Text B. The Treatment of Lobular Pnenmonia

On the first day of the disease the patient was administered a 2 gr dose of norsulphazol which was followed by a 1 gr dose every four hours during that day. The patient had been receiving 1 gr of this drug every six hours for the following 10 days when he began to feel better. In addition to norsulphazol the patient had been receiving streptomycin in doses of 500,000 units twice daily during a period of 8 days. To improve the patient's sleep and the condition of his nervous system he had been taking bromide and luminal during the whole course of the disease until his discharge from the hospital. Cough and chest pain were relieved by the administration of codein, cough mixture, cups and other necessary procedures.

On the third day after the return of body temperature to normal the patient was allowed to walk a little. The doctor prescribed the patient the necessary physical exercises.

The patient had not any possible complications such as lung abscess or pulmonary gangrene.

As the findings of all the analyses and the temperature were normal the patient was discharged from the hospital in a week.

LESSON 35

HOME ASSIGNMENTS

I. Переведите предложения, обращая внимание иа время глагола- сказуемого (письменно):

I. Сейчас кардиолог обследует этого больного. 2. Кардиолог обследует этого больного уже полчаса. 3. Сейчас мой брат находится в стационаре. 4. Мой брат находится в стационаре уже месяц. 5. Когда сестра вошла в палату, больной спал хорошо. 6. Вчера больной спал хорошо в течение нескольких часов после принятия лекарства.

II. Определите, в каких предложениях слово 'for' имеет значение: а) "для", "в течение", "так как"; б) слово 'since' имеет значение "с", "так как", "с тех пор как":

а) 1. The patient stated that he had been suffering from a bad cough with purulent sputumfor about a month. 2. The patient was administered a dietfor the physical examination of the liver had revealed its considerable enlargement. 3. The change of the patient's body temperature to abnormal was quite unexpected for the physician.

б) 1. Poorly developed bones and teeth, slow growth and even the general impairment of health occurred in some children since their food contained little phosphorus. 2.1 have been waiting for the nurse since 8 o'clock. She must give me an intramuscular injection. 3. The patient had been complaining of cough with purulent sputum since he was admitted to the hospital. 4. Since the patient's body weight had been considerably reducing and his liver became enlarged he was administered a number of laboratory analyses to make the diagnosis clear.

III. Найдите корень слова и определите часть речи корня слова и его производного. Слова переведите:

dullness, enlargement, intensity, improvement, clearly, moisture, poisonous, smoothly, thinnish, useless, preventive, severely, indication

IV. Выучите следующие слова и словосочетания:

affect [a'fekt] v поражать (болезнью); производить действие, воздей­ствовать

causative agent ['ko:z9tiv'eid3ant] п возбудитель

stage [steid3] п стадия, ступень

malaise [mae'leiz] п недомогание

fatigue [fa'ti:g] п усталость, утомление

loss [bs] п потеря, утрата

pus [рлв] п гной

involve [in'volv] v поражать, вовлекать (в патологический процесс) profuse [pra'fjurs] а обильный, чрезмерный permanent ['paimanant] а постоянный, неизменный benign [bi'nain] а доброкачественный, излечимый; неопасный elevation [,eli'vei|h] п повышение; поднятие

perspiration [.paispa'reifn] и потение, потоотделение; пот; испарина evidence ['evidans] п очевидность; основание; доказательство; показа­ние; признак(и)

V. Прочтите и переведите следующие слова и словосочетания:

1. malaise [mae'leiz]: a general malaise, to complain of a general malaise, a general malaise is one of the symptoms of tuberculosis;

2. fatigue [fa'ti:g]: a considerable fatigue, a marked fatigue, to suffer from a slight fatigue;

3. pus [pAs]: a thick pus, the discharge containing much 'pus, much pus was found in the sputum;

4. benign [bi'nain]: a benign disease, a benign tumour was revealed in the lungs, benign growth of the kidney

VI. 1. Прочтите текст С. 2. Выпишите все симптомы туберкулеза, о которых вы узиали из этого текста. 3. Переведите абзац, в котором дается характеристика температуры при туберкулезе. 4. Задайте вопросы по содержанию текста:

Text С. Pulmonary Tuberculosis-Clinical Picture

Pulmonary tuberculosis is caused by mycobacterium tuberculosis, which produces characteristic tuberculous changes in the lung. This disease may also affect other organs: bones, joints, lymphatic glands, kidneys, etc. The causative agent of tuberculosis was discovered by Koch in 1882.

