(完整版)醫(yī)生診療英語會話

UNIT1INTERNALMEDICINE

1PASTMEDICALHISTORY

i'dliketoaskyouaboutyourpastmedicalhistory.canyoutellmewhetheryouhavehadanychildhooddiseases?forexamplechickenpox,measles,mumpsorrubella

wheniwassmall,ihadmeasles,chickenpoxandwhoopingcough.butidon'tthinkieverhadrubella

haveyoueverbeeninhospitalizedforanything?orhaveyoueverhadanoperation

well,ihadmytonsilstakenoutwheniwasachild

haveyouhadanymajorhealthproblemssincethen

yes,ihavediabetes

whenwereyoufirstdiagnosedwithdiabetes?whatwereyoursimptoms

iwasdiagnosedwheniturned14.iwasalwaysthirsty,tiredanddepreassed

areyoureceivinganytreatmentforthis

ihavebeengettinginsulinshotseversinth

haveyouhadyourvaccinations

yes

good

didyourreferringphysiciangiveyoualetterforme

yes,hereitis

2FAMILYHISTORY

asfarasyouknow,arethereanyillnessesthatruninyourfamily?

nonethatiknowof,doctor

nothinglikediabetes,highbloodpressure,heartdisease,stroke,cancer,mentalillnessoranythinglikethat?

ohisee!myfatherhadaheartcondition,andihavetwomyauntswhohavediabetes

andisyourfatherstillalive

no,heisn't

howoldwasyourfatherwhenhedied

hewas68

whatdidhedieoff

hehadaheartattack

didhesufferforalongtimewiththisheardcinditionbeforehedied

ohno,itwasverysudden

andyouraunts?doyouknowwhatkindofdiabetestheyhave?dotheyhavetotakeinsulinortabletsoraretheyjustonadiet

theyjusttakesomepills,ithink

youaremarried,isee,haveyouanychildren

yes,aboyandagirl

aretheyhealthy

yes,theyare

3SOCIALHISTORY

1/3dialogueb

areyouworkingrightnow

no,ihavejustbeenlaidoff

oh,iamsorry.whatwasyourjob

iwasamanagerforanimportandexportcompany

isee.wasitanofficejoborwereyouonyourfeetallday

iworkedbehindadesk

wasitmanagerial,didyouhavealotofresponsibility

yes,iwasinchargeofalargedepartment

isee,quitestressful.now,tellme,doyousmoke

yes,ido.unfortunately,quitealot

oh,really?howmuch

allabout2packsaday

howlonghaveyoubeensmoking

sinceiwasaboutfourteen

haveyouevertrytoquitsmoking

yes,ihavetriedseveraltimes.butwithoutsuccess

whataboutdriking?doyoudrink

yes,sometimeswithmyfriends

howmuchalcoholdoyoudrinkaday

letsee.acoupleofglassesofbeeratlunchtime.awiskyintheevening.andabouthalfabottleofwinewithmydinner

that'squiteabit.howoldwereyouwhenyoustartdrinking

oh,about17ir18,isuppose

whataboutyourlivingconditions?wheredoyoulive

welivinginasmallapartment.weownit.butofcoursewearestillpayingthemorgageonit

4PRESENTCOMPLAINTS

1-4-1

what'stheproblemtoday

canyoutellmewhatyoursymptomsare

havehoueverhadthesecomplainsbefore

what'sseemstobringthisconditionon

whendidyoustartfeelingpoorly

1-4-dialoguea(1-4-dialogueb)

whatseemstobetheproblematthemoment(today)

well,ihavebeenfeelingsopoorlyrecently(illlately)

isee.feelingpoorly(ill).(now)whatdoyoumeanbythat

ihavebeengettingveryshortofbreath

hm...howlonghasthisbeengoingon

forabout18months,ithink

andwerethereanyothersymptomsbeforethenordidit(thiscondition)startquitesuddenly

ihadn'tnoticeanythingbeforethen

soyouhaven't(didn'thaveanyof)experencethissymptombefore

no,notthaticanremember,doctor

isee.wasthereanythingthatseemstocausethis(havecausedthesesymptoms)

