Tiếng Anh Trong Y Khoa

English
in Medicine
Ting Anh trong Y khoa
. . - . % . ~ w _____ '
Gio trnh
G
Cao D ing Y 1C Phu
IIKEllJip
KM.006408 Second Edition
Eric H. Glendinning
s.
Beverly A. Holmstrom
& U + /X c L v
GS. BS TRN PH ONG H M
m
NH XUT BN THNH PH H C H M INH

Ti Li u Do
Y H c Th c Hnh chia s
English in Medicine
A course in communication skills
Gio trnh v k nng giao tip
E r ic H . G l e n d i n n i n g
Beverly A. s. Holmstrm
GS. BS TRN PHNG HNH
n bn m<
Bnh n c cp nht Tham kho mi v

sch v bi bo Cc bi lm v nghe c ghi
bng li Bn i thoi-y Cc bi lm c
m ha ty thuc k nng Nhiu hnh nh b
sung Cc a ch hu ch c cp nht Cc
chc v mi trong bnh vin nc Anh
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PH TH
Ti Li u Do 'H V I N
N H X U T BN THNH PH H C H M INH
Contents Mc lc
To the t e a c h e r Gi ging v i n ................................................ 5

To th e S tudent Gi sinh v i n ...................................................8
Unit 1 Bi 1
T a k in g a h i s t o r y 1 Lm bnh n 1
1 Asking b asic q u e s t i o n s 't nhng cu hi c b n ....................... 17
2 T aking n o te s Ghi c h p .................................................... 24
3 R eading skills: S c a n n i n g a c a se K nng c: Xem xt m t bnh n . . 32
history
4 C a se history: W illiam H u d s o n Bnh n: William H u d s o n ...................34
Unit 2 Bi 2
T a k in g a h is t o r y 2 Lm bnh n 2
1 Asking a b o u t s y s t e m s Hi v cc h t h n g .................................36
2 Asking a b o u t s y m p t o m s Hi v cc triu c h n g .............................. 39
3 R eading skills: N o tin g i n f o r m a ti o n K nng c: Ghi nhn thng tin t
fro m a te x tb o o k sch gio k h o a ......................................... 56
4 C ase history: W illiam H u d s o n Bnh n: William H u d s o n ...................62
Unit 3 Bi 3
E x a m in in g a p a t i e n t Khm bnh nhn
1 Giving in s tru c tio n s Hng d n ...............................................65
2 U n d e r s ta n d in g f o rm s Hiu cc dng khm b n h .....................72
3 R ead in g skills: U sin g a p h a r m a c o l- K nng c: s dng ti liu tham
ogy referen c e kho dc l ............................................ 76
4 C a se history: W illiam H u d s o n Bnh n: William H u d s o n ...................84
Unit 4 Bi 4
S p e c ia le x a m in a tio n s Thm khm c bit
1 In stru ctin g , e x p lain in g a n d reas- Hng dn, gii ngha v trn an . . . . 90
s u rin g
2 R ephrasing, e n c o u r a g in g a n d Nhc li, khuyn khch v gi ............. 96
prom pting
3 R e ad in g skills: R e a d in g articles 1 K nng c: c cc bi bo 1 . . . . 102
4 C a se history: W illiam H u d s o n Bnh n: William Hudson ................... 109
E nglish in M e d ic in e - 3
Ti Li u Do
Unit 5 BI 5
I n v e s tig a tio n s X t nghim
1 Explaining a n d d isc u ssin g in v e s ti Gii ngha v tho lun cc xt
gations n g h i m .................................................. 113
2 Using m e d ica l d o c u m e n t s s d n g cc ti liu y h c ....................125
3 Reading skills: R eading articles 2 K nng c: c cc bi bo 2 . . . . 136
4 Case history: William H u d s o n Bnh n: William Hudson ................. 141
Unit 6 Bi
M a k in g a d i a g n o s i s Chn on
1 D iscussing a diagnosis Tho lun mt chn o n .................... 146
2 Explaining a d iagnosis Gii ngha mt chn on ................. 154
3 Reading skills: R eading articles 3 K nng c: c cc bi bo 3 . . . . 158
4 Case history: W illiam H u d s o n Bnh n: William Hudson ................. 175
Unit 7 Bi 7
T r e a tm e n t iu tr
1 Medical t r e a tm e n t iu tr ni k h o a .....................................177
2 P h y sio th e ra p y Vt l tri l i u ...........................................186
3 Surgical tr e a t m e n t iu tr ngoi k h o a ............................... 190
4 Reading skills: U sin g a n index K nng c: s d n g bng ch dn . 199
Tapescript Bn i t h o i ............................ 226
Key G ii p ........................................ 271
Appendix 1 Ph lc 1 ........................................ 319
Language f u n c tio n s Cc chc nang ngn ng
Appendix 2 Ph lc 2 ..................................... 326
C o m m o n m e d ic a l a b b r e v ia ti o n s C c ch vit tt y khoa thng ihng
Appendix 3 Ph lc 3 ..................................... 336
W h o 's w h o in th e British h o sp ita l C c chc d a n h trong h thng b n h vin
sy stem Anh
Appendix 4 Ph lc 4 ..................................... 339
A b r o a d e q u iv a le n c e o f p o s it io n s in Bng tng ng c c chc v trong cc
the NHS a n d u s h o sp ita l s y s t e m s h thng b n h vin Anh v Hoa K
Appendix 5 Ph lc 5 ..................................... 340
Useful a d d r e s s e s Cc a ch hu ch
Supplementary activities C c h o t dng b sung . . . 343
4 - English in M e d ic in e
T o th e te a c h e r Gi ging vin
T h is b o o k is for d o c t o r s , m e d i c a l s t u - Cun sch ny l dnh cho cc bc s, cc

d e n t s in t h e clinical p h a s e o f th e ir sinh vin y khoa trong giai on lm sng
s t u d i e s a n d o t h e r m e d ic a l p r o f e s s io n - ca qu trnh hc tp v cho nhng ngi
als w h o h a v e to u s e E n g lish to c o m m u - h n h ngh y khoa lun bt buc phi
n ic a te w ith p a t i e n t s a n d th e ir d n g ting Anh giao tip vi bnh
rela tiv e s a n d w ith m e d ic a l c o lle a g u e s . n h n v thn n h n ca h cng nh vi
cc ng nghip y khoa.
It a i m s to d e v e lo p s p e a k i n g a n d lis Cun sch n h m m c ch trc tin

t e n i n g skills p r im a rily b u t a t t e n t i o n is l pht trin cc k n n g ni v nghe
also given to r e a d i n g skills, in p a r t i c u n h n g cng ch n cc k nng c,
lar t h e u s e of r e f e r e n c e m a te r ia ls a n d c bit l cch s dng cc ti liu tham
j o u r n a l articles. P ra c tic e is als o p r o kho v cc bi bo. Phn thc h n h cng
v id e d in w ritin g referral le tte r s a n d cung cp cch vit th d tham kho v
co m p letin g a range of m ed ical d o c u cch b sung nhiu ti liu y khoa.
m e n ts .
T h e b o o k is d iv id e d in to s e v e n Cun sch c chia th n h by bi,

u n its , e a c h f o c u s in g o n o n e a r e a o f mi bi tp trung vo m t lnh vc giao
d o c t o r p a t i e n t c o m m u n i c a t i o n fro m tip gia bc s bnh n h n t vic lm
h is t o r y - ta k in g to t r e a t m e n t . W ith th e bnh n n vic diu tr. Ngoi tr bi 7
e x c e p t io n o f U n i t 7. w h i c h d e a ls w ith chi bn n cc dng khc nhau ca vic
d iffe re n t f o r m s o f t r e a t m e n t , all u n its iu tr, tt c cc bi du gm bn phn.
h a v e fo u r s e c ti o n s . S e c t io n 1 i n t r o P hn 1 gii thiu loi ngn ng mi lin
d u c e s n e w la n g u a g e r e l a t e d to t h e u n it quan n ni dung bi. Phn 2 cung cp
t h e m e . S e c tio n 2 p r o v i d e s f u r th e r th m cch thc h n h v gii thiu hng
p r a c tic e a n d i n t r o d u c e s a v a r ie ty of lot cc ti liu y khoa. Phn 3 tp trung
m e d ic a l d o c u m e n t s . S e c t io n 3 fo c u s e s vo cch c v Phn 4 bao gm ngn
o n r e a d i n g a n d S e c t io n 4 b r in g s t o n g hc trc trong bi tlieo khun
g e t h e r t h e la n g u a g e s t u d i e d e a rlie r in m t b n h n, h nh thc ny u c t bi
th e u n it in t h e c o n t e x t o f a c a s e h is t o r y 1 n bi 6.
w h ic h r u n s f r o m U n it 1 to 6.
T h is b o o k is t h e p r o d u c t o f m a n y Cun sch ny l kt qu ca nhiu

y e a r s te a c h in g . It h a s b e e n u s e d s u c n m ging dy. N c s dng rt
cessfully b o t h b y t h o s e w ith lo n g e x p e hiu qu bi n h n g ngi c lu nm
r ie n c e in t e a c h i n g E nglish for M e d ic a l kinh nghim ging dy ting Anh n h m
P u r p o s e s a n d b y t h o s e n e w to this a r e a cc m c ch y khoa v c n hng ngi
o f te a c h in g . mi vo lnh vc dy hc ny.
English in M ed icin e - 5
M e d ic in e is a field w h e r e i n n o v a Y khoa l m t lnh vc thng xuyn
tion a n d d e v e l o p m e n t a re c o n s t a n t . c s i mi v ph t trin. Bn in ln th
This s e c o n d e d i tio n o f E n g lish in hai ny ca cun T in g A n h tro n g Y kh o a
M ed ic in e h a s b e e n p r e p a r e d to e n s u r e dc ch u n bj bo d m r n g ni
th a t th e sp e c ia list c o n t e n t reflec ts a d d u n g chuyn khoa th hin c nhng
v a n c e s in m e d i c i n e o v e r t h e la st t e n tin b trong y hc sut mi n m va
years. L a n g u a g e t e a c h i n g is also s u b qua. Ngn n g ging dy c n g c thay i
ject to c h a n g e a n d s t e p s h a v e b e e n v nhiu bin php c th c hin bo
ta k e n to e n s u r e t h a t th is b o o k is m rn g cun sch c h n h th n h vi
s h a p e d by th e b e s t o f c u r r e n t t h e o r y ni d u n g tt n h t v' l thuyt v thc
a n d practice. h n h hin nay.
T h e key c h a n g e s are: N hng thay i ch yu l:
Histories updated Bnh n c c3p nht
New reference texts and journal articles Tham kho mi v sch v bi bo
Listening tasks rerecorded Ccbi l m v ng hed cghibn gli
Full tapescript Bn di thoai y
Tasks coded according to skill Cc bi lm c m ha ty thuc k

nng
Photographs added Nhiu hlnh nh b sung
Useful addresses updated Cc a ch hu ch c c p nht
New UK hospital gradings Cc chc v mi trong b n h vin nc

Anh
T he h isto rie s, b a s e d o n a u t h e n t i c Cc b n h n, da trn cc trng hp

ca se s a n d d r a w n fro m a r a n g e o f s p e xc thc v trch t h n g lot chuyn
cialism s as d iv e rse as o b s te tr ic s , o p h khoa khc n h au n h sn khoa, n h n khoa
th a lm o lo g y a n d n e u r o lo g y , h a v e b e e n v th n kinh hc, d'u c cp n h t v c
u p d a t e d to ta k e in to a c c o u n t d e v e l o p lu t m n cc p h t trin v k t h u t xt
m e n t s in in v e s tig a tio n t e c h n i q u e s a n d n g h i m v iu tr. Tt c cc sch v bi
tr e a tm e n t. All re f e r e n c e texts a n d j o u r bo d th a m kho u c ghi n h n li
nal articles h a v e b e e n r e p l a c e d w ith da theo n h n g bn mi n h t Mt s cc
the m o s t u p - t o - d a t e v ersio n s. A n u m bi lm n g h e dc ghi b n g li n h m
b e r o f lis te n in g ta s k s h a v e b e e n r e r e bo dm dc cn b n g tt hn. v m t
c o r d e d to e n s u r e a b e t t e r g e n d e r b a l bn i thoi y c n g c gii thiu.
a n c e , a n d a full ta p e s c r i p t is p r o v id e d . Cc bi lm cng c m ha ty theo
T asks h a v e b e e n c o d e d a c c o r d i n g to loi k n n g c h n h c ph t trin (Nghe.
th e m a i n skill d e v e l o p e d (Listening, c, Ni, Vit) v hng lot n h n g hot
Reading. S peaking, W riting) a n d a dng cng c ti cu trc v phi hp
n u m b e r o f activities h a v e b e e n r e li. Cc hnh nh c b sung
structu red a n d rese q u en c ed . P h o to m in h ha cc ti trong mi bi v
g r a p h s h a v e b e e n a d d e d to illu stra te cung cp ni dung ngoi kha. Cui cng,
t h e t h e m e s c o v e r e d in e a c h u n i t a n d to m t bng lit k cc a ch hu ch
p r o v id e e x tra t e a c h i n g c o n te x t. Fi c cp n h t v n h n g chc v mi ca
nally, t h e list o f useful a d d r e s s e s h a s bc s b n h vin nc Anh cng c ghi
b e e n u p d a t e d a n d t h e n e w UK h o s p i thm.
tal d o c t o r g r a d in g s in c lu d e d .
T h e o r g a n is a tio n o f t h e b o o k a n d Cch sp xp cun sch v nhng

t h e ob je ctiv es o f e a c h ty p e o f activity m c tiu ca mi dng hot ng du
a r e e x p la in e d in m o r e d e ta il in "To th e c gii thch chi tit hn trong phn
s t u d e n t" . A sp e c ia lis t k n o w l e d g e of Gi sinh v i n . Kin thc chuyn khoa
m e d i c i n e is n o t r e q u ir e d , b u t y o u d o v y hc khng phi l iu bt buc
re q u ir e a n in te r e s t in t h e l a n g u a g e nhng bn phi c mi quan tm v
n e e d s o f t h e m e d ic a l p r o f e s s io n s a n d a n h n g i hi ngn ng ca ngh y v
g ra sp o f c o m m u n i c a t i v e a n d p o st- nhiu k thut ging dy giao tip v sau
co m m u n icativ e te aching tech niqu es. giao tip. Bn cung cp s th n h tho VC
You p ro v id e t h e t e a c h i n g e x p e rtise : ging dy: ngi hc li cung cp kin
th e le a r n e r p r o v id e s t h e m e d ic a l thc y khoa. S ha hp n g n s to
k n o w le d g e . T h e right b l e n d will give ra kt qu. Vi i ch t thc tin, bn c
results. W ith a little p r a c tic e , y o u c a n th sng to th m n h n g hot ng h
d ev ise s u p p l e m e n t a r y ac tiv itie s of tr ca ring bn da trn n h n g khun
y o u r o w n b a s e d o n t h e m o d e l s in this mu trong cun sch ny. Hy xem trang
book. See p a g e 343 for i d e a s for s u c h 343 cho n h n g tng v n h n g hot
activities. Be c r e a tiv e a n d y o u will get ng n h vy. Hy bit sng to v bn s
th e m o s t o u t o f this b o o k a n d fro m thu n h n c phn ti a t cun sch
y our te a c h in g . ny v t cng vic ging d> cabn.
E nglish in M e d ic in e -
T o th e s tu d e n t Gi sinh vin
T his b o o k a i m s to h e l p y o u c o m m u n i Cun sch ny n h m gip bn giao tip

c a te in E nglish w ith p a t i e n t s a n d th e ir b ng ting Anh vi b n h n h n v thn
relatives, w ith m e d ic a l c o lle a g u e s , n h n ca h, vi cc ng n g h ip y khoa
a n d w ith p a r a m e d i c a l staff. It is also v vi ban iu h n h cn y khoa. Cun
d e s ig n e d to h e l p y o u c o p e w ith m e d i sch c n g c bin son n h m gip bn
cal r e a d in g o f all k in d s f r o m c a s e n o t e s quen vi cch dc loi y vn t n h n g
to jo u r n a l articles. T h o s e o f y o u w h o trng hp b n h dn cc bi bo. Cc c
are m e d ic a l s t u d e n t s will fin d this gi l sinh vin y khoa s thy cun sch
b o o k u sefu l in t h e clinic al p h a s e of ny th t hu ch trong giai on lm sng
y o u r s tu d ie s . T h e a u t h o r s h a v e c o o p ca qu trnh hc tp ca h. Cc tc gi
e r a te d closely w ith m e m b e r s o f t h e cng tc m t th i t vi n h n g ngi
m e d ic a l p r o f e s s io n in p r e p a r i n g th is h n h ngh y khoa trong lc bin son
b o o k to e n s u r e a u t h e n ti c it y . T h e y cun sch ny bo m y d tnh xc
h a v e lo n g e x p e r i e n c e in h e l p i n g o v e r thc. H c nhiu kinh n g h i m trong
s e as m e d ic a l p e r s o n n e l w ith th e ir vic gip cc n h n vin y t hi ngoi
co m m u n ic ativ e needs. v n h n g n h u cu giao tip.
T h e b o o k is d iv id e d in to s e v e n Cun sch ny c chia lm by bi.

units. T h e u n its a r e s e q u e n c e d to Cc bi c xp t to n n n hng
m a t c h y o u r o w n d e a lin g s w ith a p a n g x ca rin g bn vi ngi bnh. Bn
tient. You s ta r t w ith t h e E nglish bt u b n g loi ting Anh cn thit cho
n e e d e d for c o n s u l t a t i o n s a n d c o n vic kh m b n h v tip tc vi n h n g
t in u e w ith e x a m i n a t i o n s b o t h g e n cng vic th m khm c tng qut v
eral a n d sp ecialist. N ext y o u s t u d y th e chuyn khoa. Sau , bn hc loi ngn
la n g u a g e r e q u ir e d to d is c u s s i n v e s ti ng cn dng tho lun cc xt
gations, d i a g n o s e s a n d t r e a t m e n t b o t h n g h i m , chn on v iu tr c i vi bnh
w ith th e p a t ie n t a n d w ith E ng lish - n h n ln cc ng nghip ni ting Anh.
s p e a k in g c o llea g u es. Finally y o u e x Cui cng, bn hc ting Anh tro n g diu
a m i n e t h e E nglish o f t r e a t m e n t tr ni khoa, ngoi khoa v vt l tri
m e d ica l, surgical a n d p h y s io t h e r a p y . liu.
T h e first six u n i t s h a v e f o u r s e c Su bi u tin c bn phn. Phn

tions. T h e first s e c ti o n i n t r o d u c e s n e w u tin gii thiu ngn ng mi v cung
l a n g u a g e a n d p r o v id e s p r a c t i c e a c tiv i cp cc hot ng thc h n h trong khun
ties in a m e d ic a l c o n te x t. T h e s e c o n d kh y khoa. Phn th hai thc h n h th m
p ra c tise s f u rth e r l a n g u a g e i t e m s o n cc m c ngn ng c n g trn cc vn d
th e s a m e g e n e r a l t h e m e s a n d i n ch u n g v bao gm thc h n h n g h e v vit
c lu d e s lis te n in g a n d w ritin g p r a c tic e cc ti liu y khoa. Phn th ba cp n
8 - English in M e d icin e
in volving m e d ic a l d o c u m e n t s . T h e k n n g c n h m pht trin cc k nng
th ird d e a ls w ith r e a d in g skills a n d cn thit hiu hng lot cc bi y hc
a i m s to d e v e lo p th e skills n e e d e d to k c cc ti liu bnh vin, sch gio
u n d e r s t a n d a r a n g e o f m e d ic a l texts khoa, ti liu tham kho v bi bo. Phn
i n c lu d in g h o s p ita l d o c u m e n t s , te x t cui cng s cng c cc ni dung c
b ooks, r e f e r e n c e m a te r ia ls a n d a r t i cp trong hai phn u tin trong
cles. T h e final s e c ti o n c o n s o l i d a t e s th e khun kh m t bnh s lin tc, n h v y
m a te ria l c o v e r e d in th e first tw o s e c to dc m t cu ni t bi ny n bi
tio ns in th e c o n te x t o f a c o n t i n u i n g kia. Bi 7 gm ba phn vi nhng dng
c a s e h isto ry w h ic h p r o v id e s a link khc nhau v' iu tr v mt phn c
from u n it to u nit. U nit 7 h a s t h r e e s e c cui cng tp trung vo vic s dng mt
tio n s o n d iffe ren t f o rm s o f t r e a t m e n t bng chi dn chuyn khoa.
a n d a final re a d in g s e c ti o n f o c u s in g o n
u sin g a sp e cia list in dex.
T h e la n g u a g e activ ities in th is b o o k Cc hot ng ngn ng trong cun

are c o d e d a c c o r d in g to th e m a i n skill sch ny dc quy c ty thuc vo k
d ev e lo p e d . nng ch yu d ph t trin.
Listening tasks I S J Cc bi lm v nghe

T h e lis te n in g p a s s a g e s in c l u d e s i m u Cc on nghe bao gm n h n g cuc i
lated d o c t o r p a t i e n t in te rv ie w s, a thoi bt chc bc s bnh nhn, tho
d is c u s s io n a m o n g d o c t o r s , a p h o n e lun gia cc bc s, m t c in thoi t
call from a h o s p ita l la b o r a t o r y a n d a phng xt ng h im bnh vin, v m t bc
p h y s io t h e r a p is t giving i n s t r u c t i o n s to s vt l tr liu dang hng dn mt bnh
a p a tie n t. nhn.
T h e tasks a re v a rie d b u t all h a v e at Cc bi lm u a dng n hng tt c

least tw o o f t h e s e sta g e s: b efo re du gm ti thiu hai trong ba giai on:
listen in g , w h ile -lis te n in g a n d a fte r trc k h i ng h e, trong k h i n g h e v sa u kh i
listening. In th e b e fo r e -lis te n in g sta g e nghe, giai on trc k h i ng h e, bn c
y o u m a y b e a s k ed , for e x a m p le , to p r e th b yu cu, v d, tin on cc cu hi
dict th e q u e s t i o n s a d o c t o r will u s e in m bc s s dng trong cuc i thoi,
a n interview , or t h e o r d e r in w h i c h th e hoc trnh t m bc s s hi v cc h
d o c t o r will ask a b o u t s y s t e m s , o r s i m thng, hoc n gin l vic in vo
ply to fill in t h e g a p s in a d ia lo g u e . n h n g ch trng trong bn i thoi.
W h ile -liste n in g ac tiv itie s o f te n i n Cc hot ng trong kh i n g h e thng bao

volve c o m p a r i n g y o u r p r e d i c t i o n s gm vic so snh n h n g tin on ca
w ith t h e a c tu a l w o r d s u s e d o n th e bn vi cc t ang dng trong bng
English ill M e d icin e - 9

r e c o r d in g o r ta k in g n o t e s fro m a c o n ghi m hoc vic ghi chp t cuc khm
su lta tio n . F r e q u e n tl y y o u will b e ask bnh. Bn th ng xuyn b yu cu b
ed to c o m p l e t e a n a u t h e n t i c d o c u sung m t ti liu xc thc b n g cch s
m e n t u sin g i n f o r m a t i o n f r o m t h e r e d n g th n g tin t b n g ghi m . i khi
co rd in g . S o m e t i m e s y o u a r e a s k e d to bn c yu cu tp tru n g vo dng ca
c o n c e n t r a t e o n th e fo r m o f t h e a n s w e r , cu tr li, cc t c h n h xc d d n g hoc
t h e ex a ct w o r d s u s e d o r t h e i n t o n a t i o n kiu m iu ca ngi ni.
p a t t e r n o f t h e s p e a k e r.
A fte r-liste n in g ac tivitie s fo c u s o n u s . Cc hot ng sail k h i nghe t$p trung vo

in g th e in f o r m a t i o n y o u h a v e o b t a i n e d cch s d n g th n g tin m bn d thu
from th e r e c o rd in g . F or e x a m p le , y o u n h n c t b n g ghi m . V d. bn c
m a y h e a s k e d to d e c i d e w h i c h d e p a r t th bj yu cu quyt d nh liu khoa no
m e n t a p a t i e n t s h o u l d b e r e f e r r e d to or b n h n h n s dc ch u y n n hoc
to c o m p l e t e a referra l letter. hon tt m t bc th chuyn giao bnh
nhn.
If y o u a re w o rk in g a l o n e , y o u c a n try Nu bn lm vic m t m n h , bn c th
this a p p r o a c h : th cch tip cn ny:
1 Try to do as m uch o f the activity as C gng thc hin c c hoai n g cng

you can without the recording. Cuess nhiu c n g t( khng d n g b n g ghi m.
the answers w hen you cannot be sure. H y o n c c cu tr li khi b a n khng
This will help you to focus your listen c m th y c h c c h n lm. iu ny s
ing on any problems which remain. In gip b n tp trung hot n g nghe ca
addition, it will narrow d ow n th e pos b n vo b't k v n n o cn tn ti.
sible meanings w hen you listen. T h m na, diu ny s thu h p nhng
c c h hiu ngha c (h c c khi ban
lng nghe.
2 Listen to the recording to check your N ghe b a n g ghi m kim Ira cc cu
answers and to fill in any gaps. Listen tr li ca b an v d b sung mi ch
to sections you cannot understand as thiu ht. C n g thng xuyn c n g lt,
often as you like h y nghe c c p h n m b n cha th hiu
c.
3 Turn to theT apescnpt. p. 226, and lis Gi n b n i thoi, trang 226, v
ten to (he recording again with its help. n ghe l i b n g ghi m vi s Ir gip ny.
sp e a k in g tasks OBI Cc bi lm v ni
T h e s p e a k in g tasks fo cu s o n s p e a k in g Cc bi lm v ni tp trung vo cch ni
E nglish in all a s p e c ts o f p a t i e n t care. ting Anh trong tt c cc dng thuc
M o st o f t h e s e task s ask y ou to w o rk cng vic ch m sc bnh nhn. Phn ln
w ith a p a r tn e r, a n d s o m e ask y ou to e x cc bi lm ny oi hi bn lm vic vi
plain to y o u r t e a c h e r o r g r o u p th e m t ngi cng dng vai v c vi bi yu
w o r d s you w o u ld u se in p a r ti c u la r cu bn gii thch cho thy gio ca bn
situ a tio n s. hoc n h m ca bn n h n g t m bn s
d n g trong n h n g hon cnh c bit.
T h e s p e a k in g tasks for p a irs i n Cc bi lm v ni cho tng di bao

clu d e: g u id e d - p r a c tic e ac tivitie s w ith gm: cc hot ng thc hnh dc hung
w o rd or p ic tu r e cues, i n f o r m a t i o n - g a p dn vi nhng t hoc hnh nh, cc hot
activities w h ic h r e q u ir e t h e e x c h a n g e ng thng tin thiu ti i hi s trao i
o f d a t a to c o m p l e t e a f o rm o r to so lv e a d kin hon tt m t dng hoc d gii
p ro b le m , o p in io n - g a p activities w h e r e quyt mt vn d. cc hot ng quan
you m u s t justify y o u r c h o i c e o f in v e s ti dim thiu trong bn phi xc m inh s
g a tio n or th e d ia g n o s is y o u m a k e to la chn ca bn v xt nghim hoc v
v o u r p a r tn e r , a n d ro le-pla ys: d o c chn on m bn dnh cho ngi cng
to r p a tie n t, d o c t o r rela tiv e a n d dng vai vi bn v cc kiu ng vai: bc
d o c t o r d o c to r. s bnh nhn, bc s thn nhn bnh
nhn v bc s bc s.
T h e g u i d e d - p r a c t i c e activ itie s a re Cc hot ng thc h n h c hng

relatively s im p le as m o s t o f t h e w o r d s dn u tng i gin n v a s cc t
you r e q u ir e a r e p r o v id e d . M a k e s u r e bn cn dng u c cung cp. Hy tin
th a t you a n d y o u r p a r t n e r h a v e th e chc rng bn v ngi cng ng vai vi
c h a n c e to play b o th p a rts. If y o u finish bn lun c c hi ng c hai vai. Nu
th e activity a h e a d o f tim e, try to a d d bn hon tt hot dng trc thi hn,
o t h e r e x a m p le s o f y o u r o w n . hy th b sung th m nhng cch thc
khc theo kiu ca bn.
T h e g a p ac tivitie s r e q u i r e as a first Cc hot ng thiu i hi trong

s te p ca refu l r e a d i n g o r lis te n i n g to a c bc u tin l c cn thn v nghe
q u ir e in f o r m a t i o n a n d to u n d e r s t a n d thu n h n thng tin v hiu hon cnh.
the s itu a tio n . T h e n y o u a r e a s k e d to Sau bn c yu cu trao i nhng
e x c h a n g e y o u r f in d in g s w ith y o u r pht hin ca bn vi ngi cng ng
p a r tn e r . M ake s u r e y o u e x c h a n g e v o u r vai vi bn. Cn ch l trao i nhng
d a t a a n d id eas orally. T h e r e is n o p o in t d kin v kin ca bn bng cch ni.
in sim p ly e x c h a n g i n g w r i tte n a n s w e r s Chng c li g khi dn gin trao i nhng
so th a t y o u r p a r t n e r c a n c o p y t h e m cu tr li vit v n h vy ngi cng ng
down. O nce you have c o m p leted the vai vi bn c th chp n hng cu ra. Mt
ex c h a n g e , r e a d t h e text o r s t u d y t h e khi bn d hon tt cng vic trao di, hiy
d ia g r a m y o u r p a r t n e r h a s u s e d . T h a t c bi vit hoc nghin cu biu d m
w ay y ou c a n c h e c k t h a t y o u h a v e u n ngi cng ng vai vi bn d dng. Bng
d e r s to o d y o u r p a r t n e r c o r r e c tly a n d cch bn c th kim tra rng bn
th a t y o u r p a r t n e r h a s g iv en y o u a c c u thu hiu ngi cng ng vai vi bn mt
rate in f o rm a tio n . cch ng n v rng ngi ny cung
cp cho bn n hng thng tin xc ng.
For t h e ro le-p la y s, y o u r t e a c h e r Cho vic ng vai, thy gio ca bn

