I'm just a veterinarian! You've unlocked the Great Physician System!

"Yes! Vampire disease!"

Zhang Lingchuan nodded in reply, "That's what people call it."

System scan complete.

[Patient's name: Lin Ruruo]

[Patient's gender: Female.]

[Patient's age: 27 years old.]

[Patient Status: The patient has a long history of irregular sleep patterns, frequent dieting for weight loss, irregular eating habits, and a long-term low-carbohydrate diet. This is accompanied by repeated late nights, high stress levels, and a history of self-medicating with multiple weight-loss and analgesic drugs. The current chief complaint is sudden, severe abdominal pain, accompanied by nausea, mild vomiting, and abdominal distension. Physical examination reveals mild abdominal distension, but tenderness does not correspond to the severity of the reported pain. Bowel sounds are present, but there is no significant rebound tenderness. Vital signs: Temperature 37.2℃, heart rate 108 bpm, blood pressure 142/90 mmHg. The patient is anxious, with mild sweating and fatigue. No clear signs of mechanical intestinal obstruction were observed.]

[Patient Diagnosis: Acute intermittent porphyria attack (acute phase), presenting as pseudo-intestinal obstruction-like abdominal pain, accompanied by a risk of autonomic dysfunction, marked with a red label; misdiagnosis and mistreatment may rapidly progress to neurological damage and respiratory failure.]

[System Prompt: Porphyria, also known as vampire disease, is a metabolic disorder caused by a deficiency of enzymes in the heme synthesis pathway. Under the influence of triggering factors, intermediate metabolites (such as porphyrin precursors) can accumulate in large quantities in the body, producing toxic effects on the nervous system.]

Common triggering factors include: long-term dieting or low-carbohydrate diet, mental stress and severe sleep deprivation, certain medications (painkillers, hormones, some antibiotics, etc.), and fluctuations in hormone levels.

The patient's long-term irregular lifestyle and repeated drug exposure constitute a typical triggering background.

The most common manifestations during an acute attack are: severe abdominal pain, nausea, vomiting, abdominal distension, tachycardia, hypertension, sweating and other autonomic symptoms. In severe cases, limb weakness, paresthesia, and even respiratory muscle involvement may occur.

The greatest risk of this disease is that it is easily misdiagnosed as "acute intestinal obstruction" or "acute abdomen" and treated incorrectly. Some commonly used drugs can further induce or aggravate the condition, and the continuous accumulation of toxic metabolites can rapidly damage the nervous system.

If not identified and intervened in time, patients may develop progressive nerve damage, muscle weakness or even paralysis, and respiratory failure due to respiratory muscle involvement within days.

Emergency handling recommendations are as follows:
Immediately stop all medications that may induce porphyria;
Perform porphyrin metabolism-related tests as soon as possible to confirm the diagnosis;

Provide high-carbohydrate support (such as glucose infusion) to inhibit toxic metabolism;
If necessary, specific treatments can be used to inhibit the formation of porphyrin precursors;
Closely monitor changes in the nervous system and respiratory function;
Avoid unnecessary surgical interventions.

[Ding! The patient is currently in the acute phase of porphyria. Timely identification and standardized treatment can effectively control the condition. However, if misdiagnosed as a surgical emergency or if the patient continues to be exposed to triggering factors, the condition will rapidly deteriorate and lead to serious neurological complications. Please assist in perfecting the diagnosis and initiating targeted treatment immediately. Successful intervention will reward you with 1 regular treasure chest and 500 medical points.]

As my system scan gradually completed the attending physician's tasks, the results became increasingly detailed.

Moreover, he discovered that a reward popped up almost every time.

For example, right now it's a regular treasure chest, and it also gives you 500 medical points.

Previously, the task was only activated once in a long while.

Now, as long as you follow the system's instructions, you're highly likely to encounter those explorable individuals.

Is this also to incentivize the attending physician?
"Xiaochuan, do you suspect it's porphyria?"

Director Wu, who was well-informed and experienced, was immediately taken aback.

"Vampire disease" is not a formal medical term; it is an exaggerated folk belief.

The main reason is that her skin is pale, like a vampire's.

Moreover, they are extremely sensitive to light.

In most cases, they can only be active at night.

Going out in broad daylight can cause serious damage to the skin.

For example, ulceration, blisters, scarring, etc.

This is highly consistent with vampire disease.

"Oh--"

Yin Xiaoxiao's mind went blank for a moment when she heard about the vampire disease.

Because she felt that the name sounded familiar.

But I can't remember what it was.

It turns out to be poliomyelitis!

"Yes, I suggest that the next treatment direction should be in this direction. Even if it is not possible, we should avoid drugs that cannot be used for porphyria to avoid accidents."

