The diagnosis represents the pathology conclusion given by the attending physician, and the subsequent treatment plan will also revolve around the diagnosis results. Misdiagnosis can easily lead to medical accidents.
Adhering to a responsible attitude towards patients, since there are doubts, the diagnosis opinion should not be filled in.
He felt it was necessary to understand if the patient had any past medical history.
"Medical history inquiry."
After entering four characters, the patient's medical history information popped up.
"The patient has no history of heart disease, and neither do the relatives within three generations of the family."
This indicated that there is no issue like familial heredity.
The patient's heart should have been healthy before.
"Course of the disease."
He entered another four characters.
Normally, this information should appear in the physical examination category. However, it didn't.
Only targeted inquiries would display that information.
Zhou Can faintly realized that this was possibly the examiners deliberately hiding some information. Or they thought this information was not important, so it was omitted.
"Before the onset of the disease, the patient lost his job and divorced his wife. While living alone, he suddenly experienced chest pain and difficulty in breathing."
Seeing this information about the patient, Zhou Can's eyes slightly brightened.
He always felt something was amiss.
Now thinking about it, it should be the omission of the patient's medical history and course of the disease.
Losing his job was already bad enough, and his mood must have been low.
At this time, without any comfort, his wife instead divorced him, which was adding insult to injury.
The greatest sorrow comes from a dead heart.
When someone's heart is extremely sad and in pain, it is easy to experience symptoms like chest pain and difficulty breathing.
Zhou Can's eyes became more and more determined, gleaming with insight.
"Emergency, chest pain, difficulty breathing, elevated troponin, electrocardiogram showing myocardial infarction – from the beginning, the examinees prematurely concluded acute myocardial infarction."
Watching those examinees who completed their diagnoses and were complacent, Zhou Can couldn't help but shake his head slightly.
These examinees are likely to lose points.
To confirm whether the patient had a myocardial infarction, the most authoritative examination is not an electrocardiogram nor an X-ray but coronary angiography.
X-ray cannot detect clots.
Only coronary angiography is the sole authoritative and effective detection method.
This examination is usually performed by an experienced doctor from the Cardiovascular Department. It requires inserting a needle at the patient's femoral artery at the root of the thigh and then inserting a guide wire.
The guide wire is pushed deeper into the blood vessel, reaching the abdominal aorta, continuing further until it reaches the thoracic aorta, passing through the arch of the aorta, and finally entering the coronary artery.
Once the guide wire is successfully placed, a catheter can be inserted along it.
What for?
Injecting a contrast agent into the catheter, which can smoothly reach the coronary artery.
Now, performing an X-ray will make it visible.
It can clearly show whether the coronary arteries are blocked, and even where the narrowing is evident.
Zhou Can decisively exited the diagnosis input page and instead went back to the medical examination request page.
"Request coronary angiography."
He decisively submitted a new examination request.
"Congratulations on receiving extra points for additional examination."
The examiner is truly despicable.
Setting layers of confusing fog for the examinees, it required the examinees to have strong willpower, high-level diagnostic abilities, meticulous observation skills, and a meticulous and responsible attitude to lift all the fog to distinguish the false from the true.
Although cursing, it's undeniable that the examiner's test was truly challenging.
It could maximally filter out the true elites among more than 1,500 excellent candidates.
Recruiting the most potential talents for Tuya Hospital.
"Alright, I believe many candidates have already completed their diagnosis results, now please provide your treatment plans."
The corners of the examiner's mouth revealed a hardly noticeable cunning smile.
Clearly, it was a triumph of cunning, watching many examinees fall into the deep pit he dug, showing a smug smile.
Zhou Can ignored the examiner's urging and carefully reviewed the coronary angiogram results.
The angiography results showed that the patient's coronary arteries were normal.
There was no myocardial infarction.
Zhou Can showed a knowing smile.
"Just as I thought."
Next, it got simpler; he went to the diagnostic results page and wrote, "The patient's heart muscle is normal, with symptoms similar to myocardial infarction due to severe emotional fluctuations."
After submitting the diagnostic results, a treatment plan page popped up.
He cursed inwardly, calling the examiner sly.
After submitting the previous examination items, scores would immediately pop up, informing the candidates that their items were correct.
But when it came to submitting the diagnostic results, there was no hint; it directly jumped to the treatment plan page.
He believed many candidates would be kept in the dark.
A perfect trap laid by the examiner.
Students and examiners are natural-born enemies. That was the conclusion Zhou Can reached.
In the treatment plan section, he filled in "Suggest psychological counseling."
Then he submitted it.
Next was to patiently wait for the examiner to announce the results.
"Luckily I elevated the pathological diagnosis to Level 3, otherwise I might have failed the first part of the interview."
His gaze swept over the other candidates, some still earnestly filling out their forms.
No need to say, these heads-down types, nine out of ten would fall into the pit.
The treatment plan for acute myocardial infarction is lengthy; it can't be completed in less than ten to twenty minutes.
Medically speaking, if the diagnosis is wrong, the detailed treatment plan that follows is all incorrect as well.
It's somewhat similar to the multiplication rule.
If the multiplier is zero, no matter how large the multiplicand, the result is still zero.
He was idly bored, glancing towards the nursing candidate recruitment.
One after another, young and beautiful girls, very pleasing to the eye.
Watching them lifted his spirits, giving him the impulse to start dating.
On their side, they had also reached the interview stage, competing in basic skills like injection.
When seeing a patient, encountering a nurse with poor injection skills is truly torturous.
For a blood draw, she could jab you a dozen times just because she can't find the vein. The simplest muscle medication injection could end up hitting your bone, guaranteeing an excruciating experience.
When you feel like cursing, finding the person opposite is a young and pretty girl, a sense of chivalry kicks in, and the words at the tip of your tongue are swallowed back.
"Please, candidates who have not yet submitted their diagnostic results and treatment plans, hurry up, you have only 60 seconds left."
The sound of the examiner brought Zhou Can's attention back.
With the final deadline announced, candidates sped up their writing.
"Time's up! Now you can check your scores for the pathological diagnosis."
Candidates eagerly checked their answers.
"Ah...How come my score is only 2?"
"Examiner, is the scoring system malfunctioning? I got all the examination items right, and there were no mistakes in the subsequent diagnostic results and treatment plans, so why did I only get 5 points?"
"Mine is also 5 points, there must be a mistake in the scoring."
...
Candidates complained, turning the examination hall into chaos.
Nursing and medical technician candidates also turned their heads to look this way.
Wanting to know exactly what happened?
"What are you shouting about? What? Keep quiet, all of you."
The examiner's angry shout silenced everyone, and no one dared to challenge his authority, the complaining candidates quieted down.
But the anger on their faces expressed their strong dissatisfaction.
Without a reasonable explanation from the examination authorities, they were bound to make a fuss.
"Do you know why your scores are low? The total score for pathological diagnosis is 30 points. Those who scored below 10, mostly got only the initial part of the examination items right."
Upon hearing this, the whole room was shocked.
Those scoring less than 10 began to re-examine the questions, striving to find possible errors.
"This can't be wrong! The patient exhibited low blood pressure, elevated troponin, and ECG showing myocardial infarction signs; isn't this acute myocardial infarction?"
The candidates who answered incorrectly were perplexed.
The examiner smiled faintly, "Pathological diagnosis shouldn't rely solely on appearances. What we see and hear might deceive us. It requires us to discern carefully, to distinguish true from false, ultimately avoiding misdiagnosis. Did anyone score full marks for this question?"