MTL - I Can See Health-Chapter 12 Different Skills Test (Medium)

  Chapter 12 Different Skills Tests (middle)

  The middle-aged man stood on the podium, looked around, and said loudly: "Everyone should have seen the rules of the skill test."

   "This time, we won't test CPR, we won't test defibrillation, and we won't test the four major punctures."

   "This clinical skills test returns to the most primitive healing process!"

   "All candidates will face the four most real patients. From the most basic physical examination and consultation, to diagnosis, treatment, and prognosis, they are all done independently by everyone."

   "The examiner will supervise the whole process, record all the process, and give a grade evaluation, the highest is A, the lowest is D!"

   Having said this, the middle-aged man on the stage paused, and then continued in a deep voice: "A total of four patients, as long as they get a D-level evaluation, they will be brushed directly and withdraw from this re-examination!"

   As soon as the voice fell, everyone in the audience was in an uproar.

   As long as you get a D-level evaluation, it means being brushed, and a whole year of hard work is wasted.

   For medical students, how many years can be wasted!

   "Teacher, wouldn't this be too unfair."

   A girl suddenly stood up and said loudly.

   "We've been in the clinic for a short time, and we haven't seen many diseases. Isn't it absurd for us to see a doctor now?"

   This girl spoke the hearts of everyone.

   Do case questions, everyone can.

   But when it really reaches the clinic, it may not even be able to diagnose and treat the simplest cold.

"You said that the time in clinical practice is short?" The middle-aged man laughed instead of anger, "I remember medical school, in the senior year, the apprenticeship started, and the senior five would spend a whole year. If you think the time is short, then Everyone's situation is the same, and I think it's fair!"

   As soon as these words were said, there was no questioning voice from everyone present.

   But everyone is ashamed.

  Although the school has arranged an internship for a whole year, because of the postgraduate entrance examination, few students have completed the entire internship program.

  Most people end their internship early a few months before the postgraduate entrance examination and prepare for the postgraduate entrance examination in school.

   The mode of this skill test at Kyoto University is a wake-up call for everyone.

  Compared with high scores in the test, if the basic clinical skills are not passable, it will be a one-vote veto!

   "The first group of students came out with me, and everyone else turned over their communication equipment and waited in the classroom."

After the middle-aged man finished speaking, the four students in the first group followed him and walked out of the classroom in turn.

   All the remaining candidates will turn in their mobile phones and wait to be called.

  …

   Kyoto University Graduate School, Dean's Office.

   "You guys are just fooling around! Are you taking real patients as exam questions?"

   Dean Xu Feng sat on the office chair with a dark face.

"President Xu, this is what Vice President Yang meant." The secretary whispered, "Our school, as a pilot for postgraduate entrance examination reform, needs to innovate. The previous exams have been unable to reflect the gap between candidates, so Vice President Yang Chang Cai proposed this innovative screening model."

   "Humph." Xu Feng snorted coldly, "Don't think I don't know the dirty things in the re-examination. Now make a fuss about the reform pilot, don't get caught by me!"

   "President Xu and Vice President Yang are also doing good for the hospital."

  The secretary would not dare to speak ill of Vice President Yang.

  Xu Feng is only the dean of graduate students, but Yang Feng is the vice dean of the whole school

  Xu Feng said solemnly: "Take ten thousand steps back, once the patient suddenly falls ill during the exam, it will be difficult to handle!"

   "Principal Xu, don't worry, the patients who took the exam this time are all in relatively stable conditions."

   "Hey, I hope there will be no mistakes!"

  …

  This side of the examination room.

   The exam for the first group is over.

   The four candidates from the first group were taken to the next classroom in case they leaked the exam questions.

   "The second group, Lu Chen, Jin Miao, Jiang Qingyan, Yu Bo, these four students come with me, the third group of students get ready!"

  The girl is number seven, which means that her real name is Jiang Qingyan.

  The four candidates from the second group followed the examiner to the outside of the Cardiology Department's ward.

   "Dear classmates, there are four wards here, and the corresponding numbers are posted on the doors."

   "Every ward has a patient, and this patient is everyone's exam question!"

   "Eight minutes are limited in each room. Candidates need to conduct consultations and physical examinations on patients, during which I will ask various questions."

  According to the lottery number, Lu Chen came to the first ward.

After    and so on, Jiang Qingyan entered the third room.

   Walked into Ward No. 1.

   A middle-aged man was lying on the hospital bed in the middle.

  He is fat, about 200 pounds.

   With a slight movement of his body, he could see the fat on his face trembling.

  Lu Chen noticed that he was closing his eyes, and there seemed to be nothing unusual except for his scary body shape.

   It's just that he has a monitor attached to his body, which indicates that his condition is not simple.

  Lu Chen concentrated his energy and saw that the color on his head was red!

   "It's actually a real patient!" Lu Chen was shocked.

   He thought that the hospital would let normal people pretend to be patients and let them take the exam.

   I didn't expect the hospital to be so ruthless and let real patients be the exam questions!

   "Student, you can start the consultation and physical examination." There was also a female examiner in a white coat standing in the ward.

  Lu Chen nodded slightly, walked to the right hand of the hospital bed, and began to inquire and examine.

  …

  The consultation is over.

   The female examiner asked in a deep voice, "Please briefly describe the patient's chief complaint and current illness history."

  Lu Chen thought about it and organized some language.

   "Male patient, 47 years old. Chief Complaint: Severe chest pain for 3 hours."

"History of present illness: The patient had chest pain without obvious incentive 3 hours before admission. The pain was located in the middle and lower part of the sternum, and the pain ranged from the size of a palm. 120 was admitted to our hospital, the blood pressure was measured in the emergency department at 260/130mmHg, and the emergency department was admitted to the cardiology department with "chest pain"."

   "What's wrong with the physical examination?"

   "The blood pressure of both upper extremities varies, and there is mild pressure pain under the xiphoid process, and the rest are negative."

   "Current diagnosis and next treatment?"

   "The cause of the chest pain is to be investigated: the possibility of aortic dissection is high. It is recommended to temporarily give symptomatic treatment such as antihypertensive and analgesic; and to improve the aortic CTA, please consult with vascular surgery."

  The female examiner nodded, "That's a good answer."

  Lu Chen breathed a sigh of relief.

   The first patient had obvious symptoms, severe chest pains, and uneven blood pressure in both upper extremities.

   It is easy to think of such a dangerous disease as aortic dissection.

   But the exam is not over yet.

  The female examiner handed Lu Chen a stack of test sheets and inspection sheets.

   "After reading these test sheets and inspection sheets, re-answer the last question."

  Lu Chen opened the stack of test sheets.

   The first picture is the result of the patient's myocardial enzyme spectrum, and the troponin is elevated!

  Second ECG, ST segment elevation in anterior leads!

   "How could this happen?" Lu Chen's eyes were full of doubts.

   The auxiliary examination results given by the examiner, the elevated troponin and the changes in the electrocardiogram all point to the diagnosis of acute myocardial infarction!

   This is completely contrary to the "aortic dissection" he just diagnosed!

   Aortic dissection and acute myocardial infarction are treated in opposite ways!

   Both are very dangerous diseases.

  Once misdiagnosed, the consequences are unimaginable!

   Lu Chen's heart tensed, if the diagnosis was wrong, wouldn't he get a D-level evaluation?

   (end of this chapter)