In the early stage of tuberculosis the patient usually complains of a general malaise, fatigue, loss of appetite and bodyweight. Cough may be dry or productive, i. e. with sputum discharge. Coughing becomes worse at night and in the morning. In patients with cavities in the lungs coughing is accompanied by a considerable discharge of sputum.

Sputum is mucopurulent. Its microscopic examination reveals a large number of pus corpuscles, erythocytes, and tuberculous organisms. Blood in the sputum is sometimes the first sign of tuberculosis. If large blood vessels are involved the discharge of blood may become profuse.

Fever is one of the permanent symptoms of pulmonary tuberculosis. In benign processes the body temperature is often subfebrile. In active forms it may range from 38° to 39°C. A considerable elevation of temperature is observed in pneumonic forms, when fever persists at a level of 38°C and higher for several months.

Cold profuse perspiration at night is sometimes evidence of a severe form of tuberculosis. Loss of body weight is one of the typical signs of pulmonary tuberculosis. It is caused by tuberculous intoxication, a sharp increase in the metabolic rate and loss of appetite. Loss of body weight is particularly marked in progressive forms of the disease.

VII. Переведите слова и словосочетания о скобках. Предложения переведите:

1. It is sometimes difficult to make a correct diagnosis (в ранних стадиях) of some diseases. 2. (Потеря аппетита) is a very important symptom, which a physician must always pay particular attention to. 3. (Повышение тем­пературы) has been persisting for several months since it was a pneumonic form of tuberculosis. 4. Dullness in the lungs, accelerated respiration, dry or moist rales and crepitation may be (доказательством) of lobular pneumonia. 5. (Резкое увеличение) of the number of leucocytes is often the evidence of a certain inflammatory process in the human body.

CLASS ASSIGNMENTS

Vni. Define '-ing-forms'. Translate the sentences:

1. Having been affected by the benign process the lungs of the patient showed a marked shadowing at their base. 2. Having revealed the occlusion of numerous bronchioles and alveoli and the decrease in the respiratory surface of the lungs the physician determined the cause of breathless-ness and cyanosis. •3. Being examined by the therapeutist the patient stated that he had had an accelerated pulse rate and reduced arterial pressure a month before.

IX. Read the passages, translate theui and answer the questions:

1. The patient had a dry cough. In a day or two the cough became productive. After the attacks of cough the patient felt pain in the substernal area and in the throat. His temperature was not very high. He followed home treatment and was administered aspirin and codein. He was recommended to have warm milk with soda several times a day. Чем был болен этот пациент — трахеитом или бронхитом?

2. The patient's temperature had been changing but persisting for two weeks. His breathing was rapid and he complained of breathlessness. There was cyanosis of the face. The chest pain was particularly sharp on deep breathing in. He had cough with purulent sputum. His erythrocyte sedimentation rate was accelerated. Dry rales were heard all over the right lung. Какой диагноз вы поставили бы атому больному — бронхит или пневмония?

X. Read and translate Text D using a dictionary:

TextD

In patients who recover from tuberculosis the focus of disease is surrounded by connective tissue and the actual lesion itself may turn into a chalky nodule. In persons with more extensive involvement but with a high degree of resistance, fibroid induration of a whole lobe or lung may occur. This may limit the spread of the disease, but does not bring about (produce) complete recovery. In these cases chronic bronchitis persists for ten or twenty years or longer. A large part of the lobe or lung may be involved in the tuberculous process and many of the bronchial tubes may be dilated as a result of the chronic cough. The chest is often deformed by the partial collapse of the affected portions of the lung. The patients lose weight constantly and may die, either of the progress of the disease itself, or, more commonly, of some complicating or associated condition.

