当代医学英语微课程 临床医疗问题与对策教学参考答案

当代医学英语微课程临床医疗问题与对策教学参考答案微课程•临床医疗问题与对策教学参考答案Unit1KeytoLesson1Activity11.Pplaints5.radiologist6.motivation7.preventative8.reform9.attractive10.spinalActivity31.Thereisanationwideshortageofprimarycaredoctors.2.Oneofthefourphysicianjobsareopen.3.Itishardtoprovidecaretoanyoneinthecommunity.4.Twomajorreasons:thehealthsystemandtheincome.5.Familydoctorsearnonaverage$190,000annually,whileradiologistsearn$424,000,andspinalsurgeons,$611,000annually.6.Nationwidethenumberisonlyabout5%ofthemedicalstudents.7.Healthreformmustchangemedicinesothatfamilymedicinecanbeseenasanattractiveoption.Activity5临床医疗中一大问题是全科医生短缺。全科医生被认为是健康的守门人，在为人口最大群体提供基本医疗服务中起着重要作用。临床医疗中一大问题是全科医生短缺。全科医生被认为是健康的守门人，在为人口最大群体提供基本医疗服务中起着重要作用。全科医生短缺，意味着医疗培训和卫生系统中应对响应机制的短缺，也意味着卫生体制和政策的危机。从政策上和报酬上吸引更多医学生从事全科医学为患者提供基本的医疗服务，是卫生体制改革的一个重点。Abigcomplaintaboutclinicalmedicineistheshortageofprimarycaredoctors.Primarycaredoctorsareconsideredtobehealthconcierges,whoplayanessentialroleinprovidingbasichealthcaretothelargestgroupofthepopulation.Ashortageofprimarycaredoctorsmeansashortageofarespondingmechanisminmedicaltrainingandhealthsystems,andalsoacrisisinthehealthsystemandpolicies.Itisakeypointofhealthsystemreformtoattractmoremedicalstudents,bybothpoliciesandremuneration,topursueacareerinprimarycaretoprovidepatientswithbasichealthcare.报酬临床医疗中一大问题是全科医生短缺。全科医生被认为是健康的守门人，在为人口最大群体提供基本医疗服务中起着重要作用。全科医生短缺，意味着医疗培训和卫生系统中应对响应机制的短缺，也意味着卫生体制和政策的危机。从政策上和报酬上吸引更多医学生从事全科医学为患者提供基本的医疗服务，是卫生体制改革的一个重点。Abigcomplaintaboutclinicalmedicineistheshortageofprimarycaredoctors.Primarycaredoctorsareconsideredtobehealthconcierges,whoplayanessentialroleinprovidingbasichealthcaretothelargestgroupofthepopulation.Ashortageofprimarycaredoctorsmeansashortageofarespondingmechanisminmedicaltrainingandhealthsystems,andalsoacrisisinthehealthsystemandpolicies.Itisakeypointofhealthsystemreformtoattractmoremedicalstudents,bybothpoliciesandremuneration,topursueacareerinprimarycaretoprovidepatientswithbasichealthcare.临床医疗中一大问题是全科医生短缺。全科医生被认为是健康的守门人，在为人口最大群体提供基本医疗服务中起着重要作用。全科医生短缺，意味着医疗培训和卫生系统中应对响应机制的短缺，也意味着卫生体制和政策的危机。从政策上和报酬上吸引更多医学生从事全科医学为患者提供基本的医疗服务，是卫生体制改革的一个重点。Abigcomplaintaboutclinicalmedicineistheshortageofprimarycaredoctors.Primarycaredoctorsareconsideredtobehealthconcierges,whoplayanessentialroleinprovidingbasichealthcaretothelargestgroupofthepopulation.Ashortageofprimarycaredoctorsmeansashortageofarespondingmechanisminmedicaltrainingandhealthsystems,andalsoacrisisinthehealthsystemandpolicies.Itisakeypointofhealthsystemreformtoattractmoremedicalstudents,bybothpoliciesandremuneration,topursueacareerinprimarycaretoprovidepatientswithbasichealthcare.KeytoLesson2Activity11.pediatrics2.access3.chronic4.coordinate5.screening6.unavailable7.insurance8.consistent9.practitioner10.follow-upActivity

31.AccesstoprimarydoctorsisoftenunavailabletomanyAmericans.2.Manypatientsgounnecessarilyandexpensivelytoemergencyrooms.3.Regularfollow-upsandgoodpreventivemedicine.4.Primarycarewasofferedinanold-fashionedway:MondaythroughFriday,9to5.5.Physicianassistanceandnursepractitionersstartedtoseepatientsnightsandweekends,andprovide24-hour-phoneservice.6.Theyhaveimprovedcareforpatientsanddecreasedhealthcarecost.7.Itincreasesfrom5toalmost8percenteachyear.1.

