医学英语视听说.doc

Medical English Watching Listening and Speaking

医学英语视听说考试资料

Test Introduction：
Part 1：名词解释
Part 2：简答
Part 3：病例分析
Part 4：体检

Questions For Diagnosis &Treatment-Chest Pain
1．Possible Disease
M.I.(myocardial infarction)心肌梗塞
Angina 心绞痛
Pericarditis心包炎
Pulmonary embolism 肺栓塞
Pneumothorax 气胸
Cholecystitis胆囊炎
Severe indigestion严重消化不良
Pneumonia 肺炎
Pancreatitis胰腺炎
Musculoskelrtal 骨骼系统性疼痛
2．Descriptions of Pain
Aches疼痛 ,,throbbing悸痛,pulsing疼痛，stings 刺痛\like a stabbing pain, Sharp pain,comes in waves ,sudden pain,
My chest feels tight

It feels like a tight band around my chest
Pressure ,压迫感
3. Useful Sentences
For Chest Pain
How Long
What does the pain feel like?
Show me where the pain is?
Is the pain just in that area or does it spead anywhere else?
Do u have any pain in ur shoulder or down ur left arm?
Is the pain constant there all the time?
Does the pain get worse when u ----breathe in or out?
----walk around or do heavy work?
What painkillers did u have?
Aspirin（阿司匹林,paracetamol(扑热息痛)
Here are the Forms（化验单），U Need to have some blood test, X-ray,and ECG right away！
Ur results show that u have ----,I am afraid u will have to be admitted into hospital for treatment (住院治疗)
U need to have intravenous antibiotics (静脉输液)，and oral medication (口服药)。

Question for Diagnosis &Treatment ----Diarrhea(腹泻)
1.Possible Disease
Food poisoning 食物中毒
Dysentery痢疾
Intestinal Obstruction肠梗阻
Dehydration脱水
Intussusception 肠套叠
Enteritis 肠炎(小肠炎)
Crohn’s Disease 节段性回肠炎
Irritable bowel syndrome 过敏性结肠炎
Bowel Tumour肠瘤
Constipation 便秘
2.Descriptive Words for Faeces粪便 and Diarrhea

Liquid液体 watery 水样
Lumpy 粒状
Semi-soft 半软
Mucous 粘液
Bloody bloody and like jelly带血胶状
Dark brown 咖啡色
Cream color 乳白色
Beige 浅褐色
Dry 干燥
Black and sticky
黑色呈柏油
Smelly 发臭的
Pus 脓
Milk deposits 牛奶沉淀
Un-digested
未消化的
Pale 白色
Green 青色

3.Question for Diarrhea （顺序为横）
How long How many times
Bloody? Stool（大便 look like?
Do they smell? Pain when u have diarrhea?
Vomit? Eat something wrong?
Able to eat ?How about fluids ? Any fever or headache?
Do u feel dehydrated (脱水)?
Specimen（样品）of stools ;blood test; x-ray; ultrasound(超声)--------
U must take fluids ,and just have a light diet until feel better
Possible bowel cancer（肠癌）（顺序为横）
3 times a week 2 or 3times a day
A bit soft ,dark brown Not smell
pain going with Abdominal pain or discomfort
Feel bloated 腹胀 Press on stomach and palpate
Do test of specimen of ur stools ,blood test
Might need endoscopic内窥镜的,内窥镜检查的 or sigmoidoscopy乙状结肠镜检查[术]

Questions For Diagnosis & Treatment----Abdominal Pain

1..Possible Disease
Abdominal Obstruction 腹胀[æbˈd ɔ mənəl
Appendicitis 阑尾炎[əˌpendɪˈsaɪtɪs]
Food Poisoning 食物中毒
Hepatitis 肝炎[ˌhepəˈtaɪtɪs]
Cholecystitis(gallstones) 胆囊炎，（胆结石）[ˌkɔlisisˈtaitis]
Gynecological Problems 妇科疾病[ˌɡainikəˈlɔdʒikəl]
Stomach Ulcer 胃溃疡[ˈʌlsə]
Pancreatitis 胰腺炎[ˌpæŋkriəˈtaitis]
Urological Problems 泌尿系统问题
Respiratory problems 呼吸系统问题[ˈrespərəˌtɔ:ri
Cardiovascular problems 心血管问题[ˌkɑ:di:əʊˈvæskjələ]
2.Useful Sentences
How long?where? how painful is it?
Did the pain strat there or somewhere else?
Does it hurt more after certain exercises or actions?
Do u feel that u have had fever at anytime?
Are u passing urine ok?(你排尿正常吗？)
What does ur urine look like?
Are u having your bowels open regularly?(排便正常吗)