Zhang Lingchuan nodded.

The system said that without proper treatment, the patient may experience progressive nerve damage, muscle weakness or even paralysis, and respiratory failure due to respiratory muscle involvement within a few days.

This is probably why there's a red tag above their head.

If the delay is too long, or if the treatment is misguided.

This is a human life.

"Porphyria... But I'm perfectly healthy, how could I have porphyria! Isn't this a hereditary disease? Dr. Zhang, you must be mistaken!"

Lin Ruo Ruo did not believe that she had polio.

She herself was a medical professional and knew that polio was largely related to genetics.

But none of my family members have this disease!
It couldn't possibly appear on itself out of thin air, could it?

"Ms. Lin, first of all, your abdominal pain has no specific location, which means it is diffuse pain."

Zhang Lingchuan said, "This is also the first hint."

"Secondly, although you seem to have an intestinal obstruction, you are in poor mental condition, and even have weakness in your hands and feet. You also mentioned that your urine turns dark after settling for a while, and you are taking weight loss medication. Based on all these factors, the possibility is very high."

Zhang Lingchuan has already found a reason for himself.

Therefore, the system scan results were presented truthfully.

Neurological abnormalities such as weakness and numbness, mental abnormalities such as anxiety and insomnia, plus a triggering factor such as dieting, irregular eating habits, and medication, can actually be diagnosed by a doctor with a little experience.

"This……"

Lin Ruru hesitated, as if she wanted to say something but then stopped.

"If you put it that way, it's very likely! If it's really a misdiagnosis as bowel obstruction, that would be a big problem! Ms. Lin, could you please take off those sunglasses?"

Wu Qi had something else to say.

If the intestinal obstruction is severe, should surgery be considered?

Once surgery is performed, the consequences of misusing medication are unimaginable.

Now he's decided to take a simple test.

"OK."

Lin Ruru nodded.

At that very moment, Director Wu waved his flashlight.

"call out--"

Even if it hurts a lot.

But Lin Ruru immediately covered her glasses with her hand.

It does seem to be a bit photophobic.

"Grinning."

Wu Qi continued.

When the light shines.

The group noticed that the other person's entire teeth were glowing.

"Director Wu, I don't think I have poliomyelitis, do I? There's no history of it in my family!"

Lin Ruru continued.

"Xiaochuan, continue with your line of thinking."

Wu Qi looked at Zhang Lingchuan.

"Ms. Lin, I think you should have your blood and urine drawn first, then do some necessary tests and be admitted to the hospital. What do you think?"

After Director Wu looked at him, he immediately began to speak.

Zhang Lingchuan is no longer an intern; he is a resident physician at the hospital, a real doctor.

Treatment options are available.

The necessary tests include blood electrolytes (especially sodium), liver and kidney function tests, blood gas analysis, and urinalysis.

The tests used for diagnosis are urinary porphyrin (PBG) and urinary ALA.

of course.

It doesn't mean you have to wait for the results before being hospitalized.

That would have caused all sorts of trouble.

Instead, they proceed simultaneously.

After these examinations are completed, treatment will begin immediately.

For example, choosing the heme preparation Hemin for intravenous injection primarily works by inhibiting ALA synthase, thus blocking the formation of toxic substances at the source.

In the treatment of porphyria, this is a life-saving process.

Then came the treatment for high blood sugar.

For example, intravenous infusion of 10% glucose can inhibit the synthesis of porphyrins in the liver.

Finally, pain management was initiated. Morphine-based analgesics were used, followed by control of heart rate and blood pressure, antiemetics and electrolyte correction, and simultaneous neurological monitoring.

If shallow and slow breathing occurs, intubate immediately and put the patient on a ventilator.

Many people get into trouble with this disease because of misdiagnosis.

Misdiagnosis means that some medications that are contraindicated for this disease will be used.

For example, barbiturates, some antiepileptic drugs, and some antibiotics.

"Okay, okay... I'll follow your arrangements, Dr. Zhang! But I feel... I'm still unlikely to have poliomyelitis. I might just have intestinal obstruction, which has been the case before."

Lin Ruru accepted Zhang Lingchuan's arrangement, but deep down, she couldn't quite believe that she had contracted this so-called porphyria.

But since Dr. Ogawa is so certain, let's take a look at the test results.

"Okay, thank you for your cooperation."

Having a patient with a medical background can sometimes be an advantage.

For example, even if the other party has some doubts about many of the arrangements, they still listen and patiently wait for the results.

“It’s okay! But if I’m hospitalized, I need to stay in a private room because my condition is special and I don’t want to share a room with anyone else.”