m a y ask y o u first to p r e p a r e y o u r ro le c th yu cu bn trc tin chun b vai
w ith a n o t h e r s t u d e n t . T h is gives y o u ca bn vi m t sinh vin khc. iu ny
th e c h a n c e to w o rk o u t t o g e t h e r t h e cho bn c m ay c n g lm vic tm ra
la n g u a g e to u s e a n d to a n t i c i p a t e w h a t ngn n g s d n g v lng trc diu
the o th e r r o le - p la y e r will sa y so th a t m ngi ng vai kia s ni. n h vy bn
you c a n r e s p o n d a p p r o p r ia t e ly . You c th tr li tha dng. Ri bn s dc
will t h e n b e a s k e d to p la y t h e ro le w ith yu cu ng vai vi m t ngi cng ng
a n ew p a r tn e r. If ti m e allow s, e x vai mi. Nu thi gian cho php, hy trao
c h a n g e roles a n d r e p e a t t h e ta s k So i cc vai v lp li bi lm sao cho c bn
that b o th yo u a n d y o u r p a r t n e r h a v e ln ngi c n g dng vai vi bn u c6 c
th e c h a n c e to p la y b o t h p arts. S o m e o f may ng c hai vai. Vi p h n ng vai
th e role-p la ys h a v e b e e n r e c o r d e d so c th u bng ghi m, n h v y bn c th
th a t you c a n c o m p a r e y o u r p e r f o r m so s n h kt qu ca bn vi cch ni ca
a n c e w ith th o s e o f n a tiv e s p e a k e rs . ngi bn ng. Bng ghi m l m t kiu
T h e r e c o rd in g is a g u id e a n d d o e s n o t hng dn v khng cung cp cch duy
p ro v id e th e o n ly c o r r e c t w a y to p e r n h t ng ng vai.
form th e roles.
In all t h e s e activities, t h e r e will b e Trong tt c cc hot ng ny, s c

tim e s w h e n y o u d o n o t u n d e r s t a n d nhng lc bn khng hiu ngi cng
y o u r p a r t n e r or y o u r p a r t n e r d o e s n o t ng vai vi bn hoc ngi ny khng hiu
u n d e r s t a n d yo u . M a k in g y o u r s e lf u n bn. Hy lm cho ngi khc hiu bn
d e r s to o d in s u c h s it u a ti o n s is a n i m o n g n hng hon cnh n h vy l mt
p o r t a n t p a r t o f a c q u ir in g a la n g u a g e . phn quan trng thu n h n m t ngn
Ask y o u r p a r t n e r to clarify or r e p e a t ng. Hy ni vi ngi cng ng vai vi
p o in ts y o u d o n o t u n d e r s t a n d . R e p e a t bn d lm sng t hoc lp li n h n g diu
a n d r e p h r a s e if y o u r p a r t n e r c a n n o t bn khng hiu. Lp li v lp li c cu nu
u n d e r s t a n d you. ngi cng ng vai vi bn cha th hiu
bn.
If y o u a r e w o rk in g alo n e , o b v io u s ly Nu bn lm vic m t mnh, th r
it is difficult to h a v e m e a n i n g f u l rng l kh t c cch thc h n h ni
s p e a k in g prac tice . This d o e s n o t m e a n vi y ngha. iu ny khng c
t h a i y o u s h o u ld o m i t t h e s e activities. ngha l bn s b qua cc hot ng .
S p e a k a lo u d th e p arts, p la y in g b o t h Hy ni to cc phn, ng c hai vai khi c
roles w h e r e r e q u ir e d . T h e n c o m p a r e yu cu. Sau so snh kt qu ca bn
y o u r p e r f o r m a n c e w ith t h e r e c o rd in g . vi bng ghi m. Ngng bng ghi m sau
S to p t h e r e c o r d in g afte r e a c h p h r a s e , mi on, v th nhc li theo cng cch
a n d try to r e p e a t it u s in g t h e s a m e p r o c v m iu nh ngi ni trong bng.
n u n c i a t i o n a n d i n t o n a t i o n as th e T ham kho bn i thoi h tr.
s p e a k e r. Refer to th e T a p e s c r i p t for
help.
R eadin g tasks m B i l m v c
R e ad in g q u ic k ly a n d a c c u r a t e l y a re c n h a n h v ng l n h n g k nng
i m p o r t a n t skills for m e d i c a l p r o f e s quan trng i vi ngi h n h ngh y
sionals. T h e r e a d i n g ta sk s fo c u s o n khoa. Cc bi lm v c u tp trung
p r a c tis in g r e a d in g s tr a t e g ie s to d e vo chin lc thc h n h c pht
v elo p th e s e skills. trin cc k n n g ny.
T h e r e a d in g p a s s a g e s in c lu d e : a Cc on c bao gm: bnh n, cc

c a s e h istory, te x tb o o k e x tra c ts , a p h a r trch on sch, ti liu tham kho dc l
m a c o lo g y re f e r e n c e , j o u r n a l article s hc, cc bi bo v h n g lot dng khc
a n d a w id e v a r ie ty o f m e d ic a l d o c u nhau v' ti liu y hc. Tt c cc bi u
m e n ts . All th e texts a r e a u t h e n t i c . xc thc.
R e a d in g ac tivitie s c o ve r: lo c a ti n g Cc hot ng c gm: xc nh

sp e cific in f o r m a t i o n in a c a s e histo ry , thng tin c hiu trong m t b n h n.
tr a n s f e r r in g i n f o r m a t i o n f r o m a tex t to chuyn thng tin t m t bi sang m t ti
a ta b le o r a m e d ic a l d o c u m e n t s u c h as li hoc bng y hc di dng m u hoc
a fo rm o r a letter, c o m p l e t i n g t h e g a p s th, in vo cc ch trng o n g m t bi,
in a text, id e n tif y in g t h e s e c t i o n s o f xc nh cc phn ca n h n g bi bo y
m e d ic a l article s a n d u s i n g a s p e c ia lis t hc v s dng bng chi dn chuyn
index. khoa.
As w ith lis ten in g , t h e r e a d i n g a c Cng n h vi cch nghe, cc hot

tivities h a v e a t le a s t tw o o f t h e s e ng c g m ti thiu hai trong ba giai
sta g es: before-, w h ile - a n d a fte r on: trc, trong v sa u k h i dc. giai
rea d in g . In th e b e fo re -re a d in g s ta g e on tn t c k h i dc, bn c th c yu
y ou m a y b e a s k e d to list t h e m a i n cu lit k n h n g c im chnh ca hai
f e a tu re s of tw o sim ila r m e d ic a l p r o b vn d y hc ging nhau, giai on
lem s. In th e w h ile -r e a d in g s ta g e y o u trong k h i dc, bn c hai don t sch
rea d tw o p a s s a g e s fro m te x tb o o k s to gio khoa d xem liu cc cu t r i li ca
see w h e t h e r y o u r a n s w e r s a r e c o r r e c t. bn c d n g khng, giai on so n khi
In th e a fte r-re a d in g s ta g e y o u c o m dc, bn so s n h b n g lit k ca bn
p a r e y o u r list to d e c id e w h i c h a r e t h e quyt nh xem n h n g g l cc dc im
key f e a tu re s for d if f e r e n tia tin g b e chnh p h n bit cc vn d vi nhau.
tw ee n th e p r o b le m s .
If y ou a re w o r k i n g a l o n e , y o u c a n Nu bn lm vic m t mnh, bn c
try this a p p r o a c h : th th cch tip cn ny:
! Using whatever clues are provided, S d u n g bl k d u mi no c, v du

the text title for example, try to antici tn hi vit, hy c o n trc xem bi
pate whai the texi will contain. Read a vit r cha n hng g. c mi mu bi
sample of the text to help you vit H tr gip ban .
2 Read the text to check your answers c bi vit d kim tra c c cu tr li
and to fill in any gaps N ote h o w long it ca b n v b sung mi ch trng. Hy
takes you to find all the answers or to ghi n h n c n thi gian bao lu b jn
complete the task. tm c tt c c c cu Ir li hoc d
hon tl bi lm.
3 Check your answers with ihe Key (p. Kim tra c c cu tr li ca b a n vi phn
2 7 1). W here your answers differ from Gii p (trang 271). ch c c cu tr
the Key, reread the appropriate sec li ca b an c khc bit vi p h n Gii
tions of the text. p, hy c lai ln na c c p h n tng
ng ca bi vit.
W ritin g tasks Bi lm v v i t
M a n y of th e activities w h o s e m a i n f o Nhiu hot ng m tr n g t m chnh
cus is o n o t h e r skills also in v o lv e n h m vo cc k n n g khc cng bao
writing. W h e n y ou listen to t h e gm c k n n g vit. Khi bn nghe bng
re c o rd in g or r e a d a p a s s a g e , y o u m a y ghi m hoc c m t on, bn c th
be ask ed to w rite n o te s . W ritin g is a n c yu cu vit ra cc ghi n h n . Vit l
a u t h e n t i c r e s p o n s e to t h e lis te n i n g or m t cch p n g xc thc cho k nng
re a d in g text. n g h e hoc c.
Activities w h ic h fo c u s m a i n l y o n N hng ho t ng c trng t m ch

w ritin g in c lu d e le tte rs o f referra l a n d a yu vo k n n g vit eu bao gm cc th
d isc h a r g e s u m m a r y . T h e r e a r e n o s p e chuyn giao b n h n h n v thc hin tm
cial p r o b l e m s or s p e c ia l a p p r o a c h tt. Khng c n h n g vn d' ring bit
14 English in M e d ic in e
n e e d e d for t h o s e o f y ou w h o a r e w o r k hoc cch tip cn ring bit cn thit
ing o n y o u r ow n. A tte m p t th e task a n d cho n h n g ai trong s cc bn ang lm
c h e c k y o u r a n s w e r s w ith th e K ev in th e vic theo cch ricng ca m nh. Hy gng
n o r m a l way. thc hin bi lm v kim tra cc cu tr
li ca bn vi phn Gii p theo cch
bnh thng.
Language focus Trng tm ngn ng

T h r o u g h o u t th e b o o k th e r e a r e b rief Trong sut cun sch u c n hng bn
c o m m e n t s o n key la n g u a g e ite m s i n lun ngn v cc m c ngn ng ch yu
t r o d u c e d by th e tasks, s ta r t in g w ith c gii thiu qua cc bi lm, bt u
b asic q u e s tio n s . T h e fo cu s is o n th e bng n hng cu hi c hn. Trng tm l
la n g u a g e u s e d in m e d ic a l c o m m u n i n h m vo ngn ng dng trong giao tip
ca tio n . G r a m m a r p o i n t s w ith o u t y'khoa. Cc im ng php khng thch
m e d ic a l re le v a n c e a r e n o t in c lu d e d . hp vi y khoa u khng ghi trong sch.
A ppendices Cc ph lc
A p p e n d ix 1 p r o v id e s a c h e c k lis t o f th e Ph lc 1 cung cp bng lit k cc chc
m o st useful la n g u a g e f u n c t i o n s in n n g ngn ng hu ch nh t trong giao
m e d ic a l c o m m u n i c a t i o n . tip y khoa.
A p p e n d ix 2 lists c o m m o n m e d ic a l a b Ph lc 2 lit k cc ch vit tt y khoa
b re v ia tio n s, b o t h UK a n d us. an d in thng thng, c nc Anh v Hoa K.
c l u d e s all a b b r e v ia ti o n s u s e d in th is v bao gm tt c cc ch vit tt s
book. dn g trong cun sch ny.
A p p e n d ic e s 3 a n d 4 e x p la in w h o 's w h o Cc ph lc 3 v 4 gii ngha cc chc
in th e UK h o s p ita l s y s t e m a n d UK a n d danh trong h thng bnh vin nc Anh
US g rade s. v cch phn h n g nc Anh v Hoa K.
A p p e n d ix 5 lists a d d r e s s e s of p r o f e s Ph lc 5 lit k cc a ch n hng c
sio n a l b o d ie s in th e UK a n d USA. quan ngh nghip ti nc Anh v Hoa
K.
E nglish in M ed icin e - 15
U nit 1 Bi 1
Taking a history 1
Lm bnh n 1
Co ang
Y
PH TH
Section 1 Asking basic questions <>iTvLN
P h n 1 t nhng cu hi cdbOTi
Bi lm 1
You will h e a r a n e x tra c t fro m a n i n t e r Bn s nghe trch on n a y l i r i l i e I ll
view b e t w e e n a d o c t o r a n d his p a tie n t. bnh gia bc s v bnh nhn. Va lng
As y ou listen, c o m p l e t e th e P re s e n t nghe, bn va in thm vo Li khai bnh
C o m p la i n t s e c tio n of th e c a s e n o te s o n hin nay t trong khung ghi ch trang
th e n ex t page. sau.
SURNAME Hall FIRST NAMES Kevin
AGE 32 SEX M MARITAL S TA T U S M
OCCUPATION Lorry driver
P R E SE N T COMPLAINT
H Hall TN Kevin
TUI 32 GII N am T)NH t r n g hn nhn C v
NGH N G H I P Li xe ti
LI KHAI B N H HIN NAY
N ow c o m p a r e y o u r n o t e s w ith t h o s e By gi hy so s n h n h n g ghi n h n ca
m a d e by th e d o c to r. T h e s e a re given in bn vi n h n g iu bc s ghi nhn.
th e Key o n p. 271. Explain t h e s e s e c Tt c u c in trong p h n Gii p
tio n s in th e n o te s. trang 271. Gii ngha cc p h n ny trong
bn ghi nhn.
1 SEX M GII NAM
2 MARITAL STATUS M TNH TRANG HN N H N C v
3 3 /1 2 Trong i thng nay
4 a.m. Bui sng
5 "dull and t h r o b b i n g W h y are th e se "Am I v au nhi". Ti sao n hng t ny
w o rd s in q u o te m a rk s (' ")? li t trong ngoAc kp (" )?
6 c /o Khai b n h l
18 - English in M edicin e
Language focu s I Trng tm ngn ng 1
N o te h o w th e d o c t o r sta rts th e i n t e r Chi nh cch bc s bt u hi bnh:
view:
- W hat's brought you along today? V sao hm )M\J n< ti di/7
O th e r w ays o f s ta r t in g a n in te rv ie w Nhng cch khc bt u hi bnh l:

are:
- W hat can I do fo r you ? Ti c th g i p ng diu chng?
- W hat seems to be the problem ? y c vn gi nl?
N o te h o w th e d o c t o r asks h o w lo n g th e Chi nh cch bc s hi thi gian bnh

p r o b le m h a s la sted. bao lu.
- H o w long have they been bothering ii< b bnh l bao lu?
YOU ?
A n o th e r w a y of a sk ing a b o u l this is: C cch hi khc nh sau:

- H ow long have you h ad them ? n au n h vy lu cha?
Task 2 IQEI Bi lm 2
S tu d y this sh o rt dialogue. Nghin cu on i thoi ngn ny.
DOCTOR Well, M rs Black, w hat's Bc s: No, b Black. V sao h m nay

brought you along todayy h li d y
PATIENT: I've got a bad d o se o f flu. (1) Bnh nhn: Ti b cn cm nng. (1)
DOCTOR: How long has it been bothering Bc s: t b b n h t bao lu?
you?
PATIENT- T w o o r th r e e days. (2) Bnh nhn: Mi hai hoc ba ngy nay.
( 2)
P ra ctise this d ia lo g u e . Y o ur p a r t n e r Thc h n h on i thoi ny. Vi m t

slio u ld p la y th ep a rto fth e p atien t.H eo r ngi ng vai bnh nhn. Ngi c
s h e c a n se lec t re p lie s fro m lists (1) a n d th chn cc cu tr li trong cc ct (])
(2) oil th e n ex t page. U se all t h e w ay s of v (2) trang sau. Dng mi cch bt
s ta rtin g a n in te rv ie w a n d a s k in g h o w u cuc hi bnh v hi xem c bnh
long th e p r o b l e m h a s la ste d . lu cha.
(1)
a bad dose o f flu Cn cm nng
terrible constipation to bn nng
swollen ankles ph c c mi c chn
a pain in my stom ach au da d y
(2 )
cwo or three days hai hoc ba ngy
since Tuesday t th ba
a fortnight hai tun l
for almost a m o n th khong mt thng
Language focu s 2 Trng tm ngn ng 2

N ote h o w t h e d o c t o r ask s w h e r e t h e Ghi n h cch bc s hi v tri au:
p r o b le m is:
- Which p a rt o f your head is affected? n g au ch no tr n u?
O th e r w ays of fin d in g th is o u t are: N hng cch khc tm v tr au l:

- W hert does it hurt?* n g au ch no?
- W hrrt is it sore?'' n g b nhc ni n o ?
N ote h o w th e d o c t o r asks a b o u t t h e Ghi n h cch bc s hi kiu au:

type of pain:
- Can you describe the p a in ? n g c th m t au ra sao?
O th e r w ays of as k in g th is are: N hng cch khc d hi vn d trn l:

- W hat's the p a in like? n g au n h t h no?
- W hat k in d o f p a in is it? n g b au ra sao?
Hurt i s a v e r b . W e use It like this: M y fo o t hurts. Hurt l ng l. Ta thng ni nh th ny:

Bn chAn ti dau.
S o n \s an ad jective W e can say: M y fo o l IS sort o r Sore l tinh l. Ta c th ni: Bn li
/ have a sort fool. nhc hoc Ti c bin chAn nhc
20 - English in M ed icin e
Task 3 OBI Bi lm 3
P ra c tis e f in d in g o u t i n f o r m a t i o n like Thc tp tm ra thng tin ging n h dng
this. W ork in t h e s a m e w ay as in T a s k 2. ny. Cng lm ging n h phn bi lm
U se all th e m e t h o d s given in L a n g u a g e 2. S d n g tt c cc phng php nu
fo cu s 2 in y o u r q u e s tio n in g . trong phn Trng tm ngn ng 2 t
cu hi.
DOCTOR: Which part o f your head (chest, B c s: ng dau d u ch no Ingc,
back, etc.) is affected? lng, v.v...)
PATIENT: J u s t here. Bnh nhn: ng ch ny.
DOCTOR. Can you describe the pain? B c s: ng m l cch au d c
kh n g
PATIENT: It's a dull sort o f ache. (1) B nh n hn: l k i u d a u m . (1)
(1)
a dull sort o f ache au m
a feeling o f pressure nh c g nng
very sore, like a knife rt nhc, nh dao m
a bu rn ing pain au nng rt
Language fo cu s 3 Trng tm ngn ng 3

N o te h o w t h e d o c t o r ask s if a n y t h i n g Ghi n h cch bc s hi xem c ci g lm
relieves t h e p ain : gim au:
- Is there anything that m akes it b itte r ?* C cch g lm bt au dc khng?
S im ilarly h e c a n ask: Bc s c th hi tng t n h th:

- Does anything m ake it w orse? C iu g lm au n n g hn khng?
D o c to r s o f te n as k if a n y t h i n g els e a f Cc bc s thng hi xem c iu g lm

fects th e p r o b le m . F or e x a m p le : n h hng n bnh. V d:
- W hat effect does fo o d have? n u'ng c nh hng g k h n g ?
- Does lying dow n help the p a in ? Lc nm c g i m au khng?
B tller m e a n s 1mprovcd o r relieved. It d o e s n o t B e tte r c ngha l Wi< hn hoc g i m bt. T

m e a n cured. ny khng c ngha l k h i bnh.
English in M e d icin e - 21
Task 4 HEI Bi lm 4
Work w ith a p a rtn e r. In e a c h of th e s e Lm vic vi m t ngi cng ng vai.
cases, ask y o u r p a r tn e r w h e r e th e p a in Trong mi trng hp, hy hi ngi cng
is. T h e n ask tw o o th e r a p p r o p r i a t e dng vai dau u. Ri hi tip hai cu hi
q u e s tio n s to h e lp y o u r e a c h a d i a g n o khc thch hp gip bn t ti mt
sis. T h e r e is a d ia g ra m in th e Key s h o w chn don. Trong phn Cii p. c mt
ing your p a r tn e r w h e r e to in d ic are in biu hng dn ngi cng dng vai
each case. Use all th e w ays o f q u e s t i o n vi bn bit chi ng v tri trong mi
ing we have s iu d ie d in this section. For trng hp. s dng tt c i cch t cu hi
example: m ta d hc trong phn ny. V d:
DOCTOR: Where does it hurt? Bc s: ng Hau c h n o >
PATIENT Right across here, (in d ic a tin g Bnh nhn: ng ch ny. (chi vo
the central c h e st area) vng gia ngc)
DOCTOR: Can you describe the pain? B c s: ng c th m t du ra uo!
PATIENT: It's like a heavy w eig h t p r e s s Bnh nhn: Ging nh c vl nnfc
ing on my chest. trn ngc li.
DOCTOR Does anything make it better? Bc s: C cch g lm b t dau lchr?
PATIENT: If I Slop for a bit. it g o e s aw ay. Bnh nhn: Nu ti ngng lai mi lc
th ht dau. -JI;.
It) this e x a m p le , th e p a Trong v d ny. n h n g

tient s s y m p t o m s s u g triu ch ng ca bnh
gest an gina. n hn gi n g h n
cn au th t (ngc).
Now try e a c h of th e s e four c a s e s in th e By gi bn hy thc h n h c bn trng

s a m e way. hp ny theo cch trn.
1 DOCTOR- ............................................... Bc s: .............................................

PATIENT: Here, just under m v ribs. (1) Bnh nhn: Ch ny, ngay di xng
sn. (1)
DOCTOR: ................................................. 'B c si:
PATIENT: It gets w o rs e an d w orse. Bnh nhn: Tng lc li au n n g hn.
T h en it goes away. Ri ht hAn.
DOCTOR: ................................................. Bc s: ..........................................
PATIENT: Food m a k e s it w orse. Bnh nhn: n vo Hau nhiu hn.
2 DOCTOR: ........................................ Bc s: .................................

PATIENT: It's right here. (2) B nh nhn: ng ch ny. (2>
DOCTOR: ................................................ Bc s: ...................................
PATIENT: It's a g n aw in g kind o f pain. B nh nhn: au nh co y.
22 - English in Medicine
DOCTOR: ............................................... Bc s: ..............................................
PATIENT: Yes, if I eat, it gets b e u e r . B n h n h n : Vng, nu li n thi c
hn.
3 DOCTOR: ................................................. Bc s: ..............................................

PATIENT: D o w n here. (3) Bnh nhn: au di ch ny. (3)
DOCTOR: ........................ Bc s: .............................................
PATIENT: It's a sharp , s ta b b in g pain. Bnh nhn: au nhi m anh nh dao
It's lik e a knife. m .
DOCTOR: ................................................. Bc s: ..........................................
PATIENT. If I take a d e e p brea th , o r I Bnh nhn: Nu li ht ththt su hoc
cough, it's really sore. ho th thl au lm.
4 D O C T O R : .......................................................... Bc s: ......................
PATIENT: J u s t here. (4) Bnh nhn: ng ch ny. (4)
DOCTOR: ................................................ Bc s. .........................................
PATIENT: My c h e st feels r a w inside. Bnh nhn: Ngc ti nh au but bn
Irong.
DOCTOR: ................................................. Bc s: ..............................................
PATIENT: W h e n I co u g h , it h u r ts Bnh nhn: Khi ti ho ih au nhiu
m ost. nht.
Task 5 OBI Bi lm 5
Work in pairs. S tu d e n t A s h o u l d start. Lm vic theo i. Sinh vin A bt u
trc.
A: Play th e p a rt of th e d o cto r. R e p ea t A: ng vai bc s. Nhc li Bi lm 4

Task 4 b u t a d d tw o o r t h r e e m o r e n h n g hi th m hai hoc ba cu na
q u e s tio n s in e a c h ca s e to h e lp you trong mi trng hp gip bn
d ec id e o n a d iagnosis. For in stan c e, quyt nh chn on. V d. trong
in the ex a m p le w h e r e th e p a t ie n t 's trng hp cc triu chrib ca bnh
s y m p t o m s su g g est a n g in a , you n h n gi n gh n cn au tht ngc,
could ask: bn c th hi:
- Does anything make it w orse? C iu g lm au n n g hn khng?

- H ow long does the p a in Last? Cn au ko di bao lu?
- Is Uiert anything else you f e i l a t the C n g lc , ng c cm th y g khc
same tim e? na?
B: Play the p a rt o f th e p atien ts. Use the B: ng vai cc bnh nhn. Dng cc
replies in T a s k 4 a n d th e extra in fo r cu tr li trong Bi lm 4 v thng tin
m a tio n in th e Key to h elp you. ph trong phn Gii p h tr bn.
E nglish in M edicine - 23
Section 2 Taking notes P h n 2 Gh chp
Task 6 Bi lm 6
T h e se n o te s s h o w t h e d o c t o r 's fin d in g s Cc ghi chp ny l n h n g p h t hin ca
w h e n h e e x a m in e d M r Hall. N o te t h e bc s khi ng k h m b n h cho ng Hall.
e x p la n a tio n s given for t h e a b b r e v i a Cn ghi n h cc gii n gha ca n hng ch
tio n s used. W h a t d o t h e o t h e r r in g e d vit tt ng. Cc c h vit tt c
a b b re v ia tio n s s t a n d for? khoanh n c6 n gha g?
SU RN A M E F IR S T NAME
AGE SEX M A R IT A L STA TU S
O C C U PA TIO N
P R E S E N T C O M P LA IN T
5 /e)
G en eral C on d itio n obese, 1.65m tall 85 kg
Ear. Nose, Throat ENT) wax + + both sides
Nothing abnormal
detected
Pulse -CVS. ( p ) 80/min
Heart sounds H S ) normal
Gastro- ----------- < o is)

intestinal system
GUS
--- Fundi normal
IM M E D IA T E P A S T H IS TO R Y
P O IN TS OF NOTE
IN V E S T IG A TIO N S
Urine ^) tor sugar and albumen
D IA G N O S IS
/ n hypertension
H TN
TUI GII TlNH t r n g H n n h n
NG H N G H I P
LI KHAI BNH H IN NAY
^ T H M KHM^)
Tng trn g bo mp. cao 1m65. cn 85 kg
Tai Miii Hong ( t ^M .H Q N G ^) ry lai ++ c hai bn
H.HP
Binh thbng (khng mch u

pht hin bt thng)
T.M C H ^ M ^ 8 0 /p h u t (jT ) ( k a ^ IB O /1 2 0
Tlng tim
Tiu h a -------------------------- < T ^ a)
N.DC
^T~KINH^) y ml binh thung
TI N S G N Y
GHI CH
X T N G H I M
Nuc tiu ( ^ ddng v albumin
CH N ON
/ 7 ) Cao huyl p
X TR
Task 7 Bi lm 7
S tu d y th is le tte r fro m a G P to a c o n Nghin cu bc th ny ca m t bc si
s u lta n t. W rite d o w n t h e q u e s t i o n s tng qut gi cho m t bc s tham vn.
w h ic h a d o c t o r m ig h t ask to o b t a i n t h e Hy vit cc cu hi m bc si c n dt ra
in f o r m a ti o n r in g e d in th e le tte r. For d c dc n h n g th n g tin cn thit
e x a m p le : c khoanh trn trong bc th. Vi d:
4 How long did it last? B n h n h v y d lu cha?
8 W hat was the cause o f death? V sao m c h t
CLINICAL DETAILS
D a t e __ Oct 3rd 1 9 -
D ear Dr Scott____________________
I would be grateful for your opinion a n d advice with reg ard to
(Name) GREEN, Peter_____________________
URGENT
P lM M In d lea tt
In th b o *
A brief outline of history, sy m p to m s a n d sig n s a n d p rese n t th e ra p y IS given

below:
This 4 2 -y e a r-o ld ( sa le sm a i} ) h a d a s e v ere attack of (c e n a l ch e st p a i n )

/ 3 \ _____ f 4 \ , f - 5 \
V^SIX m onths agoy w h ic h \la s te d 10 minsJ a n d w asu reliev e d by r e s t J T h i s h as
recurred several tim es (after exertion!) His f a th e r^ d ie d ag e d 5 ) of a
(^ coronary t hr o_m b o s7s*

is ^ Physical ex a m in a tio n w a s norm al a n d I refer him to
you for further a s s e s s m e n t in v ie w of his age.

