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1、English for Doctors,English in Use,Jiangsu University,Good morning,Ms Rayner.Come and sit down.,Good afternoon,my name is,and my English name is Mary.,So you can call me Dr.Mary.I am a doctor of Internal Medicine.Im responsible for your treatment/Ill be looking after you.,Or:I work in the department
2、.Im a cardiac surgeon/.,anesthesiologistdermatologisthepatologistophthalmologistpharmacologistpulmonologistToxicologistneurologisturologist,cardiologisthematologistoncologistpathologistpsychologistradiologist,医生问话的三个主要部分：就诊原因（含症状）、询问病史、临床体检,Mr.Simpson 34,plumberc/o dyspnoea 1/12;ankle swelling 2/52S
3、H married with 1 son 25 cigs/day;50 units alcohol/weekPH nil relevantFH father d.42 MI;mother a 2 spider naevi on chest P 110/min reg.BP 100/60CXR enlarged heart and bilat.Pleural effusions,呼吸困难,胸腔积液,Chest X-ray,与患者打招呼-请患者描述症状-收集病例-临床检查-通知诊断结论、治疗方案和进一步化验项目-医嘱（-复诊）,Well now,how can I help you?Well,Mr
4、.Rayner.Whatt the trouble?What symptoms do you have?,1.问时间：如症状开始的时间、持续的时间、间隔的时间或频率2.问症状的性质和严重程度3.问诱因,医生问话的三个主要部分：就诊原因（含症状）、询问病史、临床体检,When did it begin/start?,When did you begin to notice these symptoms?,How long does each episode/attack last?How often does it happen?How often are the attacks?,Is the
5、 condition serious?Has it gotten worse?,What do you think provokes it?Has anything started this off?Does anything bring them on?,还有别的症状吗？,Has anything else troubled you?Do you suffer from indigestion/bowel trouble/?Have you noticed anything else?,发作，犯病,Ive not had much trouble with that for two year
6、s.这两年没大犯过。Does the pain come on in the night?夜间腹部疼痛吗？Are you all right between spasms?两次发作期间你感觉好吗？I keep getting dizzy spells.我的晕眩周期性发作。It used to come and go but now stays put.本来时好时坏，如今持续不好。The appendix has burst.-Wed better remove it.,How long have you had this?When did this start?,提示日期Christmas=D
7、ecemberThanksgiving(USA)=NovemberEaster=AprilSummer Holidays=July/AugustPatients BirthdayDid you have it at Christmas time?,医生问话的三个主要部分：就诊原因（含症状）、询问病史、临床体检,询问病人的既往史 Inquiring the health history,1）What disease have you had before?你过去得过什么疾病？2）Please tell me something of your past illness.请告诉我你过去的患病情况。
8、3）Did you have any childhood diseases?你小时候得过什么疾病吗？4）What kind of treatment did you have in the past?你过去曾接受过什么治疗吗？5）Did you have any operation before?你以前做过手术吗？6）Have you ever been hospitalized before?你以前住过院吗？,询问病人的家族史IInquiring the family history,1）Tell me something about your family.告诉我一些关于你家庭的事。2）A
9、re your parents still living?你父母还健在吗？4）How are your parents health?你父母的健康状况怎么样？5）What was the cause of your mothers death?你母亲的死亡原因是什么？6）Are there illnesses that seem to run in your family?你家里有什么遗传病吗？,询问病人的家族史IIInquiring the family history,7）Were your parents and their parents related by blood?你父母和祖父
10、母是近亲结婚吗？8）Does anyone in your family smoke?你家里有人吸烟吗？9）Has anyone in your family had the same trouble?你家里有人得过这种病吗？,询问病人的服药史IInquiring the medicine taken,D:Have you taken any medicine?你服过什么药吗？P：I took some aspirin.我服用过阿司匹林。D:Does it help to relieve the pain?能缓解疼痛吗？P：No,it seems helpless.不，似乎没什么效果。,询问病
11、人的服药史IIInquiring the medicine taken,1）Are you taking any medicine now?你现在服什么药吗？2）What kind of medicine are you taking for the problem?你在服什么药治疗这种病？3）What kind of vaccination did you receive?你打过什么疫苗？4）Are you allergic to any medicine?你对什么药过敏？5）Do you take sleeping pills?你吃安眠药吗？6）Do you use laxatives?你
12、服泻药吗？7）When did you stop taking the medicine?你是什么时候停服这种药的？,询问病人的社会史Inquiring the social history,病人的职业occupation,吸烟饮酒习惯smoking/drinking habits,饮食习惯 eating habits都可能和疾病有关。1）Do you smoke?How long have you been smoking?How much do you smoke a day?2）Do you drink alcohol?你喝酒吗？How much alcohol do you drink
13、 in a day?一天喝多少？3）What foods dont you like to eat?你不爱吃什么食物？4）What do you do?/Whats your job?/What do you do for living?你是做什么工作的？,Drinking habits,Do you drink at all?Do you drink everyday or just on social occasions?Roughly,how much do you drink on average every day?Do you drink alone?Do you drink in
