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
Say which statements are false. Render the text using the true statements.
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1. Hepatitis A is usually transmitted by fecal-oral rout.
2. It is never transmitted parenterally.
3. Hepatitis A may result from ingestion of fatty food.
4. Hepatitis B is transmitted by the direct exchange of contaminated blood, during intimate sexual contact or perinatally.
5. All professional groups are exposed to type B hepatitis.
6 .Hepatitis C is transmitted through transfused blood from asymptomatic donors.
7. Hepatitis D is found only in patients with acute form of hepatitis A.
8. Hepatitis E is transmitted enterically.
Ex.10. Read the text. Divide it into logical parts to make a plan. Render the text according to this plan.
Assessment findings are similar for the different types of hepatitis. Typically, signs and symptoms progress in several stages. In the prodromal (preicteric) stage, the patient typically complains of easy fatigue and anorexia (possibly with mild weight loss), generalized malaise, depression, headache, weakness, arthralgia, myalgia, photophobia, and nausea with vomiting. He also may describe changes in his senses of taste and smell.
Assessment of vital sings may reveal a fever. Before onset of the clinical jaundice stage, inspection of urine and stool specimens may reveal dark-colored urine and day-colored stools.
If the patient has progressed to the clinical jaundice stage, he may report pruritus, abdominal pain or tenderness, and indigestion. Early in this stage, he may complain of anorexia; later, his appetite may return. Inspection of the sclerae, mucous membranes, and skin may reveal jaundice, which can last for 1 to 2 weeks. Jaundice indicates that the damaged liver is unable to remove bilirubin from the blood; however, its presence doesn't indicate the severity of the disease. Occasionally, hepatitis occurs without jaundice.
During the clinical jaundice stage, inspection of the skin may detect rashes, erythematous patches, or urticaria, especially if the patient has hepatitis B or C. Palpation may disclose abdominal tenderness in the right upper quadrant, enlarged and tender liver and, in some cases, splenomegaly and cervical adenopathy.
During the recovery (posticteric) stage, most of the patient's symptoms decrease or subside. On palpation, a decrease in liver enlargement may be noted. The recovery phase commonly lasts from 2 to 12 weeks, although sometimes this phase lasts longer in patients with hepatitis B, C, or E.
Ex.11. Read the text. Entitle it. Ask as many questions as you can.
In the differentiation of the various forms of hepatitis function tests may be of only limited help since damage to the liver cells is present in all forms. The functional impairment may vary, depending on the disease, for example, in biliary hepatitis it may become apparent only with longer duration of obstruction. In general therefore tests for parenchymal damage do not necessarily differentiate various forms of hepatitis. The tests for impairment of bile flow help also only to some degree in the distinction of the different forms of hepatitis.
The clinical differentiation between primarily (medical) and secondary (surgical) hepatitis is facilitated by the use of biopsy. The chief difficulty in our experience has been differentiation between toxic and early biliary hepatitis. The difficulty in the clinical and functional differentiation of surgical and medical types of jaudaice become especially apparent in the later stages of extrahepatic obstruction when the parenchymal damage stimulates that found in the medical jaundice. It is in those instances that liver biopsy becomes of added importance because the longer duration of the extrahepatic obstruction, the more characteristic becomes the morphologic picture for biliary hepatitis and the easier it is to differentiate it from virus or toxic hepatitis. The liver biopsy thus aids in the differentiation of antihepatic obstruction in primary hepatitis from extrahepatic obstruction.
Ex.12. Read the text. Express the main idea of it in several sentences.
Translate the first passage of the text in a written form.
Cirrhosis and Fibrosis
Cirrhosis is a chronic hepatic disease characterized by diffuse destruction and fibrotic regeneration of hepatic cells. As necrotic tissue yields to fibrosis, this disease alters liver structure and normal vasculature, impairs blood and lymph flow, and ultimately causes hepatic insufficiency. It's twice as common in men is especially prevalent among malnourished, chronic alcoholics over age 50. Mortality is high: Many patients die within 5 years of onset. The prognosis is better in noncirrhotic forms of hepatic fibrosis, which cause minimal hepatic dysfunction and don't destroy live cells.
Causes. The following clinical types of cirrhosis reflect its diverse etiology: portal, nutritional, or alcoholic (Laennec's) cirrhosis, the most common type, occurs in 30% to 50% of cirrhotic patients, up to 90% of whom have a history of alcoholism. Liver damage results from malnutrition, especially of dietary protein, and chronic alcohol ingestion. Fibrous forms in portal areas and around central veins.
Signs and symptoms. Clinical manifestation of cirrhosis and fibrosis are similar for all types, regardless of cause. Early indications are vague but usually include GI signs and symptoms (anorexia, indigestion, nausea, vomiting, constipation, or diarrhea) and dull abdominal ache. Major and late signs and symptoms develop as a result of hepatic insufficiency and portal hypertension and include the following:
Respiratory: pleural effusion, limited thoracic expansion due to abdominal ascites, interfering with efficient gas exchange and leading to anorexia.
