Professional __ English in Use Medicine Eric H. Glendinning Ron Howard Sp GAMBRIDGEContents INTRODUCTION BASICS. @® Health and itiness ‘A. Asking about health B Sickness © Recovery Parts of the body 1 A Parts of the body B Referring to parts ofthe body © Describing radiation of pain ©D Parts of the body 2 A The abdomen B The chest © The pelvis Functions of the body A Eating B The five senses © Other functions D Less common functions MEDICAL AND PARAMEDICAL PERSONNEL AND PLACES Medical practitioners 1 A Practitioners B Specialties © Choosing a specialty © Medical practitioners 2 A Hospital saff B Medical teams © Shifts Nurses ‘A Nursing grades B Suppoct workers 10 12 14 16 18 20 22 © Allied health professionals A Community health B Technicians © Prosthetists and orthotiss, D Opticians Hospitals A teroduction to a hospital © Ourptinrs © Innasent @ Primary care ‘A. The National Health Service B The practice eam © AGPS day EDUCATION AND TRAINING @® Medical education 1 A. Medical education in the UK B Extract from an undergraduate prospectus © A students view Medical education 2 A ‘The Foundation Programme B People in medical education © Medical qualifications The overseas doctor A Types of regisration B PLAB € PLAB stations and advice SYSTEMS, DISEASES AND ‘SYMPTOMS. Symptoms and signs {A Describing problems 8 Presentation © Taking about symptoms Blood A Full blood count B Anaemia © Pemicious anaemia 26 28 30 32 34 36 38Bones A Bones 8 Fractures © Treatment of fractures Childhood A Milestones. ‘Common infectious diseases Coeliac disease ® The endocrine system A Excess and deficiency B_ Negative feedback systems © Goutre D A lenerof refe D the eye A Parts of theeye B_ Examination of the eye © Retinopathy The gastrointestinal system ‘A Examination of the abdomen B The facces Gynaecology ‘A The female reproductive system B- Menstruation © A gynaecological consultation D Contraception The heart and circulation 1 [A Shortness of breath B Heart rhythm © Hear failure The heart and circulation 2 A. Physical examination 8 Famining the heart and circulation Infections A Fever B Microorganisms © Source and spread of infection 42 46 52 56 Mental illness 1A Psychiatric disorders 8 Substance abuse © Afesive disorders D Neurotic and stress-related disorders E_ Other types of functional disorder The nervous system 1 A Sensory loss B Motor loss © Loss of consciousness @® The nervous system 2 A. The motor system B Tendon reflexes © Coma Oncology A Neoplasms B Symptoms and signs of malignancy © © Treatment of tumours Pregnancy and childbirth A Childbirth B Laboor Presentation and ie The respiratory system Cough Ausealation The skin 1 Sore types of sin sion B Rashes The skin 2 AA Injuries ro the skin B Case report © Sores The urinary system A Urinary symptoms. B Urinalysis 58 60 62 64 66 68 70 72 74INVESTIGATIONS. Basic investigations A Ophthalmoscopy 8 Bhod pressure © Taking blood Laboratory tests AA Microbiology test request form B A Biochemistry and Haematalogy lab report C “Terms used to describe lab results © Endoscopy A Functions of endoscopy B Enceroscopy © Report of a diagnostic endoscopy X-ray and CT A Radiography and radiology B X-ray examination ©. Computed Tomography MRI and ultrasound ‘A Magnetic Resonance Imaging (MRI) B Ultrasound © Preparing for medical imaging D Describing medical imaging ECG A Uses of an ECG B ECG procedure © Arnormal ECG TREATMENT Medical treatment A Prescripsions and drugs B The British National Formulary Surgical treatment A The operating theatre B Instruments © Theoperation D An operation report 76 78 80 82 84 86 88 @ Therapies 92 A Radiotherapy and chemotherapy BA day in the life of a physiotherapist © Cognitive Behavioural Therapy PREVENTION Sereening and 94 immunization A Screening B Common screening tests © Immunization for travellers EPIDEMIOLOGY Epidemiology 96 A Rates B Incidence and prevalence © Association and causation ETHICS Medical ethies 98 A GMC guidelines B Bioethical issues © Asssted dying RESEARCH Research studies A Case-control stidies B Cohort studies © Trials D Variables 100 TAKING A HISTORY Taking a history 1 A A fill case history B Personal details © Talking about pain Taking a history 2 A Drug history 8 Family history C Social and personal history 102 