Guía

semestral de
Inglés Técnico

Alejandra
Chávez
 Primer
parcial de
Inglés Técnico

Alejandra
Chávez
EDUCATION AND TRAINING

At some point in your life, you made the decision to pursue a career in Medicine. Now you
know that as a future doctor, you are expected to go through a lot of hard work and many
hours of study. Nevertheless, you also know that all your efforts and hard work will be
worth it in the end. Being a doctor is a very noble and rewarding profession, one that will
give you the opportunity to work in favor of people’s health and well-being.

Requirements to enter Medical School and obtain a medical degree may vary from country
to country. You know that in Mexico you have to complete the equivalent of the high
school level and then take and pass an entrance examination before being admitted into
med school.

The following are the general medical school requirements for the US:
•High school diploma •Undergraduate degree in the field of Sciences (3-4 years)
•Minimum undergraduate GPA (Grade Point Average) of 3.0 •Letters of recommendation
•Extracurricular activities •Minimum MCAT (Medical College Admission Test) exam result,
which is set by each university individually
There may be other requirements in place, depending on each university.
Just like there are different requirements to go to Medical School, requirements to obtain
a medical degree vary from country to country and even from school to school.
By now, you are probably acquainted with the requirements you will need to meet to
graduate from our Medical School, among which are:
- Earn 339 credits.
- Complete the
undergraduate rotational internship during years 4th, 5th, and 6th of your program.
- Do your social service internship.
-Fulfill some adminisnistrative requirements.

Nowadays, doctors in most countries will require further training and qualifications so as
to be competitive and meet the needs of their patients. After graduating, doctors will
apply to different programs in order to enhance their skills and advance their education.
There is a wide range of graduate programs that candidates can pursue to obtain a
specialty or subspecialty once they meet entry requirements.
In Mexico, doctors need to take the ENARM in order to be chosen for and admitted into
one of these programs.

Two useful concepts:
Residency - a period of
advanced medical training and education that normally follows graduation
from medical school and licensing to practice medicine and that consists of supervised
practice of a specialty in a hospital and in its outpatient department and instruction from
specialists on the hospital staff.
Fellowship - A period of supervised, sub- specialty medical training in the United States
and Canada that a physician may undertake after completing a specialty training program
or residency. Graduate students doing a fellowship receive an allowance of money for
teaching or doing research at a university.

Whatever path you choose to follow as a medical student and doctor, remember that
choosing the courses and programs that best match your skills and interests will be an
important factor in determining your level of professional satisfaction and success.
Always give it your all and in time you will reap the rewards. Remember that the harder
you work, the more successful you will become.



HOSPITAL DEPARTMENTS

Hospital departments
Hospitals vary widely in the services they offer and
therefore, in the departments they have. Hospitals may have acute services such as an
emergency department or specialist trauma center, burn unit, surgery, or urgent care.
These may then be backed up by more specialized units such as cardiology or coronary
care unit, intensive care unit, neurology, cancer center, and obstetrics and gynecology.

Emergency department.
This is an integral part of a
hospital that caters to life-or- death situations that need immediate medical attention. This
department may be divided into sub-units for trauma, burn, trauma surgery, and urgent
care.

Cardiology department.
This ward caters to patients diagnosed
with heart problems that need constant
monitoring and observation due to fluctuations and abnormalities in the blood circulation
and cardiac function.

Intensive care unit (ICU)
This department is where critically ill patients
with life support apparatuses get admitted to
making sure that they are being monitored by specially-trained staff nurses and doctors
who closely supervise their vital signs. This department may have three categories, the
pediatric, neonatal, or cardiovascular ICU.

Neurology, oncology, OB departments
These are specialized wards that deal with admitted patients suffering from neurological
problems, cancer, or pregnancy and reproductive complications, respectively.

Pharmacy
All medications prescribed to be taken in or out of the hospital can be purchased in this
department. Licensed pharmacists manage the distribution, dispensing, use, and supply of
medications within the entire hospital facility.

Radiology
This is where imaging tests
are performed. X-rays, CT-
scans, MRI, ultrasounds are just some of the diagnostic procedures that are performed in
this department.
HOSPITAL STAFF

A cardiologist is a doctor who specializes in diagnosing and treating diseases or conditions
of the heart and blood vessels.

A surgeon operates in the event of illness, injury, or disease, and can perform any number
of different surgical procedures on the body.

A pediatrician is a doctor who manages the health of your child, including physical,
behavior, and mental health issues.

An obstetrician is a doctor who specializes in pregnancy, childbirth, and a woman's
reproductive system.

A radiologist is a medical doctor that specializes in diagnosing injuries and diseases using
medical imaging.

A dermatologist is a medical doctor who specializes in treating the skin, hair, and nails.

A pharmacist prepares and dispenses prescriptions.

An anesthesiologist is a medical doctor who keeps a patient comfortable, safe and pain-
free during surgery.

A gastroenterologist is a medical doctor who specializes in the digestive system.

The neurologist treats disorders that affect the brain, spinal cord, and nerves.

A rheumatologist diagnoses and treats conditions that affect the joints, tendons,
ligaments, bones, and muscles.

An ophthalmologist is a medical doctor who specializes in eye and vision care.

A urologist diagnoses and treats diseases of the urinary tract in both men and women.






HOSPITAL EQUIPEMENT

HOSPITAL EQUIPEMENT : Any materials or devices used in providing care specifically in the
hospital.

Medical supplies are usually understood to mean articles which are low-cost, disposable,
and used in high enough volume that the purchasing department has standing orders in
place to ensure that the items of interest (e.g., gloves, gauze, needles,etc) are never out of
stock.

Biohazard waste containers are used for the disposal of waste that may be contaminated
with pathogens that present a danger to people and the environment. (Botes rojos ⚠ )

Examples of Hospital EQUIPEMENT and medical supplies: Wheelchair, Oxygen tank,
Pressure mattress, Gown (bata), Gauze (gasa), Syringe, Bedpans (pato para orinar).

One of the most important reasons why medical equipment is important is because it can
provide patients with better service and care. Most pieces of medical equipment that are
now coming up are high-quality and can detect things going wrong (or right) in the body
that they never could before.





RESPIRATORY SYSTEM

The respiratory system is the network of organs and tissues that help you breathe. It
includes your airways, lungs, and blood vessels. The muscles that power your lungs are
also part of the respiratory system. These parts work together to move oxygen throughout
the body and clean out waste gases like carbon dioxide.

In humans, the average breathing, or respiratory rate, mostly depends on age. A
newborn's normal breathing rate is about 40 to 60 times each minute and may slow to 30
to 40 times per minute when the baby is sleeping, according to Stanford Children's Health.
The average resting respiratory rate for adults is 12 to 16 breaths per minute, and up to 40
to 60 breaths per minute during exercise, according to the European Respiratory Society.

As we breathe, oxygen enters the nose or mouth and passes the sinuses, which are hollow
spaces in the skull that help regulate the temperature and humidity of the air we breathe.

From the sinus, air passes through the trachea, also called the windpipe, and into the
bronchial tubes, which are the two tubes that carry air into each lung. The bronchial tubes
are lined with tiny hairs that move back and forth, carrying mucus up and out. Mucus is a
sticky fluid that collects dust, germs and other matter that has invaded the lungs and is
what we expel when we sneeze and cough.

The bronchial tubes split up again to carry air into the lobes of each lung. The right lung
has three lobes while the left lung has only two, to accommodate room for the heart,
according to the American Lung Association. The lobes are filled with small, spongy sacs
called alveoli, which is where the exchange of oxygen and carbon dioxide occurs.

Lung diseases are some of the most common medical conditions in the world. Tens of
millions of people have lung disease in the U.S. alone. Smoking, infections, and genes
cause most lung diseases. Your lungs are part of a complex system, expanding and relaxing
thousands of times each day to bring in oxygen and send out carbon dioxide. Lung disease
can happen when there are problems in any part of this system.

COMMON DISEASES OF THE RESPIRATORY SYSTEM INCLUDES:
▪ Asthma
Your airways narrow and make too much mucus.

▪ Chronic obstructive pulmonary disease (COPD)
This long-term condition gets worse over time. It includes bronchitis and emphysema.

▪ Pneumonia
An infection causes inflammation in your alveoli. They might fill up with fluid or pus.



CIRCULATORY SYSTEM

Your circulatory system, also known as your cardiovascular system, is made up of your
heart and blood vessels. It works to transport oxygen and other nutrients to all the organs
and tissues in your body.

IMPORTANCE:
The Circulatory system also works to remove carbon dioxide and other waste products.
Having a healthy circulatory system is vital to your health and well-being.

