Symptoms of Diseases of the Liver and Bile Ducts

When the physician is taking the patient’s medical history he must pay attention to the patient’s working and living conditions, the diet which the patient follows, the history of past diseases, particularly of those of the alimentary tract, and the condition of the nervous and endocrine systems, because a hepatic disease is often directly associated with these factors.

For example, overeating, particularly of fatty foods, alcoholism may sometimes suggest the diagnosis of the fatty degeneration of the liver. A persistent lesion of the liver may be observed after Botkin’s disease and in chronic infections. Involvement of the liver and bile ducts is often found after gastrointestinal diseases, gastritis being one of them.

The patient’s complaints of loss of weight, pain in the right hypochondrium and abdominal enlargement may contribute to the proper diagnosis of the diseases of the liver and bile ducts. Among the characteristic symptoms of a hepatic disease are yellowish colours of the skin, sclerae and of mucous membranes of the oral cavity, dilation of the veins in the umbilical area, tenderness in the left and right hypochondrium.

Palpation and percussion of the liver and spleen may supply important evidence for a diagnosis. The size of the liver may be enlarged or contracted, it may be soft or firm, its surface may be nodular, the lower border may be sharp – all these findings enable the physician not to doubt an adequate diagnosis.

IV. Переведите тест “Fractures” со словарем.

Fractures

Fractures are broken bones. Treatment by “bone-setters” was one of the oldest medical specialties. The treatment now available from a well-trained general practitioner or surgeon backed up by the facilities of a modern hospital usually makes possible good results in even the most severe fractures.

Types of fracture. There are many types. In a simple fracture the overlying skin remains intact. In a compound or open fracture, bone fragments stick through the skin, making a wound. In a green-stick fracture, most common in children with still flexible bones, the bone is split like the end of a green stick, one side being broken and the other bent. Colles’ fracture is a break in the lower end of the large bone of the forearm (radius) near the wrist; the lower fragment is so displaced that the hand and wrist look like a reversed silver fork. Bumper fracture is the break of one or both legs immediately below the knee, as the result of being hit by an automobile bumper. In some diseases bones break without application of violence; these are called spontaneous fractures or pathological fractures.

Fractures of the skull, neck, or spine are usually the most dangerous. In skull fractures the brain is often injured; bleeding from the ears, mouth, nose, or into the eyes is often a sign of skull fracture. In neck or spine fractures the spinal cord or the nerves coming out of it are crushed and pinched between fragments of the vertebrae. If the victim cannot move his fingers, his neck may be broken; if he cannot move his legs, his back may be broken.

First-aid for fractures is not simple. The most important thing is not to meddle in any way that might make matters worse; for example, to keep a simple fracture from becoming compound and to avoid damaging the spinal cord. Severe bleeding, of course, must be controlled. The patient should be kept warm and quiet, lying down, until professional help arrives.

Do not transport a fracture victim unless absolutely necessary. Do not move a person with broken limb until splints are applied. Any long enough rigid objects – broom handle, board, stick – can be used as an emergency splint. The splint should be padded and tied loosely so that it does not interfere with blood circulation. Do not attempt to set a broken bone.

The victim of broken back must be transported face downward. The victim of a broken neck must be carried face upward. Never tilt his head forward or sideways.

Treatment of fractures is threefold: (1) The fracture is first reduced, that is, the broken bones aligned in proper position by manipulation, traction (pulling), or surgery. This usually requires X-ray observation and anesthesia. (2) Reduced fragments must be held in place until they unite a process that may take a few to many weeks. This may require plaster casts, splints, traction frames, and insertion of metal nails, wires, screws, or plates in the bones. Complications must be prevented; for example, pressure sores and infections. (3) The function of the muscles and joints around the broken bone must be maintained and restored. This may require much physical therapy, including massage, graded exercises, application of heat.

Fractures generally heal more slowly in older persons. A particularly disabling and often slow-healing fracture common in older people is fracture of the neck or head of the femur (thigh bone). With continued proper treatment, however, these fractures do eventually heal. Discouragement is unwarranted.

Precaution. X-ray diagnosis is essential to proper fracture treatment. If you suspect that a bruise or blow has resulted in an underlying bone crack or “chip fracture” go to a doctor and take his advice about the bruised part X-rayed.

Тема раздела: Infectious Diseases.

Время изучения тем раздела: 9ч

Занятие 16

Тема: Infectious Diseases. Immunity. Diphtheria. Asepsis.

Грамматика: Условные предложения. Сослагательное наклонение.