Lin Ruru made such a suggestion.

"Yes, that's possible. We also have private rooms available now."

Private wards are definitely available in hospitals.

Even the emergency department has them.

It was a major emergency.

They quickly handed it over to other nurses and took it for examination.

"Xiao Chuan, Xiao Xiao, you guys are really something! You were about to leave work and you still brought someone over for me. Okay, I really have to go back now!"

Director Wu said.

He had to run away as well.

"Director, this is an emergency, so Dr. Xiaochuan and I brought the person here. It just so happens that you have some time."

Yin Xiaoxiao said with a smile.

"Alright, alright, I'm leaving now! I'm going to go back and get a good night's sleep! By the way, Xiao Chuan, your previous live stream was really good. I haven't had time to tell you yet. The institute actually has plans to develop you into a live streaming brand."

After leaving those words, Director Wu really left.

"Ward rounds! Dr. Xiao Chuan! Actually, I think doing live streams is quite good; it'll also help you reach your 100 million target~"

Yin Xiaoshuo expressed her own thoughts.

"Sigh... Let's take a look first, time to go do rounds."

Zhang Lingchuan and Yin Xiaoxiao quickly began their rounds.

As for Lin Ruruo...

The reward certainly won't be issued so soon; the illness needs to be corrected first.

I checked around.

The patients are all doing well today.

No one went out in the middle of the night, no one smoked after undergoing finger amputation surgery, and no one told others not to eat while saying they would eat a little bit without any problem.

"Good morning, Xiao Chuan! Xiao Xiao!"

Dr. Fang Yuan has arrived at work.

He greeted Zhang Lingchuan warmly.

"Senior Brother Xiaochuan!"

Besides Dr. Fang Yuan, Zhang Lingchuan also saw a familiar face.

Shen Ziwen.

I currently work in the pediatrics department of the Provincial People's Hospital.

He became a resident physician.

"Good morning, good morning~"

Zhang Lingchuan waved his hand.

I'm getting more and more acquaintances at this provincial people's hospital.

the other side.

Lin Ruru was already lying in the hospital bed.

She feels much better now and doesn't look as haggard as she did this morning.

They even started working in a very impressive way!

Good morning, everyone! Ruoruo is sick and is currently in the hospital.

She was live-streaming.

There were a lot of people in the live stream room.

"Ruoruo, take good care of yourself. Don't overwork yourself. Nothing is more important than health!"

"Yeah, what's the point of work and money if you're dead?"

"You can work hard, but you can't overwork yourself. Without health, no matter how capable you are, you have no use for them."

"Health first. / Praying emoji"

……

One by one, they tried to persuade them.

"Thank you everyone. I'm feeling much better now. It's my old problem of intestinal obstruction, but Dr. Zhang suspects it might be porphyria. We're waiting for the results."

After it got a little better.

Lin Ruruo began to tell the viewers in the live stream about her situation.

"Veterinarian Zhang?"

"Wow, you're at the First Affiliated Hospital of Peking University?"

"If Veterinarian Zhang suspects it's polio, then it's most likely polio!"

"What kind of disease is this? Why have I never heard of it before!"

"Porphyria is a very rare disease, and it is easy to misdiagnose if you encounter an inexperienced doctor. It has a very descriptive nickname: 'vampire disease.' Hematuria and photophobia are obvious characteristics, and the urine will change color when exposed to sunlight."

There appeared to be medical-related viewers in the live stream.

Directly addressing the science popularization path.

"Vampire disease!"

Upon hearing this, many viewers immediately became interested.

An office in the emergency department.

"Xiao Chuan, Xiao Xiao, come with me to see the patient you saw this morning. Her test results are in."

Fang Yuan took over from Dr. Wu Qi, so he also took on this patient named Lin Ruruo.

Since Xiaochuan and his group were the first to receive us today, let's take them along to see it together.

"Okay, Teacher Fang!"

Yin Xiaoxiao nodded.

Then he led Zhang Lingchuan and the other person towards Lin Ruru's ward.

She was also a little curious whether Dr. Ogawa was right.

Is it really poliomyelitis?
Zhang Lingchuan, on the other hand, remained calm.

Because he felt that even without systematic analysis, the actual symptoms were very close to the truth.

"???"

They soon arrived outside the ward.

She requested to stay in a private room.

On the 27th.

When they arrived, they found Ms. Lin Ruru talking incoherently!
"Here come the babies, the doctors are here! It's probably because my test results are in! I'm kind of looking forward to it!"

Lin Ruruo also noticed Fang Yuan and Zhang Lingchuan outside.

He said it immediately.

...(End of this chapter)