PARTS:
Your circulatory system is made up of several parts, including your:
- Heart - Arteries
- Veins - Capillaries

Heart. This muscular organ works to pump blood throughout your body via an intricate
network of blood vessels.

Arteries: These thick-walled blood vessels carry oxygenated blood away from your heart.

Veins. These blood vessels carry deoxygenated blood back toward your heart.

Capillaries. These tiny blood vessels facilitate the exchange of oxygen, nutrients, and waste
between your circulatory system and your organs and tissues.

INTERESTING FACTS:
Your heart pumps about 5 liters of blood per minute, but it’s only about the size of your
fist.
In most adult humans, a normal resting heart rate is between 60 to 100 beats per minute.
The total length of all of the blood vessels in your body is about 60,000 miles.

WHEN TO SEEK MEDICAL CARE:
It’s important to see your doctor for regular checkups.
Your doctor can help monitor your cardiovascular health, as well as your blood pressure
and cholesterol levels

HOW TO KEEP THE CIRCULATORY SYSTEM HEALTHY:
-Regular cardiovascular exercise. -Healthy food.
-Maintain a moderate weight. -Manage stress
-Limit sitting -Quit smoking
-See your doctor regularly.

DYGESTIVE SYSTEM

FUNCTIONS:
The digestive system has three main functions: digestion of food, absorption of nutrients,
and elimination of solid food waste.

DIGESTION
It is the process of breaking down food into components the body can absorb.

ABSORPTION
It is the process in which substances pass into the bloodstream, where they can circulate
throughout the body. Absorption of nutrients occurs mainly in the small intestine.

ELIMINATION
Any remaining matter from food that cannot be digested and absorbed passes into the
large intestine as waste. The waste later passes out of the body through the anus in the
process of elimination.

PARTS:
The esophagus is a muscular tube that contracts in a synchronized fashion (peristalsis) to
move food down towards the stomach. The esophagus has no other digestive functions.
The stomach is a sac-like organ in which food is further digested both mechanically and
chemically.
Acid and enzymes are secreted that continue the breakdown process of the food. The
stomach muscles further mix the food.
Then, it is pushed into the duodenum (the first part of the small intestine).

Small intestine
The small intestine is a narrow tube about 7 meters (23 feet) long in adults. It is the site of
most chemical digestion and virtually all absorption.
The small intestine has three segments.
-duodenum -jejunum
-ileum

The large intestine is a wide tube that connects the small intestine with the anus. It also
consists of three parts: the cecum (or caecum), colon, and rectum.
The role of the lower GI tract is to solidify the waste product (by absorbing water), store
the waste product until it can be evacuated and help with the evacuation process.

Three accessory digestive organs
-pancreas -liver -gallbladder

Diseases of the Digestive System
Many diseases can affect the digestive system. Three of the most common are food
allergies, ulcers, and heartburn.
Food allergies occur when the immune system reacts to substances in food as though they
were harmful.
Ulcers are sores in the lining of the stomach or duodenum that are usually caused by a
bacterial infection. Symptoms typically include abdominal pain and bleeding.
Heartburn is a painful burning sensation in the chest caused by stomach acid backing up
into the esophagus.
NERVOUS SYSTEM

The nervous system in a human is made of the brain, spinal cord, sensory organs and all
the neurons that serve as communication channels between the various organs of the
body.

NEURONS
The Nervous System is primarily made of a single type of cell called the neuron.
Colloquially, they are also called nerve cells.

Neurons are made of a central cell body and a number of extensions. The cell body is also
known as the soma, and extensions can be either dendrites or axons.

PERFORMANCE OF THE NEURONS
Neurons can form connections with each other to create circuits and networks that
influence learning, perception, behavior, and even create predictable physiological
responses to external stimuli.

The primary function of the nervous system is to receive information and to generate a
response to a given stimulus.




PERCEIVING AND RESPONDING TO THE SENSES
Among the primary modes of input into the nervous system are the electrical impulses
that arise from sense organs. Touch, sound, sight, smell, and taste are conveyed to the
nervous system, in order to integrate information and assess the nature of the external
world.

ANATOMY
The anatomy of the nervous system in humans consists of the brain and spinal cord, along
with the primary sense organs and all the nerves associated with these organs. The brain
and the spinal cord form the central nervous system .


HOW TO KEEP YOUR NERVOUS SYSTEM HEALTHY
Avoid smoking and avoid drinking excessive alcohol. Eat a balanced diet that includes good
levels of B-12 and D vitamins, as well as healthy fats.


ENDOCRINE SYSTEM

The endocrine system is the collection of glands that produce hormones that regulate
metabolism, growth and development, tissue function, sexual function, reproduction,
sleep, and mood, among other things.

A gland is an organ that makes and puts out hormones that do a specific job in your body.
Endocrine glands release the substances they make into your bloodstream.

Hypothalamus
While some people don’t consider it a gland, the hypothalamus produces multiple
hormones that control the pituitary gland. It’s also involved in regulating many functions,
including sleep-wake cycles, body temperature, and appetite. It can also regulate the
function of other endocrine glands.

The pineal body is in the middle of the brain. It produces the hormone melatonin, which
helps the body know when it's time to sleep.

An adrenal gland is located on top of each kidney. Like many glands, the adrenal glands
work hand-in-hand with the hypothalamus and pituitary gland. The adrenal glands make
and release hormones and that maintain blood pressure and regulate metabolism.

The pituitary gland is located below the hypothalamus. The hormones it produces affect
growth and reproduction. They can also control the function of other endocrine glands.

The thyroid’s main role in the endocrine system is to regulate your metabolism, which is
your body’s ability to break down food and convert it to energy. Food essentially fuels the
body, and each of our bodies uses that fuel at different rates. This is why you often hear
about some people having a “fast” metabolism and others having a “slow” metabolism.



REPRODUCTIVE SYSTEM

The main external structures of the female reproductive system include:
• Labia majora: enclose and protect the other external reproductive organs.
• Labia minora: lie just inside the labia majora, and surround the openings to the vagina
and urethra
• Bartholin’s glands: These glands are located next to the vaginal opening on each side and
produce a fluid secretion.
• Clitoris: a small, sensitive protrusion that is comparable to the penis in males.

The internal reproductive organs include:
• Vagina: The vagina is a canal that joins the cervix to the outside of the body.
• Uterus: The uterus is a hollow, pear-shaped organ that is the home to a developing fetus.
• Ovaries: The ovaries are small, oval-shaped glands that are located on either side of the
uterus. The ovaries produce eggs and hormones.
• Fallopian tubes: These are narrow tubes that are attached to the upper part of the
uterus and serve as pathways for the ova (egg cells) to travel from the ovaries to the
uterus.

The female reproductive system provides several functions. The ovaries produce the egg
cells, called the ova or oocytes. The oocytes are then transported to the fallopian tube
where fertilization by a sperm may occur. The fertilized egg then moves to the uterus.
Once in the uterus, the fertilized egg can implant into thickened uterine lining and
continue to develop. If implantation does not take place, the uterine lining is shed as
menstrual flow.

Common diseases
• Uterine Fibroids. • Gynecologic Cancer. • Interstitial Cystitis.
• Polycystic Ovary Syndrome (PCOS) • Sexually Transmitted Diseases (STDs)






The external structures of the male reproductive system are:
Penis — The penis is the male organ for sexual intercourse Scrotum — The scrotum is the
loose pouch-like sac of skin
that hangs behind the penis. It contains the testicles.
Testicles (testes) — The testes are oval organs about the size of very large olives that lie in
the scrotum. The testes are responsible for making testosterone and for producing sperm.
Epididymis —It stores the sperm cells that are produced in the testes.

The internal organs of the male reproductive system, also called accessory organs, include
the following:
• Vas deferens — It is a long, muscular tube that travels from the epididymis into the
pelvic cavity, to just behind the bladder. It transports mature sperm to the urethra in
preparation for ejaculation.
• Ejaculatory ducts — These are formed by the fusion of the vas deferens and the seminal
vesicles. The ejaculatory ducts empty into the urethra.
• Urethra — The urethra is the tube that carries urine from the bladder to outside of the
body. In males, it has the additional function of expelling (ejaculating) semen.
• Seminal vesicles — The seminal vesicles are sac-like pouches that attach to the vas
deferens near the base of the bladder.
• Prostate gland — The prostate gland is a walnut-sized structure that is located below the
urinary bladder in front of the rectum.

The organs of the male reproductive system are specialized for the following functions:
• To produce, maintain and transport sperm
• To discharge sperm within the female
reproductive tract
• To produce and secrete male sex hormones

Common diseases:
• Prostate cancer. • Testicular cancer.
• Enlarged prostate • Erectile dysfunction.
• Male infertility. • Undescended testicle.


