医学英语开口说.doc

一1,whats the problem today? Can you tell me what your symptoms are?Have you ever had these complaints before?What seems to bring this condition on?When did you start feeling poorly? 2, a.What can I do for you today？how can I help you Mr. Jonesb.What do you mean by that?Can you describe that in more detail?C.What are your symptoms?Can you describe the changes that have occurred?D.Did it start suddenly?Did your condition change without any warning?E.What brings it on?What do you think causes your condition? 3. What seems to be the problem today?Well, Ive been feeling ill lately.I see, feeling ill, now, what do you mean by that?I have been very short of breath.How long has this been going on?For about eighteen months, I think.And were there any other symptoms before then or did this condition start quite suddenly?I hadnt noticed anything before then.so you didnt have any of these symptoms before?No, not that I can remember, doctor.I see, was there anything that seemed to cause these symptoms?Well, no, not really. Except maybe it gets (I get) really bad when I go up to New York to see my sister.Lets take a look to begin with Ill listen to your heart and lungs.二、A. Can you show me where it hurts? Can you point with your finger to the spot where it hurts?Where does it hurt? Where is your pain? Where is it sore? B. Could you describe what the pain feels like? Can you describe the pain? Whats the pain like? What kind of pain do you feel? What kind of pain is it? Is it getting more or less severe? How bad is the pain? Does it wake you up at night? Does it interfere with you everyday life? Does it affect your work? Is the pain better or worse now?C. How long have you had this pain? How long has it been bothering you? How long does it last? Do you have it all the time or does it seem to come and go? Is it constant or intermittent? Did it happen suddenly or gradually? How often do you get it? D. When does it come, when does it go? When did this pain start? What were you doing at the time this pain started? When was the last time you were without pain? When was the first time you noticed that something was wrong? Have you had anything like this before? /E. Does anything relieve the symptoms or make them worth? What do you do when it happens? Is there anything that makes it better or worse? Is there any position that makes it feel better or worse? Have you received any drugs for your pain? How long does it take for the medicine to take effect? After you take the medicine, how long is it before you feel better? What makes the pain go away/disappear? F. Does the pain move to another part of your body? In which direction does the pain go? Does the pain seem to move anywhere else? Has the pain spread? Has the pain affected any other part of your body? G. What brings it on? What are your symptoms? Is it related to eating/ Coughing /your mood/tiredness/broken skin/body position/movement?Do you notice any side-effects? Does anything else happen at the same time?Do you feel any pain? Yes, quite a bit. Could you show me where it hurts? Right here, Doctor, in my chest. Here, hm,. Is it always just in that spot? No, sometimes it moves around to here. I see. What kind of pain is it? Can you describe the pain? Well, most of the time it feels like a cramp, but ccasionally it is sharp and stabbing. Does it come and go or do you have it all the time? Well, its worse at times. It seems to come over me in waves. But mostly its there all the time. Does it start suddenly or build up slowly? It seems to build up gradually. What do you do when you feel this pain? Well, there isnt much I can do. I just have to put up with it. And does anything in particular seem to bring the pain on or make it worse? Well, it is more intense when climbing stairs. Also when I have to cough or take a deep breath. Its terrible, like a knife stabbing me三、1.Do you feel the pain at the top of your head?Do you feel any pain in your temples?Is the pain around your eyes?Is the pain at the back of your head?Do you have any pain in your forehead?Does the pain move to your face?Do you feel any pain around your ears?Does the pain spread to your neck?Does the pain seem to be coming from your neck?Does the pain travel your shoulders?2.Can you point out the painful area?How long does the headache last when you get it?Can you describe the (nature of the) pain?When you get the headache does anything happen at the same time?What do you do when you get the headache?Have you found any medicine that seems to have helped?Does anybody else in your family have this type of /a/ headache?3.Tell me about your headache.It comes and goes.Can you point out the painful area?It seems to be on the right side of my head.How long does the headache last when your get it (it comes)?It varies, it can be between half an hour and four or five hours When you get a headache, does anything else happen at the same times?Yes, often I feel sick (I am often nauseous ). Sometimes I actually vomit (throw up ).Does the headache ever upset your eyes, for example, does your vision get blurred?It is not blurry, but I get flashing lights that seem to be in the right eye.What do you do when you get headache?Well, I am not usually able to carry on with what Im doing. /I usually have to stop whatever Im doing/. I have to go to a dark room and lie down. Have you found any tablets (medication ) that seem/s/ to have helped? Sometimes if I take an aspirin early on, it seems to help, at other times nothing seems to help much. Does anybody else in your family have this type of headache?Yes, my mother used to suffer from migraine when she was younger.Can you describe/the character of/ the pain? Is it stabbing or more band-like, kind of pressing?It is throbs, sort of stabbing, I suppose (I guess).