ASIGNATURA : INGLES TECNICO II

CICLO : VI
SEMESTRE ACADEMICO : 2020-II
 UNIVERSIDAD PRIVADA SAN JUAN BAUTISTA
FACULTAD DE CIENCIAS DE LA SALUD
ESCUELA PROFESIONAL DE MEDICINA HUMANA
“Dr. Wilfredo Erwin Gardini Tuesta”

ACREDITADA POR SINEACE

RE ACREDITADA INTERNACIONALMENTE POR RIEV

Lesson 3
Gastrointestinal Unit
DOCENTES RESPONSABLES DE LA ASIGNATURA
SEDE LIMA : CONDORI ATAUCURI CARMEN
CHIRINOS MENDOZA ANTUANET
FILIAL ICA : FERNANDEZ DE LA CRUZ MIGUEL ANGEL
FILIAL CHINCHA : FELIX SEBASTIAN LUIS MANUEL
 Neurologic Unit

Learning Goals:
Learning about the signs and symptoms of a
gastrointestinal disease
Reading an admission note
Writing exercise
ESP grammar
Gastrointestinal Unit
Anatomy
 Warm-Up
I. Answer the following questions.
1. Can you identify the location of the epigastric area in your body?
________________________________________________________________

2. Amy said that she has experienced heartburn (pyrosis). Is heartburn a heart problem?
________________________________________________________________
3. Do you know what GERD is?
________________________________________________________________
4. What are the signs and symptoms (S/S) of GERD?
________________________________________________________________
5. What would be your advice to a person with GERD?
________________________________________________________________
 Warm-Up
II. Write down the meanings of the combining forms.
Combining Form Meaning
esophag/o
gastr/o
pylor/o
hepat/o
cholecyst/o
chol/e
choledoch/o
cholangi/o
pancreat/o
 Warm-Up
III. Complete the following chart using the list of combining forms and
organs on the left. Combining Form Organ
stomat/o
1. jejunum
lips
2. gums
3. swallow gingiv/o
4. ileum dent/o
5. teeth lingu/o
6. spleen tongue
7. mouth
phag/o
8. tongue
splen/o
9. intestine
10. duoden/o enter/o
11. gloss/o duodenum
12. cheil/o jejun/o
ile/o
 Warm-Up
IV. Complete the following chart with the correct nouns
and adjectives. Listen and repeat.

Noun Adjective
mouth oral
esophageal
stomach
duodenal
liver
pancreatic
digestion
 Pre-Reading
I. Medical Vocabulary from the Main Reading Do you know which group each of the following terms belongs to?
Write them in the correct boxes below.