URINARY SYSTEM

The urinary system is also known as the renal system. It produces, stores and eliminates
urine, the fluid waste excreted by the kidneys. The urinary system's function is to filter
blood and create urine as a waste by-product. The kidneys make urine by filtering wastes
and extra water from blood. Urine travels from the kidneys through two thin tubes called
ureters and fills the bladder. When the bladder is full, a person urinates through the
urethra to eliminate the waste.
The organs of the urinary system include the kidneys, renal pelvis, ureters, bladder and
urethra.

• Two kidneys. This pair of purplish-brown organs is located below the ribs toward the
middle of the back. Their function is to:
o Remove waste products and drugs from the body
o Balance the body's fluids
o Release hormones to regulate blood
pressure
o Control production of red blood cells

Two ureters. These narrow tubes carry urine from the kidneys to the bladder. Muscles in
the ureter walls continually tighten and relax forcing urine downward, away from the
kidneys. If urine backs up, or is allowed to stand still, a kidney infection can develop. About
every 10 to 15 seconds, small amounts of urine are emptied into the bladder from the
ureters.

Bladder. This triangle-shaped, hollow organ is located in the lower abdomen. It is held in
place by ligaments that are attached to other organs and the pelvic bones. The bladder's
walls relax and expand to store urine, and contract and flatten to empty urine through the
urethra. The typical healthy adult bladder can store up to two cups of urine for two to five
hours.

Urethra. This tube allows urine to pass outside the body. The brain signals the bladder
muscles to tighten, which squeezes urine out of the bladder. At the same time, the brain
signals the sphincter muscles to relax to let urine exit the bladder through the urethra.
When all the signals occur in the correct order, normal urination occurs.

Diseases of the urinary system
Different specialists treat urinary system ailments. Nephrologists treat kidney diseases,
while urologists treat problems with the urinary tract, including the kidneys, adrenal
glands, ureters, bladder and urethra.

Kidney stones are clumps of calcium oxalate that can be found anywhere in the urinary
tract. Kidney stones form when chemicals in the urine become concentrated enough to
form a solid mass. They can cause pain in the back and sides, as well as blood in the urine.
Many kidney stones can be treated with minimally invasive therapy, such as extracorporeal
shock wave lithotripsy, which disintegrates the kidney stones with shock waves.

Urinary tract infections (UTIs) occur when bacteria enter the urinary tract; they can affect
the urethra, bladder or even the kidneys. While UTIs are more common in women, they
can also occur in men.

Incontinence is another common disease of the urinary system. The most common
bladder problems in women are frequent urges to urinate and leakage of urine. The most
common bladder problems in men are frequent urination at nights and incomplete
bladder emptying. This is usually due to an enlarged prostate causing obstruction of
bladder emptying.

Interstitial cystitis (IC), also called painful bladder syndrome, is a chronic bladder condition,
primarily in women, that causes bladder pressure and pain and, sometimes, pelvic pain to
varying degrees. It can cause bladder scarring and can make the bladder less elastic.

Prostatitis is a swelling of the prostate gland and, therefore, can only occur in men. Often
caused by advanced age, symptoms include urinary urgency and frequency, pelvic pain and
pain during urination.

Kidney failure, also called renal failure and chronic kidney disease, can be a temporary
(often acute) condition or can become a chronic condition resulting in the inability of the
kidneys to filter waste from the blood. Conditions, such as diabetes and hypertension, can
cause chronic kidney disease. Acute cases may be caused by trauma or other damage and
may improve over time with treatment. However, renal disease may lead to chronic kidney
failure, which may require dialysis treatments or even a kidney transplant.

Bladder cancer is more frequent in men and the elderly. The symptoms, including back or
pelvic pain, difficulty urinating and urgent/and or frequent urination, mimic other diseases
or disorders of the urinary system.




GRAMMAR

Alejandra Chávez
 The Present Simple

The present simple (also called the simple present) is a very widely used verb structure in English.

We use the simple present to talk about

• General truths and laws of nature: The sun rises in the east and sets in the west.
• Routines and habits: I get up at 6:00 a.m. every day.
• Permanent states: My brother works as an HR consultant.

We often use the simple present with adverbs of frequency

(always/usually/often/sometimes/rarely/never): I always get up at 6 o’clock. / It often rains in
September.

Remember the patterns to follow:

Positive: I, you, we, you, they + base form of verb / he, she, it + base form of verb +s /es

Negative: I, you, we, you, they + don’t + base form of verb / he, she, it + doesn’t + base form of
verb

Question: Do + I, you, we, you, they + base form of verb / Does + he, she, it + base form of verb

Positive
I work Negative
we like I
you do we do not (don’t) work
they have you like
he works they do
she likes he does not (doesn’t) have
it does she
has it

Question
Do I
we work…?
you like…?
they do…?
Does he have…?
she
it
 The Impersonal “It”

The personal pronoun “it” is used in many ways in English.

• It is used as an “empty” subject (with no real meaning) in expressions referring to time,

weather and temperature. Look at the following examples and contrast them with the
Spanish structure.
It’s eight o’clock. (Use of pronoun is Son las ocho en punto. (Tacit subject, no
mandatory) pronoun)
It’s Monday. Es lunes.
It rained last weekend. Llovió el fin de semana pasado.
It can be very warm in September. Puede hacer mucho calor en septiembre.

• It can be used as an “introductory” or “preparatory” subject or object. Here are some

examples:
It’s difficult to remember all their names.
He made it clear that he didn’t want to speak to me.

• It can mean “the present situation.”

I have so much work I don’t know where to start. It’s awful!
It’s lovely in here! Let’s stay here.

• It can refer to a person when we are identifying somebody (saying who somebody is).
“Who’s that?” – “It’s John.”
A very attractive young woman stood up and shook hands with them. It was Miss
Universe.

Students of English whose first language is Spanish sometimes tend to leave out the
pronoun “it,” but it cannot be left out. Compare:

Incorrect: Correct:
*Is raining. It’s raining.
*She loved the picture because was She loved the picture because it was
beautiful. beautiful.
“Have some chocolate.” – “No, I don’t “Have some chocolate.” – “No, I don’t like
like.” it.”

Notice that the subject pronoun “it” (like any other subject pronoun) cannot normally be
used if there is already a subject in the sentence.

Incorrect: Correct:
* My house it is beautiful. My house is beautiful.
* The weather it is hot. The weather is hot.
* She loves it the car. She loves the car.
 The Imperative

In expressions like Have a drink, Come here, Sleep well, the verb forms have, come, and sleep can
be called “imperatives.” The imperative has exactly the same form as the infinitive without to
(base form of the verb); it is used for giving orders, making suggestions, and encouraging people to
do things. Note the following points:

1. The imperative does not usually have a subject, but it can be used with one (a noun or pronoun)
if it is necessary to make it clear who is being spoken to.

- Mary come here; the rest of you stay where you are.

- Somebody answer the phone!

- Nobody move.

- Relax, everybody.

2. An imperative can be made more emphatic by putting do before it. This often happens in polite
requests, complaints and apologies.

- Do sit down.

- Do forgive me – I didn’t mean to interrupt.

- Do try to make less noise, children.

3. Negative imperatives are constructed with do not (or don’t).

- Don’t worry.

- Do not lean out of the window.

4. Always and never come before imperatives.

- Always remember to smile.

- Never speak to me like that again.

The English imperative structure is simpler than its equivalent in the Spanish language, which has
several forms. Compare:

English Spanish
Please clean your room! ¡Por favor limpia tu cuarto! (informal –
speaking to one person)
¡Por favor limpie su cuarto! (formal – speaking
to one person)
¡Por favor limpien su cuarto! (speaking to
more than one person)
¡Por favor limpiad vuestro cuarto! (speaking to
more than one person, Spanish from Spain
only)
 The Present Progressive (also called Present Continuous)

The present progressive tense is made with a present form of the verb “be” (am, is, are) + the
main verb of the sentence in its -ing form.

- The most common use of the present progressive is to talk about actions and situations
that are already going on at the time of speaking.
- Hurry up! We’re all waiting for you.
- Why are you crying? Is something wrong?

- The present progressive is often used to talk about developing or changing situations.

- The weather’s getting colder and colder.

- The country’s railroad system is gradually being improved.

- The present progressive is used to talk about temporary situations. It is not used to talk about
permanent situations, or about regular happenings or habits. For these, we generally use the
present simple tense. Compare:

- My sister’s living at home for the moment.

- You live in Guadalajara, don’t you?

- Why’s that girl standing on the table?

- The castle stands on a hill just outside the town.

- I’m seeing a lot of Monica these days.

