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3. An eight-year-old child has stomach cramps and is very agitated. She ate an
pneumonia
пневмония
respiration; res piratory
дыхание; дыхательный, респираторный
râle
хрип
chronic
хронический
cough
кашель
space
пространство, промежуток
inflammation, inflamma-
воспаление, воспалительный
affect, affection
поражать, поражение
purulent spu tum
гнойная мокрота
dullness
тупость, приглушение
shadow
тень, затемнять
severe
резкий, сильный, тяжелый, серьезный (о бо-
apple, includ i ng the core , a nd thi nk s a tree is go i ng to gr ow insid e her. You
need to examine the child.
4. A twelve-year-old girl comes in with the first-degree burn on her hand.
She’s worried she’s goi ng to be scarred for life and thinks it’s her own fault
because she’d been to ld not to play with candles.
Unit 3. Respiratory Disorders
1. Read and learn the words by heart:
tory
лезни)
2. Translate the word combinations with the given key-words:
pneumonia: croupous pneumonia; lobar pneumonia; specific pneumonia; bron-
chopneumonia; lobular pneumonia; catarrhal pneumonia
62
respiration: shallow respiration; accelerated respiration; bronchial respiration;
1) disorder s of the respiratory system
a) соотношение пульса и дыхания
2) the sudden onset of lobar pneumo-
b) оценить состояние ребенка
3) pulse-respiration ratio
c) колебания температуры в течение
4) digestive diet
d) отхаркивать мокроту
5) to promote resolution
e) расстройства дыхательной систе-
6) the site of infection
f) вызывать (стимулировать) дых
7) daily fluctuations of temperature
g) незрелость дыхательных органов
8) to induce respiration
h) легкоусваиваемая диета
9) to assess the child’s condition
i) обилие свежего воздуха
10) to swallow the secretions
j) локализация инфекции
11) to produce expectorations
k) внезапное начало
12) abundance of fre sh air
l) занимать важное место в списке
13) to figure largely in the list
m) способствовать рассасыванию
14) immaturity of the respiratory or-
n) заглатывать мокроту
deep respiration; res piratory disease; respiratory failure
râles: moist râ les; bubbling râles; fine bubbling râles; crepitant râles; dry râles
cough: continuous cough; productive cough; dry cough; intermittent cough; deep
cough; painfu l cou gh
chronic: chronic lu n g dise as e; chronic bronchi ti s; chr o nic co ugh
space: axillary space; interscapular space; intercostals space; paravertebral space
3. Match Russian and English equivalents:
nia
ня
мы
ание
у детей;
gans in childre n
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4. Translate into Russian the following word-combinations:
1) respiration is shallow and accelerated; 2) a severe form of pneumonia; 3) at the
height of the disease; 4 ) moist bubblin g râles and crepit ation; 5) to resp ond well to
treatment; 6) digestive diet; 7) bronchopneumonia may be caused by pneumococci;
8) onset is usually insidious; 9) cough is continuous but often intermittent; 10) the
temperature shows da ily fluctuation.
5. Translate into English the follo wing word-combinations:
1) крупозная или долевая пневмония; 2) бронхопневмония; 3) начало долевой
пневмонии внезапное; 4) самые распространенные типы воспаления легких;
5) легкий кашель; 6) выявить бронхиальное дыхание; 7) на стадии выздоров-
ления; 8) обилие свежего воздуха; 9) незрелость дыхательных органов у де-
тей; 10) особенности дыхательной системы у детей.
6. Read and translate t he given words:
1) bronchus – bronchitis, bronchi, bronchial, bronchiectasis [,broŋki'ektasis];
2) to irritate – irritati on, irr ita ti ve ;
3) to infect – infected, infection, infectious;
4) to breath – br e at h le ss, br ea t hle s sne s s, to brea th in, to br ea t h out.
