Skills Pack I Sem 20-21 PDF

UNIVERSITÀ DEGLI STUDI DELLA CAMPANIA “LUIGI VANVITELLI” Dipartimento di medicina sperimentale Corso di Laurea Magistrale in Medicina e Chirurgia INGLESE SCIENTIFICO 2020 – 2021 I anno I semestre SKILLS Dott.ssa Rosa Colacino Dott.ssa Janet Gates e-mail: [email protected] LESSON PAGES TITLE SKILLS 1 2-5 Parts of the body Vocabulary, revision of spelling Related medical problems Speaking /Listening Instructions to a patient Giving Instructions and making requests 2 6-9 Common Ailments and Vocabulary, grammar, dialogue Symptoms Part 1 completion. Speaking – roleplaying doctor/patient Doctor / Patient Dialogues situations 3 10 - 13 Common Ailments and Vocabulary, pronunciation, reading Symptoms Part 2 comprehension, speaking Distinguishing symptoms of common diseases 4 14 - 16 Ice Treatment in First Aid Vocabulary, reading comprehension, speaking 5 17 - 20 The Medical Doctor – Reading skills, vocabulary, writing skills Training and Job description 6 21 -23 Hospital Departments and Speaking - pronunciation: word and Hospital Routines sentence stress Reading comprehension 7 14 - 26 Childhood Diseases Numbers, vocabulary, word families. Improvements in health since Common vs. scientific terminology. the 1950s Reading and listening comprehension. 8 27 -29 Health and Nutrition Food groups and vocabulary, giving advice, reading comprehension Speaking skills, nutrition labels 9 30 -33 Patient information leaflets Reading comprehension, vocabulary Giving advice, instructions Notetaking 10 34 -36 Revision Practice for progress test – grammar, skills and speaking 37 -46 Answer key Answers to exercises for self-study 1 LESSON 1 THE BODY. GIVING INSTRUCTIONS TO A PATIENT 1. LABEL THE PARTS OF THE BODY: TRANSLATE THE FOLLOWING WORDS: 23.heart 27. stomach 24.lung 28. muscle 25. liver 29. skin 26. kidney 30. brain 2 COMBINE PARTS OF THE BODY WITH THE MEDICAL PROBLEM: YOU CAN USE SOME WORDS MORE THAN ONCE. BODY : ARM HEAD ELBOW THROAT EAR NECK ANKLE STOMACH BACK LEG WRIST PROBLEM : PAIN (N) ACHE (N) SORE (ADJ) SPRAINED (ADJ) BROKEN (ADJ) E.G. a headache 1. _____________________________ 2._____________________________ 3._____________________________ 4._____________________________ 5._____________________________ 6._____________________________ 7._____________________________ 8._____________________________ 9. _____________________________ 10.____________________________ 3 INSTRUCTIONS bend COMPLETE THE INSTRUCTIONS FROM A DOCTOR TO A PATIENT USING THE VERBS IN THE BOX open lift take say hold read cough grip stretch touch stand turn close lie hold roll relax 4 GIVING INSTRUCTIONS FORM: INFINITIVE OF THE VERB E.g: Read these letters, please Clench your fist, please Stand up, please Turn over, please w Negative sho Don’t close your mouth yet, POLITE REQUESTS: FORM : CAN /COULD + YOU + INFINITIVE OF VERB E.g: Can you read these letters? Could you clench your fist? Can you stand up? Could you turn over? WHAT DO YOU SAY TO A PATIENT IN THESE SITUATIONS? You want to : A. give an injection ________________________________________________________________________________ B. check the patient’s blood pressure ________________________________________________________________________________ C. look down the patient’s throat ________________________________________________________________________________ D. position the patient for some X – rays ________________________________________________________________________________ E. check the patient’s eyesight ________________________________________________________________________________ F. reassure the patient ________________________________________________________________________________ 5 LESSON 2 COMMON AILMENTS AND SYMPTOMS PART 1 Exercise 1. Complete the following complaints. Use the expressions in the box. black eye bruise can’t sleep cough depressed headache insect bite lost my appetite lump nosebleed out of breath runny nose sore throat stomach ache swollen leg temperature 1. I’ve got a cough and a _______________. 2. When I climb the stairs I’m ___________________. 3. I don’t want to eat. I’ve _______________________. 4. At night I go to bed but I ___________________________. 5. I’ve got a __________________ and a ___________________. 6. I knocked my arm on the door and now I’ve got a big ____________________. 6 7. I got an __________________ a few days ago and now I’ve got a _______________. 8. I fell down the stairs and now I’ve got a _______________ and a _______________. 9. I feel so miserable. I’m really ______________________. 10. I’m a bit worried because I can feel a ________________ in my breast. 11. I regularly get a ___________________ 12. After I eat I regularly get a ____________________________. 7 Exercise 2. Decide who says the following, the doctor (D) or the patient (P)? Then put the following dialogue into the correct order. ___I will. Good-bye. ___How long have you been feeling like this? ___Good morning Dr Shaw. Not too well, I’m afraid. ___Well, you know there is a flu epidemic at the moment. I’d say that was the problem. ___Good morning, Mr. Jones. How are you feeling today? ___Just aspirin, really. And stay in bed for a few days. ___A couple of days, I think. ___What’s the matter? ___Do you have a temperature? ___Thank you very much. ___Yes, at night it gets to 39 degrees. Oh, and I also have a terrible headache all the time. ___Dr Shaw, is there anything I can take to make me feel better? ___Well, I’m feeling very tired, and my body aches. ___Ring me if you don’t feel better in a few days. Exercise 3. Complete the dialogue with appropriate expressions. D: Hello Miss Lindsay, ___________________________________ ? P: I have a terrible stomach ache. D: When ________________________________________________? P: Yesterday after lunch. D: Did _____________________________ anything strange? P: Well, I did eat a lot of seafood. D: Where __________________________________? P: In a restaurant. D: ____________________your family______________________ too? 8 P: No, they didn’t eat the seafood. D: It sounds like you have food poisoning. ____________________ vomiting and diarrhea, too? P: Yes, I have. D: I’ll write you a prescription. Take these tablets three times a day for two days. I’m sure you’ll feel better soon. P: Thank you very much, Dr. Brown. D: You’re welcome. Bye-bye P: Good-bye Exercise 4. Listening for specific information. A doctor visits a patient in a hospital ward. https://www.youtube.com/watch?v=u3CXYKHbrA4 Listen and complete Dr. Peterson’s notes. Patient’s surname Hartley Occupation (1) ______________ Diet (2) ______________ Weight (3) ______________ Main symptom (4) __________________ Other symptoms anaemic ? (5) ______________ (6) ______________ (7) previous___________________ (8) sometimes___________________ Previous Hospitalization for (9) __________________________ treated with (10) ____________________ and (11) ______________ Family history (12) ___________________________________ Tests prescribed (13) ___________________________ (14) _______________________ (15) ______________? Diagnosis (16) ____________________ ? Exercise 5. Write a dialogue between a doctor and a patient using the following information about one of the patients. Practice it with a partner. Name Symptoms How long Diagnosis Treatment Michael cough, sore throat 3 days bronchitis antibiotics, rest Higginbust pain in the chest drink lots of liquids Kate Plonk acute pain in lower since last night appendicitis operation in stomach, nausea hospital 9 LESSON 3 COMMON AILMENTS AND SYMPTOMS PART 2 A. Match the medical terms (1 – 15) with their definitions (a-o): 1. disease 2. symptoms 3. history 4. examination 5. prevention 6. consultation 7. abnormality 8. sequelae 9. aetiology 10. complications 11. prognosis 12. signs 13. syndrome 14. differential diagnosis 15. diagnosis a. the long-term results of an illness or treatment ______________ b. identifying several illnesses which the patient may have ______________ c. things wrong with the body which the patient complains of or experiences ______________ d. a study of the patient’s body ______________ e. the causes leading to an illness ______________ f. an unusual feature which may be worrying or dangerous ______________ g. a meeting between doctor and patient to discuss problems ______________ h. the identification of a particular illness ______________ i. a change in the structure or function of the organs or tissue of the body ______________ j. taking away the cause of illness or finding it early ______________ k. a group of signs which are characteristic of a particular illness ______________ l. additional problems to the original illness ______________ m. probable outcome of an illness ______________ n. a patient’s medical background, problems, behaviour and lifestyle ______________ o. what the doctor can see of the illness ______________ B. Discuss with a partner. What are the symptoms of the following common illnesses? How would you self-care or treat them? A COLD INFLUENZA NASAL ALLERGIES GASTROENTERITIS BRONCHITIS SINUSITIS STREP THROAT 10 C. Complete the quiz with the missing information given on the next page. SYMPTOMS DIAGNOSIS SELF-CARE/TREATMENT DO YOU HAVE…? 