well,nothing(no,not)really.exceptmaybeitgetsreallybadwhenigouptolondon(newyork)toseemysisiter

let'stakealook(tobeginwith).i'lllistentoyourheartandlungstobeginwith

1-4-5

a.whatcanidoforyoutoday

howcanihelpyoumr.jones

b.whatdoyoumeanbythat

canyoudescribethatinmoredetail

c.whatareyoursymptoms

canyoudescribethechangesthathaveoccurred

d.diditstartsuddenly

didyourconditionchangewithoutanywarning

e.whatbringsiton

whatdoyouthinkcausesyourcondition

5PAIN

1-5-1

head

doyouhaveasplittingheadache/throbbing/band-like/dull/aching/burning/sharp/stabbing/colicky/migraine/blinding/stress-induced/tension

tooth

doyouhaveasharptoothache

isyourtoothachedull/throbbing/stabbing/pulsating

isyourtoothsensitive/aching/tender

lowerback

isthepaininyourbackslowinonset\longinduration/dull/diffused/aching/steady/constant/severe/progressingpoorly/localised/crushing/deep/mild

chest

isthepaininyourchestburning

doyouhaveaconstrictingpaininyourchest

bursting/choking/squeezing/griping/pressing/crusching/sticking/jabbing/sharp/knife-like/fleeting/throbbing/dull/severe/stabbing/likeaweightonit/likeabandacrossit

abdomen

doyoufellasharppaininyourabdomen

dull/aching/gnawing/burning/cramping/colicky/diffused/localised/recurrent/constant/flank/intermittent/stabbing

doyougetbloated

doyoufeelbloated

duyouhaveanyheartburn

doyouhaveanyindigestion

kidneysandurinarytract

doyouhaveasharppain

duyouhaveadullache

duyouhaveseverediscomfort

burning/stinging/nagging/nigging/splitting/flank/back/abdominal/steady/lowgrade

doyouhaveslightdiscomfort

extremities

doyouhaveasharppaininyourshoulder

doyouhaveatinglingpaininyourhand

doyouhaveashootingpaininyourfoot

dull/burning/severe/pulsating/throbbing

doyouhaveweaknessinyourhands

doyouhavenumbnessinyourarms

doyouhavecramp

doyouhaveanacheonyourhand

1-5

dialoguea(dialogueb)

doyoufeelanypain

oh,yes.quiteabit

couldyoushowmewhereithurts

righthere,doctor,inmychest

here,hm...isitalwaysjustinthatspot

no,sometimesitmovesaroundtohere

isee.whatkindofpainisit.canyoudescriethepain

well,mostofthetimeitfeelslikeacramp.butoccasionallyitissharpandstabbing

doesitcomeandgoordoyouhaveitallthetime

well,itworseattimes.itseemstocomeovermeinwaves.butmostlyit'sthereallthetime

doesitstartsuddenlyorbuildupslowly

itseemstobuildupgradually

whatdoyoudowhenyougetthe(feelthis)pain

well,thereisn'tmuchicando.ijusthavetoputupwithit

anddoesanythinginpaticularseemtobringthepainonormakeitworse

well,ifindgoingupstairsdifficult(itismoreintensewhenclimbingstairs).alsowhenihavetocoughortakeadeepbreathit'sterriblelikeaknifestabbingme

