause syphilis, which makes sense in time.
It seems to make sense in terms of time and clinical performance.
But the time line and symptoms alone do not allow for access, and I must have more accurate information to avoid further errors.
After all, I’ve just suspected people of AIDS, and the result should not be.
This time, I suspect someone has syphilis. If you’re wrong, where’s that face?
It’s a shame if the patient doesn’t like it.
The patient’s heart was shaky and asked me what could have caused her oral ulcer.
To be honest, I can’t think of anything more than these possibilities.
I’m an emergency doctor. I’m not an all-powerful, oral disease.
I called in the intern and said I’d give the patient a gynecologist.
The intern was active and turned around and said to call the gynecologist.
I’ll call her off. No, we’ll just take a look at the patient and close the door.
I explained to the intern that the patient ‘ s condition was not compatible with AIDS, but that syphilis, albino disease and so on could not be excluded, especially pediatric disease.
Plasma is a self-immunological disease, also called oral-eye-genital disease.
Since the patient is more likely to be exposed to three serious and repeated conditions: oral ulcer, eye damage and genital ulcer, if a patient has two or more of these conditions at the same time, he or she must be warned about the disease.
About 70% of white slug patients have genital ulcer, and most female ulcer is found around the big, small and anus.
Most of the patients have pain and are not.
If the patient does not take a close look, he may miss it.
The intern knows what I mean. Assisting patients lie on the bed and take off their pants.
Patients don’t fight.
And she told us there was no ulcer down there and asked if we had to check.
I don’t know if she’s a little weird, if she’s trying to hide something, or if she’s just embarrassed.
I said it’d be more reassuring to take a look, and sometimes it’ll leak around the anus.
In fact, I’m anxious to know if the patient has a hard-on.
If there’s a hard-on, it’s syphilis.
It happens to have a genital ulcer, and it happens to have a double, one look, and it makes two.
The intern doctor was also a girl, and in order to avoid the embarrassment of the patient, I asked her to examine the patient, and I just directed her.
It’s simple, actually, to see if there’s an ulcer around the genitals and anus.
The result was good, and, as the patient said, no significant pathologies were detected.
In that case, it is unlikely that the patient will be syphilis or white slugs.
I’m doing my best. I can’t find the cause. Let’s just do it.
Maybe it’s just an ordinary mouth ulcer, but I’m just making a fuss.
But just when we were all relieved.
All of a sudden, I saw a tiny, easily neglected lump!
The lymph nodes on both sides of the patient’s groin are swollen.
Feels like a nail cover so big that it doesn’t hurt.
And the local skin is intact, undamaged, and not red and swollen.
The intern looked at me, and why did the lymph swollen in the groin?
The patient also stated that there was indeed a swelling on both sides of the thigh, found in the shower a few weeks ago, which did not itch and thought it was a fatty tumor, so it was not noticed.
In general, lymphoma swollenness involves two types of disease, one common inflammation and the other tumours, such as lymphoma, especially in painless lymphoma.
I will not take the tumor out of her until there is more evidence. After all, she has suffered enough shock today: AIDS at once, syphilis at once, and now, if that’s what the tumor says, she’s going to collapse.
But I don’t know why her groin lymph swollen on both sides.
It is fair to say if there is a partial infection, but most of the lymphoma swollen from the infection is swollen, and no signs of infection are found around the groin.
I instructed her to use my mouthwash, which might work, and wait for the blood to come out.
In addition, they have to continue with their oral consultations.
I can’t spend more time on her. There’s more and more patients out there.
When she was about to leave the clinic, she suddenly told me, Doctor, that I had some rashes on my back.
General it’s okay.
But for safety’s sake, I’ll let her lift up her clothes.
I can’t get my eyes out of this.
A large area of the patient’s back is covered with rashes, big and small, like a fingernail cap, smaller than the size of a grain of rice, red and not itching.
Looks a little scary.
The intern took a breath and asked me if I wanted to call the dermatologist.
