Файл: Учебное пособие 2 по английскому языку Для студентов лечебного и педиатрического факультета (2 семестр) 2020 год.doc

Reading
VII. Read and translate the text

History and Physical Examination

The chief complaint (CC)orpresenting complaint (PC) is a short statement describing the symptom, problem, condition, diagnosis, or other reason for a doctor’s visit.

A patient typically presents a set of complaints to the medical professional who then performs a diagnostic procedure, which generally includes obtaining further information about the patient's symptoms, previous state of health, and so forth. In the broad sense, the word symptom is used to label any manifestation of disease. In the diagnostic sense, however, symptoms are thought to be only subjective, appreciated only by the affected person. Pain and itching are pure symptoms. Signs are detectable by another person, i. e. they are objective. Pulmonary rales are pure signs. Fever and swelling are symptoms and signs as the same time. A symptom can never be a diagnosis: a headache is a symptom. Most clinical diagnoses will be comprised of a syndrome, supported by physical signs observable to the examiner, and correlated with laboratory and roentgenological findings.

General symptoms: weight change (loss or gain), change in appetite, fever, malaise.

Respiratory symptoms: cough, sputum, shortness of breath, wheeze, chest pain.

Cardiovascular symptoms: shortness of breath on exertion, chest pain, palpitations, ankle swelling.

Gastrointestinal symptoms: indigestion, abdominal pain, nausea, vomiting, constipation.

Urinary symptoms: polyuria, dysuria, haematuria.

Neurological symptoms: headaches, dizziness, weakness, tremor, fits, faints.

Locomotor symptoms: aches, pains, stiffness, and swelling.

Skin symptoms: ulcers, rashes, itch.

Physical examination generally follows the taking of the medical history. A physical examination, medical examination, or clinical examination (more popularly known as a check-up) is the process by which a medical professional investigates the body of a patient for signs of disease. Together with the medical history, the physical examination aids in determining the correct diagnosis and forming the treatment plan.

A complete physical examination includes evaluation of general patient appearance and specific organ systems. In practice the vital signs of temperature, pulse, and blood pressure are usually taken first. Respiratory rate is checked too. Vital signs may reflect abnormalities in the body systems.

Physical examination is the process of evaluating objective anatomic findings through the use of observation or inspection, palpation, percussion, and auscultation. A patient may sit or stand during this part of the examination. This includes the estimation of: face expression, constitutional type, gait abnormalities, skin color, hair, nails, visible mucous membranes, subcutaneous fat, presence of edema, lymph nodes, muscles, bones, joints.

Palpation. The examiner uses their hands to feel for abnormalities during a health assessment (lymph nodes, chest wall, abdomen) checking the presence of masses or lumps.

Percussion. The examiner uses hands to "tap" on an area of the body. The "tapping" produces different sounds. Depending on the kind of sounds the healthcare provider may determine anything from fluid in the lungs, or a mass in the stomach.

Auscultation. The healthcare provider listens to heart, lungs, neck or abdomen, to identify if any problems are present. Auscultation is often performed by using a stethoscope.

With the clues obtained during the history and physical examination the healthcare provider can formulate a differential diagnosis and a list of potential causes of the symptoms. Specific diagnostic tests generally confirm the cause. Primary care provider can form a diagnosis and treatment plan.
VIII. Choose the right variant:

Multiple Choice Test

1. 
   Chief complaint is
   

• 
  the minor health problem or concern
  
• 
  the major health problem or concern
  
• 
  the major syndrome
  

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2. 
   Symptom is thought to be
   

• 
  associative
  
• 
  subjective
  
• 
  objective
  

3. 
   Sign is thought to be
   

• 
  causative
  
• 
  subjective
  
• 
  objective
  

4. 
   Review of systems is
   

• 
  a set of ordered complaints about each major body system
  
• 
  a set of ordered questions about each minor body system
  
• 
  a set of ordered questions about each major body system
  

5. 
   Physical examination is
   

• 
  process by which a medical professional investigates the body of a patient for signs of disease
  
• 
  process by which a medical professional investigates the body of a patient for symptoms of disease
  
• 
  process by which a medical professional investigates the body of a patient for signs of symptom
  