1. hepatitis B (HBV)-related 9. frequently falling

liver cirrhosis asleep
2. Child B (Child-Pugh 10. disoriented to time
stage B) and place
3. ascites 11. weakness of all
4. T2N0M0 hepatocellular limbs
carcinoma (HCC) 12. hyponatremia
5. transcatheter arterial 13. high ammonia
chemoembolization (TACE) levels
6. pneumonia complicated 14. focal neurological
with hypoxic respiratory lesion
failure 15. constipation
7. s/p ET + MV 16. diarrhea
(endotracheal tube
insertion and mechanical 17. dyspnea
ventilation application) 18. mild cough with
8. drowsy whitish sputum
 Admission Note Reading
Chief Complaint . Change in level of consciousness since this morning
Present Illness
This 63-year-old man has a history of hepatitis B (HBV)-related liver cirrhosis (Child B)
and ascites. He also has T2N0M0 hepatocellular carcinoma (HCC), previously treated
four times with transcatheter arterial chemoembolization (TACE) with recurrence.
He also has hypertension controlled with antihypertensive agent. He received regular
follow-ups at our Metabolic OPD (outpatient department) and GI OPD and was
hospitalized due to pneumonia complicated with (C/W) hypoxic respiratory
failure s/p ET + MV (endotracheal tube insertion and mechanical ventilation
application) on February 17.
He was then discharged after his symptoms improved. Back at home, from the
Morning of February 23, his son found him drowsy, frequently falling asleep,
disoriented to time and place, and with weakness of all limbs. The patient was brought to
our ER again, where hyponatremia and high ammonia levels were noted. His son stated
that there was no fever or symptoms of focal neurological lesion, constipation, diarrhea,
or dyspnea. However, the patient was found to have a mild cough with whitish sputum in
the ER, and he was admitted for further evaluation and treatment.
 Reading
Reading Comprehension
Answer the questions. There can be more than one correct answer.
______ 1. How many times has the patient been treated for HCC with transcatheter arterial
chemoembolization (TACE)?
A. 1 time B. 2 times C. 3 times D. 4 times
______ 2. What medication did the patient take for his hypertension?
A. antihypertensive agent B. aspirin
C. nonsteroidal anti-inflammatory drugs (NSAIDs) p.r.n.
D. all of the above
______ 3. Why was the patient hospitalized on February 17?
A. pneumonia complicated with hypoxic respiratory failure
B. hepatitis B (HBV)-related liver cirrhosis
C. Child B
D. ascites
______ 4. How did the patient’s son find him on the morning of February 23?
A. drowsy B. frequently falling asleep
C. disoriented to time D. all of the above

______ 5. What symptoms were found at the ER?

A. hyponatremia and high ammonia levels B. fever
C. focal neurological lesion D. mild cough with whitish sputum
 Reading
Word Bank
 Reading Strategy
I. Skimming Exercise
Quickly read the admission note again and correct these sentences.

1. He receive regular follow-up at our Metabolic OPD and GI OPD.

________________________________________________________________

2. He is then discharged after his symptoms improve.

________________________________________________________________

3. However, the patient was found to have a mild cough with yellowish sputum in the ER.
________________________________________________________________
 Reading Strategy
II. Scanning for Symptoms
Symptoms are often important information in an admission note. You can
scan (quickly read for specific information) to find the important symptoms in
the passage.
1. This 63-year-old man has a history of HBV-related _______________
_______________ and _______________.

2. He also has _______________ controlled with _______________ agent.

3. Back at home, his son found him _______________, _______________ falling

asleep, _______________ to time and place, and with _______________ of
all limbs.
Reading Strategy
 Grammar Focus
1. how to express time • yesterday morning
a period of time in a day • this morning
• Monday morning
• Friday evening

a period of time on a specific day • 2/26 morning

2. find + O. + present participle / adj. (active voice)

His son found him drowsy.
His son found him falling asleep frequently.
The nurse found the patient lying on the floor.

3. be found + O. + infinitive / adj. (passive voice)

He was found to have a duodenal ulcer after esophagogastroduodenoscopy (EGD).
He was found to have been infected by helicobacter pylori (HP).
He was found disoriented to time.
His fecal occult blood test (FOBT) was found positive.
 Grammar Focus

Did you know?

1. PPD = packs per day
2. LMD = local medical doctor
 Guided Writing
Fill in the blanks with the following time phrases (A-F). Use each phrase only once.
A. During the periods D. during the past 6 weeks
B. until 6 weeks ago E. in the past (previously, prior to this admission)
C. periods of 3-to-4 day F. 3 days ago (3 days before, 3 days earlier)

The 75 y/o/f complains of a significant change in her bowel habits (1) _________. Her bowel
movements (BMs) were regular (once/day), (2) _________.

She experienced (3) _________ constipation alternating with non-bloody diarrhea. Although
most of her bowel movements resulted in formed stools which were brown in color
and of normal caliber, (4) _________, she passed a stool with streaks of blood on the surface.

(5) _________ of constipation, she felt bloated and had mild discomfort in the lower abdomen.
The pain was relieved by defecation.
The patient was not alarmed because she has suffered from bleeding hemorrhoids (6) _________.
 Listening for Fun
I. Listen to the conversation and tick the best answers.
1. What is the patient’s problem?
□ He has low blood pressure.
□ He is suffering from chest tightness.
□ He has passed black stools.