四、1.Do you ever get dizzy?Yes, quite often.Now, when does this happen?When I get up too quickly.Do you feel as if you are falling in a certain direction?No, not really.Does the dizziness feel like spinning or is it just a kind of unsteadiness. It feels more like spinning.How would you describe it? Is it as if the room is going around or do you feel as if its you thats going around.It feels as if I am going around.Do you have any other problems such as ringing in the ears?Yes, sometimes.Have you seen a specialist (consultant) about this?Yes, she prescribed some medication for it, but it didnt help at all.Do you have any associated symptoms like blurred vision?Not that I have noticed./No, but I havent noticed.2.Have you had any fever recently?Yes, doctor, Ive been feeling quite warm lately.Is your temperature constantly high or does it go up and down.It usually higher at night, but its still high during the day.What is the highest and the lowest it has been in the past few days?The highest was 104,the lowest was 100.And where did you take your temperature: Under your arm or orally /under your tongue? I measured it orally.Do you also have the chills /shiver?yes, sometimes.Did your teeth rattle/chatter/ or are the chills milder than that?Oh yes, they rattle, Ive bitten my tongue several time already.Did you take anything for the fever?Aspirin.Does it help?No, not really.Have you traveled to any tropical or developing countries recently? Yes, I just came back from Thailand a few months agoI see. Do you perspire more than usual?Yes, a lot. I am afraid Just when you work hard or also at other times?Well, I never used to sweat so much, but now I seem to break out in a sweat easily. My clothes often get soaking wet.Do you feel shaky or weak at all?Yes, practically all the time.五、1,Do you just feel nauseous or have you actually thrown up.oh, it seems Im throwing up all the time.When did it all start? About two months ago.And how often does this happen?About once a day, sometimes more.When are you sick? Is it in morning or after youve eaten.Well, it isnt really regular.But does it get better or worse if you eat something?Worse, I think.When you vomit, do you bring up digested food, undigested food or bile?Oh, it is usually more like bile.what color is it? Green, black, yellow or red?It seems to be a sort of yellowish green color.Does it ever have blood in it or look like ground coffee? no, never.Do you burp a lot or have a nasty taste in your mouth?Well, yes, doctor. I do burp /belch/ a lot and I have had a lot of gas lately.2.How long have you had difficulty breezing?. Since last week, Doctor.Is it very bad?Yes, I feel like I cant get enough air.Whats harder, breathing in or breathing out? Its harder to breathe in. Are you short of breath, when you are resting or only when you are doing something physical?A little when I am resting, but its worse when I try to do anything physical.Can you lie flat in bed? Oh, no.How many pillows do you use? Three.Do you ever wake up at night feeling short of breath?Yes, I do. It scares/frightens/ me because I wake up feeling as if I cant breathe. What do you do when this happens? I mean, do you sit or stand up, does some movement help you breathe easier? If I sit up, it helps a little.Let me listen to your chest. I can hear a few crackles and it sounds a bit wheezy.六、Do you have a cough?I have a cough, but I also seem to wheeze a lot. Is this a recent symptom or have you had it for some time now?Ive had it for some time, doctor.Do you cough a lot?Yes a lot.Do you bring up phlegm, or is it a dry cough? I bring up quite a bit of phlegm. I am afraid I might have asthma. What is the phlegm like?What do you mean? Can you describe for me what colour it is, whether it is white, yellow or greenish, and /what/ is it foamy or thick and sticky?Yes it is yellowish and feels kind of like jelly.Does it have a strange smell or taste?No, I dont think so.Has there ever been blood in it? Yes, just once I noticed some blood in it.Have you taken any medication lately? Yes, I was on some medication to thin my blood.七、1,Can you tell me, . what are yours complaints?I seem to be getting very short of breath lately, also I feel tightness in my chest, so I thought it would be wise to come in and see you. How long has this been going on?It seems to have been getting worse over the last few weeks.Are you short of breath all the time, or is it just when you exert yourself?Well, the pain gets worse when I exert myself, it feels kind of like a knife.Does the pain radiate/move/ to other areas as well or is the pain localized?No, it moves to my neck, my left arm, my back and my shoulder.Do you ever feel sick or sweaty when this happens?Well, I dont feel sick but I often break out in a sweat.Do you ever feel that your heart beats unusually fast or slow?Yes, sometimes it beats really slowly, then from time to time it skips a beat, then continues to beat very rapidly.Can you tap out with a finger what the rhythm feels like to you. good. have you had any swelling in you ankles?Yes, both of my feet have been somewhat swollen.Does this go down overnight or are they still swollen in the morning?Oh, my feet feel much better, and they arent as swollen in the morning.2,Have you ever had any heart problems?Ive never been diagnosed with anything but I think something could be wrong with my heart. What seems to be the problem with your heart?It beats irregularly especially when I smoke.What kind of pain do you get during exercise?I get pressure in my chest sometimes when I have to walk a long distance.Do you often get short of breath?Absolutely, I am always short of breath when I go upstairs.Do you ever feel sweaty when this happens?Yes, I break out in a really bad sweat when my chest hurts.Where does the pain move?Down my left arm.And have you had any swelling in your feet or ankles?Yes, my ankles seem to be swollen all the time.Do your feet hurt all the time?Yes, the pain is fairly constant, but it helps when I put my feet up.