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  • At the Doctor’s Unit I

  • Exercise № 1 Fill in the blanks using the following vocabulary the couch, make, remove, the grippe, to strip, the doctor, the flu

  • Exercise № 2 Use “would like” to make questions. Also, answer in the affirmative or negative as indicated Example

  • Text 1 (for reading and retelling)

  • Text 2 (for reading and questioning)

  • As regards

  • Методичка 2012 англ.. Настоящее учебное пособие


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    ПРЕДИСЛОВИЕ
    Настоящее учебное пособие (практикум) предназначен для студентов, продолжающих изучение английского языка на базе знаний, полученных на первых двух семестрах первого курса базовой части учебного плана лечебного факультета в соответствии с ФГОС ВПО.

    Цель пособия состоит в продолжение обучения иностранному языку на третьем семестре, определяя его статус в реестре вариативной части учебного плана.

    Данное пособие служит цели отработки учебно-познавательной темы «Врач-пациент» и соответствующих языковых действий, способствующих обогащению словарного запаса студентов и одному из основных видов речевой деятельности – говорению.

    Авторы исходили из принципов последовательности развития тематики, служащей основой для занятий по практике устной профессионально-ориентированной речи.

    Отсюда – соответствующая структура и содержание всех разделов (модулей) пособия. В процессе написания авторы так же исходили из принципов компетентного подхода УЦ ОПП. В частности, общекультурные компетенции (ОК-01, ОК-6) и профессиональные компетенции (ПК-31).

    Авторы


    At the Doctor’s
    Unit I
    General Information
    When we are ill, we go to our doctor (as a rule a physician) in the local polyclinic. But if we are very ill, feel poorly, unable to leave our home or too ill to attend the polyclinic, we call the doctor. When we have a headache, a stomach ache, a sore throat, a cold or a pain in some part of the body, the doctor examines us and diagnoses illness (or disease). He asks us to take our temperature (in Russia the patient takes the temperature under his arm, in UK and USA in the mouth between the molar teeth and the cheek), checks (measures) our blood pressure with the aid of a special device (this instrument is called sphygmomanometer) and checks our pulse pressing two fingertips (a forefinger and a middle finger) on the vein by the wrist. Then he usually asks us to strip to the waist (to slip off the top things) and begins to listen to our heart at the front and from behind, to examine our lungs with the aid of the stethoscope. To examine the abdominal organs (liver, gall-bladder, pancreas, bowels (intestines), kidneys, urinary bladder) the doctor asks us to lie down on the couch. He palpates the abdomen, all his parts (sections), especially that which hurts us.

    Finally the doctor allows us to rise and while we are getting dressed he tells us what the matter is with us. “Nothing to worry”, says the doctor and we feel a sense of relief. “You have a slight temperature”, or “You have the flu”, or “You have caught a cold (chill), or “You have overworked yourself” (you have been run down).

    But sometimes the doctor considers it necessary to advice us to have a complete check up. That means to take analyses (sing. analysis) of blood, urine, gastric juice and other tests. The laboratory findings help the doctor to make a correct (accurate) diagnosis and administer a proper treatment.
    Vocabulary

    to feel poorly – чувствовать себя плохо

    with the aid (of) - с помощью (чего-либо)

    to check - проверить, обследовать

    wrist - запястье

    to strip (to the waist) - раздеться (до пояса)

    to slip off the top things - раздеться (до пояса)

    to get undressed to the waist - раздеться (до пояса)

    to take off the top things - раздеться (до пояса)

    to remove the top clothing - раздеться до пояса

    couch - мед. кушетка

    to worry - беспокоить(ся)

    to catch a cold - простудиться

    you have been run down - переутомились

    he considers it necessary - он считает необходимым

    a proper treatment - соответствующее (должное) лечение
    Exercise № 1
    Fill in the blanks using the following vocabulary
    the couch, make, remove, the grippe, to strip, the doctor, the

    flu

    1. I have been having a stomach ache for three days and I wish to be examined by…

    2. Robert has missed two lectures on Biology yet, it is firm belief that Robert has fallen ill with… / Robert has caught…

    3. The physician says to the patient: “Would you like … to your waist”.

    4. The patient is hard on hearing and asked again: “Must I… my top clothing?”

    5. If the doctor wants to examine the patient’s abdomen, he asks the patient: “Could you lie down on …”

    6. The laboratory tests of blood, urine, gastric juice help the doctor… a correct diagnosis.


    Exercise № 2
    Use “would like” to make questions. Also, answer in the affirmative or negative as indicated
    Example:

    I go to the library. (no)/ (yes)

    Would you like to go to the library? No, I wouldn’t

    Yes, I would.

