I Can See Health

Lu Chen took a few tissues, wiped his greasy mouth, and then walked quickly to the doctor's office.

"A patient with gout is here, in bed 30."

When she walked into the doctor's office, Min Ling was already sitting in front of the computer.

"Well, I'm going to see the patient and ask about the medical history." Lu Chen nodded, picked up the stethoscope, and walked towards bed 30.

While walking, Lu Chen recalled the concept of gout.

Gout is a disease caused by high levels of uric acid in the blood leading to the deposition of uric acid crystals in the joints. The deposited crystals cause painful inflammation in and around the joints.

With the extension of average human life span and changes in diet and lifestyle, this data is increasing year by year.

The age of gout patients is gradually getting younger, with a male to female ratio of 15:1, and more than 50% of gout patients are overweight or obese.

…

Came to the ward where bed 30 is located.

As soon as he entered the ward, Lu Chen saw a very young male patient lying on the bed.

He was about thirty years old, with a thin body and a sickly pale complexion.

Lu Chen walked to the bed. He was holding his right leg, grinning with a painful expression on his face.

Gout is not a serious disease, but the pain is really terrible!

"Doctor, can you give me some painkillers first?"

Seeing Lu Chen walking into the ward, the patient quickly raised his head and said.

"The nurse is dispensing medicine and will give it to you right away." Lu Chen said, "I will now ask you about the specific process of your illness."

"Hey, I have this disease that occurs many times a year." Xia Jinhua sighed, exposed both sides of his ankles, and then stretched out his right hand.

Lu Chen saw a raised bump on the skin on both sides of his ankles and right hand.

This is tophi!

Tophi is a characteristic clinical manifestation of gout and is commonly found in auricles, metatarsal toes, fingertips, metacarpophalanges, elbow and other joints, Achilles tendon, patellar bursa, etc.

The tophi of the patient in front of me are quite small, about the size of a table tennis ball.

"Then your medical history is really quite long. The tophi are so big." Lu Chen sighed.

This is also the first time he has seen a patient with such large tophi, and the patient is still so young.

"Oh, I used to be young and ignorant. I drank alcohol, ate seafood, and had no control over my diet." Xia Jinhua shook his head, "In the beginning, I had attacks five or six times a year. In recent years, I have had several attacks every month. I can't stand it. !”

Gout is a disease that, in addition to genetic and environmental factors, is most closely related to personal eating habits.

Now that living conditions have improved, more and more young people will suffer from gout.

At the same time, Lu Chen noticed that the patient's health value was yellow 62.

This value is somewhat unusual. It is only one step away from the red warning line.

"Can gout reduce the health value to around 60?" Lu Chen was a little confused.

There were also gout patients in the ward, and Lu Chen noticed that the health points of others were around 70 or 80.

But the patient in front of him is so young and has only 62 health points, and there is no guarantee that his health points will continue to decline.

Lu Chen asked the patient about the disease process in more detail, followed by a physical examination.

"Are you always this pale?"

From the moment he walked in, Lu Chen noticed that the patient's complexion was sickly pale.

It was thought that he was suffering from a pain attack.

However, I feel that this "pale complexion" may be unusual.

The patient is not only pale, but also has white bulbar conjunctiva, making the whole person look anemic.

Xia Jinhua paused and recalled: "It's been about half a year, and my colleagues next to me said that I looked a little pale."

Lu Chen frowned.

Is it chronic anemia?

"How's your diet lately?"

"Hey, since I have had frequent gout attacks, I have strictly controlled my diet." Xia Jinhua said, "I don't eat any meat dishes. I just eat some vegetarian food."

Lu Chen raised his eyebrows, anemia caused by malnutrition?

"Have you ever been anemic before? Maybe when you were hospitalized last time, did a doctor tell you that you were anemic?"

"Anemia?" Xia Jinhua was stunned, "I don't think so. Doctor, are you saying that I have anemia now?"

"Not necessarily. A blood test is required to confirm the diagnosis." Lu Chen said.

Xia Jinhua nodded, and then recalled: "I have occasionally experienced fatigue and dizziness in recent months. I have never experienced this before. Could it be caused by anemia?"

"If anemia is diagnosed, it may be caused by anemia."

…

Back to the doctor's office.

Min Ling has given all the medical orders.

"How is the patient's condition?"

"It's mainly bilateral ankle pain, and I'm currently considering an acute attack of gout." Lu Chen paused, "But..."

"Is there anything else going on?" Min Ling looked back at Lu Chen.

After these several interactions, Min Ling already valued Lu Chen's opinions.

If it were an ordinary graduate student, Min Ling would just listen to his opinion and don't care too much.

But Min Ling paid more attention to Lu Chen's words.

"During the physical examination, I found that the patient had obvious anemia, but the patient denied any previous history of anemia."

Min Ling nodded and said: "I looked through the patient's previous medical records. He was also admitted to the hospital half a year ago. At that time, he had mild anemia. The patient probably didn't care."

Lu Chen leaned in front of Min Ling's computer and saw the patient's laboratory test, which showed hemoglobin Hb105g/L.

However, other blood routine indicators, including mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC), all declined slightly and have not yet reached the level of microcytic hypochromic anemia.

Generally, mild anemia is difficult to detect during physical examination.

What's more, the patient is currently showing obvious anemia.

"I just checked the blood routine urgently. UU Reading www.uukanshu.net" Min Ling said, "Let's take a look at the results."

"Yeah." Lu Chen nodded.

…

Half an hour later.

The urgent blood test came out, hemoglobin HB85g/L.

Moderate anemia!

Hemoglobin dropped further.

"Looking at the blood test, it should be microcytic hypochromic anemia." Min Ling frowned.

"The patient has been strictly controlling his diet recently and has almost no meat dishes." Lu Chen said, "Is this the reason?"

Min Ling was silent for a long time before saying.

"Malnutrition can indeed cause anemia, but it is relatively rare to cause moderate anemia."

Unexplained anemia is generally more severe in male patients than in female patients.

Female patients have fixed blood loss every month, which is likely to be anemia caused by this reason.

But male patients don't have this way of losing blood.

Therefore, generally male patients may have digestive tract diseases.

"Could it be chronic gastrointestinal bleeding?" Lu Chen asked doubtfully.

Min Ling asked: "Does the patient have black stool?"

Lu Chen frowned, "It happens occasionally, but the patient doesn't pay much attention to it."

"When the patient's gout gets better, I'll arrange a gastrointestinal endoscopy for him." Min Ling thought for a while and said.

Every time the tuba is over, it’s important to look back!

Pay special attention to the shape and color of your stool.

If there is blood in your stool, it may be bleeding hemorrhoids.

If the stool is black and shapeless, it is likely to be gastrointestinal bleeding, including gastrointestinal ulcers, or even gastrointestinal malignant tumors.

…