医学英语情景会话口语训练范例.ppt

ClinicalDialogues,Part1.Womancomplainedoftightnessinabdomenassociatedwithbelching(嗳气)windwhichdidnotrelievefeeling.Symptomsusuallybeganbetween5and6p.m.lastingseveralhours.Relievedbywhitemixture.(D=Doctor,P=Patient),D:Doesthepaincomeoninthenight?comeon:tostartIfacold,headache,orsomeothermedicalconditioniscomingon,itisjuststarting.e.g.Ifeltacoldcomingon.我觉得开始感冒了。P:Notoften.,D:Whenitcomeson,doyougetup?P:Yes,Igetupandwalkaroundanditrelieves.,Pain,Ihaveaheadache.Ihaveasplittingheadache.（我头痛得像要裂开了。）Ihaveastomach-ache.Ifeeladullpaininthestomach.Iseemtohavepainallover.（我似乎浑身都痛。）Imachingallover.（我浑身都痛。）,Itsadullsortofpain,andIdontknowwhatscausingit.Itsnotasharppain;justsortofadullache.Itallbeganyesterday.Itstartedtwodaysago.Itcameonlastnight.Ithurtsterrible.（痛得很厉害。）,Itsbeenhangingaboutfornearlyaweek.（这已经持续了将近一个星期了。）Itkeepshangingon.（这老是不好。）Itsortofhungon.（这似乎不见好。）Or:Justoffandon.（就是时断时续。）Ivegotapaininmyback.（背疼）,Myeyeshavebeensore.（眼睛发痛）Myleftfoothurts.Mytoothisachingupagain.IfeelshiveryandIvegotasorethroat.（我觉得怕冷发抖，而且喉咙疼痛。）Thepainsbeenkeepingmeawake.,D:Doesanythingbutthewhitemixturehelpit?P:Ivebeenonastrictdietforsixmonths.Inevertouchmilk.,onadiet:Ifyouareonadiet,youareeatingspecialkindsoffoodbecauseyouwanttoloseweight.（为减肥）节食touch:Ifyoudonottouchaparticularkindoffoodordrink,younevereatitordrinkit.吃；喝e.g.Drink?No,shenevertouchesthestuff.喝酒？不，他从不喝这种东西。,D:Doesanypositionhelpyou?P:No,Itcomesonaftertea,aboutfive.Ihavemymainmealmidday.D:Haveyoubeensick?（你呕吐过吗？）(=Anyvomiting?)P:OnlyatthebeginningIwasverysickthen.,Asickpersonhasanillnessorsomeotherproblemwiththeirhealth.Tobesickmeanstobringupfoodthroughyourmouthfromyourstomach.e.g.IthinkImgoingtobesick.,Notethat“Georgeisbeingsick”means“Georgeisbringingupfoodfromhisstomach”;“Georgeissick”means“Georgeisill”.However,“Georgewassick”canmeaneither“Georgebroughtupfoodfromhisstomach”or“Georgewasill”.,Vomithasthesamemeaningas“besick”.Vomitisafairlyformalword.e.g.Shewasstrickenwith(被.折磨)painandbegantovomit.Throwup:Inconversation,somepeoplesaythrowupinsteadof“besick”.e.g.IthinkImgoingtothrowup.Ivebeenthrowingup.我一直呕吐。,D:Doyoufeelsick?（恶心吗？）(=Haveyougotanyfeelingofnausea?)(=Areyoufeelingnausea?),P:Yes,IfeelsickbutIcantbesick.（我经常恶心，但不再呕吐。）Feelsick:Tofeelsickmeanstofeelthatyouwanttobesick.e.g.Flyingalwaysmakesmefeelsick.,Note:ILLandsickarebothusedtosaythatthatsomeonehasadiseaseorsomeotherproblemwiththeirhealth.e.g.Davisisill.Youruncleisverysick.Asickchild,MostBritishspeakersdonotuseillinfrontofanoununlesstheyarealsousinganadverb(副词).Forexample,theydonottalkabout“anillwoman”,buttheymighttalkabout“aseriouslyillwoman”.aterminallyillpatient.,AmericanandScottishspeakerssometimesuseillinfrontofanounwithoutusinganadverb.Wehadtogetmedicalhelpforourillsisters.,D:Doesthepaingothroughtotheback?P:No,butitgoesundermyarmpits.