    1. She takes the temperature. (yes)

    2. He lies down on the couch. (yes)

    3. Mary drinks a glass of water. (no)

    4. They take pills late. (no)

    5. I like to help the surgeon on the operation. (no)


    Taking a history
    Any first interview between a doctor and his patient starts with the statement of the available information: surname, first name, age, sex, marital status (семейное положение; женат / замужем / нет), occupation and present complaints (жалобы).

    Note how the doctor starts the interview with the patients, for his problem:

    • What’s brought you along to day?

    OR:

    - What seems to be the problem?

    OR:

    • What is ailing you?

    OR:

    • What can I do for you?


    Note how the doctor asks how long the problem has lasted:

    • How long have they been bothering you?

    OR:

    • How long have you had them?


    Note how the doctor asks questions about the patient’s occupation:

    • What’s your job?

    OR:

    • What do you do?

    OR:

    • What’s your occupation?

    OR:

    • What are you by profession?


    Note how the doctor asks where the problem is:

    • Which part of your head (of the body) is affected?

    OR:

    • Where does it hurt?

    OR:

    • Where is it sore?

    OR:

    • Whereabouts is the pain?

    OR:

    • Show me where the pain is?


    Note how the doctor asks about the type of pain?

    • Can you describe the pain?


    Other ways of asking this are:

    • What’s the pain like?

    • What kind of pain is it?


    Other questions the doctor may ask

    1. What’s your name?

    2. How old are you?

    3. Are you married?

    4. Where exactly is the pain?

    5. Did anything special bring the pain in?

    6. Is it worse at any particular time?

    7. Does anything make it better or worse?

    8. Have you any other problems?

    9. Have you taken anything for it?

    10. Did the aspirin help?


    Exercise № 3
    Study this short dialogue:
    Doctor: Well, Mr. Below. What brought you along today?

    Mr. Below: I’ve got a bad dose of flu (1).

    Doctor: How long has it been bothering you?

    Mr. Below: Two or three days (2)
    Practise this dialogue, getting a fellow student to play the part of the patient. He (she) can select replies from lists (1) and (2) below. Use all the ways of starting an interview and asking how long the problem has lasted.


    (1)

    (2)

    A bad dose of flu

    A fortnight

    Terrible diarrhoea

    Two or three days

    Swollen ankles

    Since Tuesday

    A pain in my stomach

    For almost a month


    Use this additional information to answer any questions the doctor asks.


    1. Greasy (жирная; приготовленная на топленом жире) food, like fried eggs, upsets (нарушает, расстраивает) you most. The pain lasts several hours. [gallbladder]

    2. The pain wakes you at night. Usually early in the morning. Spicy (пряности) food brings on the pain Too much to drink also makes it worse. [duodenal ulcer]

    3. The pain is really bad. You’ve been coughing up brownish spit. You’ve had a temperature [pneumonia]

    4. You’ve had a cold. You’re not coughing up phlegm [tracheitis].


    Exercise № 4
    Practise the dialogue, getting a fellow student to play the part of the patient. He/she can select replies from the list (1) below
    Doctor: What part of your back (chest, head, etc.) is affected

    Patient: Just here.

    Doctor: Can you describe the pain?

    Patient: It’s…

    (1)

    a dull (тупой) sort of ache, throbbing (пульсирующая)

    a feeling of pressure

    very sore, like a knife

    a burning pain
    Note how the doctor asks if anything relieves the pain:

    • Is there anything that makes it better?


    Similarly (аналогично) he can ask:

    • Does anything make it worse?


    Doctors often ask if anything else affects the problem. For example:

    • What effects (воздействие) does food have?

    • Does lying down help the pain?


    Exercise № 5
    Work with a partner. In each of these four cases ask your partner where the pain is. Then ask two other appropriate questions to help you reach a diagnosis. Use all the ways of questioning we studied above. For example:
    Doctor: Where does it hurt?

    Patient: Right across here (indicating the central chest area)

    Doctor: Can you describe the pain?

    Patient: It’s like a heavy weight pressing on my chest.

    Doctor: Does anything make it better?

    Patient: If I stop for a bit, it goes away.
    In this example, the patient’s symptoms suggest angina.

    Now try each of these four cases in the same way.

    1.

    Doctor: _________________________________

    Patient: Here, just under my ribs.

    Doctor: _________________________________

    Patient: It gets worse and worse. Then it goes away.

    Doctor: _________________________________

    Patient: Food makes it worse.

    2.

    Doctor: __________________________________

    Patient: It’s right here (indicating the stomach area)

    Doctor: __________________________________

    Patient: It’s a gnawing (ноющая) kind of pain.

    Doctor: __________________________________

    Patient: Yes, if I eat, it gets better.

