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1、呼吸科常用英文询问病史 case historyYou need to get a detailed history including the timing and acuity of onset, exacerbating and alleviating factors and environment triggers to help you confirm a diagnosis or discard other diseases /develop a differential diagnosis. Ask your patient whether there is a history
2、of tobacco use, or other toxic and environmental exposures and his occupational history.General/biographical data,marital status, nativity, occupation, informant, time of admission and record, chief complaint, history of present illness, previous health status(well, ordinary or bad), any infectious
3、diseases, allergic history, history of trauma or surgery, smoking (about how many years, average how many pieces per day, ceased for how many years), alcohol intake(occasional or frequent),spouses health status, menorrhea (menarche age , cycle lasting for how many days, menstrual cycle, last menstru
4、ation period or age of menopause, any menstrual pain or irregular cycle), childbearing or pregnancy( times , natural labor, abortions ,premature delivery, stillbirths, difficult labor, family history (any congenital diseases, father and mother: still alive, illness ,or cause of death, siblings and c
5、hildren)常用的症状 symptomsfeverCough 咳嗽Sputum (dry, purulent脓性的, copious green sputum大量绿色痰，tenacious yellow sputum 黄粘痰，frothy white sputum白色泡沫痰，rusty sputum 铁锈色痰wheezingDyspnea during exertion or at rest 呼吸困难Orthopnea 端坐呼吸Paroxysmal nocturnal dyspnea 夜间阵发性呼吸困难Shortness of breath （SOB）Chest tightness 胸部紧
6、迫感Exercise intolerancepleuritic chest pain 胸膜型胸痛Pharyngalgia ; pharyngodynia 咽痛Hemoptysis 咯血Bucking 呛咳Sneeze喷嚏snore 打鼾malaise 不舒服myalgia 肌痛insomia 失眠hoarseness声嘶dysphonia 发声困难常见的体征 physical signsclubbed fingers杵状指 : increased longitudinal and transverse curvature ,loss of concave nail fold angle, bo
7、gginess of nail bed and increased soft tissue bulk of distal phalanx, drumstick- likenicotine stainingcyanosis:blue discolouration of mucosal membranes and skin ,caused when mean capillary concentration of deoxyhemoglobin more than 5g/dl, O2 saturation less than 85%,PaO2 less than 8KPaperipheral cya
8、nosis: cold blue peripheries, e.g. nail beds due to cold exposurescentral cyanosis: warm peripheries, blue tongue or lipshand flap: due to CO2 retentionasterixis 扑翼样震颤papilloedema 视乳头水肿chemosis球结膜水肿enlarged supraclavicular and axillary lymph nodesincreased respiratory ratetachycardia 心动过速pulsus para
9、doxus: 10 mmHg on inspiration (seen in severe asthma)barrel chesthyperexpanded, decreased expansionkyphosis 驼背，脊柱后凸Inspection:tachypnea 呼吸急促accessory muscles of respiration: sternocleidomastoid muscle, arm support, alae flaringwide or narrow intercostal spacetactile vocal fremitus 触觉语颤subcutaneous c
10、repitus 皮下捻发感Percussion:resonancedullnessflatnesshyperresonancetympanylower borders: scapular line X left/right intercostal spacerange of mobilityAuscultation:vocal resonance 语音共振ronchi: wheeze , stridor , crackles, Velcro-like soundesmoist rales : coarse, medium, fine, crepitus捻发音pleural friction r
11、ubscomplete absence of breath soundsankle edemaweight loss，cachexia恶病质，cachectic恶病质的decreased food appetite, loss of appetite, anorexia食欲减退常做的检查 examinations or laboratory findings(to take ,undergo, perform ,receive or have)temperature charts 体温图 (take ones body temperature)sputum pot 痰盂Blood/urine/
12、stool routine, occult blood testBlood biochemistrySputum /blood culture and drug sensitivity testsputum cytologyPulse oximeter 脉氧计：continuous monitoring of blood oxygen saturationArterial blood gas analysis(ABG): arterial blood sampling , radial/ femoral artery puncturePaCO2: partial pressure of car
13、bon dioxide in arterial blood hypercarbiaPaO2: partial pressure of oxygen in arterial blood hypoxemiarespiratory failure:type 1: decreased O2 supply, PaO260 mmHg(millimeters of mercury)due to diffusion failure or V/Q dismatch (ventilation-perfusion(quotient)ratio)pulmonary edema, pneumonia, infarcti
14、on, fibrosis,or pulmonary embolism，pulmonary hypertension, shunttype 2: decreased CO2 removal, PaCO250 mmHg(millimeters of mercury)due to alveolar ventilation failureobstructive: COPD, asthma, bronchiectasisrestrictive: neuromuscular (sedatives, myasthenia), structural (ankylosing spondylitis), pleu
15、ral diseases ,obesityChest X-ray/radiograph:reticulo-nodular shadowing (reticular, linear, military nodules粟粒样结节)coin lesions 硬币样cavities空腔：amphoric 空翁音的(breathing like blowing over a bottle top)opacification浑浊：consolidation (air space infiltrate):confluent shadowing and air bronchogramcollapse: lobar(upper, middle/lingual, lower)segmental atelactasispleural effusionmediastinal mass: thyroid ,thymoma, teratom