（腋下）D:Whatsyourweightbeendoing?（你的体重最近怎样？）(=Haveyoulostweightrecently?)P:IvelostoneandhalfstonebutIvebeenonafat-freedietforsixmonths.(or:Myweightfellfrom65kg.to50kg.),Stone:aunitofweightinGreatBritain,14pounds(6.4kilograms)英石英国重量单位，等于14磅(6.4公斤）,D:Whatsyourappetitelike?（你的胃口怎样？）(=Howaboutyourappetite?)(=Doyouhaveanyappetite?),Whats(your)/(the)?/Whatseemstobethe?Whatsyourappetitelike?,Whatsyourcomplaint?(你有什么不舒服？)=Whatsyourtrouble?=Whatsthetrouble?=Whatsbotheringyou?=Whatseemstobebotheringyou?,=Whatdoyoucomplainof?=Whatsthematterwithyou?=Whatseemstobethematter?=Whatswrongwithyou?=Whathurtsyou?=Whatseemstobetheproblem?=Whatseemstobethetrouble?,P:Poorasever.(=Ivegotabadappetite.)D:Whataboutyourbowels?（大便如何？）(=Areyourbowelsactingproperly?)(=Areyourbowelsregular?)P:Igotwiceaday,inthemorning.,D:Isthisalife-longhabit?P:Yes.D:Whatdothemotionslooklike?Well-formed,firm?（大便什么形状？成形，坚实吗？）P:Yes.D:Whataboutthecolor?Hasitchanged?P:No.,D:Aretheydark?P:Yes.D:Anysignofblood?P:No.D:Dotheyfloatonthewaterwhenyouflushthelavatory?（你冲洗厕所时，它漂浮在水面上吗？）P:No.,D:Haveyounoticedanunpleasantsmell?P:No.D:Haveyounoticedanydifferenceinyourwater?（你排尿有无异常？）P:No.D:Doyouhavetogetupinthenight?（你夜间起来上厕所吗？）P:Once.,D:Yourwaterhasntbeendarker?P:No.D:Doyousmoke?P:10aday.D:Doyoudrink?P:Notmuch.,D:Haveyouanyothertrouble?P:No,myanginasbeenverygood.（我的心绞痛已经好了。）Ivenothadmuchtroublewiththatfortwoyears.（这两年没大犯过。）-Or:Ifeelabsolutelyrotten.（我觉得身体很不舒服、非常虚弱。）Ifyoufeelorlookrotten,youfeelorlookill,Ifeelabitoffcolor.（我觉得有点不舒服。）Here,colormeansreddish-pinkcolorinonesfacethatshowsthatoneshealthisgood.面色；血色Ifeelsoill.Ifeelratherunwell.Ifeelverybad.,Ireallyfeelterrible.IthinkImdying.（我难受极了。）Imfeelingratheroutofsortsthesedays.（这些天我觉得身体很不舒服。）Ifyoufeeloutofsorts,youfeelslightlyunwell,discontented,orannoyed.身体不适；心情不佳；烦恼,Imundertheweather.（我不舒服。）Ifyousaythatyouareundertheweather,youmeanthatyoufeelslightlyill.Mywholebodyfeelsweak.Ijustfeelallpoopedout.（我只觉得精疲力竭。）bepoopedout:tobeverytired;usedmainlyininformalAmericanEnglish.,D:Youvealsohadtroublewithyourleg?P:Yes,theythoughtitwasthrombosis(血栓).D:Whendidyoufirststartwithyourtummytrouble?（第一次胃病是什么时候发作的？）Tummy:thehumanstomachorbelly肚子，胃P:About14yearsago.,D:Thesame,butmorebothersomenow?（现在是否更厉害?）P:Yes,itstighter.（病情更重了。）