1. a fever NO Go to question 6 > YES 2. sore throat and YES You may > If the sore throat or fever lasts longer than 48 headache without > have STREP hours, see your doctor for a diagnostic test. nasal drainage THROAT, a If positive, you may need antibiotics. Rest bacterial infection and drink lots of water. Gargling with warm salt water may help relieve a sore throat. NO 3. YES You may have > > the FLU NO 4. YES You may be > Get plenty of rest, and drink lots of fluids. If > developing ACUTE you smoke, stop smoking. Use an over-the- BRONCHITIS, an counter medicine for pain and fever, and an infection of the expectorant to ease the coughing. A airways humidifier may also relieve some symptoms. If symptoms persist or worsen, contact your doctor. NO 5. YES You may have > > GASTRO- ENTERITIS (also called the stomach flu) NO 6. a runny and/or itchy YES > Try an over-the-counter antihistamine nose, sneezing, and > medicine. If symptoms persist or worsen, itchy eyes contact your doctor. NO 7. sneezing, a sore YES > throat, headache, > congestion and a runny nose NO 8. YES You may be > See your doctor. Acetaminophen, ibuprofen > developing and/or warm compresses may help reduce SINUSITIS facial pain. A cool mist vaporizer may help your sinuses drain more easily. Drink plenty of fluids. NO If you think your problem is serious, contact your doctor immediately. Warning: Due to the risk of Reye's syndrome, do not give aspirin to children and young adults without your doctor's approval. 11 a persistent cough with yellowish or greenish mucus, wheezing and shortness of breath swelling or pain around eyes, cheeks, nose or forehead, a headache, a dry cough, and/or discharge from the nose You may have ALLERGIES Get plenty of rest, and drink lots of fluids. Over-the-counter medicines may relieve some of your symptoms. Your doctor may suggest a prescription medicine to shorten the course of the illness. A vaccination each autumn may prevent this illness. symptoms which started suddenly, including muscle aches, chills, a sore throat, runny nose or cough Try an over-the-counter medicine to treat the specific symptoms. Get plenty of rest and drink lots of fluid. Get plenty of rest. Children should be given an oral rehydration solution to avoid dehydration. Ease back into eating with bland foods and clear liquids. You probably have a COLD a headache or muscle aches, nausea or vomiting, and watery diarrhoea D. Read the text about influenza and complete it using the following words: antiviral drugs aspirin breathe in breathing catching complications contact diagnosis examination illness immune infected infection prevention prognosis sneezing test touching vaccine virus INFLUENZA Influenza (flu) is an easily spread ____________ of the nose, throat, and lungs. Causes The flu is caused by an influenza ______________. Most people catch the flu when they _____________tiny droplets from coughs or sneezes of an ______________person, or after touching something with the virus on it, and then touching the mouth, nose, or eyes. Symptoms Flu symptoms usually appear 1 - 7 days after______________ with the virus. The flu spreads easily and often strikes a community all at once. The first symptom is a fever between 38 and 41°C. Other common symptoms include: body aches, chills, dizziness, headache, lack of energy, nausea and vomiting. Between day 2 and 4 of the ______________the fever and aches begin to go away. But new symptoms occur, including: dry cough, increased _______________ symptoms, runny nose (clear and watery), ______________ and sore throat. 12 Exams and Tests Most people do not need to see a doctor because risk for a severe case is rare. When many people in an area have flu, a doctor can make a________________ after hearing the symptoms. A physical ________________ is not needed. However, there is a _____________ to detect the flu done by swabbing the nose and throat. Treatment Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help lower fever. Sometimes doctors suggest you use both types of medicine. Do NOT use ______________. Over-the-counter cold medicines may make some of the symptoms better. Cough drops will help a sore throat. Doctors recommend rest, drinking plenty of liquids and avoiding alcohol and tobacco. Doctors may give ______________ to people who get very sick or those who are at high risk for problems. They work better if taken within 2 days of the first symptoms. _______________ Most people get better within a week or two but thousands of people with the flu can develop ________________ , such as pneumonia, encephalitis, meningitis or seizures. Those at highest risk include: people over age 65, children younger than 2 years, women more than 3 months pregnant during the flu season, anyone living in a long-term care facility and anyone with chronic heart, lung, or kidney conditions, diabetes, or a weakened _____________ system. ______________ To avoid ___________ or spreading the flu, stay at home for at least 24 hours after any fever is gone. Do not share food, utensils, cups, or bottles. Cover a cough with a tissue and throw it away after use. Use hand sanitizer often during the day and always after _____________ your face. Many public health authorities recommend the influenza _____________. E. Ask and answer these questions with a partner: 1. What causes the flu? 2. How is it spread? 3. What are the principal symptoms? 4. How is it diagnosed? 5. What complications can occur? 6. Which people are most at risk of complications? 7. How should you treat or prevent the flu? 8. How is a cold similar to and different from flu? 13 LESSON 4 ICE TREATMENT FOR INJURIES List some first aid / medicinal items you have at home. e.g. ice pack, aspirin Exercise A. What do you think? 1. What type of injuries may benefit from the application of ice? 2. What is the effect of ice on an injury? Exercise B. You will read a text about ice treatment. The words below are underlined in the text. Read the text and match the words to their definitions. No. 1 is an example. ENGLISH ITALIAN 1. bruise (n c) [ to bruise vb.reg.] gonfiore 2. burn (n c) [ to burn vb.reg] dolore 3. flannel (n c) strofinaccio 4.frostbite (n. unc) punti 5. healing (n) [to heal vb.reg] guarigione 6. numbing [to numb vb.reg, numb adj.] strofinare 7. pain (n c/unc) 1 livido/contusione 8. rub (vb. reg.) intorpidire 9. sprain (n) to sprain vb.reg] strappo muscolare 10. stiff (adj) rigido 11. stitches (n c) to stitch (vb reg) congelamento 12. strain (n c/unc) to strain (vb reg) distorsione 13.swelling (n c/unc) [to swell vb. irreg. straccio di flanella swelled –swollen] 14. tea towel.(n c) ustione Exercise C. Look at the following sentences. Insert them into the correct place in the text. a. This will stop the wound from getting wet. b. A packet of frozen peas is also ideal. These mould nicely and can go in and out of the freezer. c. If you have diabetes. d. You risk damaging the skin if ice is left on for more than 20-30 minutes at a time. e. Check the colour of the skin after 5 minutes. If it is bright pink/red remove the pack. If it is not pink replace it for a further 5-10 minutes. f. Around the front or side of the neck. g. Ice treatment may be used in both the immediate treatment of soft tissue injuries and in later rehabilitation. h. Reduce muscle spasm and pain. 14 Ice Treatment for Injuries (Adapted from http://www.patient.co.uk) With any sprain, strain or bruise there is some bleeding into the underlying tissues. This may cause swelling, pain and delay healing.____________________________________________. During immediate treatment, the aim is to limit the body's response to injury. Ice will: reduce bleeding into the tissues. prevent or reduce swelling. _________________________________. reduce pain by numbing the area and by limiting the effects of swelling which causes pain. These effects all help to prevent the area from becoming stiff by reducing excess tissue fluid that accumulates as a result of injury and inflammation. How do you make ice packs? Ice packs can be made from ice cubes in a plastic bag or wet tea towel. _____________________________. Purpose made cold packs can also be bought from pharmacies. Take care when using ice and cold packs from a deep freeze. These are very cold and can cause ice burns quickly if used without care and proper protection. How are ice packs used? Ideally, rub a small amount of oil over the area where the ice pack is to go (any oil can be used, even cooking oil!). If the skin is broken or there are stitches in place, do not cover in oil but protect the area with a plastic bag. _______________________________ Place a cold wet flannel over the oil (do not need if using plastic bag). Place the ice pack over the flannel.____________________________________________________ The effect of the ice pack improves if you press it gently onto the injured area. Ice can burn or cause frostbite if the skin is not protected with oil and/or other protection such as a wet flannel. How long should ice be applied? Ideally, ice should be applied within 5-10 minutes of injury for 20-30 minutes. ____________________You can repeat the application every 2-3 hours while you are awake for the next 24-48 hrs. Do not use cold packs:- Over areas of skin that are in poor condition. Over areas of skin with poor sensation to heat or cold. Over areas of the body with known poor circulation. In the presence of infection. ___________________________ ___________________________ On the left shoulder if you have a heart condition. 