2. What is the patient’s description of his stools?

□ It’s like coffee grounds.
□ bloody and watery
□ sticky and malodorous
 Listening for Fun

II. Listen again and answer the following questions.

1. Why is it hard for Mr. Anderson to stick to his plans these days?
________________________________________________________________

2. Does Mr. Anderson drink martinis?

________________________________________________________________
3. Is Mr. Anderson taking any medication?
________________________________________________________________
 Listening for Fun

III. Listen to the conversation one more time and fill in the blanks.
Doctor: What brought you here?
Mr. Anderson: I have (1) _________ (2) _________ (3) ________ for the past three days.
I am wondering if that is why I feel kind of light- headed these days.
Doctor: Are there any other (4) _____________?
Mr. Anderson: I found that it’s harder for me to (5) __________ (6) __________
(7)________ my usual schedule because I get fatigued very easily.
Mr. Anderson: I have chronic epigastric burning which has been a problem
(8) __________ (9) ________ (10) ________ for the past several years.
Doctor: What about smoking?
Mr. Anderson: I smoke two packs of cigarettes a day (PPD) over the past twenty
years and have an (11) _____________ cigar.
 Supplementary Reading
Diffused Abdominal Pain Chief Complaint. Diffused abdominal pain for 3 days
Present Illness
This 54-year-old female had an appendectomy on February 2, 2013. This time,
she suffered from progressive abdominal pain. No fever, diarrhea, nausea, or
vomiting was noted. She visited a local hospital first and then was transferred to
our hospital. In the ER, diffused abdominal pain with moderate rebounding pain
and muscle guarding were noted. Abdominal CT showed mural thickening of
the small bowel (jejunum & proximal ileum) and minimal ascites, but no
definite pneumoperitoneum was seen.
Enteritis was suspected. Lab data showed WBC 8000, CRP 46 and
lipase 28. Liver function impairment was also noted. General surgery (GS) was
consulted, and no emergent operation was indicated. Abdominal pain improved
after NPO and IV infusion. She was admitted for further evaluation and follow-
up management.
 Supplementary Reading
I. ESP Vocabulary Building
Check the appropriate columns.

Synonym Antonym Family

abdominal / abdomen

local / general

progressive / progress

moderate / extreme

rebounding / bounding

suspected / assumed
 Supplementary Reading
II. Reading Comprehension
Answer the questions.

______ 1. What did the woman undergo on February 2, 2013?

A. appendectomy B. X-ray
C. gastroscopy D. organ transplant

______ 2. Which of the following is not one of the patient’s symptoms?

A. muscle guarding B. progressive abdominal pain
C. diarrhea D. diffused abdominal pain

______ 3. What didn’t the abdominal CT show?

A. mural thickening B. pneumoperitoneum
C. minimal ascites D. tumor

______ 4. What reduced the patient’s abdominal pain?

A. IV infusion B. NPO and IV infusion
C. passing tarry stools D. taking medicine
 Supplementary Reading

III. Cloze Test

Fill in the blanks with the choices provided.
1. This time, she suffered from ______________ abdominal pain.
(suppressive / massive / progressive)
2. She visited a local hospital first and then was transferred ______________
our hospital. (into / to be / to)
3. In the ER, ______________ abdominal pain with moderate rebounding
pain and muscle guarding were noted. (diffused / diffusing / diffusively)
4. Abdominal CT showed mural thickening of the small bowel (jejunum &
proximal ileum) and minimal ascites, but no ______________ pneumoperitoneum
was seen. (definitely / definite / definition)
 Lesson 3

Gastrointestinal Unit
-The End-
 Bibliografía Básica

Terms And Strategies For Medical Records Reading And Writing Student´s book; Judith Perry, Doug
Nienhuis, 2016, Live ABC Publisher