Diagnosis: angina
T hank you for seein g him.
Yours sincerely.
II tra n sp ort re q u ire d p le a se s la te m u [ no ]
S tre tch e r/S ittin g ca se
S itting ca se tw o m an lift
S ig n atu re :
CC C H I T I T LM SNG
N g y 3 thng 1u n j m 19
Knh gi: 13.s ScolL_____________________________
Ti rt c m n b c s v kin v li k h u y n c a b c s v trng h p b n h
nhn G R E E N . P e t e r._______________
KHN
Vui lng
ghi ch
trong
Di y l s lc b n h n . c c Iriu c h n g v d u hiu k m c c h iu tr hin

nay:
/ 3 \ \ , ... / T~ \
( C c li d y su llic n g ,) u h rtn n g i< y 42 tu i n y b u rd n H<1U v n g g i .1 n g c . )
rt nnp, ( ko d n 0 p h ii'^ ri ^ gi.im bl kl?i nphl ng^ C rin ciu li phi nhiu ln
(Ciu khi^gn B' ng ta cl.i (Ch Iu7S(> lum)d)(1uyi khnn.ic h v a n k ) Tli.iin
khm Ih( Ihclu bnh ihrtn. v, li xin rh u y n bnh nhn n d bc s dnh gi.i
ih m , d.1 Ircn tu i (c C<1 n g la .
Chn don: Cn au thi ngc
Cm n bc si rl thm khm r h o b n h nhn.
Trn (rng,
Nu cn vn chuyn, xin KHNG

ghi r
K I
Cang khing - Gh y
Gh' c hai ngi khing
K t n : / c u -u ( J ic
Task 8 0 0 Bi lm 8
T he h o sp ital c o n s u l t a n t m a d e t h e s e Bc s th am vn ca b n h vin c
n o te s of h e r in te rv ie w w ith M r G re e n . n h n g ghi chp ny khi hi b$nh ng
C o m p le t e as m a n y o f t h e g a p s as y o u Green. Bn hy gng dicn vo nhrtg ch
c a n w ith th e h e lp o f t h e le tte r o n p. 26. trng cng nhiu cng tt trn c s dng
bc th tran g 26.
T h e n listen to t h e r e c o r d i n g a n d c o m Sau hy nghe b n g ghi m v b sung
p lete th e r e m a i n i n g gaps. U se t h e a b n h n g ch trng cn li. Hy dng cc
b r e v ia tio n s y o u h a v e s t u d i e d in th is ch vit tt hc trong bi ny.
unit.
SURNAME ................... ........... (1) FIRST NAMES Peter
AGE ................................ . 12) SEX M MARITAL S TA T U S M 1
OCCUPATION ........... .................... (3) 1
P R E SE N T COMPLAINT _
..................(4) chest pain radiating to L arm. Started with severe attack c dyspnoea.!
Pain lasted ...................... (5) relieved by rest. Has occurred since on exertion.
O/E
G e n e ra l C o n d i tio n
ENT
RS Chest ............. .................... (6)
CVS ................................ . .( 7 ) 70/min ................................... ( 8 ) 1 3 0 / 8 0
.. (9) normal
GIS
GUS
CNS
IMMEDIATE PAST HISTORY
POINTS OF NOTE
INVESTIGATIONS
DIAGNOSIS
28 - English in M ed icine
H ......................... . (1) TN Peter
TUI ..................... (2) GII N am TNH TR N G HN NHN: C v
N G H NG H I P ........ (3)

...................................(4) dau ngc lan quo c n h tay T. I3<t du l cl.iu n.ing km kh
(h. au ko di .. ..... (5) v gim bt khi nghi ngi. Lai ti phi khi
g.ng sc.
THM KHM
T n g trng
T.M .HNG
H .H P Ngc ....................... ( 6)
T.M CH ................. .(7) 70/phl ...................................(8) 130/80
(9) bnh ihng
T .H A
N.D C
T.KINH
TIN S GN Y
GHI CH
XT NGHIM
CHN ON
Task 9 Bi lm 9
S tudy th e s e c a s e n o te s. W h a t q u e s - Nghin cu cc ghi ch trong khung. Bc
tions m ig h t th e d o c t o r h a v e a s k e d to si c th t n h n g cu hi no thu
o b ta in th e i n f o r m a ti o n th e y c o n t a in ? n h n d th n g tin cha ng trong ?
SURNAME lames FIRST NAMES Robert
AGE 40 SEX M MARITAL S TA T U S s
OCCUPATION Builder
PR E SE N T COMPLAINT
c/o rontnl h e a d ac h e 4/7 following cold.
Worse in a.m. and w hen bend in g down.
Also 7o being "off colour" and feverish.
POINTS O F NOTE
Analgesics c some relief.
H James TEN Robert
TUI 48 GII N am TNH T R N G HN NHN c thn
N GHE N G H I P c n n h n xy dng

Khdi dau du vng trn. 4 ngy sau khi b c m lnh.
Oau nhiu hn vo bui sng v khi ci ngi
Cng khai l "xanh xao" v st.
GHI CH
Tliuc gim au c lam bi bnh.
3 0 - English in M edicine
b)
SURNAME Wnrner FIRST NAMES Mary Elizabeth
AGE 4 SEX F MARITAL STA T U S D
O CCUPA TIO N Teacher
P R E S E N T COMPLAINT
Vo episodic h eadaches m any years, lasting 1-2 clays every 3-4 months.
Pain behind eyes c nausea.
"tightness" back O head.
Depressed c pain, interfering c work.
H W arner TN Mary Elizabeth
TUI 54 GII N TNH T R N G HN NHN Ly d|
N G H N G H I P G io vin

T nhiu nm nay b dau u tng thi k, ko di 1-2 ngy, c 3-4 thng au
mi ln. au vng sau hai m t km bun nn (i), "cng thng" vng sau u.
Suy nhc km du, n h hng n vic lm.
Task 10 I9EI Bi lm 10
W ork in pairs a n d try to re c re a te th e Lm vic theo i v c gng thc hi*n li
co n s u lta tio n . S tu d e n t A s h o u ld start. cuc khm bnh. Sinh vin A bt u
trc.
A: Play th e part o f t h e p a tie n ts. U s e i h e A: ng vai cc bn h nhn. S dng cc

case n o te s as p r o m p ts . ghi ch trong khung nhc nh.
B: Play th e p a r t of th e d octor. F in d o u t B: ng vai bc s. P h t hin xem b^nh

w h a t th e p a t ie n t is c o m p la i n in g of. n h n than phin v iu gi. Khng
Do n o t look at d ie c a se no tes. nhn vo cc ghi ch trong khung.
Section 3 Reading skills: Scanning a case his

tory
P h a n 3 K nng c: Xem xt mt bnh n
Task 11 Q Bi lm 11
Read th e following c a se h isto ry a n d c bnh n di y tm v gch di
find a n d u n d e r li n e this i n f o r m a ti o n cng n h a n h cng tt n h n g th ng tin
a b o u t th e p a tie n t as quickly as yo u can . lin quan n bn h nhn.
1 previous o cc u p atio n ngh nghip trc y
2 initial s y m p to m s nhng triu chng khi du
3 initial d iag nosis c h n on ban u
4 co n d itio n im m e d ia te ly p rio r to a d tnh trng n g jy trc khi n h p vin
m issio n
5 reason for e m e rg e n c y a d m is s io n l do d n h p vin c p cu
6 d u r a tio n o f in c re ase d th ir s t an d thi gian cn kht tng v i tiu d m
n octu ria
7 father's cause o f d e a th nguyn n h n ci ch t ca ngi cha
8 alcohol c o n s u m p tio n mc ung ru
CASE H IS T O R Y BNH N
M r W ildgoose, a retired bus d n v e r , was n g Wildgoose, ti x xe bui nghi
unwell and in b e d with a coug h an d hu, cm thy mt v phi nm ngh km
general malaise w h en he called in his ho v c kh chu ton [hn khi ng ta gi
general practitioner. A n u p p e r resp ira mi v bc s tng qut ca minh. ng
tory tract infection was d i a g n o s e d a n d dc c h n on b( vim nhim dng h
ervthrom vcm prescribed. T w o davs
hp Irn v nil,in loa thuc erythromycin
later, at a se co n d h o m e visit, h e was Hai ngy sau, khi n thm ln thhai ti
f o u n d to b e a little breathless a n d c o m nh, v bc s nhn thy ng ta c i
plaining that h e felt worse. H e was a d cht kh th v than phin ml mi
vised to d rin k plenty a n d to continue nhiu hn. Bc s khuyn ng phi ung
with his antibiotic. A n o th e r 2 days nhiu nc v tip tc dng khng sinh.
passed a n d the general practitioner r e Hai ngy na li tri qua, v bc s tng
tu r n e d to find the p atient barely qut tr li v nhn thy bnh nhn km
rousable a n d breathless at rest. E m e r tinh to v kh th khi nm nghi. Bnh
g en cy adm ission to hospital was a r
nhn c thu xp nhp vin cp cu
ra n g e d on the g ro u n d s o f 's e v e r e chest
v l do 'vim nhim nng vng ngc'.
infection'. O n arrival in the ward, he
Khi n h p phng bnh, ng ta khng th
was u n ab le to give an y history b u t it was
k cht g v b n h s, nhng b v qu
ascertained from his wife that he h ad
quyt rng ng chng l ln v khng
been confused a n d u n able to get u p for
th ng dy sut 24 gi trc . Trong
the previous 24h. H e h a d b e e n in c o n ti
thi gian ny, nhiu khi ng ta i dm.
n e n t of u rin e o n a few occasions d u rin g
Trc 2 tun l, ng ta c i tiu m
this time. H e h a d b e e n n o te d to h a v e in
v c khi nc tng nhiu han.
creased thirst a n d n o cturia for th e p r e
vious 2 weeks.
H is past history in c lu d e d ap p e n - v tin s, ng ta c c m rut

dic ec to m y at age 11 years, cervical tha lc 11 tui, vim t sng c cch
spondylosis 10 years ago, a n d h y p e r y 10 n m v b n h cao huyt p, do
tension for w h ich he h a d b e e n tak in g vy dng thuc thiazide li niu
a thiazide diuretic for 3 years. H is fa trong 3 nm . B ng ta qua i lc 62
th e r h a d (died at 62 years o f m y o c a r tui v nhi m u c tim v b m d c
dial infarction a n d his m o t h e r h a d h a d b n h vim thp khp. V ng ta ni
rh e u m a to id arthritis. H is wife k e p t chung vn khe m n h nhng cng b
generally well b u t h a d also h a d a vim hng trong tun l trc, n g
th ro at infection the p r e v io u s week. Wildgoose ung t ru v b ht
M r W ildgoose d r a n k little a lc o h o l a n d thuc t 2 n m trc dy.
h a d s to p p e d sm o k in g 2 yea rs p r e v i
ously.
Section 4 Case history: W illia m Hudson
P h n 4 Bnh n: William Hudson
Task 1 2 @ Bi lm 12
In this s e c ti o n in e a c h u n i t w e will fol Trong p h n ny mi bi. c h n g ta s
low th e m e d ic a l h is t o r y o f W illia m theo di b n h s ca William Hudson.
H u d s o n . In th is e x tra c t h e is v isitin g Trong trch on ny, ln u tin . ng ta
his n e w d o c t o r for t h e first tim e . As y o u n kh m m t v bc s mi. Trong khi
listen, c o m p l e t e t h e p e r s o n a l d e ta ils bn lng nghe, hy b su n g th m cc chi
a n d P re s e n t C o m p l a i n t s e c ti o n o f th e tit c n h n v li khai b n h hin nay vo
ca s e n o te s below . cc khung ghi ch di y.
SURNAME Hudson FIRST NAMES William H enry
AGE SEX MARITAL STA TU S
OCCUPATION
H Hudson TN W illiam Henry
TUI GII TlNH trng hn nhn
NGH N G H I P
Task 13 IGEI Bi lm 13
Work in p ails a n d try to r e c re a te th e Lm vic theo i v c gng thc hin li
c o n s u lta tio n . S tu d e n t A s h o u ld start. cuc khm bnh. Sinh vin A bt du
trc.
A: Play th e p a r t o f William H u d s o n . A: ng vai William Hudson, s dng

U se th e c a se n o te s to h e lp you. cc ghi ch trong khung d h tr.
B: Piny th e p a r t of th e d octor. F ind o u t B: ng vai bc s. Pht hin xem bnh

w h a t th e p a tie n t is c o m p la i n in g of. n h n than phin v diu g. Khng
Do n o i look at the case n otes. nhn vo cc ghi ch trong khung.
T h e c a s e of William H u d s o n c o n t i n u e s Trng hp ca William Hudson tip tc

in U nit 2. Bi 2.
U nit 8 Bi 2
Taking a history 2
Lm bnh n 2
Section 1 Asking about system s

P h n 1 Hi v cc h thng
Task 1 I s ] Bi lm 1
You will h e a r a n e x tra c t f r o m a n i n t e r Bn hy n g h e trch on ny t cuc hi
view b e t w e e n a d o c t o r a n d h e r p a b n h gia bc s v m t b n h n h n n.
tient. T h e p a t ie n t is a 5 0 - y e a r- o ld Ngi b n h l m t n h n vin vn phng,
office w o rk e r w h o h a s c o m p l a i n e d o f 50 tui n khai b n h l m t mi. u oi
feeling tired, lacking e n e r g y a n d n o t v c i m thy khng vng tm . Trong khi
b ein g herself. As y o u listen, in d ic a te lng n g h e, hy ghi nh n xem ngi b n h
w h e t h e r th e p a t ie n t h a s a sig n ific an t c hoc khng c li khai b n h ngha
c o m p la i n t or n o t by m a r k i n g th e a p b n g cch n h du (0 vo ct thch hp
p r o p r ia te c o l u m n w ith a tick ( / ) for d n h cho mi h thng.
each sy stcij
36
System Complaint No complaint Order
ENT
RS
CVS
G1S 1
GUS
CN S
Psychiatric
H thng C kh a i b n h K h n g kh a i b n h T h t
T.M .H NG
H.HP
T.MCH
T.HA 1
N.DC
T.KINH
T m th n
Task 2 0 0 Bi lm 2
Listen ag a in a n d n u m b e r t h e o r d e r in Lng nghe li v ghi s th t
w h ic h th e i n f o r m a ti o n is o b t a i n e d . T h e tin c thu n h n , s th
first o n e is m a r k e d for yo u . c nh du gip bn.
Language focus 4 Trng tm ngn ng 4

N o te h o w th e d o c t o r ask s a b o u t th e Ghi n h cch bc s hi v' cc h thng:
system s:
- H ave you any trouble w ith y o u r s t o m B c b ri lon d dy hoc ng
a c h o r b o w e ls ? rut khng?
- W hat's y o u r a p p e t i t e like? B n c ngon ming khng?
- A n y problem s w i th y o u i w a t e r w o r k s ? Tiu lin ca b c v n g khng?
- W hat about c o u g h s o r w h e e z i n g o r Bt7 C ho hone th kh kh hoc hi hol
s h o r tn e s s o f b r e a t h ? khng?
- H a v t you noticed a n y w e a k n e s s o r B c cm th y ch n lay mi yu hodc
tinglin g in y o u r lim b s? nhi but khng?
Task 3 ^ Bi lm 3
M a tc h e a c h o f t h e s u s p e c t e d p r o b Hy ghp tng vn d nghi ng trong ct
lem s in t h e first c o l u m n w ith a s u it a b le th n h t tng n g vi m t cu hi thch
q u e s tio n fro m t h e s e c o n d c o l u m n . For hp trong ct th hai. V d: lc.
ex a m p le : lc.
Suspected problem Q uestion
Vn d nghi ng Cu hi
1 d ep re ssio n a) H ave y o u h a d an y p ain in y o u r ch e si?

suy nhc ng c au vng ngc khng?
2 cardiac failure b) D o you ev er get w h eezy?
suy' lim C bao gi ng th kh kh khng?
3 a s th m a c) W h a t s o rt o f m o o d have you b e e n in recently?
lien suyn Dao ny tm trng ng ra sao?
4 p ro state d) A n y p r o b le m w ith y o u r w a t e r w o r k s
luyn tin lp* ng di tiu tin ra sao?
5 coronary th r o m b o s is e) H ave you ever c o u g h e d u p blood?
huy khi m ch vnh C khi no ng ho ra mu khng?
6 cancer o f th e lung 0 H ave y o u h a d any s h o r tn e s s o f b re a th ?
ung th phi C khi no ng b hi hi khng?
Task 4 OBI Bi lm 4
Work in pairs. S tu d e n t A s h o u l d start. Lm vic theo (li. Sinh vin A bt u trc
A: Play th e p a r t of t h e d o c t o r. Ask A: ng vai bc s. t n h n g cu hi v

q u e s tio n s a b o u t s y s te m s a n d s p e cc h th n g v n h n g vn dc
cific p r o b l e m s for e a c h of t h e s e hiu cho tng trng hp. B nh nhn
cases. T he p a t ie n t h a s e n o u g h i n c thng tin tr li t n h t hai
fo r m a tio n to a n sw e r at le a s t tw o cu hi ch yu.
key q u e s tio n s .
B: Play th e p a r t of t h e p a t ie n t s . Your B: ng vai cc b n h n h n . Cc thng

in f o r m a ti o n is given in th e Key. tin ca bn c ghi trong p h n Gii
p.
T fiu o n g g o i la tu y n ti n li t
1 T h e p a tie n t is a m a n in late m id d le Bnh n h n l mt ngi dn ng c d
age. He h as c o u g h e d u p b lo o d sev tui cui Irung nin. ii; (a ho ro rru
eral tim e s in th e last few w eeks. nhiu ln trong vi Iu,in l v a C|Ud.
2 T he p a tie n t is an elderly m a n . He Bnh n h n l mt ngi d.n ng c lui.
has bee n g e ttin g m o r e a n d m o r e ng la cng ngy cng bi lo 00'1 -ul
c o n s tip a te d over th e p as t few m y thng qua.
m o n th s .
3 T he patien t IS a m id d le-ag e d Bnh n h n 1.1 nil'll |>ltu I1 trung nin. I.1
w o m a n . She gets pain in h e r s t o m la bj au dii dciy S.HI l)a .n.
ach after meals.
4 T h e p a tie n t is a y o u n g w o m a n . She Bnh n h n l ml phu n tr. c (.1 (I<UI
has pain w h en sh e is p a s sin g urin e. mi khi di licu.
5 T h e p a tie n t is a y o u n g m a n . H e has Bnh n h n l mi ngi d n ng Ir.
a frontal headache. Anh ta nhc du vng trn.
W h e n you h a v e fin ish e d , lo o k in th e Khi bn hon tt bi lm. hy xem

Key (p. 275) a t t h e list of d ia g n o s e s . S e bng lit k cc chn on, phn Gii
lect fro m t h e list ih e five d i a g n o s e s p (trang 275). Chn trong bng lit k
w h ic h m a t c h t h e s e cases. n m chn don tng hp vi cc trng
hp .
Section 2 Asking about sym ptom s

P h n 2 Hi v c c triu chng
Task 5 ( S Bi lm 5
III this e x tra c t y o u will h e a r a p h y s ic ia n Trong trch on ny, bn s nghe bc si
in te rv iew in g a p a t ie n t w h o h a s b e e n hi m t bnh n h n d c nhp vin v
a d m i t t e d to h o s p it a l s u f fe ri n g fro m st khng r nguyn nhn. Bc s nghi
FUO (fever o f u n k n o w n origin). T h e ng b n h lao. Bc s va hi xong v bnh
p h y sic ia n s u s p e c t s TB. S h e h a s a l s gia nh v.v... Mu sau y l mt phn
re a d y a s k e d a b o u t fam ily h is to ry , etc. bng kim tra v st khng r nguyn
T h e follow ing fo rm is p a r t o f a FUO nhn. Thot u, hy lng nghe v nh
checklist. First lis te n a n d tick ( / ) e a c h du ( / ) vo mi im ghi trong phn hi
p o in t c o v e r e d in t h e in te rv iew . bnh.
FEVER duration chills
frequency sweats
time night sweats
rigor
GENERAL malaise wi loss *n o r*n a

SYMPTOMS weakness drowsiness vonvtmg
myalgia delirium photophobis
nose
skin
urine
ACHES AND heafi abdomen ton

PAINS leelh chesl Dck
eyes neck pubc
muscle
lOints
bone
SKIN rash CVS <Jy*POO

prunlis palpitation*
bruising ht irrogulanty
GIS diarrhoea RESPIRATORY cough

m elaena coryza
sofe throat
dyspnoea
URINARY tjysuna pieuntic pain
frequency sputum
strangury haemoptysis
discolouraiion
NEUROLOGICAL visio n
photophobia
b la c k o u ts
diplopia
4 0 - English in M e d ic in e
1 Ihi gian lanh rt
tn xut ra m hi
ln ra m hi dm
rt run
kh chiu sl cn c h a n n
TR I U CHNG
yu mt u oi n n I
T NG QU A T
au ca m sng s nh sng
chy mu? m i
da
n c li u
NHC V AU du bng tht lng

rng ngc lng
mt c vng mu
co
khp
xong
DA ni ban H TIM MCH k h th

nga d n h tr n g n g c
bm llm tim d p k h n g u
H TIU HA ti u c h y H HP ho
phn m u s m i
dau hong
kh th
dau m ng ph'
TIT NIU kh di dm
tn xu t ho m u
d ' sn dau
i m u
THN KINH thi g i c
S n h s n g
h oa m t
s o n g th|
English in M edicine - 41
Task 6 I s ) Bi lm 6
N o w listen again to in d ic a te th e o rd er By gi hy nghe li xc inh th t
ill w h ich th e p o in ts a r e c o v e r e d by theo cc dim d dc ghi n h n bng
w riting a n u m b e r in th e c o r r e c t box. cch vit ch s vo tng ng dng.
The first o n e IS m a r k e d for you. Ch s u tin c ghi gip bn.
Language focus 5 I s j ( ) Trng tm ngn ng 5

Listen again to th e FUO ex tra ct from Nghe li trch on v st khng r
Task 5. N ote th a t th e d o c t o r u s e s rising nguyn n h n thuc Bi lm 5. Ch cch
in to n a tio n for th e s e q u e s tio n s . bc s ln cao ging ni cho cc cu hi
d.
- A ny p ain in your m uscles? C dnu cc M p c khn<?

- H avr you lo u any w e ig h t? n g c s t cn khng?
- Have you had a couh at a ll? n< c ho ch t no khn?
- h there any blood in it? C m u Irotg d k h n y 7
- H a vtyn u h a d any p a in s in your chest? n g c dan ch t no vrv nic
kh n y?
W he n w e ask V es/N o q u e s t i o n s like Khi ta t nhmg cu hi C/Khng nh

these, w e n o r m a lly u s e risin g i n t o n a th, ch n g ta thng ln cao ging ni.
tion. N ote th a t th e voice c h a n g e s o n Ch l ging ni c thay i trn mt t
(he i m p o r t a n t w o rd . For e x a m p le : quan trng. V d: ^
- A n y p a in in y o u r muscles? C au cc bp c kh n g ?
u n d e r l i n e th e i m p o r t a n t w o r d in e a c h Hy gch di mi t quan trng trong

of t h e q u e s t i o n s a b o v e . T h e n lis ten cc cu hi trn dy. Ri nghe li xem
ag a in to se e if y o u c a n h e a r t h e c h a n g e bn c th nghe thy s thay i trn cc
o n th e s e w o rd s . C h e c k y o u r a n s w e r s t . Kim tra cc cu tr li ca bn vi
w ith t h e Key. p h n Gii p.
Task 7 ^ Bi lm 7
S tu d y this e x tra c t fro m a c a s e histo ry . Nghin cu trch don ny t m t bnh
n.
T h e p a u e n t w a s a 5 9 - y e a r - o l d m a n . head Bnh nhn l ml ngi An ng 59 tui
o f a small engineering fir m (1), w h o com p h trch m l xng k ihuAi n h III
plained o f central chest pain (2) w hich o c kh.ibrM J vim f> giangn> ) uji hin
cu rred on exertion (3) a n d was sometimes m i k h i g .i n g s r (3) v n h i d u l n ( k m
accompanied by sweating (4). H e smoked lol m h i[4). ng la h l 4 d i u ih u c
4 0 ciareltts a day (5). T h e pain h a d first / m i ng{5). Cch cy bd thcng dau
appeared three months previously (6) a n d bt d u xut h i n (G) v dn dn Ihn !
was becoming increasingly frequent (7). x u y n hn (7). Gn dy. ng la thy c
H e h a d n o tic e d s o m e weight gain re l n cn ch t t (4 kgI (8) v cng tluin
cently [4 (8) a n d also c o m p la i n e d p h i n rng lc b x xc: v klin t n
that his hair h a d b e c o m e very dull a n d mt m . ng la cm lliy rt nhiu hn
lifeless. H e felt the cold m u c h m o r e Irc dy. ng 1.1 kli.ing dinh khn c
than he use d to. H e denied any palpita drtli trng n g c (*-)) ho.c hu n t <v>
tions (9) or ankle oedema (10). ch'in (10).
W h a t q u e s t i o n s m i g h t a d o c t o r as k a Bc s c th t n h n g cu hi no cho
p a t ie n t to o b ta in th e i n f o r m a t i o n in bnh n h n d thu n h n uc cac thng
italics in th e c a s e h istory? U se th e tin in nghing trong bnh n ny? Dng
q u e s t i o n ty p e s s tu d i e d in U n it 1 a n d cc loi cu hi hc trong Bi 1 v bi
th is unit. You m a y ask m o r e t h a n o n e ny. Bn c th t nhicu cu hi cho mi
q u e s t i o n for e a c h p ie c e o f i n f o r m a on thng tin. V d:
tion. For e x a m p le :
1 W h a t's y our job? ng lm ngh g?
2 W h a t's b r o u g h t you a lo n g to day? Hm nay v Scion(> li (ln y? n g (lau
W h ich part o f y o u r c h e s t is af ch no ngc?
fected?
W h e n y o u h a v e fin ish e d , p u t y o u r Khi lm xong, bn hy xp cc cu hi

q u e s t i o n s in th e m o s t n a t u r a l o r d e r for theo th t t nhin nht dng cho
a c o n s u lta tio n . cuc khm bnh.
Task 8 IGJEI Bi lm 8
W ork in p airs. S t u d e n t A s h o u l d sta rt. Lm vic theo di. Sinh vin A ht du
trc.
A: Play th e p a r t o f th e p a t i e n t . Base A: ng vai b n h nhn. Cc cu tr li

y our re p lie s o n t h e i n f o r m a t i o n ca bn u da vo cc thng tin nu
given in t h e e x tra c t ab o v e . trong trch on trn y.
B: Play t h e p a r t o f t h e d o c t o r . F in d o u t B: ng vai bc s. Gng Um xem bnh

w h a t t h e p a t i e n t is c o m p l a i n i n g of. n hn than phin ve diu g.
Task 9 % B i l m 9
H ere are s o m e o th e r q u e s t i o n s w h ic h y l vi cu hi khc c th dng d hi
a d o c to r m ig h t ask a p a t i e n t c o m p l a i n m t b n h nlin c triu c h n g st khng
ing of FUO. W h ich p r o b l e m s in t h e r nguyn nhn. Trong bng kim tra d
checklist in T ask 5 d o th e y refer to? I n Bi lm 5 cc cu hi lin quan n
d ic ate o n t h e fo rm by w ritin g t h e a p n h n g vn d g? Hy x ic nh trn bng
p r o p ria te le tte r in t h e c o r r e c t box. bng cch vit m t ch ci ng vio
thch hp.
Example: V d:
a) Have you any pain in p assin g w a ng c au khi liu tin khng?
te r 5
URINARY rn dysuria
TIT NIU kh di
b) Do you suffer from d o u b le vision? ng c b chng nhn î khng?

c) Any s h o rtn e s s of brea th ? ng c b hl hi khng?
d) Does light b o th e r you? ng c b nh sng gy kh chiu khng?
e) Are your scools black? ng Hi ai tin c p h n en khng?
0 Do you have a cold? ng c b| c m lnh khng?
Task 10 E3 Bi lm 1 0
M a tch e a c h o f th e m e d ic a l t e r m s for Ghp mi th u t n g y khoa biu th cho
c o m m o n s y m p to m s in th e first c o l cc triu chng th n g th ng ct u
um n w ith a term w h ic h a p a tie n t tin vi m t th u t n g m b n h nhn d
w o uld easily u n d e r s t a n d or m i g h t use, hiu hoc c th s d n g ct th hai. Vi
from th e s e c o n d c o l u m n . For e x a m d: lk.
ple: lk.
Medical term Non-medical term

