Chapter 1415: Full Moon Face, Buffalo Bump

Chapter 1415: Chapter 1415: Full Moon Face, Buffalo Bump

Xu Yino was full of energy, especially after noticing the small interactions between Liu Banxia and Chen Xuehai, her energy levels soared even higher.

"Director Chen, were we being hasty?" Liu Banxia whispered.

"Sigh... you were in charge of the patient intake, what were you doing?" Chen Xuehai whispered back.

"Well, wasn’t it that I was too anxious at the time, so I didn’t observe carefully? Plus, he was carried straight from the car to the examination bed and pushed for an MRI." Liu Banxia replied.

Xu Yino blinked; there must be a new discovery.

But when she looked closely at the patient, his walking posture seemed fine; there didn’t seem to be anything wrong with him.

At this time, Peng Bo also approached, frowning when he saw the patient’s condition. "What are your thoughts?"

"Let’s continue with the diagnosis, thank goodness we didn’t hastily prescribe medication." Chen Xuehai said.

"Doctor, what’s wrong? Does Old Du have another illness?" the patient’s wife asked worriedly.

"We can’t say right now if there’s another illness, but we might have misunderstood the cause of his non-symmetrical heart hypertrophy. Let’s do some more tests; there’s no rush." Liu Banxia said.

"That was hasty; we almost made a joke of ourselves. Director Liu, why can’t you be more alert?" Peng Bo added.

"Sigh... it’s hard to explain. Xu Yino, based on the patient’s current condition and test results, what diagnosis can you provide?" Liu Banxia asked Xu Yino.

"Uh... I’m not sure for now. But the patient’s gait seems normal; I didn’t notice anything particularly wrong." Xu Yino said.

"However, I felt there was some lack of coordination, but I can’t quite say where. It just doesn’t seem coordinated."

"Oh doctor, why not just say our Old Du is a bit unevenly fat." The patient’s wife smiled wryly.

"Others may be fat, but they’re evenly distributed. He, on the other hand, is only fat in the body; his arms and legs aren’t very fat. And his face is big too, which wasn’t the case before."

"Right, right, exactly, that’s why it looks a bit uncoordinated to me." Xu Yino nodded.

"The lady’s hinted this much, and you still haven’t noticed anything wrong?" Liu Banxia asked.

"Uh... let me think some more." Xu Yino suddenly became anxious.

Chen Xuehai and Peng Bo didn’t offer her any hints; this was Liu Banxia’s lesson, meant to be followed in his style.

"You’re a constant worry." The patient’s wife said as she looked at her husband walking over.

"I was just chasing after the bus, ran a bit too hard, and triggered my heart condition. It’s no big deal, it doesn’t hurt now, and it’s not a heart attack." The patient’s husband said.

"Doctor, can we leave once we’ve paid? The MRI doctor said they didn’t find anything, no issues. I’ve had this condition for a while, and the medicine took longer to work today, next time I’ll take an extra pill."

"Still so carefree, the doctor said you were in pretty dire straits. Your heart is as fat as your brain, rest over there for a while." The patient’s wife said.

"Alright, then I’ll rest for a bit; I’m a bit tired from walking back." The patient complied.

"Ah, I know! Full moon face, buffalo bump, hanging abdomen, Cushing’s syndrome?" Xu Yino suddenly shouted from the side.

"It took you this long to consider such typical body features; figure out how you should punish yourself." Liu Banxia said.

"Sigh... I was careless." Xu Yino sighed.

The hustle and bustle really shouldn’t have happened; it was like digging a hole for oneself.

"Doctor, what’s this illness with moons and buffaloes?" the patient’s wife asked with some concern.

"His condition matches very well with a body feature called Cushing’s syndrome." Liu Banxia said.

"Full moon face means his face is as round as a full moon. You can also see a bit of acne on his face."

The patient’s wife nodded.

"Buffalo bump, as you just mentioned, means his body is fat, but his arms and legs aren’t noticeably fat." Liu Banxia continued.

"Especially, you can see his head slightly leaning forward. It’s not actually him hunching over, but the result of fat and muscle accumulation on his back and neck."

"Hanging abdomen is simple; his belly looks like a pregnant belly. This is called central obesity, likely Cushing’s syndrome."

"The triggering of this condition is due to a hormone imbalance in the body, specifically an overproduction of cortisol."

"If our assessment is correct, then the cause of his non-symmetrical heart hypertrophy is this, not a congenital genetic disease, so we need another approach to treatment."

"Doctor, are you saying this kind of fat is a disease?" The patient sitting on the examination bed became uneasy.

