"She went for a B-ultrasound to check her appendix and said it was fine. If she suspected a urinary or gynecological problem, a B-ultrasound found no problem. Later, she found that she felt uncomfortable when I pushed my hand under the navel toward the bladder area.
, it feels like a bit of pulling pain." Xie Wanying reported her thoughts, "I suddenly remembered that this part seems to be related to the urachus. If you do B-ultrasound, it must be taken, just like the teacher said, unless you scan that part, most doctors
I would not suspect this place. If it is too small, ureteral stones within 1 centimeter may be missed by B-ultrasound and only CT can confirm the diagnosis. I finally suggested that she do a CT scan of this area to see what is going on."
"How long did you perform palpation on her?" Professor Li asked. As an old professor, he knew that the patient's symptoms were too hidden and difficult to detect, and he was curious about how the intern could detect the problem.
"I pressed her for about half an hour at that time." Xie Wanying recalled estimating the time it took for the last physical examination of the patient.
The half-hour physical examination only involves palpating the abdomen. Indeed, only interns have the time and energy to think about it slowly, because they have this curiosity in learning. Clinicians rely on experience and quickly complete the palpation.
You are used to it. If you take a long time to perform palpation, patients will doubt whether your technique is good or not. But medical students will not be questioned. Anyway, patients know that you are a student.
A lot of doctors could only smile bitterly after hearing this.
Having said that, even if medical students are not questioned by patients, there are very few medical students who really have the patience to repeatedly think about the patient's condition during the physical examination, let alone those who can really realize the missed diagnosis by their clinical predecessors during their thinking.
portion.
Perseverance alone is not enough for such medical students, they also need to lay a solid foundation. Rare diseases are not closely related to intelligence and talent, but the foundation is more important. Because rare diseases are often hidden in the corners of medical research, doctors need to be able to remember them at all times.
It is quite a test of a doctor's comprehensive grasp of the basics.
"The fact that you could think of the urachal area during palpation shows that you have learned anatomy very well." Professor Li praised the student from the bottom of his heart.
She should have been excited to be praised by the old professor, but Xie Wanying shook her head and said realistically: "I can think of it not only because of anatomy, but also the relationship between histogenesis and pathology."
Professor Li and other doctors should think about it: Oh, that’s right.
Such rare diseases of degenerative parts of the human body cannot be understood without histology, and even if they are mentioned in anatomy, they will be forgotten. Because histology studies the process of differentiation, development and development of human body structures.
In fact, in terms of anatomy, the urachal is rarely mentioned. This place basically degenerates into the median umbilical ligament in infancy, and becomes a ligament. What is there to dissect? In rare cases, I want to keep it.
It’s difficult to get specimens. The medical school’s anatomy room doesn’t have such patient specimens, maybe the hospital’s specimen room has them.
There is another underlying reason that Xie Wanying is unlikely to mention. Before her rebirth, she focused on studying pathology. To learn pathology well, you must first thoroughly understand histology.
"How many points did you get on the embryonic test?" the seniors asked her excitedly.
Xie Wanying felt uncomfortable boasting in front of everyone, so she hesitated.
Gao Zhaocheng turned around and asked her two classmates: "What score did she get in the exam?"
"Yeah - full marks." Lin Hao replied, because the squad leader Yue Wentong was a boring gourd and would not speak first.