医学英语视听说.doc

Medical English Watching Listening and Speaking医学英语视听说考试资料Test Introduction：Part 1：名词解释Part 2：简答Part 3：病例分析Part 4：体检Questions For Diagnosis &Treatment-Chest Pain 1Possible Disease M.I.(myocardial infarction)心肌梗塞Angina 心绞痛Pericarditis心包炎Pulmonary embolism 肺栓塞Pneumothorax 气胸Cholecystitis胆囊炎Severe indigestion严重消化不良Pneumonia 肺炎Pancreatitis胰腺炎Musculoskelrtal 骨骼系统性疼痛2Descriptions of PainAches疼痛 ,throbbing悸痛,pulsing疼痛，stings 刺痛like a stabbing pain, Sharp pain,comes in waves ,sudden pain,My chest feels tightIt feels like a tight band around my chestPressure ,压迫感3. Useful Sentences For Chest Pain How Long What does the pain feel like? Show me where the pain is? Is the pain just in that area or does it spead anywhere else? Do u have any pain in ur shoulder or down ur left arm? Is the pain constant there all the time? Does the pain get worse when u -breathe in or out? -walk around or do heavy work? What painkillers did u have?Aspirin（阿司匹林,paracetamol(扑热息痛)Here are the Forms（化验单），U Need to have some blood test, X-ray,and ECG right away！Ur results show that u have -,I am afraid u will have to be admitted into hospital for treatment (住院治疗) U need to have intravenous antibiotics (静脉输液)，and oral medication (口服药)。 Question for Diagnosis &Treatment -Diarrhea(腹泻)1.Possible DiseaseFood poisoning 食物中毒Dysentery痢疾Intestinal Obstruction肠梗阻Dehydration脱水Intussusception 肠套叠Enteritis 肠炎(小肠炎)Crohns Disease 节段性回肠炎Irritable bowel syndrome 过敏性结肠炎Bowel Tumour肠瘤Constipation 便秘2.Descriptive Words for Faeces粪便 and Diarrhea Liquid液体 watery 水样Lumpy 粒状Semi-soft 半软Mucous 粘液Bloody bloody and like jelly带血胶状Dark brown 咖啡色Cream color 乳白色Beige 浅褐色Dry 干燥Black and sticky黑色呈柏油Smelly 发臭的Pus 脓 Milk deposits 牛奶沉淀Un-digested未消化的Pale 白色Green 青色 3.Question for Diarrhea （顺序为横）How long How many times Bloody? Stool（大便） look like?Do they smell? Pain when u have diarrhea?Vomit? Eat something wrong?Able to eat ?How about fluids ? Any fever or headache?Do u feel dehydrated (脱水)?Specimen（样品）of stools ;blood test; x-ray; ultrasound(超声)-U must take fluids ,and just have a light diet until feel betterPossible bowel cancer（肠癌）（顺序为横）3 times a week 2 or 3times a dayA bit soft ,dark brown Not smellpain going with Abdominal pain or discomfortFeel bloated 腹胀 Press on stomach and palpate Do test of specimen of ur stools ,blood test Might need endoscopic内窥镜的,内窥镜检查的 or sigmoidoscopy乙状结肠镜检查术Questions For Diagnosis & Treatment-Abdominal Pain1.Possible DiseaseAbdominal Obstruction 腹胀bd mnlAppendicitis 阑尾炎pendsats Food Poisoning 食物中毒Hepatitis 肝炎heptatsCholecystitis(gallstones) 胆囊炎，（胆结石）klisistaitisGynecological Problems 妇科疾病ainikldiklStomach Ulcer 胃溃疡lsPancreatitis 胰腺炎pkritaitisUrological Problems 泌尿系统问题Respiratory problems 呼吸系统问题resprt:riCardiovascular problems 心血管问题k:di:vskjl2.Useful Sentences How long?where? how painful is it?Did the pain strat there or somewhere else?Does it hurt more after certain exercises or actions?Do u feel that u have had fever at anytime?Are u passing urine ok?(你排尿正常吗？)What does ur urine look like?Are u having your bowels open regularly?(排便正常吗)Are u menstruating ?is it normal ?Bleeding?is it normal ?Having a period?is it normal?(females ,月经来了吗？)Are u vomiting?What do u vomit? Is there a pattern?