诊疗英语会话PPT课件

.,1,EnglishforDoctors,EnglishinUse,JiangsuUniversity,.,2,Goodmorning,MsRayner.Comeandsitdown.,Goodafternoon,mynameis,andmyEnglishnameisMary.,SoyoucancallmeDr.Mary.IamadoctorofInternalMedicine.Imresponsibleforyourtreatment/Illbelookingafteryou.,Or:Iworkinthedepartment.Imacardiacsurgeon/.,.,3,anesthesiologistdermatologisthepatologistophthalmologistpharmacologistpulmonologistToxicologistneurologisturologist,cardiologisthematologistoncologistpathologistpsychologistradiologist,.,4,医生问话的三个主要部分：就诊原因（含症状）、询问病史、临床体检,Mr.Simpson34,plumberc/odyspnoea1/12;ankleswelling2/52SHmarriedwith1son25cigs/day;50unitsalcohol/weekPHnilrelevantFHfatherd.42MI;mothera2spidernaevionchestP110/minreg.BP100/60CXRenlargedheartandbilat.Pleuraleffusions,呼吸困难,胸腔积液,ChestX-ray,.,5,与患者打招呼-请患者描述症状-收集病例-临床检查-通知诊断结论、治疗方案和进一步化验项目-医嘱（-复诊）,Wellnow,howcanIhelpyou?Well,Mr.Rayner.Whattthetrouble?Whatsymptomsdoyouhave?,.,6,.,7,1.问时间：如症状开始的时间、持续的时间、间隔的时间或频率2.问症状的性质和严重程度3.问诱因,医生问话的三个主要部分：就诊原因（含症状）、询问病史、临床体检,Whendiditbegin/start?,Whendidyoubegintonoticethesesymptoms?,Howlongdoeseachepisode/attacklast?Howoftendoesithappen?Howoftenaretheattacks?,Istheconditionserious?Hasitgottenworse?,Whatdoyouthinkprovokesit?Hasanythingstartedthisoff?Doesanythingbringthemon?,.,8,还有别的症状吗？,Hasanythingelsetroubledyou?Doyousufferfromindigestion/boweltrouble/?Haveyounoticedanythingelse?,.,9,发作，犯病,Ivenothadmuchtroublewiththatfortwoyears.这两年没大犯过。Doesthepaincomeoninthenight?夜间腹部疼痛吗？Areyouallrightbetweenspasms?两次发作期间你感觉好吗？Ikeepgettingdizzyspells.我的晕眩周期性发作。Itusedtocomeandgobutnowstaysput.本来时好时坏，如今持续不好。Theappendixhasburst.-Wedbetterremoveit.,.,10,Howlonghaveyouhadthis?Whendidthisstart?,提示日期Christmas=DecemberThanksgiving(USA)=NovemberEaster=AprilSummerHolidays=July/AugustPatientsBirthdayDidyouhaveitatChristmastime?,.,11,医生问话的三个主要部分：就诊原因（含症状）、询问病史、临床体检,.,12,询问病人的既往史Inquiringthehealthhistory,1）Whatdiseasehaveyouhadbefore?你过去得过什么疾病？2）Pleasetellmesomethingofyourpastillness.请告诉我你过去的患病情况。3）Didyouhaveanychildhooddiseases?你小时候得过什么疾病吗？4）Whatkindoftreatmentdidyouhaveinthepast?你过去曾接受过什么治疗吗？5）Didyouhaveanyoperationbefore?你以前做过手术吗？6）Haveyoueverbeenhospitalizedbefore?你以前住过院吗？,.,13,询问病人的家族史IInquiringthefamilyhistory,1）Tellmesomethingaboutyourfamily.告诉我一些关于你家庭的事。2）Areyourparentsstillliving?你父母还健在吗？4）Howareyourparentshealth?你父母的健康状况怎么样？5）Whatwasthecauseofyourmothersdeath?你母亲的死亡原因是什么？6）Arethereillnessesthatseemtoruninyourfamily?你家里有什么遗传病吗？,.,14,询问病人的家族史IIInquiringthefamilyhistory,7）Wereyourparentsandtheirparentsrelatedbyblood?