1-5-6

a.canyoushowmewhereitherts

b.couldyoudescribewhatthepainfeelslike

c.howlonghaveyouhadthispain

d.whendoesitcome,when,doesitgo

e.doesanythingrelievethesymptomsormakethemworth

f.doesthepainmovetoanotherpartofyourbody

g.whatbringsiton

6HEADACHE

1-6-1

1doyoufeelthepainatthetopofyourhead

2doyoufeelanypaininyourtemples

3isthepainaroundyoureyes

4isthepainatthebackofyourhead

5doyouhaveanypaininyourforehead

6doesthepainmovetoyourface

7doyoufeelanypainaroundyourears

8doesthepainspreadtoyourneck

9doesthepainseemtobecomeingfromyourneck

10doesthepaintraveltoyourshoulders

1-6dialoguea(dialogueb)

tellmeaboutyourheadache

itcomesandgoes

canyoupointoutthepainfularea

itseemstobeontherightsideofmyhead

howlongdoestheheadachelastwhenyougetit(itcomes)

itvaries.itcanbebetweenhalfanhourandfourorfivehours

whenyougetaheadache,doesanythingelsehappenatthesametime

yes.oftenifeelsick(iamoftennauseous).sometimesiactuallyvomit(throwup)

doestheheadacheeverupsetyoureyes,forexample,doesyourvisiongetblurred

it'snotblurry.butigetflashinglightsthatseemstobeintherighteye

whatdoyoudowhenyougettheheadache

whll,i'mnotususllyabletocarryonwithwhat(iususllyhavetostopwtatever)iamdoing,ihavetogotoadarkroomandliedown

haveyoufoundanytablets(medication)thatseemstohavehelped

sometimesifitakeanaspirinearlyon,itseemstohelp.atothertimesnothingseemstohelpmuch

doesanybodyelseinyourfamilyhavethistypeofaheadache

yes,mymotherusedtosufferfrommigraineswhenshewasyounger

canyoudescribethe(characterofhe)pain.isitstabbingormoreband-like,kindofpressing

itthrobs.sortofstabbing,isuppose(guess)

1-6-6

acanyoupointoutthepainfularea

bhowlongdoestheheadachelastwhenyougetit

ccanyoudescribethepain

dwhenyougettheheadache,doesanythinghappenatthesametime

ewhatdoyoudowhenyougettheheadache

fhaveyoufoundanymedicanthatseemstohavehelped

gdoesanybodyelseinyourfamilyhavethistypeofheadache

7VERTIGO

Howwouldyoudescribeyourdizziness?

It?ˉsasifIamfallingtotheleft.

Whatdidthediseasegoinsistforyou?

Akindofimbalance.

Howlongdoestheepisodeofdizzinesslast?

Sometimesanhour,sometimesawholeday.

Inwhatbodypositiondoyoufeeldizzy?

EverytimeIascotorbenddownandtrytogetuptooquickly.

Doyouever(getdizzy?)sufferfromdizziness?

Yes,quiteoften.

Whendoesthishappen?

WhenIgetuptooquickly.

Doyoufeelasifyouarefallinginacertaindirection?

No,notreally.

Doesthisdizzinessfeellikespinningordoesitjustakindofunsteadiness.

Itfeelsmorelikespinning.

Howwouldyoudescribeit?Isitasiftheroomisgoingaroundordoyoufeelasifit?ˉsyouthatgoingaround.

ItfeelsasifIamgoingaround.

Doyouhaveanyotherproblemssuchasringingintheears.

Yes,sometimes.

Haveyouseenaconsultant(specialist)aboutthis?

Yes,sheprescribedsomemedicationforit,butitdidn?ˉthelpatall.

Doyouhaveanyassociatedsymptomslikeblurredvision.

No,notthatIhavenoticed.

8BODYTEMPERATUREANDSWEAT

1-8dialoguea(dialogueb)

haveyougotatemperature(hadanyfeverrecently)

yes,doctor,ihavebeenfeelingquiteflushed(warm)lately

isyourtemperature(constantly)highallthetimeordoesitgoupanddown

itususllygoesup(itisuauallyhigher)atnight.butitisstillhighevenduringtheday

what'sthehighestandthelowestithasbeeninthepastfewdays

thehighestwas104.thelowestwas100

andwheredidyoutakeyourtemperature,underyourarmorunderyourtongue(orally)