LESSON 36

HOME ASSIGNMENTS

I. Переведите предложения, обращая внимание на употребление времен (письменно):

I. При тяжелых формах пневмонии температура обычно держится на уровне 38°С. 2. Сейчас у этого больного держится температура 38°С вследствие тяжелой формы пневмонии. 3. У этого больного держится температура на уровне 38°С уже в течение месяца. 4. Больной всегда соблюдал постельный режим при сердечных приступах. 5. Больной соблюдал постельный режим, когда у него появился сердечный приступ. 6. В связи с сердечным заболеванием больной соблюдал постельный режим уже три недели.

II. Назовите корень в следующих словах и переведите эти слова:

intoxication, allowance, changeable, clearly, uncomplicated, disappear­ance, remarkable, unprotective, senselessness, thickness, warmth, ineffective, enlargement

III. Образуйте однокоренные существительные (см. 1), прилага­тельные (см. 2), наречия (см. 3), глаголы (см. 4) и переведите их:

1. accomplish, accumulate, investigate, pass, perspire, present; 2. protect, effect, change, move, pain, poison, produce, response; 3. loud, exact, mild, quiet, rapid, separate, severe, sharp, smooth, sudden; 4. accomplishment, complicated, considerable, unexpected, elevation

IV. * Выберите правильный ответ на основании текстов А, В, С (уроки 34, 35):

1. What forms of tuberculosis are accompanied by a sub-febrile temperature? (a) Benign forms of tuberculosis are;

6) Pneumonic forms of tuberculosis are.) 2. What kind of sputum has the patient with tuberculosis? (a) It is purulent;

6) It is mucopurulent.) 3. The evidence of what form of tuberculosis may cold profuse perspiration at night be? (a) It may be the evidence of a benign form of tuberculosis; 6) It may be the evidence of a severe form of tuberculosis.)

4. What erythrocyte sedimentation rate has the patient with lobular pneumonia? (a) It is slow; 6) It is accelerated.)

5. What does the X-ray examination reveal in case of lobular pneumonia? (a) It reveals a marked shadowing in the lungs; 6) It reveals a cavity in the lungs.)

V. Заполните пропуски словами 'what', 'which', 'when', 'whose':

1.... treatment is indicated if a patient has a severe form of lobular pneumonia? 2.... may the patient's erythrocyte sedimentation rate be accelerated? 3.... of the following symptoms is characteristic of tubercu­losis: a bad headache, cough with mucopurulent sputum or a coated tongue? 4. Thanks to... scientific investigations was mucobacterium tuberculosis discovered?

VI. * Замените выделенные слова близкими по смыслу словами и словосочетаниями:

1. Fever is one of the permanent symptoms of pulmonary tuberculosis, (a) changeable; 6) constant) 2. In the presence of inflammation the discharge from the wound is usually purulent, (a) clear; 6) contains pus) 3. Permanent fever is often accompanied by loss of appetite and fatigue, (a) temperature; 6) malaise)

4. Within the thoracic cavity the pressure is lower than the atmospheric one. (a) higher; 6) less)

VII. 1. Прочтите текст E со словарем. 2. Выучите выделенные слова. 3. Озаглавьте текст. 4. Выпишите неправильные глаголы и Дайте их ос­новные формы. 5. Будьте готовы к ответам на вопросы по тексту. 6. Вы­пишите английские эквиваленты следующих словосочетаний:

симптомы, характерные для первичного туберкулеза; в пораженном легком; клинические проявления; положительная проба; уплотнение легочной ткани; первичный туберкулез; перкуторный звук

Text Е

Primary tuberculosis usually begins in childhood and affects the lungs and bronchial lymphatic glands of the lung roots. Primary tuberculosis may not give any clinical manifestations and is revealed only by a positive Pirquet's¹ and Mantoux's tests² and X-ray examination. Loss of appetite, short periods of fever, slow growth, loss of weight may be some of the symptoms characteristic of primary tuberculosis.

Physical examination sometimes reveals consolidation of the pulmonary tissue. A shorter percussion sound and a small number of dry and fine moist rales are heard in the involved lung.

A favourable course of primary tuberculosis leads to the formation of a Ghon's focus.³ In unfavourable cases primary pulmonary tuberculosis may lead to an extensive inflammation.