7. Translate the following sentenc es:
1. The incidence of lobular pneumonia is high in early childhood. 2. Most
râles of various force are auscultated in bronchitis, bronchopneumonia, and pulmonary edema. 3. In early age of child’s life staphylococcus is often the cause of
severe pneumonia. 4. Moist cough is symptomatic of bronchitis. 5. In pneumonia
the cough is short and painful. 6. Oxygen and abundance of fresh air are indicated
for infants at the height of pneumonia. 7. If the bronchi are chiefly affected and no
signs of pneumonia are evident this disorder is diagnosed as bronchitis. 8. The
most common site of infecti on in lobar pneumonia is the middle and lower lobes of
64
the lungs. 9. The disorders of the respiratory system predominate in early childhood. 10. Pneumonia may have an insidious onset in newborn infants.
8. Read and translate t ext I. Make the plan of th e text using key-words.
Text I. The Disorders of the Respiratory System
in Children
The disorders of the respiratory system still figure largely in the list of causes of
death in infancy and childhood. The incidence and severity of respiratory system
diseases are due to immaturity of the respiratory organs in children. The most
common types of inflammation of the lungs are croupous or lobar pneumonia, and
bronchopneumonia or lobular pneumonia (catarrhal pne umonia).
Lobar pneumonia is caused by pneumococci, streptococci, staphylococci. In lobar pneumonia one lobe or a portion of a lobe may become affected. The pathologic process often arises in the lower right lobe, then in the lower left and upper right
lobes. The onset of lobar pneumonia is sudden. Pain in the side is often absent in
children, especially young ones. Cough is usually slight or even absent. Respiration is shallow and accelerated. The pulse-respiration ratio falls to 2-3:1. The temperature may reach 40ºC at the height of the disease.
Auscultation and percussion reveal bronchial respiration, dullness, moist bubbling râles and crepitation. On auscultation attention should be given to the following spaces: the axillae – early appearance of bronchial respiration in lobar pneumonia, the paravertebral spaces – frequent localization of bronchopneumonia in
babies and interscapular space – on se t of pne umonia.
Usually children ill with lobar pneumonia respond well to bed regimen, fresh
air, light diet, good care and specific therapy consisting of sulfonamides and antibiotics. In the convalescent stage the deeper respirations induced by exercises as
well as open-air life will tend to promote resolution of the consolidation in the
lung.
65
Bronchopneumonia which predominates in childhood may be caused by pneumococci, streptococci or influenza bacilli. The site of the infection is limited to the
pulmonary lobules. The onset of bronchopneumonia is usually insidious, its course
is slower than in lobar pneumonia, and it may follow some other kind of respiratory infection (influenza, whooping cough, bronchitis). On auscultation and percussion bronchial breathing, fine moist râles and crepitation are found. Dyspnea and
weakened cardiac activity are characteristic symptoms. Cough is usually present
through the whole course of the disease, sometimes continuous, but more often intermittent. Due to the tendency of children to swallow the secretions from their
lungs, it is unusual for them produce any expectoration. The temperature as a rule
shows daily fluctuation and is usually expected to reach its maximum in the first
few days.
Bed rest, abundance of fresh air, fluid, digestive diet and specific therapy with
two antibiotics are usually helpful in controlling bronchopneumonia in children
and infants.
The peculiarities of the child respiratory system should be fully appreciated, in
assessing the child’s condition adult standards not to be applied for examining the
child’s respiratory system.
9. Answer the questions using the text:
1. What disorders figure largely in the list of causes of dea th in infancy?
2. Why do disorders of the respiratory system still figure largely in the list of
causes of death in in f ancy?
3. What part of the lung is affected in lobar pne umonia?
4. What is the onset of lob ar pneumonia marked by?
5. What are characteristic features of cough, respiration and temperature in lobar
pneumonia?
6. What do auscultatio n and percussion reveal in lobar pneumonia?
7. How many apices must one remember for a thorough examination of the
lungs?
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8. What does treatment of lobular pn eumonia consists of?