Thut n g y khoa Thut n g khng y khoa
1 p ara esth e sia a) swelling, pu ffin ess
Hi c m sng, phng
2 p roductive cough b) in d ig e stio n
ho c dm 5n khng tiu
3 a n a es th esia c) c o u g h in g u p p h le g m or spit
v cm ho ra nhy h o c khac dm
4 r e tr o ste rn a l ch e st pain d) tr o u b le h o ld in g y o u r w a te r
d a u ngc snu xnp < k h n in ti u
5 orthopnea e) cra m p in th e leg m u scles which
kh Ih lc nm co m es and goes
chul r l c c h n lc c lc klinp
6 stress in c o n tin e n c e 0 num bness
141 khng nin chu dc l cng
7 d y s m e n o rr h o e a .g) sleep lessn ess
ri lon kinh nguyt khng ng clc
8 dysp e p sia h) o u t o f breath, o u t o f puff,
ri lon tiu ha b re a th le s s n e ss
ht hi, th khng ra hi
9 oedema i) painful perio d s
ph au bng kinh
10 i n te r m itte n t claudication j) pain beh in d th e breast bone
b di khp khic'ng lng hi au pha sau xng ngr
11 in so m n ia k) pins an d needles
m t np t l bun bun nh kim chm
12 d y spno e a I) shortness of breath w hen you lie down
kh th lil hi khi nm
Task 11 m Bi lm 11
W ork in pairs. S t u d e n t B s h o u l d sta rt. Lm vic theo i. Sinh vin B bt u
trc.
A: Play th e p a r t of a p a t ie n t . U se th e A: ng vai bnh nhn. S dng thng

i n f o r m a ti o n in th e Key to h e l p you. tin trong phn Gii p d h tr.
B: Play th e p a r t o f t h e d o c t o r . T ry to B: ng vai bc S. Gng pht hin bnh

find o u t w h a t th e p a tie n t's p r o b n h n c n h n g vn d g. Nn nh
le m s are. R e m e m b e r y o u r p a tie n t rng b n h n h n ca bn s khng
will n o t u n d e r s t a n d m e d ic a l hiu cc thut ng y khoa. Cng cn
te rm s. R e m e m b e r also to u s e rising nh ln cao ging khi t cc cu hi
in t o n a t i o n for Y e s /N o q u e s tio n s . C/Khng. Ghi nhn nhng pht
R ecord y o u r f in d in g s in t h e P r e hin ca bn trong phn li khai bnh
s e n t C o m p l a i n t s e c ti o n o f t h e fo rm hin nay bng trang sau.
o n th e n ex t page.
W h e n y o u h a v e Finished, s t u d e n t A Khi lm xong, sinh vin A s kim tra cc

s h o u ld c h e c k t h e d o c t o r ' s n o te s . S t u ghi chp ca bc s. Sinh vin B s so
d e n t B s h o u l d c o m p a r e h is o r h e r s n h ghi chp ca bn thn vi phn Gii
n o te s w ith th e Key. p.
SURNAME Wilson FIRST NAMES Peter
AGE 4H SEX M MARITAL STA T U S M
OCCUPATION SteolrojK- worker
H Wilson TEN Peler
TUI 48 GII N am TNH T R N G HN NHN CV
NG H N G H I P Cng n hn dy c p Ihp
Task 12 ^ Bi lm 12
This is p a r t of a le tte r of referra l fro m a y l m t phn bc th chuyn giao bnh
d o c t o r to a c o n s u l t a n t c o n c e r n i n g t h e n h n ca m t bc s gi m t bc s tham
s a m e p a tie n t. U sin g th e n o t e s in th e vn lin quan n cng mt bnh nhn.
Key. c o m p l e t e th is s e c ti o n o f t h e l e t Hy dng cc ghi chp trong phn Gii p
ter. U se t h e a p p r o p r i a t e m e d ic a l d in b sung cc ch trng trong thu
term s. Hy dng cc thut n gy khoa thch hp.
L e tte r o f r e fe rra l (p a ri 1) T h c h u y n g ia o b n h n h n (p h n 1)
D ear D r M acP herson,
I d b e p l e a s e d to h a v e y o u r a d v i c e o n t h e f u t u r e m a n a g e m e n t o f
th is 4 8 -y ear-o ld steelro p e w orker who gives a h isto ry of
(1 ) on e x e rtio n of one y e a r 's d u ra tio n a n d a
(2 ) cough w h ich he h a s h a d for so m e y e a r s .
D u rin g th e la s t t h r e e w e e k s he h a s h a d t h r e e a t ta c k s of c h e s t
tig h tn e s s a n d p a m r a d ia tin g in to th e u p p e r rig h t a r m The a t
tack s h a v e com e on a f te r e x e rtio n a n d h a v e la ste d s e v e r a j m in
u te s He h a s n o ticed a n k le (3 ) In crea sin g d u rin g th e d a y
46 - English in M edicine
a n d r e l i e v e d b y o v e r n i g h t r e s t . H e a l s o g i v e s a m o n t h s h i s t o r y o f
.................................( 4 ) o f t h e r i g h t le g r e l i e v e d b y r e s t . L a s t n i g h t h e
h a d a n a tta c k of a c u te ............. ( 5 ) c h e s t p a i n l a s t i n g 15
m in u tes,a sso cia te d w ith ex trem e re stlessn e ss and a
............................... ( 6 ) s p i t .
He g iv e s a h is to ry of good h e a lth b u t h a d child h o o d w h o o p in g

c o u g h a n d a w h e e z y b r o n c h i t i s . H e s m o k e s a n a v e r a g e o f 2 0 to 3 0
c i g a r e t t e s a d a y . H is s i s t e r h a s a h i s t o r y o f p o s s i b l e p u l m o n a r y
tu b e rc u lo s is a n d h is f a t h e r d ie d of a h e a r t a t ta c k a t th e ag e of 56.
Kinh gi B.s MacPherson,
Ti rt vui mng nhn li khuyn ca bc s v cch x tr

sp ti i vi bnh nhn 4 8 tui, vn l mt cng nhn
dy cp thp c bnh s v ............. (1) m i khi gng
s c , ko dai mt nm nay v ............ (2) ho c
trong vi nm nay.
Trong ba tun l v'a qua, bnh nhn c ba cn au tht

n g c , cn au lan ta ra cnh tay phi . Cdn au xay ra sau
khi gng sc v ko di vi p h t . Bnh nhn nhn thy mt
c chn ......................... (3 ) tng ln trong ngy
v gim bt sau mt m nghi n g i . Bnh nhn cng khai
bnh s trong thng va qua v ....................(4 )
ni chn phi c gim bt khi nghi ngi. m qua, bnh
nhn c mt cn au cp ...................... ...(5) au
ngc ko di 15 pht km theo tm trng cc k bt an bn
chn va mt ............................. (6) khc m.
Bnh nhn khai tinh trng sc khe tt nhng thu nh c

b ho ga v vim ph qun dng hen. Bnh nhn ht trung
bnh t 20 n 30 iu thuc l mi ngay. Ba ch c bnh s
ngh ngr l lao phi v ng c thn sinh cht lc 56 tui
VI c n a u t i m .
English in M edicinc - 47
Task 13 ^ Bi lm 13
S tudy th e s e fin d in g s o n e x a m i n a t i o n Nghin cu n h n g kt q u i k h m b<nh vi
an d details of th e t r e a t m e n t given. cc chi tit dicu tr ghi n h n di y. Sau
T h e n c o m p le t e t h e s e c o n d p a r t o f th e d, b sung th m vo p h n hai ca th
le tter of referral. ch u yn giao bnh nhn.
SURNAME Wilson FIRST NAMES Peter
AGE 48 SEX M MARITAL STA T U S M
OCCUPATION Steelrope worker
PRESEN T COMPLAINT
Retrosternal chest pain Iasi night radiating lo neck and R arm. Duration 1 5 mil*.
Accompanied by restlessness. Diif. sleeping. Cough c: rusty spit.
1 yr SOBOE, productive cough some years, past 3/52 tightness in chest x3, pain ra
diating to R arm, occurred on exertion, lasted mins.
Also 7o puily ankles in the evening, intermittenl claudication R calf for 1/12.
H Wilson TN Peler
TUI 48 GII N am TNH T R N G HN NHN Cv
N GH N G H IP Cng n h n dy c p thp
LI KHAI BN H HIN NAY

au vng ngc pha sau xng c lan ta ti c v c n h tay p. Bnh bt d i u tdm
qua ko di 1 5 pht, km tm trng bt an bn chn. Kh ng. Ho c d m m u gl
st.
Hl hi khi gng sc t mt n m nay, ho c d m t v i nm nay, t 3 t u i n l nay c
d.iu lc ngc 3 ln, au xut hin khi gng sc, lan ta ti cn h tay p, ko di vi
pht.
Cng khai b sng ty cc mt c ch n vo bui chiu, bc di khp khing tng
hi, bnh bp ch n p t mt thng nay.
48 English in M edicin e
O/E
G e n e r a l C o n d i tio n Short, barrel-chested, orthopnea and peripheral cyanosis.

early finger clubbing.
ENT
RS Poor resp. inovl. G eneralised hyper-resonance.

Loss O liver dullness. Bilateral basal creps.
CV S p 84 reg. BP 140/92 sitting. O edem a up to knees.
Sacral oedem a+. IVPApex beal outside MCL in 6th L interspace.
HS 1, II faint. No peripheral pulses below poplileals.
G IS Liver palpable and tender. J. 2ib
GUS
CNS
MANAGEMENT
R frusemide 20 mg IV
X
m orphine tartrate/cyclizine tartrate 15 mg IM
THM KHM
%
T ng trn g Ngi thp ln, ngc n vam v, kh th lc nm, v tm ti ngoai
vi. mi c ngn tay di trng.
T.M .H NG
H.HP Nhp th yu. Tng ting phi ton vng.

Mt vng due gan. Ran n vng dy plii hai bn.
T.MCH M ch 84 u. Huyt p 140/92 khi ngi. Ph chi n gi. Ph

vng xng cng +. p lc tnh m ch cnh tcngl! inh tim clp
khoang lin sn 6 T, plia ngoi dng gia xng n. Ting tim
I, II m. Khng nhp m ch ngoi vi di khoeo.
T.HA C a n m m v s thy. 2 khoi ngn lay
N.DC
T.KINH
X TR rusemide 20 mg tim TM
m orphine lartrate/cyclizine tartrate 15 mg tim TM
Letter of referral (part 2) Th chuyn giao bnh nhn (phn 2)
On e x a m i n a t i o n , h e is o f ...............................( 7 ) b u i l d w i t h a b a r r e l
s h a p e d c h e s t . H e is ..................................( 8 ) w i t h s o m e p e r i p h e r a l
........................ (9). There Is also early finger ............... ......... (10).

Pulse rate was 8 4 ..............................(11) in time and force. BP
140/92 sitting. He has p ittin g........................ (12) at the anklea to
the level of the knee. There is also .......................... (13) sacral oe
dema. He has raised Jugular ........................(14) pressure.
On examination of his chest, he had poor respiratory movement,

some hyper-resonance and loss of liver dullness. His apex beat
was just outside the left-mid ( 15) line In the sixth
.
left interspace.......................... (16) sounds were closed but faint. He

also had bilateral basal .......................... (17) while the liver seemed
enlarged two finger breadths below the .........................(18) costal
margin and somewhat tender. The peripheral pulses in the lower
limbs were impalpable below the popliteal arteries. He was given
........................ (19) frusemide, 20 mg, with good effect in relieving
his breathlessness. Morphine tartrate/cycllzine tartrate, 15 mg
was given ........................(20).
Yours sincerely,
Qua thm khm, bnh nhn c dng ............... (7 )
ngc n v m v . ng ta ............. (8) vi i cht
ngoi vi ............. (9). Cng mi c ngn tay
........... (10). Nhp mch l 84 , .............. (11)
v thi gian v lc . Huyt p 140/92 khi ngi . ng ta
c ho .............(12) vng mt c chn ti u
gi . Cng c ........ (13 ) ph vng xng c n g . ng
ta c t n g m c h c n h ............. (14) p lc.
Khi thm khm vng n g c , bnh nhn c nhp th y u ,

c tng ting phi v mt vng c gan. inh tim p
n gphia ngoi ng gia tri ............ (15 )
khoang lin sn th su t r i ................. (16)
t i n g m c nhng y u . B nh nhn c n g c v n g y
hai bn ..............(17 ) cn gan c v to qu hai
khot ngn tay di .............. (18) b sn v
hi mm. Nhp mc h ngoi v chi di khng th s
t h y ni di n g m c h khoeo. B n h n h n dc
iu tr ............ (19) frusemide, 20mg, to
h i u qu tt v g i m bt c h n g kh th. Morphine
t a r t r a t e / c y c l i z i n e tartrate, 15 mg c dng
......... (2 0 ) .
T r n trng,
Task 14 GEI Bi lm 14
Work in pairs. S t u d e n t A s h o u l d sta rt. Lm vic theo i. Sinh vin A bt u
trc.
A: Play th e part o f a tr a in e e d o c to r . A: ng vai bc si thc tp. Hy hi vi

Ask a b o u t t h e fin d in g s o n e x a m i n h n g iu p h t hin khi khm bnh
n a t io n a n d t r e a t m e n t to d a t e o f M r v iu tr trong ngy cho ng Wilson.
Wilson.
B: Play th e p a rt of th e d o c t o r w h o h a s B: ng vai bc s k h m bnh cho ng
e x a m in e d Mr W ilson. S u p p ly a n y Wilson. Cung cp th n g tin v vic
in f o rm a tio n o n M r W i ls o n s e x khm b n h v iu tri cho ng Wil
a m i n a t i o n a n d t r e a t m e n t u s in g son, qua vic s d n g cc ghi chp i
th e n o te s given in T ask 13. Bi lm 13.
Task 15 0 Bi lm 1 5
You will h e a r a d is c u s s io n b e t w e e n a Bn s n g h e cuc tho lun gia mt bc
general p r a c titio n e r a n d a c o n s u l t a n t . s tng qu t vi m t bc s th a m vn. Hy
C o m p le te th e c a s e n o te s below . in b sunt cc ghi ch trong khung
di y.
SURNAME FIRST NAMES
AGE SEX MARITAL STA T U S
OCCUPATION
IMMEDIATE P A S T HISTORY
H TN
TUI GII TNH T R N G HN NHN
N G H N G H I P
TIN S G N Y
Task 16 s Bi lm 16
T his is a tr a n s c r i p t o f t h e c o n v e r s a ti o n y l bn ghi cuc m thoi gha hai
b e t w e e n th e tw o d o c to rs . Try to c o m bc si. Hy b sung vo cc cu hi ca
p le te t h e c o n s u l t a n t s q u e s tio n s . T h e n bc s tham vn, sau nghe bng ghi im
c h e c k y o u r a n s w e r s b y lis te n i n g to t h e kim tra cc cu tr li ca bn.
rec o rd in g .
GP: Hello, Jim . I w o n d e r if you c o u ld Bc s tng qut: Cho Jim. Ban c th

see a p a tie n t for m e? khm ml b n h nhn gip Irti dc
khng'
CONSULTANT: C erta in ly , Joh n . Bc s tham vn: c ch, )ohn
..............................(1) th e story? .....................(1) bnh s?
GP Wei), it's a Mr Alan J a m e s o n , a BSTQ: , 6 l ng Alan lameson, ih
53-year-old carp en te r. He's b ee n mc, 53 lui. Trc dy. rii lc ng
an in fre q u e n t a t t e n d e r in th e p as t la c Hn kh m bnh nhng sing nay
but h e ca m e to s e e m e th is m o r n ng (a n ch ti than phin dau
in g co m p la in in g o f pain in his right chn p h i v vng lng (a).
leg and his back (a).
CONSULTANT: A nd ................................. (2) Bc s tham vn: V ..........................(2)
..............................(3) this sta rt? ..................................... ( 3 ) bt Hu ra sao?
GP W e ll. It came on about six weeks BSTQ: , con dau bt (lu khong su
ago (b) an d it's b e c o m e g radu a lly tun (b) va ngy cng nng hn Irong
m o r e severe o ver th e p a s t c o u p le hai tun qua.
o f weeks.
CONSULTANT: ...............................(4 ) th e Bc s tham vn: ................................ (4)
pain localised? dau khu tr khng?
GP No, poorly. At first h e t h o u g h t he'd BSTQ: Khng, cha r. Thoat du, ng
just pulled a m uscle. But it's g o t so ta ngh l bp r b ko cang. Nhng
bad that he h asn 't b e e n able to do ri ngy cng li t hn d n mc
his w ork properly. It's also b een khng cn kh nng lm mi vic
getcing to th e siage w h e r e [he pain n g hong dc. V n giai oan
is waking him up at nighl (c), it's cn cau lm n g ta tinh gic trong
bee n so severe, a n d he's also noticed rm (c), Hau rt m n h , n h c ci gi
some tingling in his right foot (d ). He's cn rt bn ch n p h i (d). Bnh
having difficulty in carrying on with nhn cm ihy kh kh n khi phi
his work (e). H e's a/so lost three k i lip l c c ng vi c (e). ng la st li
los (f) and has b e c o m e q u ite d e k g () v\ R n n h su y su p h n .
pressed.
CONSULTANT: ..............................(5) he Bc s tham vn: ............................. (5)
...........................(6) a n y th in g sim ila r ng ta ............................(6) c (tiu g
...........................(7) th e past? ging n h ......................... (7) (rc dy
khng?
GP: No, n o t exactly, b u t he has suffered BSTQ: Khng, khng r lm. nhng
fro m interm ittent pain in (...] back (g). b n h nhn c cn au cch qung
Paracetamol gave some relief (h ) but vng lng (g). Paracetam ol c ljm
didn 't solve th e p r o b le m com g i m b t (h ) n h n g k h n g g i i q u y t
pletely. (lt mi vn .
CONSULTANT: A part f r o m ................ (8 ), Bc s tham vn: Ngoi vic................(0),
any ...............................(9) p r o b le m s cn g ....................... (9) nhng vn cl
.........................................(10) h e a lth ..........................................(10) sc khe
..................................... (11) th e past? ........................... (1 1) trc rly ra sao?
GP: No, perfectly OK. BSTQ: Khng, hon lon binh thng.
CONSULTANT: .............................(12) you Bc s tham vn: ..............................(12)
..............................(13) a n y th in g else b<?n................................(1 3) diu g khc
..............................(14) e x a m in a tio n ? ............................. (14) khm bnh
khng?
GP: Yes, as well as th e pain h e has BSTQ: C, ngoi chng dau, bnh nhn
n u m b n e s s in his toes o n th e right cn b l cng cc ngn bn chn
foot. phi.
Task 17 ^ Bi lm 17
Look at th e i n f o r m a ti o n in italics in th e Hy ch phn thng tin cc on in
tr a n s c r ip t abov e. W h a t q u e s t i o n s n ghing trong bn ghi trn y. Bc s c
m ig h t a d o c t o r ask to o b t a i n th is k in d th dt n h n g cu hi no thu nhn
o f i n f o r m a ti o n fro m a p a t ie n t ? For e x . c thng tin n h vy t ngi bnh? V
am p le: d:
. . . i t came on about six weeks ago (b) ... bnh x y ra cch nay khon? su
tun (b)
Q u e s tio n : W h e n d id y o u first n o tic e Cu hi: L n u tin ng n h n bit cn

th e pain? au vo thi gian no?
N ow try th e o t h e r e x a m p l e s (a) to (h) By gi, hy th vi cc v d khc (a) n

in th e s a m e way. In w h ic h d e p a r t m e n t (h) theo kiu n h vy. Bn ngh rng bc
d o y o u th in k th e c o n s u lta n t w ork s? s tham vn lm vic khoa no?
Section 3 Reading skills: Noting inform a
tion from a textbook
P h n 3 K nng c: Gh nhn thng tin t
sch gio khoa
Task 18 S B i l m 1 8
Try to c o m p l e t e t h e ta b le b e l o w w h ic h B sung bng (li y, trong c ghi vi
sh o w s s o m e of t h e key f e a tu r e s o f tw o c im ch yu ca hai th bnh. Sau
m e d ic a l p r o b le m s . T h e n s t u d y t h e n g h in cu cc trch don sch gio
te x tb o o k e x tra c ts o p p o s i t e to c h e c k khoa tran g sau kim tra cc cu tr li
yo u r a n s w e r s a n d to c o m p l e t e d i e t a ca bn v b sung th m vo bng. u
ble. T h is will h e l p y o u m a k e a d i f f e r e n ny s gip bn c th thc hin vic
tial d ia g n o s is b etw een t h e tw o c h n on phn bit hai th b n h .
p r o b le m s .
A n g in a Pericarditis
Site
R adiation
D u ra tio n a few m in u te s p ersisten t
P recipitating
factors
R e lie f o f pain
A cco m p a n y in g sy m p
to m s and sig n s
C n a u tht Vim n g o i t m m c
Vi trf
Lan t a
Thi gian vi p h t dai d n g
C c y u t' g y t p h t
G i m d a u
C c triu c h n g v d u
h i u k m th e o
ANGINA PECTORIS C n a u th t n g c
Angina pectoris is the term used to de- Can au thi ngc l ml thujl ng dng
s c rib c discomfort due to transient myo- d m l tinh trang kh chiu do thiu
cardial isc b a e m ia and c o n stitu te s a m u c tim th on g qua v tdo ra m t hi
clinical syndrom e rather than a disease; chng lm sng hn l mt bnh; linh
ii may occur w henever there is an im- tring ny c th x iy ra b it k lc no c
b a la n c e betw een myocardial oxygen s mt cn bng gia cung v cu oxygen
supply and dem and. ca c tim.
FACTORS INFLUENCING MYOCAR C C YU T NH HNG N

DIAL OXYGEN SUPPLY AND DE C U N G V C U O X YG E N C A C
MAND TIM
Oxygen demand Nhu CU o x y g e n

Cardiac work Hol dng ca lim
Heart rate Nhp lim
8lood pressure Huyt p
Myocardial contractility Tnh trng co c tim
Oxygen supply Cung c p oxygen

Coronary blood flo w ' Dng m u m .ich vnh*
Duration of diastole Thi gian t.im Irng
Coronary perfusion pressure (aortic p lc huyl lu mach vnh (p lc
diastolic-right atrial diastolic pressure) ng mch ch thi tm triiong-tm
nh phi ihii tm trJcng)
Coronary vasomotor tone Sc vn mach ca mach vnh
Oxygenation Hp th oxygen
Haemoglobin Hemoglobin (Huyt cu t)
Oxygen saturation Bo ha oxvgen
N B coronary blood (low is confined to dias Chi ch - D n g mu mach vnh dc gii

tole han (hi iSm (rng
C oronary atherom a is by far the most X va mch vnh l nguyn nhn ch

c o m m o n cause b u t a n g in a is also a fea yu nhl thng gp hn c moi nguyn
ture ol aortic valve disease, hypertro nhn khc nhng cn au Iht cung l
phic cardiom yopathy and some other mt c im ca bnh van dng mch
lorms of heart disease. c h , b n h c tim p h i a i v n h i u d n g
khc ca bnh tim.
C linical features c i m lm s n g
T h u liislorv is by far the m ost im p o rta n t B n h s l yu t t|Ucin I rong n h l hn c

laclor in m a k in g the diagnosis. Stable m i cliu k h c Iron g v i c c h n o n . Cn
a n g in a is cha ra c te rise d by left-sided o r dnu th t h n g d in h c ddC i m Id rfu
conlral chcsl pain that is p rccip itatcd bv p h a tr i h o 5c gia ngc v au tng
e x crlion a n d p ro m p tly relieved by rest. n h a n h d o g n g s< v j lo i g i m m t ngdy
kh i n m n g h i.
Mosi patients describe a sense of a s b n h n h n m t m i c m gi<k

o p p re ssio n o r lightness in ihc ch esl - n n g ho<k b p c h i Irong ngc -
'like a b a n d ro u n d ihi; chesl'; 'p ain ' m a y 'g i n g nh m i d i b<5ng q u n q u an h
by denied. W hen describing angina ihe ng c'; c th kh n g Ih y ' a u '. Khi m t
victim often closcs a h a n d a r o u n d the cn tla u th i, ngi b n h thng xit mt
ihroal, puls a h a n d o r c lc n c h c d fist on b n la y q u a n h c h n g , d l m i b;\n Itiy
ihe sternum, or plates both hands h o r An c n m la y Ir n xng c liOU
across ihe lo w er chcsl. T h e lerm d i c hdi U y ng d n g qu a v n g ngc (li.
angina' is d eriv e d Irom (.he G r e e k w o rd T h iM t ng ' n g in a ' b l ngun t I h H y
for strangulation a n d m a n y p aiienis Ldp r n g h a Id b p n g h e t v n h i u b n h
I'eporl a 'c h o k in g ' se n satio n . Lircalh- n h n nu c m g i c b i c h o n g v<ng'.
lessness is so m e tim e s a p r o m i n e n t i k h i, tn h Ira n g kh ih (h i hi) l
feature m i clac d i m ni bt.
The pain m a\ radiate to ihc ncrk or Cn (lau c th lan ti n c h u i h m .

jaw an d is often a t c o m p a n i o d bv d is Ihng k m tn h trang kh r h iu ( nh
com fort 111 ihe arm s, particularly ihc tay. (l r b i l p h d tri, hai c la y Vd (li
I d l. Ihi.' wrists an d so m tim c s ihc h an d s; k h i c lid i b n Idy; ngi b n h r n g c lh c
the patient mav also descnbi- a k vlin g m td c m g i c n n g n lio c n h th d y v
o f h eavine ss o r uselessness in Iho a rm s. ( l n g c h a i c n h U y . t) i k h i d a u v n g
Occasionally ihc pain IS cpigastnc or Ihng vj h o c gia hai xng vai. Cn
interscapular. A ngina m a v o c c u r ai anv (la u lh l c lh x y r a h l k v iir i n o v d
o f these places o f re fe re n c e w ithout nu Ircn mA kh n g h c ln h Irang kh
cAm/discomfort bul a h i s l o n of p re c ip i c h u n g i nh ng mt b n h s r (lau
tation bv elTort. a n d relief bv rest o r t n g k h i g n g s c v g i m b! du n g h i ngi
sublingual nilralc, should still allow the h o c do n g n i n itra t di li s cho ph p
c ondition to b e recognised. x c d in h tn h trdng b n h d.
Sym ptom s lend lo be w orse alter a C c tric u c h n g c x u h n g n n g h u n

m eal, in the cold, and w hen w alking up Scu m i bd n, ni gi l n h , kh i d i ln
hill or into a strong w ind. S o m e patienls d c, h o c bc vo ni gi m a n h . V i
find thal the pain co m es w hen ihcy start l)n h n h n n h n th y cn dau x y ra khi
w alking a n d that laler it d o e s n o t retu rn ho bt (lu bc i v ri sau d cn au
despite gre a te r effort ('start-up angina'). kh n g (i h i n m c d ho gn g s r n hi u
S o m e e x p e rie n c e the p a in w h e n lying hn ('cn clau tht khi khi n g ']. V i
flal (decubitus angina), and some are ngi l i c m Ili y dau k h i n m cli Icn
a w a k e n e d by it (n octurna l angina). cld uthl do V ih n m l, v m t sngrti Idi
lin h *idC v i( la u ( c n d a u th tb d n clm).
A n g in a m a y also o c c u r capriciously Cn dau thi c n g c th x i y ra th t
as a result of coronary arterial spasm; th ng d o m<)( cn CO d n g m a c h v n h ;
occasionally this is a c c o m p a n ie d b y i khi tnh (rang n y c k im tng ST
tr ansient S T elev a tio n o n the E C G th on g qua Irn din l m (con d a u lh l
(Prinzmetal's o r v a ria n t angina). kiu P rinzm etal h o c d a u t h i ib i n d d i ) .
CLINICAL SITUATIONS PRECIPITATING TNH TRNG LM SNG G Y t
ANGINA XUT CN AU THT

Physical exertion G ng sc th lc
Cold exposure Bj ln h
Heavy meals Ba an kh tiu ( d iy bng)
Intense emotion Cm xc mnh lit
Lying flat (decubitus angina) N m di (cn au tH t do v th n m )
Vivid dreams (nocturnal angina) Nhng gic m m nh (con dau thlt
ban d tm )
A C U TE P E R IC A R D IT IS VIM NGOI TM MAC CAP
It is useful to classify the types of peri Tht l hu (ch khi phn loi cc kiu
carditis both clinically and eco lo g i vim ngoi tm m c c v mt lm tng
cally, since this disorder is by far the ln b n h cn, bi v th b n h ny l qui
most c o m m on pathologic process in trinh bnh thng thng nhi hn c
volving the pericardium. Pain of a p eri mi bnh khc gy n h hiing dn
cardial friction rub, electrocardio ngoi lm m ac. Cn au ca linh Irng
graphic changes, and pericardial effu c xt ngoi tm m c, nhng thay di
sion with cardiac tam p o n ad e and p a r a in lm k, v Irn dch ngoi tm mc
doxic pulse are cardinal manifestations km ch n p tim v nhp m ch nghch
of m a n y form s o f acute p e ric a rd itis a n d u l nhn biu hin ch yu ca
will be considered prior to a discussion nhiu d n g vim ngoi tm m c c p v
of the m o st c o m m o n fo rm s o f th e d is s c bn n trc khi t h i o lun cc
order. d n g thng thng nht ca bnh.
Chest pain is an important but not in au ngc l mt triu chng quan
variable symptom in various forms of trng nhng khng p h i i l b t bin
acute pericarditis; it is usually present in trong nhiu dng vim ngoai lm mc
the acute infectious types a n d in m a n y o f c p khc nhau; Iriu chng thng
the forms p re s u m e d to b e related to h y hin din trong c c kiu vim nhim
persensitivity o r auto im m u n ity . Pain is c p tnh v trong nhiu d ang c ih xem
often absent in a slowly d e v e lo p in g tu nh lin quan n tnh trang qu nhy
berculous postirradiation, neoplastic, o r cm hoc l min dich. au thng
uremic pericarditis. T he pain of pericar k h n g xy ra trong c c v i m ngoai t m
ditis is often severe. It is characteristically m c d o ur huyt, ung th h o c Irong
retrosternal a n d left precordial referred v i m lao p h t trin c h m Su xa tr|. Con
10 the back and the trapezius ridge. O f au Irong vim ngoai tm mac thng
ten the pain IS pleuritic consequent to n ng , c d c i m vng sau xng ic
6 0 - E nglish in M e d ic in e
a c c o m p a n y in g p leu ral in flam m a tio n , v ni trc tim tri lan ra vng lng v
i.e. s h a r p a n d a ggravate d b y in sp ira nh c thang. i khi cn au mng
tion, co u g h in g a n d c h a n g es in b o d y p o phi do c vim mng phi km theo;
sition, b u t s o m e tim e s it is a steady, ngha l au nhi v tng khi hl vo, khi
constrictive p a in w hich rad iates into ei ho v thay di vj tr c th, nhng i khi
th e r a r m o r b o th arm s a n d re sem b le s l m l c n dau c o tht, u u v lan
th at o f m y o c a rd ia l is chem ia; th erefo re, la hoc mt cnh lay hoc c hai cnh
confusion with m y o c a rd ia l infarction is lay ging nh cn dau ca Ihiu mu c
c o m m o n . Characteristically, h o w ev er, lim, do vy thng gy nhm ln vi nhi
the p ericard ial p ain m a y b e relieved by mu c lim. Tuy nhin, cn au ngodi tm
sitting u p a n d lean in g forw ard. T h e dif mac c d,Jc im l1c th gim bt do
ferentiation o f acute m y o c a rd ia l infarc ngi ln hoc ci ngi ra trc. S khc
tion from acute pericarditis b e c o m e s bit ca nhi mu c tim cp vi vim
ev en m o re p e rp le x in g w h e n w ith acute ngoai lm mc cp i khi Ir nn rc ri
pericarditis, the serum transaminase hn khi km vim ngoi lm mc cp li
and creatine kinase levels rise, p re c hin tng lng cc mc transaminase
sumably because of concomitanl in huyt ihanh v creatine kinase c l do tc
volvement of the epicardium. However, ng cng lc ca thng tm mc. Tuy
these e n z y m e elevations, if they occur, vy, cc mc Ung enzym nu xy ra,
are quile m od est, given the ex tensiv e u hu nh khng ng k, so vi hin
electrocardiographic ST-segment ele tng (3ng r rt on ST trn in tm k
vation in pericarditis. trong bnh vim ngoi tm mc.
T h e pericardial friction rub is the most Ting c xt ngoi tm m<tc l du
important physical sign; it may have up to h i u th c th q u a n tr n g n h ; v c th
three c om ponents p er cardiac cycle an d is bao gm ti ba yu tcho mi chu k tim,
high-pitched, scratching, a n d grating; it ting d tht cao r, xt xodt v ku rt;
can sometimes b e elicited only w h en firm di khi ting d ch oc nhn r khi n
pressure with the d iap hragm o f the stetho mnh mng ng nghe Veto lng ngc
scope is applied to ihe chest wall at the left vng b tri di xng c. Ting d
lower sternal border. It is h eard most fre thng c nghe thy r nht khi th ra
quently during expiration with the patient lc bnh nhn t th ngi, nhng c
in the sitting position, but an independent th nghe thy ting c xt mng phi
pleural friction rub may be audible during c lp Irong khi hl vo lc bnh nhn
inspiration with the patient leaning for i th c i ng i v p h a trc h o c n m
ward o r in the left lateral dccubitus posi nghing b n tr i. Ting c xt ihng
tion. T h e rub is often inconstant an d k h n g h n g n h v th o n g qua, v m i
transitory, and a loud to-and-fro leathery m v e n g to k i u m n h da c xt x o a l c
sound m ay disappear wiihin a few hours, Ih b i n m t trong v i g i la i c th l i
possibly to re a p p e a r the following day. xul hin vp ngy hm sau.
M o d e r a te elevations of the MB C th th y nhng m c l n g n h e c
fraclion o f cre a tin e p h o s p h o k i n a s e p h n M B c a c r e lin e p h o s p h o k in a s e v
m a y o c c u r a n d reflect a c c o m p a n y in g i u n^y b i u th| c v i m c tim Ihng
cp im yocarditis. l m m a c k m ih e o .
Section 4 Case history: W illiam Hudson
P h a n 4 Bnh n: William Hudson
Task 1 9 ^ B i l m 1 9
You will h e a r a n e x tra c t from a c o n s u l Bn s n g h e m t trch on t cuc khm
t a tio n w ith M r H u d s o n . T h e d o c t o r b n h cho ni Hudson. By r m qua bc
h as n o t s e e n h im for s e v e n years. H e s khng gp ng ta. Bnh n h n lm vic
h a s just retire d fro m t h e Post Office. As Bu in va mi nghi hu. Bn va
y ou liste n , c o m p l e t e t h e P r e s e n t C o m nghe va b sung vo p h n li khai bnh
pla in t s e c tio n o f t h e c a s e n o t e s b elo w . hin nay t trong kh u n g ghi ch di
y.
SURNAME Hudson FIRST NAMES William Henry
AGE (vS SEX M MARITAL STA TU S
OCCUPATION Retired postmaster
TUOI 65 GII N am TNH T R N G HN NHN
NGH N G H I P Trng phng bu din hu tr
Task 20S Bi lm 20
H e r e is a n e d i te d v ers io n o f t h e c o n y l bin bn ghi cuc khm bnh. Hy
s u lta tio n . C o m p l e t e t h e d o c t o r 's b sung vo nhng cu hi ca bc s. Ri
q u e s tio n s . T h e n c h e c k y o u r a n s w e r s kim tra cc cu tr li ca bn da Iheo
w ith t h e r e c o r d i n g a n d th e T a p e s c r i p t . bng ghi m v bn di thoi.
DOCTOR: G o o d afte rn o o n . M r H u d B.S: Cho ng Hudson. Xin mi ngi.