undermytongue(imeasureditorally)

doyoualsohavetheshivers(chills)

yes,sometimes

do(did)yourteethchatter(rattle)oraretheshivers(chills)milderthanthat

ohyes,theychatter(rattle).i'vebittenmytongueseveraltimesalready

do(did)youtakeanythingforthefever

aspirin

doesithelp

nonotreally

haveyoubeenabroad(traveled)toanytropicalordevelopingcountriesrecently

yes,ijustcamebackfromtailandafewmonthsago

isee.doyouperspiremorethanusual

yes,alot,iamafraid

justwhenyourworkhardoralsoatothertimes

well,ineverusedtosweatmuch.butnowiseemstobreakoutinasweat(atthedropofahat)easily.myclothesoftengetsoakingwet

doyoufeelshakyorweakatall

yes,practicallyallthetime`

9NAUSEAANDVOMITING

doyoujustfeelsick(nauseous)orhaveaactuallyvomited?(thrownup)

ou,iamvomittinganditseemsallthetime(oh,itseemslikeiamthrowingupallthetime)

whendiditallstarted?

abouttwomonthsago

andhowoftendoesthishappen?

aboutonceaday,sometimesmore

whenyouaresick,isitinmorningorafteryou'veeaten(afteryou'veeaten)

well,itisn'treallyregular

butdoesitgetbetterorworseifyoueatsomething?

worse,ithink

whenyouvomit,doyoubringupdigestedfood,undigestedfoodorbile?

oh,itisusuallymorelikebile

whatcolourisit?green,black,yelloworred?

itseemstobeasortofyellowishgreencolor

doesiteverhavebloodinitorlooklikegrowncoffe?

no,never

doyoubelchalot(burpalot)orhaveabad(anasty)tasteinyourmouth?

well,yesdoctor.idobelchalot(burpalot)andiseemtosufferfromalotwindjustlately(andihadhavealotofgaslately)

10DYSPN(O)EA

Dyspnea

Doyouhaveanydifficultybreathing?

What?ˉsharderbreathinginorbreathingout?

Areyoushortofbreathwhenyouareresting?

Canyoulieflatinbed?

Isitrelievedbysittingupinbed?

Doyouhavetostopfrequentlywhenyouclimbthestairs?

Haveyoueverhadanybreathingtests?

Dialoguea

Howlonghaveyouhaddifficutlybreathing?

Sincelastweek,doctor.

Isitverybad?

Yes,IfeelasifIcan?ˉtgetenoughair.

Whichismoredifficult,breathinginorbreathingout?

Itishardertobreathingin.

Areyoushortofbreathwhenyouarerestingoronlywhenyoudoingsomething?

WhenIamrest,butitisworsewhenItrytodoanything.

Canyoulieflatinbed?

Oh,no.

Howmanypillowsdoyouuse?

Three.

Doyoueverwakeupnightfeelingshortofbreath?

Yes,Ido.

(Iffrightensmebecausewheniwakeupfeelingasificann'tbreath.

Whatdoyoudowhenthishappens?Imean,doyousitorstandup,doessomemovementhelp?

IfIsitup,ithelpsalittle.

Letmelistentoyourchest.Icanhearfewcracklesanditsoundsabigwheezy.

DialogueB

Howlonghaveyouhaddifficultybreezing?.

Scincelastweek,doctor.

Isitverybad?

Yes,IfeellikeIcan'tgetenoughair.

What?ˉsharder,breathinorbreathout?

It?ˉshardertobreathin.

Areyoushortofbreath,whenyouareresting,oronlywhenyouaredoingsomethingphysical.

AlittlewhenIamresting,butit?ˉsworsewhenItrytodoanythingphysical.

Canyoulieflatinbed?

Oh,no.

Howmanypillowsdoyouuse?

Three.

Doyouoftenwakeupnightfeelingshortofbreath?

Yes,Ido.It?ˉsscaresmebecauseIwakeupfeelingasifIcan?ˉtbreath.