- She sees her analyst twice a week.

- I think the cat’s going mad.

- I go to the mountains about twice a year.

- The present progressive is also used to talk about future arrangements.

- We’re probably spending next weekend at home.

- What are you doing this evening?

Model

I am (not) -ing I’m working.

He Tom is writing a letter.
She is (not) -ing She isn’t eating.
It The telephone is ringing.
We We’re having dinner.
You are (not) - ing You’re not listening to me.
They The children are doing their homework.
 The Past Simple

The past simple (also called the simple past) is a very widely used verb structure in English.

We use the past simple for many kinds of past events: short, quickly finished actions and
happenings, longer situations, and repeated events.

• I broke a glass last night.

• I spent my childhood in the Midwest.
• Regularly every summer, I got a job for a few weeks.

The past simple is common in stories and descriptions of past events, e.g. One day the princess
decided that she didn’t like staying at home all day, so she told her father that she wanted to get
a job…

The simple past is often used with words referring to finished times.

I saw Jack yesterday morning.

Remember the patterns to follow: Positive

Regular verbs I
you
Positive: I, you, he, she, it, we, you, they + base form of verb + -ed he
she played
Negative: I, you, he, she, it, we, you, they + didn’t (did not) + base form of it
verb we
you
Question: Did + I, you, he, she, it, we, you, they + base form of verb
they

Negative Question
I I
you you
he he
she did not (didn’t) play Did she play
it it
we we
you you
they they

Irregular verbs

Irregular verbs follow the same patterns, but they have to be memorized. If you do not know
them, find a list of irregular verbs in a book or online.

Model:

Positive: I, you, he, she, it, we, you, they wrote

Negative: I, you, he, she, it, we, you, they did not (didn’t) write
Question: Did I, you, he, she, it, we, you, they write…?
 Comparatives and Superlatives

We use a comparative to compare one person, thing, action, event or group with another person,
thing, etc. We use a superlative to compare somebody/something with the whole group that
he/she/it belongs to.

Compare:

- Eugene is taller than his three brothers.

Eugene is the tallest of the four boys.
- Raúl’s accent is better than Tony’s.
Raúl’s accent is the best in the class.
- Tom plays better than everybody else in the team.
He’s the best in the team.

One-syllable adjectives normally have comparatives and superlative endings in -er, -est.

Adjective Comparative Superlative

old older oldest Most adjectives:

tall taller tallest + -er, -est
cheap cheaper cheapest

late later latest Adjectives ending in -e:

nice nicer nicest + -r, -st.

fat fatter fattest One vowel + one consonant: double consonant.

big bigger biggest
thin thinner thinnest

Two syllable adjectives ending in -y have -ier and iest.

happy happier happiest

easy easier easiest

Longer adjectives of three or more syllables have more and most.

intelligent more intelligent most intelligent

practical more practical most practical

beautiful more beautiful most beautiful

Irregular comparatives

Adjective Comparative Superlative

 good better best

bad worse worst

far farther/further farthest/furthest

Than: After comparatives we use than, not that or as, e.g. Today’s hotter than yesterday.

Definite article: We normally use the definite article “the” with the superlative, e.g. Canada is the
largest country in North America.
 Segundo
parcial de
Inglés Técnico

Alejandra
Chávez
NEUROLOGY

It is the medical specialty concerned with the diagnosis and treatment of
disorders of the nervous system, which includes the brain, the spinal cord,
and the nerves.

THE CENTRAL NERVOUS SYSTEM
The central nervous system is made up of the brain and spinal cord.
It controls all parts of the body. It receives and interprets messages from all parts of the
body and sends out instructions.
Here are some key points about the central nervous system.
The brain is the most complex organ in the body and uses 20 percent of the total oxygen
we breathe in.
The brain consists of an estimated 100 billion neurons, with each connected to thousands
more. The brain can be divided into four main lobes: temporal, parietal, occipital and
frontal.

THE PERIPHERAL NERVOUS SYSTEM
The peripheral nervous system is made up of nerves that branch off from the spinal cord
and extend to all parts of the body. Has two components: the somatic nervous system and
the autonomic nervous system. The PNS consists of all of the nerves that lie outside the
brain and spinal cord. Nerves are bundles of neuron fibers (axons) that are grouped
together to carry information to and from the same structure.

THE SOMATIC NERVOUS SYSTEM
It is made up of nerves that connect to voluntary skeletal muscles and to sensory
receptors. It is composed of afferent nerves that carry information to the central nervous
system (spinal cord) and efferent fibers that carry neural impulses away from the central
nervous system.
The autonomic nervous system also consists of two components: the sympathetic division
and the parasympathetic division. This system mediates much of the physiological arousal
experienced by a fearful person in an emergency situation.

COMMON DISORDERS
-Alzheimer's disease attacks brain cells and neurotransmitters, affecting the way your brain
functions, your memory and the way you behave.
-Parkinson’s disease results from damage to the nerve cells in a region of the brain that
produces dopamine, a chemical that is vital for the smooth control of muscles and
movement.
-Cerebral palsy is a condition in which the ability to control muscles is reduced due to
nervous system damage before, during or after birth. This nervous system damage affects
body movement and posture.
SURGERY

Surgery is a medical specialty that uses operative manual and instrumental techniques on
a person to investigate or treat a pathological condition such as a disease or injury, to help
improve bodily function or appearance or to repair unwanted ruptured area.

The job description for surgeons varies depending on what environment they are
practicing in. Many surgeons find themselves in a multifaceted career that allows them to
put their skills to good use in a combination of workplace settings. Although the workplace
settings may vary, one factor remains the same: the surgical profession is one of
responsibility and leadership.

The surgeon is responsible for the preoperative diagnosis of the patient, for performing
the operation, and for providing the patient with postoperative surgical care and
treatment. The surgeon is also looked upon as the leader of the surgical team.

During the course of an operation, the surgeon must make important decisions about the
patient's health, safety, and welfare. Furthermore, the surgeon must work to ensure
cooperation among the other members of the surgical team, which typically includes
another surgeon or qualified person who acts as the surgeon's assistant, the
anesthesiologist, and operating room nurses.

There are seven major settings in which surgeons can put their education, training, and
skills to valuable use: private practice, academic medicine, institutional practice, hospitals,
ambulatory surgery settings, government service programs, and the uniformed services.

Surgical instruments are hand-held tools or implements used by surgeons for the
performance of surgical tasks. A vast assortment of instruments can be found in an
operating room.
Scalpels, forceps, scissors, retractors, and clamps are used extensively. The nature of
certain surgical procedures requires a more specialized set of instruments. For example,
bone saws, files, drills, and mallets are commonly utilized in orthopedic surgery. Surgical
instruments are generally made of carbon steel, stainless steel, aluminum, or titanium,
and are available in a range of sizes.

Pre-op is the time before your surgery. It means "before operation." During this time, you
will meet with one of your doctors. This may be your surgeon or primary care doctor: ... If
you see your primary care doctor for your pre-op checkup, make sure your hospital or
surgeon gets the reports from this visit.

Postoperative care is the care you receive after a surgical procedure. The type of
postoperative care you need depends on the type
of surgery you have, as well as your health history. It often includes pain management and
wound care. Postoperative care begins immediately after surgery.

Recovery room
» Patients who have had surgery or diagnostic procedures requiring anesthesia or sedation
are taken to the recovery room, where their vital signs (e.g., pulse, blood pressure,
temperature, blood oxygen levels) are monitored closely as the effects of anesthesia wear
off. The patient may be disoriented when he or she regains consciousness, and the
recovery room nursing staff will work to ease their anxiety and ensure their physical and
emotional comfort.

































FAMILY MEDICINE
Also called family practice. The medical specialty which
provides continuing and comprehensive health care for the
individual and family. It is the specialty which integrates the
biological, clinical, and behavioral sciences. The scope of
family practice encompasses all ages, both sexes, each organ
system, and every disease entity.

Primary care is the day-to- day healthcare given by a health care provider. Typically this
provider acts as the first contact and principal point of continuing care for patients within a
healthcare system.
A family practitioner will use their knowledge as a medical professional to diagnose and
treat a variety of medical issues. If a medical problem is outside the range of practice of a
family practitioner, they will then refer the patient to an appropriate specialist.
Prevention has had an enormous impact on the health of western nations. Because people
are now living longer, educating patients about prevention is becoming increasingly
important.

Priorities for preventive medicine are reviewed in office practice, the most important
preventive strategies are helping patients to quit smoking, giving advice on nutrition,
recommending moderate regular exercise, detecting and treating patients at high risk for
suicide, and detecting and treating hypertensive patients.