14、 the mornings?Have you ever been a drinker?,Drinking habits,Do you ever feel guilty about your drinking?Have you ever tried to cut down your drinking?Have you ever had any fits or blackouts through drinking？昏厥，眼前发黑Do you think your drinking causes any problems?At work?With your marriage?Have you eve
15、r got into trouble with the law through drinking?,与患者打招呼-请患者描述症状-收集病例-临床检查-通知诊断结论、治疗方案和进一步化验项目-医嘱（-复诊）,临床检查：Instruct the patient in a clear but polite manner,When examining a patient,polite forms are often used for the initial instruction:Could you bend forward as far as you can?If you could cross y
16、our arms in front of your chest.What Id like to do is examine you standing up.After that direct instructions may be used:Stand with your feet together.Lie perfectly still.To soften the instruction:Can you just turn to the side again?Could you just lie on the couch?,Useful expressions,Please lie on y
17、our tummy.请肚子朝下躺着。Please turn over and lie on your back.请转过来，背朝下躺着。Roll over onto your left/right side.左/右侧卧。Bend your knee.屈膝。Sit up.坐起来。Lean forward.前倾。Get off the couch and stand up.下床并站立。Walk across the room.步行穿过这个房间。,Show sensitivity to the patients needs and respond to discomfort,reassuring if
18、 appropriate.,You might feel a little bit of discomfort.This might hurt a little but Ill be quick.Tell me if it hurts.Let me know if its sore.It will be over very quickly.It wont take long.Youre doing very well.,Talk the patient through the procedure（See page 5）,Im just going to.First Ill.Then IllNo
19、w Im going to.Youll feel.When its over,IllThats it.All over.,测量生命体征Vital Signs,我需要量一下你的体温，我将把这个放到你的耳朵里面。I need to take your temperature.I am going to put this in your ear.请问我能把体温计放到你的腋窝处几分钟吗？Please can I put this thermometer under your arm for a few minutes?,测量生命体征Vital Signs,你的体温正常/低烧/高烧/比正常体温低。You
20、r temperature is normal.slightly high.high.below normal.,Blood Pressure,我要量一下你的血压。I need to take your blood pressure.我要在你的上臂绑一个血压计。I am going to put a tourniquet around your upper arm.tnkt Sphygmomanometer sfimumnmit,Blood Pressure,会感觉很紧，但是一会就好。It will feel very tight,but only for a short time/a lit
21、tle time/for a moment.请保持你的手臂不动。Please can you keep your arm still.你的血压是120/90。Your blood pressure is 120 over 90.,Pulse,I need to take your pulse.Please may I feel your wrist,指导穿衣,You can get dressed now and then come out to me.你现在可以穿上衣服跟我出去。Dont hurry.Take your time.别着急，慢慢来。,与患者打招呼-请患者描述症状-收集病例-临床
22、检查-通知诊断结论、治疗方案和进一步化验项目-医嘱（-复诊）,Share your findings with the patient.,I havent found anything to suggest any problems.There doesnt seem to be anything wrong with you.Im sure this will clear up on its own.,无需治疗,需要做某些检查或化验,开检查用语：,1）All right,the last thing left is a physical examination/a few lab tests
23、/an X-ray picture of the chest.好，再做项体格检查/化验/拍胸片就行了。2）Well,Miss Hartley,I cant find anything seriously wrong with you,but Id like you to have your chest X-rayed and an ECG.3）You need to have an ECG test./I need you to have an ECG test.你需要做一下ECG。/我需要你做一下ECG。,Expression:X-ray,你需要拍一下X光。You need to have
24、an X-ray.你需要拍一下.部位（头部）的X光。You need an X-ray of your.,开检查用语2：,4）You need to take a MRI scan/ultrasonic scan/ultra-scan.你需要做个核磁扫描/超声。5）A sputum culture should be done for your case.你需要做个痰培养。6）we would like to have your stool examined.Will you please give us a specimen?你要查一下粪便。能留个样本吗？7）Id like to have
25、a specimen/sample of your water.我想留一份你的尿样。Id like to have a midstream specimen.我想留一份中段尿样。,Expression:Blood test,你需要做一下血液测试。You need to have some blood tests.你需要查一下空腹血糖。You need to have a fasting blood sugar test.请带着这张化验单到血液科（hematology）。hi:mtld Please take this form to hematology.化验结果出来后请带给我。Please
26、bring the results back to me.,Expression:Usages on Ultra-scan,你需要做一下.部位的超声波扫描。You need to have an ultra-scan of your.请带着化验单，做完之后带着化验结果来找我哦。Please take the form with you.After you get the result,please bring it back to me.,Expression:Ultra-scan,在做超声波扫描前，请憋尿。You will need to have a full bladder bld(r)
27、before the ultra scan.请在做超声波扫描前喝足够的水。Please can you drink glasses of water before you have the scan.,You need fasting before the test.The test needs your empty stomach.你的检查需要空腹。Please do not eat anything or drink water in the morning before taking the test.请您早晨检查之前不能吃饭喝水。Please drink water and hold