Warning:1)Youdonotsaythatsomeonebecomes“iller”or“moreill”.Yousaythattheybecomeworse.2)Youdonotuseillorsicktosaythatsomeonehasreceivedaninjury.Yousaythattheyareinjuredorhurt.,D:Haveyoueverbeenjaundiced?（得过黄疸吗？）P:No.D:Isyourtummyswollenwhenyoufeellikethis?（犯病时肚胀吗？）P:ItfeelsasthoughImgoingtoburst.（我觉得肚子快要爆炸了。）,D:Well,Idliketohavealookatyou.（检查一下）Willyougetundressedandlieonthecouchplease?（请脱去衣服，躺在检查床上。）Or:Liedownonthecouchthere.Letmejustsee.Liedownonthecouchthere.Letmeexamineyourbelly.,Wouldyoumindtakingoffallyourclothesexceptyourpants(formen)/exceptyourpantsandbra奶罩(forwomen)?Lieonthecouchandcoveryourselfwiththeblanket.Well,letssee.Nowslipoffyourcoatandshirt,please.Striptoyourwaist,please.把上身衣服脱掉,Rollyoursleeveup.Slipyourshoesoffandhopuponthebed.Slipoffyourshoesandsocks.Letmecheckyourlungsandheart.Letmelistentoyourlungsandheart.,Letmeexamineyourstomach.Letmesoundyourlungs.(叩诊)Unbuttonyourshirtandletmelistentoyourlungs.Openyourmouthandsay“Ah”.Openyourmouthplease,andshowmeyourtongue.,Putthisthermometer(体温计)underyourtongue.Illhaveyourtemperaturetaken.Well,Idbettertakeyourbloodpressure.MayItakeyourbloodpressure?Letmetakeyourbloodpressure.,ClinicalExamination,Duringtheexaminationthedoctoraskedthefollowingquestions:,D:Doyousufferfromheartburn?P:No.D:Haveyouhadanychildren?P:No.D:Areyourhandsalwayscoldandred?P:Yes.Alovelycolorinthewinter!（冬天简直红得可爱！）,D:Justholdyourbreathforamoment.Breathethroughyourmouth.Showmewhereyougetthispain.Yourage?P:72.D:Yourperiodsfinishedwhen?（你什么时候停经的。）P:WhenIwasabout52or3.,D:Anytendernesshere?P:Itsabitsorebutnotalot.D:Doesitcatchyouatallwhenyoubreathe?（你每次呼吸都觉得痛吗？）P:No.,D:Haveyouanypainsinyourlegs?(=Doyouhaveanypainsinyourlegs?)P:Igetcramp（抽筋）abitwhenIminbed.D:Moreinonelegthantheother?P:Igetitinmyrightleg;thatsmyvaricose（静脉曲张）leg.,D:Apartfromthis,youvehadnootherseriousillnessinthelast14years?P:No.D:ImgoingtotakeadropofyourbloodandIdlikeyoutohaveastomachX-ray.Youllhavetocomespecially,donteatanythingbeforeanddrinkawhitepastewhichoutlinesyourstomachandwelltakesomepictures.,Or:Ithinkwedbettergiveyouafewtests.Abloodtestisnecessary.Takeyourbloodcountfirst,please.Youretohaveabloodtest.,Imgoingtotakeathroatculturesowellknowforsure.Youmusthaveanelectrocardiographexamination.Well,letstakeanX-rayofyourchest.GoandhaveyourchestX-rayed.,BOWELS大便Medicalwords:faeces,stools,todefaecateColloquialwords:motion,tohavethebowelsopened,UsefulquestionsHowoftendoyouhaveyourbowelsopened?Isthisalife-longhabit?Whatdothemotionslooklike?Aretheyquitewellformed?Whataboutthecolor?Hasitchanged?,Aretheydarkerincolor？Haveyoueverseenanybloodinyourmotions?Haveyounoticedanunpleasantsmell?Doyoueverhavediarrhea(腹泻)orconstipation(便秘)?Doyouhavetogoinahurry?