Central nervous system: progressive signs or symptoms of hepatic encephalopathy-lethargy, mental changes, slurred speech, asterixis (flapping tremor), peripheral neuritis, paranoia, hallucinations, extreme obtundation, and coma.
Hematologic: bleeding tendencies (nosebleeds, easy bruising, and bleeding gums) and anemia.
Endocrine: testicular atrophy, menstrual irregularities, gynecomastia, and loss of chest and axillary hair.
Skin: severe pruritus, extreme dryness, poor tissue turgor, abnormal pigmentation, spider angiomas, palmar erythema, and possibly jaundice.
Hepatic: jaundice, hepatomegaly, ascites, edema of the legs, hepatic encephalopathy, and hepatorenal syndrome comprise the other major effects of full-fledges cirrhosis.
Ex.13. Read the text. Write down the key sentences of it using the following models.
1. There is no doubt that …
2. It is likely that …
3. The facts can be proved …
4. It provides the basis for …
5. We have reason to believe …
Find in the text the passage dealing with causes of the disease and translate it.
Fatty liver, also known as steatosis, is a common clinical finding consisting of comprises as much as 40% of the liver’s weight (as opposed to 5% in a normal liver) and the weight of the liver may increase from 3.31 lb (1.5 kg) to as much as 11 lb (4.9 kg). Minimal fatty changes are temporary and asymptomatic; severe or persistent changes may cause liver dysfunction. Fatty liver is usually reversible by simply eliminating the cause; however, this disorder may result in recurrent infection or sudden death from fat emboli in the lungs.
The most common cause of fatty liver in the United States and in Europe is chronic alcoholism, with the severity of hepatic disease directly related to the amount of alcohol consumed. Other causes include malnutrition (especially protein deficiency), obesity, diabetes mellitus, Cushing’s syndrome, Reye’s syndrome, pregnancy, large doses of hepatotoxins,tetracycline, carbon tetrachloride intoxication, prolonged parenteral nutrition, and poisoning. Whatever the cause, fatty infiltration of the liver probably results from mobilization of fatty acids from adipose tissues or altered fat metabolism.
Clinical features of fatty liver vary with the degree of lipid infiltration, and many patients are asymptomatic. The most typical sign is a large, tender liver (hepatomegaly). Common signs and symptoms include right upper quadrant pain (with massive or rapid infiltration), ascites, edema, jaundice and fever (all with hepatic necrosis or biliary stasis). Nausea, vomiting, and anorexia are less common. Splenomegaly usually accompanies cirrhosis. Rarer changes are spider angiomas, varices, transient gynecomastia and menstrual disorders.
Ex.14. Scan the medical annotation and give the directions to CARSIL usage.
Composition: Silymarin 35 mg
Action:The liver has a very important influence over all living functions of the human body: a main role in the metabolism (carbohydrates, proteins and oils), for normal digestion (bile secretion) and desintoxication of residual.
Any liver harming leads to cell membranes changing and respectively its improper functioning.
The Silymarin as an active vegetable compound part of the Carsileffects stabilizing over the cell membrane and in that manner protects the liver of harmful influences, also contributes for restoring the liver harmed cells. It improves totally the body condition, decreases the digestion problems and also acts good at patients with poor food assimilating after hepatic disease. It also stimulates the appetite and increases the body weight with resultant improvement and normalization of the liver function.
Indication:Chronic hepatic inflammations, hepatic dystrophy, cirrhosis, liver mastopathia after hepatitis, liver disturbance of function caused by intoxication, applied as a prophylactic medicine in case of increased substance inflow overloading the liver.
Without side effects/ contra-indications.
Administration and dose:It is recommended to be taken 1 drug three times. In heavy and medical cases of illness the doze may be doubled.
Medical form and package: 80 drugs in a package.
Term of validity: 2 years.
1. What hepatobiliary disorders do you know?
2. What are the causes of these diseases?
3. What are the most common clinical manifestations of hepatobiliary disorders?
4. What diagnostic tests are used for assessment of this pathology?
5. What data are revealed by each method?
6. What do you know about age, sex, occupation of people exposed to the hepatobiliary disorders?
7. Why is hepatitis considered to be a public health hazard?
8. Discuss the ways of prevention of hepatobiliary diseases.
1. А.П. Миньяр-Белоручева. Англо-русские обороты научной речи. Издательский дом: «Проспект-АП», Москва, 2005.
2. Chamberlains, Symptoms and Signs in Clinical Medicine. An Introduction to Medical Diagnosis. Wright, Bristol, 1987.
3. Collin P.H. Dictionary of Medical Terms. London, 2004.
4. Longman Dictionary of Contemporary English, 2003.
5. Murray J.P. Rivkin V.L. English-Russian Medical Dictionary “English in Medical Practice”, Moscow, 1999.
6. Professional Guide to Diseases. USA, Boston, 2004.
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