Notes

1. Pirquet's [pia'keiz] test— накожная туберкулиновая проба Пирке

2. Mantoux's [mar)*tu:z] test — внутрикожная туберкулиновая проба Манту

3. Ghon's ['ganz] focus — очаг Гона (кальцинированный очаг, свидетельствующий о перенесенном туберкулезе)

CLASS ASSIGNMENTS (CYCLE VI, § 1)

VIII. Translate the following word combinations:

1. a bad wound; 2. a bad malaise; 3. a bad rupture; 4. bad manifestations;

5. a bad fatigue

IX. Answer the following questions:

1. In what cases is erythrocyte sedimentation rate accelerated? 2. What temperature are benign forms of tuberculosis accompanied by/ 3. In case of what disease is a marked shadowing in the lungs revealed by the X-ray examination? 4. What sputum has the patient with tuberculosis of the lungs? 5. Is cold profuse perspiration at night the evidence of a benign or a severe form of tuberculosis of the lungs? 6. What is permanent fever often accompanied by?

X. Choose the proper verb from those given in brackets. Use it in the necessary tense:

1. The patient's general condition (to improve, to recover) gradually since he was administered streptomycin injections. 2. The most characteristic symptoms of primary tuberculosis such as loss of appetite and weight, short periods of fever and slow growth (to develop, to produce) in a child since the age of two. 3. As the patient's temperature (to enlarge, to elevate) constantly since he was admitted to the hospital he had to follow a bed regimen.

XI. Use 'one' ('ones'), 'that' ('those') Instead of the words in bold type. Translate the sentences:

1. In case of pulmonary gangrene the right lung is more often affected than the left lung. 2. In acute forms of pulmonary gangrene the sputum has a bad smell, like the smell of dead tissues — or of a destroyed tooth. 3. In pulmonary edema the clinical picture reveals some findings like the findings observed in other lung diseases.

XII. Read the passages. Say what respiratory tract disease is described in each of them:

1. The girl developed a permanent loss of appetite and she had not been increasing in weight for several months. Her growth was slow. She often had short periods of fever. On physical examination the physician revealed a small number of dry and fine moist rales. The percussion sound was considerably reduced.

2. The patient complained of a general malaise, fatigue and cold profuse perspiration at night. His temperature had been persisting at a level of 38°C for about a month. He had mucopurulent sputum sometimes containing blood. When the doctor was examining him the patient stated that he had lost much weight.

3. When the patient was admitted to the hospital his breathing was rapid and there was a marked cyanosis of the face. He complained of chest pain on deep breathing in. The physician determined that his arterial pressure was reduced, his pulse rate was accelerated and there was dullness in the lungs. There were numerous foci of inflammation in the lungs revealed by the X-ray examination.

XIII. 1. Read Text F. 2. Ask each other questions on the text. 3. Retell it. 4. Summarize the essence of the second paragraph:

Text F. Lung Abscess

Lung abscess may develop because of various factors. In cases where an abscess develops as a complication of pneumonia the patient's general condition gradually becomes worse. Sometimes the first clinical manifestations of a chill, pain in the affected side, fever elevating to 39°-40°C, and loss of appetite are present. There is a profuse perspiration at night, dry cough, and a considerable increase of the white blood cell count up to 20, 000 per cu mm of blood and accelerated ESR. Both fever and the increase in the number of leucocytes depend on the presence of pus in the cavity. When pus is evacuated from the thoracic cavity the temperature decreases and the white blood cell count returns to normal. The repeated increase of white blood cells may be observed when pus is again accumulated in the cavity.

The course of the lung abscess may be divided into two periods: that before and that after the rupture of the abscess into a bronchus. The length of the first period varies in different cases. The second period begins from the moment of the abscess rupture into a bronchus usually with 0.5 litre or more of sputum discharge. After the rupture of sputum into a bronchus, the body temperature returns to normal, and the patient's general condition becomes better. The sputum discharge gradually reduces in its amount. The appetite increases, the white blood cell count and ESR return to normal. Within 4-5 weeks of effective treatment complete recovery is usually observed in most cases of lung abscess.

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