许多美国人常常无法获得初级医生的诊治。2.

许多病人不必要而昂贵地去了急诊室。3.定期随访和良好的预防医学。4.

初级保健是以传统的方式提供的:周一到周五，朝九晚五。5.

医生助理和护士从业人员开始在晚上和周末看望病人，并提供24小时电话服务。6.

他们改善了对病人的护理，降低了医疗成本。7.

每年从5%增长到8%。Activity5除了全科医生严重不足，临床医疗还面临着包括看病难和成本高的问题。著名的梅奥诊所也存在这些问题，不过通过一系列的医疗改革措施，不仅患者得到了周到的服务，而且医疗费用也下降了。看病难和成本高也是中国卫生服务中常常被抱怨的问题。美国梅奥诊所的那些应对措施能为中国的医疗改革提供哪些借鉴？Apartfromtheseriousshortageofprimarycarephysicians,theproblemsexistinginclinicalmedicinealsoincludedifficultaccesstohealthcareandhighmedicalcost.ThisisalsothecasewiththefamousMayoClinic,butthroughaseriesofhealthcarereformmeasures,theMayoClinichasnotonlyprovidedpatientswiththoughtfulhealthservice,butalsodecreasedmedicalexpenses.DifficultaccesstohealthcareandhighmedicalcostarealsocommoncomplaintsaboutthehealthcareinChina.WhatlessonscanbedrawnfromthemeasurestakenbytheMayoClinicintheU.S.forthehealthcarereforminChina?当代医学英语微课程•临床医疗问题与对策教学参考答案Unit

2KeytoLesson4Activity11.triage2.admission3.agonizing4.round-the-clock5.stuck6.understaffed7.streamline8.instantaneously9.moan10.suiteActivity31.Thewait.2.Fourhours.3.Byhiringmoredoctorsandnurses,andstreamlininglabtechniques.4.Patientswillbeseenwithin30minutesoftheirarrival.5.Itsemergencydepartmenthasnowa“Fast-track”program,24-hoursaday.6.Bynewclinicalinformationsoftware.7.Itisnotonlygoodmedicine,butalsogoodbusiness.Activity5提升医疗服务的效率和质量历来是临床医疗始终关注的问题。急诊室等候时间过长可能是患者就医最痛苦的经历。一般患者在急诊室要等上4-5小时，原因可能是患者人数过多或急诊室人员配备不足。减少急诊室等候时间是优质医疗服务的一部分。一些医院已在采取各种措施，如“30分钟急症室保障项目”来提升快速的急诊室医疗服务。Improvingtheefficiencyandqualityofmedicalserviceshasalwaysbeenaconcerninclinicalmedicine.Waitingforalongtimeinemergencyroommaybethemostagonizingexperienceforpatientsseekingmedicaltreatment.Theaveragepatienthastowaitintheemergencyroomfor4-5hours,perhapsbecauseemergencyroomsareovercrowdedandunderstaffed.ReducingERwaittimesisapartofgoodmedicine.Somehospitalshavetakenvariousmeasures,suchas“30-minuteEmergencyRoomGuarantee”,toimprovetherapidERservice.KeytoLesson5Activity11.overhaul2.brushupon3.disgruntled4.bland5.renowned6.aslewof7.implemented8.lousy9.courtesy10.gripeActivity

31.Doctorsandnursesarebrushingupontechniques.2.Blandfood,longwaitsandoftenlousybedsidemanner.3.Becausehospitalsthatdischargedisgruntledpatientsstandtolosebigmoney.4.“Howoftenwereyoutreatedwithcourtesyandrespect?”5.Cuttingwaittime.6.Toteachtechniquestoimprovepatientcare.7.Toimprovethequalityofhealthcareforeveryone.Activity5医院的形象与医疗服务质量密切相关。现在很多医院正在努力改进食物淡而无味、候诊时间长以及诊疗态度差劲的形象。医生和护士在温习技术，管理者也在增设大量特色项目，尽可能让患者在住院期间感到舒适。很多医院也在努力减少候诊时间，防止院内的致命感染和医疗事故。这些变化最终有助于提升医疗质量以及医院的形象。Theimageofahospitaliscloselyrelatedtoitsqualityofmedicalservice.Nowmanyhospitalsaretryingtopolishtheimageofblandfood,longwaitsandoftenlousybedsidemanner.Doctorsandnursesarebrushingupontechniques,andadministratorsareaddingaslewofnewfeaturestokeeppatientsascomfortableaspossibleinhospitalization.Manyhospitalsarealsotryingtocutwaittimeandpreventdeadlyhospitalinfectionsandmistakes.Thesechangeswillultimatelyhelptoimprovethequalityofmedicalcareandtheimageofhospitalsaswell.当代医学英语微课程•临床医疗问题与对策教学参考答案Unit

