Chapter 16
The candidates, after careful contemplation, successively submitted their requests for examinations.
“Time’s up.”
The examiners only allotted about 10 minutes.
This undoubtedly increased the difficulty of the exam.
However, in actual clinical practice, when faced with emergencies or critical conditions, the reaction time given to a doctor is even shorter.
“Now you can view the scores for the examination items and the results.”
Just at this moment, Zhou Can had finally completed the written exam.
He submitted his answer sheet.
The results were almost instantaneous.
A.
The score should be between 90 and 95.
If the score were above 95, it would be an A+.
But considering the difficulty of the exam, covering content from Internal Medicine, Surgery, Obstetrics, Pediatric… all medical departments, scoring an A was quite excellent.
He had also vaguely heard some of the questions posed by the examiners earlier.
Now that he had passed the written exam, it was time to face the interview stage.
“Pain in the patient’s chest, difficulty breathing?”
First of all, it was imperative to rule out cardiac diseases. He swiftly ordered a physical examination, complete blood count, and electrocardiogram.
Submit.
“Congratulations, you have correctly chosen all the examination items and received full marks.”
Zhou Can smiled slightly.
After all, he had advanced to a Level 3 pathological diagnosis, reaching the Resident Doctor standard. If he managed to make a mistake in ordering tests, then his Level 3 diagnosis must have been bought with money.
He quickly reviewed the various test results.
Physical examination, heart rate 122 beats/minute, blood pressure 97/49mmHg.
The normal range for heart rate is 60-100 beats/minute, the patient’s heart rate is clearly too fast.
Normal systolic blood pressure ranges from 90-140mmHg, and diastolic blood pressure from 60-90mmHg. The patient’s blood pressure is conspicuously low.
A man in his thirties, in the prime of life, with such low blood pressure, could lead to shock. Not to mention, with such low blood pressure, all organs in the body would not receive sufficient blood and oxygen, cellular functions and metabolism would be impeded.
If it persists a little longer, organs will become overwhelmed and shut down.
The patient would die.
Next, he looked at the blood test results.
Wow, the troponin levels are so high.
Clearly above the normal range.
Zhou Can involuntarily thought of a frightening disease, acute myocardial infarction. The Mr. Cui he saved this morning, it was somewhat similar to this condition.
Acute myocardial infarction is also a type of coronary heart disease.
If not treated promptly, the mortality rate is extremely high, with a poor prognosis.
Based solely on the initial two test results, it was difficult to conclude. He continued to inspect the most crucial, the electrocardiogram.
There were clearly changes on the electrocardiogram similar to those of a myocardial infarction.
Under normal circumstances, the human heart can continuously produce electrical activity. An electrocardiogram is a monitoring of this electrical activity, transformed into a waveform, used by doctors for diagnostics.
When a part of the heart muscle becomes necrotic, or a blood vessel becomes blocked, causing the heart muscle to lose vitality,
the peaks on the electrocardiogram’s waveforms will be noticeably displayed.
Doctors can roughly determine which blood vessel is blocked based on the electrocardiogram.
“Damn, it truly is an acute myocardial infarction.”
Based on the three test results, Zhou Can preliminarily concluded that the patient likely had an acute myocardial infarction.
Yet he had a nagging feeling that something wasn’t quite right.
The words that Dr. Hee said to him after yesterday’s consultation echoed in his ears once again.
“Medicine is a rigorous discipline; I never conclude lightly. Diagnosis must be based on a comprehensive assessment of the patient’s history, condition, gender, and various test data.”
At this point, the examiner, expressionless, said, “I believe after reviewing the diagnostic results, you have made your judgments. Please fill in the diagnostic outcome.”
Many candidates had already confidently begun to fill in their diagnostic results.
Zhou Can, however, was frowning tightly, feeling that something was amiss.
But he could not find the reason.