It’s not an emergency. No one’s working in dermatology.
Somehow, I feel that the rashes of the patient are not mere rashes.
The patient told me that these rashes had been on their own for almost a week and that they were taking some anti-allergy medication.
“You’re definitely not allergic. I told her.
Allergy rashes are clearly itching.
“With the exception of rashes on the back, do you have any on the chest, do you have any on the limbs, do you have any on the palms and feet? I’m sorry.
I checked, only back there.
I told the patient that this rash reminds me of a disease, syphilis. These rashes may be syphilis.
As a result, not only the patient was terrified, but even the intern found it inconceivable.
The reason I think it’s syphilis is that I’m in the first place thinking it’s syphilis, but I don’t see it.
I blame the patient for not telling us this rash is an important sign.
Besides, I ask the patient again, has the genitals never ulcer?
Patients change their decisions, they’re dazzling, they’re hesitant, I guess.
I asked her if she had had an ulcer before, and then automatically.
She nodded and said that she had had an ulcer with an external genitalia (big lip), but that it was small, and it was small and painless, and that she had bought some medicine for her own network, which would have been better.
I couldn’t stop crying and asking her why she didn’t just say that she was looking for an ulcer from the genitals, why didn’t she tell us about it?
She said that the ulcer was ready and that she had checked the information and said that she had been cured by the infection and had bought her own medication.
I’m so impressed. I can’t stop crying. Wasted so much time.
Well, now we’ve got it figured out.
The patient is infected with syphilis. The oral ulcer was also caused by syphilis, which is the symptom of stage II syphilis, no doubt.
The patient looked up and didn’t believe it.
Believe it or not, she’s right to draw blood when we have to complete the syphilis and AIDS tests and sign if we don’t agree.
Fortunately, she agreed.
I told her that an unprotected and unclean sex life was likely to have syphilis because it was a sexually transmitted disease.
About two weeks after contracting the syphilis pathogen, there is a genital rash, which quickly turns into an ulcer, pain-free, called the first stage of syphilis.
Even without treatment, the ulcer automatically heals, rather than the drugs purchased by the patient network.
In addition, the ulcer of the genital ulcer is accompanied by a groin lymphoma swollen, which lasts a long time and may still be swollen when the ulcer heals. It’s like the patient is now.
Without or incomplete treatment, the syphilis pathogen enters the blood cycle, spreads the whole body, causes rashes, osteoporosis, mucous mucous rashes, etc., in particular the occurrence of syphilis, which is the second stage of syphilis, as well as a pain-free oral ulcer.
The second stage of syphilis would last for several months and could then be automatically restored and then entered the latency period.
If effective treatment against syphilis is not available, it will enter three stages of syphilis, which is later, when there will be significant damage to the internal organs.
In general, syphilis is a step-by-step damage to humans.
This patient is supposed to be second stage syphilis.
After hearing my analysis, she still doesn’t believe it.
It’s okay to believe that it’s possible to give an answer by the results of the check, and it’ll be done in the afternoon as soon as possible.
The same day, the patient took his mouthwash and returned.
Before she left, I called her and told her privately that the so-called safety period of the menstruation cycle did not exist, that there was no absolute security period, that it would be unwise to have a safe time to use contraception or to have safety measures. And let her come by the next day to get the results.
She should know what I mean.
By the afternoon, I had the patient’s results.
As expected, the anti-AIDS test was negative, and I was relieved.
Both are positive.
That’s what I expected.
The next morning, the patient returned.
After seeing the results, she’s been wailing for a long time.
I comforted her that the disease could be cured.
The treatment is simple, mystic penicillin, penicillin is the best drug against syphilis.
And long penicillin is one shot a week and two shots a week. Treatment is easier.
The patient told me to keep it a secret.
Of course I know that, but there’s one person who has to know this, that’s her boyfriend.
