Chapter 233: Chapter 233

"When did the diarrhea start? Did you eat or drink anything unusual?" Liu Banxia asked after wheeling the patient to the bedside.

"I went out with friends yesterday and had some barbecue. I ate some oysters and scallops, and drank some beer," the girl replied, lowering her head.

"Wow, having kebabs and a bit of beer is usually fine, but seafood and beer together can be quite rough on the stomach," Liu Banxia said.

"Hmm... Let's do a routine blood test and then a stool test. Diarrhea can be caused by many different things. You look a bit weak; do you have any other symptoms?"

The girl shook her head. "No, I've been fine. It was probably just what I ate yesterday. Maybe I also got chilled because it was a bit windy."

"What about your hands? Have they trembled before?" Liu Banxia then asked.

"Usually only when I'm hungry. Could it be hypoglycemia? I've been eating irregularly recently, and I get flustered easily. I've also been a bit sensitive to the cold," the girl replied.

"Your complexion doesn't look too good. Is it always , or is it because of makeup? You seem a bit anemic," Liu Banxia asked after a moment's hesitation.

This was a common difficulty when treating female patients. Girls liked to look their best and often wore makeup. However, heavy makeup could easily lead to missed diagnoses during an examination.

Liu Banxia didn't know much about makeup, but he could tell that even though she was here for diarrhea, the girl had made a considerable effort with her appearance.

"My skin is naturally fair; I didn't put on much powder." Hearing Liu Banxia's question, the girl wasn't offended; in fact, she seemed a little pleased.

"Alright, let's do a routine blood test and a stool test first. Are your legs still weak? Try to put some weight on them," Liu Banxia asked.

The girl tried, shook her head, and looked embarrassed.

"Xu Yino, please accompany the patient. Draw her blood for the routine blood test and help her with the stool sample collection," Liu Banxia said, looking at Xu Yino.

Xu Yino was stunned for a moment. She hadn't expected Liu Banxia to ask her to do this. Weren't these tasks normally done by nurses? Even though she was puzzled, Liu Banxia's authority was imposing, so Xu Yino could only comply.

"Dr. Liu, something's not right, definitely not right. Tell me, what's going on?" Wang Huan came over as Xu Yino wheeled the patient to the restroom.

"I just have a feeling that there's something abnormal about this patient's weak legs and trembling hands. But since her chief complaint is diarrhea, we have to start with a routine blood test and a stool test," Liu Banxia said.

"Then why did you ask Xu Yino to take care of this patient?" Wang Huan asked next.

"I want to see if she can pick up on it. Whether the symptoms are obvious or not, they're still symptoms, right? It's a bit of a 'cast a wide net' approach, a little pop quiz," Liu Banxia said casually.

The others standing nearby felt a shiver run down their spines. They hadn't expected the respected Teacher Liu to have such "devious intentions."

Girls often had certain advantages. Besides Liang Xiaolin and Qing Kewa, who had been studying with Liu Banxia for a while, Xu Yino and Liu Yiqing were the two girls in their group of six.

Liu Banxia usually looked out for these two a bit more. They just hadn't expected that right after he mentioned taking everyone to a nice restaurant, implying a moment of relaxation, his tests would prove to be so sudden and omnipresent.

"Why are you all looking at me like that? In a while, you'll have to rotate with Doctor Wang and go through every department," Liu Banxia said with a smile. Thɪs chapter is updatᴇd by noᴠelfire.net

The interns didn't dare to speak. Only now did they realize that working under Teacher Liu wasn't such an easy task. Though daily interactions seemed relaxed, there were pitfalls everywhere.

The routine blood test and stool test would take some time. When Xu Yino returned with the patient, she felt something was off. Why was everyone glancing her way?

"Su Wenhao, tell me the truth. What happened while I was gone?" Xu Yino cornered Su Wenhao, the most honest one among them.

"Nothing, really, nothing," Su Wenhao said, trying his best to remain calm.

"Xu Yino, come here," Liu Banxia beckoned to her.

"Teacher Liu, did I do something wrong?" Xu Yino asked as she approached him.

"No, you did pretty well. You did what you were asked. In the future, when you're not busy, you should try to help the nurses out with some of their work," Liu Banxia said seriously.

Xu Yino felt a little pleased, but then she noticed everyone looking at her strangely again. This troubled her; something was definitely up.

"What are your thoughts on this patient? What do you think the symptoms indicate?" Liu Banxia asked.

"It's probably caused by E. coli. Seafood often has E. coli levels that exceed the standard," Xu Yino said.

After she spoke, she noticed their expressions became even stranger, and Liu Yiqing kept winking at her.

"Teacher Liu, just tell me, what did I do wrong? I'm going crazy," Xu Yino said helplessly.