（上厕所）Canyouholdyourmotions?（控制排便）,Doyouhavetostrain(用力)topassyourmotions?(tenesmus)（里急后重,下坠）Doyoutakelaxatives(轻泻剂)?Dothemotionsfloatonthewaterafterflushingthelavatory?Doyoueverhaveanypainonpassingyourmotions?,Doyougetpainbefore,duringorafterpassingyourmotions?Doyousufferfromwind?Haveyounoticedanyspecialfoodupsetsyourbowels?Haveyoulostanyweight?,DescriptivewordsColor:black,brown,clay-like,colorless-likerice-water(cholera霍乱),darkbrown,green,grey,pale,pea-soup-like,putty-like(油灰样),porridge-like)(麦片粥样)(steatorrhoea脂肪痢),jelly-like,tarry(柏油样),white,yellow,etc.,Formandconsistency(稠度):bloody,bulky,dry,fatty,floating,friable,frequent,frothy(泡沫样的),greasy(油脂过多的),hard,harddryballs,loose,purulent(脓性的),slimy(粘液的),soft,watery,well-formed,worms,etc.,Amount:copious,scantyOdor:offensive(verybad),UsefulExpressionsGreeting“Goodmorning,Mrs.Rayner,comeandsitdown.”Askingpatientstodescribetheirsymptoms“Wellnow,howcanIhelpyou?”“Well,Mrs.Rayner,whatsthetrouble?”“Yourdoctorsaysyouvebeenhavingtroublewithyourback.Tellmeaboutit.”,CollectingcasesMentionedabove.Directingpatientshowtoundress“Wouldyoumindtakingoffallyourclothesexceptyourpants(formen)/exceptyourpantsandbra(forwomen)?Lieonthecouchandcoveryourselfwiththeblanket.”“Slipoffyourshoesandsocks.”“Rollyoursleeveup.”,Directingpatientshowtoassumeappropriatepositions“Pleaselieonyourtummy.”“Pleaseturnoverandlieonyourback.”“Rolloverontoyourleftside.”“Bendyourknees.”,“Situp.”“Leanforward.”“Getoffthecouchandstandup.”“Walkacrosstheroom.”,painful:1)Yousaythatsomethingispainfulwhenitmakesyoufeelpain.e.g.alongandpainfulillness2)Ifapartofyourbodyispainful,ithurts.e.g.MybackissopainfulthatIcannotstandupright.,3)Whensomeonefeelspain,youdonotsaythattheyare“painful”.Yousaythattheyareinpain.e.g.Hewasinpainandcouldnotmoveintoacomfortableposition.,Part2.,D:Iseeyouhavehadseveralattacksofinfluenza(流行性感冒).Anythingelse?P:Ivehaddizziness(头晕目眩)andIvebeensick.Ifyoufeeldizzy,youfeelthatyouarelosingyourbalanceandareabouttofall.Tobesickmeanstobringupfoodthroughyourmouthfromyourstomach.,D:Whendidthisstart?P:Twomonthsago.D:Howoftenaretheattacks?P:Nearlyeveryday.,D:Howlongdotheylast?P:Somelastallday,someacoupleofhours.