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Clinical Dialogues. Part 1. Woman complained of tightness in abdomen associated with belching( 嗳气 ) wind which did not relieve feeling. Symptoms usually began between 5 and 6 p.m. lasting several hours. Relieved by white mixture. (D=Doctor, P=Patient). - PowerPoint PPT Presentation


  • Clinical Dialogues

  • Part 1. Woman complained of tightness in abdomen associated with belching() wind which did not relieve feeling. Symptoms usually began between 5 and 6 p.m. lasting several hours. Relieved by white mixture.(D=Doctor, P=Patient)

  • D: Does the pain come on in the night?[come on: to startIf a cold, headache, or some other medical condition is coming on, it is just starting.e.g. I felt a cold coming on. ]P: Not often.

  • D: When it comes on, do you get up?P: Yes, I get up and walk around and it relieves.

  • Pain

  • I have a headache. I have a splitting headache. I have a stomach-ache.I feel a dull pain in the stomach.I seem to have pain all over. Im aching all over.

  • Its a dull sort of pain, and I dont know whats causing it.Its not a sharp pain; just sort of a dull ache.It all began yesterday.It started two days ago.It came on last night.It hurts terrible.

  • Its been hanging about for nearly a week. It keeps hanging on. It sort of hung on. Or: Just off and on. Ive got a pain in my back.

  • My eyes have been sore. My left foot hurts. My tooth is aching up again. I feel shivery and Ive got a sore throat. The pains been keeping me awake.

  • D: Does anything but the white mixture help it?P: Ive been on a strict diet for six months. I never touch milk.

  • on a diet: If you are on a diet, you are eating special kinds of food because you want to lose weight. touch: If you do not touch a particular kind of food or drink, you never eat it or drink it. e.g. Drink?No, she never touches the stuff.

  • D: Does any position help you?P: No, It comes on after tea, about five. I have my main meal midday.D: Have you been sick? (=Any vomiting?)P: Only at the beginning I was very sick then.

  • A sick person has an illness or some other problem with their health.To be sick means to bring up food through your mouth from your stomach.e.g. I think Im going to be sick.

  • Note that George is being sick means George is bringing up food from his stomach; George is sick means George is ill. However, George was sick can mean either George brought up food from his stomach or George was ill.

  • Vomit has the same meaning as be sick. Vomit is a fairly formal word.e.g. She was stricken with(...) pain and began to vomit.Throw up: In conversation, some people say throw up instead of be sick.e.g. I think Im going to throw up.Ive been throwing up.

  • D: Do you feel sick?(= Have you got any feeling of nausea?)(=Are you feeling nausea?)

  • P: Yes, I feel sick but I cant be sick. Feel sick: To feel sick means to feel that you want to be sick.e.g. Flying always makes me feel sick.

  • Note:ILL and sick are both used to say that that someone has a disease or some other problem with their health.e.g. Davis is ill.Your uncle is very sick.A sick child

  • Most British speakers do not use ill in front of a noun unless they are also using an adverb(). For example, they do not talk about an ill woman, but they might talk about a seriously ill woman. a terminally ill patient.

  • American and Scottish speakers sometimes use ill in front of a noun without using an adverb.We had to get medical help for our ill sisters.

  • D: Does the pain go through to the back?P: No, but it goes under my armpits. D: Whats your weight been doing? (=Have you lost weight recently?)P: Ive lost one and half stone but Ive been on a fat-free diet for six months.(or: My weight fell from 65kg. to 50 kg.)

  • Stone: a unit of weight in Great Britain, 14 pounds (6.4 kilograms) [14(6.4]

  • D: Whats your appetite like?(=How about your appetite?)(=Do you have any appetite?)

  • Whats (your)/(the) ? / What seems to be the ?Whats your appetite like?

  • Whats your complaint? ()=Whats your trouble?=Whats the trouble?=Whats bothering you?=What seems to be bothering you?

  • =What do you complain of?=Whats the matter with you?=What seems to be the matter?=Whats wrong with you?=What hurts you?=What seems to be the problem?=What seems to be the trouble?

  • P: Poor as ever.(=Ive got a bad appetite.)D: What about your bowels? (=Are your bowels acting properly?)(=Are your bowels regular?)P: I go twice a day, in the morning.

  • D: Is this a life-long habit?P: Yes.D: What do the motions look like? Well-formed, firm? P: Yes.D: What about the color? Has it changed?P: No.

  • D: Are they dark?P: Yes.D: Any sign of blood?P: No.D: Do they float on the water when you flush the lavatory? P: No.

