BXBX NOVEL Chapter 1216: 【1216】Check carefully
Universal vaccination has greatly reduced the number of people with measles in the country. Unfortunately, some groups of people have individual differences, and they will get sick even if they are vaccinated, but the symptoms are relatively milder than those who have not been vaccinated, and they are basically moderate to mild symptoms.
Even so, early detection and accurate diagnosis of the disease is definitely best for the patient. A prudent doctor will check all the common key diseases for the patient.
For measles patients, there will be specific signs of measles mucosal plaques, so doctors will examine the buccal mucosa in the patient's mouth.
The so-called measles mucosal plaques refer to the small gray-white spots that appear on the buccal mucosa of the patient's mouth 1 to 2 days before the rash, with a diameter of about 0.5 to 1.0mm, and there will be some flushing around. It is said that it is a measles-specific sign, because this symptom is only present in measles, and it can be greatly differentiated from other diseases to make a diagnosis. Once a measles mucosal spot is detected, the probability of measles is close to ten.
Xie Wanying took a closer look at the buccal mucosa and saw no measles mucosal spots. After that, two cotton swabs continue to carefully press the child's tongue to examine the throat. The cotton swab replaces the tongue depressor to check the patient. The precautions for the use of the tongue depressor are the same. The placement position should be at the junction of the anterior 1/3 and the middle 1/3 of the tongue. The V-shaped groove is called the anatomical position of the boundary groove superior. Too far forward, the base of the tongue is not pressed in place, and the back of the tongue is too high to obstruct the doctor's sight, and it is impossible to clearly see the situation of the tonsils and pharyngeal mucosa. Too far behind can easily cause nausea and vomiting in the patient.
"Ah."
Sister Doctor said this, and the boy made an "ah" sound obediently.
The child opened his throat wide, and with the effect of the tongue depressor, the doctor could soon see that there were two small pink lumps on both sides of the throat, which were the palatine tonsils, commonly known as tonsils.
The light of the flashlight revealed the phenomenon of hyperemia and edema of the child's tonsils. It seemed that there were thick white spots on the surface, which meant that the acute tonsillitis had disappeared.
"My grandson has a cold, isn't it, doctor? You give him some cold medicine." Sui Tong's grandmother anxiously urged the doctor to prescribe medicine, and wanted to rush home to cook with the medicine.
Xie Wanying was not in a hurry, she put down the cotton swab, and then asked the child about his diet, bowel movements, and whether there was any physical pain, and then looked at the child's skin for any wounds or rashes.
"He can eat it. The stool is there, and the urine is a little yellow."
Based on the information provided by the family members of the patients, the overall initial diagnosis tends to be acute tonsillitis in children. Xie Wanying said to the child's grandmother: "In this case, he needs blood tests, intravenous infusions, and drips."
"Aren't you going to give him cold medicine?" Sui Tong's grandmother was surprised and asked.
"He doesn't have a cold, it's acute tonsillitis in a child. There are signs of suppuration. He must have an injection. Just taking oral medicine is not enough." Xie Wanying emphasized that the child's condition is relatively serious.
"Injection? Oops, I didn't have that much money with me, so I need to call his parents." The sick child's grandmother patted her thigh.
Xie Wanying, as a doctor, did not dare to say that the child might be hospitalized for treatment, mainly because of the family's clothes and estimated that the economic conditions were not very good.
In clinical practice, most doctors will try their best to consider the patients and their families, and will consider their economic situation. If the economy really does not allow it, you can try not to let the patient be hospitalized in the outpatient and emergency department without being hospitalized.
(end of this chapter)