Counseling is an approach to formally talking with you to understand and treat the
behavioral health challenges you're facing. Behavioral health counselors at a family
medicine health center have professional training in different counseling methods to help
manage many behavioral health diagnoses. Sometimes, counseling alone works.

Patient education can be defined as the process of influencing patient behavior and
producing the changes in knowledge, attitudes and skills necessary to maintain or improve
health. The education of patients and their families, as well as communities, is the
responsibility of all physicians. Family physicians are uniquely suited to take a leadership
role in patient education. Family physicians build long-term, trusting relationships with
patients.

If an individual develops illness and injury that requires immediate care when his or her
doctor is available, this should be the first line of treatment. Examples of minor illnesses,
conditions, and injuries that can be treated by a primary care physician include:
▫ Colds, cough, ear infection, or flu ▫ Minor burns, cuts, lacerations, or bites
▫ Urinary tract infection ▫ Nausea or diarrhea
The family doctor should also be visited for regular checkups, wellness visits, and
vaccinations.
CHRONIC VS ACUTE ILLNESSES

A chronic illness is a condition that lasts for a very long time and usually can not be cured
completely, although some illnesses can be controlled or managed through lifestyle (diet
and exercise) and medications.

Examples of chronic illnesses include diabetes, heart disease, arthritis, kidney disease,
HIV/AIDS, lupus, and multiple sclerosis.

ACUTE ILLNESS
Any illness that develops quickly, is intense or severe and lasts a relatively short period of
time.

Any condition—e.g., infection, trauma, fracture—with a short (often less than 1 month)
clinical course. Acute illnesses usually respond to therapy; a return to a state of complete
health is almost the norm.

Examples:
-Asthma attack -Broken bone
-Bronchitis -Burn
-Common cold -Flu
-Pneumonia -Respiratory infection
-Strep throat

COMPARISON
Broadly speaking, acute conditions are those that occur suddenly, have immediate or
rapidly developing symptoms, and are limited in their duration (e.g., the flu). Chronic
conditions, on the other hand, are described as those that are long-lasting and develop
and potentially worsen over time (e.g., Crohn's disease).

GENERAL RECOMMENDATION
Prevention and visiting a doctor in the early stages of an illness can help to avoid
dangerous complications later.





DIABETES
Diabetes is a chronic disease that occurs when the Pancreas is no longer able to make
insulin it produces insulin, or when the body cannot make good use of the insulin it
produces.

TYPES OF DIABETES
Type 1 diabetes can develop at any age, but occurs most frequently in children and
adolescents. When you have type 1 diabetes, your body produces very little or no insulin,
which means that you need daily insulin injections to maintain blood glucose levels under
control.

SYMPTOMS
THE MOST COMMON SYMPTOMS OF TYPE 1 DIABETES INCLUDE:
o ABNORMAL THIRST AND DRY MOUTH
o SUDDEN WEIGHT LOSS
o FREQUENT URINATION
o LACK OF ENERGY, TIREDNESS
o CONSTANT HUNGER BLURRED VISION BEDWETTING

Type 2 diabetes is more common in adults. When you have type 2 diabetes, your body
does not make good use of the insulin that it produces.

Type 2 diabetes is most commonly diagnosed in older adults, but is increasingly seen in
children, adolescents and younger adults due to rising levels of obesity, physical inactivity
and poor diet.

















SYMPTOMS
THE SYMPTOMS OF TYPE 2 DIABETES ARE SIMILAR TO THOSE OF TYPE 1 DIABETES AND
INCLUDE:
o EXCESSIVE THIRST AND DRY MOUTH
o FREQUENT URINATION
o LACK OF ENERGY, TIREDNESS
o SLOW HEALING WOUNDS
o RECURRENT INFECTIONS IN THE SKIN
o BLURRED VISION
o TINGLING OR NUMBNESS IN HANDS AND FEET.

GESTATIONAL DIABETES
GESTATIONAL DIABETES (GDM) IS A TYPE OF DIABETES THAT CONSISTS OF HIGH BLOOD
GLUCOSE DURING PREGNANCY AND IS ASSOCIATED WITH COMPLICATIONS TO BOTH
MOTHER AND CHILD. IT USUALLY DISAPPEARS AFTER PREGNANCY BUT WOMEN AFFECTED
AND THEIR CHILDREN ARE AT INCREASED RISK OF DEVELOPING TYPE 2 DIABETES LATER IN
LIFE.

SYMTOMS
o EXTREME FATIGUE AND LETHARGY.
o URGE TO URINATE INCREASES TO EXTREMES.
o EXTREMELY DRY MOUTH AND CONSTANT THIRST.
o FEELING EXTREME NAUSEA AFTER EATING.
o UNUSUALLY STRONG CRAVINGS FOR SWEET FOODS AND DRINKS.
o BLURRED VISION.
o TINGLING IN THE HANDS OR FEET.



OB/GYN

OB
o Obstetrics is the field of study concentrated on
pregnancy, childbirth and the postpartum period.
o Obstetrics is the branch of medicine related to medical
and surgical care before, during, and after a woman
gives birth.

GYN
o Gynecology is the medical practice dealing with the health of the female
reproductive system (vagina, uterus, and ovaries).
o Gynecology is the branch of medicine that focuses on women’s bodies and their
reproductive health.

OBSTETRICIAN-GYNECOLOGIST
o Doctor who has broad and specific training in obstetrics and gynecology.
o They can answer a person’s questions about pregnancy, sex, reproductive health,
infertility, and numerous other topics.

WHAT PROCEDURES CAN THEY PERFORM?
-Cesarean sections -Instrumental deliveries during childbirth
-A hysterectomy -Surgery to repair pelvic organ injuries
-Removing growths, such as ovarian cysts and uterine fibroids

HYSTERECTOMY
Hysterectomy is the surgical removal of the uterus. In a total hysterectomy, the uterus and
cervix are removed.

ROUTINE AND IN-OFFICE PROCEDURES OF AN OBSTETRICIAN-GYNECOLIGST.
-Pap smears to test for cervical cancer -STI tests
-Fertility treatments -Breast exams
-Pelvic ultrasounds to check the pelvic organs and monitor pregnancy
-Infertility treatments and counseling -Management of urinary issues

FIRST VISIT
The American College of Obstetricians and Gynecologists (ACOG) recommend that a
person should first visit an OB-GYN between the ages of 13 and 15.
This visit will establish a relationship between the teenager and the doctor. The doctor will
not typically perform a pelvic exam if the individual has no medical problems and is not
sexually active.

GERIATRICS
Geriatrics is the branch of healthcare that
focuses on our unique needs as we age. Just as
pediatricians specialize in the health needs of
children, geriatricians specialize in the health
needs of older people. Geriatricians also often
work with a whole team of fellow geriatrics
health professionals, including nurses,
physician assistants, pharmacists, social
workers, and many others.

ASSISTED LIVING
There are times when an older adult needs more assistance than can be provided in the
home when it comes to personal care. In many cases, however, the older person still may
not need the round-the- clock skilled nursing and medical care that a nursing home
Provides. In that case, an assisted living arrangement might be an option to consider in
order to protect the older person’s independence and privacy for as long as possible.

Home Care
"Home care" addresses both house calls made by physicians, nurse practitioners, and
physician assistants, and care delivered by nurses and rehabilitation therapists working for
home healthcare agencies.

ROLE OF HEALTH CARE PROFESSIONALS IN HOME CARE
Your physician is usually the leader of an interdisciplinary healthcare team that may
include nurses, therapists (such as: speech, physical, occupational, and respiratory
therapists), social workers, personal care aides, home medical equipment suppliers, and
most importantly, formal and informal caregivers (e.g., family members). Although all
team members are important, the physician is legally responsible for working with you or
someone you identify to determine your health care needs. Physicians also develop,
certify, and recertify the plan of care.

COMMON CHRONIC CONDITIONS AND AGING
Chronic diseases can have a profound impact on the health and quality of life of the
elderly, not to mention the financial burden that is often associated with long-term illness.
But specialists in geriatrics and the emerging field of anti- aging medicine are quick to
point out that while the risk of disease and disability undoubtedly can increase with
advancing years, poor health is not an inevitable consequence of aging.
A lot of the sickness, disability, and even death associated with chronic disease can be
avoided through preventive measures. The CDC suggests lessening the possibility of the
onset of chronic disease in later years by:
•Practicing a healthy lifestyle that includes healthy eating, regular exercise and avoiding
tobacco use
•Regular use of early detection and testing such as breast, prostate and cervical cancer
screenings, diabetes and cholesterol screenings, bone density scans, etc.