  • D: Have you noticed an unpleasant smell?P: No.D: Have you noticed any difference in your water?P: No.D: Do you have to get up in the night?P: Once.

  • D: Your water hasnt been darker?P: No. D: Do you smoke?P: 10 a day.D: Do you drink?P: Not much.

  • D: Have you any other trouble?P: No, my anginas been very good. Ive not had much trouble with that for two years. -- Or:I feel absolutely rotten. [If you feel or look rotten, you feel or look ill]

  • I feel a bit off color. [Here, color means reddish-pink color in ones face that shows that ones health is good. ]I feel so ill.I feel rather unwell.I feel very bad.

  • I really feel terrible.I think Im dying. Im feeling rather out of sorts these days. [If you feel out of sorts, you feel slightly unwell, discontented, or annoyed. ]

  • Im under the weather. [If you say that you are under the weather, you mean that you feel slightly ill.]My whole body feels weak.I just feel all pooped out. [be pooped out: to be very tired; used mainly in informal American English.]

  • D: Youve also had trouble with your leg?P: Yes, they thought it was thrombosis ().D: When did you first start with your tummy trouble?Tummy: the human stomach or belly P: About 14 years ago.

  • D: The same, but more bothersome now? ?P: Yes, its tighter. Warning: 1) You do not say that someone becomes iller or more ill. You say that they become worse.2) You do not use ill or sick to say that someone has received an injury. You say that they are injured or hurt.

  • D: Have you ever been jaundiced? P: No.D: Is your tummy swollen when you feel like this? P: It feels as though Im going to burst.

  • D: Well, Id like to have a look at you. Will you get undressed and lie on the couch please? Or:Lie down on the couch there. Let me just see.Lie down on the couch there. Let me examine your belly.

  • Would you mind taking off all your clothes except your pants (for men)/except your pants and bra (for women)? Lie on the couch and cover yourself with the blanket.Well, lets see.Now slip off your coat and shirt, please.Strip to your waist, please.

  • Roll your sleeve up.Slip your shoes off and hop up on the bed.Slip off your shoes and socks.Let me check your lungs and heart.Let me listen to your lungs and heart.

  • Let me examine your stomach.Let me sound your lungs. ()Unbutton your shirt and let me listen to your lungs.Open your mouth and say Ah.Open your mouth please, and show me your tongue.

  • Put this thermometer() under your tongue.Ill have your temperature taken.Well, Id better take your blood pressure.May I take your blood pressure?Let me take your blood pressure.

  • Clinical Examination

  • During the examination the doctor asked the following questions:

  • D: Do you suffer from heartburn?P: No.D: Have you had any children?P: No.D: Are your hands always cold and red?P: Yes. A lovely color in the winter!

  • D: Just hold your breath for a moment. Breathe through your mouth. Show me where you get this pain. Your age?P: 72.D: Your periods finished when? P: When I was about 52 or 3.

  • D: Any tenderness here?P: Its a bit sore but not a lot. D: Does it catch you at all when you breathe?P: No.

  • D: Have you any pains in your legs?(=Do you have any pains in your legs?)P: I get cramp a bit when Im in bed.D: More in one leg than the other?P: I get it in my right leg; thats my varicose leg.

  • D: Apart from this, youve had no other serious illness in the last 14 years?P: No.D: Im going to take a drop of your blood and Id like you to have a stomach X-ray. Youll have to come specially, dont eat anything before and drink a white paste which outlines your stomach and well take some pictures.

  • Or:I think wed better give you a few tests.A blood test is necessary.Take your blood count first, please.Youre to have a blood test.

  • Im going to take a throat culture so well know for sure.You must have an electrocardiograph examination.Well, lets take an X-ray of your chest.Go and have your chest X-rayed.

  • BOWELS Medical words: faeces, stools, to defaecateColloquial words: motion, to have the bowels opened

  • Useful questions How often do you have your bowels opened? Is this a life-long habit? What do the motions look like? Are they quite well formed? What about the color? Has it changed?

  • Are they darker in color Have you ever seen any blood in your motions? Have you noticed an unpleasant smell? Do you ever have diarrhea() or constipation ()? Do you have to go in a hurry? Can you hold your motions?

  • Do you have to strain() to pass your motions? (tenesmus) , Do you take laxatives()? Do the motions float on the water after flushing the lavatory? Do you ever have any pain on passing your motions?

  • Do you get pain before, during or after passing your motions? Do you suffer from wind? Have you noticed any special food upsets your bowels? Have you lost any weight?

  • Descriptive wordsColor: black, br