常用英语问诊.doc

69

English for doctors：Authentic consulting－room activities for doctors, dentists, students and nurses

From DXY.CN

1 PAST MEDICAL HISTORY
i 'd like to ask you about your past medical history.can you me whether you have had any childhood diseases?for example chickenpox ,measles,mumps or rubella
when i was small ,i had measles,chickenpox and whooping cough .but i don't think i ever had rubella
have you ever been in hospitalized for anything?or have you ever had an operation

well,i had my tonsils taken out when i was a child
have you had any major health problems since then
yes,i have diabetes
when were you first diagnosed with diabetes?what were your simptoms
i was diagnosed when i turned 14.i was always thirsty ,tired and depreassed
are you receiving any treatment for this
i have been getting insulin shots ever sinth
have you had your vaccinations
yes
good
did your referring physician give you a letter for me
yes ,here it is
2 FAMILY HISTORY
as far as you know,are there any illnesses that run in your family?
none that i know of, doctor
nothing like diabetes, high blood pressure, heart disease ,stroke,cancer,mental illness or anything like that?
oh i see! my father had a heart condition, and i have two my aunts who have diabetes
and is your father still alive
no, he isn't
how old was your father when he died
he was 68
what did he die off
he had a heart attack
did he suffer for a long time with this heard cindition before he died
oh no, it was very sudden
and your aunts? do you know what kind of diabetes they have? do they have to take insulin or tablets or are they just on a diet
they just take some pills, i think
you are married, i see,have you any children
yes, a boy and a girl
are they healthy
yes, they are
3 SOCIAL HISTORY
are you working right now
no , i have just been laid off
oh , i am sorry .what was your job
i was a manager for an import and export pany
i see . was it an office job or were you on your feet all day
i worked behind a desk
was it managerial,did you have a lot of responsibility
yes ,i was in charge of a large department
i see,quite stressful.now,tell me ,do you smoke
yes,i do. unfortunately, quite a lot
oh ,really? how much
all about 2 packs a day
how long have you been smoking
since i was about fourteen
have you ever try to quit smoking
yes , i have tried several times .but without success
what about driking?do you drink
yes ,sometimes with my friends
how much alcohol do you drink a day

let see.a couple of glasses of beer at lunch time.a wisky in the evening.and about half a bottle of wine with my dinner
that's quite a bit.how old were you when you start drinking
oh,about 17 ir 18, i suppose
what about your living conditions? where do you live
we living in a small apartment.we own it .but of course we are still paying the morgage on it
4 PRESENT PLAINTS
4 present plaints
1-4-1
what's the problem today
can you tell me what your symptoms are
have hou ever had these plains before
what's seems to bring this condition on
when did you start feeling poorly

1-4-dialogue a (1-4-dialogue b )
what seems to be the problem at the moment(today)
well,i have been feeling so poorly recently(ill lately)
i see . feeling poorly(ill).(now)what do you mean by that
i have been getting very short of breath
hm...how long has this been going on
for about 18 months ,i think
and were there any other symptoms before then or did it(this condition) start quite suddenly
i hadn't notice anything before then
so you haven't (didn't have any of)experence this symptom before
no , not that i can remember , doctor
i see.was there anything that seems to cause this(have caused these symptoms)
well,nothing(no,not) really.except maybe it gets really bad when i go up to london(new york) to see my sisiter
let's take a look(to begin with).i'll listen to your heart and lungs to begin with

1-4-5
a .what can i do for you today
how can i help you mr. jones
b .what do you mean by that
can you describe that in more detail
c .what are your symptoms
can you describe the changes that have occurred
d .did it start suddenly
did your condition change without any warning
e .what brings it on
what do you think causes your condition

5 PAIN
5 pain
1-5-1
head
do you have a splitting headache/throbbing/band-like/dull/aching/burning/sharp/stabbing/colicky/migraine/blinding/stress- induced/tension

tooth
do you have a sharp toothache
is your toothache dull/throbbing/stabbing/pulsating
is your tooth sensitive/aching/tender

lower back
is the pain in your back slow in onset\long in duration/dull/diffused/aching/steady/constant/severe/progressing poorly/localised/crushing/deep/mild

chest
is the pain in your chest burning
do you have a constricting pain in your chest
bursting/choking/squeezing/griping/pressing/crusching/sticking/jabbing/sharp/knife- like/fleeting/throbbing/dull/severe/stabbing/like a weight on it/like a band across it