6. 
   Observation is
   

• 
  the review of the symptoms for signs of any potential conditions
  
• 
  the review of the internal organs for signs of any potential conditions
  
• 
  the review of the appearance for signs of any potential conditions
  

7. 
   Palpation is
   

• 
  the use of feet to feel for abnormalities during a health assessment
  
• 
  the use of hands to feel for complaints during a health assessment
  
• 
  the use of hands to feel for abnormalities during a health assessment
  

8. 
   Percussion is
   

• 
  the use hands to "tap" on an area of the body to determine a sounds
  
• 
  the use hands to "tap" on an area of the body to determine a fluid or a mass
  
• 
  the use ears to "tap" on an area of the body to determine a fluid or a mass
  

9. 
   Auscultation is
   

• 
  listening to heart, lungs, neck or abdomen performed by using a stethoscope
  
• 
  listening to heart, lungs, neck or abdomen performed by using an otoscope
  
• 
  listening to heart, lungs, neck or abdomen performed by using a microscope
  

IX. Read the following sentences and choose a correct word:

1. 
   The chief complaint\secondary complaint is a short statement describing the symptom, problem, condition, diagnosis, or other reason for a doctor’s visit.
   
2. 
   A patient typically presents a set of systems\complaints to the medical professional.
   
3. 
   Secondary complaints are based on the review of complaints\systems.
   
4. 
   In practice the vital signs are usually taken first\second.
   
5. 
   A general examination generally starts at the extremities\head and finishes at the head\extremities.
   
6. 
   The first part of examination is palpation\observation.
   
7. 
   The examiner uses feet\hands to "tap" on an area of the body.
   
8. 
   Auscultation is often performed by using a stethoscope\otoscope.
   
9. 
   With the clues obtained during the history and physical examination the healthcare provider can formulate a differential\ provisional diagnosis.
   

X. Make word combinations, match the words:

presenting history

diagnostic plan

physical system

medical diagnosis

treatment assessment

vital examination

health symptom

organ procedure

provisional sign
XI. Match the symptoms (A-G) and the body system (1-7):

1. 
   ulcers, rashes, itch
   
2. 
   cough, sputum, wheeze
   
3. 
   shortness of breath on exertion, chest pain, palpitations
   
4. 
   indigestion, abdominal pain, nausea, vomiting
   
5. 
   headaches, dizziness, weakness, faints
   
6. 
   polyuria, dysuria, haematuria
   
7. 
   aches, pains, stiffness
   

1. 
   Muscular-skeletal system
   
2. 
   Respiratory system
   
3. 
   Cardiovascular system
   
4. 
   Integumentary system
   
5. 
   Urinary system
   
6. 
   Nervous system
   
7. 
   Digestive system
   

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XII. Fill in the blanks with the correct words or word combinations from Word Bank:

Word bank: medical history,palpation, physical examination, review of systems, auscultation, secondary complaints, treatment plan, presenting complaint, organ systems.

The __________________________ is the major patient’s health problem or concern. Following the presenting complaints, the healthcare provider makes a ____________________. _________________are based on the review of systems. Physical examination generally follows the taking of the ____________. A complete _______________________ includes evaluation of general patient appearance and specific____________________. A general examination generally starts at the head and finishes at the extremities and consists of observation, _______________, percussion, and_____________. Together with the medical history, the physical examination aids in determining the correct diagnosis and forming the__________________.
XIII. Look at the pictures and answer the questions


XIV. Read the Case Report and define the information for each section in the chart below:

Case Report

On general inspection, Lucy appeared to be tired. She showed a prominent sign of proptosis. She also had a few bruises on her left arm, due to frequent cannulation and blood test, and a scar from her recent biopsy on the right side of her forehead.

On cardiovascular, respiratory and abdominal examinations, no significant signs were detected. Blood pressure was normal, 130/82. Pulse rate was 80 beats per minute and respiratory rate was 14 beats per minute.

On neurological examination, there were no signs of muscle wasting, abnormal movements or tremor. The upper limbs showed full range of active and passive movements. On flexion and extension of the right arm, however, pain was detected. The patient had normal tone, power, coordination and sensation in both arms. Reflexes, however, were increased in both arms.