Liu Banxia nodded, "That’s why we have to admit you to the hospital today. And then we need to conduct a series of tests, especially the measurement of hormone levels in your body. This needs to be done in stages and at different times."

"It requires such tests, doesn’t that cost a lot of money?" the patient said.

"Even if it costs money, the tests need to be done. Your condition needs to be treated." Liu Banxia said, and gave the patient’s wife a knowing look.

"You sit tight, I’ll go handle the paperwork." the patient’s wife said.

The patient didn’t dare say more and obediently sat back down.

"Doctor, is there something else you’re not saying?" the patient’s wife asked Liu Banxia, who had followed them.

Liu Banxia nodded, "The secretion of cortisol is mainly controlled by two aspects: one is the pituitary gland, and the other is the adrenal cortex."

"At present, we can’t determine the cause of his illness. There might be pituitary tumor, adrenal tumor, or adrenal cortex hyperplasia."

"I didn’t dare say this in front of him just now, so to determine the cause, we need to conduct further examinations. We need to check the brain and both adrenal cortices, and as I mentioned earlier, measure hormone levels."

"If the cause is related to the pituitary gland, we’ll need to call in a neurologist or a neurosurgeon. If it’s related to the adrenal cortex, that falls under our department."

"Doctor, does this mean that even though he has heart disease, the root of the issue isn’t in the heart?" the patient’s wife asked.

Liu Banxia nodded, "His heart condition is merely one manifestation of the symptoms. The root isn’t in the heart, but in the hormone secretion."

"Doctor, is it cancer?" the patient’s wife asked worriedly.

"At the moment, this is just one direction we’re speculating towards, and even if a tumor is present, it’s more likely to be benign. Let’s not jump to conclusions; it’s better to first conduct tests and rule out possible causes in these two areas." Liu Banxia said.

Even though Liu Banxia tried to reassure her, the patient’s wife remained very concerned.

It’s understandable; without tests, anything is possible.

"This is so dangerous, Teacher Liu, how will you punish me?" Xu Yino asked guiltily.

"Think about it yourself, the symptoms are so obvious, yet you couldn’t diagnose them." Liu Banxia said.

"It’s been ages since I’ve encountered something like this. Generally, patients with such symptoms would have been thoroughly checked and diagnosed a long time ago." Xu Yino muttered.

"Exactly, the patient is somewhat careless and also hesitant to spend money. So the symptoms have dragged on to this extent, but that doesn’t excuse you from punishment." Liu Banxia said with a smile.

Xu Yino was left with no choice, "Then I’ll treat Qingqing to an extra chicken drumstick."

"Even though you came up with a sneaky idea, this punishment is acceptable." Liu Banxia smiled and nodded.

Xu Yino was fretting, but what could she do; the blisters on her feet are from her own walking.

Everyone else went on rounds, while she insisted on joining a discussion below.

"Ah... got up early but caught the late market. Sending him was our job, yet in the end, it might not even be related to us." When Liu Banxia came back, Chen Xuehai remarked.

"It’s really hard to say, shouldn’t we also consider the possibility of a tumor secreting ectopic ACTH?" Liu Banxia asked.

"That’s possible, but testing for that would be quite troublesome. Oh, I remember you diagnosed a case like this before, didn’t you? What was the condition again?" Chen Xuehai countered.

"Forgotten? Small cell lung cancer." Liu Banxia replied with a laugh.

"Because I remembered that case, that’s why I have this suspicion now. Thinking about it, I feel this could very well be the underlying cause."

"If there was a direct impact on the pituitary or adrenal cortex from a tumor, it couldn’t have only caused this much effect after so many years, could it?"

"It’s possible, but it’d be laborious to rule it out." Chen Xuehai said.

Xu Yino blinked a few times, feeling a bit frustrated.

She remembered too; Liu Banxia indeed diagnosed it before. But why didn’t it occur to her at that time? The patient’s high blood pressure, high blood lipids, high blood sugar, and low blood potassium were also signals.

"I actually thought of suggesting a PET-CT scan directly just now, but then considered the cost was too high, so decided to take it step by step." Liu Banxia continued.

"After all, the likelihood of an ectopic endocrine tumor is quite low. More likely causes are the pituitary or adrenal cortex. Drug-induced causes don’t need to be considered, saving some effort."

"Teacher Liu, why so?" Xu Yino asked.

Liu Banxia glanced at her, "What’s gotten into you today? Your standard is so low, it’s fallen into a pit. He can’t even be bothered to take hypertension medication, what else would he be taking?"

"Hahaha, true. Actually, I’m still recovering from the earlier blow, it hit me pretty hard." Xu Yino said sincerely.

Without being affected by Liu Banxia, she wandered off to the side after speaking.