Are u menstruating ?is it normal ?
Bleeding?is it normal ?
Having a period?is it normal?(females ,月经来了吗？)
Are u vomiting?
What do u vomit? Is there a pattern?(一般什么情况下呕吐)
Are u able to eat or drink?
Do u get pain after eating and drinking?
Please lay down ,I need to examine u
I will need to do some investigations :blood tests ,x-ray and ultrasound ,urine tests and stool tests
Cholecystitis
D:Hello ,my name is Dr pan ,how can I help u?
P:I have had abdominal pain for a few days and it’s getting worse.
D;how long have u had abdominal pain?
P;about three days.
D;where is it?can u show me ?
P:yes ,just here .
D;how painful is it?
P:at first it was just on and off ,but now it seems to be there all the time.
D: on a scale of 1 to 10;if no pains is 1 and very painful 10,what number would u give

your pain?
P; I’d give it a 7
D;did the pain start there or somewhere else?
P;it’s always been there .
D;does it hurt more after exercise or actions?
P；if iam waling around a lot ,it will hurt a bit more.
D; do u feel that u have had a fever at any time?
P;no,I don’t think so ,I have felt hot but I haven’t taken my temperature.
D；I need to take ur temperature ,pulse ,and B/P
Are u passing urine ok?
P;yes
D;what does ur urine look like?
P;normal
D;are u having ur bowels open regulatly?
P;usually I do ,but I haven’t had my bowels open for a couple of days.
D;have u vomited?
P;no,I thought I was going to today but the feeling passed.
D;are u able to eat and drink anything?
P;I’m drinking but I haven’t really felt like eating.
D:what have u been drinking?

P：I have had a couple of glasses of water and a couple of cups of coffee.
D:does the pain get worse after eating or drinking、
P;no ,not that I ‘ve noticed.
D;I need to examine you.please lay down,and loosen ur clothing for me.
P;ok.
D;show me where it hurts.
P:it hurts just there.
D;ok take a nice big breth, breathe in and out ,now try and relax.
P:ouch,that hurts.
D；OK thanks ,u can get dressed now.
P:I will need to do some investigations : :blood tests ,x-ray and ultrasound ,urine tests and stool tests
D;hello ,your results show that u might have cholecystitis,u need to be admitted to hospital for observation and treatment ,and we may need to do more tests before we have a correct diagnosis.
P;do I really need to be admitted into hospital, isn’t there anything u can give me for the pain and to help the problem?
D; sorry , no ,it is best that u are admitted for further test ,we can check that u haven

’t got gallstones or something seriously with ur liver.
P;all right ,

PPT of Abdomial Pain

“All who have had much experience of the group of cases known generally as the acute abdomen will probably agree that in that condition early diagnosis is exceptional.”

Types of abdominal pain
• Colicky（绞痛 0pain - caused by distention（膨胀）of a hollow viscus（空脏器）, such as bowel.
• Somatic （躯干身体）pain - caused by inflammation（炎症）of the parietal peritoneum（壁层腹膜）;
• Visceral（内脏的）pain - caused by inflammation of the visceral peritoneum and capsule of solid organs.
Quadrant（象限）View of the Abdomen

Right Upper

Cholecystitis（胆囊炎）
• Inflammation of the gall bladder  胆囊, caused by duct obstruction （管道堵塞）with a gall stone.

• Pain is usually steady for an hour or more after onset and made worse by eating.
• If there is significant inflammation associated with the cholecystitis, there may be local peritoneal pain (somatic pain)腹膜性疼痛.
• Pain may be referred to the scapular(肩胛的)area and accompanies nausea恶心, vomiting, and fever without jaundice黄疸.
• Diagnosed with ultrasound(超声).
Cholangitis 胆管炎
• Caused by obstruction of the biliary tract(胆道)leading to bacterial overgrowth in the gall bladder.
• Marked by Charcot’s Triad（查科三联征）
– RUQ(右上腹)pain, jaundice and fever.
• Diagnosed by ultrasound.
• Is an emergency and must be treated with IV antibiotics(静脉抗生素).
• May require decompression(解压)via（凭借）endoscopic(内窥镜的)or surgical means.