"You didn't really make a mistake. At most, it's a lack of careful observation," Liu Banxia said with a smile.

"Look, the patient's legs are still weak, and her hands are still shaking after all this time. She was given chocolate, wasn't she? There's no improvement, so it's not really related to hypoglycemia."

"Ah..." Xu Yino exclaimed, then quickly covered her mouth. "Teacher, are you saying the patient has something else wrong with her, not just diarrhea?"

Liu Banxia nodded confidently. "For a girl about your age, how poor would her constitution have to be for diarrhea alone to cause symptoms like these?"

"When you have a moment, chat with the patient. You're all around the same age, so you should have more in common. Let's see what the routine blood and stool test results show."

Xu Yino blinked, a shrewd smile playing on her lips. "Teacher, are you suggesting that the patient isn't telling the truth?"

Liu Banxia shrugged. "Not necessarily. The key is that sometimes patients themselves don't notice certain things, so they don't realize their significance."

Xu Yino nodded with understanding, then moved closer to the patient's side and started chatting casually with her.

The stool test and blood test results arrived one after the other. The stool test showed excessive E. coli, confirming acute enteritis as the likely cause of the diarrhea. Her hemoglobin was 80 grams per liter, which met the criteria for severe anemia.

"Your diarrhea isn't too severe; we can treat it with an IV drip. However, what concerns me most right now is your anemia. You're at the level of severe anemia," Liu Banxia said, holding the lab report.

"People with anemia generally have poorer overall health. I recommend an anemia panel—we're looking at four specific items. This test can be done while you're receiving the IV."

"Only by determining the type of anemia can we provide the appropriate supplements. It's not just a matter of going home and taking iron to build up your blood. What if the anemia isn't caused by a serum ferritin deficiency?"

"Doctor, is it really that serious?" the patient asked worriedly.

Liu Banxia nodded gravely. "Considering your persistent leg weakness and hand tremors, I strongly recommend you have this test done. If you neglect it, it could lead to more serious conditions in the future."

The patient nodded. She now also felt that the weakness in her legs wasn't normal. She had experienced leg weakness before, but it had never lasted as long as it did today.

While the IV treatment for her diarrhea began, Liu Banxia called Xu Yino over. "Did you manage to find out any useful information?"

Xu Yino shook her head. "Nothing particularly useful. She just likes to go out and have fun. It's summer break, so she's been frequently meeting up with old high school classmates and friends she hasn't seen in ages. Her sleep schedule is all messed up."

"Sigh... I'm so envious of them. When they have a break, it's a real break. As for us, when do we ever get a proper holiday? We didn't when we were students, and we'll have even fewer once we start working."

Liu Banxia tapped her on the head. "That's just how this profession is; complaining is useless. Keep a close eye on the patient, and go back to chatting with her."

Xu Yino stuck her tongue out and obediently slipped back to the patient's side.

Actually, Liu Banxia really wanted to order an electromyography (EMG) for this patient, but there were no clear indications for it yet, so he didn't dare order it recklessly. Young people these days are well-informed. She came in for diarrhea; ordering an EMG would seem like a big jump.

Before lunchtime, the results of the anemia panel came back. The patient's vitamin B12 level was extremely low. This suggested her anemia could be megaloblastic anemia or a related hematological disorder.

Liu Banxia walked over, first testing the patient's grip strength, then the strength in her feet. Her hand strength was better than her foot strength.

"I can't wait any longer. Let's get an EMG. Your feet are even weaker now. And just now, when I prodded the sole of your foot, you barely felt it, right?" Liu Banxia asked, frowning.

The patient was taken aback for a moment, then nodded, somewhat embarrassed.

"Alright, let's do it. I'll also call a neurologist for a consult," Liu Banxia continued.

The patient looked at him and nodded.

"What's wrong? An EMG now?" Wang Huan, having just finished with his patients, walked over.

"Vitamin B12 deficiency, numbness in the feet, unsteady hands... I hope my guess is wrong. Otherwise, I suspect the hospitals in our city will be seeing a lot more patients with this," Liu Banxia said with a wry smile.

"Numbness already? Peripheral neuropathy?" Wang Huan also frowned.

"To get a more accurate picture, after the EMG, let's also get a spinal MRI. Sigh... young people these days," Liu Banxia lamented.

Wang Huan's brow furrowed as well. He also guessed what Liu Banxia was thinking, and it really wasn't good news for the patient.

The interns also gathered around, studying the case intently. Clearly, something serious was going on; otherwise, an EMG wouldn't have been ordered.

However, they still didn't know the specific diagnosis. Although they knew Wang Huan and Liu Banxia had some general idea, they felt it wasn't appropriate to go over and ask directly.

This was also part of the learning process. Asking directly would be like looking up the answers in the textbook during an exam.