9. What procedure tend s to promote r esolution of the consolidation in the lung?
10. What pneum onia pre dominates in childhood?
11. What is the site of infection in bronchopneumonia?
12. What is the course of bro nchopneumonia?
13. What are the results of auscultation and percussion in bronc hop n eumonia?
14. What are ch aracteristic symptoms of bronchopneumonia?
15. What treatment is helpful in controlling bronchopne umonia in children?
10. Give the English equivalents to the word combinations in brackets. Translate the sentences:
1. (Возбудителями долевой пневмонии) are pneumococci, streptococci, staphylococci. 2. (Начало долевой пневмонии) is sudden. 3. Respiration is (поверхно-
стное и учащенное). 4. Auscultation and percussion (обнаруживают бронхиальное дыхание), dullness, moist bubbling râles and crepitation. 5. (Локализация
инфекции) is limited to the pulmonary lobules. 6. (На стадии выздоровления)
the deeper respirations induced by exercises and open-air life. 7. The onset of
bronchopneumonia is usually (скрытое). 8. (Незрелость дыхательных органов)
is responsible for the incidence of diseases of these organs in children. 9. (Осо-
бенности детской дыхательной системы) should be fully appreciated. 10. Bed
regimen, (обилие свежего воздуха), fluid, (легкоусваиваемая диета) and sp ecific treatment ar e helpful in controlling bronchopneumonia in children and infants.
11. Give the summary of text I according to you r plan.
12. Read and translate the dialogue:
-Good morning.
-Good morning, do c tor .
-What troub les you?
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-My son is ill, doctor. He complains of a generalized aches and pains in his back
and legs, headache. Also he has a sore throat and nonproductive cough. You see
his face is flushed. He has chills an d fever up to 39ºC.
-Let me examine him thoroughly… Y our son has i nfluenza.
-What should I do?
-He should remain in bed. I administer him antipyretics and analgesics. 1 or 2
drops of 0.25% phenyleprine will relieve nasal obstruction. Gargles of warm isotonic saline and steam inhalation will be useful for sore throat.
-Thank you, doctor.
-Not at all. Good bye.
-Good bye.
13. Listen to the dialogue. F ill in the gaps:
Doctor: OK, Joe, I need to look at your _____, so can I get Mummy to take off
your lovely Bob the Builder T-shirt for a few moments? Will you let me ____ __
_____? … Ah , thank you, Joe. I won’t be long, and then you can put it back on.
This is called a _______, Joe. It’ll help me to find where your cough is ______
______. I have teddy here to show you what I’ll do. I put this part in my ears and
then I put this part on _____ _____ to hear his breathing. It won’t hurt you in any
way. It’ll feel a bit cold, but I’ll warm it up. Do you understand what _____ ____
__ __, Joe?
Joe: Yes.
Doctor: OK. Now I need you to take a big _____ for me and hold it. That’s great,
Joe … once more … and hold it. That’s fine. Thank you, Joe. You can put your top
back on now.
13. Make up your own dialogue “The doctor and the pediatric patient with
some respiratory trou ble”. The following points are helpful:
Key points from the history
• Is the child short of brea th or wheezy (remem ber to define terms)?
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• Is there stridor or croup?
• Is there a cough? Does it disturb sleep?
• Does anything trigger the symptoms: sport, cold weather, pets?
• Has the child expectora ted or vomited any sputum?
• Is the infant short of breath d uring breast or bottle feeding?
• Is there a possibility the child could have inhaled a foreig n body?
• Is there any FHx of respiratory problems such as asthma or cystic fibrosis?
• Does the child have a fever suggestive of infection?
• Has anyone else been unwell? Any contacts with tuberculosis?
• Has the child travelled abroad rece ntly?
• How does the respiratory problem limit the child's life how much school is
missed, can they play sport, how fa r can they run, is sleep disturbed?
14. State the function of Infinitives in the following sentences. Translate the
sentences:
1. Pus resulting from bacterial action is mixing with the mucus, making it opaque
and white or staining it yellow; the discharge is then mucopurulent. 2. The effect
produced by the drugs was too strong in many cases to be considered safe. 3.
Obsrtuction of bronchioles evokes coughing that helps to clear the lungs. 4. Much
remains to be said about the effect of this scientific method. 5. Any accumulation
of fluid in the pleura of a young child eas ily causes displacement of the mediastinal
organs, the first organs to be displaced are the heart and the vena cava inferior. 6.
Many questions remain to be answered.
