诊疗英语会话课件

EnglishforDoctorsEnglishinUseJiangsuUniversity1可编辑课件PPTGoodmorning,MsRayner.Comeandsitdown.Goodafternoon,mynameis

,andmyEnglishnameisMary.SoyoucancallmeDr.Mary.IamadoctorofInternalMedicine.

I’mresponsibleforyourtreatment/I’llbelookingafteryou.Or:Iworkinthe…department.I’macardiacsurgeon/….2可编辑课件PPTanesthesiologistdermatologisthepatologistophthalmologistpharmacologistpulmonologistToxicologistneurologisturologistcardiologisthematologistoncologistpathologistpsychologistradiologist

3可编辑课件PPT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;ankleswelling2/52SHmarriedwith1son

25cigs/day;50unitsalcohol/weekPHnilrelevantFHfatherd.42MI;mothera&wOEobese;2spidernaevionchestP110/minreg.BP100/60CXRenlargedheartandbilat.Pleuraleffusions呼吸困难胸腔积液ChestX-ray4可编辑课件PPT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.What’tthetrouble?Whatsymptomsdoyouhave?5可编辑课件PPTcomplaintsPatientssaylossofenergyIfeeltiredallthetime.Ifeelcompletelywornout.LatelyI'vebeenfeelingcompletelyexhaustedattheendoftheday.generalfeelingofbeingunwellIfeelunwell.Idon'tfeelwell.I'vebeenfeelingoff-colorfortwodays.Ihaven'tbeenfeelingmyselfforaweek.I'vebeenoutofsortsallday.lossofappetiteMyappetiteisverypoor.I'vebeenoffmyfoodfordays.IncreaseinweightI'veputoneightkilosinthelastyear.I'vegainedfivekilos.decreaseinweightI'mnoteatinganylessthanusualIlostalotofweightrecently.hard,infrequentfaecesMymotionsareveryhard.I’vebeenquiteconstipatedlately.I'mnotveryregular.6可编辑课件PPT1.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/attack

last?Howoftendoesithappen?Howoftenaretheattacks?

Istheconditionserious?Hasitgottenworse?Whatdoyouthinkprovokesit?Hasanythingstartedthisoff?Doesanythingbringthemon?7可编辑课件PPT还有别的症状吗？Hasanythingelsetroubledyou?Doyousufferfromindigestion/boweltrouble/…?Haveyounoticedanythingelse?8可编辑课件PPT发作，犯病I’venothadmuchtroublewiththatfortwoyears.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.We’dbetterremoveit.9可编辑课件PPTHowlonghaveyouhadthis?

Whendidthisstart?提示日期Christmas=DecemberThanksgiving(USA)=NovemberEaster=AprilSummerHolidays=July/AugustPatient’sBirthdayDid

youhaveitatChristmastime?10可编辑课件PPT医生问话的三个主要部分：

就诊原因（含症状）、询问病史、临床体检询问病人的既往史

Inquiringthehealthhistory询问病人的家族史Inquiringthefamilyhistory询问病人的服药史Inquiringthemedicinetaken询问病人的社会史Inquiringthesocialhistory11可编辑课件PPT询问病人的既往史

Inquiringthehealthhistory1）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？12可编辑课件PPT询问病人的家族史I

Inquiringthefamilyhistory1）Tellmesomethingaboutyourfamily.告诉我一些关于你家庭的事。2）Areyourparentsstillliving?你父母还健在吗？4）Howareyourparents'health?你父母的健康状况怎么样？5）Whatwasthecauseofyourmother'sdeath?你母亲的死亡原因是什么？6）Arethereillnessesthatseemtoruninyourfamily?你家里有什么遗传病吗？

13可编辑课件PPT询问病人的家族史II

Inquiringthefamilyhistory7）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？14可编辑课件PPT询问病人的服药史I

InquiringthemedicinetakenD: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。15可编辑课件PPT询问病人的服药史II

Inquiringthemedicinetaken1）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？16可编辑课件PPT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）Whatfoodsdon'tyouliketoeat?你不爱吃什么食物？4）Whatdoyoudo?/What'syourjob?/Whatdoyoudoforliving?你是做什么工作的？17可编辑课件PPTDrinkinghabitsDoyoudrinkatall?Doyoudrinkeverydayorjustonsocialoccasions?Roughly,howmuchdoyoudrinkonaverageeveryday?Doyoudrinkalone?Doyoudrinkinthemornings?Haveyoueverbeenadrinker?DrinkinghabitsDoyoueverfeelguiltyaboutyourdrinking?Haveyouevertriedtocutdownyourdrinking?Haveyoueverhadanyfitsorblackoutsthroughdrinking？昏厥，眼前发黑Doyouthinkyourdrinkingcausesanyproblems?Atwork?Withyourmarriage?Haveyouevergotintotroublewiththelawthroughdrinking?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）20可编辑课件PPT临床检查：Instructthepatientinaclearbutpolitemanner

Whenexaminingapatient,politeformsareoftenusedfortheinitialinstruction:

Couldyoubendforwardasfarasyoucan?Ifyoucouldcrossyourarmsinfrontofyourchest.WhatI'dliketodoisexamineyoustandingup.Afterthatdirectinstructionsmaybeused:

Standwithyourfeettogether.Lieperfectlystill.Tosoftentheinstruction:

Canyoujustturntothesideagain?Couldyoujustlieonthecouch?21可编辑课件PPTUsefulexpressionsPleaselieonyourtummy.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。22可编辑课件PPTShowsensitivitytothepatient'sneedsandrespondtodiscomfort,reassuringifappropriate.

