Exercise 4

A doctor is examining a patient who is complaining of a cough. What a preliminary diagnosis would you like to make?

Doctor : How long have you had the cough ?

Patient: Oh, for years.

Doctor : Do you smoke ?

Patient: I used to smoke heavily, but I gave up a year ago.

Doctor : Do you cough up any phlegm?

Patient: Yes.

Doctor : What color is it?

Patient: Usually yellow.

Doctor : Have you ever noticed any blood in it ?

Patient: No.

Doctor : Any problems with your breathing?

Patient: Yes, I get very short of breath. I have to stop halfway up the

stairs to get my breath back.

Exercise 5

Read the follow dialogue and try to determine what specialist is taking a history

Doctor : Are you having any trouble with your waterworks?

Patient: Well , I do seem to have to go to the toilet more after than I

used to.

Doctor : How often is that?

Patient: It depends, but sometimes it is every hour or even more often.

Doctor : What about at night ? Do you have to get up at night?

Patient: Yes, nearly always two or three times.

Doctor : Do you get any burning or pain when you pass water?

Patient: No, not usually.

Doctor : Do you have any trouble getting started?

Patient: No.

Doctor : Is the stream normal? I mean is there still a good strong

flow?

Patient: Perhaps not quite so good as it used to be.

Doctor : Have you ever passed blood in the urine?

Patient: No, never.

Text 2 a patient is being instructed by the doctor

Mr. Scott, because you have been having this trouble with abdominal pain after fatty foods I think you may have some stones in your gall bladder. You will need to have a special X-ray done. This is called a cholecystogram and it will involve you taking some tablets before attending the X-ray department. They’ll take an ordinary X-ray first and then give you something fatty to eat, after which they’ll take pictures of the gall bladder area to see if your gall bladder is working properly and if there are any stones present. They may also do an ultrasonograph (ультразвуковой снимок). This is a way of examining your abdomen using a special machine which can show us pictures of your stomach and gall bladder using sound signals. It is not painful at all and it doesn’t take more than five or ten minutes to perform.

Text 3 Translate the following letter from Dr. Scott to Dr. Jones Dear Dr. Jones

Thank you to referring this pleasant 42-year-old salesman. These episodes of central chest pain which he describes with radiation to the L. arm and fingers sound very typical of angina. Physical examination was unrevealing.

I have checked various blood parameters including serum cholesterol and total glycerol. CXR (chest X-ray) was normal but exercise ECG showed ST depression.

Serum cholesterol was elevated at 7,2 mmol/l. I will be seeing him again next week to led him have these results. I shall arrange for him to be seen by the dietician and prescribe bezafibate 600mg daily. In view of the family history I am sure this will be worthwhile.

Yours sincerely,

Dr. Paul Scott.