104Taking a history 3 106 Reviewing the systems Asking about the central nervous system Patient ideas, concerns and expectations Phrasal verbs in hisory-taking coe> EXAMINATION Physical examination ‘A. Examining a patient B Giving instructions 108 Mental state examination 110 A. Some symptoms of psychiatric disorders B Mood © Typical questions from a mental state examination EXPLANATION Explaining diagnosis and management A Explanations B Using lay terms in explanations © Anexplanation of angina 112 ©) Discussing treatment 114 Offering options Advising a course of action Advising patienrs to avoid something Warnings © Giving bad news A. Principles of giving bad news BA consultant medical oncologists report coer 116 PRESENTATIONS Data presentation 1 A. Referring toa table or figure B- Comparing variables © Approximating. 18 Data presentation 2 A Line graphs 8 Pic chars and bar chars © Describing ends Research articles A The structure of a research article B Objectives C Main findings B® Abstracts A Structured abstracts B The BM} abstract Conference presentations A The structure of a presentation 8 The introduction © Signaling D Theconelusion © Case presentations A. Scetions ofa case presentation B Bedside presentation © Slides Appendix | Pars of the boy Appendix I Medical abbreviations Appendix II ‘Types of medication Appendix IV Syimptcans and pain Appendix V Verbs used in instructions Appendix VI Lay terms and definitions Answer key Index 120 122 124 126 128 130 131 143 144 145 146 147 16810 fl Health and illness Asking about health Health is the state of the body. When doctors want to know about a patient's usual health, they ask questions such as¢§ —————"/-— What is your general | (How's your health, health like? generally? — \ — 7 If you are in good health, you are well and have no illness (disease). If you are healthy you are normally well and can resist illness. If you are fit, you are well and strong, healthy fit unhealthy unfit unwell ini ml Ci) Tg tik gt iy tt Sickness Sickness has a similar meaning to illness. It is also used in the names of a few specific diseases, for example sleeping sickness and travel sickness. Patients also talk about sickness when they mean nausea and vomiting. Twas ill this morning. 1 felt unwell this morning. I vomited this morning, Hed sick. 1 feel ill 1 fee! unwell. Jam nauseous. | feel the need to vomit. ‘The combination sickness and diarrhoea means vomiting and diarrhoea. Recovery ‘When patients return to normal heaith aftr illness, they have recovered. We can also say: ‘good | The patent | madea full recovery. complete If patient's health is in the process of returning, to normal, the patient is improving. The ‘opposite is deteriorating. We can also say that the patients condition improved or deteriorated. In speech, we often use the verb get to talk about change: ore (anil = ORE Ifa patient is better, but then gets worse again, the patient has relapsed. oe [bee SR mene. Another word for aoe worse = 10 deteriorate especially in recurring, conditions such as cancer, is remission, a scare Hegotover the Two years later she remains. illness very quickly in complete remission.Complete the table with words from A and B opposite. The first one has been done for you a fitness ft health sickness Make word combinations using a word from each box. Look at B and C opposite to help you. ‘complete sickness feel health get remission poor sick travel over: ‘Complete the conversation. Look at B opposite to help you. Doctor: How are you feeling today? Patient: Not very (1) Doctor: How long have you been feeling (2) ? Patient: About a week Doctor: What is your (3) like normally? Patient: Very good. 'm usually quite (4) .--—-en-nme and (5) Doctor: What is the problem now? Patient: Irs my stomach. Doctor: Do you fel (6)... ? Patient: Yes. Doctor: Have you actually been (7) 2 Patient: No. Doctor: Have you had any serious (8) in the past? + Noy none at all Choose the correct word to complete each sentence. Look at B and C opposite to help you. 1 Her condition (deteriorated/improved) and she died. 2 He (relapsedirecovered) and was allowed to go home from hospital 3 The cause of sleeping (illnesssickness) was discovered in 1901 4 The patient made a full (remission/recovery}. 