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):

a) What’s your job?

b) What’s brought you along today?

c) Have you had any problem with swelling of the ankles?

d) Have you noticed any change in the frequency of the pain?

e) How has your weight been?

f) Does the pain come on at any particular time?

g) When did you first notice the pain?

h) Apart from the pain, do you feel anything else wrong?

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

j) Do you smoke? How much do you smoke?

k) 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.