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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 th
2、e department.Im a cardiac surgeon/.,anesthesiologist dermatologist hepatologist ophthalmologist pharmacologist pulmonologist Toxicologist neurologisturologist,cardiologist hematologist oncologist pathologist psychologist radiologist,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, plumber c/o dyspno
3、ea 1/12; ankle swelling 2/52 SH married with 1 son25 cigs/day; 50 units alcohol/week PH nil relevant FH father d.42 MI; mother a 2 spider naevi on chestP 110/min reg.BP 100/60 CXR 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）,W
4、ell now, how can I help you?Well, Mr. 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
5、it happen? How often are the attacks?,Is the 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
6、病,Ive not had much trouble with that for two years. 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
7、long have you had this? When did this start?,提示日期 Christmas = December Thanksgiving (USA) = November Easter = April Summer Holidays = July/ August Patients 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 be
8、fore? 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。 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
9、家族史I Inquiring the family history,1）Tell me something about your family. 告诉我一些关于你家庭的事。 2）Are 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
10、人的家族史II Inquiring the family history,7）Were your parents and their parents related by blood? 你父母和祖父母是近亲结婚吗？ 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I Inquiring the medicine taken,D: Have you taken any medicine? 你服过什么药吗？ P：I
11、 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。,询问病人的服药史II Inquiring 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
12、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。
13、 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 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
14、 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 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?
15、 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 ever 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 p
16、olite 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 your 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?,
