I Can See Health

Lu Chen was very happy and successfully gained some gratitude points.

After the old woman ate snacks, her symptoms of hypoglycemia, such as palpitation and cold sweats, were much better.

Back in the duty room, Lu Chen couldn't sleep.

He was woken up in the middle of the night, which made him sleepless.

He simply put on his white coat and came to the office.

There was no one in the office, and Teacher Min Ling should have gone to rest.

Lu Chen sat in front of the computer and clicked on the laboratory system.

The little girl with hypokalemia who was admitted to the hospital in the middle of the night had a blood potassium level that had risen to 2.8mmol/L.

According to the doctor's instructions, Dr. Min Ling prescribed a few more doses of potassium and would recheck the blood potassium at six in the morning.

While he was full of energy, Lu Chen focused his attention on the cause of "hypokalemia".

Take out a blank A4 paper.

Lu Chen wrote down all the common causes of hypokalemia on paper.

First, the intake of potassium is insufficient. Including fasting or anorexia, which had previously been excluded.

Secondly, potassium excretion increases.

Loss of digestive juices, including diarrhea, severe long-term vomiting and long-term gastrointestinal drainage, in addition to loss of potassium from the skin.

These are also excluded.

In addition, there is renal potassium loss.

Including the use of diuretics, hydrochlorothiazide, furosemide, etc., as well as renal diseases, Cushing's syndrome, renal artery stenosis, reninoma, pheochromocytoma, and Liddle syndrome.

Through the patient's relevant examinations at the county-level hospital, all cases were ruled out one by one.

Finally, it is the abnormal distribution of potassium in the body, including heart failure, renal edema, excessive fluid infusion, and insulin action.

None of these seem to fit.

Lu Chen fell into deep thought again.

He kept looking through the patient's medical records, and also used his mobile phone to check relevant papers in the literature library, trying to find clues.

…

Time passes slowly.

Four o'clock in the morning.

Even relying on the super comprehension ability of the "Literature Reading" skill book, he still could not find the reason for the girl's low potassium.

Is it really necessary to attribute her hypokalemia to "idiopathic hypokalemia" for which no cause can be found?

But as a last resort, you should try to find out the cause of low potassium.

After all, this is just a teenage girl!

…

Five o'clock in the morning.

Lu Chen still hasn't found the cause of hypokalemia.

He returned to the duty room and prepared to take a nap for a while.

Because I have to get up again at six o'clock to check my blood sugar.

…

Six o'clock in the morning.

Lu Chen opened his eyes, wore a white coat, held a blood glucose meter, and began to measure blood sugar in each ward.

At this time, most patients are awake.

Lu Chen had a lot of blood sugars to test.

The journey of "poke poke" begins again.

"Auntie, your blood sugar L is under good control."

"Mother-in-law, your blood sugar is too high. It's 1L. Did you eat something last night? Hey... don't eat anymore at night. Look at the fasting blood sugar during the day!"

"Uncle, your blood sugar is 7.3mmol/L. You haven't taken any medicine or insulin? Then if you continue to control your diet and exercise more, you may not need to take medicine to lower your blood sugar in the future."

….

Come to the ward where bed No. 12 is located.

Lu Chen finished measuring the blood sugar of other beds and came to the girl's bed in bed 12.

The girl was lying on the bed, curled up on the corner of the bed, soundly asleep.

"Is she feeling better?" Lu Chen looked at the middle-aged woman aside and asked softly.

"It's better, thank you doctor."

The middle-aged woman nodded, and then helped the girl tuck herself into bed.

"Ah That's good."

Lu Chen was about to leave when he was suddenly stopped by a middle-aged woman.

"Doctor, do you have licorice tablets in your hospital?"

"Licorice tablets?" Lu Chen stopped, "What's wrong? Is she coughing?"

"Hey, she has been in poor health since she was a child and is prone to colds and coughs."

The middle-aged woman sighed.

"Take cough medicine whenever you cough?" Lu Chen frowned.

