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VII. Выпишите все слова, необходимые для описания работы а) врача в поликлинике, б) стационара.
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VIII. 1. Прочитайте и переведите Текст А со словарем. 2. Выделите три основные момента при обследовании больного и раскройте их содержание. 3. Найдите в тексте английские эквиваленты следующих словосочетаний:
получить толковый ответ; чувстовать себя непринужденно; установить точную область; отмечать все видимые признаки; необычные симптомы; вы могли бы спросить; точно выяснить неясности
Text A. How to Take the Case
When we become doctors, we should always remember the following things.
As soon as the patient enters the consulting, or when we enter his room, observation should begin immediatly. We look for external signs and symptoms as long as the professional visit lasts.
How do you begin the consultation with the patient? A first requirement is to develop a feeling of sympathy with the patient by your questions, your actions, your interest in him and his troubles. Select and choose your questions well to be adequate for the situation.
Now when the patient begins to tell you his complaints, his signs and symptoms, and various diagnostic terms that have been given to his disease, you should carefully note what he is telling you.
When the patient has finished his description, it is for you to make clear some points he did not give in detail. Your questions must be understood by the patient well to get a meaningful answer.
When questioning the patient your aim should be to make the patient feel free, so that he tells you everything. The patient must feel at his ease. Never hurry him, that is the worst thing you can do. When you record his symptoms, be sure to have the exact expressions used.
Always ascertain the exact region in which the patient feels this or that. When the patient has finished his story, and you have ascertained some points, then is the time to make your physical examination. There again be very observant and note all the visible signs or symptoms in all the regions of the body.
A good physical examination is important. First because only by knowing his physical impairments, his past diseases, can you differentiate between strange,
rare and particular symptoms, and symptoms logically depending upon these results, i. e. common symptoms.
Secondly, a physical examination is important to establish the prognosis of the case: sometimes without a physical examination you cannot say if something is malignant or benign. The prognosis may be very different. If there is a malignancy you need more time for the cure than with a benign case if cure is possible.
Thirdly, a physical examination is important to establish an exact diagnosis. You might ask why is an exact diagnosis important? It is needed for the administration of a proper treatment.
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So you see now how to take the case: first let the patient tell you his symptoms. Secondly try to clear up indistinct things precisely by careful questioning. Thirdly make your physical examination.
CLASS ASSIGNMENTS
Revision
IX. Find the word-building elements. Translate the words into Russian:
a) painful - painless, restful - restless, hopeful - hopeless; b) breathlessness, sleeplessness; c) intercostal, intramuscular, interspace, intrapleural
X. Translate into Russian paying attention to the meaning of the words in bold type:
I, We call "aetiology" the causes of a disease. 2. We call in a doctor when some of our relatives is seriously ill. 3. I cannot find this patient's temperature chart. 4. I cannot find out any changes in the course of this patient's disease. 5. He cannot carry.this heavy box. 6. He can carry out this difficult experiment.
XI. Translate the following sentences into Russian. Define 'ing-forms':
1. A tooth is covered with a thin layer of enamel (эмаль) preventing it from being destroyed. 2. The increasing flow of blood into the lungs is associated with breathing out. 3. The partial pressure of carbon dioxide being higher in the venous blood enables the passing of carbon dioxide from the blood into alveolar air. 4. Being associated with the amount of carbon dioxide in the blood the respiratory rate and its depth change according to it. 5. On having been formed in the cortex conditioned reflexes determine many actions of the human being.
XII. Translate into Russian paying attention to the meaning of the word 'both':
1. Both the description of the course of the disease and all the changes in the patient's condition are written down in his case history. 2. Both investigators came to the same conclusion having studied the structure of this substance. 3. The examination of the blood includes both the determination of the red and white cell count.
XIII. Translate into Englisn:
1. Больной взвесится еще раз перед тем, как его выпишут из больницы. 2. Как только вы поступите в стационар, лечащий врач назначит вам лабораторные исследования. 3. Обследование больного будет проведено после того, как будут собраны семейный и жизненный анамнезы.
to be applied to diseased eyes. These were made up and handed out to the patients at the chemist's, a little booth-like space3 in the corner of the hall.
They sat down on a bench among the patients, and waited for their turn. People were being admitted in groups of five or six at a time, the rest were moving up nearer as others went in.
(From "I Knock at the Door" by Sean O'Casey. Adapted)
Notes
1. a small grocer's - бакалейная лавочка
2. a ticket of admission - талон на прием к врачу
3. a little booth-like space - маленький закуток
XIV. 1. Read Text В. Entitle it. 2. Say what impression the described hospital has made on you:
Text В
They came to the hospital, a shabby (убогий) place, that looked like a small grocer's shop.1 Over the windows, in big letters, were the words, "ST. MARK'S OPHTHALMIC HOSPITAL FOR DISEASES OF THE EYE AND EAR".
