My Medical Skills Give Me Experience Points

This time, they made an appointment with a urology specialist at the Provincial People's Hospital.

After the specialist's diagnosis, a water deprivation test was conducted on the patient, and a saddle area MRI was performed, indicating thickening of the pituitary stalk and elevated prolactin levels, hence confirming a diagnosis of type 2 diabetes and hyperprolactinemia.

There's a note about diabetes insipidus?

It's likely the specialist was merely suspecting the presence of diabetes insipidus, but it's difficult to rashly conclude which type it might be.

The specialist from the Provincial People's Hospital prescribed the woman Rosiglitazone, Acarbose, and Glipizide controlled-release tablets to control blood sugar.

At the same time, Desmopressin and Bromocriptine were prescribed to control urine output.

After taking Desmopressin, the woman's urine output significantly decreased, but the good times didn't last long; just a few hours later, the patient showed symptoms of increased urination again.

After returning home from the Provincial People's Hospital, the patient persisted in taking medications like Desmopressin for treatment.

All were medications prescribed by that specialist from the Provincial People's Hospital.

There was a noticeable improvement in her condition.

Because of long-term use of Desmopressin, the patient experienced symptoms of 'weight gain,' so she stopped taking the medication herself. Under the suggestion of a relative, she sought treatment from a local Traditional Chinese Medicine practitioner instead.

As a result, after taking the herbal medicine, symptoms of polyuria and polydipsia worsened, and she felt particularly fatigued.

A few days ago, the patient began to speak nonsense, experienced consciousness disorder, and couldn't even recognize her husband anymore. She also showed symptoms of limb weakness and trembling. Incidents of urinating on herself occurred frequently.

Now, she has to be changed into a large-sized adult diaper at regular intervals.

In desperation, her husband quickly brought his wife to Xinxiang Women and Children's Hospital for help.

After fully understanding this female patient's condition, Zhou Can became aware of the complexity of the case.

"May I ask if your wife has not had her menstrual period for over a year since undergoing curettage?" Zhou Can inquired of the woman's husband.

The female patient was virtually in a state of stupor, simply unable to communicate normally.

"Yes!"

The family member's brows were tightly furrowed.

At this moment, Yang Chan also came over on her own initiative, helping with the diagnosis.

"Yang Chan, the patient hasn't had her period for over a year since the curettage. What do you think is the most likely cause of her condition?"

Zhou Can proactively engaged her in dialogue.

Each has his own expertise; when it comes to obstetrics, Yang Chan has already learned much from Director Zhang Bihua.

Although she had been studying for less than two years, in this field, she was certainly more skilled than Zhou Can.

"What's your suspicion?"

Yang Chan countered with a question instead of responding.

"The patient's imaging test results indicate a mass in the pituitary stalk, so I believe that the most probable cause is hypothalamic or pituitary lesion."

Zhou Can, in diagnosing such difficult and complex diseases, always starts by finding a breakthrough and then carries out comprehensive differentiation and analysis.

This diagnostic technique has never failed him and has proven effective.

"There are many potential causes of amenorrhea, including uterine, hypothalamic, pituitary, or ovarian abnormalities. She has undergone a curettage, so the uterus should also be considered as a primary object of investigation."

After listening to Zhou Can's diagnostic opinion, Yang Chan made a supplementary statement.

Zhou Can's lips curled slightly; this young woman was intentionally asserting her authority as a team leader!

The likelihood of a uterine abnormality was very low, and she had insisted on bringing it up, simply to remind Zhou Can that she, the team leader, still knew a bit more than he did.

However, given that the patient also had symptoms of diabetes insipidus, investigating the uterus was indeed necessary.

Zhou Can closely reviewed the patient's test data again and quickly ruled out the possibility of a uterine abnormality.

The reason being, thickening of the patient's pituitary stalk could also cause diabetes insipidus.

"Director Jiang, I'd like to ask, can thickening of the pituitary stalk possibly lead to central diabetes insipidus?" Combining his experience with neurosurgery, Zhou Can couldn't help but recall a similar case.

That patient had developed central diabetes insipidus due to a pituitary abnormality.

"Dr. Zhou, your expertise is quite strong, no wonder Director Tan from Internal Medicine thinks so highly of you! I have the same suspicion, and since you've brought it up as well, I think it's necessary to perform a water deprivation test on the patient and re-examine the saddle area MRI."

Director Jiang from Neurology had been a little uncertain before.

Hearing that Zhou Can also suspected a pituitary abnormality causing central diabetes insipidus, he immediately decided to proceed with the investigation for the patient.

"Fellow experts, my wife previously had that saddle area something M checked at the Provincial People's Hospital, and just now, Dr. Du also said that the results of the saddle area something M could be used. What do you think, can we not do the test?"

Once the family member heard about the need for another test, particularly one that had already been done, he couldn't help showing a bitter face.

Patients and family members dread various tests the most.

This is all due to excessive testing by many hospitals.

Regardless of whether the patient is sick or not, all necessary tests have to be done first.

"I think it is absolutely necessary to have a reexamination."

Director Jiang said seriously.

The family member, frowning, hesitated for twenty to thirty seconds before finally agreeing, "Alright then, I'll take my wife for another test. I believe you experts wouldn't deliberately order additional tests just to charge us twice for the test fees."

This statement actually contained a warning to the doctors.

It was also evident that after being fooled by Du Leng, the family member had become quite difficult to talk with.

The doctors exchanged glances but did not respond.

Director Jiang issued an examination request for the patient.

"Go quickly! Rest assured, even if we doctors have to work overtime today, we will figure out the specific cause of your wife's illness. However, some tests and examinations, as well as the effectiveness of medications, require time to evaluate. If you trust us doctors, you'll need to prepare for a possible inpatient treatment. Let me be frank; her condition is extremely complicated, and it's unrealistic for us doctors to guarantee a cure with certain confidence. We can only assure you that we will do our utmost."