“Acoupleofthingsorquantities”meansapproximatelytwothingsorquantities.Youusethisinformalexpressionwhenyouarenotsureoftheexactnumberofthingsorquantitiesyouarereferringtoandthenumberisnotimportant.,D:Doesanythingbringontheseattacks?bringon:tocausetooccur引起（疾病、痛苦、发作等）Youcanusethestructure“Somethingbringsonanillness,pain,orattack”.P:No.,D:Willyoudescribeoneoftheseattacks?P:Itstartswithaheadacheathrobbing(跳动)headache.Myeyesstartrunning.Icanttouchthem,theyaresosore(疼痛的).Andthenthewholehousegoesround.Thenitgoesdark.,D:Doyouseeflashinglights(闪光)?P:No.D:Whenyousayyougodizzy,whatdoyoumean?P:IfeelIllfalloverandtheroomspins(旋转)round.IfIgotobed,thebedgoesround.,fallover:Ifyoufalloverfromanuprightorstandingposition,youbecomeunbalancedandfalltotheground,lyinglengthways(纵向地)orinaheap.跌倒；摔倒,D:Whenyoumove,doyoustagger?stagger:tomoveorstandunsteadily,asifyouabouttofall蹒跚；摇晃P:Imtooscaredtomove.（吓得一点都不敢动）Ifyouarescared,youareveryfrightenedofsomeoneorsomething,andthereforeunabletobehavecalmly.吃惊的；吓坏了的,D:Haveyounoticedanythingelse?P:Icoughalot.D:Doyoubringanythingup?（有没有呕吐vomit/痰sputum？）Whenyoubringupfood,youvomit;aninformaluse.P:No.,D:Isyourhearingaffected?Doyouhavebuzzing(嗡嗡声)orringingnoises?P:Yes.D:Inbothears?P:Yes.,D:Whenyougotobed,doyousleep?P:Ijustlieanditgoesoffwithinafewhours.Ifyougooff,youfallasleep;aninformaluse.入睡e.g.Hewentoffassoonashisheadtouchedthepillow.,D:Haveyoueverwokenuplikethis?wakeup:Whenyouwakeuporsomethingwakesyouup,youbecomeconsciousagainafterbeingasleep.醒来；唤醒,Youcanuse“likethis”or“likethat”whenyouaredrawingattentiontosomethingthatyouaredoingorthatsomeoneelseisdoing.像这样（引起对正做之事的注意）e.g.Sorrytobreakinonyoulikethis(原谅我这样打扰您),Dr.Mark.,P:No.Itisalwaysintheday.D:Doesmovementoftheheadcauseit?P:No.D:Ifyousuddenlygetupoutofachairdoesitstart?P:No.,D:Howlonghaveyoubeendiabetic(糖尿病)?P:Fouryears.D:Anyotherseriousillness?P:Ihadmygallbladder(胆囊)removed.,“havesth.done”patternGoandhaveyourchestX-rayed.Youmusthaveyourtoothextracted.Youmusthaveyourappendix(阑尾)removed.Youllhavetohaveyourdecayedtoothpulledout.,D:Anythingelse?P:IhadVD性病(venerealdisease)nineyearsago.Iwasinhospitalforthreeweeksandhadacourseofinjections(注射).,ClinicalExamination,D:Takeadeepbreathinandholdyourbreath.Closeyoureyesgently.Nottootight.Lookuptotheceiling(天花板).Holdyourarmsout.Areyourbowels(大便)allright?P:Yes.,D:Notroublewithyourwater(排尿)?P:No.D:Yourperiods(绝经)finishedsomeyearsago?P:Yes.Fouryearsago.,D:Well,theredoesntseemanythingseriouslywrongwithyou.IdlikeyoutohavesomeX-raysthroughandabloodtest.,Diagnosingandtreating,Bythelookofit,itshouldbearash.从表面看，这应该是皮疹。Bythesoundofit,itsbronchitis(支气管炎).Itlookslikemeasles.看上去像麻疹。ItlooksasifitsSLE.看起来这似乎是红斑狼疮。,Itsoundslikebronchitis.听起来像支气管炎。Itsoundsasifyouvecaughtcold.听上去你似乎得了感冒。Ishouldsayyouvecaughtcold.感冒Ishouldthinkyouvegottheflu.流行性感冒,Youprobablyhavecontractedtheflu.你大概得了流行性感冒。Youseemtohavepickedupsomekindofinfection.你似乎已受了某种感染。ItcouldbeacaseofTB.可能是肺结核病。Itsinflam