15 Exercise D. Now read the text again and answer the questions. 1. What type of injuries may benefit from the application of ice? 2. What is the effect of ice on an injury? 3. How should you apply ice to an injury? 4. How long should you apply ice for? 5. What precautions should you take, if any? 6. When and where should you avoid using ice? Exercise E. Listen to Dr. David Lee talking about using ice packs and heat pads on injuries. https://www.youtube.com/watch?v=MAJG_yWFW_Y 1. What effect does heat have on the body? 2. When should you not use a heat pad on an injury? Why? 3. What type of condition does he recommend heat for? 4. Why does he recommend using moist heat? 5.How long should you use a heat pad for? 6. What can happen if you use it for longer? 16 LESSON 5 THE MEDICAL DOCTOR – TRAINING AND JOB DESCRIPTION 1. READ THE TEXT AND INSERT THESE 4 TITLES a) Qualification and training required b) What does a GP do? c) Doctor (general practitioner, GP): job description d) Key skills for general practitioners 1. ____________________________________________ General practitioners provide confidential patient consultations and initial medical care within a community-based setting. The total amount of time spent studying and training to qualify as a general practitioner is normally eight years. 2. _____________________________________ General practitioners (GPs) are doctors employed by the National Health Service as independent contractors to work within local communities. Typical responsibilities include: patient consultations at home and within the surgery physical examinations diagnoses and treatment of illnesses/ailments minor surgery health education practice management and administration liaison with other health care professionals and/or hospitals. The job can be demanding but nevertheless rewarding and highly respected. Career advancement is possible via specialisation, hospital work, research or teaching. Publications advertising vacancies include General Practitioner, British Medical Journal and The Lancet. 3. __________________________________________________ Qualification as a GP is a lengthy process. Initially it is necessary to undertake a five year medical degree which is approved by the General Medical Council. This is followed by compulsory hospital and general practice based vocational training through the two-year Foundation Programme. Additionally, many doctors sit an examination to gain 'Membership of the Royal College of General Practitioners' (MRCGP). Subsequent professional updating, such as attending lectures, conferences and meetings is also a key feature of the job. 17 Graduates from a non-medical background wishing to become a GP must follow the same route, but can take the shorter, but no-less-demanding graduate medical degree, for which they must possess a minimum 2.1 degree, preferably in a scientific subject. They must also have good academic references, be highly motivated, and possess appropriate personal characteristics such as perseverance and energy. 4. ______________________________________ ability to work long hours, often under pressure good practical skills ability to solve problems effective decision-making skills. 2. NOW READ THE TEXT AGAIN AND FIND NOUNS AND ADJECTIVES THAT MEAN a) Medical office ___________ (n) b) Private, secret _____________ (adj) c) Meetings with patients __________________ (n) d) Medical operations ______________________ (n) e) Connections, networking ________________ (n) f) Obligatory _________________ (adj) g) Important, fundamental __________________ (adj) h) Person who has a university degree _______________ (n) i) Ability, capacity ________________ (n) j) Difficult, challenging ________________ (adj) 18 What to Expect as a Medical Student: Your Medical Education and the Process of Becoming a Doctor Admission to medical schools in the United States is highly competitive, with about 17,800 out of approximately 47,000 applicants receiving at least one acceptance to any medical school in recent application years. Before entering medical school, many schools require that students must complete a four-year undergraduate degree and take the Medical College Admission Test (MCAT); Your Medical Education: The First and Second Year Medical School Curriculum The first two years of your medical education will be spent in the classroom. The sheer volume of what you must learn will probably overwhelm you for the first few months, but US medical schools grade on a pass/fail basis and surprisingly, over 97% of entering students graduate in 4 years with an MD degree. Basic medical science curricula in the first and second year vary from school to school, but will include the following courses or similar subjects: Molecular Biology Gross Anatomy Human Genetics Biochemistry Medical Neuroscience Microscopic Anatomy Medical Ethics and Humanities Human Embryology Physiology Behavioral Medicine Physical Diagnosis Second year courses include the following: Clinical Correlation Microbiology and Immunology Pharmacology Pathology and Laboratory Medicine Advanced Physical Diagnosis Introduction to Clinical Medicine and Physical Diagnosis Upon completion of the second year of the medical school curriculum, you must take the first part of the three-part exam, the United States Medical Licensing Examination, or USMLE, Step 1. You must pass the three parts of this exam with a minimum score to become licensed to practice medicine in the United States. Most schools include classes to prepare you to sit for this exam which you must pass before continuing on to your third year. Step 2 is administered after your fourth year of medical education and must be passed before residency, and Step 3 is taken prior to completion of residency to gain licensure. Your Medical Education: The Third and Fourth Year Medical School Curriculum The third and fourth years of medical school are spent learning hands-on patient care. They are the "clinical" years. Third year students complete eight week rotations through various departments in the hospital which include: Psychiatry Internal Medicine Obstetrics/Gynecology Surgery Family Medicine Pediatrics The fourth year rotations are longer and are called Clerkships. Students are required to rotate through Internal Medicine, Surgery, and often Neurology, but are encouraged to choose elective 19 rotations in departments that they may be interested in pursuing as a specialty. Students are also given time off to apply for residency and interview for prospective programs. Paying for Your Medical Education Most medical school students accumulate a great deal of debt. The 2009-2010 AAMC Annual Student Tuition and Fees Report found that the average in-state tuition and fees for first-year medical students at public universities was $23,622. For out-of-state nonresident students, the average public university tuition and fees were $44,309. The average tuition and fees for first-year medical students at private universities was $41,063. These costs do not include health insurance fees, possible tuition and fee raises, books, housing, and other living expenses incurred during the typical course of medical school. Tuition and fees for a medical education range from about $10,300 per year for residents at public universities, to $51,200 per year for non-residents at private schools. On top of tuition you can add costs of around $3,000 per year for books, fees, and materials. Unless you live with your parents or a supporting spouse, you will have basic living expenses too. Working while in medical school is virtually impossible since you simply will not have the time. Therefore you will most likely take out a few student loans. Fortunately, your earning potential will be great, so obtaining loans isn't very difficult. The Financial Aid office at your school will have many resources and a lot of information to help you fund your education 3. PUT THE FOLLOWING 10 EVENTS INTO CHRONOLOGICAL ORDER: USMLE, Step 1 ______ Study Human Genetics _____ Study Advanced Physical Diagnosis ____ MCAT ______ Residency _____ Admission _____ USMLE Step 2______ 8-week rotations __________ Pay tuition and fees Clerkships ____________ 4. FIND WORDS IN THE TEXT THAT BELONG IN THE FOLLOWING CATEGORIES: Medical subjects Money Hospital work University 5. NOW WRITE A SHORT DESCRIPTION OF A MEDICAL STUDENT’S ACADEMIC CAREER IN ITALY. INCLUDE ADMISSION, SUBJECTS, COSTS, AND TRAINING ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 20 LESSON 6 HOSPITAL DEPARTMENTS AND HOSPITAL ROUTINES PRONUNCIATION - SYLLABLES AND WORD STRESS A syllable consists of a single vowel sound e.g. A I OR a vowel sound and a consonant sound e.g. AT TO a vowel sound and consonant sounds before and after e.g. CAN MAKE Words of more than one syllable have a syllable which is stressed (i.e. you hear it more loudly) e.g. ‘Doctor - the first syllable is stressed. Ad’vise - the second syllable is stressed. Influ’enza - the third syllable is stressed. HOSPITAL DEPARTMENTS Exercise A. Which department should I go to if…..? 1. …I’m going to have a tooth extracted? 2. …my daughter has a fever? 3. …I am going to have a baby? 4. …I cut my hand and need stitches? 