"Siying, think carefully about this case. It should greatly help you improve your clinical diagnostic thinking."
Li Jingsheng turned to look at Han Siying beside him.
"Mm, mm!"
She had already started pondering the differential diagnosis.
Li Jingsheng began performing so necessary physical examinations on the child.
Temperature: 38.7 degrees Celsius, mild fever.
The child did not exhibit diarrhea but had vomited due to severe coughing, which was dry heaving.
Lifting the child’s shirt, the sunken abdon and clearly defined ribs were visible—this child was very thin.
"Too thin, you need to give the child more nutritious food!"
Li Jingsheng said to the family mbers.
"Alright."
The middle-aged woman nodded in agreent, but her heart wasn’t in it.
One can understand the hardships of this family.
She had referred to the child as the fourth, indicating the family likely had more than four children.
Even for families with good financial conditions, supporting four children is not easy. For a struggling family like this, it is even harder.
Just managing to get their children educated and fed is already quite an achievent.
How could they possibly drink milk every day and have fish and at at every al?
Li Jingsheng auscultated the child’s heart and lung sounds.
The crackling sound of moist rales could be clearly heard.
At this point, Li Jingsheng already had so idea.
"Siying, co and listen to his lung sounds."
She took the stethoscope, operating clumsily and appearing sowhat flustered.
She even joked because she was too nervous, auscultating in the wrong spot and failing to hear the lung sounds.
Under Li Jingsheng’s guidance, she grasped the basic essentials.
"I hear it, a very coarse sound."
She said.
"Listen carefully, do you hear any other sounds? Or rember this child’s lung sounds. Also, many patients have noticeable differences between left and right lung sounds, you need to differentiate carefully."
Li Jingsheng was not one to readily take on students.
However, for this earnest and humble dical student, he was willing to ntor her as best as he could.
A doctor’s ti and energy are limited, and they can only treat a few patients.
Only by training more doctors can the dostic demand for dical consultations be t.
The current state of healthcare here is like drought in drought-stricken areas and floods in flooded areas.
Small hospitals struggle for patients, while large hospitals have long queuing lines overnight. Many major hospitals have a shortage of beds.
Even if the patient’s condition is severe and ets the admission criteria, without a bed, they have to wait.
With Han Siying’s dical skills and diligence, and her displayed learning ability, it is believed that she will definitely not lag behind once she enters a large hospital in the future.
At the ti she needs assistance and guidance most, Li Jingsheng’s help could be considered a sort of fate.
As long as she is not ungrateful, she will surely rember this teacher-student bond.
In the future when Li Jingsheng needs help, she will give her all to assist.
"Seems like I heard so strange sound, like a friction sound, or a... bubble popping sound!"
Her talent was truly excellent.
She could quickly notice so many things.
"Have you rembered that kind of sound?"
"Yes!"
She nodded.
"The lung sound you heard is a moist rale. Pay attention to distinguishing their subtle differences, like the moist rales in this child being rather coarse, akin to large bubbles bursting. The lighter ones are dium moist rales, and there’s another that is quite subtle, requiring very careful listening, known as fine moist rales. Additionally, there is a sound similar to hair rubbing, which is also a moist rale."
"Lastly, you need to pay attention to the location and differences in the sounds. Beginners easily confuse it with pleuropericardial friction sounds..."
Li Jingsheng taught her these clinical skills earnestly.
It’s sothing that can’t be learned from textbooks, as theoretical knowledge is conveyed through words. Only through this kind of real combat, after hearing it a few tis, can you easily differentiate which sound is a moist rale, which is a dry rale, and which one is both dry and moist rales coexisting.
It also demonstrates that Li Jingsheng’s skills far surpassed hers by several levels.
After all, Li Jingsheng had been a resident in a major hospital for a few years and later advanced his capabilities in respiratory diagnosis to the Minor Achievent level through the attribute panel.
Under normal circumstances, she might need over ten years of clinical experience to reach Li Jingsheng’s current level.
This is still because her talent is very good.
"Preliminarily suspect that your child’s lung has issues. An X-ray chest film is needed, the charge is one hundred yuan as a pure examination fee, is that okay?"
Li Jingsheng asked the family mbers.
"That’s fine! Coming to you, we definitely trust you. There are even more checks when going to a large hospital."
The woman with four children had certainly been to big hospitals before.
She felt the clinic was far more economical than the hospital.
Taking the X-ray consud over twenty minutes of Li Jingsheng’s ti; he was tempted to smash that old machine.
Now, with a bit of extra money in hand, and being a doctor at the Second Hospital, there’s an opportunity to establish a good relationship with the hospital’s logistics departnt, perhaps opening up the chance to purchase a retired X-ray detection device.
Judging by the feeling, the infrastructure at the Second Hospital should be quite decent.
The X-rays for orthopedic patients had amazingly good clarity.
The old machine could then be disposed of at a low cost.
After taking the X-ray for the child, he had already co to a fairly clear diagnostic conclusion in his mind.
In the cardio-diaphragmatic angle area and inner band of both lungs, there were small patchy increased density shadows with blurry edges, deeper density in the middle and shallower at the edges. Moreover, the density was uneven.
The uneven density was patchy, due to the mixing of air-filled alveoli.
From the aforentioned X-ray findings, it’s highly likely to determine that the patient has pneumonia.
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