3KeytoLesson7Activity11.diagnostic2.stature3.staggering4.ails5.outpatients6.elevate7.grave8.ulcer9.misdiagnosis10.Awake-upcallActivity31.Misdiagnosis.2.Verygraveconsequences.3.Misdiagnosescontributeto1outof10patientdeaths.4.1in20.5.Changingthepaystructurefordoctors,elevatingthestatureofnurses,andimprovingcommunicationsthroughouttheprocess.6.Herkidneycancerwasmisdiagnosedasastomachulcer.7.Theyneedtoknowwhattheirsymptomswereandwhethertheirdoctorfullylistenedtothemashegavediagnosis.Activity5误诊意味着在当时那个时点错过了做出及时正确的医学判断机会。误诊是临床医疗中常见的问题，也是门诊医疗差错的主要原因。据估计，每年去门诊就医的美国人中有1/20被误诊，误诊还导致1/10的患者死亡。由此可见，误诊的后果十分严重，足以向医患双方敲响警钟，需更多关注医疗体制中这一危险的盲点。Misdiagnosismeansthattherewasamissedopportunitytomakeatimelyandcorrectmedicaldiagnosisatthatpointoftime.Misdiagnosisisacommonprobleminclinicalmedicineandalsotheleadingcauseofmedicalerrorinoutpatientfacilities.Itisestimatedthat1in20Americansseekingoutpatientcareismisdiagnosedeveryearandthatmisdiagnosescontributeto1outof10patientdeaths.Thisshowsthattheconsequencesofmisdiagnosisaregraveenoughtobeawake-upcallforbothdoctorsandpatients,demandingmoreattentiontothisdangerousblindspotinthehealthcaresystem.KeytoLesson8Activity11.pathology2.undergo3.Galluppoll4.recovery5.biopsy6.matchup7.mastectomy8.monitor9.appropriate10.gutActivity

31.Shewasdiagnosedwithbreastcancer.2.Sheexpectstomakeafullrecoveryafterherdoublemastectomy.3.Becauseshecaughtbreastcancerearlyandgotasecondopinion.4.Shewasurgedtogetasecondopiniononthepathology.5.Theyhadtheirtreatmentplanschanged.6.Theyhavetimetoseekasecondopinionandtoplanthemostappropriatecourseoftherapy.7.Althoughconfidentintheirdoctor’sadvice,mostpatientsneedtogetasecondopinionordotheirownresearch.Activity5演员及歌手丽塔·威尔逊因患乳腺癌而作了双乳切除手术。她的经历表明求医治病中听取第二方意见有多么重要。癌症专家也认为，一旦诊断有乳腺癌，患者有时间去咨询第二方意见，规划最合适的疗程，不必立即治疗。医疗中误诊并不少见，但多达70%的美国人很相信医生，不觉得有必要获得第二方意见或自己研究一下，而威尔逊的案例给患者带来了警示。RitaWilson,anAmericanactressandsinger,underwentadoublemastectomyforherbreastcancer.Herexperienceshowshowimportantitistoseekasecondopinioninthetreatment.Accordingtocancerspecialists,whenthediagnosisofbreastcancerismade,thepatienthastimetoseekasecondopinionandtoplanthemostappropriatecourseoftherapy.Thereisnoimmediateneedtohavetreatment.Amisdiagnosisisnotuncommoninmedicine,butasmanyas70%ofAmericansaresoconfidentintheirdoctor’sadvice.Theydidn’tfeeltheyneedtogetasecondopinionordotheirownresearch.Nevertheless,theWilson’scaseisawake-upcallforpatients.当代医学英语微课程•临床医疗问题与对策教学参考答案Unit

7KeytoLesson19Activity11.nausea2.heartburn3.sweat4.tightnessinthechest5.highlights6.atypical7.empowered8.shortnessofbreath9.hefty10.overwhelmingActivity