son. Ju st have a seat. I haven't seen Lu I|u khng gp ng. Th hm
you f o r a l o n g t i m e ........................(1) nayngdnc . (U v y ?
b r o u g h t you h ere today?
PATIENT: Well, doctor. I've bee n having B.N: Tha bc si, ti mi bi nhc du v
th e se hea dac h es an d I've lost a bit c sl cn chi t.
o f weight.
DOCTOR: A n d h o w long ....................(2) B.S: bao l u ................ (2) cn nhc
the hea d ac hes ...............................(3) Hu ............. (3) lm ng kh
b o th e rin g you? chu?
PATIENT. W ell, for q u ite a w h ile n ow . B.N: Da, cng mi .y B x li va
T h e wife p as sed away four m o n t h s qua i c bn lling. T d li
ago. I've b een feeling d o w n since suy sp clil t.
then.
DOCTOR: .....................(4) p art o f y our B.S: ......................(4) ng au ch no
h ead is affecied? Ir c n clu?
PATIENT: Just here, on th e top . It feels B.N: N gay cly, clinli du. Nh c ml
like a heavy w eight p ressin g d o w n v t n n g Irn d u l i.
on me.
DOCTOR: ...................... (5) they affectcd B.S: ..................... (5) chuyn d t nh
y our eyesight at all? , h ngn ih lc ca ng khng?
PATIENT: N o , 1 w o u ld n 't say so . B.N: Khng, ti khng mun ni th.
DOCTOR- T h ey .....................(6) m a d e B.S: T h bcnh ....................(6) lm ng
you ...................................... (7) sick? ....................(7) au m?
PATIENT: N o . B.N: Khng.
DOCTOR: N ow , you told m e you've B.S: Th ng ni l c st cn th i l.
lost s o m e w e ig h t.......................... (8) ....................(8) n g n c n go n
y o u r a p p e t i t e .....................(9) like? m i n g .................... (9) khng?
PATIENT: I've b een o f f m y fo o d . B.N: Ti khng thch n cht no c.
DOCTOR: .......................(10) a b o u t y o u r B.S: ......................(10) np di doi tin
b o w e ls ........................ (11) p ro b le m s ? .................(11) vn (lc chng?
PATIENT: N o , I'm q u ite all right. B .N : K h n g , (i h o n (o n b in h thng.
DOCTOR W hat ..................... (12) yo u r B.S: Cn <121 tiu tin ra
w aterw o rk s5 sao?
PATIENT W ell, I've b e e n h a v in g p r o b B N: Da, ti mi bi kh khan v hng
le m s g e t t i n g s t a r t e d a n d I h a v e to m phi dy hai ba ln.
get u p tw o o r t h r e e t i m e s at n ig h t .
DOCTOR.............................. (13) this B.S: ................................. (1 3) chuyn ny
..................... (14 ) o n re c e n t ly ? .................... (14) mi gn y ?
PATIENT N o, I've n o tic e d it g ra d u a lly B.N: Khng, ti n h n thy mi dn dn
o v e r th e p a s t few m o n t h s . xut hin vi thng qua.
DOCTOR .....................(1 5 ) p a in w h e n B.S: ............................. (15) au khi ng
v ou ..................... (1 6 ) w a t e r ...................(16) tiu khng?
Pa t i e n t N o . B.N: Khng.
DOCTOR ......................... (1 7 ) yo u B.S: .......... (17) ng ................ (18)
..................... (18) a n y b lo o d ? c chi mu khng?
Pa t ie n t N o. B.N: Khng.
Note h o w th e a c tu a l c o n s u lta tio n o n Nhn xt xem cuc kh m b n h ghi trong

the re c o rd in g d iffe rs s lig h tly f r o m th is bng ghi m c khc bit ch t t nh th
version. VVhat d iffe re n c e s c a n y o u no so vi bn ghi trn. Bn n h n thy
note? T h is c o n s u lta tio n c o n tin u e s in n h n g khc bit no? Cuc khm bnh
Unit 3. tip tc Bi 3.
Unit 3 Bi 3
Examining a patient
Khm bnh nhn
Section 1 Giving instructions

P h n 1 Hng dn
Task 1 0 Bi lm 1
Mr J a m e s o n (see U n it 2, p. 52) w a s e x n g Jam eson (xem Bi 2, trang 52) n
a m in e d by a n e u r o lo g is t. S tu d y t h e s e m t bc s khoa thn kinh khm bnh.
draw ings w h ic h s h o w s o m e o f t h e Nghin cu cc h nh v biu hin cc
m o v e m e n ts e x a m in e d . P re d ic t t h e o r ng tc c th m khm. D on
der in w h ic h t h e n e u r o lo g i s t e x a m i n e d th t theo bc s khoa thn kinh thm
her p a t ie n t by n u m b e r i n g t h e d r a w khm b n h n h n bng cch nh s cc
ings. D ra w in g (e) s h o w s th e first h n h v. Hnh (e) l ng tc u tin
m o v e m e n t e x a m in e d . c th m khm.
N ow listen to t h e e x tra c t fro m t h e n e u By gi hy lng nghe trch on cuc

rolo gist's e x a m i n a t i o n a n d c h e c k y o u r khm b n h ca bc s khoa thn kin h v
p red ic tio n s. kim tra li cc d on ca bn.
b)
d) & IL e) f)

N o te h o w t h e d o c t o r i n s t r u c t s t h e p a Ghi nh cch bc s hng dn cho bnh
ti e n t w h a t to do: n h n phi lm g:
- N o w I ju s t w a n t to steyou s ta n d in g . By gi n g hy ng cho ti coi.

- Could y o u b e n d d o w n as far as y o u n g c th ci ngi cng thp cng (t
can? d c khng?
- Keep y o u r k n e e s a n d feet s te a d y . Gi ch c hai du gi v hai chn.
In stru c tio n s, espec ially to c h a n g e p o Cc hng dan, c bit khi yu cu thay

sition or r e m o v e c lo th in g , a r e o f te n i t th hoc ci q u n o, th ng nh
m a d e like this: sau:
- W ould you slip off y o u r t o p th in g s , n g v u i l n g ci Irn, d u c ch?
please?
- N o w I w ould like you to l e a n b a c k By gi ti m u n coi n g uOn ngi ra
w ards. phia sau.
T he d o c t o r o fte n p r e p a r e s t h e p a t i e n t Bc s th ng ch u n b b n h n h n cho
for th e nex t p a r t of t h e e x a m i n a t i o n in phn khm bnh tip theo n h sau:
this way:
- I'm ju st goinz to find o u t w h e r e th e B y gi ti s phi hin x em im au

sore s p o t is. c h no.
Task 2 0 Bi lm 2
T h e se d r a w in g s s h o w a d o c t o r te stin g Cc h nh v ny m t cng vic bc s
a p a t i e n t 's reflexes. P re d ic t t h e o r d e r th cc phn x ca bnh nhn. Hy d
in w h ic h th e reflexes w e r e te s te d by on th t theo cc phn x dc th
num bering them . bng cch nh s cc hnh.
Now listen to th e e x tra c t a n d c h e c k By gi hy lng nghe trch on v kim

y our p red ic tio n s. tra li cc d on ca bn.
Task 3 ^ Bi lm 3
Using th e p ic tu r e s in T a s k 2 to h e lp s dng cc h nh trong Bi lm 2 h
you. w rite d o w n w h a t y o u w o u l d sa y to tr, hy vit cc hng dn m bn s ni
a p a tie n t to te st t h e s e reflexes. W h e n vi b n h n h n th cc phn x . Khi
y ou h a v e fin ish e d , c o m p a r e y o u r in lm xong, hy so snh cc hng dn v
s tr u c t io n s a n d c o m m e n t s w ith t h e li dn gii ca bn vi bng ghi m.
r ec ording .
Task 4 a a ( s i Bi lm 4
In stru c t a p a t ie n t to ta k e u p t h e c o r Hng dn b n h n h n gi d n g t t h d
rect p o sitio n , p r e p a r e h im o r h e r for chun b ng ta/b ta p h i n x v bn lun
th e se tests, a n d c o m m e n t o n e a c h th m v mi loi p h n x .
one.
1 A lternative m e th o d o f eliciting the
ankle jerk
Phng p h p lu n p h i n x c r fin li
p h n xa g i t g n gi
2 R e inforcem en t in eliciting th e kn ee
je r k
T n g lc n h m x c n h p h n x g i l
u gi
3 Eliciting th e p la n ta r reflex
Xc n h p h n x l n g b n chn
W h e n y o u h a v e fin ish e d , c o m p a r e
you r i n s t r u c tio n s a n d c o m m e n t s w ith
th e r e c o rd in g .
Task 5 ^ S ) Bi lm 5
T h e n e u r o lo g i s t c a rrie s o u t s tr e t c h Bc s khoa thn kinh thc hin cc kim
tests o n M r J a m e s o n for t h e s c ia tic a n d tra co dui i vi ng Jameson khm
p o ste rio r tibial n e r v e s a n d t h e f e m o r a l cc dy thn kinh chy sau v dy thn
nerve. C o m p le t e t h e g a p s in h e r i n kinh i. Hy in vo ch trng trong
s tr u c tio n s o n t h e n e x t p a g e w ith t h e cc hng dn ca bc s ghi trang sau
help of th e d raw in g s . da theo cc h nh v.
DOCTOR W o u ld yo u lik e to g e t o n to B S: n g vui l n g l n p ilin g v
th e couch a n d ....................... (1) o n ................... (1) n m nga. Ti s
y our back, please? N o w I'm g oing c m c h n tri v xem ta c Ih nng
to take y o u r left leg a n d see h o w c h n cao .................... (2). C i t h i n g
far w e c a n ..................... (2) it. Keep d u gi. ng c dau cht no
the knee straight. D o es chat h u r t khng?
ai all?
Pa t ie n t Yes. ju s t a lit t le . J u s t s lig h tly . BN: D, c au ml cht. MI chi IhAi.
DOCTOR Can 1 do th e sa m e w ith this BS: T i c l h l m n h v y v i c h n n y
leg? H ow far will [his o n e g o 7 Not c ch? C h n n y gi c a o dc
very far. N o w let's see w h a t h a p bao n h i i? Khng c a o lm. By gi,
pens if I ...................... (3) y o u r to es ti xom s ra sao nu ti
back. ...................... (3) ngc c c ngn
c h n li.
Pa t ie n t O h , th a t's w o rse . BN: y. c au hn nhiu.
DOCTOR I'm going t o ........................... (4) BS: Ti s p sa .................... (4) du gi
vour knee. H o w d o e s that feel? ng. N h vy c sao khng?
Patient - a little b elter. BN: C d chu hn.
DOCTOR: N o w let's see w h a t h a p p e n s BS: By gi th xem ra sao khi ti
w h e n w e ........................ (5) y o u r .................. ( 5 ) c h n n g m t ln na.
leg again.
Pa t ie n t T h a t's sore. BN: N h vy c dau.
DOCTOR I'm just g o ing to BS: Ti s p sa .................... (6) pha di
.......................(6) b e h in d y o u r knee. u gi ng.
PATIENT O h , th a t h u r ts a lo t. BN: i, dau lm .
DOCTOR W h e r e do es i t .....................(7)? BS: C h no lm .................... (7)?
PATIENT: In m y back. BN: Ch sau lng.
DOCTOR Right. N o w w o u ld you BS: By gi ng vui lng ...............(8)
........................ (8) over o n t o y o u r n m sp nh. G p u gi phi.
tu m m y ? B en d y o u r r ig h t knee. N h (h ra sao ................... (9)?
H ow does th a t .............................(9)?
PATIENT: It's a li t t le b it sore. BN: C hi dau mt cht.
DOCTOR N o w I'm g oing to BS: By gi ti s p sa (10)
........................ (10) y o u r th ig h off Hi ng khi ging
the couch.
PATIENT O h . th a t re a lly h u rts . BN: i au lm d!
N ow listen to th e r e c o r d i n g to c h e c k By gi hy n g h e b n g ghi m kjm

y our an s w ers . tra cc cu tr li ca bn.
Task 6 0 Bi lm 6
A d o c to r h a s b e e n called as a n e m e r Bc s c mi n khm cp cu cho
gency to s e e a 5 5 -yea r-old m a n at m t bnh nhn 55 tui. nam . ti nh, c
h o m e w ith a h isto ry o f h ig h b lo o d p r e s bnh s cao huyt p v try mch km
sure w h o h a s c o lla p s e d w ith a s u d d e n cn au t ngt vng gia ngc lan ra
cru shing ce n tral c h e s t p a i n r a d ia tin g to sau lng v hai chn. Hy lit k nhng
the back a n d legs. List w h a t y o u w o u ld vic bn s lm khi khm m t bnh nhn
exa m in e w ith s u c h a p a tie n t. n h u vy.
Listen to th e extract a n d n o t e w h a t th e Hy lng nghe trch on v ghi nh

d o c to r ex am ined. n h n g g bc s th m khm.
C o m p a r e y o u r list w ith t h e e x a m i n a So snh bn lit k ca bn vi nhng
tions the d o c to r c a r rie d o u t. vic bc s lm khi thm khm bnh.

Listen to th e r e c o r d i n g a g a in . N o te Nghe li bng ghi m m t ln na. Ch
h o w the d o c t o r m a r k s t h e e n d o f e a c h cch bc s kt thc mi giai on trong
stage of th e e x a m in a tio n . H e r e a re cuc khm bnh. y l vi phng cch
so m e of th e w ays h e uses: bc s thng dng:
1 He pauses. ng la ngng li.

2 He uses e x p re s s io n s s u c h as OK, n g ta dng nhng c c h din di nh
Fine, That's it. c, Tt, T h dy.
3 He uses falling in to n a tio n o n th e s e ng (a ha thp ging ni trong cc cch
expressions. d i n t d.
Task 7 ^ Bi lm 7
T u rn bac k to T a sk 5. U s in g o n ly t h e Tr li Bi lm 5. s dng cc biu d
d ia g ra m s to h e lp yo u , w rite d o w n h tr, hy vit n h n g iu bn s ni vi
w hat y o u w o u ld sa y to p a t i e n t w h e n b n h n h n khi thc hin cuc khm bnh
m a k in g this e x a m i n a t i o n . T h e n c o m ny. Ri so s n h cu tr li ca bn vi
p are y o u r a n s w e r w ith t h e T a p e s c r ip t. bn i thoi.
Section 2 Understanding form s
P h n 2 Hu c c dng khm bnh
Task 8 B i l m 8
S tudy this c h e c k list for t h e first e x a m i Nghin cu b n g kim tra ny dng cho
n a tio n of a p a t ie n t o n a t t e n d a n c e at a n cuc kh m b n h ln <fiu tin cho mt
a n t e n a ta l clinic. S o m e o f t h e s e e x a m i b n h n h n ti b n h vin tin sn. Mt vi
n a t io n s a re ca r rie d o u t as r o u t i n e o n cng vic th m k h m ny s c thc
s u b s e q u e n t visits. M ark t h e m w ith a hin thng l trong cc ln sau. nh
tick ( / ) o n th e checklist. du ( / ) n h n g cng vic trn bng
kim tra.
THE FIRST EXAMINATION

KHM LN U
1. H e ig h t Chiu cao D
2. W e ig h t C n n n g
3 A u s cu ltatio n o f h e a rt a n d lu ngs N g h e tim v phi D
4 E x a m in a tio n o f b re a s ts a n d n ip p le s o Khm v v nm v O
5 E x a m in a tio n of u rin e o Xt n g h i m nc tiu
6 E x a m in a tio n of pe lvis Khm vng ch u D
7. E x a m in a tio n of leg s D Khm hai chi di n
8 In spectio n o f te e th Khm rang
9 E stim atio n o f blood p re s s u re o huyt p
10 Blood s a m p le for blood g ro u p Ly mu lm nhm m u
11. Blood s a m p le for h a e m o g lo b in Ly m u xc n h huyt sc l
12. Blood s a m p le for s e ro lo g ic a l te st for Ly m u xt ngh im huyl thanh
syphilis tm giang mai
13 Blood s a m p le fo r r u b e lla a n tib o d ie s Ly m u tm khng th b n h si
14 E x a m in a tio n of ab d o m e n to assess Khm bng d n h gi kch ihc l
s iz e o f u teru s cung
15. E x a m in a tio n o f v a g in a a n d c e rv ix D Khm m o v c t cung
N ow s tu d y t h e s e e x tra c ts fro m a n o b By gi hy n g h i n cu n h n g trch on

s te tr ic ia n 's e x a m in a tio n o f a p a tie n t ny t cuc k h i m b n h ca bc s sn khoa
a t t e n d i n g for h e r 3 2 - w e e k a n t e n a t a l di vi m t b n h n h n n kh m tin sn
a p p o i n t m e n t . M a tc h e a c h e x tra c t to vo tun l t h 32. G hp mi trch on vi
t he n u m b e r e d e x a m i n a t i o n s o n th e m t cng vic khm b n h c nh s
checklist. For e x a m p le : trong bng kim tra. VI d:
a. Have you brought your urine sample? _5 B c m a n g m u n c ti u ( n khng?
5_
b. Now would you like to sit up and ill By g i b<) hAy ngi d y Vc li s do
take your blood pressure?.................. h u y t p ..............................
c. Now r il take a sample o f blood to check By g i ti s y m u d x t nghim
your haemoglobin..................... h u y t sc l. .......................
d. Have you noticed any swelling o f your B c thy hai m l c chn b sng p h
ankles? ... Let's have a quick look. k h n g ... ti khm x e m sao.
e. Now if you'd like to lie down on the By g i b vui lng n m Irn ging c h o
couch, ril take a look at the baby, m ti khm thai. Ti s d o x e m hai nhi cao
just measure to see what height it is. bao n h i u ........................
Task 9 ^ Bi lm 9
Put th e ex tra cts a b o v e in t h e o r d e r in x p cc trch don trn theo th t m
w h ic h y o u w o u ld p re fe r to c a r ry o u t bn m un thc hin tin h n h cuc
th e se e x a m in a tio n s . khm bnh.
Task 10 I Q E I t S ] Bi lm 10
W ork in pairs. S tu d e n t A s h o u l d start. Lm vic theo di. Sinh vin A bt u
trc.
A: Play th e p a r t o f t h e o b s te tr ic i a n . A: ng vai bc s sn khoa. Bng di
T h e c a rd b e lo w s h o w s t h e Findings y cho thy n h n g ghi nhn khi
o n e x a m in a tio n o f a p a t i e n t a t th m khm m t sn ph tun l th
te n d in g for h e r 3 2 - w e e k a p p o i n t 32. Da trn n h n g ghi n h n ny, bn
m e n t. Base y o u r c o m m e n t s to t h e hy hng dn sn ph.
p a t ie n t o n th e s e fin d ings.
B: Play th e p a r t o f t h e p a t ie n t . You a re B: ng vai bnh nhn. Bn ang dc

a t t e n d i n g for a 3 2 - w e e k a p p o i n t th m khm theo hn tun l th 32.
m e n t. Ask a b o u t a n y t h i n g t h e d o c Hy hi bt k iu g bc s ni m
to r says w h ic h y o u d o n o t bn khng hiu. Hi bt k iu g
u n d e r s t a n d . Ask a b o u t a n y t h i n g trn bng m bn khng hiu.
o n th e c a rd w h i c h y o u d o n o t u n
d e r s ta n d .
W h e n y o u h a v e c o m p l e t e d y o u r role- Khi bn hon tt vic ng vai. hy so
play, c o m p a r e y o u r v e r s io n w ith t h e s n h bng din t ca bn vi bn ghi
r e c o r d e d c o n s u lta tio n . m cuc khm bnh.
English in M ed ic in e - 75
Section 3 Reading skills: Using a pharmacology
reference
P h n 3 K nng c: s dng ti liu tham
kho dc l
Task 11 Q Bi lm 11
U sing th e p r e s c rib in g in f o r m a t i o n o n s dng cc thng tin trong toa thuc i
p ages 77-84, c h o o s e t h e m o s t a p p r o trang 77-84, hy la chn loi khng linh
priate a n tib io tic for t h e s e p a t ie n ts . thch hp n h t cho cc b n h n h n saudy.
1. A 4-year-old boy w ith m e n in g itis B trai 4 tui b vim m n g no do|M