MOST COMMON CHRONIC CONDITIONS OF THE ELDERLY
All too often, because there are so many chronic conditions that seem to afflict older
persons, there is the mistaken perception that diabetes, arthritis and the like, are just
"part of growing old" — and nothing can be done about them. The truth is most of these
diseases and conditions are treatable and should be addressed by a physician. Some of the
most common chronic diseases afflicting the elderly are:
• Adult onset diabetes • Arthritis
• Kidney and bladder problems • Dementia
• Parkinson's disease • Glaucoma
• Lung disease • Cataracts
• Osteoporosis • Enlarged prostate
• Alzheimer's disease • Macular degeneration
• Depression • Cardiovascular disease

MEDICATIONS WORK DIFFERENTLY IN OLDER ADULTS
Medication dosages, as well as information about the effectiveness and side effects of
medication, are generally determined by studies done in relatively young, healthy people.
This information may not be appropriate for older adults, because changes can occur with
age that can affect how our bodies deal with drugs.
Changes in metabolism and body composition as we age can affect how well a medication
works. Both the effectiveness and side effects of medications can be affected by diseases
and conditions that develop later in life, and the medicines we take for them.

Polypharmacy
Many older adults cope with more than one medical condition at the same time. Often,
managing these medical conditions can mean that the older adult may need many
different medications.
When older adults take five or more medicines, it is called “polypharmacy.” With
polypharmacy, the medicines can interact with each other and with their body in harmful
ways. For example, the medications can increase negative side effects or decrease desired
effects. Primary care providers know about the negative effects that taking multiple
medications can cause. But unless the patients tell them about all the medicines they are
taking, they may not realize what’s causing their problem.
Elderly patients should tell all their healthcare providers about all of the medicines they
are taking, no matter which provider prescribed them.
Patients should discuss vitamins, supplements, and other over the counter medications, as
well as any prescribed by other healthcare providers. Then they and their provider can
figure out whether one or more drugs might be changed or stopped.
CANCER
Cancer is the name given to a collection of related diseases. In all types of cancer, some of
the body’s cells begin to divide without stopping and spread into surrounding tissues.
Cancer can start almost anywhere in the human body.These extra cells can divide without
stopping and may form growths called tumors.

Cancerous tumors are malignant, which means they can spread into, or invade, nearby
tissues. In addition, as these tumors grow, some cancer cells can break off and travel to
distant places in the body through the blood or the lymph system and form new tumors
far from the original tumor.

Cancer is a genetic disease—that is, it is caused by changes to genes that control the way
our cells function, especially how they grow and divide. A cancer that has spread from the
place where it first started to another place in the body is called metastatic cancer. The
process by which cancer cells spread to other parts of the body is called metastasis.

There are more than 100 types of cancer. Types of cancer are usually named for the organs
or tissues where the cancers form. For example, lung cancer starts in cells of the lung, and
brain cancer starts in cells of the brain. Metastatic cancer has the same name and the
same type of cancer cells as the original, or primary, cancer. For example, lung cancer that
spreads to and forms a metastatic tumor in the liver is metastatic lung cancer, not liver
cancer.

At any stage after a cancer diagnosis, the patients may experience times of distress and
feel a range of strong emotions, such as disbelief, fear, sadness, anxiety and anger.
These reactions can be seen as a type of grief − cancer often involves a series of losses,
such as the loss of good health, temporary or permanent changes to the patients’
appearance, not being able to work or do their normal activities, changed financial plans, a
loss of independence, changed relationships, and a shift in how they see themselves. It
usually takes time to adjust to these changes.
When the patients’ mental health needs are met, they are in the best position to manage
the demands of treatment. The patients should let their treatment team know if they have
a history of anxiety or depression, as this could make them more vulnerable now. It is
important to manage emotional distress and seek professional support if it is ongoing.
Many people say that their experience after a cancer diagnosis also includes feelings of
hope and connection. For some, it can be a time of reflection and lead to new goals and
priorities.

Treatment
There are many types of cancer treatment. The types of treatment that the patients
receive will depend on the type of cancer they have and how advanced it is.
Some people with cancer will have only one treatment. But most people have a
combination of treatments, such as surgery with chemotherapy and/or radiation therapy.
When someone needs treatment for cancer, they have a lot to learn and think about. It is
normal to feel overwhelmed and confused. But, talking with their doctor and learning
about the types of treatment they may have can help them feel more in control.

TYPES OF TREATMENT
Surgery
When used to treat cancer, surgery is a procedure in which a surgeon removes cancer from
your body.

Radiation Therapy
Radiation therapy is a type of cancer treatment that uses high doses of radiation to kill
cancer cells and shrink tumors.

Chemotherapy
Chemotherapy is a type of cancer treatment that uses drugs to kill cancer cells.

Immunotherapy to Treat Cancer
Immunotherapy is a type of cancer treatment that helps your immune system fight cancer.

Targeted Therapy
Targeted therapy is a type of cancer treatment that targets the changes in cancer cells that
help them grow, divide, and spread.

Hormone Therapy
Hormone therapy is a treatment that slows or stops the growth of breast and prostate
cancers that use hormones to grow.

Stem CellTransplant
Stem cell transplants are procedures that restore blood-forming stem cells in cancer
patients who have had theirs destroyed by very high doses of chemotherapy or radiation
therapy.

Precision Medicine
Precision medicine helps doctors select
treatments that are most likely to help
patients based on a genetic
understanding of their disease.



HEART DISEASE
If you're like most people, you think that heart disease is a problem for others. But heart
disease is the number one killer in the U.S. It is also a major cause of disability. There are
many different forms of heart disease. The most common cause of heart disease is
narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the
heart itself. This is called coronary artery disease and happens slowly over time. It's the
major reason people have heart attacks.

TYPES OF HEART DISEASE

ARRHYTHMIA
Electrical impulses from specific areas in the heart initiate your heart beat and ensure its
normal pumping function. The term “arrhythmia” describes any change in the heart’s
normal electrical impulses. Arrhythmias can cause the heart to beat too quickly, too slowly
or irregularly, resulting in a broad range of symptoms. It is one of the most common heart
conditions. It may show up as a fluttering feeling in your chest or feeling as though your
heart is skipping a beat. If you experience arrhythmias, let your doctor know so they can
determine if further examination is necessary.

ATHEROSCLEROSIS
Is a disease in which the inside of an artery narrows due to the buildup of plaque. Initially,
there are generally no symptoms. When severe, it can result in coronary artery disease,
stroke, peripheral artery disease, or kidney problems, depending on which arteries are
affected. Symptoms, if they occur, generally do not begin until middle age.

CORONARY ARTERY DISEASE
Develops when the major blood vessels that supply your heart with blood, oxygen and
nutrients (coronary arteries) become damaged or diseased. Cholesterol-containing
deposits (plaque) in your arteries and inflammation are usually to blame for coronary
artery disease.
When plaque builds up, it narrows your coronary arteries, decreasing blood flow to your
heart. Eventually, the decreased blood flow may cause chest pain, shortness of breath, or
other coronary artery disease signs and symptoms. A complete blockage can cause a heart
attack.
Because coronary artery disease often develops over decades, you might not notice a
problem until you have a significant blockage or a heart attack. But there's plenty you can
do to prevent and treat coronary artery disease. A healthy lifestyle can make a big impact.


PREVENTION
Heart disease is a debilitating condition for many Americans. It’s the leading cause of
death in the United States according to the Centers for Disease Control. Certain risk factors
make some people more likely to have heart disease. Risk factors are either modifiable or
non-modifiable. Modifiable risk factors are factors you can control, such as body weight.
Non-modifiable risk factors are factors you can’t control, such as genetics.
Your choices can influence your heart health.
Lifestyle changes can greatly reduce your chance of heart disease. Positive lifestyle
changes include:
✓quitting smoking if you smoke ✓healthy eating
✓exercise ✓managing diabetes if you have diabetes
✓managing blood pressure ✓stress management

TREATMENT
Treatment for heart disease varies by condition and severity. For example, coronary artery
disease can be treated with lifestyle changes or medication, while a serious heart rhythm
problem may need an implantable device, like a pacemaker.
Your doctor will devise a treatment plan that is best for your needs. Make sure to follow
directions carefully and fully.

Heart disease treatment can include:

Lifestyle Modifications
These are often the first steps to managing heart disease. Lifestyle changes include eating
a heart- healthy diet low in sodium and fat, exercising regularly, quitting smoking, and
limiting alcohol use.

Medication
When lifestyle changes are not enough, your doctor may prescribe medication to treat
heart disease. The type of drug prescribed will depend on the condition and severity.

Surgery
If both lifestyle changes and medication are not enough, surgery may be needed. The type
of heart disease you have and how much damage has been done to your heart will
determine which procedure your doctor recommends.