Her boyfriend probably infected her with syphilis, so she’s bringing her boyfriend to our hospital for skin and sexually transmitted diseases.
“Can we not go to skin and STD? She asked me.
“Why?”
“That name, it’s not very nice. It’s like something went wrong to go to this department. I’m sorry.
That’s a disease? I’m crying.
I explained to her that the EMS was not suitable for this examination and treatment, but rather for skin and STDs.
I don’t know if she took her boyfriend for a check.
This young girl has a lot to learn from.
First, there was no significant oral ulceration without pain and more than two weeks to visit the doctor, which was delayed.
Secondly, at the outset, the history of hard-core disease was concealed, leading to errors in the doctor ‘ s judgement. She may think that the history of the disease, which is not important, is probably the key to the solution.
Cope classroom: What kind of disease can an ulcer cause?
What is syphilis? Why is there an ulcer?
Syphilis is a chronic disease caused by the syphilis spiral, transmitted mainly through sexual contact. Early major skin mucous membranes, with late-stage attacks on vascular, central nervous and other organs, is a complex, systemic disease.
If you have sex with someone who has syphilis, then two to four weeks later there may be a hard down, i.e., a pain-free rash in the genitals, which rapidly develops into a ulcer. The ulcer is pain-free, and the symptoms are called a syphilis. This period lasted for several weeks.
Then the syphilis spiral causes blood, causing the second stage of syphilis. The second stage of syphilis focuses on skin problems, which can be characterized by heat and inactivity, and the second stage has complex and diverse skin changes that can mimic many skin diseases. The second stage of this rash is generally not clearly itching or painful. Some patients have oral mucous forms and even ulcer, which are the result of skin mucous lesions. Most of the ulcer is pain-free. It’s completely different from a re-emergence, which has severe pain and burns.
If prompt and effective treatment is not available, the patient ‘ s condition continues to increase, entering the third stage of syphilis. The third stage of syphilis, also known as late syphilis, can cause damage to various organs, with serious consequences.
Syphilis must therefore be detected early, treated early and treated thoroughly.
What are the modes of transmission of syphilis?
Syphilis is a sexually transmitted disease, 95 per cent of syphilis is sexually transmitted, while a few are vertically transmitted (mother-to-child) and very few patients may be infected by kissing, breastfeeding or exposure to contaminated clothing, appliances.
Does an AIDS patient have an ulcer?
Yes. But let’s split it up.
The entire process of AIDS is classified as acute, non-symptomatic and AIDS. Acute periods refer to 2-4 weeks of first-time infections, most of which are minor, with cases of oscillation, nausea, vomiting, diarrhoea, rashes, joint pains, lymphoma swollenness, etc., but generally do not appear to be apparent oral ulcer.
After an acute period, the patient enters a non-symptomatic period, during which no symptoms can be observed, but the immune capacity of the organism is gradually impaired. It’s impossible to know if this person has AIDS, simply looking at symptoms. The non-symptomatic period may last for several years, mostly 6-8 years.
At the end of the period of AIDS, the patient’s immunity has been severely reduced, with a range of symptoms, including significant oral infections, such as oral ulcer, white spots, etc.
In one sentence, it is concluded that there is generally no significant oral ulcer in the case of early AIDS patients, most of whom have had a long onset of the disease.
What’s a ulcer? Is it common?
Yeah, the most common oral ulcer is the re-emergence of the Aphrodisiac ulcer.
It is often said that, although textbooks do not contain the diagnosis of fire, which is part of traditional medicine, it is more or less equivalent to a relapse into the aphrodisiac.
He’s a Greek translator. It means burning. So the essence of the disease is called re-emergence, burning, oral ulcer. The causes of the disease are unclear and may be linked to immunization, genetics and the environment. Many people have oral ulcer from the beginning of the year, which lasts for 10 days and 8 days, and over and over again, which is called relapse. Document number: YXA1l8bdo4F2B3dQaFwdwL
I don’t know.
Keep your eyes on the road.