Whatdoyoudowhenthishappens.Imean,doyousitorstandup?Doessomemovementhelpyoubreatheeasier?

IfIsitup,ithelpsalittle.

Listentoyourchest...Icanhearafewcracklesanditsoundsabigwheezy.

howlonghaveyouhaddifficultybreathing?/howlonghaveyoubeenshortofbreath?

i'vehaddifficultybreathingforabouttwoweeks.

whenisyourbreathingmostdiffcult?

iwheezeintheearlyhours.

whichismoredifficult,breathinginorbreathingout?

breathingoutisharder.

areyoushortofbreathwhenyouarerestingoronlywhenyouareworking?

i'mshortofbreathwheni'mworking.

canyoulieflatinbed?/canyousleeponyourback?

yes,icansleeponmyback.

canyoueverwakeupatnightbecauseyouareshortofbreath?/isyoursleepdisturbed?

yes,ieakeupseveraltimesbecausei'mshortofbreath.

whatdoyoudothen?

iusuallygetupandwalkaroundwhenithappens

11COUGH

DialogueA

Doyouhaveacough?

Ihaveacough,butIalsoseemtowheezealot.

Isthisarecentsymptom,orhaveyouhaditforsometimenow?

I?ˉvehaditforsometime,Doctor.

Doyousufferformcoughingfits?

Yes,alot.

Doyoubringupphlegmorisitadrycough?

Ibringupquiteabitofphlegm,IamafraidImighthaveasthma.

Whatisitlike?

Whatdoyoumean?

Canyoudescribethephlegmforme?Whatcolorisit?Isitwhite,yellow,orgreenish,andisitfrothy/foamy/orsticky?

Yes,it?ˉsyellowishandfeelskindoflikejelly?

Doesithaveastrangesmellortaste?

No,Idon?ˉtthinkso.

Hasthereeverbeenbloodinit?

Yes,justonceInoticedsomebloodinit.

Haveyoutakenanymedicineortabletslately?

Yes,Iwasonsomethingtothinmyblood.

DialogueB

Doyouhaveacough?

Ihaveacough,butIalsoseemtowheezealot.

Isthisarecentsymptomorhaveyouhadforsometimenow?

I?ˉvehaditforsometime,doctor.

Doyoucoughalot?

Yesalot.

Doyoubringupphlegm,orisitadrycough?

Ibringupquiteabitofphlegm.IamafraidImighthaveasthma?

Whatisthephlegmlike?

Whatdoyoumean?

Canyoudescribeformewhatcolouritis,whetheritiswhite,yelloworgreenish,andwhatisitfoamy,thickandsticky?

Yesitisyellowishandfeelskindoflikeajelly.

Doesithavestrangesmellortaste?

NoIdon?ˉtthinkso.

Hasthereeverbeenbloodinit?

Yes,justonceInoticedsomebloodinit.

Haveyoutakeanymedicationlately?

YesIwasonsomemedicationtothinmyblood.

Yes,itsmellsverybad.

Itisfrothy!

I?ˉvehadthiscoughfor3weeks.

Yes,Ibringupalotofphlegm.

IfIsituporusetwopillowsIfeelbetter.

It?ˉsabarkingcough.

12HEART

A

whatseemstobetheproblematthemoment?

iseemtobegettingveryshortofbreathnowadays,soithoughtitbesttocomeintoseeyou.ialsofeelatightnessinmychest.

howlonghasthisbeengoingon?

itseemstohavebeengettingworseoverthelastfewweeks.

areyoushortofbreathallthetimeorisitjustwhenyouwalkupthestairs?

well,itishardworkgoingupthestairs,thepainfeelslikeaknife.

doesthepainmovetootherareaaswell?

yes,itmovestomyneck,myleftarm,mybackandmyshould.

doyoueverfeelsickorsweatywhenthathappens?

well,idon'tfeelsickbutioftenbreakoutinasweat.

doyoueverfeelthatyourheartbeatsusuallyfastorslow?

yes,sometimesitbeatsreallyslowly.thenfromtimetotimeitskipsabeat,thencontinuestobeatveryrapidly.

canyoutapoutwithafingerwhattherhythmfeelsliketoyou?..good,haveyouhadanyswellinginyouankle?

yes,bothmyfeethavebeensomewhatswollen.

doesthisgodownovernightoraretheystillswelloninthemorning?

oh,myfeetfeelmuchbetterandtheyaren'tasswolleninthemorning.

