Capítulo 17: Did Anyone Score Full Marks?
Editor: Atlas Studios
The diagnosis represented the theoretical conclusion given by the receiving doctor. The subsequent treatment plan would also revolve around the diagnosis. It was very easy to cause a medical accident if there was a misdiagnosis.
He could not fill in the diagnosis since he had doubts, which represented his responsible attitude towards the patient.
He felt the need to know if the patient had a past medical history.
"Historical query."
The patient's medical history appeared after typing in words.
"The patient has no history of heart disease. His family members within three generations also have no history of cardiac disease."
This meant that it was not hereditary.
The patient's heart should have been very healthy.
"What happened when the symptoms showed itself."
He typed in another query.
This information should have appeared in the physical examination column, but it did not.
Only targeted queries would show that information.
Zhou Can vaguely realized that it was very likely that the examiner had deliberately withheld some information. Or perhaps he thought that the information was unimportant, so he omitted it.
"The patient lost his job before his illness acted up and had a divorce. He suddenly had chest pain and had difficulty breathing when living alone."
Zhou Can's eyes lit up when he saw the patient's information.
Something felt wrong.
Now that he thought about it, there should be no indication of the patient's medical history or onset.
He was already unlucky enough to lose his job. He would definitely be depressed.
His wife divorced him at this time instead of comforting him. It was no different from adding insult to injury.
The greatest sorrow would be a heart that was broken.
When a person was extremely sad and in pain, it was very easy to have chest pain and breathing difficulties.
Zhou Can's eyes became more and more determined as his intelligence flashed past.
"Emergency, chest pain, Difficult breathing, elevated troponin, electrocardiogram showing a myocardial infarction. The candidates had a preconceived idea and walked into the trap of an acute myocardial infarction from the beginning."
Zhou Can couldn't help but shake his head slightly as he looked at the smug candidates who had filled in the diagnosis.
These candidates would probably lose points.
The most authoritative test to determine if the patient had a myocardial infarction was not an electrocardiogram or X-ray, but a coronary angiography.
X-rays alone could not detect any blood clots.
The coronary angiography was the only authoritative and effective test method.
This test, usually performed by an experienced cardiothoracic physician, requires an injection into the femoral artery at the apex of the patient's thigh and a guide wire inserted.
He would insert the guide wire deep into the blood vessel. When the guide wire reached the abdominal aorta, he would continue to push further until it reached the thoracic aorta and passed through the aortic arch before finally entering the coronary artery.
A catheter could be placed along the guide wire if the guide wire was in the right position.
What would that do?
It could reach the coronary artery smoothly by injecting contrast into the catheter.
He would be able to see if the coronary artery was blocked or even where it was narrowed clearly if they did the X-ray again.
Zhou Can exited the diagnosis page decisively and returned to the medical examination application page.
"Apply for a coronary examination."
He decisively submitted a new inspection application.
"Congratulations on obtaining additional points for the supplementary examination."
The examiner was really despicable.
Layers of traps were set up for the candidates. It required an extremely strong willpower, high-level diagnostic ability, meticulous observation ability, and a rigorous and responsible attitude to uncover all the traps and seek the truth.
Nonetheless, it was undeniable that the examiner's question was really good.
It would be able to sieve out the true elites among more than 1,500 outstanding candidates to the greatest extent so that they could recruit the most promising talents for Tu Ya Hospital.
"Alright, I believe many candidates have already filled in the diagnosis. Please give me your treatment plan now."
An imperceptible strange smile appeared on the examiner's lips.
It was obvious that his evil plan had succeeded. He smiled smugly as he watched the examinees fall into the deep pit he had dug.
Zhou Can ignored the examiner's urging and checked the coronary angiography results seriously.
The results of the angiography showed that the patient's coronary artery was normal.
This was no myocardial infarction.
Zhou Can revealed a knowing smile.
"I thought so."
Everything next would be simple. He came to the diagnosis page and wrote, "The patient's myocardial muscles are normal. He has symptoms similar to myocardium due to violent emotional fluctuations."
The treatment plan page jumped out after submitting the diagnosis.
He cursed in his heart. The examiner was a schemer.
The score would immediately pop out from the screen when the diagnosis was submitted and tell the candidate how he or she fared.
At the point of submitting the diagnosis, there was no prompt and it jumped to the treatment plan page.
He believed that many candidates would be kept in the dark and would definitely be tricked to death by the examiner.
Students and examiners were natural mortal enemies. This was Zhou Can's conclusion.
He filled in the treatment plan column and said, "I suggest psychological counseling."
Then submit.
Next, he had to wait patiently for the examiner to announce the results.
"Fortunately, I raised my pathology diagnosis to Level Three. Otherwise, I might have fallen in the first round of the interview."
His gaze swept across the other candidates. Some were still seriously filling in with their heads lowered.
Needless to say, 90% of them with their heads lowered down had fallen into a pit.
The treatment plan for acute myocardial infarction was very long. It would take more than 10 to 20 minutes to finish writing it.
From a medical perspective, the diagnosis was wrong no matter how detailed the treatment plan was.
This was a little similar to a multiplication rule.
As long as the multiplier was zero, it was useless no matter how many times it was multiplied. The result would still be zero.
He was bored and looked up at the recruitment of the nursing candidates.
All the young and beautiful girls were very eye-catching.
It made him feel happy and had the urge to fall in love.
They had also reached the interview stage and were competing in basic skills like injection.
He encountered a nurse who was very bad at injections when he was at the clinic. He suffered a lot.
She could prick you more than 10 times because she could not find the vein when she's drawing your blood. She could prick your bones with a needle for the simplest muscle infusion. It was guaranteed to make you want to die.
Just as you were about to curse, you saw that she was actually a young and beautiful girl. You had to have tender, protective feelings for the fairer sex, so you could not bear to do it. You swallowed the words that were about to come out of your mouth.
"Candidates who have yet to submit the diagnosis and treatment plan, please hurry up. There are only 60 seconds left."
The examiner's voice pulled Zhou Can's attention back.
The candidates filled in faster after being given the final time limit.
"Time's up! Next, you can check the scores of the pathology diagnosis."
The candidates could not wait to see the answer.
"Ah… Why is my score only two points?"
"Examiner, did the score system make a mistake? I got my checkup all right. The diagnosis and treatment plan were not wrong either. Why did I only get 5 points?"
"I also got only five points. There must be a mistake."
…
The examinees complained one after another, and the examination hall was in chaos.
The House Officers who were in charge of nursing and medical skills also turned to look at them wanting to know what exactly happened.
"What are you shouting for? Keep quiet."
The examiner shouted angrily. No one dared to challenge his authority, and the examinees who were complaining quietened down.
However, the anger on their faces expressed their strong dissatisfaction.
If the examination hall did not give a reasonable explanation, they would definitely cause more trouble.
"Do you know why your score is so low? The total score for the pathology diagnosis is 30 points. Most examinees who got below 10 points only got the first part of the test correct."
Everyone was shocked.
Those candidates who scored less than 10 points began to reexamine the questions and work hard to find where they could go wrong.
"This, this can't be wrong! The patient has blood pressure, troponin elevation, and an electrocardiogram showing a myocardial obstruction at the same time. Isn't this an acute myocardium infarction?"
The examinees who had answered wrongly were puzzled.
The examiner smiled slightly. "You can't just look at pathology diagnosis on the surface. It's possible that what we see and hear will lie to us. This requires us to carefully screen it to preserve the truth so that we won't misdiagnose in the end. Did any candidate score full marks for this question just now?"
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