TRAUMATIC INJURIES

Traumatic injury is a term which refers to physical injuries of sudden onset and severity
which require immediate medical attention.
Traumatic injuries are the result of a wide variety of blunt, penetrating and burn
mechanisms.
They include motor vehicle collisions, sports injuries, falls, natural disasters and a
multitude of other physical injuries.

WHERE DO THEY OCCUR? They can occur at home, on the street, or while at work and
require immediate care.

TYPES:
Traumatic brain injury Spinal cord injury
Spine fractures Amputation – traumatic
Broken bone Jaw - Broken or dislocated
Burns Cuts and puncture wounds

ESI
The Emergency Severity Index (ESI) is a five-level emergency
department (ED) triage algorithm that provides clinically relevant
stratification of patients into five groups from 1 (most urgent) to 5
(least urgent) on the basis of acuity and resource needs.

TRAIGE
A process for sorting injured people into groups based on their
need for or likely benefit from immediate medical treatment.
Triage is used in hospital emergency rooms, on battlefields, and at
disaster sites when limited medical resources must be allocated.

INFECTIONS

WHAT IS AN INFECTION? An infection is the invasion and multiplication of microorganisms
such as bacteria, viruses, and parasites that are not normally present within the body.

VECTOR OF INFECTIONS
Vector is an organism which transports the disease causative agent form infected person
to healthy person.

NOSOCOMIAL INFECTION
an infection whose development is favoured by a hospital environment, such as one
acquired by a patient during a hospital visit or one developing among hospital staff.

Known nosocomial infections include:
-Ventilator-associated pneumonia -Staphylococcus aureus
-Candida albicans
-Tuberculosis
-Urinary tract infection -Hospital-acquired pneumonia -Legionnaires’ disease.

E. coli (Escherichia coli), is a type of bacteria that normally lives in your intestines. It's also
found in the gut of some animals. Most types of E. coli are harmless and even help keep
your digestive tract healthy.

Staph infection
Infection caused by bacteria that are usually found on the skin or nose. Staphylococcus can
spread from person to person and is highly contagious.

SYMPTOMS OF STAPH INFECTIONS
• Common symptoms are a painful red lump, red and swollen skin sores, crusts or blíster
sores, red eyelids or eyes.
• It can also cause poisoning that causes nausea, vomiting and stomach pain.











MRSA
Methicillin-resistant Staphylococcus aureus (MRSA) infection is caused by a type of staph
bacteria that's become resistant to many of the antibiotics used to treat ordinary staph
infection.


















WAYS TO PREVENT SPREAD OF INFECTIONS IN HOSPITALS
• Wash your hands regularly
• Use Alcohol-based Hand Sanitizers Create an Infection-Control Policy
• Provide Infection Control Education
• Use Gloves
• Disinfect and Keep Surfaces Clean
• Prevent Patients From Walking Barefoot
• Have Clean Procedures


FIRST AID

When basic medical care is provided to somebody experiencing a sudden injury or
malaise, it is known as first aid. First aid is an emergency measure, generally consisting of
simple, often life-saving techniques that most people can train to perform with minimal
equipment and no prior medical experience. First aid is not classified as medical treatment
and it does not replace the assistance and interventions from a trained medical
professional.

In some cases, first aid consists of the initial support provided to someone in the middle of
a medical emergency. This support might help them survive until professional help arrives.
In other cases, first aid consists of the care provided to someone with a minor injury. For
example, first aid is often all that is needed to treat minor burns, cuts, and insect stings.
First aid is a combination of simple procedures and common sense.

AIMS OF FIRST AID
The aims of first aid are:
To preserve life: Saving lives is the main aim of first aid.
To prevent further harm: The person who has experienced the injury must be kept stable,
and their condition must not deteriorate before medical services arrive. This may include
moving the individual away from harm, applying first aid techniques, keeping them warm
and dry, and applying pressure to wounds to stop any bleeding.
To promote recovery: Taking steps to promote recovery may include applying a bandage to
a wound.

3 STEPS FOR EMERGENCY SITUATIONS
If you encounter an emergency situation, follow these three basic steps:

1. Check the scene for danger
Look for anything that might be dangerous, like signs of fire, falling debris, or violent
people. If your safety is at risk, remove yourself from the area and call for help.
If the scene is safe, assess the condition of the sick or injured person. Do not move them
unless you must do so to protect them from danger.

2. Call for medical help, if needed
If you suspect the sick or injured person needs emergency medical care, tell a nearby
person to call 911 or the local number for emergency medical services. If you are alone,
make the call yourself.




3. Provide care
If you can do so safely, remain with the sick or injured person until professional help
arrives. Cover them with a warm blanket, comfort them, and try to keep them calm. If you
have basic first aid skills, try to treat any potentially life-threatening injuries they have.
Remove yourself from danger if at any point in the situation you think your safety might be
at risk.

FIRST AID FOR BURNS
If you suspect that someone has a third-degree burn, call an emergency service number.

Seek professional medical care for any burns that:
• cover a large area of skin
• are located on the person’s face, groin, buttocks, hands, or feet
• have been caused by contact with chemicals or electricity

To treat a minor burn, run cool water over the affected area for up to 15 minutes. If that is
not possible, apply a cool compress to the area instead. Avoid applying ice to burned
tissue. It can cause more damage.
Over-the-counter pain relievers can help relieve pain. Applying lidocaine or an aloe vera
gel or cream can also reduce discomfort from minor burns.
To help prevent infection, apply an antibiotic ointment and loosely cover the burn with
clean gauze.

FIRST AID CPR
If you see someone collapse or find someone unconscious, call your local emergency
service number. If the area around the unconscious person seems safe, approach them
and begin CPR.
Even if you do not have formal training, you can use hands-only CPR to help keep someone
alive until professional help arrives.
This is how to treat an adult with hands-only CPR:

1. Place both hands on the center of their chest, with one hand on top of the other.
2. Press straight down to compress their chest repeatedly, at a rate of about 100 to
120 compressions per minute.
3. Continue performing chest compressions until professional help arrives.


FIRST AID FOR NOSEBLEED
To treat someone with a nosebleed, ask them to:
1. Sit down and lean their head forward.
2. Using the thumb and index finger, firmly press or pinch the nostrils closed.
3. Continue to apply this pressure continuously for five minutes.
4. Check and repeat until the bleeding stops.
If you have nitrile of vinyl gloves, you can press or pinch their nostril closed for them.
If the nosebleed continues for 20 minutes or longer, seek emergency medical care. The
person should also receive follow-up care if an injury caused the nosebleed.

FIRST AID FOR HEATSTROKE
When your body overheats, it can cause heat exhaustion. If left untreated, heat exhaustion
can lead to heatstroke. This is a potentially life- threatening condition and medical
emergency.
If someone is overheated, encourage them to rest in a cool location. Remove excess layers
of clothing and try to cool their body down by doing the following:
• Cover them with a cool, damp sheet.
• Apply a cool, wet towel to the back of their neck.
• Sponge them with cool water.

Call 911 if they develop signs or symptoms of heatstroke, including any of the following:
• nausea or vomiting • mental confusion
• fainting • seizures
• a fever of 104°F (40°C) or greater

If they’re not vomiting or unconscious, encourage them to sip cool water or a sports drink.

FIRST AID KIT
You never know when you might need to provide basic first aid. To prepare for the
unpredictable, consider storing a well-stocked first aid kit in your home and car. It is also a
good idea to have a first aid kit available at work.
You can buy preassembled first aid kits from many first aid organizations, pharmacies, or
outdoor recreation stores. Alternatively, you can create your own first aid kit using
products purchased from a pharmacy.

A standard first aid kit should include:
- adhesive bandages of assorted sizes
- roller bandages of assorted sizes
- absorbent compress dressings
- sterile gauze pads
- adhesive cloth tape
- triangular bandages
- antiseptic wipes
- aspirin
- Acetaminophen or ibuprofen
- Antibiotic ointment
- Hydrocortisone cream
- Calamine lotion
- Nitrile or vinyl gloves
- Safety pins
- Scissors
- Tweezers
- Thermometer
- Breathing barrier
- Instant cold pack
- Blanket
- First aid manual

It is also smart to include a list of your healthcare providers, emergency contact numbers,
and prescribed medications in your first aid kits.

It is important to protect yourself from contagious illnesses and other hazards when
providing first aid. To help protect yourself:
• Always check for hazards that could put your safety at risk before approaching a sick or
injured person.
• Avoid direct contact with blood, vomit, and other bodily fluids.
• Wear protective equipment, such as nitrile or vinyl gloves when treating someone with
an open wound or a breathing barrier when performing rescue breathing.
• Wash your hands with soap and water immediately after providing first aid care.

