vII0rMmjA6

30.Хорошо известно, что маленьким детям необходимо принимать рыбий жир регулярно.

31.Есть ли в отделе ручной продажи пипетки и грелки?

32.Оказалось, что эта мазь вызвала раздражение кожи.

33.Нужно соблюдать строгую диету при расстройстве пищеварения.

4. Read the text and do the exercises that follow.

THE WORK OF THE IN-PATIENT DEPARTMENT

Patients whose state is too serious are admitted to hospital. They are usually directed to hospital by the district doctor. Emergencies are hospitalized even without any doctor’s recommendation. There are general hospitals where patients with different diseases are treated. There are teaching and research hospitals where students are taught and research work is done. There are also special hospitals, such as infection, children’s, military hospitals, etc.

A person who is to go to hospital is first admitted to the reception ward. On admission the patient’s history is taken as part of clinical case-taking. Apart from the patient’s personal data (name, surname, address, age, place of employment, occupation, etc), the case history should contain the date of admission and discharge, complete physical examination and laboratory studies, the systemic classification of the common symptoms and signs, the diagnosis made by the doctor in charge as well as clinical notes. They include the description of the course of the disease with any changes in the symptoms and the condition of the patient, the medicines administered and the effect of the treatment. All these findings will compose the history of the present illness.

As soon as the patient is admitted to the in-patient department the ward doctor fills in the patient’s case history. It must include the information about the patient’s parents – if they are living or not. If they died, the doctor must know at what age and of what causes they died. The doctor must know if any of the family has ever been ill with tuberculosis or has had any mental or emotional impairment. This information composes the family history.

The patient’s medical history must include the information about the diseases the patient has suffered, about the operations he has undergone, about any traumas he has had. The patient’s blood group and his sensitivity to antibiotics must be determined and written down in the patient’s case history. These findings compose the past history.

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The hospital staff carry on the following duties. Doctors make their morning rounds, write case reports and give instruction to the nurse as to the treatment of the patients. Surgeons perform operations and dress wounds. Nurses carry on the doctors’ orders, give out drugs, take the patients’ temperature, feel their pulse and give them injections. Laboratory assistants collect blood and throat cultures from the patients, make blood counts, urine and other kinds of analyses.

Working days at the in-patient department are very busy. Sometimes cases are complicated.

Here are some cases admitted to the in-patient department.

The onset of patient Hill’s disease was sudden. On admission his condition was poor. The doctor in charge examined him thoroughly. He questioned the patient and found out that severe pain in the heart and substernal area had begun two days before. He was still complaining of the pain radiating to the left arm and shoulder. The patient was pale, and his lips were cyanotic. He suffered from breathlessness. The pain and breathlessness increased on the slightest physical exertion. The doctor determined that the borders of his heart were dilated, the heart sounds were dull, the pulse was irregular at times. He also examined his other inner organs and found out that it was necessary to take the electrocardiogram, to make the analyses of blood and urine. Having got all the subjective and objective findings the doctor made the initial diagnosis of angina pectoris which was confirmed later.

Emergency admission to hospital was arranged at night. The patient was a retired bus driver, 65 years of age, having a severe chest infection. He couldn’t walk and was brought to the ward on a stretcher. On arrival in the ward, he was unable to give any history. His wife stated that a week before an upper respiratory tract infection accompanied by cough and general malaise was diagnosed by the general practitioner. But two days later the general practitioner returned and found the patient very excited and breathless at rest. The doctor insisted on hospitalization. Immediate examination was carried out, urine and blood analysis were made, and the patient’s chest was X-rayed.

Another patient was a 39-year-old male who had been confined to bed for several days. The pain in the chest hadn’t subsided by the time he was admitted to hospital. He was admitted to hospital with acute myocardial infarction. On his admission to hospital, the blood pressure measured 120/80. Normal pulsations were found in the radial, ulnar, and carotid arteries and in the abdominal aorta, but pulses in both legs were reduced to one half of their normal amplitude or less. The feet were warm with a normal colour and no swelling was evident. An electrocardiogram showed typical changes of infarction. Work at the inpatient department requires deep knowledge of medicine, quick thinking and a great sense of responsibility. A good bedside manner is of great importance. There is no doubt that such an attitude to the patients helps much in their recovery.

