Immunity. As a rule, one attack of whooping cough is followed by life-long immunity. Second attacks o__________(23) pertussis are rare.

Prophylaxis. Children should be immunized at the age o__________(24) 5-6 months with a pertussis - diphtheria v__________(25).

(10)

Exercise 1.

Guess the diagnosis and prove your choice:

The child aged 4 is in the bed. Some medical students with the attending doctor are around him.

DOCTOR: The child suffers from vomiting and complains of pain in the back and legs. He has some giddiness and general malaise.

FIRST STUDENT: Is his temperature curve constant?

DOCTOR: He has a slight fever.

SECOND STUDENT: How old is he?

DOCTOR: 4 years old.

THIRD STUDENT: I see generalized rapidly progressing pigmentation changes all over his body.

FIRST STUDENT: They are particularly marked on the hairy part of the head.

SECOND STUDENT: I see red macula and papules with vesicles in the centre.

THIRD STUDENT: But on the other side of the head there are brownish crusts.

DOCTOR: How many vesicles do you see?

FIRST STUDENT: Oh, it’s difficult to count, some hundred ones.

DOCTOR: I suppose you can diagnose the disease. During the course of the disease the body and the scalp may be covered with macula, papules, vesicles and crusts at the same time. Troublesome pruritus of the skin leads to its being scratched that should be avoided.

FIRST STUDENT: And what’s the average number of vesicles?

DOCTOR: The amount of vesicles is variable. It depends on severity of the disease. Who knows anything about this?

SECOND STUDENT: I do. In a slight case there may be only 8-10 vesicles, but sometimes in severe cases their number may amount to six-seven hundred. These papules are usually of semi-spherical shape and look like limited erythematous patches.

DOCTOR: Right you are. And in the majority of cases it is not difficult to diagnose the disease, but it is necessary to differentiate it from other skin eruptive disorders of fungal and parasitogenic character.

Exercise 2.

Study the following information:

X-ray examination

The chest X-ray is the commonest diagnostic X-ray examination. Normally a frontal (anteroposterior) view is obtained. The patient stands facing the photographic plate with the chest pressed to the plate, with hands on his hips and elbows pushed out in front. The radiographer, the technician who takes the X-rays, asks the patient not to move, then to breathe in deeply and not to breathe out. This makes a blurred, unclear X-ray image less likely and improves the quality of the image, as it is easier to see abnormalities in air-filled (inflated) lungs than in deflated lungs. For a side, or lateral view, the patient is asked to stand sideways to the photographic plate with arms raised. A chest X-ray may be repeated at intervals to track for any changes. These repeated examinations are called serial chest X-rays.

Complete the radiographer’s instructions. Use the phrases from the text above:

Please, stand (1) __________ this board.

Put your hands on the back of your hips and your elbows forward. I’ll help you.

(2) __________your elbows (3) __________ .

Keep (4) __________ .