B

canyoutellme,...whatareyouscomplaints?

iseemtobegettingveryshortofbreathlately,alsoifeeltightnessinmychest,soithoughtitwouldbewisetocomeinandseeyou.

howlonghasthisbeengoingon?

itseemtohavebeengettingworseoflastfewweeks.

areyoushortofbreathallthetimeoritisjustwhenyouexertyourself?

well,thepaingetsworsewheniexertmyself,itfeelskindoflikeaknife.

doesthepainradiatetootherareasaswelloristhepainlocalised.

no,itmovestomyneck,myleftarm,mybackandmyshould.

doyoueverfeelsickorsweetywhenthishappens?

well,idon'tfeelsickbutioftenbreakoutinasweet.

doyoueverfeelthatyourheartbeatsunusuallyfastorslow?

yes,sometimesitbeatsreallyslowly,thenfromtimetotimeitskipsabeat,thencontinuestobeveryrapidly.

canyoutapoutwithafingerwhattherhythmfeelsliketoyou?..good,haveyouhadanyswellinginyouankles?

yes,bothmyfeethavebeensomewhatswollen.

doesthisgodownovernightoraretheystillswolleninthemorning?

oh,myfeetfeelmuchbetterandtheyaren'tswolleninthemorning

haveyoueverhadanyheartproblems?

i'veneverbeendiagnosedwhitangthing,butithinksomethingcanbewrongmyheart.

whatseemstobetheproblemwithyourheart?

itbeatsirreguallyespeciallywhenismoke.

whatkindofpaindoyougetduringyouexercise?

igetpressureinmychestsometimeswhenihavetowalkalongdistance.

doyouoftengetshortofbreath?

absolutely,iamalwayshortofbreathwhenigoupstair.

doyoueverfeelsweatywhenthishappens?

yes,ibreakoutinareallybadsweatwhenmychesthurts.

wheredoesthepainmove?

downmyleftarm.

andhaveyouhadanyswellinginyourfeetorankles?

yes,myanklesseemtobeswollenallthetime.

doyourfeethurtallthetime?

yes,thepainisfairlyconstant,butithelpswheniputmyfeetup.

13BODYWEIGHTANDDIET

What?ˉsyourappetitelike?

Areyouonaspecialdiet?

(Haveyoueverfollowadiet?)

(Haveyoutriedtoloseweight?)

Haveyouhadyourcholesterolchecked?

Isyourweightsteady?

Tellme,what?ˉsyourappetitelike?/how'syourappetiti?

Sometimesit?ˉsgood,butatothertimesIdon?ˉtfeellikeeatingatall.

Howdoyoufeelaboutyoureatinghabits?/describeyoureatinghabitstome?

well,Iusuallyeatfiveorsixtimesaday.Lotsoffoodsandvegetables,butwhenIamanxious/nervous/Ican?ˉteatatall.

Haveyoulostorputon/gained/anyweightrecentlyordoesyourweightstayatsame?

I?ˉvebeenputting/gaining/onquiteabit/lot/ofweightlikely.

Howmanypoundshaveyougaindoyouthink/you'vegained?

About10poundsorso.

Overhowlonga/what/periodoftimehasthishappened?

Sinceaboutcharismas,sointhelast6months.

Areyoutryingtodoanythingtocontrolyourweight,forexample,areyouonadiet?

Yes,butitdoesn?ˉtseemtowork.