15. Give the a) appropriate tense forms of the verbs in brackets; b) appropriate forms of the infinitive. Translate the sentences:
A. 1. Chronic bronchitis, emphysema, and other lung diseases (to aggravate) by
small particles. 2. Type C influenza (to be) relatively uncommon and type B (to
produce) endemic and small epidemics of influenza. 3. Influenza (to characterize)
69
by a short incubation period of 1-4 days, followed by the sudden onset of fever,
headaches, myalgia and a cough. 4. Each basic type of influenza virus (A, B or C)
(to have) its own distinctive ribonucleoprotein consisting of the S or soluble antigen. 5. Bacteria (to consist) of only a single cell, but don’t let their small size and
seeming simplicity fool you. 6. Bacteria (to eat) everything from sugar and starch
to sunlight, sulfur and iron. 8. Bacteria (to find) that they can live in temperatures
above the boiling point and in cold that would freeze the blood.
B. 1. The mother said the child (to produce) expectoration still. 2. The doctor made
the patient (to X-ray) at once. 3. The young doctor reported all peculiarities of the
child’s development (to take) into consideration. 4. The pediatrician stated bed regimen, fresh air, good care to promote) resolution of consolidation. 5. The doctor
believes the course of therapy (to repeat) as needed. 6. They expect the infant (to
respond) well to the treatment
16. Fill in b lanks with the following words – until, since, than, that, above, all:
1. The upper portion of the respiratory tract is affected more often … the lower
one. 2. … the cilia can no longer clear the lungs of mucu s it accumulates … the
flow of air through the bronchioles is obstructed. 3. This obstruction then evokes
coughing … helps to clear the lungs. 4. … chronic bronchitis should receive the
treatment of a physici an.
17. Point out the senten ces with Complex Subject and Complex Object. Translate the sentences:
1. This man seems to have a third-degree burn. 2. He i s thought to be discharged
from the hospital today. 3. She was believed to have high blood pressure. 4. The
doctor ordered the nurse to give intramuscular injection of penicillin to this patient.
5. I know this surgeon to operate on successfully. 6. Our data seem to support the
theory. 7. This diet seems to be good for the patient and should be recommended.
8. The results lead us to believe that the technique is useful. 9. She heard the child
cough at night. 10. The child was managed conservatively and then discharged
70
when she appeared to have fully recovered. 11. Other reasons why this viral pneumonia proved to be fatal for this patient are not clear. 12. Atypical pneumonia appears to be more severe in patients with sickle cell disease, who often have a prolonged toxic course. 13. The type of onset of lobar pneumonia appears to be influenced by the pneumococci type. 14. Streptococci pneumonia is likely to occur in
the course of or following epidemics of measles or “flu”. 15. By the third hospital
week the infant’s condition was seen to be rap idly improving.
18. Translat e the following sentences into English:
1. Основной симптом хронического бронхита – кашель. 2. Восприимчивость
к бактериальной пневмонии обусловлена повреждением бронхиального эпи-
телия. 3. Грипп и другие респираторные заболевания протекают у новорож-
денных тяжело. 4. Анатомо-физиологические особенности организма ново-
рожденных объясняют частоту и тяжесть респираторных заболеваний по
сравнению со взрослыми. 5. Мелкие пузырчатые хрипы, сопровождаемые ас-
тматическим дыханием, часто являются первым признаком начала пневмо-
нии, особенно у младенцев. 6. Важным фактором в профилактике пневмонии
является борьба с такими инфекционными заболеваниями, как грипп, корь,
коклюш, которые часто осложняются пневмонией.
19. Read text II. Give the abstract of the text. Answer the question What is necessary for a correc t di a gno s is of pn eumonia?:
Text II. Pneumon i a in Children
Although a large number of children are admitted to the hospital with initial
diagnosis of bronchopneumonia, this diagnosis is found to be correct in only a few
of them. The suspected diagnosis of pneumonia is not confirmed. Bronchopneumonia in children may easily be confused with bronchitis or upper respiratory infection without broncho-pulmonary involvement. In some cases it is difficult to
make an exact diagnosis and sometimes it remains undetermined until characteristic manifestations of the disease are evident.