Examination of the lower limb showed normal tone, power, coordination and sensations. Plantar reflexes in both legs, however, were decreased. There were no signs of abnormal gaits. Trendelenburg test, Pull test, and Romberg's test all showed negative results.

Symptoms	Data
Vital signs
General symptoms
Cardiovascular symptoms
Respiratory symptoms
Gastrointestinal symptoms
Neurological symptoms
Locomotor symptoms
Skin symptoms:

XV. Match the definitions with the words:

1. 
   boil a) when the skin goes blue and yellow
   
2. 
   lump b) when a part of the body makes you to scratch it
   
3. 
   rash c) twisted part of your body
   
4. 
   scab d) infected swelling with the liquid inside
   
5. 
   spot e) red mark on the skin (much smaller than a boil)
   
6. 
   swelling f) allergic reaction which makes the skin goes to red
   
7. 
   bruise g) deep cut
   
8. 
   bump h) like a graze but more painful
   
9. 
   cut i) swelling
   

10) gash j) dry skin that forms over a cut

11) graze k) when something sharp breaks the skin and you bleed

12) itch l) slight cut – not enough to bleed much

13) scratch m) an irritation or infection that makes the skin rise

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14) sprain n) when you hit yourself and get a slight swelling
Listening

XVI. Watch the video ‘Abdominal examination’

https://www.youtube.com/watch?v=O1ajZJvrITg

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XVII. Watch the video ‘How to Diagnose Tonsillitis- Physical Examination For Tonsillitis’and answer the questions:

https://www.youtube.com/watch?v=yHPQGlEAIM0

• 
  What is tonsillitis?
  
• 
  What are the symptoms of tonsillitis?
  
• 
  What microorganisms cause tonsillitis?
  
• 
  How is tonsillitis diagnosed?
  

LESSON 24
Grammar: Revision Functions of One & That

Laboratory and imaging tests

I. Answer the questions

• 
  What laboratory and imaging tests do you know?
  
• 
  Why are these tests ordered by the doctor?
  

Word building

Suffix, prefix	Meaning	Example
-osis	1. condition, disease, action (typically denotes production or increase) 2. invasion or increase of parasites within an organism	halitosis trichinosis
-graphy	a process of writing or recording	adenography
-gram (-gramma)	tracing, mark, drawing, writing, or record	electrocardiogram
pan-(pant-, panto-)	all, entire	panmixia
end- (endo-, ento-)	within, inside	endotherm

I. Read and translate the words of Latin-Greek origin. Pay your attention to the pronunciation of the words:

urinalysis [,juqrI`nalIsIs], hypodermic [,haIpqu`dWmIk], hematocrit [`hJmqtqkrIt], leukocytosis [,ljHkqsQi’tousJz], leukopenia [,ljHkq’pJniq], cytopenia [‘sQitq’pJniq], anemia [q`nJmIq], thrombocytopenia [,TrOmbq,sAItq`pJnIq], coagulation [kou,qegju’leiSn], index [`Indeks], glucose [`glHkqus], cholesterol [kq`lestrOl], viscus [`vIskqs], cancer [`kxnsq], echo [‘ekou], signal [‘signl], invasive [In`veIsIv], endoscopy[en`dOskqpI],
Active vocabulary

image [`ImIdZ] - изображение, образ

imaging [`ImIdZIN]- визуализация, получение изображения

to track - следить, отслеживать

sample [`sRmpl] - проба, образец

to extract [Ik`strxkt] – извлекать, выделять

to prick – колоть, прокалывать

complete / full blood count [kqmp`lJt , kaunt] – общий анализ крови

to bleed [blJd] - кровоточить

bruise [brHz] - гематома, синяк

X-ray [`eksreI] - рентгеновские лучи, рентгенограмма

to depict [dI`pIkt] - изображать, описывать

tumor [`tjHmq] – опухоль

to create [krI`eIt] - создавать

injury [`IndZqrI] – травма, повреждение, рана

advantage [qdv`RntIdZ] - преимущество

to expose to [Ik`spquz] - подвергать

stroke [strquk] - внезапный приступ, инсульт

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