5. …I broke my arm and need an operation? 6. …I have trouble breathing? 7. …I have a skin rash? 8. …I need an X-ray? Listen to the pronunciation of the words in the answers above. How many syllables do they have? Which is the stressed syllable? Exercise B. Read the text on the next page. Match the underlined words with the translation. Italian English Italian English armadietto provvista/scorta reparto ward intero parente più prossimo intervento essere ricoverato to be admitted distribuire essere dimesso turni se formare primario ampio svolgere fornire aggiornare riuscire 21 ADMISSION TO A HOSPITAL - WARD ROUTINE Adapted from BBC Health Before you are admitted If possible, contact the ward before to find out its regulations on: Visiting times and number of visitors allowed Friends and relatives bringing in food Use of mobile phones and tablets Checking in On your arrival, you’ll be given a bed and a locker for your personal items. Don't bring too much as lockers are usually quite small. Leave valuable items such as jewellery and money at home. Things to take with you: Contact details of your next of kin, family and friends Regular medicines Night clothing Toiletries The nurse will check details such as your full name, address and date of birth and information such as your religion, dietary preferences and details of your next of kin. They'll also measure your weight, blood pressure, pulse and temperature. One of the doctors looking after you will visit and ask questions about your health and any medicines you take. They'll also examine you. If you're having an operation, an anaesthetist may also come to ask questions and examine you. You may be asked the same questions by different people. This is routine to ensure that everyone has accurate information on you. During your stay Usually, there are three nursing shifts during the day and night, with each shift accompanied by a 'hand-over' where nurses are updated on each patient and any specific care required. The first routine activity of the day will be a hot drink, breakfast and the medication round. This is followed by bathroom activities, with nurses assisting those who can't manage alone. A nurse will measure your pulse, blood pressure and temperature at regular intervals and issue your medication at the appropriate times. Blood tests or x-rays are carried out on the ward or in the respective laboratory or department. Breakfast, lunch and an evening meal are provided. There's a wide choice of foods to accommodate all needs and dietary requirements. Doctors' rounds A team of doctors led by a consultant will look after you. Make a note of their name, in case anyone needs to know. On certain days the whole team will see you during what's known as the “consultant ward round” and you'll have daily visits from at least one member of the team. These visits aren't just for them to tell you things - they're an opportunity for you to tell them how you're feeling and ask any questions you may have. Whenever a healthcare professional comes to see you during your stay, they should explain what they're doing or plan to do. If they don't - or you don't understand what they've said - don't be afraid to ask them to explain. Many hospitals train student doctors on the rounds. If you do not want them to be present during an examination, just say so. Checking Out When discharged from the ward, you will be given a supply of your medication your hospital doctor has prescribed and possibly a list to give to your GP. Remember to check whether the hospital doctor wishes to see you in their outpatient clinic. 22 Exercise C. Read the text again and answer the questions. 1. Where do patients keep personal items in a hospital ward? ____________________________ 2. Name 4 things that a patient must take to hospital. __________________________________ 3. What routine tests do nurses perform immediately? ____________________________________________________________________________ 4. How many nursing shifts are there during the day?__________________________________ 5. What happens in the handover at each shift? _____________________________________________________________________________ 6. Name 3 things which the patient receives each morning. _____________________________________________________________________________ 7. Name 4 things nurses do during the day. _____________________________________________________________________________ 8. How often does a doctor visit a patient? ___________________________________________ 9. What do we call the visit of the whole team of doctors? _______________________________ 10. What must health care professionals explain when they visit a patient? ______________________________________________________________________________ 11. What do patients receive when they are discharged from hospital? ______________________________________________________________________________ 12. Where does a hospital doctor receive patients after they are discharged? _______________________________________________________________________________ PRONUNCIATION - SENTENCE STRESS In connected speech only certain words in English are stressed. This gives the English language its characteristic rhythm. The vowel sounds in unstressed/weakly stressed words are reduced to an identical vowel sound - the schwa- and make these words more difficult to hear. Exercise D. Which words are stressed and which are unstressed? Put them in the box. adjectives adverbs articles auxiliary verbs nouns main verbs (infinitive, participle) prepositions personal pronouns Stressed words Unstressed words Exercise E. Practice listening and pronunciation by repeating words and sections of the text in ‘immersive reader’ on your own.(Team – General - Posts. Click on the 3 dots to open the dropdown menu. Select immersive reader. N.B. Use the syllable function for word stress.) 23 LESSON 7 CHILDHOOD DISEASES 1. CHOOSE THE COMMON NAMES FOR THESE DISEASES FROM THE LIST BELOW DISEASE COMMON NAME 1. Morbilli / rubeola 2. Rubella 3. Varicella 4. Infectious parotits 5. Pertussis 6. Acute laryngotracheitis 7. Scarlattina 8. Rheumatic fever 9. Tetanus 10. Poliomyelitis Polio Measles Whooping cough Scarlet fever Mumps Rheumatic fever Chickenpox Lockjaw German measles Croup 2. WRITE THE COMMON ENGLISH NAME FOR EACH DISEASE, USING YOUR MEDICAL KNOWLEDGE: 1. Enlarged parotid glands ___________________________________ 2. Difficulty opening the mouth _______________________________ 3. Rash and enlarged posterior occipital nodes ___________________ 4. Paroxysmal cough with vomiting ___________________________ 5. Papules and vesicles, first on trunk __________________________ 6. Cough and cold followed by rash ___________________________ 7. Sore throat and rash ______________________________________ 8. Swollen joints and heart murmur ____________________________ 9. Fever follwed by muscle weakness __________________________ 10.Cough with stridor ______________________________________ 3. LOOK AT THE SHORT ARTICLE ABOUT CELIAC DISEASE. WHAT DO YOU KNOW ABOUT THIS DISEASE? Celiac disease is a disease of the small intestine caused by sensitivity to gluten. It can present at any age but in infancy it appears after weaning on to cereals containing gluten. The clinical features include diarrhea, malabsorption and failure to thrive. There may be signs of malnutrition and there may be some abdominal distension. There is delayed growth and delayed puberty, leading to short stature in adulthood. 24 4. COMPLETE THE TABLE WITH WORDS FROM THE TEXT. THEN COMPLETE THE SENTENCES WITH WORDS FROM THE TABLE VERB NOUN(S) ADJECTIVE(S) delayed develop distend fail growth sensitivity (mal) absorption nourish 1. Babies with the fetal alcohol syndrome may present with _________________ to thrive. 2. Abdominal _______________ may be due to an enlarged liver. 3. Small amounts of alcohol in pregnancy can affect fetal ______________ 4. Mortality from measles can be reduced by better ______________ IMPROVEMENTS IN HEALTH SINCE THE 1950s The words are in italics in the text below: 5a. MATCH THE WORDS TO THEIR ITALIAN EQUIVALENTS 1. developing _f_ a. nonostante 2. preventable __ b. disponibile 3. despite__ c. difondere 4. challenges __ d. approssimativamente 5. lack __ e. numeri 6. income__ f. in via di sviluppo 7. spread__ g. avvenire 8. headlines__ h. sfide 9. roughly __ i. mancare 10.occur ___ j. reddito 11.available k. evitabile 12. figures__ l. titoli dei giornali 5b. HOW DO WE SAY THESE NUMBERS? 