Влияние общества на человека
Приготовление дезинфицирующих растворов различной концентрации
Практические работы по географии для 6 класса
Организация работы процедурного кабинета
Обработка изделий медицинского назначения многократного применения
Изменения в неживой природе осенью
Уборка процедурного кабинета
Сольфеджио. Все правила по сольфеджио
Балочные системы. Определение реакций опор и моментов защемления
Ex.1. Choose sentences with Complex Subject and translate them.
1. He is supposed to discharge the patient from the hospital.
2. Academician A.N. Bakulev is considered to have been the founder of a new branch of surgery – cardiosurgery.
3. She appears to study at the Medical University.
4. He is known to be the most qualified specialist in this field of medicine.
5. They seem to study English for the first two years.
6. Renal and splenic infarctions are likely to occur in endocarditis.
Ex.2. Translate the following sentence into Russian.
1. Brain cortex stimuli are considered to send impulses to the stomach and duodenum.
2. On physical examination the liver was considered to have been enlarged.
3. The damage of the blood supply was supposed to have been present before the operation.
4. He is supposed to be discharged from the hospital.
5. Pain intermittent in occurrence is known to be characteristic of gastric or duodenal ulcers.
6. Chronic gastritis is known to occur as a separate or primary disease or it may be associated with other diseases, particularly chronic liver and kidney diseases.
7. Exacerbation of duodenal ulcers is known to occur in spring and autumn.
Ex.3. Translate the following sentences into English.
1.Известно, что операция прошла успешно.
2.Вероятно, у больного метастазы в печени вследствие рака желудка.
3. Было обнаружено, что у него язва желудка.
4.Оказалось, что больной был слишком слаб для такой операции
5.Сообщили, что пациент умер от отравления.
6.Считается, что он самый известный хирург в городе.
Your assessment of the patient with suspected gastrointestinal disease must begin with a careful history that includes occupation, family history, and recent travel. The medical history should include previous hospital admission; surgical procedures (including recent tooth extraction); family history of ulcers, colitis or cancer and current medications, such as aspirin, steroids, or anticoagulants.
a) Ask the patient about his digestive complaints.
b) Put the words in the correct order to make questions.
Abdominal pain indigestion heartburn or rectal bleeding he does have?
Long how it has he had?
These symptoms relieves what or makes them worse?
Difficulty in swallowing recently has he experienced?
Any has recent weight he had loss or gain?
On special diet he is?
Alcoholic he does drink beverages or smoke?
If yes to either; how much and how often?
What bowel his habit is?
Nausea and vomiting he does experience?
He describe his can pain?
Is it where located?
Does it last how long?
Does when it occur?
Triggers what it?
It relieves what?
Ex.2. Read the text. Find the words describing the abdominal pain. Write them down in the order of gravity.
How to Get Patients to Describe Abdominal Pain
Pains in general are difficult to describe, but the description of abdominal pain is very important. The quality or character of abdominal pain can be very useful to you as you try to interpret such pain and you should explore the character as far as you can.
There are many ways to describe the quality of pain in the abdomen. Patients often use descriptive terms voluntarily but some patients will not volunteer descriptions. It is useful to ask first, “What is the pain like?” The answer to this question may be quite specific like “a sharp pain,” or the patient may refuse to answer, saying “just a pain.” In either case you should press for a further description and it is always fruitful to do so. Do this by offering terms or descriptions from which the patient can choose. Ask, “Does the pain feel hot, burning, like a knife, like something sharp, like something moving around, like something squeezing, like something too big, or like a cramp?” Offered such choices, most patients will select one of these terms and you then can explore the description further. Sometimes after considering such a set of these terms, a patient will refuse them all. Pains in the abdomen can be classified usefully in three categories: bright pains, dull pains, and undifferentiated pains. These three categories have different implications. In this chapter we use “dull” to mean “not sharp” rather than “mild”: we usedull to refer to the character rather than to the severity of pain.
Ex.3. Read the text. Speak on the tests used for assessment of gastric patient. What data are revealed by each of them?
Observe how the patient looks and note appropriateness of behavior. Visual examination should check the skin, size, and shape of the abdomen, abdominal scars, excessive skin folds.