Youmightfeelalittlebitofdiscomfort.ThismighthurtalittlebutI’llbequick.Tellmeifithurts.Letmeknowifit'ssore.Itwillbeoververyquickly.Itwon'ttakelong.You'redoingverywell.23可编辑课件PPTTalkthepatientthroughtheprocedure（Seepage5）

I'mjustgoingto...FirstI'll...ThenI'll…NowI'mgoingto...You'llfeel...Whenit'sover,I’ll…That'sit.Allover.24可编辑课件PPT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?25可编辑课件PPT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.26可编辑课件PPTBloodPressure我要量一下你的血压。Ineedtotakeyourbloodpressure.我要在你的上臂绑一个血压计。

Iamgoingtoputatourniquetaroundyourupperarm.

[ˈtʊənɪkɪt

]Sphygmomanometer[ˌsfiɡməuməˈnɔmitə

]

27可编辑课件PPTBloodPressure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。Yourbloodpressureis120over90.28可编辑课件PPTPulseIneedtotakeyourpulse.PleasemayIfeelyourwrist29可编辑课件PPT指导穿衣Youcangetdressednowandthencomeouttome.你现在可以穿上衣服跟我出去。Don’thurry.Takeyourtime.别着急，慢慢来。30可编辑课件PPT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）31可编辑课件PPTShareyourfindingswiththepatient.

Ihaven'tfoundanythingtosuggestanyproblems.Theredoesn’tseemtobeanythingwrongwithyou.I’msurethiswillclearuponitsown.无需治疗需要做某些检查或化验32可编辑课件PPT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,Ican’tfindanythingseriouslywrongwithyou,butI’dlikeyoutohaveyourchestX-rayedandanECG.3）YouneedtohaveanECGtest./IneedyoutohaveanECGtest.你需要做一下ECG。/我需要你做一下ECG。33可编辑课件PPTExpression: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...34可编辑课件PPT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）I’dliketohaveaspecimen/sampleofyourwater.我想留一份你的尿样。I’dliketohaveamidstreamspecimen.我想留一份中段尿样。35可编辑课件PPTExpression: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）。[ˌhi:mə'tɒlədʒɪ]Pleasetakethisformtohematology.化验结果出来后请带给我。Pleasebringtheresultsbacktome.36可编辑课件PPTExpression: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.37可编辑课件PPTExpression:Ultra-scan在做超声波扫描前，请憋尿。Youwillneedtohaveafullbladder

[ˈblædə(r)]beforetheultrascan.请在做超声波扫描前喝足够的水。Pleasecanyoudrink…

glassesofwaterbeforeyouhavethescan.38可编辑课件PPTYouneedfastingbeforethetest.

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Pleasedrinkalotofwateranddon’tgotothetoiletaspossibleasyoucanbeforethetest.

Expression:Ultra-scan39可编辑课件PPT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.40可编辑课件PPTShareyourfindingswiththepatient.

Well,I’mfairlycertainyou'vegota...Onepossibilityisitcouldbewhatwecall...Ihaven'tfoundanythingtosuggestanyproblems.41可编辑课件PPTExplainingdiagnosisYou’resufferingfrom…You’vedeveloped…Youhave…Thisiswhy…Thisismainlybecause…42可编辑课件PPTPrescriptionI’dlikeyouto…I’llgiveyouaprescriptionforsometabletstoeasethepain.Takethismedicinetwiceadayaftermeal.Youshouldtakethispill(tablet/capsule)rightafterbreakfastandrightafterdinner.I’dlikeyoutocomeintohospitalforafewdayssothatwecankeepaneyeonyou./tofindoutwhatexactlyiscausingthistrouble.43可编辑课件PPT消除疑虑Don’tworryaboutthis.It’squiteacommonconditionandshouldclearupinaweekorso.Thisisnotaseriouscondition.Thesetabletsshouldhelp.Theonlywaytotreatthisisbyanoperation.Itisaroutinesurgeryandyoushouldbebacktonormaltwomonthsaftertheoperation.Youwillnodoubtwanttogohomeassoonaspossible,butweareheretohelpyouwheneveryouneedus.44可编辑课件PPTTheprognosisIexpectthetreatmentwill…Hopefullywecan…Wecanneverbeabsolutelycertainabout…Youshouldremainoptimistic.Doyouhaveanyquestions?Isthereanythingyou’dliketoask?45可编辑课件PPT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intramuscular

injection皮内注射intradermicinjection皮下注射hypodermicinjection[英][ɪnt'rədəmɪk]

[美][ɪnt'rədəmɪk]注射室InjectionRoom做一次注射haveaninjection

3.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。

46可编辑课件PPT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./You’dbetterhaveagoodrest.

Youshouldrestinbedanddrinkplentyofwater.

47可编辑课件PPTDiscussingtreatment：AdvisingacourseofactionSometimeoffworkmighthelp.Ifyoufeltthatwouldbehelpful,youcouldtakeaweekoffandseehowyoufeltafterthat.Carryondrinkinglotsoffluids.Ifyoustillhavesomepain,youcankeeptakingparacetamol.Otherthingsmighthelp,likeraisingtheheadofyourbed.That’soneofthesimplethingswecouldstartyouoffwith.Yousaidyouhaven’ttriedindigestionremedies.That’ssomethingyoucouldtry.48可编辑课件PPT饮食方面的医嘱Choosefreshorfrozenvegetablesandfruits

withoutaddedsaltandsugars.

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。Don‘teat

veryhotorcoldfood,andkee