d u e to p n e u m o co c cu s. H e is aller cu. B bi clj ng vi penicillin.
gic to penicillin.
2. A 67-year-old m a n w ith a h isto ry n g gi 67 tui c tin s vim phquin
o f chronic b ro n ch itis n o w su ffe r m n, nay bi vim phi. Vi khun gy
ing from p n e u m o n ia T h e c a u s a b n h khng vi tetracycline.
tive o rg a n ism is re sis ta n t to
tetracycline.
3. A 27-year-old w o m a n w ith u r in a ry Ph n 27 tui c n h i m trng dng tit
tracc infection in early pregnancy. niu u (hai k.
4. A 4 -year-old girl w ith se p tic arth ri B gi 4 tui c vim khp nhim trng
tis d u e to h a e m o p h il u s influen zae. do haem ophilus influenzae.
5 An 18-year-old m a n w ith left leg Thanh nin 18 tui d o an chi tri Irn
a m p u ta t io n above th e k n e e fo llow u gi do Mi nn giao Ihng.
ing a road traffic accident.
6. A 50-year-old w o m a n w ith e n d o Ph n 50 tui, c vim ni tm mc cho
carditis c a u se d by strep, viridans. lin cu virians.
7. A 13-year-old girl w ith disfig u rin g B gi 13 tui b trng c si lm bin
acne. d n g mt.
8. An 8-year-old boy w ith to n sillitis B trai 8 tui b vim a m i a n do lin cu
d u e to (3-haemolytic s tr e p t o c o c tan huyt p.
cus.
9. A 43-year-old d a iry m a n w ith n ng 43 tui lm ngh b n sa bi
brucellosis. bnh st hi quy.
10. A 4-year-old u n i m m u n i s e d sibling B trai 4 tui cha
o f a 2-year-old boy w ith w h o o p in g c min dch c
cough. e m Ir a i rut 2 tu i
b b n h ho g.
76 English in M ed icin e
CEFUROXIME
Initiations: see under Cefaclor; surgical Chi nh: xem mc Cefaclor; d phng
p ro p h y la x is; m o r e active against H ae ngoai khoa; lc ng mnh hn chng
mophilus influenzae a n d Neiiieria gonor H aem ophilus influenzae v Neisseria
rhoeat gonorrhoeae
Cautions; Contra indications; Side-tffecls: Ch - Chng ch nh - Tc ng ph:
see u n d e r C e fa c lo r xem mc Cefaclor
Dose: by mouth (as cefuroxime axctil), Liu lng: n g(nhcefuroxime axetil)
250 m g twice daily in m o s t infections 250 mghai ln hng ngy trong a scc
including mild to m o d e r a te lo w er nhim khun k c cc nhim khun
respiratory-tract infections (e.g. b r o n Irung bnh cln nh ca dng h hp
chitis); d o u b le d for m o r e se v e re lo w er di (v d vim ph qun); liu gp i
respiratory-tracl infections or if p n e u cho cc nhim khun ng h hp di
monia suspected. Urinary-tract infec h o c nu c nghi ng vim phi. Nhim
tion, 125 m g twice daily, doubled in khun ng niu, 1 25 mg hai ln hng
p yelon eph ritis ngy, liugpdi cho vim bthn-lhn
G o n o r r h o e a , 1 g as a single do se Bnh lu, mt liu c nht 1g
C H I L D o v e r 3 m o n th s , 125 m g twice TR EM trn ba thng 1 25 mg hai ln
daily, if necessary doubled in child hng ngy, khi cn thi dng liu gp
ov er 2 years with otitis m e d i a i cho tr trn hai lui b vim tai gia
By intramuscular injection or intravenous Tim bp hoc tim tinh m ch hoc
injection or infusion, 750 m g every 6-8 truyn (lch. 7 5 0 m g c h o m i 6 - 8 gi;
hours; 1.5 g every 6-8 hours in severe 1,5 g cho 6-8 gi Irong cc nhim khun
infections; single doses over 750 m g in n n g ; c c li u c n h t tr n 7 5 0 m g v o
travenous route only tnh mch l
C H I L D usual do se 60 m g / k g daily TR EM: liu thng dng 60 mg/kg mi
(range 30-100 m g /kg daily) in 3-4 d i ngy (phm vi 30-100 mg/kg mi ngy)
vided doses (2-3 divided doses in n eo phn chia trong 3-4 liu lng Ip h n
nates) chia trong 2-3 liu lnglr ssinh)
Gonorrhoea, 1.5 g as a single dose by Bnh lu, liu lng c nht 1,5g tim
in tra m u sc u la r injection (d iv id e d b e bp (chia gia hai a im)
tw een 2 sites)
Surgical p ro p h y la x is, 1.5 g b y in t ra v e D phng ngoi khoa, 1,5 g tim tnh
no us injection at in d u c tio n ; m a y be mch gy cm ng, c th b sung 750 mg
s u p p l e m e n t e d with 750 m g i n t r a m u s (im bp sau 8 v 16 gi (cc phu
cularly 8 a n d 16 h o u r s la ter (ab thut vng bng, vng chu v chnh
d o m in a l, pelvic, a n d o r t h o p a e d ic hnh) hoc tim bp tip theo vi liu
operations) or followed by 750 m g in 750 mg, cho mi 8 gi. trong 24-48 gi
tramuscularly every 8 hours for fur sau (cc phu Ihul tim, phi, thc
ther 24-48 hours (cardiac, pulmonary, qun v mch mu)
o e so p h a g e a l, a n d v a sc u la r o p e ra tio n s)
Meningitis, 3 g in trav en o u sly e v e ry 8 Vim m n g n o . 3 g li m lnh m t c h
hours; mi thi (lon 8 gi;
C H I L D , 200-240 m g / k g daily (in 3-4 TR EM 2 0 0 -2 4 0 mg/kg rrvAi ngiy
divided doses) re d u c e d to 100 m g / k g (trong 3-4 liu dc p h n chia) v gim
dailv after 3 day s o r o n clinical im cn 100 mg/kg mi n g y SdU 3 ngy
p r o v e m e n t; N K O N A T F ., 100 m g / k g h o c sau khi c lin trin lm sng khi
daily re d u c e d lo 50 m g / k g daily q u an ; TRE s SINH 100 rng/kg mi
ng y v gi.im c n 5 0 mg/Vg mi ngy
BEN z YLPENICILLIN
(Penicillin G)
Indications: th ro a t infections, otitis m e C h nh: nhim khun vng hng, vim
dia, streptococcal endocarditis, m e n in tai gia, vim ni lm m a r lin ciu
gococcal meningitis, p neum onia (see khun, vim m ng no do no citt\
tabic 1); p ro p h y la x is in lim b am p u ta - khun, vim phi (xem bng II; d
lion p h n g khi o n chi
Cautions: history of allergy; renal im Ch : bnh s d ng; ri loan thn;
pairment:
in te ra c tio n s : A p p e n d ix 1 (penicil lc dng tng h: Ph lc 1 (penicil
lins) lin)
Contra-indications: penicillin h y p e r Chng ch nh: qu nhay cm vi
sensitivity penicillin
Side-effecti: sensitivity reactions includ Tc n g p h : phn ng nhy cim
ing urticaria, fever, joint pains; angioe- gm: m n nga, sl, a u khp; ph
dema; transienl le u c o p e n ia and mch; gim bach cu v tiu cu thong
ih m m b o c v t o p e n ia ; a n a p h y la c tic sh o c k qua; sc phn v cc bnh nhn qu
in hyp ersen sitiv e p atients; d i a r r h o e a af- nhay cm; tiu chy sau khi ung thuc
u*r a d m in is tratio n b y m o u t h
Dose: by intramuscular or by slow intrave Liu lng: li m bp hoc tim lnh
nous injection or by infusion, 1.2 g daily in m ch chm hoc truyn dch, 1,2 g
4 div id ed doses, in c r e a se d if n e c e ss a ry h n g ngy p h n c h ia trong 4 liu lng,
1 0 2.4 g daily o r m o r e (see also below ); nu c n t.lng liu ti 2,4 g h n g ngy
P R E M A T U R E IN F A N T and N E O hoc nhiu hn (xem Ihm trang sau);
N ATE, 50 m g /k g daily in 2 divided TR THIU T H N G v TR s SINH,
doses; I N F A N T 1-4 w eeks, 75 m g / k g 50 mg/kg hng ngy phn chia trong 2
daily in 3 d iv id e d doses; C H I L D 1 liu lng; TR EM 1-4 lu n. 75 mg/kg
m o n th -1 2 years, 100 m g / k g daily in 4 h n g ngy p h n chia trong 3 liu lng;
d iv id e d d oses (h ig her d oses m a y b e r e TR EM 1 l h n g - 1 2 tui. 100 mg/kg
qu ire d , see also below ) h n g ngy p h n ch ia trong 4 liu lng
(liu c a o hn c ih dc S d u n g xem
ih m trang sau)
Baclcrial endocarditis, by slow intrave Vim ni lm mc vi khun, lim tnh
nous injection or by infusion, 7.2 g daily in m ch chm hoc truyr dch, 7,2 g
4-6 divided doses p h n chia Irong 4-6 liu lng
Meningococcal meningitis, by slow intra Vim m n g no do no cu khun, lim
venous injection or by infiuion, 2.4 g ev ery tnh m c h chm h o c Iru y r c lc h 2 A g
4-6 hours; P R E M A T U R E IN F A N T cho mi llii oan 4-6 gi; TR THIU
and N E O N A T E , 100 m g /k g daily in 2 TH N G v S SINH 100 mg/kg hng
divided doses; IN F A N T 1-4 weeks, ngy phn chia trong 2 liu lng; TR
150 m g/kg daily in 3 divided doses; EM 1-4 tun, 1 SO m gA g h n g ngy
C H IL D 1 month-12 years. 180-300 p h n chid Irong i liu lng; TR EM 1
mg/kg daily in 4 divided doses thng-12 tui, 180-300 mg/kg hdng
ngy p h n chia trong 4 liu lng
Im portant. If m e n in g o c o c c a l disease Q u a n trng. N u nghi ng b n h no
IS suspected general practitioners are Cu khun, cn c li khuyn ca bc s
advised to give a single injection ofben- tng qut d lim mt liu b enzylpeni-
zylpenicillin by intramuscular or by in cillin. lim bp hoc lim lnh nidch
travenous injection before transporting Irc khi khn c p chuyn bnh nhn
the palient urgently to hospital. Suit dn bnh vin. C<c liu lng thch hp
able doses arc: A D U L T 1.2 g; IN F A N T l: NGI LN 1,2 g; TR EM 300 mg;
300 mg; C H IL D 1-9 years 600 mg, 10 TR EM 1-9 tui 600 mg, 10 lui v ln
years and over as for adult hn dng liu lng nh ngi ln
Prophylaxis in limb am putation, section D phng Irong on chi. phn 5.1, bng
5.1, table 2 2
By intrathecal injection, n o t re c o m Tim trongngty, khngc sdng
mended
AM PICILLIN
Indications: urinary-tract infections, oti C h i n h : N h i m khun ng n i u ,
tis media, sinusitis, chronic bronchitis, vim tai gia, vim xoang, vim ph
invasive salmonellosis, g o n o rrh o e a qun mn, nhim salmonella, bnh lu
Cautions: history of allergy ; renal impair C h : b n h s d ng; ri lon thn; vt
ment; erythematous rashes co m m o n in hng ban Ihng g p trong st hach.
glandular fever, chronic lymphatic leu bnh b a c h huyt limph m n. v nghi
kaemia, and possibly H IV infection; ng nhim HIV;
in te ractio n s: A ppendix 1 (penicillins) tc ng tng h: Ph luc 1 (penicillin)
Contra-indalions: penicillin hypersen C hng ch nh: qu nhy cm vi
sitivity penicillin
Side-efftcU: nausea, diarrhoea; rashes Tc ng ph: bun nn, tiu chy; vt
(discontinue treatment); rarely, anti- ban (iu tr khng lin lc); hn hu,
biolic-associatcd colitis; see also u nder vim i Irng do kt hp khng sinh,
Bcnzylpenicillin (section 5.1.1.1) xem thm mc Benzylpenicillin (phn
5.1.1.1)
Dose: by mouth, 0.25-1 g every 6 hours, at Liu lng: ung 0,25-1 g cho mi thi
least 30 minutes before food on 6 gi, (I nhl 30 pht trc khi n
Gonorrhoea, 2-3.5 g as a single dose Bnh lu, 2-3,5 glrongmc liuduy nht
with probenecid 1 g km probenecid 1g
Urinary-tract infections, 500 m g every Nhim khun dng niu, 500 mg cho
8 hours . mi thi on 8 gi
By intramuscular injection or intravenous Tim bp hoc tim tinh m c h hoc
injection or infusion, 500 m g every 4-6 truyn dch, 500 mg cho mi Ihi dotn
hours; higher doses in meningitis 4-6 gi; liu lng cao hn irong bnh
vim mng n.1o
C H IL D under 10 years, any route, half TR EM di 10 tui, liu luong b in j
adull dose na liu ca ngi In, theo mi cch
dng
ERYTHROMYCIN
Indations: alternative to penicillin in C h nh: Thay th penicillin nhng
hypersensitive patients; cam pylobacter bnh nhn q u nhy cm; vim rut do
enteritis, pneum onia, legionnaires' dis campylobacter, vim phi, bnh ca
ease, syphilis, non-gonococcal urethri linh l dng", giang mai, vim niu
tis. chronic prostatitis, acne vulgaris o khng do lu cu khun, vim luyn
(see section 13.6); d ip h t h e r i a and tin lp mn, bnh ac n e vulgaris (xem
whooping cough prophylaxis phn 13.6); phng bnh bach hu v ho
e
Cautions: hepatic and renal im pairm ent; Ch : r lon thn v gan; khong
prolongation of Q T interval (ventricu cch QT ko (li (nhp nhanh tm tht
lar tachycardia reported); p o rp h y ria c ghi nhn); porphyr niu (xem
(see section 9.8.2); pregnancy (not phn 9.8.2); mang thai (khng r gy
known to be harmful) and breastfeed tc hi) v cho con b (ch c lung nh
ing (only small am ounts in milk); i n t e r trong sa); t c d n g tng s: Ph lc 1
a c tion s: A ppendix 1 (erythromycin (erythromycin v cc macrolide khc)
and other macrolides)
A rrhythm ias. Avoid concom itant ad m i Lon nhp tim. Trnh dng dng thi
nistration with astemizole or terfena- vi astemizole hoc terfenadine, xem
dine, see pp. 139-40 also avoid with Irang 139-40, cng trnh VI cisapride
cisapride [o th er in te ra c tio n s, A ppen [tc ng (ng h k h c, Ph lc 1|
d ix 1]
Contra-indications: estolate contra-indi- C hng ch nh: estolate bi chng chi

cated in liver disease inh trong bnh gan
Side-ejfects: nau.sca. v om iting, a b d o m i T c n g p h : bun n n, i, kh ch iu
nal discom fort, d i a r r h o e a (antibiotic- v n g b u n g , li u c h y (v i m tld i (l n g do
associate d colitis repo rted): urticaria, kt h p k h n g sinh c gh i n h n );
rashes a n d o th e r allergic reac tion s; r e m n nga; v t b a n v c c p h n ng di
versible h e a rin g loss r e p o r te d after ng k h c ; m t th n h lc nh ng kh hi
large doses; cholcstalic ja u n d ic c a n d c gh i n h n sau d n g nh ng li u
card iac effects (including ch est pain lng ln, v n g d a n h i m m l v l c
a n d a rrh y th m ias) also re p o r te d n g li tim c n g c ghi n h n (b ao
g m d a u v n g ng'Jc v lo an n h |p tim )
Dose: by moutli, A D U L T a n d C H I L D L i u l n g : u n i, N G I L N v TRE-

o v e r 8 years. 250-500 m g ev e ry 6 h o u rs EM trn 8 tui . 2 5 0 - 3 0 0 m g ch o m i
or 0 .5 -lg every 12 h o u rs (see notes Ih i o a n 6 gi h o c 0 ,5 -1 g ch o m i
ab ove); u p to 4 g daily in se v e re in fec Ih i o n 12 gi (x e m g h i ch Ir n y ):
tions; C H I L D u p lo 2 y ears 125 m g c h o li 4 g h n g n g y (ron g c c b n h
ev ery 6 hours, 2-8 y ears 250 m g e v e ry 6 n h i m k h u n n n g ; TR E M li 2 lui
hours, do ses d o u b le d for se v e r e infec 1 2 5 m g c h o m i Ihi o a n 6 gi, tr 2 -8
tions tui dng 250 mg cho mi thi doan (>
gi, li u lng g p i tron g c r n h i m
khun nng.
A cne, see section 13.6 A c n e , x e m p h n 1 3 .6
Early syphilis, 500 m g 4 tim e s daily for G ia n g m a i g ia i d o a n sm, 5 0 0 m g 4 ln

14 days h n g n g y Iro n g 14 n g y
By intravtnous infusion, A D U L T an d T ru y n (lc h ln h m a ch, N G I L N v

C H I L D severe infections, 50 m g / k g TR EM nhim khun nng 50 mg/kg
daily by co n tin u o u s infusion or in d i hng ngy qua truyn dch lin tchoc
vided doses e v e ry 6 ho u rs ; m ild in fec c h ia thnh n h i u li u trong m i thi do an
tions (oral tr e a tm e n t no t possible), 25 6 gi, n h i m k h u n n h (khi kh n g th
m g /k g daily i u tr b n g c c h ung) 2 5 m g /k g hng
ngy
G F .N T A M IC IN
Indications: septicaemia and neonatal C h nh: Nhim trng huyl v nhim
sepsis; meningitis and other C N S infec trng s sinh; vim m ng no v cc
tions; biliary-tract infection, acute p y e nhim khun h thn kinh Irung uwig;
lonephritis or prostatitis, endocarditis nhim khun ng m^t, vim b th in -
caused by Strep, viridansox Strep, faecahi thn cp hoc vim tuyn lin lp. vim
(with a penicillin); pneu m o n ia in hospi ni tm mc do lin cu k h u in vindnm
tal patients, adjunct in listerial m eningi v lin cu khun (aecalis (vi m*
tis (section 5.1, table 1) penicillin); vim phi bnh nhn dang
nm vin, ph thm Irong vim ming
no do listeria (phn 5.1 b i n g 1)
Cautions: renal im pairment, infants and Ch : ri loan thn, Ir nh v ln han
elderly (adjust do se a n d m o n i to r renal, (iu chnh liu lung v kim Ira chc
auditory a n d vestib u lar function to nang thn, thnh gic v lin nh cng
g eth er with p la s m a g e n ta m ic in co n cen - vi nng geniamicin huyi lng);
irations); avoid p r o l o n g e d use; see also trnh s dung ko di, xem ihm ghi
notes above; in te r a c t io n s : A ppendix 1 ch trn y; t c d n g tng h: Ph luc
(aminoglycosides) 1 (aminoglycosides)
C ontra-indations: p r e g n a n c y , m yas C hng ch nh: mang thai, nhc co
th en ia gravis nng
Side-effects: vestibular and auditory Tc n g p h : ln thng lin nh v
da m a g e , n e p h ro to x ic ity ; rarely, h yp o- th n h g i c , n h i m c Ih n ; h n hu.
magnesaemia on prolonged therapy, gim Ihiu magnesium huyt khi diu tri
antibiotic-associated colitis; see also ko di, vim ai Irng kt hp khng
notes a b o v e sinh; xem thm ghi ch trn y
Dose: by intramuscular or by slow intrave Liu lng: tim bp hoc ti m lnh
nous injection over at least 3 minutes or by m ch ch Am t nhi Irn 3 pht hoc
intravenous infusion, 2-5 m g / k g daily (in truyn dch tnh m ch 2-5 mg/kg hng
div id ed d o ses e v e ry 8 hours) see also ngy (phn chia trong nhiu liu lng
notes above; reduce dose and measure cho mi 8 gi) xem thm ghi ch trn,
plasma concentrations in renal im gim liu lng v o nng d huyl
pairment tng Irong ri loan ihn
C H IL D up to 2 weeks, 3 m g /k g every 12 TR EM ti 2 tun tui 3 mg/Vg trong mi
hours; 2 w eeks-12 years, 2 m g / k g thi o n 1 2 t;i, 2 lu n n 1 2 tui 2
ev ery 8 h o u rs mg/kg cho mi thi on 8 gi
By mtrathical injection, 1 m g daily (in Tim trong ng ty, 1mg hng ngy (nu
creased if necessary to 5 mg daily), c n , tng ti s m g h n g ngy) vi 2-4
with 2-4 m g/k g daily by intramuscular mg/kg hng ngy. qua tim bp (phn
injection (in divided doses every 8 chia trong nhiu liu lng cho 8 gi)
hours)
TETRACYCLINE
Indications: exacerbations of chronic Ch nh: cn bc phi ca vim ph
bronchitis; brucellosis (sec also notes q u n m n ; n h im Brucella (xem c t tihi
above), chlamydia, mycoplasma, and ch Irn dAy), n h im chlamytlid, my< n-
rickctlsia, pleural effusions due to m a plasnia v ricketlsia; trn d |c h mdn^
lignancy or cirrhosis; acnc vulgaris (sec- phi rlo ung ih hoc xu grirr t*cne vul-
section 13.6) dri!> Ixem p h n 1 3.6)
Cautions: hepatic im p airm en t (avoid in Ch : ri loan gan (lr<$nh sdung ng
travenous administration); renal im lnh mch); r lon Ihn (xem phu lr
pairment (sec A ppendix 3); rarely 3); him gy nhdy cm nh sng; tc
causcs photosensitivity; in te r a c t io n s : d n g tng h: 1'h lc 1 (tetracyclines)
Appendix 1 (tetracyclines)
Contra-indicatioiu: renal im pairm ent C h n g c h n h : ri lcin th n U e m Phu
(.see A p p e n d ix 3), pregnancy and lc 3), m<\ng lhai V\ cho con b (xem
breast-feeding (see also A ppendixes 4 ihm cc Phu lc 4 v 5), Ir em di 1 2
and 5), children u n der 12 years of age, tui. lupus ban ton thn
syslcmic lupus erythcmaiosus
Side-eJJects: nausea, vomiting, d ia rrh o e a ; r c n g p h : bun nn, i, liu chy;
erythema (discontinue Ircalmcnl); h ea d hng b<n (ngng diu Ir), nhc u v
ache and visual disturbances may indi ri lo<jn th gic c ih biu hin lng cip
calc benign intracranial hypertension; lc n i s l n h tn h ; n h i m (l c gn,
hcpatoxicity, antibiotic-associaled p an vim tuy v vim i trng kl hp
creatitis and colitis reported khng sinh d dc ihng bo
Dose: by mouth, 250 m g every 6 hours, in Liu lng: ung 250 mg trong mi thi
creased in severe infections 10 500 mg o an t) gi, Irong ng hp nhim
every 6-8 hours khun nng, U n g li 5 0 0 mg trong mi
(hi o<jn b-8 gi,
Acne, see section 13.6 Acne, xem phn 13.b
Primary, secondary, or latcnl syphilis, G ian g mai giai d o n 1,2 h o c lim n
500 mg every 6 hours for 15 days 50 0 mg Irong mi thi dodn b gi Irong
15 ngy
Non-gonococcal urethritis. 500 mg V i m n i u d a o k h n g do lu c u k h u n ,
every 6 hours for 7-14 days (21 days if 5 0 0 m g tron g m i th i d o d n b gi Iron g
failure o r relapse follow ing ihc first 7-14 n g y (21 ngy nu tht bi hodc tci
coursc) phi lip Sdu ln u)
Counselling: T a b le ts or cap.sulcs sh o u ld K h u y n c o : Th u c v i n hoc Ih u i
bo sw a llo w e d w ho le with p le n ty ol fluid n n c Ih n u i u n g VI n h i u n c khi
w hile silting o r s ta n d in g ngi hu^c dng
By intravenous infusion, 500 mg every 12 Truyn (lch linh m jc /i:500 mg Irong mi
hours; max. 2 g daily thi d o a n 12 gi; li d a 2 g h n g ngy
PHEN OXYMETHYLPENICILLIN
(P enicillin V)
Indications: tonsillitis, otitis media, erysi CM nh: viom am id a n . v i m tai gito.
pelas; rheumatic fever and p n e u m o c o c vim qung; st thp v d phng
cal infection prophylaxis (see table 2) n h i m p h c u khun (x em b in g 2)
Cautions; Contra-indications; Side- Ch - Chng ch nh - T ie ng

effects: see under Benzylpenicillin; ph: xcm mc Benzylpenicillin. tic
in te ractio n s: A ppendix 1 (penicillins) dng tng h: Ph lc 1 (penicillin)
Dose: 500 mg every 6 hours increased to Liu lng: 500 mg h n g ngy, (rong
750 mg every 6 hours in severe infpc- mi ihi on 6 gi, tang ti 750 mg
tions; C H I L D , e very 6 ho u rs, u p to 1 Irong mi (> gi khi c nhim khun
year 62.5 mg, 1-5 years 125 mg, 6-12 nng; TR FM ti 1 nm tui, 62,5 mg
years 250 mg trong mi thi oan 6 gi - TR EM1-S
tui 1 25 mg - TR EM 6-1 2 tui 250mg
Rheumatic fever and pneum ococcal St t h p v d phng nhim ph cu
infection prophylaxis, section 5.1, khun, phn 5.1. bng 2
table 2

Task 12 ca Bi lm 1 2
S tu d y th e s e c a s e n o te s f r o m M r H u d Nghin cu n h n g ghi ch t cuc khm
so n 's c o n s u lta tio n , p a r t o f w h i c h y o u b n h cho ng Hudson, bn hc mt
s tu d i e d in U n it 2, S e c tio n 4. T ry to p h n d Bi 2, P h n 4. Hy tim hiu
w o rk o u t th e m e a n i n g s o f t h e c irc le d ngha ca cc c h vit tt c khoanh
a b b r e v ia tio n s . Refer to A p p e n d i x 2 for trn. T h am kho Ph lc 2 h tr.
help.
SU R N A M E H u d son F IR S T N A M E S W illia m H enry
AGE 65 SEX M M A R IT A L S T A T U S w
O C C U P A T IO N R etired p o stm a ste r
P R E S E N T C O M P L A IN T
H e a d a c h e s for 4 m th s. W t loss. H e a d a c h e s fe e l "like a h e a v y w eight".
N o n a u se a or visu al sy m p to m s.
N o a p p e tite .
D ifi. starting to N o ctu ria x 3 .
O /E
G e n e r a l C o n d it io n
ENT
RS c h e s t c le a r
CVS p 110/ . irreg.

/m in Bpl6X o 5
G IS ( b d ) NA
GUS ( j x r ) p rostate m o d e r a te ly e n la r g e d
CNS (N A D )
IM M EDIATE P A S T H IS T O R Y
P O IN T S O F N O T E
W ife d ie d ( 7 / 12/ a g o o f ( c T ) ovary.
IN V E S T IG A T IO N S
H Hudson TN William Henry
TUl 65 GII N nm TNH TRNG HN NHN Ga v
NG H N G H I P Trng ph n g bu i n hu tr
LI KHAI B N H H I N N A Y N hc u 4 th n g nay. Syt c n . N hc d iu

"nng nh Heo H '.
K hng b u n n n hoc triu c h n g Ih g i c .
n k h n g n gon .
( t u l i rT) k h . f ) i ti u d m 3 l n .
THM KHM
T n g tr n g
T .M .H N G
H .H P p h i tronn
T .M C H M a c h 1 1 0 /p h l k h n g d u
HUVT P (^ fie n g t im ') 1,11
T.HA ( b ^ J ) KHNG PHT HIN BT THNG
N .D C (^ T h u m on^> lu y n li n l p lo va
T .K IN H C kH PNG pht h i n bt t h n g ^
T I N S G N Y
X T N G H I M
Task 13 ^ [ s i Bi lm 13
T h e c a s e n o t e s r e c o r d t h e d o c t o r 's Nhng ghi ch di y c ghi m t
fin d in g s o n e x a m i n a t i o n . W rite d o w n n h n g n h n xt ca bc s khi khm
w h a t y o u w o u ld sa y to M r H u d s o n bnh. Bn hy vit nhng g s ni vi
w h e n c a r ry in g o u t th is e x a m in a tio n . ng Hudson trong khi khm bnh. Sau
T h e n lis te n to t h e r e c o r d i n g to c o m , nghe bng ghi m so snh vi tr
p a r e y o u r an s w e r. li ca bn.
Task 14 ^ Bi lm 1 4
You d e c id e to refer M r H u d s o n for f u r Bn quyt nh gii thiu ng Hudson
th e r tr e a tm e n t. T h e s u r g e o n is M r n ni iu tr khc. Bc s phu thut l
Fielding. W rite a le tte r to h i m o u t l i n ng Fielding. Bn hy vit th cho bc s
ing M r H u d s o n 's p r o b le m s . U se th e phu thut lc k v tnh trng ca
form below. W h e n y o u h a v e fin ish e d , ng Hudson. Dng m u di y. Khi vit
c o m p a r e y o u r v e r s io n w ith t h e Key. xong, bn hy so snh bi vit vi th
T h e c a s e o f M r H u d s o n c o n t i n u e s in m u phn Gii p. Trng hp ca ng
Unit 4. Hudson li tip tc Bi 4.
Hospital
use Day Hospital
Only Clinic Date Time No. GP112
A m bulane* |y | [No| REQUEST FOR OUT-f ATiarr CONSULTA T M (VS)
Required It
Slttlng/Stretehr Hospital .............................. D a te ............... Required QC1
Please arrange for this patient 10 attend th e .......... clinic ot O r/M r.
IN BLOCK LETTERS PLEASE
PARTICULARS OF PATIENT
Patients S u rn a m e .............................................. M stoan S u m a m a

First N am es. Slnglo/Marned/WldowwVOlher
Address ...... Oale ol Birth................................
Patient's Occupation ...............
Postal Code ................... Telephone N u m b e r...............
H as the patient attended hospital belore: Y E S /N O ?
If "Y E S ' please slate:
Nam e of H o s p ita l...................................................................
Year ol Attendance ................. Hospital No.................
If the patient's nam e and/or address has/have A ddK M *d Tm ^ iw Number 0
changed since then please give details MEDtCAUOEMTAL PRACTITIONER
PtolU U M ru O M f f U m p
I would be grateful lor your opinion and advice on the above named patient. A bnaf outline ol
history, symptoms and signs IS given below:
Diagnosis/provisional diagnosis .......................................
Presem drug treatment and potential special hazards:
Relevant X-rays available Irom: .................................... NO- (if known)
Signature
Dnh cho Th Bnh vin BS
bnh vin Lm sng Ngy Gi S tng qut 112
Khlm Co
Gh/cng
VU CU khAm Bnh nhAn ngoi tr
Cp cu KhOng
Bnh vin N gy ............
X _
V lng xp bnh nhn n iy th im khm ...................... Khoa ca bc S/Ang
1 Ho bnh nhn .................................................................... H (nh danh)..................................
i Tn bnh nhn .................................................................. c thn/C gia dlnh/Ga/Tinh I rng
o a c h l ..................................................... ........................... khc
< o
5 * M biAi din ................. S in thoi............................ Ngy sinh ..........................................
5 o Bnh nhn i dn khm bnh IruOc y: CCVKHNG. Nghi nghip.......................................
I Z Nu "C". VUI lng ghi r.
5 <0 Tn bnh vin ....................................................................
Nm dn khm ............... Bnh vin s6 ..........................
S *
o 5 Nu ln v/h oc da chl bnh nhn l d d thay i, Tn. da chl. s6 din thoi ca
xin ghi chi tit: BC s i tng QUA Y/NHA KHOA

IX s
z
Vui lng dng con du ca o su
TAi xin cm an v kin v l khuyn ca Ngi li(n quan dn bnh nhn c ln trn dy. Oui dy l tm
l i t bnh s. trtyu chng v d u hiu ca bnh nhn:
Chn don/chn on Um thi: ......................
Thudc diu (r hin nay v nhng bin i kh nng dc bit: .................................
Phim x-quang c gi tri t ........................................................................... S (nu bit)
Ch k ..................................................
English in M ed icin e - 8 9
Unit 4 Bi 4
Special examinations
Thm khm c bit
F '^ f
ty - .K -
- :
- **?
Section 1 Instructing, explaining and reassur*

ing
Ph n 1 Hng dn, gii ngha v trn an
Task 1 Is] Bi lm 1
You will h e a r a n in te r v ie w b e t w e e n a Bn s nghe m t cuc hi b n h gia bc
h o sp ita l c o n s u l t a n t , M r D a v id s o n , s th a m vn b n h vin, n g Davidson vi
a n d a p a tie n t, M r Priestly. As y o u lis m t b n h n h n , ng PriesUy. Trong khi
ten, c o m p l e t e t h e c a s e n o t e s a n d d e nghe, hy in th m vo k h u n g ghi ch
cid e w h ic h d e p a r t m e n t t h e p a t i e n t v quyt nh chuyn b n h n h n n
h a s b e e n re f e r re d to. khoa no.
SU R N A M E F IR S T N A M E S John
AGE 58 SEX M M A R IT A L S T A T U S M
O C C U P A T IO N
H ___________________________________ T N )ohn____________________________
TUI s G I I Nim T N H T R N G H N N H N C v
N G H N G H I P ___________________ ___________________________________________
LI KHAI B N H H I N N A Y
Task 2 I s l Bi lm 2
Now listen ag a in to c o m p l e t e t h e d o c By gi hy nghe li hon chnh cc
tor's q u es tio n s . cu hi ca bc s.
1 Can you see any le tte rs at ng c th n h n th y nhng ch
............. .... (a)? ............. la)?
2 Well, w ith th e rig h t eye, Tt, bng mt phi, ....................(b), ng
................. (b) you s e e ..................... (c)? nhn thy .................... (c)?
3 N o w do es .................... (d) m a k e By gi h y .............. (d) l m ................. (e)
................... (e) difference? khc?
4 Whac a b o u t .................... ( 0 one? C n ...............() kia th sao? C ............. (g)
D o e s ................. (g) have an y effect? tc dng g?
W hat d o y o u th in k (d) a n d (fi refer to? Theo bn, (d) v (0 lin quan ti iu g?
Task 3 0 Bi lm 3
Think a b o u t t h e i n t o n a t i o n o f t h e Hy lu n m iu ca cc cu hi
c o m p le t e d q u e s t i o n s in T a s k 2. M a rk c hon chnh trong Bi lm 2. nh
the w o r d s w h e r e y o u e x p e c t t h e du cc t ni bn cho rng ging ngi
s p e a k e r 's voice to go u p o r d o w n . ni s tng cao hoc h thp.
N ow listen to th e r e c o r d i n g to c h e c k By gi hy lng nghe bng ghi m

y o u r a n s w e rs . kim tra cc cu tr li ca bn.
N ote h o w th e d o c t o r s ta r t s t h e e x a m i Ch cch bc si bt du cuc khn
nation: bnh:
- I'd ju s t like to ... - Ti mun ...

