s*******q
发帖数: 310 | 1 今天去看医生，本人咳嗽了一两个星期了，晚上咳嗽的时候睡都睡不好，今天去看医生
给做了肺部的x-ray，说肺部没毛病然后就开药了，开的是omeprazole 20mg，我去药房
抓药拿来一看是治heartburn的，根本没来得及问。而且我看到盒子上写着是一天一粒
，但是医生跟我说一天两次，还开了一个月的量。我彻底糊涂了，版上有懂医药的吗？
给说一下，照说医生不会这么糊涂乱开药的，谢谢了 | g*****j
发帖数: 1211 | 2 Acid reflux is a common cause for cough during sleep. The trial treatment
is often used as a way of diagnosis, because it is a fairly safe medicine.
Next time before you leave his office, you should ask your doctor what
diagnosis he has made, and what treatment he is prescribing :) | s*******q
发帖数: 310 | 3 Thanks 帅锅，医生还说吃一个月药后再去见他，我看到说明书上写不要超过一天一粒
的量，他说让我一天吃两粒有没有关系啊
其实我最近腹部左上侧老是隐隐作痛，就是肋骨附近，三角的左侧，他也说不出是啥来
。哎，其实我觉得感冒咳嗽到是事情小，腹部那里不舒服才是最重要的
【在 g*****j 的大作中提到】
: Acid reflux is a common cause for cough during sleep. The trial treatment
: is often used as a way of diagnosis, because it is a fairly safe medicine.
: Next time before you leave his office, you should ask your doctor what
: diagnosis he has made, and what treatment he is prescribing :)
| n******s
发帖数: 210 | 4 OK, runny nose, cough, and mild left abdominal pain, all these remind
infectious mononucleosis which is rare.
For acid reflux (GERD), cough while lying down is one of symptoms, but note
the cough is caused by the refluxed acid, typically the patient gets metal
taste in the mouth, in fact, asthma is more often than cough.
Several questions may help with the Dx, like any heartburn, chest pain,
asthma, association with eating, lying down. exacerbating and alleviating
factors. | s*******q
发帖数: 310 | 5 你分析的好专业啊，可是我有点看不明白，我自己不也知道自己有没有heartburn，我
对heartburn的理解就是胃里有酸水回流。我倒是有时候咳嗽的时候喉咙里有痰，味道
有点你说的金属味。还有我肚子一侧隐隐痛到底是怎么回事啊，谢谢你帮我解难，送你
两个包子
note
【在 n******s 的大作中提到】
: OK, runny nose, cough, and mild left abdominal pain, all these remind
: infectious mononucleosis which is rare.
: For acid reflux (GERD), cough while lying down is one of symptoms, but note
: the cough is caused by the refluxed acid, typically the patient gets metal
: taste in the mouth, in fact, asthma is more often than cough.
: Several questions may help with the Dx, like any heartburn, chest pain,
: asthma, association with eating, lying down. exacerbating and alleviating
: factors.
| n******s
发帖数: 210 | 6 before I can give you any suggestion, may I ask you some questions, like
when did it start,
do you have any sputum,
could you describe the abdominal pain, severity, any radiation, any
exacerbating or alleviating factors?
any chest pain?
do you cough in the daytime?
ill contact?
family history?
or any other information that you think you need to tell me?
no need to "pay" any baozi, in fact, I have no idea how to use them. | s*******q
发帖数: 310 | 7 我肚子隐痛有快一个月了，就是像刚吃完饭后马上运动之后的那种疼痛，我咳
嗽有少量的痰，颜色有时候微黄。胸口不疼，白天也会咳嗽，感觉吃了
heartburn的药晚上咳嗽好像稍微好一点了。肚子那边疼，咳嗽的时候用力的时
候肚子那里会更难受点.(难道我咳嗽的时候太用力导致肚子一侧隐痛？我自己
猜测）然后有时候感觉吸气用力一点会触发那里的隐痛，不过平时没感觉。我去年9月
初从国内回
来的时候，过了一个月也就是10月份有剧烈咳嗽，
也没看医生，过一阵子好一点了就没理，我当时觉得可能是粉尘或者其他东西过敏，最
近怎么又来了。还有前一段时间里也就是12月份的时候
左下侧腹部也有隐痛过一阵子，我晚上查了下可能得了附件炎，然后吃了一个
星期的花红片，现在左下腹不痛了，然后就是现在的左上腹肋骨附件这里隐痛
了。我家里人没什么遗传史的。
不好意思，让你听我说了一堆罗里罗嗦的话 | T*****u
发帖数: 7103 | | n******s
发帖数: 210 | 9 busy with something else, just got time to come back.
OK, now the differentials in my mind:
1. Upper respiratory tract infection (RUI), runny nose, cough, yellow sputum
, but we can roughly rule out pneumonia, since the CXR is normal.
2. GERD: nocturnal cough, and relieved by losec, right? but typically, the
patient with GERD will tell that they can feel heartburn or chest pain, and
most of them can feel the reflux of the acid.
3. Gastritis: LUQ abdominal pain, not sure, sometimes, the pain as y | s*******q
发帖数: 310 | 10 谢谢回复啊，看了你的诊断，太吓人了，我觉得肚子隐痛真可能是脾有问题或者有胃炎啊
怪不得以前和朋友去workout跑步，感觉肚子隐痛那里更加不舒服了。医生说让下个月
去再看看，这么多毛病很想回国看得了，555
sputum
and
【在 n******s 的大作中提到】
: busy with something else, just got time to come back.
: OK, now the differentials in my mind:
: 1. Upper respiratory tract infection (RUI), runny nose, cough, yellow sputum
: , but we can roughly rule out pneumonia, since the CXR is normal.
: 2. GERD: nocturnal cough, and relieved by losec, right? but typically, the
: patient with GERD will tell that they can feel heartburn or chest pain, and
: most of them can feel the reflux of the acid.
: 3. Gastritis: LUQ abdominal pain, not sure, sometimes, the pain as y
| s*******q
发帖数: 310 | 11 还有下次把你得回复打印了带去给我医生看看，呵呵
sputum
and
【在 n******s 的大作中提到】
: busy with something else, just got time to come back.
: OK, now the differentials in my mind:
: 1. Upper respiratory tract infection (RUI), runny nose, cough, yellow sputum
: , but we can roughly rule out pneumonia, since the CXR is normal.
: 2. GERD: nocturnal cough, and relieved by losec, right? but typically, the
: patient with GERD will tell that they can feel heartburn or chest pain, and
: most of them can feel the reflux of the acid.
: 3. Gastritis: LUQ abdominal pain, not sure, sometimes, the pain as y
| n******s
发帖数: 210 | 12 another several points.
Family doctors and internal medicine doc approach the patient in different
ways. FP always put the simplest and commonest one first, treat, if fail,
next one or refer to specialist. While internist makes a list of
differentials, and try to rule out one by one.
And another one is: remember, even one question can change the diagnosis
totally, e.g. if you told me there is trace of blood in your sputum, then
what I listed above is totally wrong. that's why I told you that you |
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