你父母和祖父母是近亲结婚吗？8）Doesanyoneinyourfamilysmoke?你家里有人吸烟吗？9）Hasanyoneinyourfamilyhadthesametrouble?你家里有人得过这种病吗？,.,15,询问病人的服药史IInquiringthemedicinetaken,D:Haveyoutakenanymedicine?你服过什么药吗？P：Itooksomeaspirin.我服用过阿司匹林。D:Doesithelptorelievethepain?能缓解疼痛吗？P：No,itseemshelpless.不，似乎没什么效果。,.,16,询问病人的服药史IIInquiringthemedicinetaken,1）Areyoutakinganymedicinenow?你现在服什么药吗？2）Whatkindofmedicineareyoutakingfortheproblem?你在服什么药治疗这种病？3）Whatkindofvaccinationdidyoureceive?你打过什么疫苗？4）Areyouallergictoanymedicine?你对什么药过敏？5）Doyoutakesleepingpills?你吃安眠药吗？6）Doyouuselaxatives?你服泻药吗？7）Whendidyoustoptakingthemedicine?你是什么时候停服这种药的？,.,17,询问病人的社会史Inquiringthesocialhistory,病人的职业occupation,吸烟饮酒习惯smoking/drinkinghabits,饮食习惯eatinghabits都可能和疾病有关。1）Doyousmoke?Howlonghaveyoubeensmoking?Howmuchdoyousmokeaday?2）Doyoudrinkalcohol?你喝酒吗？Howmuchalcoholdoyoudrinkinaday?一天喝多少？3）Whatfoodsdontyouliketoeat?你不爱吃什么食物？4）Whatdoyoudo?/Whatsyourjob?/Whatdoyoudoforliving?你是做什么工作的？,Drinkinghabits,Doyoudrinkatall?Doyoudrinkeverydayorjustonsocialoccasions?Roughly,howmuchdoyoudrinkonaverageeveryday?Doyoudrinkalone?Doyoudrinkinthemornings?Haveyoueverbeenadrinker?,Drinkinghabits,Doyoueverfeelguiltyaboutyourdrinking?Haveyouevertriedtocutdownyourdrinking?Haveyoueverhadanyfitsorblackoutsthroughdrinking？昏厥，眼前发黑Doyouthinkyourdrinkingcausesanyproblems?Atwork?Withyourmarriage?Haveyouevergotintotroublewiththelawthroughdrinking?,.,20,与患者打招呼-请患者描述症状-收集病例-临床检查-通知诊断结论、治疗方案和进一步化验项目-医嘱（-复诊）,.,21,临床检查：Instructthepatientinaclearbutpolitemanner,Whenexaminingapatient,politeformsareoftenusedfortheinitialinstruction:Couldyoubendforwardasfarasyoucan?Ifyoucouldcrossyourarmsinfrontofyourchest.WhatIdliketodoisexamineyoustandingup.Afterthatdirectinstructionsmaybeused:Standwithyourfeettogether.Lieperfectlystill.Tosoftentheinstruction:Canyoujustturntothesideagain?Couldyoujustlieonthecouch?,.,22,Usefulexpressions,Pleaselieonyourtummy.请肚子朝下躺着。Pleaseturnoverandlieonyourback.请转过来，背朝下躺着。Rolloverontoyourleft/rightside.左/右侧卧。Bendyourknee.屈膝。Situp.坐起来。Leanforward.前倾。Getoffthecouchandstandup.下床并站立。Walkacrosstheroom.步行穿过这个房间。,.,23,Showsensitivitytothepatientsneedsandrespondtodiscomfort,reassuringifappropriate.,Youmightfeelalittlebitofdiscomfort.ThismighthurtalittlebutIllbequick.Tellmeifithurts.Letmeknowifitssore.Itwillbeoververyquickly.Itwonttakelong.Youredoingverywell.,.,24,Talkthepatientthroughtheprocedure（Seepage5）,Imjustgoingto.FirstIll.ThenIllNowImgoingto.Youllfeel.Whenitsover,IllThatsit.Allover.,.,25,测量生命体征VitalSigns,我需要量一下你的体温，我将把这个放到你的耳朵里面。