This miracle doctor just wants to be fired!

Emergency Department Observation Room.

Zhou Cheng immediately followed up, "Do you usually feel hot easily, sweat a lot, and have recently experienced an increased appetite but weight loss? Have you had your thyroid checked before?"

The young man, panting, shook his head with difficulty.

The patient's family member quickly added, "He's been feeling hot and bothered lately, his appetite is bigger than before, and he's lost a few pounds. We all thought it was just from being tired at work."

Zhou Cheng's heart sank.

Trembling hands, palpitations, increased appetite, and weight loss are all typical symptoms of hyperthyroidism!

I initially thought it was just a common cold and didn't consider this possibility.

The sudden deterioration of the condition is likely an early manifestation of thyroid storm triggered by hyperthyroidism complicated by infection!

Thyroid storm, as the name suggests, is very dangerous. If it is not treated in time, the consequences are unimaginable!

Thinking of this, Zhou Cheng immediately communicated with the patient's family: "Uncle, we may need to do a blood test to see if these symptoms are caused by hyperthyroidism, and then we need to do another electrocardiogram."

"Hyperthyroidism?" The patient's family member was a little confused, but nodded anyway. "We'll do whatever you say, get all the necessary tests done."

This patient is completely different from the family members of the patients who had dizziness before; they are easy to communicate with, and Zhou Cheng is able to better carry out his diagnosis and treatment.

Zhou Cheng immediately found Zhao Wenqi: "First, check that young man's thyroid function, then do an electrocardiogram! Oh, and also check his blood sugar."

"Okay." Zhao Wenqi nodded and immediately began to act.

Fang Hang also ran over, and when he saw the young man's appearance and heard Zhou Cheng mention the suspected hyperthyroidism crisis, his expression changed.

"Junior brother, what should we do now? Should we stop using the cephalosporin?"

"Don't stop yet, the infection isn't under control, but we need to add a beta-blocker to lower the heart rate and prevent the condition from worsening."

Zhou Cheng quickly issued the medical orders.

If it really is a thyroid storm, and treatment is not timely, it could be fatal!

Zhao Wenqi quickly pushed over the treatment cart and inserted an IV into the young man.

"Let's use some esmolol to lower the heart rate first," Zhou Cheng told Fang Hangdao. "If the thyroid function test results come out later and hyperthyroidism is diagnosed, we'll have to contact an endocrinologist for a consultation."

Fang Hang nodded, looking at Zhou Cheng's methodical manner with a sense of admiration.

He was just hesitating about whether or not to use painkillers, but Zhou Cheng was able to quickly assess the situation and act decisively in the face of a sudden worsening of his condition.

Don't let his PhD fool you; that's the difference in clinical experience!

Zhou Cheng didn't notice Fang Hang's gaze; he was focused on the young man's state, feeling somewhat helpless.

I just wanted to have a peaceful day shift, but I never expected to encounter such a critical situation.

He felt something was off. Had he been seeing too many patients with such critical conditions lately?

He used to work many shifts and had many critically ill patients in the emergency department, but he had never encountered this many times before!

……

A few minutes later, the electrocardiogram results from the young man's test came back.

The results indicated sinus tachycardia, 125 beats/min, with no obvious abnormalities in the ST-T segment.

The heart rate is increased, but other cardiac arrhythmias, such as elevation myocardial infarction, have been temporarily ruled out.

Zhou Cheng felt a little relieved. As long as it wasn't a heart attack, he would first control his heart rate and infection, and then make further plans after the thyroid function test results came out.

After an intravenous injection of esmolol, the young man's heart rate dropped to 105 beats per minute.

His breathing became more stable, and although his hand tremors had not completely disappeared, the amplitude had decreased significantly, and the flush on his face had also faded.

"How are you feeling? Is your heart palpitations any better?" Zhou Cheng asked softly.

The young man nodded, his voice still a little weak: "Much better, not as uncomfortable as before, but I still feel a bit weak."

"It's alright. Once the thyroid function test results are in and the cause is clear, we can then treat it accordingly," Zhou Cheng reassured the family. He then instructed the family, "If he feels palpitations, hand tremors worsen, or experiences any other discomfort, call me immediately."

The family members thanked him repeatedly, and Zhou Cheng finally straightened up and breathed a sigh of relief.

Next, just wait for the test results and contact the endocrinology department for a consultation.

……

As Zhou Cheng turned around, he saw Fang Hang still lingering by the bedside of the patient suffering from abdominal pain, his brows still furrowed.

He thought for a moment, then went over and asked, "Senior, how's your patient doing? Has the abdominal pain subsided after the painkillers were administered?"

Fang Hang turned around, his tone tinged with helplessness: "It's been almost twenty minutes, and he says the pain is still coming in waves and hasn't eased much, just a little less intense."

He pointed to the middle-aged man on the hospital bed.

The middle-aged man was still lying on the bed, hunched over, his hands pressed against his stomach, his face still pale, but he was not in as much pain as before.

"I just asked about his medical history again. He said he ate some leftovers yesterday, and the pain started last night. It began in his upper abdomen and then moved to his lower abdomen. He didn't vomit, have diarrhea, or have a fever." Fang Hang briefly recounted the medical history to Zhou Cheng. "He had an abdominal ultrasound done in the emergency room, but they didn't see any gallstones or kidney stones. I initially thought it was acute gastroenteritis, so I gave him anti-inflammatory drugs and painkillers. Why is he still in so much pain?"

Zhou Cheng frowned.

Acute abdomen is one of the most common diseases in the emergency department, and also one of the most problematic.

If a diagnosis cannot be made in time, it's a ticking time bomb!

"Senior brother, shall I take another look at the patient?" Zhou Cheng said.

Fang Hang nodded repeatedly: "Okay."

After those few minor incidents, Fang Hang still had a lot of faith in Zhou Cheng's abilities.

Zhou Cheng stepped forward and performed another physical examination on the middle-aged man.

When his upper abdomen was pressed, the middle-aged man didn't frown much, but when his lower abdomen, especially his lower right abdomen, was pressed, he cried out in pain, his expression clearly showing distress.

"Uncle, when I let go later, please check if it hurts." Zhou Cheng asked as he gently raised his hand. The middle-aged man immediately shook his head: "It doesn't seem to hurt, but it hurts a lot when I press on it."

There is tenderness in the abdomen, but no rebound tenderness.

"Have the test results come out yet? Like the complete blood count, liver and kidney function tests, D-dimer, etc." Zhou Cheng stood up and turned to look at Fang Hang.

Although patients in the observation room are not tested for many things, D-dimer is routinely checked to rule out thrombotic diseases.

Although acute gastroenteritis generally does not affect D-dimer, Zhou Cheng felt that the patient's abdominal pain was somewhat unusual.

"I just had the nurse bring it over, I haven't had a chance to look at it yet," Fang Hang said, taking a stack of lab reports from the nurses' station and handing them to Zhou Cheng. "Could you take a look and see if there's anything wrong?"

Zhou Cheng took the lab report and looked at the blood routine test first.

The white blood cell count was 13.5 × 10⁹/L, and the neutrophil percentage was 85%, indicating elevated inflammatory markers consistent with an acute infection.

Liver and kidney functions are both within the normal range.

Zhou Cheng was about to put down the lab report when his eyes inadvertently swept over the D-dimer value: 1200 ng/mL (FEU)!

The normal reference value is generally no more than 500 ng/mL, and this value is more than twice as high!

Zhou Cheng's expression changed instantly.

Things seem to be getting increasingly wrong!