5 T have been in (poor/good) health for months and feel very fi. 6 It was a month before 1 (gor over / got better) the illness. 7 He seems to be rather (unhealkhy/unwell) ~his diet is bad and he never eee ed eRe MeeV4 Parts of the body 1 HD Parts oF the boay Most external parts of the body have ordinary English names as well as anatomical names. Doctors normally use the English names, even when talking to each other. There are a few exceptions where doctors use the anatomical name; these ate shown in brackets below jaw (mandible) neck shoulder armpit (axilla) upper arm dbow back =, buttock wrist \ 10 thigh 1 elf 12 keg 13 chest (thorax) 14 breast \ 15 stomach, tummy | (abdomen) 16 navel (umbilicus) 17 hip | 18 groin (inguinal region) 19 knee (patella = kneecap) 20 shin Limb means arm (upper limb) or leg (lower limb). The trunk is the body excluding the head and limbs, For a more detailed diagram showing parts of the body, see Appendix I on page 00. HEED Fe ferring to parts of the body fj [hip ‘When patients speak about their problem they I'm having trouble with my | shoulder. often refer to a part of the body: ee knee. x ‘The doctor often needs to ask about a part | Do you get any pain in of the boy an Describing radiation of pain A patient is telling the doctor about his back pain and the parts of the body it radiates to Ie starts in the back. Then it seems to go into the right) F buttock and down the back of the right thigh to the knee. S n Prefessonal Englth in Use Mediine24 2.4 Write the ordinary English words for the corresponding anatomical terms in the table using your medical knowledge. Look at A opposite to help you. een ‘Common word abdomen ‘carpus nates patella Complete the sentences using ordinary English words. Look at A and C opposite to help you. a A male patient describing angina pectoris: 4 It like a tightness across my (1) 4 and it goes up @) my (3) and into my left | Qe and (Soc the left (6) sewn b A male patient describing renal coke Ie starts (1) the loin and goes into the (2) serene and (3) nos into the testicle Complete the sentences, Look at A opposite to help you Anatomical term Patient's statement 1 inguinal swelling ye got a lump in the 2 abdominal pain My litle boy’ got a ache 3 periambilical rash T've gor some spots around my... - 4 thoracic pain I've gor a pain in the middle of the = 5 enlarged axillary node There's a painful swelling in my 6 mandibular pain Pe got a pain in my Je with words from the box. The first one has been done for you. Complete the t abdomen elbow ——loin—_wrist, thigh | chest am —_ leg finger i Uma a oN Zane co or 5 Make a list of the words from A apposite that you find it hard to remember or that Cee RO ee eee ere Professenal Engish in Use Medline 13BJ Parts of the body 2 The abdomen The main organs of the body have ordinary English names and doctors use these words. But when an adjective is needed they often use an anatomical word. For example, we can say disease of the liver or hepatic disease. Some abdominal organs, for example the pancreas, have no ordinary name. pancreas, duodenum. gall bladder. Se stomach right kidney left kidney ‘When doctors talk about the main parts of the digestive system, they use the words bowel oor intestine: the small intestine or the small bowel, the large intestine or the large bowel. ‘When speaking to patients, doctors may refer to the anus and rectum as the back passage, The chest ‘The chest (thorax) contains the organs of respiration and the heart. The main parts of the respiratory system are the airways and the lungs. The left lung is divided into two lobes, and the right into three. The airways consist of the larynx, the trachea (or windpipe), the right and left bronchus, and the bronchioles. The chest is separated from the abdomen by the diaphragm. A doctor is explaining the function of the bladder to a patient. ‘The bladder is situated in the pelvis, as you know, and itis connected to each kidney by a long tube called the ureter — one on each side. The ureters eatry the urine from the kidneys to the bladder, where itis stored until you decide to empty your bladder. When that happens, the urine passes down another tube, called the urethra, to the outside Professional Engis in Use Medicine F3.1 3.2 3.3 Label the diagram using words from the box. Look at B opposite to help you. lang, ‘Match the conditions (1-8) with the organs affected (a-h), using your medical knowledge. 