- Could you ju s t ...fo r m i? - C t h v u i l n g ...
N ote h o w t h e d o c t o r i n d ic a t e s t h e e x Ch cch bc s ni khi k t thc khfcn

a m in a t io n is finished: bnh:
- Right, thank you very much indeed. - uc ri. xin cm n nhiu.
Task 4 OBI Bi lm 4
You w a n t to e x a m i n e a p a t ie n t . M a tc h Bn m un khm bnh m t bnh nhki
th e e x a m in a tio n s in t h e first c o l u m n Xp cc b phn khm ct th nht vtt
w ith th e i n s t r u c tio n s in t h e s e c o n d nhng hng dn ct th hai. Ri thc
c o lu m n . T h e n p r a c tis e w ith a p a r t n e r tp vi ngi cng dng vai ni vi
w h a t you w o u ld say to a p a t i e n t w h e n bnh nhn khi tin hnh khm bnh.Ni
carrying o u t t h e s e e x a m i n a t i o n s . R e li nhng hng dn theo nhng u
p h r a s e t h e in s t r u c t i o n s a c c o r d i n g to bn d hc trong bi ny v trong Bi 1 V
w h a t yo u h a v e s tu d i e d in th is u n i t a n d d:
in U nit 3. For e x a m p le :
l-(d ) I'd j u s t like to e x a m in e y o u r Ti m u n k h m h n g c h o n g . C th vui

throat. C o u ld you p le a se o p e n lng h min; tht to c khng?
you r m o u t h as w id e as you can?
Examinations Instructions
Thm khm Hng dn
1 the th ro at a. R em ove your sock and shoe.
hng Ci giy v v.
2 the ears b. R em ove your top clothing.
tai Ci b o trn.
3 the chest c. Turn your head this way.
ngc Q u ay u v ph(a ny.
4 th e back d. O p en your m outh.
lng H ming.
5 che foot e. T ilt your head back.
bn chn Nga u ra sau.
6 th e nasal passage f. Stand up.
dng mi ng dy.
Task 5 ^ Bi lm 5
W h a t d o y o u t h in k t h e d o c t o r is e x a m Bn th n gh bc s s thm khm b
in in g b y givin g e a c h o f t h e s e i n s t r u c phn no khi cho nhng hng dn ny?
tions?
1 1 w a n t y o u CO p u sh as hard as you Hy d y vo bn lay ti cng m anh cng

can a g a in st m y hand. lt.
2 B reathe in as far as you can. N o w Hy ht v o c . n g s u c n g l t . Bygi loi
o u t as far as y ou can. ih ra c n g di cng lt.
3 Say 99. N o w w h is p e r it. Ni 99. By gi ni thm s d.
4 C o u ld y o u fix y o u r eyes o n th e tip o f ng c lli d n mt vo u cy bt ca
m y pen a n d k eep y o u r eyes o n it? ti v nhn c h m ch lu nh th c
khng?
5 I w a n t you to k eep this u n d e r y o u r Hy ngm gi ci ny di li cho n
to n g u e u n til I r e m o v e it. khi ti ly ra.
6 W o u ld you roll ov er o n y o u r left Vui lng nm -nghing sang (ri v co hai
side an d b e n d y o u r k n e e s u p ? T h is u gi dc khng? C (h hi kh chiu
may be a bit u n c o m fo rta b le . di cht y.
7 I w a n t to see you ta k e y o u r right H y ly gt ch n phi c st mt trc
heel a n d r u n it d o w n th e fro n t o f cn g c h n tri.
yo u r left leg.
8 Put o u t y o u r to n g u e . Say Aah. L li ra. Ku aa .
Task 6 I3BI Bi lm 6
W ork in p a i rs a n d loo k b a c k a t T a s k 1. Lm vic theo i v xem li Bi lm 1.
S tu d e n t A s h o u l d s ta rt. Sinh vin A bt u trc.
A: Play t h e p a r t o f M r D a v id s o n . A: ng vai ng Davidson.

1 G re et t h e p a tie n t. C h o n b n h nhn.
2 In d icate th a t you have h a d a le tte r T bn nhn dc th chuyn giao
o f referral. b n h nhn.
3 Ask a b o u t th e d u r a t i o n o f t h e p r o b Hi v thi gian mang bnh.
lem.
4 A sk a b o u t th e p a t ie n t 's o c c u p a tio n . Hi ngh nghip b n h nhn.
5 A sk a b o u t t h e effect o n his o c c u p a Hi tc ng i vi ngh nghip.
tion.
6 In d ica te th a t you w o u ld like to e x T b n mun thm khm b n h nhn.
a m in e him.
7 A sk h im to read th e chart. Bo bnl n h n dc bng khm thi lc.
8 Ask abo u t the right eye. Hi v ml p h i.
9 You change th e lens - d o e s it m a k e B an d i knh - c g y k h c bit g khng?
any difference?
10 You iry a n o t h e r one. Ban th mt kinh khc.
1 ] Indicate th a t th e e x a m in a tio n is N i rn g c u c k h m b n h kt thc.
over.
B: Play th e p a r t of M r Priestly. U se t h e B: ng vai ng Priestly. Dng cc ghi
case n o te s as p r o m p ts . ch gi .
Task 7 C EI I s ] Bi lm 7
You will h e a r a n ex tra ct fro m a n e x Bn s nghe m t trch on t cuc khm
a m in a tio n . As y ou listen, tick off t h e bnh. Trong khi nghe hy nh ducc
sy ste m s e x a m in e d . h thng dc khm bnh.
System Examined H th n g th m khm
ENT T .M .H N G
RS H .H P
CVS T.M CH
GIS T.HA
GUS N .D C
CNS T.KINH
O th e rs (specify) C c h th n g
k h c (ghi r)
W hat kind of e x a m i n a t i o n is this? Cch kh m b n h ny thuc loai gi?

How old d o y ou th in k t h e p a t i e n t is? Bn cm n g h b n h n h n bao nhiu tui?
H ow do you know ? Bn bit bng cch no?

Note h o w th e d o c t o r carefu lly r e a s Ch cch bc s cn thn train an bnh
sur es th e p a tie n t b y e x p la in in g w h a t n h n qua vic gii thch n h n g vic s
she is g o in g to d o a n d in d ic a t in g t h a t lm v ni rng mi vic du tt p:
ev e ry th in g is all right:
- Can I have a look a t you to f i n d out Vui l n g d t i k h m x e m VI u li hc
where your bad cough is com m gjrom ? n hi u th?
... T h a t's f i n (. ... ic ri.
9 4 - English in M edicine
Task 8 I j Bi lm 8
Try to c o m p l e t e t h e d o c t o r 's e x p l a n a Hy b sung nhng li gii ngha v trn
tio n s a n d e x p r e s s i o n s o f r e a s s u r a n c e an ca bc s bng cch din thm mt t
by a d d i n g o n e w o r d in e a c h gap. vo mi ch trng.
.Now lis te n to t h e e x tra c t a g a in a n d By gi bn hy nghe li trch don v
check y o u r a n s w e r s . kim tra cc cu tr li ca bn.
1 N o w I'm ..................... (a) to p u t th is By gi, ti s ....................(a) dt ci ny

th in g o n y o u r chest. ln ngc ng.
2 Its ....................(b) a ste th o s c o p e . l ..........................(b) c h i c ng nghe.
3 It ................... (c) be a bit cold. N ..................(c) lii lanh mt chi.
4 OK? First ........................ (d) all, 1 c ch? Thoai tin (d) lt
listen .................... (e) y o u r fro n t c, li nglic .................... (e) ngc v,
a n d ....................... ( 0 y o u r back. .................... (f) pha lng.
5 W ell .................. (g). you d id n 't TI .................. (g), n clu c c d n g
m o v e at all. cht no.
6 N o w I'd ....................(h) to see y o u r By gi ti ..................... (li) khm vng
t u m m y .......................... (i) will y o u lie bng, ..................... (i) ng vui lng ln
on th e bed for a m in u t e ? ging nm ml lcl dc ch?
7 N o w w h ile .................... (j) lying By gi trong lc ...................(j) nm d,
t h e r e , ................... (k) feel y o u r n e c k .................... (k) khm vng c v nch.
an d u n d e r y o u r arm s.
8 A re you .................. (I)? ng c b .................... (I)?
9 ............... (m ) th e to p o f y o u r legs. .................... (m) pha trcn i.
10 T hat's ................. (n) very quick, N livy l ....................(n). N h an h qu.,
................... (o) it .................... (o) phi khng?
Listen ag a in . T ry to n o t e t h e i n t o n a Nghe li. Ch ng iu ca cc dng cu

tion o f t h e q u e s t i o n fo rm s. hi.
Task 9 ^ Es) Bi lm 9
Look b a c k to T a s k 4. H o w w o u l d y o u Xem li Bi lm 4. Bn s nhc li cc
r e p h r a s e t h e i n s t r u c t i o n s for a 4 -y ea r- hng dn n h th no cho m t em b 4
old? W h e n y o u h a v e f in is h e d , lo o k at tui? Khi bn hon tt xong, hy xem
th e Key a n d lis te n to t h e r e c o rd in g . phn Gii p v nghe bng ghi m.
Section 2 Rephrasing, encouraging and prompting
Phan 2 Nhc li, khuyn khch v g
Task 10 O E I Bi lm 1 0
T he form belo w is u s e d to m e a s u r e Mu di y c dng o hinjmt
m e n ta l im p a i r m e n t . D isc u ss w ith a suy nhc tm thn. Hy th o lu n v t
partn e r: ngi cng ng vai:
- in w h at o rd e r you m ig h t ask th e s e bijn c th dt nhng cAu hi ny thd

q u e s tio n s th t no
- in w h a t form you m ig h t ask chem bn c th hi nhng cu di hint
thc no
I S A A C S -W A L K E Y M E N T A L IM P A IR M E N T M E A S U R E M E N T
I
Date of test / /
A s k th e p a t ie n t t h e f o llo w in g q u e s t io n s .
S c o r e 1 fo r a c o r r e c t a n s w e r , 0 fo r a n e r r o r .
Score
1 W h a t is t h e n a m e of th is p l a c e ? ..............
2 W h a t d a y o f th e w e e k is it t o d a y ? ( * ) ........
3 W h a t m o n t h is it? ...............
4 W h a t y e a r is it? ...........
5 W h a t a g e a r e y o u 7 ( a llo w 1 y e a r e rro r) ................
6 In w h a t y e a r w e r e y o u b o r n 7 ............
7 In w h a t m o n t h is y o u r b i r t h d a y ? .........
8 W h a t t im e is it? ( a llo w 1 h o u r e rro r) - ........
9 How long h a v e you b e e n h e r e ? (allow 2 5 % error) .......
Total s c o r e .........
S i g n i f i c a n c e of s c o r e
8 or 9 No significant im p a ir m e n t
5 to 7 M o d e ra te im p a ir m e n t
1 to 4 S e v e r e im p a ir m e n t
0 C o m p le t e failure
S ig n a tu r e o f e x a m in e r ............................................
( ) C A u hi va c u (r ti tro n g ti n g A n h v ting V i^ t c k tA c n f i* u
hng A n h - W h at ay > (n g y gi) - M o n d a y (ln n y tbd hi)
ti n g V i t n g a y !h u 'ny'> - T h hai
O LNG MC SUY NHC TM THAN
THEO PH NG PH P
ISA A C S-W A LK EY
N gy tr c nghim / /
Hi b n h n h n nhng cu sau y.
Cho i m 1: tr li ng, i m 0: tr li sai.
im
1. Tn a i m ny l g? ..........
2. Hm nay l ngy g trong tun?(**) ..........
3. By gi l thng g? ..........
4. N m nay l n m g)? ...........
5. ng bao nhiu tui? (cho p h p sai 1 nm) ..........
6. n g sinh nm no? ..........
7. Sinh nht ca ng vo thng my? ..........
8. My gi ri? (cho p h p sai 1 gi) ..........
9. n g y bao lu ri? (cho p h p sai 25%)
im tng cng ..........
ngha dim
8 hoc 9: Khng suy nhc n g k
5 n 7: Suy nhc trung bnh
1 n 4: Suy nhc nng
0: Hon ton suy nhc
C h k ngi k h m ........................
Task 1 l H Bi lm 11
You will h e a r a n in te r v ie w b e t w e e n a Bn s nghe cuc hi b n h gia bc s v
d o c t o r a n d a p a t i e n t h e h a s k n o w n for m t b n h n h n quen bit t nhiu
years. As y o u lis ten , n u m b e r t h e q u e s nm . Trong khi nghe, n h s cc cu hi
tio n s a b o v e in t h e o r d e r t h e y a r e trn y theo th t c hi. So snh
asked. C o m p a r e t h e o r d e r w i t h y o u r th t vi n h n g iu bn d on.
p r e d ic tio n s .
C o m p l e t e T a s k 12 b e f o r e y o u c h e c k Hon tt Bi lm 12 trc khi kim tra cc
y o u r a n s w e r s in t h e Key. cu tr li phn Gii p.
( ) Xem () trang 96
E nglish in M ed icin e - 9 7
Task 12 s Bi lm 12
Study th e in f o r m a ti o n a b o u t t h e p a Nghin cu cc thng tin v bnh nhin
tie nt given below . T h e n lis te n to th e di y. Ri lng nghe cuc dm thoi
interview ag a in w ith t h e p u r p o s e of m t fn na nhim cho im b nh nhn.
giving th e p a t ie n t a score.
SURNAME Wallers F IR S T N A M E S John Edward

O CCUPATION Retired millworker
H Walters TN John Edw ard

TUI 83 GII N am ___________ TNH T R N G HN NHN Gav
N GH N G H I P Cng nhn nh my xay hu tr
Date of test: T h u rs d a y 27 F e b ru a ry N gy trc nghim: th n m 27 thng 2

1997 n a m 1997.
Patient's DOB: 17 April 1913 Ngy sinh ca b n h nhn: 17 th n g 4
n a m 1913.
H ow d o e s y o u r s c o r e c o m p a r e w ith im ca bn cho ra sao khi so snh vi

t h a t given b y y o u r p a r t n e r a n d in th e im ca ngi cng ng vai v ca
Key? phn Gii p?

N ote h o w t h e d o c t o r u s e s a r e p h r a s i n g Ch cch bc s s d n g k thut nhc
t e c h n iq u e to e n c o u r a g e t h e p a t i e n t li khuyn khch b n h n h n v t30 cho
a n d give h im tim e to a n s w e r . F o r e x h thi gian tr li. V d:
am p le:
Q u e s tio n 9: Have you b e e n h e r e long? Cu hi 9: ng y d lu cha?

In this house, have you been ng nh n y d l u c h i?
here long?
How long have you been liv ng d ng High d bao
ing in the High Street? lu r i
N o te a ls o t h a t t h e r e p h r a s e d q u e s t i o n Cng nn ch cu hi nhc li thng
4s o f te n p r e c e d e d b y a n e x p r e s s io n like bt u bng m t cch din t nh: n g
Do y o u r e m e m b e r ...? For e x a m p le : c n h ...? V d:
J- Do you remember where th ? Where - n g c nh y l u khng? Ch
this pla ce? n y l nai n o ?
Task 1 3 S Bi lm 13
'P r e d ic t t h e m is s in g w o r d s in t h e s e e x D on cc t thiu h t trong cc trch
tracts. S everal w o r d s a r e r e q u i r e d in on ny. Nhiu t cn phi c trong a
- m o st o f t h e g a p s . T h e n lis te n a g a in to s cc ch trng. Ri nghe li cuc m
th e in te rv ie w to c h e c k y o u r p r e d i c thoi kim tra d on ca bn. Th
tions. T ry to m a t c h t h e r e p h r a s i n g s g hp cc cu nhc li vi cc cu hi trc
with th e c o r r e s p o n d i n g te s t q u e s n g h i m tng ng. V d (a) c lm cho
t i o n s . E x a m p le (a) is d o n e for y ou. bn.
a. Q u e s t i o n .........: D o you r e m e m b e r w h e n you ng c nh ng sinh ra khi

(Mu hi .............: w e r e b orn? n o khng?
W h a t .................... (1)? No ................... (1)?
C a n you .................... (2)? ng c th ................... (2)?
b. Q u e s t io n ........... : D o you r e m e m b e r w h a t tim e n g c n h thi gian n o
Cu h i ............... s. o f th e m o n t h ? trong th n g khng?
W h a t .................... (3)? No ....... ........ (3)?
c. Q u e s t i o n ............: H o w old will y ou be n o w By gi n g b a o n h iu tui
O u hi ...................................... (4)? ................... (4)?
d. Q u e s t io n ........... : W h a t y ea r is it th is year? D o N m n a y l n m g? n g c
Cu h i ................ you .................... (5)? ................. (5)?
e. Q u e s t i o n ............: Fine, a n d w h a t m o n t h are w e TI,v b y gi l ih n g my?
Cu hi .................: in? Th ( 6 )?
W ell, .................... (6)?
f. Q u e s t i o n ........... : D o y ou r e m e m b e r w h a t day ng c n h h m n ay l ngy
C5u hi ................ : o f th e w e e k it is? g trong tu n khng?
O r d o t h e ............ (7) n o w Hoc c phi ................... (7)
th a t y o u 're ............. (8)? b y g i n g c a n g .............(8)?
Task 1 4 ^ 0 Bi lm 1 4
T h in k a b o u t t h e i n t o n a t i o n o f t h e Hy lu n m iu ca cc cu hi
c o m p l e t e d q u e s t i o n s in T a s k 13. M a rk dc hon chnh trong Bi lm 13. nh
t h e w o r d s w h e r e y o u e x p e c t th e du cc t ni bn cho rng ging ngi
s p e a k e r 's v o ic e to go u p o r d o w n . ni s tng cao hoc h thp.
N ow listen to t h e r e c o r d in g to c h e c k By gi bn hy nghe bng ghi im ti
your answ ers. kim tra cc cu tr li ca bn.
Task 15 ^ Bi lm 1 5
Look bac k at t h e te st fo rm in T a s k 10. Hy xem li (lng trc nghim trong Bi
T h in k of at le ast tw o w ay s of r e p h r a s lm 10. Hy ngh ra t nht l hai cch d/
ing e a c h q u e s tio n . nhc li mi cu hi.
Task 16 \ s i Bi lm 1 6
Mr J a m e s o n (see U n it 3, p. 65) w a s r e n g Jam eson (xem Bi 3, trang 65) dupc
ferred to a n e u r o lo g is t for e x a m i n a gii thiu n khm bnh mt bc i!
tion. D u rin g t h e e x a m i n a t i o n t h e khoa th n kinh. Trong lc khm b n h .u
n eu ro lo g ist to u c h e s M r J a m e s o n w ith: bc s c h m vo ngi ng Jameson
bng:
a. a needle kim
b a piece o f c o tto n wool m ing bng gn
c. hot and cold tu b e s cc ng nng v lnh
d. a vibrating fork thanh m u rung
Listen to P arts 1 to 4 o f t h e e x a m i n a Hy lng nght t p h n 1 n 4 cuc khm

tion a n d n u m b e r t h e s t e p s in t h e o r d e r b n h v nh s cc bc theo th t mi
th a t th e n e u r o lo g is t c a rrie s t h e m o u t. bc s khoa th n kinh thc hin.

N o te h o w th e n e u r o lo g i s t e x p la in s Ch cch bc s khoa thn Idnh giii
w h a t s h e is g o in g to d o in P a r t 1 o f t h e thch vic b s lm o n g phn 1 c
exam ination: cuc k h m bnh:
- I now w a n t to ... - B y g i ti m u n ...
- I'm going to ... - Ti sp sa ...
- I'll - T i s ...
Listen to P art 1 of t h e in te r v ie w to Lng nghe p h n 1 ca cuc m thoi i i

c o m p l e t e t h e s e e x p l a n a tio n s . b sung n h n g cu gii ngha ny.
100 - E nglish in M e d ic in e
T h e n lis te n to P a rts 2 ,3 a n d 4 to n o t e : Sau , lng nghe phn 2, 3 v 4 ri ghi
nhn:
a) H o w t h e d o c t o r in s t r u c ts t h e p a Cch bc si hng dn bnh nhn.
tient.
b) H o w t h e d o c t o r m a r k s th e sta g es o f Cch bc s lm du cc giai on khm
h e r e x a m in a tio n . bnh.
To i n s t r u c t t h e p a t ie n t , s h e uses: hng dn bnh nhn, bc s dng:

- I w a n t you to ... - Ti m un ng ...
T o m a r k t h e s ta g e s o f h e r e x a m i n a lm du cc giai on khm bnh, bc

tion, s h e says: s ni:
- N o w I'm going to try som ething ... - B gi, ti s th li i n y ...
- N e xt I'm going to test you ... - R[ t i s k im tra ng ...
Task 17 ^ Bi lm 17
U sin g t h e e x p r e s s io n s s t u d i e d in L a n Dng cc cch din t hc trong phn
g u ag e fo c u s 11. ex p la in to M r J a m e s o n Trng tm ngn ng 11, hy gii ngha
e a c h s ta g e o f t h e e x a m i n a t i o n a n d i n cho ng Jam eson v mi giai on khm
s tr u c t h im . b nh v hng dn ng ta.
T ask 18 ^ I s ] Bi lm 1 8
T h e n e u r o lo g i s t t h e n e x a m i n e s M r Sau , bc s khoa thn kinh khm mch
l a m e s o n 's leg p u ls e s . T h e s e q u e n c e o f chn ng Jameson. Trnh t khm nh
e x a m i n a t i o n is a s follows: sau:
1 t h e g roin hng
2 b e h i n d th e k n e e khuu chn
3 b e h i n d t h e an k le b o n e mt c ch n pha trong
4 t h e to p o f th e foot mu bn chn
5 th e o t h e r leg cng ch n kia
W rite w h a t y o u w o u l d sa y to M r Hy vit ra iu bn s ni vi ng
J a m e s o n . T h e n lis ten to P a r t 5 o f th e Jameson. Ri lng nghe phn 5 ca cuc
e x a m i n a t i o n to c o m p a r e . th m k h m so snh.

Task 19 GEI Bi lm 19
Work in pairs. C h o o s e a s p e c ia lis t e x Lm vic theo di. Chn m t chuyn vin
a m in a t io n in y o u r o w n Held. T o g e t h e r k h m b n h trong lnh vc chuytn min
d e c id e h o w you c a n e x p la in to t h e p a ca bn. Cng n h au quyt n h cich bn
tient e a c h sta g e o f t h e e x a m i n a t i o n c th gii ngha cho b n h nhn v mii
a n d h o w y ou w o u ld i n s t r u c t t h e p a giai on ca cuc thm khm vi cch
tient. T h e n find a n e w p a r t n e r to play bn s hng dn bnh nhn. Ri tm
the patien t. m t ngi mi ng vai b^nh nhn.
Section 3 Reading skills: Reading articles I

Phn 3 K nng c: c bi bo l
Task 20 c a Bi lm 2 0
H ere a re th e h e a d in g s t h a t a r e c o m y l nhn! tiu d thng dng trong
m o n ly u se d in article s fro m A m e r ic a n cc bi bo trch t bo M. Hy nh si
journals. N u m b e r t h e m in t h e o r d e r theo th t m bn d on cc bi
that you w o u ld e x p e c t t h e m to f e a tu re . dc a ra.
References Ti liu tham kho

S u m m ary Tm tt
Com m ent Bn lun
M aterials and m e th o d s Vt liu v phng p hp
A u th o rs Cc lc gi
Editor's n o te Ghi ch cija bin tp
Title Ta d
Results C( kt qu
Incroduction N h p
Task 21 D Bi lm 21
H ere are s o m e b r ie f e x tra c ts fro m a n y l vi trch on ngn t bi bo ni
article th a t f e a tu r e d in t h e A rc h iv e s o f bt trong Tp c h Y h c N h i khoa v ngi
P ediatric a n d A d o le sc e n t M ed ic in e. Trng thnh. Th xp tng ng c
Try to m a t c h t h e m to t h e h e a d i n g s on vi cc tiu ghi trong Bi lm
given in T ask 20. W h a t f e a tu r e s o f t h e 20. N hng c dim no ca bi gip
text h e l p e d y ou to id e n tify t h e p arts? bn xc nh c cc phn ?
102 - English in M ed ic in e
N o w p u t t h e h e a d i n g s in t h e o r d e r t h a t By gi xp cc tiu d theo th t m bn
y o u w u u ld e x p e c t to find t h e m . ngh rng c th tm thy chng.
K a th iJ . K e m p er, M D , M P H ; P a u lL . M c C a r th y , M D ; D om enic V. C icchet,

PhD
Abstract scoring and selection re G h i n h n irc h yu v b jn ch n la d e ll

mained constant throughout the sludy vn h n g n h sut Iron g nhng nm
years. All abslracls were rated a n o n y n g h i n cu. Tt c cc trc h yu u c
mously, ie authors' nam es and institu H n h gi kh u y l d a n h ; n g h a l tn tc
tions were omilted. All abstracts were gi v c c c q u an u bi loaI b. Tdl ca
rated from 1 to 5, with 1 indicating u n c c trc li yu u dc (l n h gi l 1 n
suitable for presentation; 2, consider 5 vi i m 1 b iu th kh n g th c h hp d
only if necessary; 3, borderline; 4, . trn h b y; 2, ch xe m xt nu c n th it; 3,
good; 5, a "must". T he ratings for each g i p b i n ; 4 , tt: 5 , "phi". C c n h gi
abstract were averaged. Abstracts were d i vi m i trc h yu u dc tn h i m
sorted by rank, with the highest aver (run g b n h . C c trch yu d u c ly ra
age scores al the lop. T he top abstracts th e o x p h n g , vi c c n h gi trung
were selected for platform (oral) p res b n h cao n h t. C c trc h yu du bng
entation. As space allowed, the next c ch n la ch o v i c trn h b y (m i n g ).
highcst-scoring abstracts were selected K hi v ng kh n g g ian ch o p h p , cc trch
for posler presentation. y u c i m n h gi cao nh t ti p sau
clu c ch n trn h b y trn bng p
p h tc h .
Between 1990 and 1991, the n um b e r G i a c c nm 1990 v 1 9 9 1 . s
of reviewers per abstract was reduced lng cc vj x l d u y l ch o m i trc h yu
from 11 to six. In 1995, the pool of re g i m t 11 xung 6 ngi. N m 1 9 9 5 ,
viewers was expanded to include the b an xt d u yt c m rng b a o gm cc
chairpersons of two S I G s - E R and ch tc h ca h ai SIG s ER v I3 E H v
B K H -and 10 regional chairpersons 10 ch tc h a phng (RCs). C c trch
(RCs). Abstracts were divided inlo three yu dc c h ia th n h ba loai: ER. B E H v
categories: ER, BEH, and GP. T h e ER G P . C c trch yu loi ER c xt duyt
abstracts were reviewed by the chairper bi ng ch tc h ca ER S IC hai RCs v
son of the ER SIG, two RCs, and one m t th n h v i n ca B O D . C c trch yu
m e m b er of the BOD. T he BEH a b lo i B E H dc xt d u yt bi ng ch tch
stracts were reviewed by the chairper ca I3E H S IG , hai RCs, v hai th n h vin
son of the BEH SIG, two RCs, and two ca B O D . C c trch yu loi C P c xt
m em bers of the BOD. T he G P abstracts d u y l bi n m ih n h v i n ca B O D v
were reviewed by five m em bers of the su RCs, nh v y m i trc h yu c xl
BOD and six RCs, so every abstract was d u yt bi t n h t n m ngi n h gi.
reviewed by at least five raters. Specific Hn hu, nhng p h n c ng (l c hiu
assignments were made random ly by c (hc h i n bi ban i u h n h vn
administrative staff al ihe APA office. phng APA.