八、Tell me, how is your appetite?Sometimes its good, but at other times I dont feel like eating at all.Describe your eating habits to me?Well, I usually eat five or six times a day. Lots of fruit and vegetables, but when I am nervous I cant eat at all. Have you lost or gained any weight recently or does your weight stay at same? Ive been gaining quite a bit of weight lately. How many pounds do you think youve gained? About 10 pounds or so.Over what period of time has this happened? Since about Christmas, so in the last 6 months. Are you trying to do anything to control your weight, for example, are you on a diet?Yes, but it doesnt seem to work. Are there any foods that you dislike or is there anything that you particularly like to eat? I eat lots of pasta dishes, but I cant have anything with nuts in them because I am allergic to most kinds of nuts. Do your eating habits change for any reason?Yes, I eat quite a bit more when I feel good.九、Do you have regular bowel movements?Yes, but sometimes I get constipated and sometimes I have diarrhea.When you say you have diarrhea, do you mean the stool is very loose, or that you have to go to the bathroom more frequently?I have to go four or five times a day.When you have to go, do you have to go quickly?Yes, I have real problems holding it.Could you describe your stool?The last time it was loose and watery, but very dark.Do you have any problems flushing it down at all?No, I havent noticed anything like that.Has there been any blood or mucus in the stool?Yes, I have noticed some blood but no mucus.Is it mixed in with the stool or is it just there on the paper when you wipe yourself?It seems to be mixed in with the stool, Doctor.I see. And when you are constipated, do you take laxatives, or do you use enenema?If I cant go for three days, only the laxative helps.Do you feel bloated when you are constipated?Yes, occasionally. But the laxative helps with that too.Do you have any problems with excessive gas or burping?No, not particularly.十、A: So, you say that you are having problems with bleeding or bruising.B: Yes, I am.A: Can you tell me what you mean by that? Do you bleed or bruise easily?B: Yes, every time I scrape myself or bump into something I get bruised.A: Have you always had this problem, or is it just a recent development?B: I noticed that the problems started about the time I started shaving.A: Do your gums bleed when you brush your teeth?B: Yes, quite a lot.A: Do you have any trouble stopping the bleeding?B: Oh, yes, even from the most minor cuts.A: How long dose it take to stop the bleeding?B: At least 10 or 15 minutes.A: Are there any other members of your family with bleeding tendencies?B: No , not that I know of. A: Have you ever needed the blood transfusion, or have you given blood recently?B: I dont like needles, so I dont give blood. But I needed a transfusion after a car accident a few years ago when I was 15.A: Do you remember how many units of blood you received?B: No, I dont remember, sorry.A: Do you know what your blood type is?B: I think its AB negative, but I am not sure. 十一、medical examination1 Now Mr Jacob, Id like to examine you. I just want to check one or two things, your heart and your lungs and abdomen. Would you take off your clothes just down to your underwear and put on this gown with the opening at the back.2 please get on the table for me, can you do it yourself or would you like me to help?3 Right, give me your wrist, will you? I am going to take your pulse. That is fine.4 Now lets take your blood pressure. Will you straighten your arm for me, please?5 Now lets have a look at your eyes. Look up for me. Please.6 Let me check the reflexes in your arms and legs. Relax.7 Turn your head to the right to look at the wall. I want to check the pulse in your neck.8 Let me feel your windpipe Let me just feel your glands. Thats fine.9 Stick your tongue out for me, please. Open your mouth and say “ahh“.10 Right, now I want to listen to your heart. Just breathe out quietly 11 Now sit forward while I listen at the back, hold your breath. . Good. Now lets listen to your lungs. Take deep breaths through your mouth- in .out . keep going.12 Id like to feel your abdomen. Put your arms down by your side and let your stomach relax thats it. Are there any places that are tender or painful? Now I want to check your liver and spleen so take deep breath in, hold it.fine.13 Id just like to examine your prostate and rectum. Now this will be slightly uncomfortable, but it shouldnt hurt. Lie down on your left side and bend your knees right up to your chestfine. I am going to insert a finger into your rectum. Dont worry, you wont lose any control.十二、1.you will be given an intravenous injection, make a fist, then let it go. the injection contains a substance to make necessary organ visible on the machine. therell be some waiting time before the actual examination. This is necessary so that the test substance can reach the appropriate organ.you must remain completely still during the examination. the results will be given to your regular physician.2. have you drunk any liquids today? youll have to drink about 4 glasses of fluids before the examination , you ll also be given a substance which will make you have to go to the bathroom frequently. What blood pressure medication are you taking ?3. A ) before receiving the rejection you should lie on your back for 10 minutes.B ) Now you must inhale the spray. it resembles water vapour and has no taste or smell, in these cases youll have to sit in front of inhaler. well clip your nose shut and you will have to breathe through your mouth,4.the waiting time is about 2 hours, during which you should drink approximately a liter of fluid, please go to the bathroom before you are called ,so that your bladder will be empty, otherwise we will not be able to make a precise examination of the pelvic bones.5.you will have to drink a sucrose solutions to constrict your gallbladder, it is v