Auscultation provides helpful clues to GI abnormalities.
Palpating the abdomen helps to detect tenderness, muscle tone and abdominal masses.
Percussion helps detect air, fluid and solid matter in the abdomen.
After physical assessment, several tests can identify GI malfunction. A barium or gastrografin swallow is used primarily to examine the esophagus. The barium outlines stomach walls and delineates ulcer craters and defects.
A stool specimen is useful to detect suspected GI bleeding, infection or malabsorption.
In esophagogastroduodenoscopy, insertion of a fiber-optic scope allows direct visual inspection of the esophagus, stomach and duodenum. These structures are examined for tumors, inflammation, hernias, polyps, ulcers and obstruction.
Colonoscopy is used for inspection of descending, transverse, and ascending colon. This test helps visualize tumors, polyps, hemorrhoids, or ulcers. Gastric analysis examines gastric secretions for the presence of high levels of gastric mucosa and the amount of acid produced.
Ex.4. Read the text “Common digestive disorders”. Find in it the sentences with Complex subject and translate them. Answer the questions.
1. What principle serves as the basis for classification of gastric disorders in this text?
2. What functions are affected?
a) in mouth pathology
b) in diseases of esophagus
c) in disorders of stomach and duodenum
d) in large intestine pathology
3. What symptoms are produced by each dysfunction?
Common digestive disorders
Main disorders of the alimentary tract are concerned with its parts and affect its functions. As the mouth is concerned with chewing and mixing of food with saliva, any disorder (lack of teeth, aching teeth, ill-fitting dentures) is likely to interfere with these functions and thus prevent proper mastication. Besides, the inferior of the mouth can also develop various infections. Diseases of the esophagus, by interfering with the transmission of masticated food from the mouth to the stomach are likely to cause difficulty in swallowing, pain, vomiting. Common diseases of the stomach are known to be gastritis, ulcer and carcinoma. Interference with its functions may cause at first loss of appetite, nausea, abdominal discomfort; with progression of the disease, the patient is likely to develop vomiting, abdominal pain and loss of weight. The part of the duodenum, nearest to the stomach, called the duodenal cup is frequently affected by peptic ulceration that occurs in the stomach - which may interfere with emptying of the stomach. Since both the stomach and the small intestine are considered to be concerned with the digestion and absorption of foodstuffs, any disorder in these regions is likely to produce abdominal pain, vomiting, diarrhea and loss of fluid. The large intestine or the colon is concerned with the onward passage of the contents of the intestine, the absorption of water from them. Diseases of the large intestine (the most common are colitis, carcinoma and diverticulitis) are certain to cause diarrhea, abdominal pain and discomfort.
Ex.5. Read the text “Gastritis” and find in it the equivalents to:
Приступообразная жгучая боль, неразборчивость в диете, злокачественное малокровие, устранение раздражающих факторов, переход к жидкой диетической пище.
Answer the following questions:
1. What is gastritis?
2. What are the causes of it?
3. What are the clinical manifestations of gastritis?
4. What pathological conditions are associated with gastritis?
5. What are the possible complications of gastritis?
6 What measures may prove to be helpful in prevention of gastritis?
Inflammation of the stomach lining, which can be either acute or chronic.
Symptoms: Sensation of fullness in the upper abdomen, loss of appetite. In acute gastritis there may be fever, nausea and vomiting, as well as diarrhea and general aches and pains depending on the cause. In chronic gastritis there may be intermitted burning pain, nausea and vomiting, intolerances to certain foods and anemia, or no symptoms at all.
Cause: Acute gastritis may be caused by dietary indiscretion, specific food intolerances, chemical irritants (especially aspirin and alcohol), food poisoning, or many types of viral or bacterial infections. Chronic gastritis is probably not very common (other diseases and conditions are often called gastritis, however) but can be associated with gastric ulcer, gastric carcinoma and pernicious anemia.
Severity of problem: Usually boresome and temporary.