(一般什么情况下呕吐)Are u able to eat or drink?Do u get pain after eating and drinking?Please lay down ,I need to examine u I will need to do some investigations :blood tests ,x-ray and ultrasound ,urine tests and stool testsCholecystitisD:Hello ,my name is Dr pan ,how can I help u?P:I have had abdominal pain for a few days and its getting worse.D;how long have u had abdominal pain?P;about three days.D;where is it?can u show me ?P:yes ,just here .D;how painful is it?P:at first it was just on and off ,but now it seems to be there all the time.D: on a scale of 1 to 10;if no pains is 1 and very painful 10,what number would u give your pain?P; Id give it a 7D;did the pain start there or somewhere else?P;its always been there .D;does it hurt more after exercise or actions?P；if iam waling around a lot ,it will hurt a bit more.D; do u feel that u have had a fever at any time?P;no,I dont think so ,I have felt hot but I havent taken my temperature.D；I need to take ur temperature ,pulse ,and B/PAre u passing urine ok?P;yesD;what does ur urine look like?P;normal D;are u having ur bowels open regulatly?P;usually I do ,but I havent had my bowels open for a couple of days.D;have u vomited?P;no,I thought I was going to today but the feeling passed.D;are u able to eat and drink anything?P;Im drinking but I havent really felt like eating.D:what have u been drinking?P：I have had a couple of glasses of water and a couple of cups of coffee.D:does the pain get worse after eating or drinking、P;no ,not that I ve noticed.D;I need to examine you.please lay down,and loosen ur clothing for me.P;ok.D;show me where it hurts.P:it hurts just there.D;ok take a nice big breth, breathe in and out ,now try and relax.P:ouch,that hurts.D；OK thanks ,u can get dressed now.P:I will need to do some investigations : :blood tests ,x-ray and ultrasound ,urine tests and stool testsD;hello ,your results show that u might have cholecystitis,u need to be admitted to hospital for observation and treatment ,and we may need to do more tests before we have a correct diagnosis.P;do I really need to be admitted into hospital, isnt there anything u can give me for the pain and to help the problem?D; sorry , no ,it is best that u are admitted for further test ,we can check that u havent got gallstones or something seriously with ur liver.P;all right ,PPT of Abdomial Pain“All who have had much experience of the group of cases known generally as the acute abdomen will probably agree that in that condition early diagnosis is exceptional.”Types of abdominal pain Colicky（绞痛 0pain - caused by distention（膨胀）of a hollow viscus（空脏器）, such as bowel. Somatic （躯干身体）pain - caused by inflammation（炎症）of the parietal peritoneum（壁层腹膜）; Visceral（内脏的）pain - caused by inflammation of the visceral peritoneum and capsule of solid organs.Quadrant（象限）View of the AbdomenRight UpperCholecystitis（胆囊炎） Inflammation of the gall bladder 胆囊, caused by duct obstruction （管道堵塞）with a gall stone. Pain is usually steady for an hour or more after onset and made worse by eating. If there is significant inflammation associated with the cholecystitis, there may be local peritoneal pain (somatic pain)腹膜性疼痛. Pain may be referred to the scapular(肩胛的)area and accompanies nausea恶心, vomiting, and fever without jaundice黄疸. Diagnosed with ultrasound(超声).Cholangitis胆管炎 Caused by obstruction of the biliary tract(胆道)leading to bacterial overgrowth in the gall bladder. Marked by Charcots Triad（查科三联征） RUQ(右上腹)pain, jaundice and fever. Diagnosed by ultrasound. Is an emergency and must be treated with IV antibiotics(静脉抗生素). May require decompression(解压)via（凭借）endoscopic(内窥镜的)or surgical means.Hepatitis（肝炎） Caused by inflammation（感染） of the liver by viruses（病毒）, alcohol or certain drugs. Marked by tender, enlarged liver with malaise（不舒服）, fever and jaundice. Diagnosed by history and laboratory evaluation - liver function tests and viral serologies.