Hepatitis（肝炎）
• Caused by inflammation（感染） of the liver by viruses（病毒）, alcohol or certain drugs.
• Marked by tender, enlarged liver with malaise（不舒服）, fever and jaundice.
• Diagnosed by history and laboratory evaluation - liver function tests and viral serologies.（病毒血清学的检查）
• Treatment depends on etiology （病因，病原）of disease.
Pancreatitis（胰腺炎）
• Most commonly caused by alcoholism (50%) and gall stones (30%) obstructing the common bile .（胆汁）duct（管道）.
• Constant mid-epigastric（上腹部的） visceral（内脏的）pain usually occurring after a heavy meal or alcoholic binge.
• Pain may radiate to the back (50%) and is accompanied by nausea, vomiting and anorexia  （厌食症）.
• Diagnosed by amylase  （淀粉酶）and lipase脂肪酶. Imaging by CT scan may be desirable in some cases.
Left Upper

Peptic Ulcer  （胃溃疡）
• Caused by increased gastric acid production （胃酸容物）or decreased mucosal（粘膜的）protection.
• Increased gastric acid production may be caused by alcoholism（酒精中毒）or gastrin producing tumor (Zollinger-Ellison Syndrome佐林格-埃利森综合征).
• Decreased mucosal protection may be caused by overuse of NSAID’s（非类固醇抗炎药）or by infection with Helicobacter pylori幽门螺旋杆菌.
• Pain is visceral and may become somatic （腹膜性疼痛）if perforation（穿孔）occurs. There may be radiation to the back.
• Diagnosed by H. pylori antigen（抗原）in the serum（血清）, endoscopy内镜检查
Left Lower

（卵巢囊肿不考。。。
Right Lower

Appendicitis
• Caused by obstruction of the appendiceal（阑尾的）lumen(腔)
• Pain starts as periumbilical(脐周的)and migrates(迁移)to the RLQ (McBurney’s Point)
• Is accompanied by nausea, vomiting and anorexia(厌食症). May have fever - especially if ruptured.

• Diagnosed by ultrasound or CT scan.
• Treatment is surgical and is an emergency if ruptured.

General Abdominal Pain
• Some causes of abdominal pain are generalized and not restricted to any specific quadrant.
Gastritis(胃炎)
• Caused by inflammation of the gastrointestinal tract by microorganisms(微生物), radiation（放射物）and other irritants（刺激物）.
• Described as diffuse（扩散）crampy（痉挛）痛 abdominal pain.
• Often accompanied by diarrhea, nausea, vomiting, dehydration（脱水）and fever.
• Diagnosis is by history and so on
Bowel Obstruction（肠梗阻）
• Caused by obstruction of the bowel lumen （空腔）by mass, volvulus（肠扭转）, intussusception（肠套叠）around scar（伤疤）adhesions（粘连）.
• Pain is colicky in nature，accompanied by vomiting
• May be accompanied by watery diarrhea -

• Diagnosed by abdominal x-rays looking for distended(膨胀的)loops环结 of bowel and air-fluid levels（气液面）.
Kidney Stones
• Caused by obstruction of the upper urinary tract（上泌尿道）by a stone that is induced（导致）by dehydration（脱水）, infection, hypercalcemia  （血钙过多）and other metabolic imbalances.（代谢不平衡）
• Pain is described as colicky and located anywhere from the flank（侧面）to the groin  （腹股沟）.
• Diagnosed by intravenous pyelogram（静脉注射肾盂造影图）, ultrasound or CT scan.
Appropriate Exam
• Vital signs to evaluate for signs of infection, dehydration, shock, instability.
• Inspect visually for distention, scars,jaundice, signs of hernias疝, or masses.
• Auscultate - high pitched bowel sounds may indicate early obstruction. No bowel sounds indicate ileus（肠梗阻 Increased bowel sounds may be associated with gastritis.
• Palpate and Percuss - for tenderness（疼痛）, masses（包块）, pulsation（脉动), hernias疝, ,CVA tenderness0（脊肋角疼痛）, liver and spleen size, ascites（腹水）and hyperresonance

（过清音）.
• Pelvic exam in women
• Rectal exam（直肠检查）

General Introduction Stroke
Classification of Stroke
• Ischemic Stroke缺血性脑卒中... (75% “Brain Infarct”脑梗死 )
– Occlusive:闭塞性
• Thrombosis 血栓形成
• Embolism 栓塞
– Anterior Circulation 前循环
• Occlusion of carotid artery  （颈动脉）involve cerebral hemispheres  （大脑两半球）
– Posterior Circulation 后循环
• Vertebro-basilar artery （椎基底动脉） distribution involve brainstem（脑干）or cerebellum（小脑）
• Hemorrhagic Stroke出血性卒中
– Subarachnoid 蛛网膜下的
• Aneurysm  动脉瘤(most common)
• Arteriovenous malformation动静脉型血管畸形

