1.

Use the questions in the box to complete the conversation at a doctor’s

consultation.

And have you had anything like this before? - How have you been sleeping? -
Have you suffered from any viral infections lately? - Can you describe the
pain to me? - How often have you had these pangs of pain? - How have you
been? - Would that be alright? - And what are your complaints? - And how
long have you had these symptoms? - Have you had any heart diseases in
your family? - And do you get nauseous at that time?

AT THE DOCTOR’S!
The patient enters the GP´s surgery.
P: Hello, doctor.
D: Good afternoon, Ms Martin. I´m Dr Pitt. Just have a seat, please.
P: Thank you, doctor.
D: I haven´t seen you for a good long time. __________How have you been?
_________________
P: Thank you for asking. I haven’t been feeling well recently.
D: I see. ________And what are your complaints? _________
P: You see, when I walk longer distances or do some gardening, I have pain, pain in
my chest. Mostly here (points at the chest), sometimes also in my shoulder and
sometimes I feel that my heart starts pounding.
D: ______________________Can you describe the pain to me?
_____________________________________
P: I wouldn´t say the pain is very bad but it´s very unpleasant and sometimes I´m out of
breath.
D: Does the pain come on only after exertion or during exertion or also at rest?
P: More often after exertion. When I sit or lie down, it usually goes away.
D: ______________________________How often have you had these pangs of pain?
_____________________________
P: I´m not sure. Maybe once a week. Usually the pain comes on at weekends when
there is a lot of work to do at home.
D: So, how are things at home? Any problems?
P: No, no problems at home. But I´ve been very busy at work. I´ve had to put in a lot
of extra hours.
D: I see. Do you feel tired?
P: Yes, sometimes I ´m very tired.
D: __________________________How have you been sleeping?
__________________________________ P: It
depends. Sometimes I have difficulty falling asleep but sometimes I sleep quite well.
D: You mentioned your heart is pounding.
P: Yes, doctor. When I´m having the pain.
D: _______________________And do you get nauseous at that time?
_____________________________________
P: Yes, sometimes.
D: ________________________And how long have you had these symptoms?
____________________________________
P: About two months.
D: ________________And have you had anything like this before?
____________________________________________
P: No, I haven´t.
D: _________________________Have you suffered from any viral infections lately?
___________________________________
P: Yes, in spring I was ill for some days. I had a sore throat, a runny nose and a cough.
D: Did you have a fever?
P: I didn´t take my temperature but maybe I had a mild fever too.
D:_________________________Have you had any heart diseases in your family?
____________________________________ Have there been any heart
attacks, strokes or high blood pressure?
P: My mother had high blood pressure and my grandfather died of a heart attack.
D: I see. If you don’t mind, I am going to take your blood pressure and then we´ll go to
the next room. There I can listen to your heart and lungs and we can have
your electrocardiogram made. _______________Would that be alright?
_________________

The doctor measures the patient’s blood pressure and has her ECG made.

D: When I listened to your heart, I could detect increased ______heart rate_______ and

the _______electrocardiogram_________showed some ____arrhythmia________. I
think it´s necessary to refer you to a cardiologist who can examine your heart
more thoroughly. Here is a letter of HYPERLINK
"javascript:void(0);"______referral_______, please make an HYPERLINK
"javascript:void(0);" ______appointment________  with a ________cardiologist
__________ at the reception. I am also going to prescribe you some _______-
medication ___________.
P: Thank you, doctor. I hope next time things will look better.
D: So.
P: Good-bye!
D: Good-bye!
2. Some words are missing in the last part of the conversation. What are these
words?
referral - cardiologist - electrocardiogram - medication - arrhythmia – appointment -
heart rate

3. Watch a video on taking a patient’s medical history and write a brief case report
(an example can be found on the PDF – medicine book, page. 11 – lesson13).
https://youtu.be/eiRIm6BOzP4
4. Have some clinical practice on https://geekymedics.com/a-rather-yellow-looking-
lady/. Read the clinical case of a lady with jaundice. Start by reading the history of
the presenting complaint.