100 10,000 200,000 5,000,000 1,000,000,000 240,000 571,000 2.7 3.5 0.75 10.8 1950 2000 2004 1st 2nd 3rd 4th 5th 60% 97% ½ ¼ 1/3 25 5c. LISTEN TO THE TEXT, AND FILL IN THE SPACES WITH THE NUMBERS YOU HEAR. Despite incredible improvements in health since 1950, there are still a number of challenges, which should have been easy to solve. Consider the following: ___________ people lack access to health care systems. Cardiovascular diseases (CVDs) are the number one group of conditions causing death globally. An estimated _________ people died from CVDs in_________, representing _____________ of all global deaths. Over ______________ of CVD deaths occur in low- and middle-income countries. Over ________________children under the age of ______________ die from malnutrition and mostly preventable diseases, each year. In ___________, almost ________________ million people died of infectious diseases alone, far more than the number killed in the natural or man-made catastrophes that make headlines. (These are the latest figures presented by the World Health Organization.) AIDS/HIV has spread rapidly. UNAIDS estimates for ___________ that there are roughly: o __________ living with HIV o ___________ million new infections of HIV o ___________ million deaths from AIDS Tuberculosis kills _________ million people each year, with ________million new cases a year. _________ million people still die from pneumococcal diseases every year, making it the number one vaccine-preventable cause of death worldwide. More than ________ of the victims are children. (The pneumococcus is a bacterium that causes serious infections like meningitis, pneumonia and sepsis. In developing countries, even ___________ of those children who receive medical treatment will die. Every _____________surviving child will have some kind of disability.) Malaria causes some _________ million acute illnesses and ____________ deaths, annually. ____________ people, mostly children under ________, died from measles in _____________ even though effective immunization costs less than 1 US dollar and has been available for more than ___________ years. These and other diseases kill more people each year than conflict alone. How many diseases are mentioned in the text? What are they? 26 LESSON 8 HEALTH AND NUTRITION 1. WHAT'S A HEALTHY DIET? COMPLETE THE QUIZ. Underline the correct sentences. 1Which of the following statements about nutrients is true? a) You can see the nutrients in your food. b) Nutrients help keep your body healthy. c) You can get all the nutrients you need by eating one food. d) Nutrients give you energy. 2 How do proteins help your body? a) Your body needs proteins to grow and repair itself. b) Meat and beans are a good source of protein. c) All foods contain some protein. d) Proteins are a source of quick energy for your body. 3 What do vitamins and minerals do? a) You can get energy to store from vitamins and minerals. b) They make you eat different kinds of foods. c) They help your bones and organs work properly. d) Vitamins and minerals are a good source of protein. 4 What foods are a good source of proteins? a) meat, fish, and cheese b) cake and orange juice c) spaghetti d) bread, corn, and potato chips 5 Why do you need to eat foods high in carbohydrates? a) Foods from the bread group are a good source of carbohydrates. b) Your body needs lots of carbohydrates to help build strong bones and teeth. c) Carbohydrates give your body energy to store. d) Carbohydrates give your body quick energy to move, grow, and keep warm. 6 What does your body do with fats? a) Your body stores fat and uses it later for energy. b) You should not have any fats in your diet. c) Fats give you quick energy. d) Foods like butter, sausage, and potato chips are sources of fats. 7 Why do you need to eat different kinds of foods? a) All foods have the same nutrients. b) You should not eat any foods at all with fat in them. c) No one food has all the nutrients you need. d) You should only eat fruits and vegetables. 27 2. PUT THE FOLLOWING FOODS INTO THE CORRECT COLUMN. THEN THINK OF OTHER FOODS AND PUT THEM IN THE RIGHT COLUMN: CARBOHYDRATES FRUIT AND PROTEIN DAIRY FATS & OILS VEGETABLES FOODS PRODUCTS Bread yoghurt olive oil eggs cauliflower oranges milk margarine pork cheese rice tomatoes beef pasta chicken/poultry fish bananas cream cheese flour 3. COMPLETE THE FOLLOWING SENTENCES TO GIVE ADVICE FOR A HEALTHY DIET: a) Avoid ______________________________________________ b) Limit your intake of __________________________________ c) Try to _____________________________________________ d) Do not _____________________________________________ e) Drink ______________________________________________ f) You should _________________________________________ 28 What information can you find on a nutrition label? 4. LOOK AT THE FOLLOWING NUTRITIONAL LABELS AND ANSWER THE QUESTIONS LABEL A LABEL B Nutrition facts Nutrition facts Serving size 1 cup (245g) Serving size 1 cup (244g) Servings per container Servings per container Amount per serving Amount per serving Calories 80 Calories from fat 0 Calories 120 Calories from fat 45 % Daily value* % Daily value* Total fat 0g 0 Total fat 5g 8 Saturated fat0g 0 Saturated fat 3g 15 Trans fat 0g 0 Trans fat 0g 0 Cholesterol 5mg 2 Cholesterol 20mg 7 Sodium 105mg 4 Sodium 100mg 4 Total carbohydrate 12g 4 Total carbohydrate 11g 4 Dietary fiber 0g 0 Dietary fiber 0g 0 Sugars 12g Sugars 11g Protein 8g Protein 8g Vitamin A 10% Vitamin C 0% Vitamin A 10% Vitamin C 0% Calcium 30% Iron 0% Calcium 30% Iron 0% * Percent daily values are based on a 2,000 calorie diet a) Which of the foods is reduced fat milk? ____________________________________ b) Which is nonfat milk? __________________________________________________ c) Which has more saturated fat? ____________________________________________ d) Which has more cholesterol? _____________________________________________ e) Which has more calcium and vitamin A? ____________________________________ f) What is a recommended daily calorie intake? _________________________________ 29 LESSON 9 READING AND UNDERSTANDING PATIENT INFORMATION LEAFLETS (PILs) 1.Match the drugs with their definitions TYPE OF DRUG DEFINITION 1. Analgesics They prevent blood clots forming 2. Diuretics They are used to calm and relieve anxiety 3. Stimulants They relieve constipation 4. Anti – inflammatory drugs They suppress nausea and vomiting 5. Narcotics They help to clear a blocked nose 6. Anti-emetics They destroy harmful bacteria 7. Sedatives They help to remove excess fluid from the body 8. Tranquillizers They help patients to sleep 9. Anticoagulants 1 They relieve pain 10. Laxatives They increase activity 11. Decongestants They reduce and suppress swelling 12. Antibiotics Painkillers originally derived from opium 2. Read the patient information leaflet about Ventolin QUICKLY. In the spaces, give a title to each section, according to the content of the paragraph. 3. Now read the information again and complete the table in note form with the key information. Name Ventolin Syrup Type of drug and form Use Dosage Side effects Important information and warnings Storage 30 Ventolin syrup Patient Information Leaflet for Ventolin Syrup (salbutamol sulphate). Your doctor has decided to prescribe Ventolin Syrup as part of your treatment. ____________________________________ Ventolin Syrup is an orange flavoured, sugar-free liquid providing 2 mg per 5 ml of the active ingredient salbutamol (as salbutamol sulphate). It also contains water, sodium citrate, citric acid, hydroxypropylmethylcellulose, saccharin sodium, sodium chloride, the preservative sodium benzoate (E211), and orange flavour. Total sodium content 5.6 mg per 5 ml. _____________________________________ Salbutamol is one of a group of medicines called bronchodilators. It relaxes the muscles in the walls of the small air passages in the lungs. This helps to open up the airways and so helps to relieve chest tightness, wheezing and cough so that you can breathe more easily. Ventolin Syrup is prescribed to ease breathing problems in asthma and other chest illnesses. It is suitable for children and adults who cannot use an inhaler device. TELL YOUR DOCTOR BEFORE STARTING TO TAKE THIS MEDICINE: if you are pregnant (or intending to become pregnant); if you are breast-feeding a baby; if you have ever had to stop taking this or another medicine for this illness because you were allergic to it or it caused problems; if you are having treatment for an over active thyroid; if you are having treatment for high blood pressure; if you have an irregular heartbeat/rhythm, including a very fast pulse; if you are taking any medicines to control an irregular heartbeat/rhythm, including a very fast pulse; or if you are diabetic. Sometimes this medicine may not be suitable and your doctor may want to give you something different. Make sure that your doctor knows what other medicines you are taking (e.g. treatment to reduce fluid, any other kind of bronchodilator tablets, steroid tablets), including those you have bought from the chemist. Remember to take this medicine with you if you have to go into hospital. ____________________________________ Use a 5 ml plastic spoon or oral syringe available from the pharmacist to take the syrup. The usual doses are: Children 2 to 6 years: 2.5 ml (1 mg) to 5 ml (2 mg) three or four times daily. Children 6 to 12 years: 5 ml (2 mg) three or four times daily. Children over 12 years: 5 ml (2 mg) to 10 ml (4 mg) three or four times daily. Adults: 5 ml (2 mg) to 20 ml (8 mg) up to four times daily. It is very important that you keep to your doctor’s instructions as to how much syrup to take and how often to take it. DO NOT TAKE more than you were told to. Keep taking your medicine for as long as your doctor tells you. DO NOT STOP just because you feel better. 