Ineedtotakeyourtemperature.Iamgoingtoputthisinyourear.请问我能把体温计放到你的腋窝处几分钟吗？PleasecanIputthisthermometerunderyourarmforafewminutes?,.,26,测量生命体征VitalSigns,你的体温正常/低烧/高烧/比正常体温低。Yourtemperatureisnormal.slightlyhigh.high.belownormal.,.,27,BloodPressure,我要量一下你的血压。Ineedtotakeyourbloodpressure.我要在你的上臂绑一个血压计。Iamgoingtoputatourniquetaroundyourupperarm.tnktSphygmomanometersfimumnmit,.,28,BloodPressure,会感觉很紧，但是一会就好。Itwillfeelverytight,butonlyforashorttime/alittletime/foramoment.请保持你的手臂不动。Pleasecanyoukeepyourarmstill.你的血压是120/90。Yourbloodpressureis120over90.,.,29,Pulse,Ineedtotakeyourpulse.PleasemayIfeelyourwrist,.,30,指导穿衣,Youcangetdressednowandthencomeouttome.你现在可以穿上衣服跟我出去。Donthurry.Takeyourtime.别着急，慢慢来。,.,31,与患者打招呼-请患者描述症状-收集病例-临床检查-通知诊断结论、治疗方案和进一步化验项目-医嘱（-复诊）,.,32,Shareyourfindingswiththepatient.,Ihaventfoundanythingtosuggestanyproblems.Theredoesntseemtobeanythingwrongwithyou.Imsurethiswillclearuponitsown.,无需治疗,需要做某些检查或化验,.,33,开检查用语：,1）Allright,thelastthingleftisaphysicalexamination/afewlabtests/anX-raypictureofthechest.好，再做项体格检查/化验/拍胸片就行了。2）Well,MissHartley,Icantfindanythingseriouslywrongwithyou,butIdlikeyoutohaveyourchestX-rayedandanECG.3）YouneedtohaveanECGtest./IneedyoutohaveanECGtest.你需要做一下ECG。/我需要你做一下ECG。,.,34,Expression:X-ray,你需要拍一下X光。YouneedtohaveanX-ray.你需要拍一下.部位（头部）的X光。YouneedanX-rayofyour.,.,35,开检查用语2：,4）YouneedtotakeaMRIscan/ultrasonicscan/ultra-scan.你需要做个核磁扫描/超声。5）Asputumcultureshouldbedoneforyourcase.你需要做个痰培养。6）wewouldliketohaveyourstoolexamined.Willyoupleasegiveusaspecimen?你要查一下粪便。能留个样本吗？7）Idliketohaveaspecimen/sampleofyourwater.我想留一份你的尿样。Idliketohaveamidstreamspecimen.我想留一份中段尿样。,.,36,Expression:Bloodtest,你需要做一下血液测试。Youneedtohavesomebloodtests.你需要查一下空腹血糖。Youneedtohaveafastingbloodsugartest.请带着这张化验单到血液科（hematology）。hi:mtldPleasetakethisformtohematology.化验结果出来后请带给我。Pleasebringtheresultsbacktome.,.,37,Expression:UsagesonUltra-scan,你需要做一下.部位的超声波扫描。Youneedtohaveanultra-scanofyour.请带着化验单，做完之后带着化验结果来找我哦。Pleasetaketheformwithyou.Afteryougettheresult,pleasebringitbacktome.,.,38,Expression:Ultra-scan,在做超声波扫描前，请憋尿。Youwillneedtohaveafullbladderbld(r)beforetheultrascan.请在做超声波扫描前喝足够的水。Pleasecanyoudrinkglassesofwaterbeforeyouhavethescan.,.,39,Youneedfastingbeforethetest.Thetestneedsyouremptystomach.你的检查需要空腹。Pleasedonoteatanythingordrinkwaterinthemorningbeforetakingthetest.请您早晨检查之前不能吃饭喝水。Pleasedrinkwaterandholdbackurine.请多喝水憋尿Pleasedrinkalotofwateranddontgotothetoiletaspossibleasyoucanbeforethetest.,Expression:Ultra-scan,.,40,请你拿着单子先去收费处交费，交完费后去隔壁的化验室抽血化验，然后回这儿来。