（病毒血清学的检查） Treatment depends on etiology （病因，病原）of disease. Pancreatitis（胰腺炎） Most commonly caused by alcoholism (50%) and gall stones (30%) obstructing the common bile .（胆汁）duct（管道）. Constant mid-epigastric（上腹部的） visceral（内脏的）pain usually occurring after a heavy meal or alcoholic binge. Pain may radiate to the back (50%) and is accompanied by nausea, vomiting and anorexia （厌食症）. Diagnosed by amylase （淀粉酶）and lipase脂肪酶. Imaging by CT scan may be desirable in some cases.Left UpperPeptic Ulcer （胃溃疡） Caused by increased gastric acid production （胃酸容物）or decreased mucosal（粘膜的）protection. Increased gastric acid production may be caused by alcoholism（酒精中毒）or gastrin producing tumor (Zollinger-Ellison Syndrome佐林格-埃利森综合征). Decreased mucosal protection may be caused by overuse of NSAIDs（非类固醇抗炎药）or by infection with Helicobacter pylori幽门螺旋杆菌. Pain is visceral and may become somatic （腹膜性疼痛）if perforation（穿孔）occurs. There may be radiation to the back. Diagnosed by H. pylori antigen（抗原）in the serum（血清）, endoscopy内镜检查 Left Lower（卵巢囊肿不考。）Right LowerAppendicitis Caused by obstruction of the appendiceal（阑尾的）lumen(腔) Pain starts as periumbilical(脐周的)and migrates(迁移)to the RLQ (McBurneys Point) Is accompanied by nausea, vomiting and anorexia(厌食症). May have fever - especially if ruptured. Diagnosed by ultrasound or CT scan. Treatment is surgical and is an emergency if ruptured.General Abdominal Pain Some causes of abdominal pain are generalized and not restricted to any specific quadrant.Gastritis(胃炎) Caused by inflammation of the gastrointestinal tract by microorganisms(微生物), radiation（放射物）and other irritants（刺激物）. Described as diffuse（扩散）crampy（痉挛）痛 abdominal pain. Often accompanied by diarrhea, nausea, vomiting, dehydration（脱水）and fever. Diagnosis is by history and so on Bowel Obstruction（肠梗阻） Caused by obstruction of the bowel lumen （空腔）by mass, volvulus（肠扭转）, intussusception（肠套叠）around scar（伤疤）adhesions（粘连）. Pain is colicky in nature，accompanied by vomiting May be accompanied by watery diarrhea - Diagnosed by abdominal x-rays looking for distended(膨胀的)loops环结 of bowel and air-fluid levels（气液面）.Kidney Stones Caused by obstruction of the upper urinary tract（上泌尿道）by a stone that is induced（导致）by dehydration（脱水）, infection, hypercalcemia （血钙过多）and other metabolic imbalances.（代谢不平衡） Pain is described as colicky and located anywhere from the flank（侧面）to the groin （腹股沟）. Diagnosed by intravenous pyelogram（静脉注射肾盂造影图）, ultrasound or CT scan.Appropriate Exam Vital signs to evaluate for signs of infection, dehydration, shock, instability. Inspect visually for distention, scars,jaundice, signs of hernias疝, or masses. Auscultate - high pitched bowel sounds may indicate early obstruction. No bowel sounds indicate ileus（肠梗阻）. Increased bowel sounds may be associated with gastritis. Palpate and Percuss - for tenderness（疼痛）, masses（包块）, pulsation（脉动), hernias疝, ,CVA