Treatment: For acute gastritis removal of any irritants and rest of the stomach is usually all that is needed. Changing the diet to bland liquids and increasing what is eaten are usually curative. For chronic gastritis removal of any potential irritants (caffeine, alcohol, aspirin, tobacco, spices) and some frequent meals may be of help.
Discussion: Probably many problems that are labeled of are actually due to such conditions as peptic ulcer disease and reflex esophagitis. Chronic or recurrent abdominal distress warrants a medical evaluation.
Ex.6. Read the text “Chronic and acute gastritis”. Compare the course of disease and the symptoms in both forms. Fill in the table.
Chronic and Acute Gastritis
Gastritis, an inflammation of the gastric mucosa, may be acute or chronic. Acute gastritis produces mucosal reddening, edema, hemorrhage, and erosion. Chronic gastritis is common among elderly persons. Acute or chronic gastritis can occur at any age.
Acute gastritis has numerous causes, including: chronic ingestion of (or an allergic reaction to) irritating foods or beverages, such as hot peppers or alcohol, drugs, ingestion of poisons, endotoxins released from infecting bacteria.
Acute gastritis leading to stress ulcers also may develop in acute illnesses, especially when the patient has had major traumatic injuries; burns; severe infection; hepatic, renal, or respiratory failure; or major surgery. Recurring exposure to irritating substances, such as drugs, alcohol, cigarette smoke, or environmental agents, may also lead to chronic gastritis.
After exposure to the offending substance, the patient with acute gastritis typically reports a rapid onset of symptoms, such as epigastric discomfort, indigestion, cramping, anorexia, nausea, vomiting. The symptoms last from a few hours to a few days.
The patient with chronic gastritis may describe similar symptoms or may have only mild epigastric discomfort, or his complaint may be vague, such as an intolerance for spicy or fatty foods or slight pain relieved by eating. Atrophic gastritis may be asymptomatic.
Ex. 7. Read the text” Ulcer-Peptic”. Write down the key sentences of it using the following models:
1.This text is concerned with …
2. The current interest in this problem lies in …
3. … is under discussion.
4. The question of … has become acute.
5. It is generally agreed that …
Ulcer Peptic (Duodenal)
Branch or wound of the surface tissue of the first part of the small intestine (duodenum).
Symptoms: Most often a fairly constant burning, aching and gnawing pain in the stomach (generally after eating). Other symptoms may include heartburn,vomiting, blood in stools (looks black, not red); and usually no loss of appetite, but a sense of fullness after meals.
Cause: Stress, anxiety, tension, and certain foods and drugs may essentially produce a breakdown in the stomach and small intestine natural protection against acids, and/or this may occur because of an oversecretion of hydrochloric acid (a gastric acid).
Severity of problem: Peptic Ulcer may cause extremely severe pain. If serious complications occur, such as obstruction, hemorrhage or perforation, death can take place without immediate medical intervention. Also, cardiovascular disease is not uncommon in those with peptic ulcer.
Treatment: A physician’s evaluation and care are necessary. Bland foods, the use of antacids, more frequent but smaller meals, and the management or reduction of stress help to control the problem if it is diagnosed and treated early. Medications to reduce the production of stomach acid are often used. At times sedatives may be prescribed to control the stress and anxiety. Surgery is necessary if obstruction, perforation or hemorrhage occur.
Prevention: Avoidance of stressful situations; stress management, proper dietary habits, prudent use of caffeine and other stimulants found in food or drink, adequate exercise and overall fitness/wellness. Also the early recognition of symptoms of possible peptic ulcer and prompt medical attention to avoid serious complications.
Discussion: Occasionally, an ulcer may occur in the stomach itself (called a gastric ulcer). This type of ulcer has other causes, including cancer and pernicious anemia. Its medical evaluation is also essential.
Ex. 8. Read the text “Peptic ulcers”. Answer the questions.
1. What pathologic conditions are referred to peptic ulcer?
2. What symptoms are both gastric and duodenal ulcers characterized by?
3. What is the character of pain in peptic ulcers?
4. What methods of examination are used in assessing the ulcers?
5. What is revealed by each test?
6. Why is ulcer called “ seasonable" disease?
7. What are the possible complications of peptic ulcers?
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