In many cases, basic first aid can help stop a minor situation from getting worse. In the
case of a medical emergency, first aid might even save a life. If someone has a serious
injury or illness, they should receive follow-up care from a medical professional.




ADMINISTERING MEDICATION

The administration of medication to a patient is often a chief responsibility of the nurse.
The practice of administering medication involves providing the patient with a substance
prescribed and intended for the diagnosis, treatment, or prevention of a medical illness or
condition.
There are many routes of medication administration (the
way that a drug is placed into the body). Based on the
specific medication being used, the rate of absorption
desired, and the specific site of action (where the
medication needs to have an effect) your doctor or
pharmacist will instruct you on the route of
administration needed for you.

Most drugs are manufactured for a specific route of administration and must be used as
directed for safety and efficiency.

DIFFERENT WAYS TO ADMINISTER DRUGS
The method selected for administering drugs to a patient is dependent on the drug’s
chemical and physical properties as well as the response desired and the patient’s
demographics. Fundamentally drugs can be administered orally , by injection or topically.
In some cases inhalation may be preferred to oral or by injection and in recent years more
drugs have been introduced that are administered by mucoadhesion. All of these forms of
administration require different formulations of the pharmaceutical products.










ORAL ADMINISTRATION
Oral administration of medication is the most common method; it is the most convenient
and safest way to give medicine. Administration is in the form of tablet, capsule, mixture
or as a gel. The body absorbs many of the oral drugs in the market today once they reach
the small intestine; some medicines are absorbed from the colon and stomach area. While
oral administration is common, there are some medicines that cause irritation of the
gastrointestinal tract and other methods may be preferred.


SUBCUTANEOUS
The administration of drug is through the
subcutaneous layer of the skin. The drug is
injected in small amounts, usually less than
2.0 ml. Absorption of the drug is slow but
the effect is longer lasting than other
methods. The subcutaneous method is not
recommended for patients who have
suffered shock, as it reduces the peripheral
circulation, which would then lead to a
decreased absorption rate by the body.




INTRAVENOUS
Intravenous administration of drugs is recommended when fast
or immediate response is required or when absorption is
compromised. This method enables the drug to reach the blood
stream directly. A type of intravenous administration is that of
infusion where large amounts of fluid are involved. The solution
typically flows from a graduated bottle through the drip set.






TOPICAL
Topical medicines are those that are absorbed by
the skin. As the skin or dermis is permeable to
different liquids, drugs can be easily absorbed by
topical application. Other medication can be applied
to the skin include gels, creams, ointments and
lotions.



MAINTANING HYGIENE

HYGIENE
The application of scientific knowledge to the preservation of health and prevention of the
spread of disease.

CLEANLINESS
The quality or state of being clean : the practice of keeping oneself or one's surroundings
clean.

THE IMPORTANCE OF HYGIENE IN HOSPITALS
Good hygiene or cleanliness is a basic requirement for good health. The importance
becomes much more in a hospital setting, where sick people come to restore their health.

HYGIENE IN HOSPITALS
Hospitals also become a potential source of spread of infection if people concerned are
not vigilant enough. A person may be hospitalized for some other problem say cardiac
failure and may become more sick after acquiring some infection in the hospital.

INFECTIONS OCCUR BY 3 MODES
The infection can spread from one patient to another, from patient to doctor or nurse. A
doctor or health care personnel can also infect a patient

HOSPITAL ACQUIRED INFECTIONS
The microbes responsible for hospital acquired infections usually cause more severe illness
and are resistant to the more conventional antibiotics being used.

BE AWARE
Hence it is important for all concerned to be aware of these infections and take utmost
precautions to prevent them.




TAKING A HISTORY

Interviewing the patient in private, introducing yourself, helps building a relationship with
the patient and explaining the purpose for the interview. Taking a history is not just going
down a checklist of symptoms.
Eliciting a patient’s history does not need to be done in a set order. It is not just
information-gathering from the patient, it is a two-way communication in which you need
to be aware of what and how you are communicating and its impact on the patient. It
includes active listening to the patient, awareness of non-verbal communication, with
respect and support of their feelings.

It is important to use your communication skills effectively, in order to data gather and
reach a diagnosis, so that you may decide with the patient the appropriate management.
Use the communication skills you have learned, and your own experience when talking
with people.

INTERACTING WITH PATIENTS
Patient history should always feel more like a conversation
rather than an interrogation. It’s important to establish trust,
respect and honesty so that they feel relaxed and
comfortable. You can do this through little gestures like
making small talk and asking what their preferred name is.
Not only does this benefit the doctor-patient relationship,
but it can also help calm the patient’s nerves. You don’t want
them to feel anxious or excited.

When discussing their medical history, especially in regards to potentially sensitive topics,
it’s essential to remain neutral. If the patient feels judged or uncomfortable for any reason,
he or she might hold back and you won’t be able to get as accurate and detailed notes as
possible. Practice active, empathic listening to show him or her that you care and
understand. Also, always remember to avoid using medical terms that might cause
confusion.

PAST MEDICAL HISTORY
Always ask the patient if they have or have had any
serious illnesses. The precise details will depend on the
clinical condition and the circumstances.
Include:
• Operations
• Hospital admissions
• Ask specifically about hypertension, heart disease,
strokes, diabetes, asthma, jaundice, TB, rheumatic fever




FAMILY HISTORY
This gives a clue to any predisposition to any illnesses and
may highlight specific concerns the patient may have
about a certain disease.
You could ask:
• Are your parents alive or have they died?
• Are there any diseases running through the family?
Ask the patient what their parent(s) died from and at
what age. If they have died, be
sensitive to how the patient may feel about this. It is
always important to acknowledge a death.
Then ask similar questions about brothers and sisters and
children.


SOCIAL HISTORY
This is a very important part of the patient’s
history. It provides information about:
▸ The patient as a person
▸ How the illness affects the patient and their
family ▸ What are the home circumstances?
Questions you can ask include:
▸ How are things at home?
▸ Who is at home?
▸ Are there any problems at home?






TAKING ABOUT SYMPTOMS

Discussing your symptoms with a patient can be one of the most important tasks you
perform as a doctor.
It is important to know what the patient feels, what makes it better or worse, what’s
worked before and what hasn’t.

TIPS
v Make the patient give you a basic description of his
problem
v Make him tell you when he experiences the
symptoms and how often they occur
v Ask him if anything makes the symptoms better or
worse
v Ask him if he has ever experienced the symptoms
before, and under what circumstances

PATIENT

SYMPTOMS
A symptom is evidence of a disease or disorder in the body.
Be clear when describing your symptoms. Your description helps the doctor identify the
problem. A physical exam and medical tests provide valuable information, but your
symptoms point the doctor in the right direction.

QUESTIONS TO ASK YOURSELF ABOUT YOUR SYMPTOMS:
Ø What exactly are my symptoms?
Ø Are the symptoms constant? If not, when do I experience them?
Ø Does anything I do make the symptoms better? Or worse?
Ø Do the symptoms affect my daily activities? Which ones? How?

GIVE INFORMATION ABOUT ALL YOUR MEDICATIONS
Ø Your doctor needs to know about ALL of the medicines you take, including over-
the-counter (nonprescription) drugs.

REMEMBER
Ø Doctors want to hear how you feel, not what you think your
diagnosis is Don’t use medical terminology
Ø "The doctor is not a mind reader”.



PHYSICAL EXAMINATIONS

It is the process of evaluating objective anatomic findings through the use of observation,
palpation, percussion, and auscultation. It measures important vital signs.

PHYSICAL EXAM
The doctor will use tools to look in your eyes, ears, nose, and throat. ...
This exam also includes: touching, or “palpating,” parts of your body (like your abdomen)
to feel for abnormalities. checking skin, hair, and nails.

VITAL SIGNS
Clinical measurements, specifically pulse rate, temperature,
respiration rate, and blood pressure, that indicate the state
of a patient's essential body functions. These numbers
provide critical information about a patient's state of health.

PARTS OF A PHYSICAL EXAM

INSPECTION/OBSERVATION
The doctor will look at, or "inspect" specific areas of your body for normal color, shape and
consistency.

AUSCULTATION
The action of listening to sounds from the heart, lungs, or other organs, typically with a
stethoscope, as a part of medical diagnosis.

PERCUSSION
It is a method of tapping body parts with fingers, hands, or small instruments as part of a
physical examination. It is done to determine: The size, consistency, and borders of body
organs. The presence or absence of fluid in body areas.

PALPATION
It is a method of feeling with the fingers
or hands during a physical examination.
The health care provider touches and
feels your body to examine the size,
consistency, texture, location, and
tenderness of an organ or body part.