abdomen
do you fell a sharp pain in your abdomen
dull/aching/gnawing/burning/cramping/colicky/diffused/localised/recurrent/constant/flank/intermittent/stabbing
do you get bloated
do you feel bloated
du you have any heartburn
do you have any indigestion

kidneys and urinary tract
do you have a sharp pain
du you have a dull ache
du you have severe disfort
burning/stinging/nagging/nigging/splitting/flank/back/abdominal/steady/low grade
do you have slight disfort

extremities
do you have a sharp pain in your shoulder
do you have a tingling pain in your hand
do you have a shooting pain in your foot
dull/burning /severe/pulsating/throbbing
do you have weakness in your hands
do you have numbness in your arms
do you have cramp
do you have an ache on your hand

1-5
dialogue a (dialogue b)
do you feel any pain
oh,yes . quite a bit
could you show me where it hurts
right here, doctor, in my chest
here,hm...is it always just in that spot
no, sometimes it moves around to here
i see.what kind of pain is it.can you descrie the pain
well,most of the time it feels like a cramp.but occasionally it is sharp and stabbing
does it e and go or do you have it all the time
well,it worse at times.it seems to e over me in waves.but mostly it's there all the time
does it start suddenly or build up slowly
it seems to build up gradually
what do you do when you get the(feel this) pain
well,there isn't much i can do.i just have to put up with it
and does anything in paticular seem to bring the pain on or make it worse
well,i find going upstairs difficult(it is more intense when climbing stairs).also when i have to cough or take a deepbreath it's terrible like a knife stabbing me

1-5-6
a. can you show me where it herts
b.could you describe what the pain feels like
c.how long have you had this pain
d.when does it e,when,does it go
e.does anything relieve the symptoms or make them worth
f.does the pain move to another part of your body
g.what brings it on

6 HEADACHE
6 headache
1-6-1
1 do you feel the pain at the top of your head
2 do you feel any pain in your temples
3 is the pain around your eyes
4 is the pain at the back of your head
5 do you have any pain in your forehead
6 does the pain move to your face
7 do you feel any pain around your ears
8 does the pain spread to your neck
9 does the pain seem to be eing from your neck
10 does the pain travel to your shoulders

1-6 dialogue a (dialogue b)
tell me about your headache
it es and goes
can you point out the painful area
it seems to be on the right side of my head
how long does the headache last when you get it(it es)
it varies.it can be between half an hour and four or five hours
when you get a headache ,does anything else happen at the same time
yes.often i feel sick(i am often nauseous).sometimes i actually vomit(throw up)
does the headache ever upset your eyes,for example , does your vision get blurred
it's not blurry.but i get flashing lights that seems to be in the right eye
what do you do when you get the headache
whll, i'm not ususlly able to carry on with what(i ususlly have to stop wtatever) i am doing,i have to go to a dark room and lie down
have you found any tablets(medication) that seems to have helped
sometimes if i take an aspirin early on ,it seems to help.at other times nothing seems to help much
does anybody else in your family have this type of a headache
yes,my mother used to suffer from migraines when she was younger
can you describe the (character of he ) pain.is it stabbing or more band-like, kind of pressing
it throbs.sort of stabbing ,i suppose(guess)

1-6-6
a can you point out the painful area
b how long does the headache last when you get it
c can you describe the pain
d when you get the headache,does anything happen at the same time
e what do you do when you get the headache
f have you found any medican that seems to have helped
g does anybody else in your family have this type of headache

7 VERTIGO
How would you describe your dizziness?
It’s as if I am falling to the left.
what does the disease spell constist for you?A kind of imbalance.
How long does the episode of dizziness last?
Sometimes an hour, sometimes a whole day.
In what body position do you feel dizzy?
Every time I squat or bend down and try to get up too quickly.