1 hepatitis a bladder 2 pneumonia b gall bladder 3 nephitis © heart 4 gastric ulcer 4 kidney 5 cystitis ¢ liver 6 angina pectoris flung 7 cholecystitis 4 stomach 8 ulcerative colitis h large bowel ‘Complete the textbook extract. Look at A and C opposite to help you. Examination of the abdomen ‘Toexamine the patient for enlarged abdominal (1)... «frst fee! for the (2)... and the (3) nen (on the right side To do ths, sk the patient to take a deep breath, while pressing with the fingers upwards and inwards. Next, feel forthe right (4) 2s and then cross over to the other side fr the left 6) Still onthe lft side, palpate for an enlarged (6) Finally, moving to the lower abdomen, feel for the (8) whichis only felt if itis fll. foam veel) ou iny patients do not know the location or function of the spleen or the pancreas. How would you explain them to a patient, in English? Professional English in Use Medicine 5Functions of the body HY ating Yavsaat iit | «ees Youreina appetic-rou [| ofthefeod.te | butthen Ftiname before fssawrantand BR wanto et tastes good and Be deny you ‘vomiting all the the water brags ‘Your mouth you dew itand [> EMHEsomething T° food you've eaten your food. | waters filing | swallow vnpeatant. You "Semeting bat with saliva, | — disagreed with you HED 1h five senses In addition to smell and taste,the (‘YT senses include sight (or vision), What is your | s8ht | tikeed a hearing, and touch (also called sense ofsmetl (-———— sensation or feeling). To ask about conse of tate | normal? ) the senses, doctors use the questions: | Is your To ask about the sense of touch, doctors talk about muchos fou Siemcieah = ( Have you noxiced any numbness (in your fingers or toes}? Other functions i speech walking walk sat breathing inhale / breathe in / take a breath in breath respiration _| exhale / breathe out urination urinate rine micturition | micturate pass urine / pass water defecation | defecate | acces pass faeces / pass stools stools menstruation | menstruate (menstrual) period have a period (monthly) period When taking a history, dactors cam ask; r ] walking?) When auscultating a pariene’s trouble | | lungs, the doctor tells the patient: is breathir difficulty ——_— Do you haveany | Frias | Passing wine? Take a deep breath in, hold with your speech: your breath, then breathe when you breathe out completely. [ERED common tunevors ‘There are some things we do less often. When we are hor, we sweat, When we are nervous, we shake. When we are sad, we ery YZ Do y see | more than usual? iv J 16 Profesional English in Use Medcine41 42 4.3 Match the symptoms (1-5) to the questions (a-e), using your medical knowledge, What is your breathing like? Do you have any pain when you pass water? Do you have any difficulty with your speech? Do you have any trouble swallowing? Is your vision normal? 1 drsuria 2. dysphagia 3 diplopia 4 dysphasia 5 dyspnoea Patients are describing symproms of the conditions shown in brackets. Complete the sentences. Look at C and D opposite to help you 1 Te got pain and «in both feet. (peripheral neuropathy) 2 Pm having difficulty .. solid food. (oesophageal stricture) 3 Thave a lot of problems ..... (prostatic hypertrophy) 4 Pve been ._. more than usual, even when its not hot. (hyperthyroidism) 5 ve noticed that my hands when I'm not using them, (Parkinsonism) sn climb the stars. (left heart failure) 6 Dhave trouble - an ennnenm W Complete the sentences. Look at A, B, Cand D opposite to help you. eee (When I eat solid food, I have to .— (bite/chew) it for a long time before I can (swallow/eat) it eee (Do you have any pain when you... (passhave) stools?) / — 90 Thave no. (tastelappetite) and “7 Pve lost five kilos in the last few weeks. X a ar es (When did you lase (haverpass) a px “ $$ —_—_—_— At Bin The garden is full of flowers, but my... of smell has disappeared and I ca (sense/sensation) = ( Takea deep... oF ang od ou You think a patient may have diabetes, Think of five questions you can ask the patient to investigate further. Try to use the question types presented in this unit. Professenal Engish in Use Medicne 7