tenderness0（脊肋角疼痛）, liver and spleen size, ascites（腹水）and hyperresonance（过清音）. Pelvic exam in women Rectal exam（直肠检查） General Introduction StrokeClassification of Stroke Ischemic Stroke缺血性脑卒中. (75% “Brain Infarct”脑梗死 ) Occlusive:闭塞性 Thrombosis 血栓形成 Embolism 栓塞 Anterior Circulation 前循环 Occlusion of carotid artery （颈动脉）involve cerebral hemispheres （大脑两半球） Posterior Circulation 后循环 Vertebro-basilar artery （椎基底动脉） distribution involve brainstem（脑干）or cerebellum（小脑） Hemorrhagic Stroke出血性卒中 Subarachnoid蛛网膜下的 Aneurysm 动脉瘤(most common) Arteriovenous malformation动静脉型血管畸形 Intracerebral大脑内的 Hypertension 高血压(most common) Amyloid angiopathy（淀粉样脑血管病）in elderlyStroke Risk FactorsModifiable Hypertension Tobacco use -TIA( Transient ischemic attack) Heart Disease Diabetes Mellitus Sickle Cell 镰状细胞and increased RBCUnmodifiable Age Gender Race Previous CVA（脑血管意外） Heredity（遗传）Stroke Signs and SymptomsIschemic(缺血性的)- Carotid Circulation(.颈动脉循环) Unilateral paralysis单侧的瘫痪(opposite side) Numbness麻痹 (opposite side) Language disturbance（障碍） Aphasia失语症 difficult comprehension, nonsense胡说, difficult reading/writing Dysarthria发音困难 slurred speech语言不清, abnormal pronunciation. Visual disturbance (opposite side) Monocular blindness（单眼盲）(same side)-Vertebrobasilar Circulation 椎基底动脉循环 Vertigo 眩晕 Visual disturbance 视力障碍(Both eyes simultaneously) Diplopia复视 Paralysis Numbness Dysarthria Ataxia 共济失调Diabetes糖尿病Patient: Recently Ive been feeling very thirsty and passing a lot of urine, Is there any wrong with me?最近我总觉得口渴和尿量很多。是有了什么毛病吧？Doctor: How is you appetite? How do you feel otherwise?你的胃口怎么样？一般健康状况好吗？P: Ive lost weight despite my good appetite, and I feel weak all the time.尽管我的食欲很好，我的体重还是减轻了。我整天觉得很疲劳D: Let me examine your urine. You may have diabetes. 我给你检查一下尿吧。很可能你得了糖尿病。P: What is that? Can it be cured?这是什么意思？糖尿病能够治愈吗？D: Diabetes is a chronic disease due to poor functioning of the pancreas. It upsets the metabolism of sugar, fat and protein. Right now, it cant be cured, but it can be controlled so that you can enjoy life and feel well. You should stick to a special diet and avoid sugar and sweets.糖尿病是一种慢性病，由于胰腺功能不良引起。它使糖、脂肪喝蛋白质的代谢发生异常。目前还没有治愈办法。但是可以被控制，因此你能生活得很愉快。你应坚持控制饮食，不吃糖和甜食。P: Can I smoke?我能吸烟吗？D: Smoking is harmful to anyones health. Better give it up.吸烟对任何人都是有害的。我劝你戒烟。P: Can I drink alcohol?我能饮酒吗？D: In moderation. As you know alcohol contains calories and must be counted in your meal plan.可适当喝一点。你知道酒精能增加热卡，因此必须计算在你的食谱之内。P:How can I keep to a good diet?我怎样才能保持一个良好的饮食方案呢？D: You should learn as much as you can about diabetes, have your urine tested regularly, stick to your diet, take your medicine and have some regular exercise. Then you can live a full, useful and meaningful life.你应当尽量学习一些有过糖尿病的知识，定期检查你的小便。坚持食谱中的规定，按时服药。要有定量的运动。于是你能生活得美满、有益和有意义。Symptoms of Diabetes(糖尿病) Few glucose can reach muscle cellweak and fatigue Breakdown protein to release energyfeels hungry,loss weight Kidney extract excess glucose thirsty,frequent urinaion,kidney damage消化系统疾病*Peptic Ulcer 消化性溃疡Patient: I have a pain in my stomach我胃疼。Doctor: How long have you had it?疼了多久？P: I have had it off and on ( intermittently) for the past three years. It has been really bad these past two weeks.断断续续已经疼了三年，近两周来疼的很厉害。D: Do you feel it only when your stomach is empty?是在肚子空的时候才觉得疼痛吗？P: Yes. After I eat, it goes away for a while.是的，吃了东西以后疼痛缓解一会儿。