Arethereanyfoodsyoudislikeoristhereanythingthatyouparticularlyliketoeat?

Ieatlotsofpastadishes,butIcan?ˉthaveanythingwithnutsinthembecauseIamallergictomostkindsofnuts.

Doyoureatinghabitschangeforanyreason?

Yes,IeatquiteabitmorewhenIfeelgood.

Iamlosingmyappetiteabit.

Yes,Iamgettingverythin.

Ihavelost20pounds.

I?ˉdsay,duringthelast3monthsorso.

Yes,Ican?ˉtstandasightofmeat.

14BOWELMOVEMENTS

1-14

dialogueA

-Doyouhaveregularbowelmovements?

-No,(Yes,but)sometimesIgetconstipatedandsometimesIhavediarrhea.

-Whenyousayyouhavediarrhea,doyoumeanthestoolisveryloose,orthatyouhavetogotothetoilet(bathroom)morefrequently?

-Ihavetogofourorfivetimesaday.

-Whenyouhavetogo,doyouhavetogoquickly?

-Yes,Ihaverealproblemsholdingit.

-Couldyoudescribeyourstool?

-Thelasttimeitwaslooseandwatery,butverydark.

-Doyouhaveanyproblemsflushingitdownatall?

-No,Ihaven'tnoticedanythinglikethat.

-Hastherebeenanybloodormucusinthestool?

-Yes,Ihavenoticedsomeblood,butnomucus.

-Isitmixedinwiththestoolorisitjustthereonthepaperwhenyouwipeyourself?

-Itseemstobemixedinwiththestool,Doctor.

-Isee.andwhenyouareconstipated,doyoutakelaxative,ordoyougiveyourself(use)anenema?

-IfIcan'tgoforthreedays,onlythelaxativehelps.

-Doyoufeelbloatedwhenyouareconstipated?

-Yes,occasionally.Butthelaxativehelpswiththattoo.

Doyouhaveanyproblemswithexcessivewindorbelching(gasorburping)?

No,notparticularly.

1-14-5

A

Isitactuallypainfultohaveabowelmovement?=Doesithurtwhenyouopenyourbowels?

B

Haveyouevertriedtakinganylaxativesthatyoucangetatachemist's?=Doyoutakeanythingforyourbowels?

C

Doesyourstomacheverfeeldistended?=Doyoueverfeelbloatedwhenyouareconstipated?

D

Doyouhavewindmovingaroudinyourbowels?=Doyoufeelgassy?

E

Doyoupasswind?=Doyoubreakwind?

F

Doyouhaveatendencytowardsflatulence?=Doyoueversufferfromexcessivewind?

15BLOOD

DialogueA:

A:Soyousaythatyouarehavingproblemswithbleedingorbruising?

B:YesIam.

A:Canyoutellmewhatyoumeanbythat?Doyoubleedorbruiseeasily?

B:B:Yes,everytimeIscrapemyselforbumpintosomethingIgetbruised.

A:Haveyoualwayshadthisproblemorisitrecentdevelopment?

B:InoticedtheproblemstartedaboutthetimeIstartedshaving.

A:Doyourgumsbleedwhenyoubrushyourteeth?

B:Yes,quiteabit.

A:Doyouhaveanytroublestoppingthebleeding?

B:Oh,yes,evenfromthemostminorcuts

A:Howlongdoseittaketostopthebleeding?

B:Atleast10or15mins

A:Arethereanyothermembersofyourfamilywithbleedingtendencies?

B:No,nothatIknowof.

A:Haveyoueverneededthebloodtransfusion,orhaveyougivenbloodrecently?

B:Idon'tlikeneedles,soIdon'tgiveblood.ButIneededatransfusionafteracaraccidentafewyearsagowhenIwas15.

A:Doyourememberhowmanyunitsofbloodyoureceived?

B:No,Idon'tremembersorry.

A:Doyouknowwhatyourbloodtypeis?

B:Ithinkit'sABnegativebutIamnotsure.