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Going inside, they found themselves in a long narrow hall, divided in two by a barrier. At the upper end there were two doors, one to let patients in to the doctors, and the other to let them out when the doctor had finished examining them. Near the entrance was a big stove (печь) and near this stove was a table on which was a big book containing all the details about the patients' names, addresses, and occupations.
A sixpence was handed over, and they were given a ticket of admission2 which would also be used by the doctor to write down the prescribed remedies
CYCLE VI. DISEASES
UNIT 1. THE DISEASES OF THE RESPIRATORY TRACT
Грамматика: Времена группы Perfect Continuous.
LESSON 34
HOME ASSIGNMENTS
I. Ответьте на следующие вопросы (см. с. 267):
1. Назовите формулу времен группы Continuous. 2. Поставьте глагол to be в этой формуле в Perfect и скажите, формула какой группы времен у вас получилась. 3. Какой вспомогательный глагол изменяется по временам в этой формуле? Как называются такие времена? 4. Прочитайте примеры и скажите, какое действие показывает глагол в Perfect Continuous, и когда это действие происходит? 5. Как переводится глагол во временах группы Perfect Continuous?
I have been examining the patient for half an hour. Я обследую этого больного (уже) полчаса.
I had been examining the patient for half an hour when you came. Я обследовал больного (уже) полчаса, когда вы пришли.
П.* Найдите сказуемые, назовите формулу, по которой они образованы. Предложения переведите:
1. The patient has been making a slow recovery for a month. 2. We shall have been investigating this case for three weeks by the end of the year. 3. The patient had been coughing for a month by the time he was admitted to the hospital.
III. Перепишите пары предложений, подчеркните сказуемые и определите, в чем их различие. Предложения переведите:
1. a) I am waiting for the findings of my blood analysis. 6) I have been waiting for the findings of my blood analysis for an hour. 2. a) Dry rales are disappearing slowly. 6) Dry rales have been disappearing during this week. 3. a) The nurse is giving the injections. 6) The nurse has been giving the injections for two hours.
IV. Напишите вопросы к выделенным членам предложения:
1. My mother has been suffering from a bad pain in the substernal area for three hours. 2. The patient had been complaining of a considerable muscular pain before he was admitted to the hospital. 3. By three o'clock the professor will have
V. Запомните чтение следующих слов. Найдите их перевод ниже:
lobular f'mbjub], focus ['fovkss] pi foci ['fausai], cyanosis [,sai3'n9usis],
bronchiole ['brrjrjkiaul], crepitation [,krepi'teijn], diffuse [di'fju:s], differentiate [,dif3'renjieit], pleurisy ['plugnsi]
дифференцировать; бронхиола; крепитация, хруст, потрескивание; плеврит; цианоз, синюшность; очаг (очаги); дольчатый; дольковый; лобу-лярный, диффузный, разлитой
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VI. Выучите следующие слова:
gradually ['graedjuah] adv постепенно, последовательно
improve [im'pru:v] v улучшаться
accompany [э'клтрэш] v сопровождать, сопутствовать
occlusion [г/к1и:з(э)п] п закупорка
purulent ['pjuarubnt] а гнойный, гноящийся
sputum fspjuitam] n мокрота
accelerate [ask'sebreit] v ускорять(ся), учащать(ся) '
reduce [n'dju:s] v понижать; ослаблять, уменьшать
dullness ['dAlnis] n тупость, приглушение
spleen [splirn] n селезенка
enlarge [m'la:d3] v увеличивать(ся), расширять(ся); разрастать(ся)
sign [sam] n признак, симптом
intensity [m'tensiti] и напряженность, сила; яркость, плотность
shadow ['Jaedau] n тень; v затемнять
severe [si'via] а резкий, сильный; тяжелый; серьезный (о болезни)
unit ['ju:mt] n единица, единица измерения; отделение
VII. Прочитайте и переведите следующие слова и словосочетания:
1. occlusion [п'кш:з(э)п]: the occlusion of the artery, the occlusion of the small intestine, to reveal the intestine occlusion
2. sputum ['spju:tgm]: purulent sputum, thick sputum, the analysis of the sputum failed to reveal cellular elements
3. sign [sam]: abnormal signs, the signs of the disease, these signs indicated the presence of inflammation
4. severe [si'vra]: a severe form of the disease, a severe inflammation, to suffer from a severe cardiovascular disease, to suffer a severe form of the grippe
VIII. Переведите следующие однокоренные слова:
appear, appearing, appeared, appearance, disappear, disappearance; reduce, reduced, reducing, reduction; large, enlarge, enlarged, enlarging, enlargement; improve, improving, improved, improvement; intensity, intensive, intensively, intensify
IX.* Закончите следующие предложения, выбрав подходящий по смыслу вариант:
1. The spleen is the organ... (a) located in the left side of the abdominal cavity behind the stomach; 6) located in the right side of the thoracic cavity behind the lung) 2. Purulent sputum... (a) never contains any microorganisms; 6) always contains some microorganisms) 3. The patient with severe form of pneumonia... (a) was allowed to attend the treatment at the polyclinic; 6) was admitted to the in-patient therapeutic department of the hospital)
X. 1. Прочитайте текст А. 2. Найдите предложения, в которых употребляется одно из времен группы Perfect Continuous, переведите их. 3. Напишите план текста. 4. Подготовьте ответы на вопросы по тексту. 5. Выпишите английские эквиваленты следующих словосочетаний:
в пределах; при глубоком вдохе; поступить в больницу; по всему легкому; тяжелая форма пневмонии
Text A. Lobular Pneumonia
Patient Smirnov aged 48 was admitted to the hospital with the diagnosis of lobular pneumonia. He had been developing lobular pneumonia gradually. A week before the admission to the hospital he had had bronchitis after which his condition did not improve.