28、back urine.请多喝水憋尿 Please drink a lot of water and dont go to the toilet as possible as you can before the test.,Expression:Ultra-scan,请你拿着单子先去收费处交费，交完费后去隔壁的化验室抽血化验，然后回这儿来。,Please take the printout to the cashier to pay your fees first.After paying,let them draw blood for a blood test in the Laborato
29、ry next door.Then,come back here.,Share your findings with the patient.,Well,Im fairly certain youve got a.One possibility is it could be what we call.I havent found anything to suggest any problems.,Explaining diagnosis,Youre suffering fromYouve developedYou haveThis is whyThis is mainly because,Pr
30、escription,Id like you to Ill give you a prescription for some tablets to ease the pain.Take this medicine twice a day after meal.You should take this pill(tablet/capsule)right after breakfast and right after dinner.Id like you to come into hospital for a few days so that we can keep an eye on you./
31、to find out what exactly is causing this trouble.,消除疑虑,Dont worry about this.Its quite a common condition and should clear up in a week or so.This is not a serious condition.These tablets should help.The only way to treat this is by an operation.It is a routine surgery and you should be back to norm
32、al two months after the operation.You will no doubt want to go home as soon as possible,but we are here to help you whenever you need us.,The prognosis,I expect the treatment willHopefully we canWe can never be absolutely certain aboutYou should remain optimistic.Do you have any questions?Is there a
33、nything youd like to ask?,完成各项检查后的初步治疗措施：如静脉给药、理疗等。,1.This is your IV sheet.Take the IV first.这是你的静脉输液单，先输次液。IV是intravenous 的简写。也可以说IV drop/intravenous drop，输液室IV room 输一次液have an IV2.This is your injection sheet.这是你的注射单。肌肉注射intramuscular injection 皮内注射intradermic injection 皮下注射hypodermic injection
34、英ntrdmk美ntrdmk 注射室Injection Room 做一次注射have an injection 3.Are you allergic to penicillin?/Do you have penicillin allergy?你对青霉素过敏吗？4.You need a shot of penicillin today.（Shot=injection，表示“注射”）今天你需要注射一支青霉素。,在离开门诊前，医生可能给予病人一些家庭指导，包括一些注意事项、某些在家要进行的活动或措施。,请翻译：你应该卧床休息，多喝水。,Drink plenty of water and have a
35、 good rest./Youd better have a good rest.,You should rest in bed and drink plenty of water.,Discussing treatment：Advising a course of action,-Some time off work might help.If you felt that would be helpful,you could take a week off and see how you felt after that.-Carry on drinking lots of fluids.-I
36、f you still have some pain,you can keep taking paracetamol.-Other things might help,like raising the head of your bed.Thats one of the simple things we could start you off with.You said you havent tried indigestion remedies.Thats something you could try.,饮食方面的医嘱,Choose fresh or frozen vegetables and
37、 fruits without added salt and sugars.多吃不添加盐和糖的新鲜或冷冻蔬菜和水果。2.Please eat a diet high in protein,fresh fruits and vegetables.吃富含蛋白质的食品以及新鲜水果和蔬菜。Dont eat very hot or cold food,and keep off stimulating foods such as sour or spicy food.不要吃过热或过冷的食品，不吃刺激性食品如酸辣的食品。Have regular meals first.Keep off alcohol an
38、d give up smoking,at least one time.规律饮食，不喝酒，不吸烟，至少短期内不吸。,Discussing treatment：Advising patients to avoid something,-There are a few things about your lifestyle we could address.Perhaps cut down on the amount youre drinking.Giving up smoking would help.-Cut out fatty foods.-You should try to avoid t
39、ight clothing,sitting in deep armchairs and bending,especially after meals.,其他医嘱,7.You should get outdoors more and get some exercises.你应该多到户外去，锻炼身体。You should avoid heavy/vigorous activities/strenuous sports,especially contact sports.你应该避免剧烈运动，尤其是接触性的运动。9.Avoid visiting crowded places,dont contact
40、with persons with respiratory diseases.尽量少去人多的场所，避免接触（呼吸道疾病）感染者。,First Visit 结束：请你拿着单子先去收费处交费，然后就可以去药房领药了。,Please take the printout to the cashier to pay your fees first.Then,pick up your medicine at the pharmacy.,First Visit 结束语,1）Dont forget,your next appointment with the doctor is next Tuesday morning.您下次的复诊时间是下周二上午，别忘了啊！2）Before seeing the doctor again,they have to draw your blood for a blood test.Please remember not to eat or drink anything after midnight the night before,not even water.复诊时要抽血检查，请记得来之前晚上十二点以后就 不要吃东西了，连水也不要喝！,