DialogueB

A:Soyousaythatyouarehavingproblemswithbleedingorbruising?

B:YesIam.

A:Canyoutellmewhatyoumeanbythat?Doyoubleedorbruiseeasily?

B:Yes,everytimeIscrapmyselfforbumpingtosthIgetbruised.

A:Haveyoualwayshadthisproblemorisitjustrecentdevelopment?

B:InoticedthattheproblemstartedaboutthetimeIstartedshaving.

A:Doyourgumsbleedwhenyoubrushyourteeth?

B:Yes,quitealot.

A:Doyouhaveanytroublestoppingthebleeding?

B:Oh,yes,evenfromthemostminorcuts

A:Howlongdoseittaketostopthebleeding?

B:Atleast10or15minutes

A:Arethereanyothermembersofyourfamilywithbleedingtendencies?

B:No,notthatIknowof.

A:Haveyoueverneededthebloodtransfusionorhaveyougivenbloodrecently?

B:Idon'tlikeneedlessoIdon'tgiveblood.ButIneededatransfusionafteracaraccidentafewyearsagowhenIwas15.

A:Doyourememberhowmanyunitsofbloodyoureceived?

B:No,Idon'tremembersorry.

A:Doyouknowwhatyourbloodtypeis?

B:Ithinkit'sABnegativebutIamnotsure.

16MEDICALEXAMINATION

1-16-3A

1NowMr.Jacob,I'dliketoexamineyou.Ijustwanttocheckoneortwothings,yourheart,yourlungsandabdomen.Wouldyoujusttakeoffyourclothesdowntoyourunderwear?Putonthisgownwiththeopeningoftheback.

2Hoponthetableforme,canyoumanage?ShallIgiveyouahand?

3Right,givemeawrist,willyou?Iamgoingtotakeyourpulse.Thatisfine.

4Nowlet'stakeyourbloodpressure.Willyourstraightyourarm,please.

5Nowlet'shavealookyoureyes.Lookupformeplease.

6Letmecheckthereflexesinyourarmsandlegs.Relax!

7Turnyourheadtotherighttolookatthewall;Iwillcheckthepulseinyourneck.

8Letmefeelyourwindpipe.Letmejustfeelyourglands.Thatisfine.

9Stickoutyourtongueformeplease.OpenyourmouthandsayAH.

10RIGHT,nowIwanttolistenyourheart.Justbreatheoutquietly

11NowsitforwardwhenIlistentoyourback,holdbreath....Good.Nowlet'slistentoyourlungs.Takedeepbreaththroughyourmouthin....out...keepgoing

12Iwouldliketofeelyourabdomen.Putyourarmsdownbyyoursideandletyourtummyrelax.Thatisit.Arethereanyplacestenderorpainful?NowIwanttocheckyourliverandspleen.Sotakedeepbreathinandholdit...fine...

13I'djustliketoexamineyourprostateandrectum.Nowthiswillbeslightlyuncomfortable,butitshouldn'thurt.Liedownonyourleftsideandbendyourkneesrightuptoyourchest.Fine.Iamgoingtoinsertafingerintoyourrectum.Don?ˉtworry,youwon'tloseanycontrol.

1-16-3B

1NowMr.JACK,I'dliketoexamineyou.Ijustwanttocheckoneortwothings,yourheart,lungsandabdomen.Wouldyoujusttakeoffyourclothesjustdowntoyourunderwear?Putonthisgownwithopeningattheback.

2Pleasegetonthetableforme,canyoudoityourself?Orwouldyoulikemetohelp?

3Right,givemeawrist,willyou?Iamgoingtotakeyourpulse.Thatisfine.

4Nowlet'stakeyourbloodpressure.Willyourstraightyourarm,please.

5Nowlet'shavealookinyoureyes.Lookupformeplease.

6Letmecheckthereflexesinyourarmsandlegs.Relax!

7Turnyourheadtotherighttolookatthewall;Iwant