– Intracerebral 大脑内的
• Hypertension  高血压(most common)
• Amyloid angiopathy（淀粉样脑血管病）in elderly
Stroke – Risk Factors
Modifiable
Hypertension
Tobacco use
--TIA( Transient ischemic attack)
Heart Disease
Diabetes Mellitus
Sickle Cell  镰状细胞and increased RBC
Unmodifiable
Age
Gender
Race
Previous CVA（脑血管意外）
Heredity （遗传）
Stroke – Signs and Symptoms
Ischemic(缺血性的)
--- Carotid Circulation(. 颈动脉循环)
Unilateral paralysis单侧的瘫痪(opposite side)
Numbness麻痹 (opposite side)

Language disturbance（障碍）
Aphasia失语症– difficult comprehension, nonsense胡说, difficult reading/writing
Dysarthria发音困难 – slurred speech语言不清, abnormal pronunciation.
Visual disturbance (opposite side)
Monocular blindness（单眼盲）(same side)
---Vertebrobasilar Circulation 椎基底动脉循环
Vertigo 眩晕
Visual disturbance 视力障碍(Both eyes simultaneously)
Diplopia复视
Paralysis
Numbness
Dysarthria
Ataxia 共济失调

Diabetes糖尿病
Patient: Recently I've been feeling very thirsty and passing a lot of urine, Is there any wrong with me?
最近我总觉得口渴和尿量很多。是有了什么毛病吧？
Doctor: How is you appetite? How do you feel otherwise?
你的胃口怎么样？一般健康状况好吗？

P: I've lost weight despite my good appetite, and I feel weak all the time.
尽管我的食欲很好，我的体重还是减轻了。我整天觉得很疲劳
D: Let me examine your urine. You may have diabetes.
我给你检查一下尿吧。很可能你得了糖尿病。
P: What is that? Can it be cured?这是什么意思？糖尿病能够治愈吗？
D: Diabetes is a chronic disease due to poor functioning of the pancreas. It upsets the metabolism of sugar, fat and protein. Right now, it can't be cured, but it can be controlled so that you can enjoy life and feel well. You should stick to a special diet and avoid sugar and sweets.糖尿病是一种慢性病，由于胰腺功能不良引起。它使糖、脂肪喝蛋白质的代谢发生异常。目前还没有治愈办法。但是可以被控制，因此你能生活得很愉快。你应坚持控制饮食，不吃糖和甜食。
P: Can I smoke?我能吸烟吗？
D: Smoking is harmful to anyone's health. Better give it up.吸烟对任何人都是有害的。我劝你戒烟。
P: Can I drink alcohol?我能饮酒吗？

D: In moderation. As you know alcohol contains calories and must be counted in your meal plan.可适当喝一点。你知道酒精能增加热卡，因此必须计算在你的食谱之内。
P:How can I keep to a good diet?
我怎样才能保持一个良好的饮食方案呢？
D: You should learn as much as you can about diabetes, have your urine tested regularly, stick to your diet, take your medicine and have some regular exercise. Then you can live a full, useful and meaningful life.
你应当尽量学习一些有过糖尿病的知识，定期检查你的小便。坚持食谱中的规定，按时服药。要有定量的运动。于是你能生活得美满、有益和有意义。

Symptoms of Diabetes(糖尿病)
• Few glucose can reach muscle cell
>weak and fatigue
• Breakdown protein to release energy
>feels hungry,loss weight
• Kidney extract excess glucose
>thirsty,frequent urinaion,kidney damage

消化系统疾病*
Peptic Ulcer 消化性溃疡
Patient: I have a pain in my stomach我胃疼。
Doctor: How long have you had it?疼了多久？
P: I have had it off and on ( intermittently) for the past three years. It has been really bad these past two weeks.
断断续续已经疼了三年，近两周来疼的很厉害。
D: Do you feel it only when your stomach is empty?
是在肚子空的时候才觉得疼痛吗？
P: Yes. After I eat, it goes away for a while.
是的，吃了东西以后疼痛缓解一会儿。
D: When do you get it?
什么时候才疼呢？
P: Usually when I get very nervous. Sometimes it wakes me up in the middle of the night.
通常是在我兴奋激动时，有时半夜把我疼醒了。
D: What kind of pain do you have?
是怎样一种疼痛？
P: It gives me a burning sensation.
象烧灼一样地疼。
D: Usually

how do you get relief?
平常您是怎样止疼的呢？
P: After I take some sodium bicarbonate, the pain goes away temporarily.
在服小苏打后，疼痛可暂时缓解。
D: Have you