31 __________________________________________________ If you miss a dose take it as soon as you remember, BUT if it is near to the time for the next dose, wait until this is due. It is important to keep to the dose on the pharmacist’s label. If you accidentally take a LARGER DOSE THAN RECOMMENDED you may notice that your heart is beating faster than usual and that you feel shaky. These effects usually wear off in a few hours but you should tell your doctor as soon as possible. AFTER TAKING YOUR MEDICINE If the medicine does not seem to be working as well as usual, TELL YOUR DOCTOR AS SOON AS POSSIBLE. It may be that your chest condition is getting worse and you need a different medicine. DO NOT TAKE EXTRA SYRUP unless told to by your doctor. ________________________________________ Most people do not have any problems when taking this medicine. Some people may feel a bit shaky or have a headache. Some people who are unusually sensitive may notice that their heart is beating faster and/or more forcefully than usual. This awareness of their heart beating is called palpitations, is normally harmless, and usually passes off as treatment continues. Some might notice that their heartbeat becomes uneven or their heart gives an extra beat. Tell your doctor as soon as possible, but do not stop using this medicine unless told to do so. Muscle cramps have also been commonly reported. Patients taking this medicine sometimes become restless or excitable although this is very rare. Very rarely, Ventolin Syrup may cause allergic reactions. Ventolin Syrup may affect the salt balance of the body, although this is rare. If you feel unwell or you notice anything unusual or which you don’t understand, tell your doctor as soon as possible. _______________________________________ Keep your medicine in a safe place WHERE CHILDREN CANNOT REACH IT. Store the syrup at room temperature below 30°C (86°F). Protect from light. If the pharmacist has had to dilute the syrup, the label will tell you to store the mixture below 25°C and to throw it away after 28 days. You should follow the instructions on the pharmacist’s label. Wipe the neck of the bottle after use. If you are told to stop taking this medicine RETURN ANY UNUSED VENTOLIN SYRUP TO YOUR PHARMACIST to be destroyed. FURTHER INFORMATION REMEMBER: This medicine is for YOU. Only a doctor can prescribe it for you. Never give it to someone else. It may harm them even if their symptoms are similar. Keep this leaflet. You may need to use it again. This leaflet does not tell you everything about your medicine. If you have any questions or are not sure about anything, ask your doctor or the pharmacist. 32 IMPERATIVES, MODAL VERBS AND OTHER EXPRESSIONS Look at the following sentences and put them in the correct column Use a 5ml plastic spoon. Ask your doctor or pharmacist. Do not store above 30°C. Patients sometimes become restless. You should tell your doctor as soon as possible. Keep your medicine in a safe place. Make sure that your doctor knows what other medicines you are taking. The medicine should not be used after the expiry date printed on the label. You should follow the instructions on the pharmacist’s label. Do not take more than you were told to. Ventolin may affect the salt balance. Some patients might notice that their heartbeat becomes faster. Never give it to someone else. If you feel unwell, tell your doctor. Instructions Possibility Advice Prohibition What are some other ways of saying the same thing? Speaking: 1. Give your partner some instructions, advice etc on how to lead a healthier lifestyle. 2. Give your partner some instructions, advice etc on how to be a successful student. 33 LESSON 10 - REVISION GRAMMAR Read the text and put the verbs in the correct form –active or passive. The term diabetes describes a deficiency of insulin or a decreased capacity of the body 1.____________________(use) insulin, a hormone which 2._________________(produce) by the pancreas. Insulin 3._________________(permit) glucose to enter body cells where it 4._________________ (convert) to energy. Insulin is necessary to synthesize protein and store fats. In uncontrolled diabetes, glucose and lipids 5._________________(absorb) into the blood and, with time, they can damage the body's vital organs and 6.________________(contribute) to heart disease. Diabetes can 7.________________(divide) into two main types: insulin-dependent diabetes mellitus (IDDM – type 1) and non-insulin- dependent diabetes mellitus (NIDDM – type 2). The most common type is NIDDM. It 8._________________(affect) 90% of those with diabetes and usually after the age of 40. Less than 10% of those with diabetes 9.________________ (affect) by the other type - IDDM. This type of diabetes10.________________ (appear) at any age, but it is most common in childhood or the teens. Before insulin 11. _____________________( discover) in the 1930s, it 12. __________________ (be) possible to treat type 1 diabetes by strictly controlling carbohydrates in the diet. Now, however, it 13.________________________________( control) by daily insulin injections. For type 2 diabetes, doctors will encourage patients to reduce blood sugar levels by a balanced diet and regular exercise before starting medication. Often two or more types of medication 14. __________ (combine) to reduce possible side effects. SKILLS 1. Complete the sentences (giving advice or instructions) a) __Give___ me your hand, please. b) _____ you ______ your eyes, please? c) ____ not ____ your breath during the test. d) _____ you please ____ me about your diet? e) Never ______ these pills on an empty stomach, always ______ them after meals. f) You ______ _______ a lot more fruit and vegetables. g) _________ drinking too much alcohol. h) ______ out of reach of children. 2. Write the probable problem next to the symptoms a) Cough, sneezing, runny nose _____a cold________ b) Temperature, sore joints, cough ____________ c) Sore swollen ankle after falling ____________ d) Sneezing, runny nose, red eyes, difficulty in breathing ______________ e) A headache or muscle aches, nausea or vomiting, and watery diarrhoea ________________ f) Fever, sore throat and headache without nasal drainage ________________________ 34 Now write the possible symptoms next to the problem g) Mumps _____________________ h) Measles _____________________ i) Sunburn _____________________ j) Bronchitis _________________________________ K)Sinusitis ______________________________ Now match the diagnosis to the treatment 1. Gastroenteritis _____ a.Aspirin 2. Influenza ______ b.Antihistamines 3. Headache ______ c. Antibiotics 4. Strep throat ______ d. Rest and drink lots of fluids 5. Nasal Allergies ______ e. Oral rehydration solution 3. Ice treatment can be used for the following (choose from the words) prevent circulate numb rub reduce delay cause a) to _________ bleeding b) to _________ swelling c) to _________ pain 4. How many syllables are in the following words? Mark the stressed syllable: dermatology oncology paediatrics emergency diabetes transplant gastroenterology surgery 5. Complete the box with the corresponding words verb noun adjective prepare delay swollen examine preventable treat broken blood developing 6. Go through your course materials. Find the names of as many diseases as possible, and fill out the table Name of Childhood Communicable? Vaccine- Mortal? Symptoms? disease /adult? preventable? The common both Yes, very no no runny nose, cough, sore cold throat, sneezing 35 7. Speaking - In pairs, ask your partner some of these questions about his/her health. Based on his/her answers, give some advice on how to make his/her lifestyle healthier. Are your parents healthy? Do you smoke? If so, do you smoke more Do think that you need to lose weight? than two cigarettes a day? Do you always eat healthy food? Do you take medicine when you are sick? Do you catch a cold more than once a Do you take vitamins or mineral year? supplements? Do you drink a lot? Do you usually get enough sleep? Do you eat a lot of vegetables? Have you ever been hospitalized? Do you eat lots of fruit? Have you ever donated blood? Do you ever get headaches? Have you ever taken a sleeping pill to get Do you ever read magazines or news to sleep? articles about health? If yes, what How can you reduce stress in your life? subject(s) do you find the most How many hours of sleep do you usually interesting? get? What kind of exercise do you do? How often do you eat junk food? o How often do you exercise? What are some things that cause stress in Do you go for regular medical check-ups? your life? Do you have a lot of stress? What kind of pollution is the most risky? Do you have any allergies? What's your blood type? Do you often eat fast food? 8. Writing and speaking. Write and act out a short dialogue about the following questions: EXAMPLE: What are some of the causes of headaches? A: What do you think often causes headaches? B: Well, sometimes stress does. Or if you don’t sleep enough. A: When do you get headaches? B: Usually I get a headache when I study too much! 1. When do people get bruises? 2. Why is smoking bad for one’s health? 3. What causes backaches? 4. What foods should one eat /avoid to lose weight? 5. What are some common causes of allergies? 6. Is doing sport good for you? Why? 7. Why do doctors say to limit salt intake? 8. What are some symptoms of the common cold? 9. Is the sun good for your skin? 10. What are some causes of /treatments for insomnia? 