,Pleasetaketheprintouttothecashiertopayyourfeesfirst.Afterpaying,letthemdrawbloodforabloodtestintheLaboratorynextdoor.Then,comebackhere.,.,41,Shareyourfindingswiththepatient.,Well,Imfairlycertainyouvegota.Onepossibilityisitcouldbewhatwecall.Ihaventfoundanythingtosuggestanyproblems.,.,42,Explainingdiagnosis,YouresufferingfromYouvedevelopedYouhaveThisiswhyThisismainlybecause,.,43,Prescription,IdlikeyoutoIllgiveyouaprescriptionforsometabletstoeasethepain.Takethismedicinetwiceadayaftermeal.Youshouldtakethispill(tablet/capsule)rightafterbreakfastandrightafterdinner.Idlikeyoutocomeintohospitalforafewdayssothatwecankeepaneyeonyou./tofindoutwhatexactlyiscausingthistrouble.,.,44,消除疑虑,Dontworryaboutthis.Itsquiteacommonconditionandshouldclearupinaweekorso.Thisisnotaseriouscondition.Thesetabletsshouldhelp.Theonlywaytotreatthisisbyanoperation.Itisaroutinesurgeryandyoushouldbebacktonormaltwomonthsaftertheoperation.Youwillnodoubtwanttogohomeassoonaspossible,butweareheretohelpyouwheneveryouneedus.,.,45,Theprognosis,IexpectthetreatmentwillHopefullywecanWecanneverbeabsolutelycertainaboutYoushouldremainoptimistic.Doyouhaveanyquestions?Isthereanythingyoudliketoask?,.,46,完成各项检查后的初步治疗措施：如静脉给药、理疗等。,1.ThisisyourIVsheet.TaketheIVfirst.这是你的静脉输液单，先输次液。IV是intravenous的简写。也可以说IVdrop/intravenousdrop，输液室IVroom输一次液haveanIV2.Thisisyourinjectionsheet.这是你的注射单。肌肉注射intramuscularinjection皮内注射intradermicinjection皮下注射hypodermicinjection英ntrdmk美ntrdmk注射室InjectionRoom做一次注射haveaninjection3.Areyouallergictopenicillin?/Doyouhavepenicillinallergy?你对青霉素过敏吗？4.Youneedashotofpenicillintoday.（Shot=injection，表示“注射”）今天你需要注射一支青霉素。,.,47,在离开门诊前，医生可能给予病人一些家庭指导，包括一些注意事项、某些在家要进行的活动或措施。,请翻译：你应该卧床休息，多喝水。,Drinkplentyofwaterandhaveagoodrest./Youdbetterhaveagoodrest.,Youshouldrestinbedanddrinkplentyofwater.,.,48,Discussingtreatment：Advisingacourseofaction,-Sometimeoffworkmighthelp.Ifyoufeltthatwouldbehelpful,youcouldtakeaweekoffandseehowyoufeltafterthat.-Carryondrinkinglotsoffluids.-Ifyoustillhavesomepain,youcankeeptakingparacetamol.-Otherthingsmighthelp,likeraisingtheheadofyourbed.Thatsoneofthesimplethingswecouldstartyouoffwith.Yousaidyouhaventtriedindigestionremedies.Thatssomethingyoucouldtry.,.,49,饮食方面的医嘱,Choosefreshorfrozenvegetablesandfruitswithoutaddedsaltandsugars.多吃不添加盐和糖的新鲜或冷冻蔬菜和水果。2.Pleaseeatadiethighinprotein,freshfruitsandvegetables.吃富含蛋白质的食品以及新鲜水果和蔬菜。Donteatveryhotorcoldfood,andkeepoffstimulatingfoodssuchassourorspic