Время изучения темы: 3 часа

Цель: Научиться переводить тексты по специальности; вести беседу на базе изученных текстов; осуществлять профессионально-ориентированное общение, пользуясь изученным лексико-грамматическим материалом

Задачи:

1) выучить и тренировать активную лексику

2) тренировать грамматические модели

3) тренировка навыков аналитического и информативного чтения, перевода, устного высказывания

4) научиться применять полученные знания на практике

I. Самостоятельная работа. (Home Assignments)

1. Определите значение слова “if”:

1) If there is common bile duct obstruction jaundice usually develops.

2) The surgeon wanted to know if all the surgical instruments necessary for the operation had already been adequately sterilized.

3) Persons who have been in contact with the sick may be infected with hepatitis if prophylactic vaccination against it is not carried out.

2. Прочтите предложения и сравните их с переводом на русский язык. Обратите внимание на выделенные сказуемые. Ответьте на вопросы:

I. a) If he is at the Institute tomorrow he will see my brother.	Если он будет в институте завтра, он увидит моего брата.
II. b) If he were at the Institute tomorrow he would see my brother. c) If you took this drug now you would feel an immediate relief.	Если бы он был в институте завтра, он увидел бы моего брата. Если бы вы приняли это лекарство сейчас, вы почувствовали бы немедленное облегчение.
III. d) If he had been at the Institute yesterday, he would have seen my brother. e) If he had taken this drug yesterday he would have felt an immediate relief.	Если бы он был в институте вчера, он увидел бы моего брата. Если бы он принял это лекарство вчера, он почувствовал бы немедленное облегчение.

1) Какое условие выражает предложение I (а), и к какому времени относится действие в этом предложении?

2) В каком времени стоят глаголы в I типе условных предложений? Как переводятся на русский язык эти предложения?

3) Какое условие выражают предложения II (b), (c), и к какому времени относится действие в этих предложениях?

4) В каком времени стоят глаголы во II типе условных предложений? Как они переводятся на русский язык?

5) Какое условие выражают предложения III (d), (е), и к какому времени относится действие в этих предложениях?

6) В каком времени стоят глаголы в III типе условных предложений? Как они переводятся на русский язык?

3. Переведите следующие предложения. Определите тип условных предложений:

1) If biopsy had revealed cancer cells in the lung, the patient would have been operated on.

2) If the temperature is extremely high viruses will not survive.

3) The gastric juice would contain much mucus if the examined patient had carcinoma.

4) The patient would not have developed severe anaemia, if he had not suffered profuse external bleeding because of a bad injury.

4. Дайте полную форму бессоюзных придаточных условных предложений:

1) Had obstruction not been controlled, the patient would have undergone an emergency surgery.

2) Could the nurse carry out this procedure herself, she would not ask the doctor to help her.

?3) Were I in your place, I should (would) discontinue penicillin treatment.

4) Had the pain not radiated to the substernal area, the diagnosis of angina pectoris would have been excluded.

5. Прочтите предложения, обратите внимание на выделенные слова и их перевод. Ответьте нВ вопросы и выполните задание:

a) If he were not ill he would be at the Institute today (tomorrow). Were he not ill, he would be at the Institute today (tomorrow). If he had not been ill he would have been at the Institute yesterday.	Если бы он не болел, он был бы в институте сегодня (завтра). Если бы он не болел, он был бы в институте вчера.
b) It is necessary that he should examine the patient immediately. It is desirable that she be at the clinic at 2 o’clock. It is important that he that he take this book.	Необходимо, чтобы он осмотрел больного немедленно. Желательно, чтобы она была в клинике в 2 часа. Важно, чтобы он взял эту книгу.
c) The doctor insists that this procedure be carried out immediately. I wish he be well again as soon as possible.	Врач настаивает, чтобы эта процедура была выполнена немедленно. Как я хотел бы, чтобы он выздоровел как можно скорее!
d) She looks as if (as though) she were ill.	Она выглядит так, как будто бы она больна.
e) You must keep your bed lest you should have a complication. He repeated his experiments many times so that he might get the exact data.	Вы должны лежать в постели, чтобы не было осложнения. Он повторял эксперименты много раз, чтобы можно было получить точные данные.

1) Что выражает сослагательное наклонение?

2) Как передается в английском языке сослагательное наклонение?

3) Определите виды придаточных предложений, в которых употребляется сослагательное наклонение?

4) Как образуется сослагательное наклонение в русском языке?

6. Переведите предложения и объясните перевод:

1) It is necessary that the group of blood be determined before the transfusion is given to the patient.

2) The physician suggested that the electrocardiogram should be repeated.

3) He looked as if he were very tired.

4) It is not very likely that hemoglobin level should increase in the course of the disease.

5) It is better to operate on immediately lest the appendix should rupture.

6) The doctor insisted that chemotherapy be discontinued.

7) I wish the findings of the laboratory analyses be better.