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Fever had an irregular course and the temperature changes were caused by the appearance of the new foci of inflammation in the pulmonary tissue. Fever had been persisting for two weeks and had been decreasing gradually.
The patient's breathing was rapid with 30-40 respirations per minute. There was breathlessness and cyanosis of the face associated with the accompanying bronchitis, decrease in the respiratory surface and occlusion of numerous bronchioles and alveoli.
The patient complained of the pain in the chest particularly on deep breathing in and cough with purulent sputum. The pulse rate was accelerated and the arterial pressure wa s reduced
On physical examination dullness in the left lung, abnormal respiration, numerous r a les and crepitation were revealed. Dry r a les caused by diffuse bronchitis were heard all over the lungs. The liver and spleen were not enlarged. The examination of the organs of the alimentary tract failed to reveal any abnormal signs but the tongue was coated.
The blood analysis revealed leucocytosis in the range of 12,000 to 15,000 per cu mm of blood and an accelerated erythrocyte sedimentation rate (ESR).
The urine contained a small amount of protein and erythrocytes. The X-ray examination of the lungs revealed numerous foci of inflammation of various size, irregular form and different intensity. Shadowing was particularly marked at the root of the left lung due to the enlargement of the lymphatic glands.
It was a severe form of lobular pneumonia which was difficult to differentiate from pulmonary tuberculosis and pleurisy. Yet the physician made a correct diagnosis.
CLASS ASSIGNMENTS
XI. Form and translate the nouns:
a) -ment: develop, improve, accompany, enlarge, impair
b) -ness: dull, clear, complete, breathless, ill
c) -ance (-ence): appear, enter, exist, occur, persist
XII. Define the tense of the verbs. Translate the sentences:
1. Although the patient had been receiving the injections of streptomycin for several days she showed little improvement. 2. The red blood cell count has been gradually returning to normal as the patient is being given blood transfusions. 3. My friend will have been living in Moscow for a month when I come there.
XIII. Use the verbs in brackets in the proper tense:
1. As fever (to persist) for about three weeks the patient's condition is very poor. 2. The researcher (to investigate) the origin of the inflammation for about a week before he drew a definite conclusion. 3. Some symptoms of the vascular impairment of the brain (to develop) gradually for some time before they became clearly marked.
XIV. Choose the statements corresponding to Text A:
1. a) Dry rales caused by diffuse bronchitis were heard all over the lungs, b) Moist rales produced by pleurisy were heard all over the lungs. 2. a) The examination of the organs of the alimentary tract failed to reveal any abnormal signs, b) The examination of the organs of the cardiovascular astern revealed the signs of the heart impairment.
XV. Choose the appropriate word from those given in brackets. Translate the sentences into Russian:
1. (Dry, moist) rales were caused by diffuse bronchitis. 2. The shadow at the base of the left lung was particularly marked due to the (enlargement, decrease) of the lymphatic glands. 3. (Mild, severe) forms of lobular pneumonia are difficult to differentiate from pulmonary tuberculosis and pleurisy. 4. Luminal and bromide were prescribed to the patient (to improve, to impair) his sleep.
XVI. Answer the following questions:
1. Where is the spleen located? 2. In what cases may the spleen be enlarged? 3. What does purulent sputum always contain? 4. Where is a patient with a severe form of pneumonia admitted to? 5. When does the pulse rate accelerate? 6. In what disease may a shadow in the lungs be revealed? 7. What unit of blood pressure is used in medicine? 8. What temperature is a severe form of lobular pneumonia usually accompanied by? 9. What particular signs is bronchitis accompanied by? 10. What treatment must a patient follow to improve his state in case of bronchitis?
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