"Haha." Zhou Congwen ignored the doctor in the ultrasound room's faint mockery and focused on doing the ultrasound.

The patient's right parathyroid gland was enlarged and there were a large number of hypoechoic nodules.

"It's the problem here." Zhou Congwen said, "The diagnosis is relatively clear, and it is a neurological symptom caused by hyperparathyroidism."

"What?" The doctor in the ultrasound room didn't understand.

The diagnosis of hyperthyroidism is very unfamiliar, but he knows what it means. But why does hyperthyroidism lead to Alzheimer's disease?

"Liu Na, take the elderly to have blood tests to see if the blood calcium is high." Zhou Congwen said, "If the blood calcium is very obvious, the hospitalization of the nothrax department will be relieved after the parathyroid gland is cut off."

"..." The doctor in the ultrasound room was stunned.

He had heard the word hyperthyroidism, but he didn't understand it specifically. He only knew that hyperthyroidism seemed... well, it just seemed that it would cause gastrointestinal symptoms.

"Professor Zhou, is it just a test for blood calcium?" asked the instrument nurse.

"This outpatient examination is enough. There are still many remaining items to check, so let's go to the hospitalization fee." Zhou Congwen said, "Normally speaking, if the parathyroid gland is removed, people will understand."

“!!!”

"But it's better to start as soon as possible. After all, the old man is old and can't stand the trouble."

"Okay!" said the instrument nurse quickly.

Although she didn't believe it, or was half-doubted, Zhou Congwen gave an almost perfect ending. As the patient's family, she would rather believe Zhou Congwen's unreliability than believe that her grandmother had the "incurable disease" of Alzheimer's disease.

"Go quickly."

Zhou Congwen helped the old man down from the clinic bed, and the doctor in the ultrasound room looked confused.

Seeing that Zhou Congwen was about to leave, the doctor in the ultrasound room asked quickly, "Professor Zhou, can you tell me?"

"I rarely encounter similar patients?" Zhou Congwen asked back.

The doctor in the ultrasound room nodded.

"The typical symptoms of hyperparathyroidism are called 4S, including kidney stones, cystic fibrous osteitis, gastrointestinal symptoms and mental symptoms. It is usually mainly gastrointestinal symptoms, which is very common."

Seeing that the doctor on duty in the ultrasound room was still confused, Zhou Congwen continued to explain.

"The damage to the central nervous system may lead to symptoms such as memory loss, emotional instability, personality changes, depression, and lethargy. If there are no other typical symptoms, they may be misdiagnosed as delayed treatment of mental illness."

"So as long as you know this, when you meet a patient who is suspected of Alzheimer's disease, that is, Alzheimer's disease, you need to check for a B-thyroid ultrasound and test for blood calcium."

"Is this a differential diagnosis?" the doctor in the ultrasound room asked vaguely.

"Yes." Zhou Congwen said, "This is the differential diagnosis. Some Alzheimer's disease is caused by hyperparathyroidism, but many people don't know about it in clinical practice."

The doctor in the ultrasound room was speechless.

Although he was still suspicious, he saw that Zhou Congwen said it was certain that the patient's parathyroid gland was indeed swollen and had high-density nodules. These seemed to be a vague reminder that what the young Professor Zhou said was right.

But his tone was too big, so big that it made people feel very unreal.

"Congwen, you thought of kidney stones because of Alzheimer's disease and gallbladder stones?" Shen Lang asked.

"It is rare for both organs to have psychotic symptoms to appear stones at the same time," Zhou Congwen said. "It is either a coincidence or it is caused by increased blood calcium in the patient. In addition, Alzheimer's disease appears almost at the same time, differential diagnosis must be done."

Shen Lang silently remembered what Zhou Congwen said next.

Although I heard it, Shen Lang still found it difficult to understand for a while.

Xiao Kai stood aside silently, sighing in his heart.

The disease of hyperparathyroidism... may be considered by ordinary people as a doctor is the embodiment of omnipotence, and all diseases and diagnosis should be clear in the chest.

But for a clinical old fried dough stick like Xiao Kai who has a skill, he has long sneered at this view.

It is so difficult to train an awesome general practitioner. At least Xiao Kai thinks that he has good talent, but he will definitely not be able to become a general practitioner like Zhou Congwen.

Speaking of hyperplasia, Xiao Kai knew about this disease, but he only knew it. As for the symptoms of 4S, he didn't know at all. He should have learned it back then, but after graduation, Xiao Kai returned all the knowledge that had nothing to do with thorax to the teacher.

However, Zhou Congwen was completely the opposite.

Talk freely, speak aggressively, and have a good foundation.

Xiao Kai cherishes his chance to further study in the Second Hospital of Medical University.

When Xiao Kai first came here to study, he had a little terrible idea. His main purpose was to make friends with Zhou Congwen and perhaps have the opportunity to make friends with Mr. Huang.

After all, he was born in the psychothoracic surgery department, and Mr. Huang’s subconscious position could not be shaken.

Although these may be useless, they can at least brag for the rest of their lives.

Even...it's even more awesome than being a vice president in charge of clinical practice.

As time goes by, Xiao Kai's attention is successfully transferred to Zhou Congwen.

Whether it is cardiothoracic surgery or diagnosis of other diseases, Zhou Congwen has a sense of maturity and etiquette that is not consistent with his age.

Alzheimer's disease caused by hyperparathyroidism...

Xiao Kai silently recorded it, which is part of clinical experience.

He didn't want to explore why Zhou Congwen had such rich clinical experience. It would be enough to get benefits from it. Want to know why?

Xiao Kai definitely doesn't want to.

Curiosity kills the cat, and it is unnecessary curiosity. An old man like Xiao Kai knows that some things cannot be touched, and they must not be touched!

It’s fine if there are benefits. I know so much, but the result is only two words - a young man!

Even though I think so, Xiao Kai still feels excited occasionally.

"If it's okay, I'll leave." Zhou Congwen and the doctor in the ultrasound room explained, smiled slightly, turned around and left.

"Liu Na!"

"Here, Professor Zhou."

"Send me a text message if there is any result." Zhou Congwen said.

"Okay!"

Zhou Congwen was also very proud.

After returning for more than half a year, I finally got used to saying text messages instead of WeChat.

"Professor Zhou, how high do you estimate the probability?" Xiao Kai asked.

"Almost 100%."

"Is the surgery effective?"

"It's immediate."

Xiao Kai sighed, "To be honest, Professor Zhou, I have encountered similar situations. Now I think the patient must have been delayed by me."

"Don't be depressed, remember to talk to others more and misdiagnose less." Zhou Congwen is more tolerant of this because after all, it is impossible for everyone to be like him.

Especially for hyperparathyroidism, which is within the treatment scope of endocrinology and malformation, blood calcium is not a necessary examination for admission, and there is no way to see it.
Chapter completed!