Chapter 1733: Chapter 1737: I’m Sorry, I Was Wrong!
However, early the next morning, Chen Cang was woken up by a phone call.
“Professor Chen, a patient has been transferred from East University First Hospital. The main symptoms are shortness of breath, and after so ti, the extremities and around the mouth go numb, and even the hands and feet begin to spasm. Could you co and take a look?”
The call was from the on-duty ergency doctor, Wu Hui, who originally didn’t want to bother Chen Cang, but the neurology director from East University First Hospital and the neurosurgery director from Provincial Second Hospital were both puzzled and couldn’t ascertain the cause.
Chen Cang responded, “Yes, I’ll be right over!”
At that mont, dawn had just broken, and there were few pedestrians on the road.
Upon arriving at the hospital, Chen Cang headed directly to the intensive care unit.
Seeing Chen Cang arrive, everyone nodded and made way.
“Good morning, Director Chen!”
“Hello, Director Chen!”
In winter, dawn cos relatively late, so it was actually already past six o’clock.
Noticing several directors gathered together, Chen Cang gave a slight nod to everyone.
“Good morning, directors, thank you for your hard work.” Chen Cang nodded in gratitude.
Everyone waved their hands, brows tightly furrowed, not relaxed.
“What’s the situation with the patient?” Chen Cang asked.
Here, the neurology director at East University First Hospital, He Caiyun, said: “This patient has been an old patient of ours. Last year they ca and went four or five tis, and had a period of rest. Unexpectedly, after being admitted a few days ago, their condition suddenly worsened!”
“It’s mainly the shortness of breath. After breathing for a long ti, the extremities and around the mouth beco numb, and even the hands and feet begin to spasm. Additionally, there are so abnormal consciousness signs!”
The main diagnosis was: Hyperventilation syndro, respiratory alkalosis accompanied by tabolic acidosis, hysteria pending exclusion.”
“But today we suddenly found the eyes had lost light perception, pupils dilated to the edges, and no light reflex!”
“We couldn’t find the cause at our side, so we had to rush the patient over!” He Caiyun said with a lingering fear.
She arrived at the hospital at around three o’clock this morning.
The patient had been struggling for over two hours, yet the situation only worsened.
Seeing the pupils dilate and needing imdiate action, yet the ergency and intensive care teams had no solutions!
We hurriedly transferred the patient to Provincial Second Hospital’s ergency departnt.
Chen Cang nodded, carefully examining the patient. This woman was roughly in her forties. He turned to Wu Hui and said, “Tell the patient’s test results.”
Wu Hui nodded.
“Patient’s test results: blood gas shows decreased carbon dioxide partial pressure, decreased bicarbonate, and a high anion gap.”
These test results are sowhat strange.
However, they fit the patient’s symptoms well.
“Any underlying diseases?” Chen Cang asked.
He Caiyun shook her head: “None, this patient is an old patient who has been hospitalized multiple tis, and every potential issue has been checked without any findings!”
“Respiratory alkalosis combined with tabolic acidosis?” Chen Cang frowned, “That’s not common!”
Both He Caiyun and Du Juanhong, the old directors, nodded.
“Has ophthalmology been consulted?” Chen Cang asked.
“We’ve examined! But…
After the ophthalmology consultation, the eye specialist didn’t find any issues upon examining the fundus and intraocular pressure!
So, there’s currently no way to diagnose.
But, there’s sowhat of a silver lining, as at least common sudden blindness causes like glaucoma and uveitis have been ruled out.”
This is perhaps the small rcy.
“Could it be optic neuritis or NMOSD? But sudden blindness in both eyes is more like a vascular issue.”
“Could it be bilateral occipital lobe infarction?”
“It shouldn’t be. If it were occipital lobe infarction, it wouldn’t cause the light reflex in pupils to disappear, right?”
Du Juanhong and several directors began discussing.
The patient’s condition is extrely rare.
Such pupil dilation due to respiratory alkalosis has hardly ever been heard of!
Yet, the patient inherently has respiratory alkalosis!
Diagnosis holds almost no aning.
Following this diagnosis leads us to…
The only thing hard to explain is the neurology issue.
While a few people were discussing.
Chen Cang also began sorting through his thoughts.
There are many diseases of occipital lobe cortical blindness, like adrenoleukodystrophy, basilar artery tip syndro, although pupil light reflex disappears, it essentially doesn’t occur in this situation!
Occipital lobe lesions can basically be excluded.
However, unexpected and unexplained situations in clinical practice are abundant.
Thus, an expedited MRI was done!
The MRI results showed the patient’s condition was too normal!
This truly puzzled everyone.
It didn’t seem to be a change in the nervous system.
Could it be an optic nerve issue?
After struggling since five in the morning till ten o’clock, still no results.
Outside, the patient’s family had beco completely panicked!
Even the conscious patient began to feel scared.
Not being able to see with both eyes easily causes anxiety.
At this ti, the ophthalmologist suddenly said: “Shall we try steroids?”
Facing the urgency to save the vision, side effects of steroids could not be worried about.
After all, currently, there’s no other option.
Chen Cang also felt sowhat helpless.
The imaging materials were normal, the test data only showed respiratory alkalosis, later combined with tabolic acidosis.
Chen Cang flipped through all previous dical records of the patient again.
Just then, suddenly a voice rang from behind Chen Cang.
“Did you ask about the patient’s occupation?”
A single sentence!
Made Chen Cang pause instantly.
It’s like soone turned on a light in his mind!
Then, his mind suddenly beca clear.
What surprised him the most was that the elderly gentleman behind him was none other than Old Mister Zhong!
Chen Cang quickly stood up, surprised and asked: “Old Mister Zhong, why are you here?”
The old man gave a slight smile: “Here to apply.”
“However, let’s discuss this matter later.”
“There’s another thing, why didn’t you inquire about the patient’s occupation during diagnosis?”
Chen Cang’s face flushed instantly!
He had been going too smoothly all along, causing him to overlook many details!
“Interrogation can never be overlooked!”
“The patient’s diagnosis isn’t incorrect; it still shows respiratory alkalosis combined with tabolic acidosis!”
“But, you mixed up the order. The patient isn’t suffering from hyperventilation syndro, his gasping isn’t the cause, but the result!”
“The patient’s overventilation is caused by acidosis, acidosis is the cause, and respiratory alkalosis is the effect; the essence is acidosis!”
“Think about it, why didn’t you ask about the patient’s occupation?”
Following Old Mister Zhong’s words, the answer was already surfacing in Chen Cang’s mind!
Chen Cang was quite knowledgeable about poisoning scenarios!
What could cause tabolic acidosis and respiratory alkalosis, along with toxic blindness?
It’s clearly: thanol!
And what was the patient’s occupation?
This was particularly critical!
Looking at Old Mister Zhong, Chen Cang’s face turned red: “Sorry, I made a mistake!”
…
ps: Thanks to Alliance Hierarch “Man Jue Da Lao” for the 50,000 reward, thank you.
Today is the Zhongyuan Festival, according to hotown customs, I went back ho to visit the graves and burn paper, ca back late, sorry, will make it up tomorrow.
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