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I. Practice the pronunciation of the following words and word combinations:

therapy – to have practical work in Therapy, to get a credit in Therapy, to take the exam in Therapy, therapeutic [ˌθerə’pju:tik], at the therapeutic department, at the in-patient therapeutic department

a ward – a nurse on duty is in the ward, the reception ward, she works at the reception ward, a ward doctor, he works as a ward

heart attack – the onset of the heart attack, a bad heart attack, he has a heart attack

impairment – heart impairment, impairment of blood supply, impairment of health, impairment of blood pressure

procedure – to carry out some procedures, the nurse carried out some procedures

percussion – by means of percussion, percussion of the chest, percussion of the heart area

auscultation [ˌo:skəl’teiʃ n] – the method of auscultation, by means of auscultation, auscultation is applied while examining a patient

a doctor in charge – to work as a doctor in charge, he is the doctor in charge of this ward

to radiate – to radiate to smth, the pain radiates to the shoulder, the pain radiates to the back, the pain radiates to the side

cyanotic [ˌsaiə’notik] – cyanotic lips, cyanotic hand, the patient was cyanotic, to look cyanotic

breathlessness – a bad breathlessness, to suffer from breathlessness, to relieve breathlessness, breathlessness subsides completely

to dilate – to be dilated, the borders of the heart are dilated, the stomach is dilated urine [‘juəri:n] – the analysis of urine, urinalysis [ˌjuəri’nælisis], to make the analysis of urine, to make urinalysis to confirm

to subside – subsided, the pain subsides, breathlessness subsided gradually, fever will subside completely

to discharge – to discharge a patient from hospital, to be discharged from hospital

II. Discuss the following questions in pairs:

1.When are patients admitted to hospital?

2.What cases do general hospitals deal with?

3.What kinds of hospitals are there?

4.What data are recorded in the patient’s case history?

5.What are the responsibilities of the doctor on duty at the reception ward?

6.What information does the history of the present illness include?

7.What data compose the family history?

8.What findings does the past history contain?

9.What are the duties of the hospital staff (doctors in charge, nurses, and laboratory assistants)?

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10.Describe the condition of the first patient admitted to the in-patient department.

11.Who examined this patient?

12.What was revealed on examination?

13.What analysis was it necessary to make?

14.What diagnosis was made?

15.What treatment was administered?

16.What preceded the retired bus driver’s admission to hospital?

17.What was his condition on admission?

18.What examination was carried out?

19.What diagnosis was the 39-year-old male patient admitted to hospital with?

20.What findings were revealed on his admission?

21.Was the diagnosis confirmed?

22.What is important to know dealing with in-patients?

III. Find English equivalents for the following word combinations or sentences:

1) инфекционная больница; 2) хороший подход (врача) к больным; 3) страдать от одышки; 4) инфекция верхних дыхательных путей; 5) было необходимо снять электрокардиограмму; 6) утренний обход; 7) сонная артерия; 8) пульс временами был неправильным; 9) место работы; 10) губы у него были синюшные; 11) настоять на госпитализации; 12) тоны сердца были глухие; 13) явный отек; 14) границы сердца были расширены; 15) описание течения болезни; 16) прикован к постели; 17) психические нарушения; 18) сильная боль, отдающая в левую руку и плечо; 19) дата поступления (в больницу); 20) группа крови; 21) чувствительность к антибиотикам;

22)боль и одышка усиливались при малейшем физическом напряжении;

23)инфаркт миокарда; 24) приемный покой; 25) чувство ответственности;

26)полное физикальное обследование; 27) предписания врача; 28) персонал больницы; 29) перевязывать раны; 30) лечащий врач.

IV. Translate the following sentences into English:

1.Лечащий врач – опытный терапевт. Он очень хорошо умеет обращаться с больными.

2.Тяжелые сердечные заболевания могут быть вызваны нарушением кровообращения.

3.Больная была прикована к постели. Даже малейшее физическое напряжение вызывало приступ острой боли.

4.Больные со стенокардией при физическом напряжении чувствуют боль, особенно при ходьбе на улице.

5.Наиболее тяжелые приступы стенокардии бывают (occur) ночью; как правило, больной просыпается от болей, при этом он чувствует необходимость сесть.

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6.Лечащий врач прописал больному, страдающему тяжелым заболеванием сердца, уколы гепарина. Больной должен был соблюдать строгий постельный режим.

7.Чем больна ваша дочь? – У нее что-то с сердцем.

8.Данные анализов, сделанных в клинике, подтвердили первоначальный диагноз участкового врача.

9.Этот больной поступил в стационар после тяжелого сердечного приступа.

10.Bрачи делают все возможное, чтобы бороться с сердечно-сосудистыми заболеваниями.

11.С четверга он прикован к постели после тяжелого сердечного приступа.

12.При выстукивании определяются границы сердца, легких и других внутренних органов.

13.Синюшный больной был доставлен в приемный покой на носилках.

14.При помощи пальпации исследуются некоторые внутренние органы.