D: When do you get it?什么时候才疼呢？P: Usually when I get very nervous. Sometimes it wakes me up in the middle of the night.通常是在我兴奋激动时，有时半夜把我疼醒了。D: What kind of pain do you have?是怎样一种疼痛？P: It gives me a burning sensation.象烧灼一样地疼。D: Usually how do you get relief?平常您是怎样止疼的呢？P: After I take some sodium bicarbonate, the pain goes away temporarily.在服小苏打后，疼痛可暂时缓解。D: Have you had any nausea or vomiting?你恶心呕吐过吗？P: Yes, occasionally.是的，有时候有。D: Are your bowels regular? Have you observed your stools?你大便正常吗？你注意过你的粪便吗？P: I usually have to go once every other day. I was very worried because last night I went twice and the color was black(tarry).平常我隔日大便一次。昨晚我大便了两次，颜色还是黑（象柏油似）的，我很担心。D: Let me examine your abdomen. Lie down on your back and bend your knees up please.让我检查一下您的肚子，请仰躺，把腿卷起来。It sounds like a duodenal ulcer, but we have to do some tests, and take an x-ray first, before we can be certain.看起来象十二指肠溃疡，但需做一些化验和拍张X线片才能确诊。You should have a complete rest and give your stomach as little work as possible. Take only fluids. There is nothing better than boiled tepid milk taken regularly in small quantities. In addition, I will give you some medicine. If the black stools persist or your condition gets worse, come back to the hospital at once.您应当彻底休息并尽量减轻胃的工作，应当吃流食。按时少量吃些煮过的温牛奶是最好不过了。此外，我还要给您一些药。如果持续有黑便或病情有恶化，就马上来看。P: Thank you. Ill follow your advice.谢谢您，我将遵嘱。Peptic-duodenal Ulcer（胃十二指肠溃疡）Patient: My stools have been black for the past two days and I feel weak.这两天我大便发黑而且感到虚弱。Doctor: Have they ever been black before?以前你的大便发黑过吗？P: No. This is the first time.没有。这是第一次。D: Have you had any pain?你感到有什么地方疼痛吗？P: Yes, in my stomach.是的，我胃痛。D: How long have you had it?你痛了多久？P: Ive had it on and off for the past two years, but it was never as bad as this before.我好好坏坏疼了两年，但从来没有象这次那样疼过。D: When do you feel the pain?什么时间疼？P: Just after meals my stomach aches. Sometimen vomited.刚吃完饭就疼，有时还吐。Now I have it almost every day. It often awakens me 2 to 3 hours after I go to sleep.我几乎每天都疼，常常在夜间入睡两、三小时就把我疼醒了。D: What kind of a pain is it?是什么性质的疼呢？P: like heartburn.烧心样疼。D: Does spicy food affect if?辛辣食物会加重疼痛吗？P: Yes. Its often worse after I eat spicy food or onions.是的，吃了辛辣的食物或洋葱都加重疼痛。D: Do you have less pain after eating?吃东西后疼痛就缓和些吗？P: Yes, a little.是的，稍缓和些。D: Did you vomit sometimes?你吐过吗？P: Yes, I did.吐过。D: What did you vomit, food or blood?吐出的是什么东西，食物还是血？P: Food with a little blood.食物和一点血。D: What was the color of the blood, red or black?吐出的血是鲜红的，还是黑的？P: Like coffee.象咖啡似的。D: Ill examine you abdomen. Lie down on your back and loosen you clothes. Please bend your knees. I think wed better take a x-ray film of your gastrointestinal tract. I think youve got a peptic ulcer ( duodenal ulcer). Ill give you some medicine. Have a good rest at home.让我检查一下你的腹部。躺下，松开衣服请屈膝。我想我们最好照个胃肠X线片像。我看你得的是胃（十二指肠）溃疡。我要给你一些药。好好在家休息。P: Is there anything else I should do?还要注意些什么吗？D: If possible avoid all alcohol. Whenever you have any bleeding, come immediately to the hospital.如果可能应戒酒，若再有出血马上到医院来。Your problem probably comes from a duodenal ulcer. You are suffering from shock due to bleeding. The medicine we have been using has not been effective and so we feel that it is necessary to perform an operation.你可能是十二指肠溃疡。你的休克是因失血引起的。我们用过许多药效果都不好。所以我们认为需要手术治疗。P: Do anything you feel is necessary, Doctor!医生，你认为需要就做吧！D: I would like to talk about the opera