31.Heartdiseasekillsmorewomenthanallcancerscombined.2.Itishighlightingwhysomanywomenaredyingofheartattacks.3.Shewasjust41yearsold.4.Theydon’thaveclassicsymptomsofheartattacks.5.Shortnessofbreath,lightheadedness,paininthejaw,neckorarms,nausea,coldsweatsandextremefatigue.6.Beingovertiredandterriblystressed,tightnessinherchest,paininherjaw.7.Knowinggenderdifferencesinaheartattackandactingonthemcansaveyourlife.Activity5在美国，心脏病这一头号杀手造成的女性死亡人数超过女性死于所有癌症之合，因此成为临床医疗中的重大问题之一。临床上，心脏病发作有着性别差异。女性更可能有的非典型症状包括冷汗、恶心、呼吸浅短、头晕、胸闷、下颚及颈部疼痛、极度乏力等。很多心脏病发作的案列表明，了解这些差异并根据这些差异采取行动，能挽救很多女性的生命。Heartdisease,thenumberonekillerintheU.S.,killsmorewomenthanallcancerscombined.Therefore,itisoneofthemajorproblemsinclinicalmedicine.Clinically,therearegenderdifferencesinheartattacks.Womenaremorelikelytohaveatypicalsymptoms:coldsweats,nausea,shortnessofbreath,lightheadedness,tightnessinthechest,paininthejaworneck,andextremefatigue.Numerouscasesofheartattacksshowthatknowingthosedifferencesandactingonthemcansavemanywomen’slives.KeytoLesson20Agnosis8.myocarditis9.lymphocytic10.inconjunctionwithActivity

31.Nearlyhalfamillion.2.Coronaryarterydiseaseoryearsofhighbloodpressure.3.Arareformofheartfailurecalledlymphocyticmyocarditis.4.Acommonvirus.5.Byimplantinganintra-aorticballoonpumpandmedication.6.Shortnessofbreath,fatigueandageneralfeelingofbeingunwell.7.Thefasteryougettreatmentforit,thehealthieryouwillbe.Activity5当心脏无法有效泵送血液以满足身体的需要时，就发生心力衰竭。每年将近50万美国人诊断有心力衰竭，足以表明它是临床医疗中的重大问题。心力衰竭的常见原因有冠状动脉疾病（包括以前的心脏病发作）、高血压、感染、过量饮酒、心肌炎等。治疗取决于此病的原因和严重程度。典型的心力衰竭康复比较慢。不过，治疗开始得越早，心力衰竭的预后会越好。Heartfailureoccurswhentheheartisunabletopumpbloodefficientlytomeetthebody’sneeds.EveryyearnearlyhalfamillionAmericansarediagnosedwithheartfailure,andthisshowsthatitisamajorprobleminclinicalmedicine.Commoncausesofheartfailureincludecoronaryarterydisease(includingapreviousheartattack),highbloodpressure,excessalcoholuse,infection,andmyocarditis.Treatmentdependsonthecauseandseverityofthedisease.Typicalheartfailurecomesonslowly.However，theprognosisofheartfailuregetsbettertheearlieryoustarttreatment.当代医学英语微课程•临床医疗问题与对策教学参考答案Unit

11KeytoLesson31Activity11.allergen2.Spasm3.allergies4.pollen5.drastically6.reactive7.inhaler8.kickup9.allergist10.triggersActivity

31.Morethan17millionAmericans.2.Theywillwheeze,coughandgetshortnessofbreath.3.Hethinkspollutionisprobablythemostimportantreason.4.Infections.5.Byrecognizingtriggers,avoidingthetriggersandknowingwhatmedicationstouse.6.Anyeffectivecarecouldbecompromised,whichcouldleadtomoretroublesomesymptoms.7.Thetheorygoesthatbeingexposedtoawholehostofallergensonthefarmcandothat.Activity5哮喘是呼吸道常见疾病之一。据估计2011年全球有235百万-330百万人患哮喘，每年25万-34万人死于此病。哮喘由复杂的、未完全明了的环境和遗传因素相互作用引起。与哮喘发生有关的众多环境因素包括过敏原、空气污染和其他环境化学物。据一项全国调查发现，80%以上的患者未能有效控制疾病。这就意味着他们将面临哮喘严重发作及肺部长期损伤的风险。Asthmaisoneofthecommonrespiratorydiseaseswithestimatesthatasof2011,235–330millionpeopleworldwideareaffectedbyasthmaandapproximately250,000–345,000peopledieperyearfromthedisease.Asthmaiscausedbyacombinationofcomplexandincompletelyunderstoodenvironmentalandgeneticinteractions.Manyenvironmentalfactorsassociatedwithasthma’sdevelopmentincludeallergens,airpollution,andotherenvironmentalchemicals.Accordingtoanationwidesurvey,morethan80%ofpatientswithasthmafailedtoeffectivelycontrolthedisease.Thismeanstheywillfacetheriskofsevereasthmaattacksandlong-termlungdamage.KeytoLesson32Aent8.mortality9.category10.predispositionActivity