15.Говорят, что приступ стенокардии начался внезапно.

16.Нужно всегда соблюдать курс лечения, прописанный врачом.

17.Оказалось, что это лекарство произвело заметное воздействие на больного.

18.Нужно снять электрокардиограмму больному к трем часам.

19.Этого больного думают выписать из больницы через неделю.

20.Предполагают, что нарушение сердечной деятельности было вызвано передозировкой лекарствa.

21.Нужно всегда подробно и внимательно записывать все данные в отношении состояния больного.

II. Focus on essential vocabulary

Health and illness I

1. Study words, phrases and collocations.

A. Phrasal verbs and verb-preposition collocations for health and illness:

I’m fighting off the cold at the moment. [trying to get rid of]

Marge isn’t in today; she has gone down with flu. [has caught, usually a nonserious illness]

I won’t be going today. I’ve come down with a dreadful cold. [with I we say come down not go down]

I had a virus last week, but I got over it quite quickly. [got better, recovered] My sister’s recovering from a major operation. [getting better; used for more serious illnesses]

Harry suffers from hay fever and sneezes a lot if he is near grass or flowers. [used for more long-term problems]

He died of/from lung cancer.

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B. Health systems:

In Britain, healthcare1 is paid for through taxes and national insurance2 payments taken directly from wages and salaries. The government decides how much will be spend on the National Health Service3, but a lot of people feel they do not spend enough. Hospital treatment and visits to a family doctor (or GP)4 at a surgery5 or clinic6 are free, but there is a prescription charge7. Dentists and opticians charge fees. Private healthcare is available and a large number of insurance schemes exist to enable people to ‘go private’8.

1general expression for all of the services offered by hospitals, clinics, dentists, opticians, ect.

2tax paid by most adults which covers the costs of healthcare for everyone

3British name for the service that covers hospitals, clinics, dentists, etc.

4doctor who looks after peoples’ general health: GP means general practitioner

5small center with just two or three doctors

6large center with several doctors and kinds of services

7charge for the medication the doctor prescribes, which you pay at a pharmacy

8choose private healthcare

C. Serious illnesses and health problems:

Here are some serious illnesses, with the word-stress underlined.

diabetes: disease where the body does not properly absorb sugar and starch bronchitis: inflammation in the breathing system, causing you to cough

heart disease: serious illness connected with heart which can lead to a heart attack skin cancer / lung cancer / breast cancer: harmful tumours in those areas

TB (tuberculosis): infectious disease in the lungs

cholera: an intestinal disease that can be caused by bad drinking water hepatitis: inflammation of the liver

typhoid: fever with red spots on the chest and abdomen heart attack/failure: when the heart fails

D. Medical information leaflets:

Read these extracts from a leaflet contained in a packet of headache pills.

If your answer to any of the following questions is YES, then you should tell a doctor or pharmacist before taking these pills.

Are you pregnant or breastfeeding?

Are you sensitive to any of the ingredients in these pills?

Do you suffer from liver, kidney or heart problems?

Do you suffer from haemophilia [problems with your blood not clotting1 properly]?

Are you taking any other medicines – particularly for blood pressure, anticoagulants for thinning the blood, antidepressants, cortico-steroids, antiepileptic drugs?

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Are you asthmatic?

Are you suffering from dehydration2?

Do you suffer from or have you suffered from a stomach ulcer3? WARNING:

DO NOT EXCEED THE STATED DOSE

Medicines can cause unwanted side effects4 in some people. If, after taking some medicines for the first time, you have an asthma attack or bronchiospasm (difficulty in breathing), gastro-intestinal haemorrhage (vomiting of blood or passing of dark, tarry stools5), stop taking these pills and consult a doctor or pharmacist.

1forming a partly solid lump

2not having enough water in your body

3painful infected area on the skin or inside your body

4unwanted effects in addition to the intended one

5medical term for (formal) excrement or (informal, childish) pooh

2. Language focus. Do the exercises.

A. Which is the odd one out in each group, in terms of the main word stress?

1) diabetes bronchitis cholera

2) heart attack sore throat lung cancer

3)hepatitis typhoid tuberculosis

4)illness disease sickness

5)consultant doctor surgeon

6)hospital ambulance transfusion

7)heart disease surgery TB

B. Sort these everyday phrasal verbs and expressions connected with health and illness into two groups, depending on whether they have positive or negative meanings with regard to health:

Now fill the gaps using the expressions above:

1.[Nurse to visitor in a hospital] ‘I’m sorry, Mr Pickering is rather _____ today and we’re not allowing visitors.’

2.[Someone speaking to a colleague just returned to work after an illness] ‘Hello? Frank? Good to see you _____.

