It's so simple that I can't even find a flaw, and there is no prompt. How to deal with such a disease?

"It's a little trouble." Everyone looked puzzled.

"Is it a mental problem?"

"There is a certain possibility that the patient has been under great mental stress in recent months. This time the child was finally diagnosed. Once the pressure suddenly relaxes, it is easy to have problems."

"I looked at the patient's basic situation. She has no diabetes, hypertension and other symptoms. It's not like routine systemic diseases. It may be mental factors."

All the emergency department doctors present, and they have no knowledge of diseases in the neurological and mental fields.

But it is also known that there is indeed a type of disease in neuropsychiatry that can cause similar symptoms.

Hysteria!

A more professional name is called the Separation Transformation Barrier.

When the patient is mentally stimulated, he will experience hysteria and may experience a narrowing of the visual field. In severe cases, it can really lead to sudden blindness.

Combined with Xu Qiu's physical examination of Lu Ruping, it is difficult not to consider mental illness...

"Doctor Xu, what do you think?" Wang Ping spoke.

The case this time was so strange that even he couldn't help but be curious.

Xu Qiu pondered Lu Ruping's medical records and shook his head slowly for a moment, saying, "I will not consider mental illness for the time being."

He is a clinician who uses a knife and has very little foothold in psychiatry.

Furthermore, there are not so many mysterious diseases in clinical practice. The seemingly incredible signs are actually just not clarifying the pathogenic mechanism.

Compared with the common manifestations of rare diseases such as separation and transformation disorder, rare manifestations of various common diseases are more common.

Therefore, Xu Qiu was considering common diseases at the first time.

There must be some common disease that can cause sudden blindness, but it is ignored because there are too few cases.

Xu Qiu read Lu Ruping's inspection results.

Generally speaking, a major symptom, coupled with secondary other manifestations, can make a basic judgment, that is, a preliminary diagnosis.

For example, blindness accompanied by ptosis, extraocular muscle paralysis, consciousness disorders, movement disorders, etc., we must consider the craniocerebral and nerve problems;

Having a history of diabetes and with floaters, vision loss occurs in a short period of time, either due to endocrine problems or eye problems.

But there is only one blindness on Lu Ruping's medical record.

Her blood pressure, blood sugar, and physical examination did not find a second abnormality.

I have to choose a question, probably her bmi index is only about 17, which is a thinner type.

This morning, the laboratory and ophthalmology department received Xu Qiu's patient and completed all examinations as soon as possible.

The first is the slit lamp inspection.

This project mainly determines the turbidity of the conjunctiva, cornea, anterior chamber, iris, pupil and lens, and can diagnose various abnormalities in the optical pathways in the eye.

However, all parts of Lu Ruping's eyes were intact.

The second one is fundus.

This examination can detect fundus retinal optic neuropathy, which also has a certain suggestive effect on central nervous system diseases.

And coherent phototometry imaging - it can accurately judge the changes in various layers of retinal tissue and diagnose various retinal diseases including macula.

However, after all the examinations, no abnormalities were found in Lu Ruping's eye integrity and various organizational structures!

"There is no problem with blood sugar and glycated hemoglobin..." Xu Qiu frowned.

Diabetes is most likely to affect the retina, but Lu Ruping does not have any underlying diseases.

"Sex hormones have also been measured, and prolactin, growth hormone, adrenocorticotropin, etc. are also normal."

These indicators can eliminate common diseases such as pituitary tumors, inflammation and hyperthyroidism.

However, a low indicator was found in the blood routine.

Hemoglobin!

Like her son Xiang Kai, Lu Ruping's hemoglobin is also lower than normal and has mild anemia.

However, in addition to this, blood sedimentation and other items have returned to normal levels, so toxic diseases, giant cell arteritis, etc. can also be eliminated.

A single hemoglobin is low, and it has no guidance value except for the diagnosis of mild anemia.

"Prepare to check the rounds." Xu Qiu stood up and said.

This sentence also means that the early handover is over, and everyone will soon disperse and scatter to various wards to check the rounds. Then, those who should go to the surgery will go to the outpatient clinic.

Xu Qiu also arranged the operation this morning.

However, before that, he came to Lu Ruping's ward.

Although no problems were found during the previous few physical examinations, when facing a disorder that is inconspicuous, all you can do is to repeat the physical examination and the process of examination, hoping to encounter some changes that prompt the condition.

But luck did not favor Xu Qiu.

During this physical examination, he conducted motor and sensory nerve examinations, reflex examinations, etc., and tested all other senses except vision. What makes people helpless is that there are no other abnormalities except blindness.

"Arranging a head ct," Xu Qiu said.

There is no better way at the moment, so we can only further eliminate the problem of the brain.

Although according to his experience, patients with only blindness and no other neurological symptoms are almost impossible to have a parenchymal lesions in the brain, in the face of the patient's lives, no matter how experienced the doctor has to put down the medical building he built.

In case of exception, it only adds a regret to the doctor's career, a paper, but for this exceptional patient, what he has paid is his life.

"Doctor Xu, I have something I want to tell you..."

After checking the room and preparing to leave, Lu Ruping suddenly called Xu Qiu.

The latter paused and looked at Lu Ruping, who had his eyes closed and his face calm on the hospital bed.

"What's up?"

Lu Ruping paused slightly and said, "I'm in my menstrual period."

Although she is already a young woman, she is still a little embarrassed to speak in the face of such a thing.

However, this is not surprising to doctors. The periodic fall of the endometrium is just apart from losing a few hairs.

"Well, is it large?" Xu Qiu asked.

"It's big, I'm dyed a large piece of the bed sheet last night. I'm sorry..." Lu Ruping felt a little embarrassed.

Xu Qiu nodded slightly...Is it just in time for menstruation?

From this point of view, mild anemia may be related to the period of menstruation and may not necessarily indicate a disease.

Xu Qiu frowned immediately.

Originally, the low hemoglobin was the only abnormal indicator, but now it points to excessive menstrual bleeding, and there is no such possible hint.

Now it really becomes a normal disease except blindness...

"Okay, what changes will happen in the subsequent condition? Communicate with medical staff at any time." Xu Qiu had no better way for the time being, so he could only wait for the results of the brain CT investigation.

"Doctor Xu, don't worry about me for now. My son's surgery is more important..." Lu Ruping's gentle voice suddenly became firm.
Chapter completed!