Do you ever suffer from dizziness? (get dizzy?)
Yes, quite often.
When does this happen?
When I get up too quickly.
Do you feel as if you are falling in a certain direction?
No, not really.
Does this dizziness feel like spinning or is it just a kind of unsteadiness.
It feels more like spinning.
How would you describe it? Is it as if the room is going around or do you feel as if it’s you that's going around.
It feels as if I am going around.
Do you have any other problems such as ringing in the ears.
Yes, sometimes.
Have you seen a consultant(specialist) about this?
Yes, she prescribed some medication for it, but it didn’t help at all.
Do you have any associated symptoms like blurred vision.
No, but I haven't noticed(not that I have noticed. )

8 BODY TEMPERATURE AND SWEAT
8 body temperature and sweat

1-8 dialogue a(dialogue b)
have you got a temperature(had any fever recently)
yes, doctor,i have been feeling quite flushed(warm) lately
is your temperature (constantly)high all the time or does it go up and down
it ususlly goes up( it is uaually higher) at night.but it is still high even during the day
what's the highest and the lowest it has been in the past few days
the highest was 104.the lowest was 100
and where did you take your temperature,under your arm or under your tongue(orally)
under my tongue(i measured it orally)
do you also have the shivers(chills)
yes, sometimes
do(did) your teeth chatter(rattle) or are the shivers(chills)milder than that
oh yes, they chatter(rattle).i've bitten my tongue several times already
do(did) you take anything for the fever
aspirin
does it help
no not really
have you been abroad( traveled) to any tropical or developing countries recently
yes, i just came back from tailand a few months ago
i see.do you perspire more than usual
yes, a lot, i am afraid
just when your work hard or also at other times
well,i never used to sweat much.but now i seems to break out in a sweat (at the drop of a hat)easily .my clothes often get soaking wet
do you feel shaky or weak at all
yes , practically all the time`

9 NAUSEA AND VOMITING
Do you just feel sick /nauseous/ or have a actually vomited?/thrown up/
oh, I am vomiting and it seems (I’m throwing up) all the time.
When did it all started?
About two months ago.
And how often does this happen?
About once a day, sometimes more.
When are you sick? Is it in morning or after you've eaten.
Well, it isn't really regular.
But does it get better or worse if you eat something?
Worse, I think.
When you vomit, do you bring up digested food, undigested food or bile?
Oh, it is usually more like bile
what colour is it? Green, black, yellow or red?
It seems to be a sort of yellowish green color.
Does it ever have blood in it or look like ground coffee?
no, never
Do you belch a lot/burp a lot/or have a bad /a nasty/ taste in your mouth?
Well, yes, doctor. I do belch a lot and I seem to suffer from a lot wind just lately. /and I have had a lot of gas lately/

10 DYSPN(O)EA
Dyspnea
Do you have any difficulty breathing?
What’s harder breathing in or breathing out?
Are you short of breath when you are resting ?
Can you lie flat in bed?
Is it relieved by sitting up in bed?
Do you have to stop frequently when you climb the stairs?
Have you ever had any breathing tests?

Dialogue a
How long have you had difficutly breathing ?
Since last week, doctor.
Is it very bad?

Yes, I feel as if I can’t get enough air.
Which is more difficult, breathing in or breathing out?
It is harder to breathing in.
Are you short of breath when you are resting or only when you doing something?
When I am rest, but it is worse when I try to do anything.
Can you lie flat in bed?
Oh no.
How many pillows do you use?
Three.
Do you ever wake up night feeling short of breath?
Yes, I do.
(If frightens me because when i wake up feeling as if i cann't breath.
What do you do when this happens? I mean, do you sit or stand up, does some movement help?
If I sit up, it helps a little.
Let me listen to your chest. I can hear few crackles and it sounds a big wheezy.

Dialogue B
How long have you had difficulty breezing?.
Scince last week, doctor.
Is it very bad?
Yes, I feel like I can't get enough air.
What’s harder, breath in or breath out?
It’s harder to breath in.

Are you short of breath, when you are resting, or only when you are doing something physical.
A little when I am resting, but it’s worse when I try to do anything physical.
Can you lie flat in bed?
Oh, no.
How many pillows do you use?
Three.
Do you often wake up night feeling short of breath?
Yes, I do. It’s scares me because I wake up feeling as if I can’t breath.
What do you do when this happens. I mean, do you sit or stand up? Does some movement help you breathe easier?
If I sit up, it helps a little.
Listen to your chest... I can hear a few crackles and it sounds a big wheezy.

how long have you had difficulty breathing? / how long have you been short of breath?
i've had difficulty breathing for about two weeks.
when is your breathing most diffcult?
i wheeze in the early hours.
which is more difficult,breathing in or breathing out?
breathing out is harder.
are you short of breath when you are resting or only when you are working?
i'm short of breath when i'm working.
can you lie flat in bed?/ can you sleep on your back?
yes, i can sleep on my back.
can you ever wake up at night because you are short of breath? /is your sleep disturbed?
yes,i eake up seve