36 37 INGLESE SCIENTIFICO - I ANNO 1 SEMESTRE CORSO DI LAUREA IN MEDICINA E CHIRURGIA SKILLS – KEY TO EXERCISES LESSON 1 – THE BODY. GIVING INSTRUCTIONS TO A PATIENT Ex1 1. eye 2. nose 3.mouth 4.throat 5.arm 6.thumb 7. hand 8.finger 9.leg 10.knee 11.ankle 12.foot 13. toe 14.elbow 15.face 16.ear 17.breast 18.hip 19. head 20.neck 21.shoulder 22.back 23. heart = cuore 27. stomach =stomaco 24.lung =polmone 28. muscle =muscolo 25. liver =fegato 29. skin =pelle 26. kidney =rene 30. brain=cervello MATCH THE PARTS OF THE BODY WITH THE PROBLEM: 1. headache 2. stomach ache 3. ear ache 4. backache 5 a pain in the arm/neck/leg/elbow/wrist/ankle 6. a sprained elbow/wrist/ankle 7. a broken arm/leg/elbow/wrist 8. a sore throat INSTRUCTIONS 1. Can you clench your fist? 2. Show me your hands please? 3. Could you open your mouth? 4. Just lift your arm, please. 5. Take a deep breath. 6. Say Aaaah! 7. Grip the bar tightly! 8. Can you read the letters? 9. Cough, please. 10. Can you bend your leg? 11. Stretch as far as you can! 12. Can you touch your toes? 13. Can you try to stand on one leg? 14. Can you turn over, please? 15. You can close your mouth now! 16. Could you lie down, please? 17. And hold your breath! 18. Just roll up your sleeve, please! 19. Can you rest your arm here? 20. Don’t worry! Relax! WHAT DO YOU SAY TO A PATIENT IN THESE SITUATIONS? A. give an injection Just roll up your sleeve, please! Can you rest your arm here? B. check the patient’s blood pressure Just roll up your sleeve, please! Can you rest your arm here? Clench your fist, please. C. look down the patient’s throat Could you open your mouth? Say Aaaah! You can close your mouth now! D. position the patient for some X – rays Could you lie down, please? E. check the patient’s eyesight Can you read these letters? F. reassure the patient Don’t worry! Relax. LESSON 2 - COMMON AILMENTS AND SYMPTOMS PART 1 Exercise 1 1. cough, sore throat 2. out of breath 3.lost my appetite 4. can’t sleep 5. temperature. runny nose 6. bruise 7. insect bite, swollen leg 8. black eye, headache 9. depressed 10. lump 11. nosebleed 12. stomach ache Exercise 2 D: Good morning, Mr. Jones. How are you feeling today ? P: Good morning Dr. Shaw. Not too well, I’m afraid. D: What’s the matter? P: Well, I’m feeling very tired, and my body aches. 37 38 D: How long have you been feeling like this? P: A couple of days, I think. D: Do you have a temperature? P: Yes, at night it gets to 39 degrees. Oh, and I also have a terrible headache all the time. D: Well, you know there is a flu epidemic at the moment. I’d say that was the problem. P: Dr. Shaw, is there anything I can take to make me feel better? D: Just aspirin, really. And stay in bed for a few days. P: Thank you very much. D: Ring me if you don’t feel better in a few days. P: I will. Goodbye. Exercise 3. (possible answers) D: Hello Miss Lindsay, how are you feeling today?/ What’s the matter? P: I have a terrible stomach ache. D: When did it start? P: Yesterday after lunch. D: Did you eat anything strange? P: Well, I did eat a lot of seafood. D:Where did you eat it / have lunch? P: In a restaurant. D: Did your family eat the same thing? P: No, they didn’t eat the seafood. D: It sounds like you have food poisoning. Have you had / Do you have vomiting and diarrhea, too? P: Yes, I have. D: I’ll write you a prescription. Take these tablets three times a day for two days. I’m sure you’ll feel better soon. P: Thank you very much, Dr. Brown. D: You’re welcome. Bye-bye. P: Good-bye. Exercise 4. https://www.youtube.com/watch?v=u3CXYKHbrA4 Patient’s surname Hartley Occupation (1) florist Diet (2) vegetarian Weight (3) 62 kilos Main symptom (4) tiredness Other symptoms anaemic? (5) weight loss (6) lost appetite (7) previous urine infections (8) sometimes breathless / out of breath Previous Hospitalization for (9) bladder infection treated with (10) antibiotics and (11) a drip Family history (12) mother - kidney disease Tests prescribed (13) blood sample for haemoglobin (14) urine dip for protein (15) kidney scan? Diagnosis (16) kidney disease? LESSON 3 - COMMON AILMENTS AND SYMPTOMS PART 2 A. Match the medical terms with their definitions a. the long-term results of an illness or treatment SEQUELAE b. identifying several illnesses which the patient may have DIFFERENTIAL DIAGNOSIS c. things wrong with the body which the patient complains of or experiences SYMPTOMS d. a study of the patient’s body EXAMINATION e. the causes leading to an illness AETIOLOGY f. an unusual feature which may be worrying or dangerous ABNORMALITY g. a meeting between doctor and patient to discuss problems CONSULTATION h. the identification of a particular illness DIAGNOSIS i. a change in the structure or function of the organs or tissue of the body DISEASE j. taking away the cause of illness or finding it early PREVENTION k. a group of signs which are characteristic of a particular illness SYNDROME l. additional problems to the original illness COMPLICATIONS m. probable outcome of an illness PROGNOSIS n. a patient’s medical background, problems, behaviour and lifestyle HISTORY o. what the doctor can see of the illness SIGNS 38 39 C Quiz SYMPTOMS DIAGNOSIS SELF-CARE/TREATMENT DO YOU HAVE…? 1. a fever NO Go to question 6 YES 2. sore throat and YES You may have STREP If the sore throat or fever lasts longer than 48 headache without nasal THROAT, a bacterial hours, see your doctor for a diagnostic test. If drainage infection positive, you may need antibiotics. Rest and drink lots of water. Gargling with warm salt water may help relieve a sore throat. NO 3. symptoms which YES You may have the FLU Get plenty of rest, and drink lots of fluids. Over- started suddenly, the-counter medicines may relieve some of your including muscle aches, symptoms. Your doctor may suggest a chills, a sore throat, prescription medicine to shorten the course of the runny nose or cough illness. A vaccination each autumn may prevent this illness. NO 4. a persistent cough YES You may be Get plenty of rest, and drink lots of fluids. If you with yellowish or developing ACUTE smoke, stop smoking. Use an over-the-counter greenish mucus, BRONCHITIS, an medicine for pain and fever, and an expectorant wheezing and shortness infection of the airways to ease the coughing. A humidifier may also of breath relieve some symptoms. If symptoms persist or worsen, contact your doctor. NO 5.a headache or muscle YES You may have Get plenty of rest. Children should be given an aches, nausea or GASTRO- oral rehydration solution to avoid dehydration. vomiting, and watery ENTERITIS (also Ease back into eating with bland foods and clear diarrhoea called the stomach flu) liquids. NO 6. a runny and/or itchy YES You may Try an over-the-counter antihistamine medicine. nose, sneezing, and itchy have ALLERGIES If symptoms persist or worsen, contact your eyes doctor. NO 7. sneezing, a sore YES You probably have Try an over-the-counter medicine to treat the throat, headache, a COLD specific symptoms. Get plenty of rest and drink congestion and a runny lots of fluid. nose NO 8. swelling or pain YES You may be See your doctor. Acetaminophen, ibuprofen around eyes, cheeks, developing and/or warm compresses may help reduce facial nose or forehead, a SINUSITIS pain. A cool mist vaporizer may help your headache, a dry cough, sinuses drain more easily. Drink plenty of fluids. and/or discharge from the nose? NO If you think your problem is serious, contact your doctor immediately. WARNING: Due to the risk of Reye's syndrome, do not give aspirin to children and young adults without your doctor's approval. D Complete the text with the missing words Influenza Influenza (flu) is an easily spread infection of the nose, throat, and lungs. Causes The flu is caused by an influenza virus. Most people catch the flu when they breathe in tiny droplets from coughs or sneezes of an infected person, or after touching something with the virus on it, and then touching the mouth, nose, or eyes. Symptoms Flu symptoms usually appear 1 - 7 days after contact with the virus. The flu spreads easily and often strikes a community all at once. The first symptom is a fever between 38 and 41°C. Other common symptoms include: body aches, chills, dizziness, headache, lack of energy, nausea and vomiting. Between day 2 and 4 of the illness, the fever and aches begin to go away. But new symptoms occur, including: dry cough, increased breathing symptoms, runny nose (clear and watery), sneezing and sore throat. 