    3.

    Doctor: __________________________________

    Patient: Down here (indicating down part of the chest).

    Doctor: __________________________________

    Patient: It’s a sharp (острая), stabbing (колющая) pain. It’s like

    a knife.

    Doctor: __________________________________

    Patient: If I take a deep breath, or I cough, it’s really sore

    4. Doctor: __________________________________

    Patient: Just here (indicating upper part of the chest)

    Doctor: __________________________________

    Patient: My chest feels raw inside (боль внутри).

    Doctor: When I cough, it hurts most.
    Exercise № 6
    Study this extract from a case history and try to select below questions the doctor might ask a patient to obtain the information in italics

    The patient was a 55-year-old man, head of a small motor transport firm (1), who complained of central chest pain (2) which occurred on exertion (3) and was sometimes accompanied by sweating (4). He smoked 40 cigarettes a day (5). The pain had first appeared three months previously (6) and was becoming increasingly frequent (7). He had noticed some weight gain recently (8) and also complained that his hair had become very dull (вялый, не упругий) and lifeless. He felt the cold much more than he used to. He denied (отрицает) any palpitations (9) or ankle oedema (10).

    And now question (have been given not in the order for each piece of information in italics):

    1. What’s your job?

    2. What’s brought you along today?

    3. Have you had any problem with swelling of the ankles?

    4. Have you noticed any change in the frequency of the pain?

    5. How has your weight been?

    6. Does the pain come on at any particular time?

    7. When did you first notice the pain?

    8. Apart from the pain, do you feel anything else wrong?

    9. Do you ever become aware (знали ли вы) of your heart beating too quickly?

    10. Do you smoke? How much do you smoke?

    11. Which part of your chest is affected?


    Text 1 (for reading and retelling)
    A case history
    A 53-year old bachelor (холостяк) who worked as a bank clerk developed symptoms similar to those which had affected several of his colleagues who had been diagnosed as having influenza. He felt feverish, had a running nose, aches in his muscles and generalized malaise. He therefore stayed off work in his bed-sitting room (не пошел на работу, оставшись в своей жилой комнате = и спальня, и кухня все в одном). After 48 hours the landlady (владельца дома) noticed that the milk on the doorstep had not been taken in for the previous two days, and also that his cat had not been fed. On entering his room she found him confused (дезориентированный во времени и пространстве) and delirious (делириозный = находящийся в бреду). She called a doctor, who immediately had him admitted to hospital.

    A routine blood count had been performed which showed some deviation (откровение). At that stage he was referred to hospital, where it was found that he had some enlarged lymph nodes in both sides of the neck and both axilae (подмышечная ямка), and that the spleen tip (верхушка) was palpable. Chrome lymphatic leucaemia was diagnosed.
    Text 2 (for reading and questioning)
    It’s my job
    My name is Dr. Choudhary, and I am a GP (General Practitioner = врач общей практики) working in an inner city area in London, just on the edge of the East End. I started work as a GP in this area over 20 years ago. In recent years many development, both technological and social, have occurred, affecting the practice enormously. I enjoyed my work here a lot at the beginning and I still do now. But there are many problems an in area like this, which you would not find in rural communities (сельских поселениях) in this country or in my home country – India. The crime rates (криминальность) are high, which affects the morale of patients we serve and ultimately (в конечном счете) the morale of the GP practice. The workload is heavier than in most rural districts, which sometimes puts potential GB’s off moving into the area. However, I have always found the job very rewording. Another feature of an inner city GP practice is that patients move around a lot. As regards (что касается) compensation for working in deprived (бедных) areas in the inner city, sometimes GPs receive extra payment.

    Unit II
    Dialog 1
    Doctor: Come in Mr. Hall. Good Morning! Take a seat right here.

    What seems to be a problem, Mr. Hall?

    Patient: Doctor, I have a bad headache and I have no appetite

    Doctor: Show me your tongue

    Patient: (He opens his month and shows his tongue / he puts out his

    lounge)

    Doctor: Yes, you have a very nasty (плохой) tongue. Have you a

    pain in the stomach?

    Patient: Yes, doctor, sometimes, especially after meals. I have a

    temperature after meals too

    Doctor: I must examine your stomach… Does it hurt here?

    Patient: No. not there.

    Doctor: Here?

    Patient: Oh, yes, it does there.

    Doctor: You have digestion trouble. But it is not serious. I shall

    prescribe some tablets. You must take two before each

    meal. Do not eat any roast meat or any heavy food. Eat

    boiled vegetables and milk puddings. You need no to go to

    bed (to keep your bed), but do not overtire your self. If you

    follow my prescriptions, you will feel much better

    tomorrow and in two or three days you will be quite well

    again.

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