31.Theswinefluwasdeclaredaglobalpandemic.2.Becausethevirusisspreadingfrompersontopersoninatleast37countries.3.BecausetheUSgovernmenthasbeeninfaceofthepandemicforsometime.4.Morethan30deaths.5.Menandwomenwithasthmaandotherlungproblems,heartdisease,diabetesandobesity.6.Theonein1918killed50millionpeopleworldwide.In1957,2millionpeopledied.Andin1968thetollwasImillion.7.Theviruscouldchangeasitmovesfromplacetoplace.Activity5呼吸道疾病是全球疾病和死亡的一个常见和重大的原因。呼吸道疾病中的病毒性肺炎及哮喘的恶化，可能是流感导致的并发症。2009年至少37个国家暴发了猪流感，被世界卫生组织宣布为全球大流行病。在现代历史上曾发生三次流感大流行，每次死亡人数在100万以上。为什么在医学取得很大进步的今天还会暴发全球流感大流行？这个问题确实值得研究。Respiratorydiseaseisacommonandsignificantcauseofillnessanddeatharoundtheworld.Amongrespiratorydiseases,viralpneumoniaandworseningofasthmacanbecomplicationsduetoinfluenza.Theoutbreakoftheswinefluin2009inatleast37countriesaroundtheworldwasofficiallydeclaredaglobalpandemicbytheWorldHealthOrganization.Therehavebeenthreeglobalinfluenzapandemicsinmodernhistory,eachresultinginmorethanamilliondeaths.Whydoesaglobalflupandemicstilloutbreakinadaywhenmedicinehasachievedalotofprogress?Thisisindeedaworthwhileresearchquestion.当代医学英语微课程•临床医疗问题与对策教学参考答案Unit

12KeytoLesson34Activity11.paralyzing2.abdominal3.alteration4.spontaneous5.evacuation6.bloating7.constipation8.gastroenterologists9.bowelhabit10.IrritablebowelsyndromeActivity

21.Acasediagnosedwithirritablebowelsyndrome(IBS)2.ThesymptomsforIBS3.EffectsofIBSanditscause4.TreatmentforIBS5.SuggestionsaboutcontrollingthesymptomsActivity

31.It’snotlifethreatening,butitcausesagreatdealofdistress.2.It’scharacterizedbyabdominaldiscomfortorpain.3.Aftergoingthroughaseriesoftests.4.Alterationofbowelhabit,feelingofincompleteevacuation,bloating,andabdominalfullness.5.IBSiscausedbyemotionalconflictorstress.6.Itistoestablishagooddoctorpatientrelationship.7.Throughtherightcombinationofmedication,dietandcounselingtocontrolthesymptoms.Activity5胃肠道疾病是临床上常见的，肠易激综合征就是其中之一。此病不威胁生命，但谈起它来却令人尴尬。肠易激综合征的常见症状包括腹痛、腹胀、腹泻和便秘，对患者生活质量造成不利影响。引起此病的原因尚不清楚，目前也没有治愈的方法。一些患者可以通过调整饮食、生活方式和压力来控制症状；另一些则需要药物治疗和心理咨询。Gastrointestinaldiseasesarecommondisordersclinically,oneofwhichisirritablebowelsyndrome(IBS).Thediseaseisnotlife-threatening,butitisembarrassingtotalkabout.ThegeneralsymptomsforIBSincludeabdominalpain,bloating,diarrheaandconstipation,affectingnegativelythepatient’squalityoflife.ThecausesofIBSarenotclear,noristhereacureforit.Somepatientscancontroltheirsymptomsbymanagingdiet,lifestyleandstress.Otherswillneedmedicationandcounseling.KeytoLesson35Activity11.reluctance2.fecal3.occult4.sigmoidoscopy5.oncologist6.polyp7.exert8.barium9.exhaustion10.sporadicActivity

21.Acaseof3rd-stagecoloncancer2.Theoccurrenceanddeathrateofcoloncancer3.Appropriatescreeningtestsforcoloncancer4.Theimportanceofearlydetectionbycolonoscopy5.Thepubliceducati