3.[Person ringing their place of work] ‘Jo? I won’t be in today, I’ve _____ a cold.’

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4.[Person in hospital, just beginning to get better, talking to a visitor] ‘Oh, I’m OK. I’m _____ now. I still feel bad, but I should be out within a week or do.’

5.[Parent to a child with a cold] ‘Don’t worry, darling. Everyone has a cold now and then. You’ll _____ it.’

6.[Someone to their partner, who is worried about them] ‘Don’t worry. It’s nothing serious. I’m just feeling _____, that’s all.

7.[Someone ringing a workmate] ‘I’m trying to _____ the flu, but nothing seems to help. I don’t think I’ll be in work tomorrow.’

8.Hilary was quite ill last week, but she’s _____ now and should be back at work next week.

C. Which of these collocations are normal, and which are not normal? Correct the inappropriate ones:

1.Her mother died with skin cancer.

2.Is there a prescription price in your country?

3.In Britain, national security is a separate tax from income tax.

4.Healthcare is the biggest item in the nation’s budget.

5.Are there insurance societies for private healthcare in your country?

6.Private dentists charge very high fees.

7.She suffers of a severe allergy and can’t be in a smoky room.

D. Complete the word formation table:

Health and illness II

1. Study words, phrases and collocations.

A. Minor ailments and ways of talking about minor problems:

Note that hurt is different from ache:

My arm hurts where I banged it against the car door. [gives pain caused by in injury]

My wrists ache from too much typing at the computer.

The fixed expression (the usual) aches and pains is often used to refer in a non-serious way to minor problems

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A:How’ve you been keeping recently? Mona?

B:Oh fine, you know, just the usual aches and pains.

The fixed expression cuts and bruises can refer to minor injuries.

A:I hear you fell off your bicycle. Are you all right?

B:Yeah, fine, just a few cuts and bruises, nothing serious.

Some other kinds of physical discomfort:

My hand is stinging since I touched that plant. [sudden, burning pain] My head is throbbing. [beating with pain]

I have a stiff neck from turning round to look at the computer screen all day. I’ll have to move the monitor to a better position. [pain and difficulty in moving your neck round]

I feel a bit dizzy. I feel I should sit down. [a feeling that you are spinning round and can’t balance]

She was a bit feverish this morning, so I told her to stay in bed. [with a high temperature]

I had a terrible nauseous feeling after taking the medicine, but it passed. [feeling that you want to vomit]

He was trembling all over; I knew it must be something serious. [shaking] My nose is all bunged up today with this horrible cold. [blocked]

Other informal expressions that mean ‘not well, but not seriously ill’: You look a bit off-colour today. Are you all right?

I was feeling a bit under the weather, so I stayed home that day.

I’m just feeling a bit out of sorts, it’s nothing to worry about. I’ll be fine tomorrow.

B. Alternative medicine:

Nowadays a lot of people prefer alternative medicine. For example:

homeopathy: taking tiny amounts of natural substances to treat an illness aromatherapy: using aromatic oils and massage

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2. Language focus. Do the exercises.

A. Correct the mistakes in the sentences:

1. She was feeling out of the weather and a bit fevering so she took the day off. 2. I felt really off my colour yesterday and my head was throwing, so I took a

tablet.

3. I felt a bit off the sorts and seemed to have more pains and aches than usual. 4. My arms are hurting after carrying that heave suitcase.

B. Rewrite the underlined parts of these sentences using words and phrases from A above:

1.I was feeling quite a as if I had a high temperature.

2.The drugs always gave her a feeling that she wanted to vomit.

3.I felt as if my head was spinning and went and lay down an hour.

4.My nose was blocked so I got a spray from the chemist.

5 I got a pain in my neck from driving a long time in an awkward position. 6. Joanna was shaking and looked unwell, so I asked her if she needed help.

C. Complete these sentences with words from the box:

1.I can’t take penicillin; I’m _____ it.

2.Before you take those pills, read the label to see what the correct _____ is.

3.I’m going abroad next month so I have to get the necessary _____.

4.If you consult a new doctor you should tell him or her if you are already on any _____.

5.Did the doctor give you a _____? Do you want me to take it to the chemist’s for you?

6.I told the doctor my _____, but I don’t think she was listening.

7.The doctor gave me a _____ for my employer. I was off work for two weeks.

D. What do we call the type of alternative medicine which…

1.Uses herbs and other natural plants?

2.Uses oils which smell nice and are rubbed into your body?

3.Uses needles to stick into specific parts of your body?

4.Uses tiny amounts of substances which cause the illness the doctor is trying to cure?

5.Manipulates your spine and bones to ease backache and other pains?

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