7. Прочтите слова, которые совпадают с русским значением, а затем слова, которые не совпадают:

immunity antidote

invasion specific

natural neutralize

absolute vital

8. Выучите следующие слова. Переведите предложения:

lack (v) – не хватать, недоставать

(n) – недостаток, нехватка, отсутствие

The patient was lacking red blood cells.

relative (a) – относительный

relative to smth – относительно чего-либо, по поводу чего-либо

Relative association was established in those two cases.

This article was relative to the latest developments in genetics.

previous (a) – предшествующий, предыдущий

The previous attack of pain was particularly severe.

injure (v) – повреждать, поражать, травмировать

The patient developed acute pain because of the injured leg.

inject (v) – вводить (лекарство); делать инъекцию

Tuberculin was injected to this patient.

subcutaneous (a) – подкожный

Subcutaneous injections were given to this patient daily.

employ (v) – применять, использовать

9. Образуйте новые слова при помощи префиксов и переведите их:

sub-: cutaneous, cortical, febrile, serous, sternal, mucous

in-: sufficient, direct, active, adequate, digestion, complete

10. 1) Прочтите текст “Immunity”. 2) Найдите и переведите предложение, содержащее сослагательное наклонение. 3) Выпишите английские эквиваленты следующих сочетаний: прямой контакт, особое свойство сопротивляемости, в (при) различных условиях, выздоровление наступает, наличие любой инфекции. 4) Напишите аннотацию текста:

Immunity

Infectious diseases are known to be caused by the invasion and growth of microorganisms in the human body. Infection may result from direct contact with patients or from indirect one.

But the human organism is known to have a specific capacity of resistance against infection, which is called immunity, it being natural and artificial. Under various conditions it may be entirely lacking, it may be relative, it rarely may be absolute. A previous attack of an infectious disease produces a more or less permanent protection against its subsequent infection.

In the course of their growth in the body many pathogenic microorganisms produce virulent poisons or toxins, they causing the characteristic symptoms of a particular disease. To meet the infection the cells of the body produce a chemical antidote which is specific for this particular infection and is known as an antitoxin. If the patient can produce a sufficient amount of this antidote to neutralize the toxins before the vital organs are injured recovery occurs. If the human body had not this capacity we should suffer from all infectious diseases.

If the toxin can be isolated from bacterial cultures and injected into men an artificial immunity can be produced which results from the formation of antitoxin.

The cellular elements of the tissues also take an active part in the protection of the body against the infection. The presence of any infection usually produces leucocytosis and bacteria in the tissues are surrounded by white cells or phagocytes which prevent the spread of bacteria destroying them.

If the reaction against invading bacteria is insufficient, vaccines may be injected subcutaneously to produce a more active resistance of the protective mechanisms of the body. Vaccines are employed not only to contribute to the treatment of a disease, but to establish an active artificial immunity.

II. Class Assignments

1. Translate the following sentences:

1) If Anton Leeuwnhock (1632 - 1723) had not discovered the specific power of lenses, he should not have seen the world of microbes.

2) The patient’s sclerae were yellow as if he had jaundice.

3) The patient must be given vaccination lest he should become infected.

4) Chronic gastritis would not be so dangerous to life if the patient were not so young.

5) It is likely that the symptoms should recur since the process of inflammation has not been controlled yet.

6) It is necessary that the patient be administered a strict diet to control gastric pains.

2. Pick out the appropriate phrase to end the sentences:

1) If the human body had no resistance capacity … .

(a) people would develop any infectious diseases; (b) even direct contacts with infected people would never result in diseases

2) If a previous attack of a certain infectious disease did not produce a more or less permanent immunity … .

(a) all of us would be immune (невосприимчивые) to any subsequent attack of this particular infection; (b) people would lack resistance to subsequent infection

3) If all of us had absolute immunity … .

(a) antitoxins would not be able to neutralize toxins; (b) no infectious disease would ever develop in the human body

3. Finish the sentences using Complex Object:

1) In the practical therapy class the students watched … .

(a) как сестра делала больным подкожные и внутримышечные инъекции; (b) как оперировали больного с закупоркой желчных протоков

2) The scientists have found … .

(a) что фагоциты окружают и разрушают бактерии, проникшие в ткани; (b) что антитоксины нейтрализуют действие токсинов

4. Pick out the sentences corresponding to the text “Immunity”:

1) a) Artificial immunity results from prophylactic vaccination. b) Artificial immunity is due to the formation of specific antitoxins.

2) a) Immunity may vary depending on various conditions. b) Immunity may be present only in certain persons.

3) a) Toxins produce the characteristic symptoms of a particular infectious disease. b) Some microorganisms, like mycobacterium tuberculosis, produce little or no toxin during growth.

5. 1) Read the text “Asepsis”. 2) Determine the meaning of the words in bold type from the context. 3) What did Paster say delivering his lecture on the theory of microbes? 4) What conclusion have you come to having read the text?