英语课件--医生是怎么思考的？how-physicians-think

HowPhysiciansThink陈雪英SherryChanNo:11214494E-mail:1305396009@StomatologyTheSixthAffiliatedHospitalMainIdeaLanguagePointsHowPhysiciansThinkHereMyReactionMyStructureMainIdeaHowPhysiciansThinkParagraph4Doctorstendtocategorizeandthencontinuetooperateinaccordwiththeoriginalcategorization.Paragraph5Becarefultoalwaysreevaluateadiagnosisandnotthinkrigidly.LanguagePointscategorizevt.placeintoorassigntoacategory分类，把…分类(或分等级)；把…归入一类(或同一等级)Ininformationretrieval,awordusedtocategorizeorindexinformation.categorizationn.Onepossiblecategorizationofactionsisasharedhistoricalcontext.inaccordwith与…一致；与…相符合；与…调和Basicandapplyingdisciplineswhichareinaccordwithtimesrequestandadvancewithtime.

Themoststrikingobservationabouthowdoctorsthinkisthetendencytocategorizeandthentocontinuetooperateinaccordwiththeoriginalcategorization.(para.4line1-3)LanguagePointsAlthoughmychestpainwasatypicalforcoronaryocclusion……(para.4line3)atypical

adj.notrepresentativeofagroup,class,ortype非典型的；不合规则的TheexperiencesofNashandYatesaretypicalinsomewaysbutatypicalinothers.coronaryn.obstructionofbloodflowinacoronaryarterybyabloodclot(thrombus)

1.冠状动脉2.【病理学】冠状动脉血栓形成adj.surroundinglikeacrown(especiallyofthebloodvesselssurroundingtheheart)coronaryarteries1.冠的；冠状的2.【医学】冠状的；(心脏的)冠状动脉的occlusionn.

closureorblockage(asofabloodvessel)闭塞LanguagePoints……continuedforsevenoreighthours,andwasnotcrushingorsevereormadeworsebyexertion.(para.4line4-5)crushingadj.physicallyorspirituallydevastating;oftenusedincombination压倒的；使人受不了的；决定性的；支离破碎的Youcouldn'tgoanywherewithoutseeingpeoplewhonaturehadgiven,inmanyways,averybaddealalongwithcrushingpoverty.exertionn.useofphysicalormentalenergy;hardwork发挥；运用；努力,尽力，使劲；费力Theproblemtodayisthatwhatcanbedonebyameasureofexertionisconsideredbymanytobeimpossible.

LanguagePointsEvenwhenthelaboratoryreportedthatthecardiacfractionoftheserumcreatinephosphokinase(CPK)levelwasnormal……(para.4line7-8)creatinephosphokinase肌酸磷酸激酶Routinelaboratorytestsshowedamildanemia,metabolicacidosisandelevationofplasmacreatinephosphokinase.cpk

肌酸(creatine)和磷酸肌酸(creatinephosphate)在能量储存及利用中起重要作用。二者互变使体内ATP供应具有后备潜力。肌酸在肝和肾中合成，广泛分布于骨骼肌、心肌、大脑等组织中。肌酸以甘氨酸为骨架，精氨酸提供脒基、SAM供给甲基、在脒基转移酶和甲基转移酶的催化下合成。在肌酸激酶(creatinephosphohinase,CPK)催化下将ATP中Pi转移到肌酸分子中形成磷酸肌酸LanguagePoints……thenextdiagnosisthatwasentertainedwasunstableangina(thelaboratorydidreportthatthetotalCPKlevelintheserumwaselevated).(Page41line1-2)entertainvt.1.takeintoconsideration,haveinview愿意考虑(想法、怀疑等)：2.maintain(atheory,thoughts,orfeelings)心存，怀着，怀抱，抱有(希望、信心、观点、意见等)：ThegoldenruleasfarasI'mconcernedistonotentertainanyunsolicitedcontact.

anginan.aheartconditionmarkedbyparoxysmsofchestpainduetoreducedoxygentotheheart心绞痛Anginabeforeoperationisaseriousproblem.

elevatev.raisefromalowertoahigherposition提升；举起；LanguagePointscondemnv.expressstrongdisapprovalof谴责，非难WecondemntheracisminSouthAfrica.

generalizev.drawfromspecificcasesformoregeneralcases概括；推广;使...一般化reevaluatev.reviseorrenewone'sassessment.再评估；重新估计You'dbetterreevaluateyourpriorities;youarebusyworkingandspendlittletimewithyourfamilies.

Isaythisnotsomuchtocondemnastoremindusthatweall,tosomeextent,thinkincategoriesandtendtogeneralizefromafixedposition.(para.5line1-2)Wehavetobecarefultoalwaysreevaluateadiagnosisandnotthinkrigidly.(para.5line1-2)LanguagePoints以上来源于:WordNetincidentallyadv.

introducingadifferenttopic;bytheway顺便；偶然地；附带地affiliatev.joininanaffiliation使附属；接纳；使紧密联系ThesixthaffiliatedhospitalofSun-Yat-SenUniversityprominentadj.havingaqualitythatthrustsitselfintoattentionorimportance突出的，显著的；杰出的；卓越的prestigiousadj.havinganillustriousreputation;respected有名望的；享有声望的Ifyouexpecttoenterthisprestigiousuniversity,youshouldapplynow.Incidentally,IliveinBoston,andthehospitalsinvolvedwerebothuniversityaffiliated,onebeingaratherprominenthospitalaffiliatedwithaprestigiousBostonmedicalschool.(thelastsentence)HowPhysiciansThinkHereDiagnosis:myocardialinfarctionThecardiogramwasreadadpossiblemyocardialinfarction.ThetotalCPKlevelintheserumwaselevated.Peoplekeptthinking“heart”.it’swrong!WHY?HowPhysiciansThinkHereWhydidthephysiciansmakeawrongdiagnosis?ChestpainwasatypicalItcameonatrest.Itcontinuedfor7or8hoursItwasnotcrushingorsevereormadeworsebyexertion.Thedetailswerelost.Thepatienttoldhisdoctorsthedetailsregardingthevigorousarmmovementsinkarate.TheserumCPKlevelwadnormal.Heartspecialiststhoughtrigidly.Theydealtwithheartsandthought“heart”.MyReactionThinking:howphysiciansthinkcorrectly?Whenitcomestome…MyReaction1.HowPhysiciansThinkCorrectly

Getthewholeinformationanddon’tignoreanydetails.Considertheoverallsituationanddon’tonlyfocusyourmajors.Broadenyourhorizonsanddon’tdevelopastereotypedmind.Reevaluateyourdiagnosisanddon’tthinkrigidly.MyReaction2.Howtogettherightdiagnosis?AskWhatelsecoulditbe?

Combatsatisfactionofsearchbiasandconsiderabroaderrangeofpossibilities.MyReactionAskIsthereanythingthatdoesn'tfit?

Combatconfirmationbiasandagainthinkbroadly2.Howtogettherightdiagnosis?MyReactionAskIsitpossibleIhavemorethanoneproblem?Becausemultiplesimultaneousdisordersdoexistandfrequentlycauseconfusingsymptoms.2.Howtogettherightdiagnosis?MyReactionTellwhatyouaremostworriedabout.Opendiscussionandleadeithertoreassurance(iftheworryisunlikely)orcarefulanalysis(iftheworryisplausible).2.Howtogettherightdiagnosis?MyReactionRetellthestoryfromthebeginning.Detailsthatwereomittedintheinitialtellingmayberecalled,ordifferentwordingorthedifferentcontextmaymakecluesmo