"There is nothing we can do. She keeps coughing. We feel uncomfortable listening to her cough." The middle-aged woman looked helpless and distressed.

"Didn't you investigate why?"

"I've checked it out. I've checked it out at all the major hospitals in Beijing, but no cause has been found."

"Auntie, it's not an option to keep eating licorice tablets like this." Lu Chen frowned, "There is a substance in licorice tablets that is addictive."

The main ingredients contained in compound licorice tablets are licorice extract powder, opium powder, camphor, star anise oil, sodium benzoate, etc.

Among them, opium powder has analgesic, sedative, and antitussive effects, and is a drug that can easily cause human dependence.

Although the content is very low, it can become addictive if taken for a long time or in large doses.

Therefore, taking compound licorice tablets for a long time may lead to addiction, and patients may experience pleasure and gradually develop craving and dependence on it.

"Addicted?" The middle-aged woman was stunned. "Doctor, please give us another cough medicine."

"Yeah." Lu Chen nodded, "But maybe she doesn't have a bad cough, but she just wants to eat licorice tablets."

"I really haven't noticed this." The middle-aged woman said solemnly, "When I first saw the doctor, he asked me to take licorice tablets, and I have been taking them intermittently since."

"Approximately how long did she eat?"

"It's been more than half a year."

Lu Chen raised his eyebrows.

More than half a year?

This seems to be about the same time that her symptoms of dizziness and limb weakness appeared!

Lu Chen suppressed the doubts in his heart.

He was going to test all his blood sugars and then read the instructions on the licorice tablets to see if there was any risk of hypokalemia.

Just like that, Lu Chen poked his fingers faster.

Hit the nail on the head!

…

After measuring my blood sugar, I returned to the doctor’s office.

Lu Chen opened the doctor's order system and entered the licorice tablets. Drug-related information immediately popped up, including adverse reactions to the drug.

Adverse reactions of licorice tablets: mild nausea and vomiting reactions...

He saw no description of hypokalemia.

"Isn't it because of the licorice tablets?"

Lu Chen frowned, and the thoughts he had just had were interrupted again.

"Xiao Lu, did you get up so early to check your blood sugar?"

At this time, Min Ling walked into the office.

She stretched out and sat next to Lu Chen.

"I couldn't sleep, so I tested my blood sugar in advance. UU Reading www.uukanshu.net" Lu Chen smiled.

"Yeah." Min Ling nodded slightly, and suddenly saw Lu Chen's computer screen, "What are you looking for? Licorice tablets?"

"Yes." Lu Chen nodded, "When I just tested my blood sugar, I found out that the girl with hypokalemia last night had been taking licorice tablets. I wanted to check whether the hypokalemia was related to this. The result was not found.”

Min Ling was shocked when she heard this.

"She's been eating licorice tablets?"

"Well, yes." Lu Chen looked at Min Ling doubtfully, not knowing why she had such a big reaction.

"No need to check, licorice tablets can cause hypokalemia!" Min Ling said solemnly.

"Ah?" Lu Chen was stunned.

Min Ling explained: "Licorice tablets contain glycyrrhizic acid and glycyrrhetinic acid. The chemical structures of these two substances are similar to corticosteroids. They can directly act on mineralocorticoid receptors to retain sodium and excrete potassium, leading to hypokalemia." "

"In addition, glycyrrhizic acid can enhance the physiological effects of other glucocorticoids, causing intracellular potassium transfer, leading to hypokalemia."

Lu Chen rubbed the back of his head, "But I didn't find this adverse reaction in the drug instructions."

"Drug instructions are updated only after a long time, and the information lags behind." Min Ling smiled, "Actually, your time in the clinic is too short. As long as you stay longer, you will understand this knowledge."

Lu Chen only practiced clinical practice for one year, and was exposed to more textbook knowledge.

Medicine is a highly empirical science.

In addition to textbook knowledge, practical experience is equally important!

"In other words, the cause of her hypokalemia is long-term oral administration of licorice tablets?"

"Most likely." Min Ling nodded and looked at Lu Chen with a smile.