39 40 Exams and Tests Most people do not need to see a doctor because risk for a severe case is rare. When many people in an area have flu, a doctor can make a diagnosis after hearing the symptoms. A physical examination is not needed. However, there is a test to detect the flu done by swabbing the nose and throat. Treatment Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help lower fever. Sometimes doctors suggest you use both types of medicine. Do NOT use aspirin. Over-the-counter cold medicines may make some of the symptoms better. Cough drops will help a sore throat. Doctors recommend rest, drinking plenty of liquids and avoiding alcohol and tobacco. Doctors may give antiviral drugs to people who get very sick or those who are at high risk for problems. They work better if taken within 2 days of the first symptoms. Prognosis Most people get better within a week or two but thousands of people with the flu can develop complications, such as pneumonia, encephalitis, meningitis or seizures. Those at highest risk include: people over age 65, children younger than 2 years, women more than 3 months pregnant during the flu season, anyone living in a long-term care facility and anyone with chronic heart, lung, or kidney conditions, diabetes, or a weakened immune system. Prevention To avoid catching or spreading the flu, stay at home for at least 24 hours after any fever is gone. Do not share food, utensils, cups, or bottles. Cover a cough with a tissue and throw it away after use. Use hand sanitizer often during the day and always after touching your face. Many public health authorities recommend the influenza vaccine. LESSON 4 ICE TREATMENT IN FIRST AID Ex B. ENGLISH ITALIAN 1. bruise (n c) to bruise (vb reg) 13 gonfiore 2. burn (n c) to burn (vb reg) 7 dolore 3.flannel (n c) 14 strofinaccio 4.frostbite (n. unc) 11 punti 5. healing (n) to heal (vb reg) 5 guarigione 6. numbing to numb (vb) numb (adj) 8 strofinare 7. pain (n c/unc) 1 livido/contusione 8. rub (vb reg) 6 intorpidire 9. sprain (n) to sprain (vb reg) 12 strappo muscolare 10. stiff (adj) 10 rigido 11. stitches (n c) to stitch (vb reg) 4 congelamento 12. strain (n c/unc) to strain (vb reg) 9 distorsione 13.swelling (n c/unc) to swell (vb irreg swelled –swollen) 3 straccio di flanella 14. tea towel.(n c) 2 ustione Ex C. Ice Treatment for Injuries (Adapted from http://www.patient.co.uk) With any sprain, strain or bruise there is some bleeding into the underlying tissues. This may cause swelling, pain and delay healing. (g) Ice treatment may be used in both the immediate treatment of soft tissue injuries and in later rehabilitation. During immediate treatment, the aim is to limit the body's response to injury. Ice will: Reduce bleeding into the tissues. Prevent or reduce swelling. (h) Reduce muscle spasm and pain. Reduce pain by numbing the area and by limiting the effects of swelling which causes pain. These effects all help to prevent the area from becoming stiff by reducing excess tissue fluid that accumulates as a result of injury and inflammation. How do you make ice packs? Ice packs can be made from ice cubes in a plastic bag or wet tea towel. (b) A packet of frozen peas is also ideal. These mould nicely and can go in and out of the freezer. Purpose made cold packs can also be bought from pharmacies. Take care when using ice and cold packs from a deep freeze. These are very cold and can cause ice burns quickly if used without care and proper protection. How are ice packs used? Ideally, rub a small amount of oil over the area where the ice pack is to go (any oil can be used, even cooking oil!). If the skin is broken or there are stitches in place, do not cover in oil but protect the area with a plastic bag. (a) This will stop the wound from getting wet. Place a cold wet flannel over the oil (do not need if using plastic bag). Place the ice pack over the flannel. 40 41 (e) Check the colour of the skin after 5 minutes. If it is bright pink/red remove the pack. If it is not pink replace the pack for a further 5-10 minutes. The effect of the ice pack improves if you press it gently onto the injured area. Ice can burn or cause frostbite if the skin is not protected with oil and/or other protection such as a wet flannel. How long should ice be applied? Ideally, ice should be applied within 5-10 minutes of injury for 20-30 minutes. (d)You risk damaging the skin if ice is left on for more than 20-30 minutes at a time. You can repeat the application every 2-3 hours while you are awake for the next 24-48 hrs. Do not use cold packs:- over areas of skin that are in poor condition. over areas of skin with poor sensation to heat or cold. over areas of the body with known poor circulation. (c) if you have diabetes. (f) around the front or side of the neck. in the presence of infection. on the left shoulder if you have a heart condition. Ex D. 1. Sprains. Strains, bruises, tissue injuries. 3. Rub a small amount of oil over the area. Place a cold wet flannel over the area. Place the ice pack over the flannel. (If skin is broken or there are stitches in place, protect with a plastic bag and place the ice over the bag.) 4. For 20 – 30 minutes (within 5 – 10 minutes of the injury) 5. Protect the skin with oil and/or other protection such as a wet flannel because ice can burn or cause frostbite. 6. No, not if the patient suffers from diabetes or, if the patient has a heart condition, ice should not be put on the left shoulder. Ex E. 1. Heat increases the blood flow so muscles relax more. 2. Don't use heat when you first injure your body because it produces a lot more swelling in the area. 3. Dr. Lee recommends heat for a chronic back injury. 4. Your body responds to moist heat a lot better than dry heat. 5. You should use a heat pad for 10-15 minutes every hour. 6. A heat pad can cause burns if you use it for longer. LESSON 5 – THE MEDICAL DOCTOR – TRAINING AND JOB DESCRIPTION Ex 1 1. Doctor (general practitioner, GP): job description 2. What does a GP do? 3. Qualification and training required 4. Key skills for general practitioners Ex 2 a) Surgery b) Confidential c) Consultations d) surgery e) Liaison f) Compulsory g) Key h) Graduate i) Skill j) demanding Ex 3 MCAT Admission Pay tuition and fees Human Genetics Study Advanced Physical Diagnosis 41 42 USMLE, Step 1 8-week rotations Clerkships USMLE Step 2 Residency Ex 4 Medical subjects Money Hospital work University Biochemistry etc Tuition Debt Residency Admission Applicants Fees Loans Rotations Undergraduate Degree Expenses Clerkship Education Curricula Financial aid Departments Courses Fund Earning LESSON 6 - HOSPITAL DEPARTMENTS AND ROUTINES Exercise A Which department should I go to if…..? 1. …I’m going to have a tooth extracted? Dentistry / The Dental clinic 2. …my daughter has a fever? Paediatrics 3. …I am going to have a baby? Gynaecology/Obstetrics 4. …I cut my hand and need stitches? Accident and Emergency 5. …I broke my leg? Orthopaedics 6. …I have trouble breathing? Pneumology 7. …I have a skin rash? Dermatology 8. …I need an X-ray? Radiology Listen and note the number of syllables. Which is the stressed syllable? 1. Dentistry 3 ‘ Dentistry The Dental clinic 2 2 The ‘Dental ‘clinic 2. Paediatrics 4 Paedi’atrics 3. Gynaecology 5 Gynae’cology Obstetrics 3 Ob’stetrics 4. Accident 3 and Emergency 4 ‘Accident and E’mergency 5. Orthopaedics 4 Ortho’paedics 6. Pneumology 4 Pneu’mology 7. Dermatology 5 Derma’tology 8. Radiology 5 Radi’ology Exercise B Italian English Italian English armadietto locker provvista/scorta supply reparto ward intero whole parente più prossimo next of kin intervento operation essere ricoverato to be admitted distribuire to issue essere dimesso to be discharged turni shifts se whether formare to train primario consultant ampio wide svolgere to carry out fornire to provide aggiornare to update riuscire to manage 42 43 Exercise C. Read the text again and answer the questions. 1. Where do patients keep personal items in a hospital ward? In a locker 2. Name 4 things that a patient must take to hospital. Contact details of next of kin, family and friends/ regular medicines/ night clothing/ toiletries. 3. What routine tests do nurses perform immediately? Measure the patient’s weight, blood pressure, pulse and temperature. 4. How many nursing shifts are there during the day? Usually three. 5. What happens in the handover at each shift? Nurses are updated on each patient and any specific care required. 6. Name 3 things which the patient receives each morning. A hot drink, breakfast and medication. 7. Name 4 things nurses do during the day. Assist patients with bathroom activities, measure pulse, blood pressure and temperature at regular intervals and issue medication at the appropriate times. 8. How often does a doctor visit a patient? Daily/once a day. 9. What do we call the visit of the whole team of doctors? The consultant ward round. 10. What must health care professionals explain when they visit a patient? What they're doing or plan to do. 11. What do patients receive when they are discharged from hospital? A supply of medication the hospital doctor has prescribed and possibly a list to give to the GP. 12. Where does a hospital doctor receive patients after they are discharged? In the outpatient clinic. Exercise D. Stressed words: adjectives, adverbs, nouns, main verbs (infinitive, participle) Unstressed words: articles, auxiliary verbs, prepositions, personal pronouns LESSON 7 - CHILDHOOD DISEASES Ex 1 DISEASE COMMON NAME 1. Morbilli / rubeola Measles (Ital: morbillo) 2. Rubella German measles (rosolia) 3. Varicella Chickenpox (varicella) 4. Infectious parotits Mumps (orecchioni / parotite) 5. Pertussis Whooping cough (pertosse) 6. Acute laryngotracheitis Croup (crup, difterite della laringe) 7. Scarlattina Scarlet fever (scarlattina) 8. Rheumatic fever Rheumatic fever (febbre reumatica) 9. Tetanus Lockjaw (tetano) 10. Poliomyelitis Polio (poliomielite) Ex 2 1. mumps 2. lockjaw 3. German measles 4. whooping cough 5. chickenpox 6.measles 7.scarlet fever 8. rheumatic fever 9. polio 10.croup Ex3 VERB NOUN(S) ADJECTIVE(S) (often in the form of past/present participle) delay delay delayed develop development (developing /developed) distend distension distended 43

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