1. S ta ndards o f R e p o rtin g T rials C c c h u n m c b o c o ca nhm th
G roup. A p ro p o s a l for stru c tu r e d r e nghim. MI d< nghj v bo co c cu
porting o f r a n d o m iz e d c o n tro lle d trials. tr c c a c c th n g h i m sai l c h d i (V*JC
JAMA. 1994; 272: 1926-1931. kim tra. /AMA 1994; 272: 1926-1931.
2. W o rk in g G roup on R e c o m m e n d a Nhm lm vic v cc khuyn co cho
tions for R e p o rtin g Clinical T rials in bo co cc th nghim lm sing trong
the Biomedical Literature. Call for ti liu sinh y hc. Gi cho nhng bnh
comments on a proposal to im prove re lun v mt ngh nhm c ii lin blo
porting of clinical trials in the b iom e d i1 co cc th nghim lm sng Irong Ui
cal literature. Ann Intern Mtd. 1994; 121: liu sinh y hc Ann Intern Med. 1994;
894-895 121: 894-895.
3. Haynes RB, Mulrow CD, Huth EJ, Haynes RB. Mulrow CD, Hulh E). All-
Altm an D G , G a r d n e r MJ. M o r e info r m an D C , G a r d n e r M J. T h m n h i u lric h
mative abstracts revisited. A n n Intern yu thng tin d c xem Ui. Ann In
Med. 1990; 113: 69-76. te rn M ed. 1990; 1 13: 69-76.
4. Purpose and procedure. A C P J Club. nh v th tc. A C P I Club. 1991; 115

1991; 115 (suppl 2): A-13-A-14. (ph b n 2): A-13-A-14.
d)
The num ber of abstracts submitted and S lng c c trlch yu c d Irtnh v

selected for presentation in 1990,1991, ch n la trinh b y trong cc nam
1993, and 1995 are given in T a b l e 1. 1990, 1991, 1993 v 1 9 9 5 d u d u c n t i
Data from 1991 and 1993 are included trong Bng 1. D liu t 1991 v 1993
for comparison.
u c gii thiu so snh.
T he nu m be r of abstracts submitted S lng c c trch yu trnh d

for consideration forpresentation at the xem xt cho vic trinh b y li Hi ngh|
annual APA meeting increased steadily APA h n g n a m tng u n gia cc
between 1990 and 1995. T h e increased n m 1 9 9 0 v 1995. Dung lng tng cho
capacity for poster presentations each vic trnh b y b n g p phch mi n m t
year since 1990 increased the overall 1990 lm tang ti l c h p n h n lng
acceptance rate from 42% in 1990, q u i l 4 2 % trong n m 1990, khi M
when 14 posters were presented, to b n g p p h ch c gii thiu, ln
62% in 1995, w hen 182 posters were 6 2 % trong n m 1995, khi 182 b i n g p
presented. T he n u m b e r of oral p rese n p h ch c gii thiu. S long c J r
tations rem ained constant at about 90 b o c o n i vn h n g d n h rrKc khong
per year since the late 1980s. 90 hng nam, k t nhng nm 1980.
O f all abstracts submitted to APA in Trong lt c cc trch yu c
1995, 246 were reviewed by the G P trnh cho APA trong n m 1995, 246
com m ittee (11 reviewers), 118 were re c xt duyt bi hi ng GP (11 y
viewed by Ihe ER com m ittee (four re vin xl duyt), 11 8 c xt duyl
viewers), and 43 were reviewed by the bi hi ng ER (4 y vin xl Huyl) v
BEH com m ittee (five reviewers). T h ere 4 3 c x l d u yt bi H i clng B E H (5
were no reported logistical problem s as y vin xl duyt). Khng thy c bo co
<t result of increasing the n u m b e r and v cc v'n logiclic xy ra do tng s
variety of reviewers. All reviews were lng v s a dng ca cc ngi xt
returned within 10 days. .duyt. Tt c cc bn xt duyl du c
gi li trong vng 10 ngy.
A few cannot agree. A dd m ore, and Mt s nh khng th tn Ihnh. B sung

they also ca nn ot agree. If not reliable, at th m v h cng c th khng ln thnh.
least they are consistent. Perhaps this N u khng n g tin cy th 1 nht ho u
should be entitled "Raters of the Lost kin nh. C l nn dl tiu "Nhng
Art". ngi n h gi ca N gh T h u l mt*.
Catherine D. DeAngel, M D Catherine D. DeAngelis. MD
These results arc consistent with p r e Cc kt qu (| (lu ihch hp vi nhng

vious studies of the p ee r review process nghin cu Irc ca qu trnh xt duyt
indicating that after correcting for chung (vi ng nghip) v biu th rng
chance, inlerrater agreem ent is poor. sau khi sa cha tnh c, vic tn thnh
W ithout specific criteria an d training gia cc ngi nh gi lng h l nh
for reviewers, interrater agrc cm e n l is b. Khng c tiu chun c th cng
only slightly better than chance. T his is nh khng c lp hun cho cc ngi xt
also true for evaluating funding p ro p o s
duyt, vic tn thnh ca cc ngi dnh
als 23 and in clinical medicine.24 Interra
gi tng h ch i cht kh hn s may
ter agreem ent on the quality o f patient
ri. iu ny cng ng i vi vic
care often shows K values less than
nh gi cc d ngh thu Ihp v Irong y
0 .4 0
hc lm sng. Vic tn thnh ca cc
ngi nh gi tng h v cht ca s
chm sc bnh nhn thng cho nhng
tr gi K nh hn 0,40.

g)
EER R E V IE W is a c o rn e r V i r xt d u y H c h u n g (VI d n g n g h itp tu
P stone of the m o dern scientific

process. It is the m eans by
w hich g ra n t a p p lic a tio n s are
selected for funding, e x p e r i m e n t s in
volving human subjects are approved,
hn d t n g ca qu (rin h khoa hc hin
dai. l nhng phngIhc nhddio
php c c ng d ng c ch on lc d (hu
thp, cc (h nghim lin quan dn d c
ti v con ngi c chpthun.cic
m anu scrip ts are selected for p u b li c a bn tho ijc chon loc d rng b. v
tion. an d abstracts a re selected for p r e s cc trrh yu c rhon loc d Irtnh biy
entation al scientific m eetings. tai cc hi nthi khoa h o r . Cc trinh biy
Research p rr s e n ta tio n s help d is se m i nghin cu gip ph bin kin thr mi
nate new k n o w led g e an d m a y im p r o v e v c th cI (hin vic ch m sc bnh
patient care, health services, and health nhn, cc dich v y l, v gio due sc
education. T hrough abstract presen ta khe. Qua cc bui trinh by Irch yfu,
tions, new re s e a rc h e rs a re in tro d u c e d to nhng nh nghin cumi duduocgii
the a c a d e m ic c o m m u n it y a n d c a re e r thiu vi cng dng hoc thut v iphli
development is enhanced. Failure to be trin ngh nghip uoc khch l. Phii
accepted lor p re s e n ta tio n often has chp nhn l S thi bai trong vic (rinh
d a m ag in g effects o n ju n i o r inv estig a by i khi c hiu qu lc hai rhou/t
tors self-esteem a n d interest in a re tin ca nh nghin cu Ir va M/hnglh
search career. trong S nghip nghin cu.
h)
Improving Participation Ci thin s tham gia v vic

and Interrater A gree tn thnh ca ngi dnh gi
ment in Scoring Ambula tng h trong vic chm
tory Pediatric Association im cc trch yu ca Hip
Abstracts Hi Nhi Khoa lu dng.
How Well Have We Succeeded? C h ng ta thnh cng dn

m c no?

Task 22 Q Bi lm 22
U su a lly t h e p a r t o f t h e artic le t h a t o n e Phn bi bo ngi ta c u tin thng
r e a d s first is t h e a b s t r a c t o r t h e s u m thng u l trch yu hoc bn tm tt.
m a ry . In A m e r ic a n j o u r n a l s it u s u a lly Trong cc bo M, bi d thng c bn
c o m p r i s e s f o u r p arts: phn:
C o n c lu s io n s Kt lun
M e th o d s Phng php
O bjective(s) Mc tiu
R e su lts Kl qu
P u t t h e h e a d i n g s in t h e o r d e r y o u Hy t cc d mc theo th t m bn
w o u ld e x p e c t t h e m to a p p e a r . on rng ch n g s xut hin.
Task 23 ^ Bi lm 23
H e re is t h e S u m m a r y o f th e article fro m y l tm tt m t bi bo t Bi lm 21.
T a s k 2 1. C o m p l e t e t h e text by p u t t i n g in Hy hon chnh bi vit bng cch t vo
th e a p p r o p r i a t e h e a d in g s a n d m is sin g cc m c thch hp v cc t thiu h t
w ords. E ach g a p c a n b e c o m p l e t e d by Mi ch trng c th c hon chinh
a d d i n g e ith e r o n e w o rd , o r o n e w o rd bng cch thm hoc mt t hoc m t t
p lu s a n article (the, a o r an). cng vi m t mo t (the. a hoc an).
................. (1): T o d e t e r m i n e w h e t h e r ................... (1): xc nh vic tang

in c re asin g th e n u m b e r a n d ty p es o f s lng v cc loi ln thnh ca
i n te r r a te r a g r e e m e n t in s c o rin g a b ngi n h gi tng h trong vic
s tr a c ts s u b m i t t e d ....................(2) A m c h m im cc trch yu c H trnh
b u la to r y Pediatric A sso c iatio n . .....................(2) Hip Hi Nhi Khoa lu
ng.
........................ (3): In 1990, all a b .................. (3): N am 1990, tl c cc

s tr a c ts w e re r a te d by each trch yu du dc n h gi bi mi
.........................(4) 11 m e m b e r s o f th e .................(4) 11 thnh vin ca y ban
b o a r d o f d ire c to rs .........................(5) cc ch t c h .............. (5) Hip Hi Nhi
A m b u la to r y P ed iatric A ss o c iatio n . In Khoa lu ng. N m 1995, c c trch
1995, a b s tra c ts w ere rev ie w ed yu u c xt duyt ..................(6)
..........................(6) fo u r to five raters, bn n nm ngi n h gi, bao gm
in c lu d in g eig h t m e m b e r s o f th e 8 thnh vin ca y ban cc ch lch,
b o a rd o f d irecto rs, tw o c h a ir p e r s o n s liai ch tch ca cc nhm c lin quan
o f special in te r e s t g ro u p s, a n d ten c bit, v mi ch tch a

regional ch a irp erso n s, for a total o f phng, nh vy tng s c 20 thnh
20 p otential review ers. S u b m is s i o n s vin xt duyt c nang lc. C ic xt
w ere divided in to th e follow ing th r e e duyt dc chia thnh ba loi MU
categories ...........................(7) review: ............. (7) xt duyt: y hccpcdu,
em ergency m ed icin e, b eh av io u ral Nhi khoa ng x v Nhi khoa * 1
pediatrics, an d general p ediatrics. q u t. T l p h n trm tn th n h r rt
W eig h ted p erc en ta g e a g r e e m e n t and v im s K duc ghi n h n r rt (Mu
w eighted K scores w ere c o m p u te d c ghi m y vi tnh cho cc im 4
for 1990 and 1995 ab s tra ct scores. trch yu ca n3m 1990 v 1995.
....................(8): Betw een 1990 an d .............. (8): Gia cc nam 1990 v

1995, th e n u m b e r o f ab s tra c ts s u b 1995, s lng cc trch yti dc
m itte d .....................(9) A m b u la to r y P e t r n h ................7(9) H i p H i N h i Khoa
diatric A ssociation in creased from lu n g tan{ t 246 ln ti 407, J
246 to 407, th e num ber l n g .............. (10) cc thnh vin xl
.................. (10) review ers inc re ase d duyl tng l 11 ln ti 20, t l phin
from 11to 20, the w e ig h te d p e r c e n t tram tn th n h c ghi nhn r rt
age a g re e m e n t b e tw e e n r a te rs r e gia cc ngi d n h gi v n gi
m a in ed a p p ro x im a te ly 7 9 % an d nguyn k h o in g 7 9% v cc dim i6
w eig h ted K scores r e m a in e d less K d c g h i n h iin r rt v n g i n g u y n
.................. (11) 0.25. A g r e e m e n t w as mc di .................. (11) 0,25. S tn
no t significantly b e t te r for th e e m e r thnh khng tt hn di vi cc trch
gency m e d icin e a n d b e h a v io u ra l a b yu y hc c p cu v ng x so vi nhi
stracts th a n for gen eral p ed iatrics, khoa lng q u t ....................(12) tt hn
.................... (12) w as it b e t te r for th e i vi ngi (lnh g i .................... (13)
r a t e r s .....................(13) r ev ie w ed few er xl duyt s lng trch yu ll hn u
ab stracts th a n th o s e w h o rev iew ed nhng ngi xl duyt s lng nhiu.
many.
.................... (14): T h e n u m b e r a n d e x ..................... (14): S lng v gimdnh

pertise .................... (15) t h o s e ra tin g .....................(15) nhng ngi nh gi
abstracts in creased from 1990 to c c trch yu u tng T nm 1990
1995........................... (16), in t e r r a t e r n 1 9 9 5 ......................(16) s ln thnh
ag re e m e n t did .........................(17) ca ngi n h gi tung h lm
change and r e m a in e d low. F u r t h e r ...................... (17) thay i v vn th p
efforts are n e e d e d ....................... (18) N hng c gng thm na l cn thit
im prove th e in te r ra te r a g r e e m e n t. ...................... (18) ci thin s ln thnh
ca ngi n h gi tng h.
108 - E n g lish in M ed icin e

T h in k a b o u t s o m e o f t h e j o u r n a l a r t i Hy ngh n vi bi bo m bn c
cles t h a t y o u re g u la rly re a d . D o th e y thng xuyn. Cc bi c theo cng
follow t h e s a m e s tr u c t u r e , o r a r e t h e r e cu trc n h vy hoc c vi khc bit nao
s o m e d if fe re n c e s? C o m p a r e n o t e s khng? Hy so snh cc ghi ch vi mt
w ith a p a r t n e r o r o t h e r m e m b e r s of ngi cng dng vai hoc vi cc thnh
y o u r g ro u p . vin khc trong n hm ca bn.
If y o u h a v e t h e o p p o r t u n i t y , visit t h e Nu bn c c hi, hy n m t th vin y

m e d ic a l library, o r a lib ra ry t h a t h a s khoa hoc m t th vin c cha tp ch y
s o m e m e d ic a l a n d sc ie n tific j o u r n a l s hc v khoa hc v so snh cc cu trc
a n d c o m p a r e th e ir s t r u c t u r e s . H o w d o ca cc tp ch. Chng ra sao khi so snh
th e y c o m p a r e w ith t h e s t r u c t u r e s o f vi cu trc cc bi bo c vit bng
j o u r n a l a rtic le s w r i tte n in y o u r m o t h e r ting m c bn?
to n g u e ?

Task 24 D Bi lm 2 4
M r H u d s o n w a s p u t o n a w a i t i n g list n g Hudson c ghi ln bng ch phu
for a T U R fo llo w in g h is c o n s u l t a t i o n th u t ct tuyn tin lp qua ng niu
w ith M r F ielding. H o w e v e r, af te r five o sau khi dc ng Fielding khm
w e e k s h e w a s a d m i t t e d to h o s p i t a l as bnh. Tuy vy, sau n m tun l, bnh
a n e m e r g e n c y . S tu d y t h e r e g i s t r a r s n h n li c cp cu nhp vin. Hy
c a s e n o t e s o n M r H u d s o n follo w in g nghin cu cc ghi ch trn bnh n sau
h is a d m is s io n . khi ng Hudson nhp vin.

P R E S E N T COM PLAINT
Unable to PU for 24hrs
In severe pain
Awaiting TUR for enlarged prostale
0 /E
G eneral C ond itio n Restlessness d u e to pain
Sweating ++
ENT
RS Chest clear
CVS PI 20 AF
BP HS I, II no murmurs
120
GIS I 1 b la d d e r d is te n d e d lo umbilicus
G US
PR prostate enlarged, soft
CN S
NAD
DIAGNOSIS
(1) Acute retention due 10 prostate hypertrophy
(21 A tr ia l f ib r illa t io n > cause
MANAGEMENT
S c d .ite
C'dlhelerise
Ask p h y s ic ia n to see h im
U q . t n g l i s h in M ed icin e
LI KHAI B N H H IN NAY
K h n g ti u t i n d c Ir o n g 2 4 gi
au nhiu
C h m tu y n ti n l p q u a d n g n i u o v luyn lin l p to
THM KHM
Tng trng Khng ng c v au
Ra m hi ++
T.M .H N G
H.HP P h i tro n g .
T.MCH M c h 1 20 Kng nh
80
Huyl p T in g lim I, II khng ling thi
T.HA b n g q u an g c n g rn li rn
N.DC
Q u a Irc trng: tuyn lin l p lo, m m .
T.KINH
Khng p h t h i n bl thng
CHN ON
(1 ) ti u c p d o p h ii tu y n ti n l p
(2) Rung nhi nguyn n h n
X TR
An (hn
t)l ng thng
Mi bc si k h m cho b n h n h n

T he follow ing n o te s w e r e a d d e d a f te r Cc ghi ch di y c b sung saukh
c a th e te r isa tio n : t n g thng:
urinalysis 3+ sugar
M ANAGEM ENT
Rx digoxin 0.25 mg daily

metformin 500 mg t.d.s
X T N G H I M
Phn tch nc tiu ng 3+
X TR
D ng digoxin 0,25 mg Hng ngy
metformin 500 mg 3 ln/ngy
W h a t a d d i tio n w o u ld y o u m a k e to t h e Bn m u n ghi th m gi vo phn chn

D iag n o s is se ctio n ? on?
W rite a le tte r to M r H u d s o n ' s d o c t o r , Hy vit th cho bc s Watson (bc s! c

Dr W a tso n , e x p la in in g y o u r fin d in g s. ng Hudson) gii thch cc pht hin
ca bn.
U nit 5 Bi 5
Investigations Xt nghim
Section 1 Explaining and discussing investigations

P h n 1 Gii ngha v tho lun c c xt nghim
Task 1 ^ Bi lm 1
In T a sk 2 y o u will h e a r a h o s p i t a l d o c Trong Bi lm 2 bn s nghe m t bc s
to r p r e p a r i n g a p a t i e n t for a l u m b a r bnh vin chun b chc d ty sng cho
p u n c t u r e . T h e p a t i e n t h a s b e e n ill for a m t bnh nhn. Bnh n h n m mt
w e e k w ith h e a d a c h e s a n d a t e m p e r a tun l km nhc u, v st sau nhim
t u r e follo w in g a r e s p i r a t o r y in f e c tio n . trng ng h h'p. Khm bnh thy c
E x a m in a ti o n s h o w s n e c k stiffness. cng. Trong trch on ny bc s hng
D u rin g t h e e x tra c t t h e d o c t o r i n s t r u c t s dn bnh n h n ly t th ng chc d
th e p a t i e n t to ta k e u p t h e c o r r e c t p o s i ty sng. Bn hy d on li hng dn
tio n for t h e l u m b a r p u n c t u r e . T ry to ca bc s t n h n g u mi di y. Mi
p r e d ic t h e r i n s t r u c t i o n s f ro m t h e s e khong trng c th thiu m t hoc
clu es. E ach b l a n k m a y r e p r e s e n t o n e nhiu t.
or s e v e r a l m is s in g w o rd s .

1 N o w I w a n t you to m o v e rig h t to B y g i ti m u n n g n h c h q u i p h u phi
the edge o f the bed. n st m p ging.
2 Lie on ................................ Hy n m .............................
3 N ow can you b e n d b o th y our By gi ng c th co c hai ...........

? c khng?
4 Put your h e a d .................................. Dt u .............................
5 Curl ................................... C u n ..................................
6 Lie ................................. N m .............................
Task i B 0 Bi lm 2
Listen to t h e e x tra c t a n d c h e c k y o u r Hy lng nghe trch on v i kim tra ck
p re d ic tio n s. d on ca bn.

I n th e ex tra ct a b o v e t h e d o c t o r tr ie s to Trong trch on trn bc s mun thc
d o th r e e things. hin ba iu.
1 Explain w h a t sh e is g o in g to d o a n d Gii thch diu b ta sp lm v nu ldo
why. ti sao.
- N ow I'm going to ta k e s o m e fluid off E y g i ti s ly ra cht d|ch Kmg ng
y o u r b a c k to f i n d out w h a t 's g iv in g tm x e m ti sao ng tM nhc du
y o u th e s e h e a d a c h e s .
2 In stru c t th e p a tie n t to ta k e u p th e Hng d n b n h n h n nm dngtth.

correct positio n.
- v V o w /u jan /ô u /o m o v erig h tto th e B y gi ti m u n n g nhch qua phb
e d g e o f th e b e d . phi n st m p giung.
3 R e ass u re th e p a tie n t a b o u t t h e i n Trn an b n h n h n v vic xt nghim.

vestigation.
- I t w on't take very long. V ic n y kh n g lu qu u.
- N o w I 'm g o in g to g iv e y o u lo c al By gi ti s gy v c m (gy t) tai ch
a n a e s th e ti c so it w o n 't b i sore. c h o ng, n h t h s kh n g au nB.
1 1 4 - E nglish in M e d ic in e
Task 3 ^ Bi lm 3
H ere is p a r t o f a d o c t o r ' s e x p l a n a t i o n y l m t don gii ngha ca bc s khi
during a s t e r n a l m a r r o w in v e s tig a tio n . thc hin chc ty xng c xt
The e x p l a n a t i o n h a s b e e n p u t in t h e nghim . Li gii thch c xp t
/vrong o r d e r . T ry to r e a r r a n g e it. khng n g th t. Bn hy sp xp li.
0 N o w I'm g oing to give you an in jec By gi ti s tim cho ng thuc v r m
tion o f local a n a e s th e tic . F irst in to (gy t) li ch. u tin s tim vo da
th e sk in a n d th e n in to th e bone. ri sau d vo xng.
o) T h e n we'll p u t a d r e s s i n g o v e r t h e Sau ti s dp thuc trn vng tim.
area.
:) N o w th e n e x t t h in g I'm g o in g t o d o By gi ti s dt mt chic khn, mi
is to p u t a tow el, a clean tow el, o v er khn sch, trn vng tim.
th e area.
I'd) First o f all, I'm ju s t g o ing to w a s h Trc lin, ti s ra vng tim bng cht
J the area w ith a bit o f a n tise p tic, thuc st trng.
e) Ju st g oin g to r e m o v e th e n e e d le By gi s rt kim ra khi ngc.
from y o u r chest.
0 N o w w e're rea dy to d o th e actu al By gi chng ta s.n sng tin hnh
test. xt nghim ny.
t
g) N o w I'm g o in g to r e m o v e th e actual By gi ti s ht ly cc t bo t xng
cells from y o u r bone. ra.
: Language focus 13 Trng tm ngn ng 13

D o c to r s o f te n c o m b i n e r e a s s u r a n c e Cc bc s thng kt hp trn an vi li bo
i w i t h a w a r n in g . S tu d y t h e s e e x a m p l e s trc. Hy nghin cu cc v d sau y
fro m a s t e r n a l m a r r o w in v e s tig a tio n : trong vic xt nghim chc ty xng c:
- It s h o u l d n ' t b e p a in fu l, but yo u w ill Se khng au, nhig n g s cm th y

be aw are o f a feelin g o f pressure. hi nng.
- This m ay fe c i a little b it uncomfortable, C th cm th y hi kh chu, nhng
b u t it w o n 't ta k e lo n g . khng lu du.
Task 4 I3DI s Bi lm 4
W ork in pairs. P ra c tis e p r e p a r i n g a p a Hy lm vic theo i. Thc tp chun b
ti e n t for t h e fo llo w in g in v e s tig a tio n s . b n h n h n cho n h n g xt nghim sau
E xplain, in s t ru c t, r e a s s u r e a n d w a r n y. Gii ngha, hng dn, trn an v bo
w h ere necessary. trc khi cn thit.

1 ECG / man, 68 / ? m yocardial i n Din tm d / d n ng, 68 tui / nh)
farction m u c tim?
2 b arium meal / w o m a n , 23 / ? d u o ung bari / ph n, 23 tui / lot l

denal ulcer
3 Crosby capsule / girl, 6 / ? coeliac nang Crosby / b gi, 6 tui / bnh dai
disease trng?
4 u ltra s o u n d scan / w o m a n , 2 6 / siu m / ph n, 26 tui / (hai nhi dl 32
baby small for d ates at 32 w ee k s tun tui
5 m yelogram / m an, 53 / c a r p e n te r / ty rt / n ng, 53 tui / th mc /li
? p rolapsed in te rv erteb ral disc a m t sng?
W he n you h a v e finishe d, c o m p a r e Khi bn lm xong, hy so snh nhng

vour e x p l a n a tio n s a n d i n s t r u c tio n s li gii thch v hng d i n ca bn vdi
with the recordin g. bng ghi m.
Task 5 S Bi lm 5
S tudy this list o f in v e s tig a tio n s for a Nghin cu bng k cc xt nghim cho
4 3 -yea r-old s a le s m a n w h o p r e s e n t s m t doanh n h n 43 tui c huyt p
w ith a b lo o d p r e s s u r e o f 200 o v e r 130. 200/130. Sau , xp vo ba nhm dui
T h e n list t h e m in th e th r e e c a te g o r ie s y.
below.
b ariu m meal ung bari

chest X-ray c h p X-quang phi
creatin in e creatinin
ECG din tm
IVP (IVU) c h p b thn qua tnh m a ch (chp
Hng niu qua tnh m ch)
MR1 scan o f the brain c h p hnh n h cng hng t vingno
rad io iso to p e stu d ie s nghin cu dng v phng xa
s e ru m cholesterol cholesterol hyt thanh
s e ru m th y ro x in e Ihyroxin huyt thanh
urea an d electro ly tes ur v c c c h l in g iii
uric acid acid uric
urinalysis xt ng h im nc tiu
Essential Not required
N o w lis ten t o t h r e e d o c t o r s d i s c u s s i n g . By gi hy lng nghe ba bc s tho lun

this c a s e a n d t h e in v e s tig a tio n s . N o te trng hp ny v cc xt nghim. Ghi
h o w th e y g r o u p t h e in v e s tig a tio n s . n h n cch h xp loi cc xt nghim.
H ave y o u g r o u p e d t h e m in t h e s a m e Bn c xp loi ging n h cch khng?
way?

N ote th e s e e x p r e s s io n s u sed b e tw e e n Ch cc t ng c c c bc t ni l i
doctors in d is c u s s in g a c h o i c e o f in v e s- nhau khi tho lun chn la cfc
tig a tio n s . n g h i m .
Essential Possibly useful N ot required
sh ould could need not

m u st
be + requ ired be + n o t necessary
essential n o t required
im p o r ta n t n o t im portant
indicated
Essential not Co do
shou ld n o t
m u s t not
be + con tra in d ic ate d
C n th i t C I h h u c h Khng cn thit
nn c ih khng cn
phi
l + c n th i t l + k h n g c n ihit
th i t y u k h n g i hi
q u a n trng k h n g q u a n trong
c h n h
N h t t h i t k h n g l m
khng nn
k h n g c
l + c h n g c h n h
For e x a m p le : V d:
- T h e p a t i e n t should b e g i v e n a n X- Nn chp X-quang cho bnh nhn

ray.
- It im portant to g iv e a n X -r a y . iu quan trng l chp X-qang.
- A n X - r a y in d ic a te d (form al). ch dnh chp X-quang (qui uc).
Task 6 w Bi lm 6
S tu d y t h e s e b r ie f c a s e n o t e s a n d Hy nghin cu cc ghi ch tm lc di
c h o o s e o n ly t h e m o s t a p p r o p r i a t e i n y v ch chn la nhng xt nghim
v e s tig a tio n s f r o m t h e list w h i c h f o l thch hp nh t trong bng lit k km theo
low s e a c h c a se . A d d a n y o t h e r mi trng hp. B sung thm nhng xt
in v e s tig a tio n s y o u th i n k e s se n tia l. nghim khc khi bn thy cn thit!
T h e n w o rk in p airs. T a k e t h r e e c a s e s Sau , lm vic theo i. Dng tng ba
e a c h . E xplain to e a c h o t h e r y o u r trng hp mi ln. Hy gii thch vi
c h o i c e o f in v e s tig a tio n s for t h e s e p a nhau vic bn chn la cc xt nghim
tients. cho n h n g bnh n h n ny.
I.
SU RNA M E G umley F IR S T N A M E S John
O C C U P A T IO N Electrician
Coughing up blood. Has te m p. Smoker.
O /E
finger clubbing, air entry ^ L mid zone
H C um ley TN John
TUI 60 G II N am T N H T R N G H N N H N C v
N G H N G H I P Th in
LI K H A I B N H H I N N A Y
Ho ra mu. st. C ht thuc.
TH M KHM
T n g tr n g
Ngn tay di trng, th ht V vng gia phi tri
c h e st X -iay ch p X-quang phi

bronchoscopy soi p h qun
u rinalysis xt nghim nc tiu
s p u t u m c u l tu r e cy m
s e r u m p r o te i n s . protein huyt thanh

2
SURNAME S h a rp F IR S T N A M E S Em m a
AGE 43 SEX F MARITAL S T A T U S M
OCCUPATION H o u s e w ife
a b d o m in a l p a in , h e a v y p e rio d s
O/E
G eneral C on d itio n
H S h a rp TN Emma
TUI 41 GII N TNH T R N G HN NHN C chng
NGH N G H I P Ni tr

D a u v n g b n g - K in h n g u y t n h i u
THM KHM
Tng trn g
pelvic u l t r a s o n o g r a p h s i u m v n g c h u
Hb h e m o g lo b in
EUA and D & c khm c g y v c m (g y m ) v n o n g v nao

chest X-ray c h p X -q u a n g p h i
LFTS th m d ch c n n g ph i
3.
SU RN A M E Donaldson F IR S T N A M E S Grace
AGE 23 SEX F M A R IT A L S T A T U S s
O C C U P A T IO N Schoolteacher
agitation, difficulty in s le e p i n g ,^ appetite
wt
O /E
warm, sw eaty skin, tachycardia, soft goitre with bruit
H Donaldson TN G race
TUI 23 G I I N T N H T R N G H N N H N cth n
1 N G H N G H I P Gio vin
LI K H A I B N H H I N N A Y
v lt v, kh n g ,T n ngon
^ st cn
THM KHM
T n g tr n g
vui v, da m m hi, nhp tim n h an h , bu c m m km ting ihi
a n g io g ra m ch p m ch mu
C A T scan o f skull ch p ct lp in ton hp s
s e r u m th y r o x in e thyroxin huyt thanh
TSH hormon klch tuyn gip

4.
S U R N A M fe Pritt FIRST NAMES W illia m
AGE 44 SEX M MARITAL STATUS D
O C C U P A T IO N Printer
abdominal pain after ealing falty foods
O /E
G e n e r a l C o n d itio n
obese ++, tender R hypochondrium
H Priti TN William
TU I 44 GII T N H Nam T N H T R N G HN NHN Ly d
N G H N G H I P Th in
au bung sau khi an (hc p h m c m
TH M K H M
T n g tr n g
m p ph ++, ha sn phi m m
c h o le c y s to g ra m c h p X-quang li mt
M S xt n g h i m nc tiu gia dng
b a riu m m eal ung bari
ECG i n t m
e n d o sco p y ni soi
a b d o m in a l u ltra s o n o g ra p h siu m bng
5.
SU RNA M E Scoll F IR S T N A M E S Barry
AGE 2 '/2 SEX M M A R IT A L S T A T U S
O C C U P A T IO N
sore lliroat, mother says he has a temp, and rash
O /E
G e n e r a l C o n d i t io n ,
occipital glands enlarged and tender, maculopapular rash behind ears and
spreading down trunk
H Scolt TEN Barry
TU I 2 '/2 G I I N am T N H T R N G H N N H
N G H N G H I P
LI K HAI B N M H I N N A Y
au hng. M khai b c st v ni ban
THM KHM
T n g tr n g
*:c hch vng c h m to v m m , ni ban sn cc sau hai tai v lan xung llin
ngi
chest X-ray ch p X-quang phi

throat sw ab ngoy hng
serum iron st huyl thanh
m o n o sp o t du n lam knh
viral a n tib o d ie s khng th chng virus
full b lo o d c o u n t cng (hc mu ton plin

6.
SURNAME Lock_____________________FIRST NAMES Mary
AGE 68 SEX F___________________ MARITAL STATUS Sgp
O CCUPATION Retired waitress_________________________________
dull ache above R eye, sees haloes round lights
O/E
G e n e r a l C o n d i t io n
hazy cornea, pupil half-dilated an d fixed
H Lock TN M ary
TUI 68 GII N TNH TR N G HN NHN Ly thn
NGH NG H I P Hu bn nghi hu
LI KHAI BNH HIN NAY

au m trn mt phi, nhn thy qung sng quanh n
THM KHM
T n g tr n g
gic m ac m, ng t rn na v c nh
to n o m e try do n hn p
sw ab from c o rn e a to b acteriology pht gic mc x! nghim vi khun
skull X-ray ch p X-quang s
124 - E ng lish in M e d ic in e
Task 7 ( S S Bi lm 7
W ork in pairs. S tu d e n t B s h o u l d start. Lm vic theo i. Sinh vin B bt u
trc.
A: Play th e p a r t o f th e p a t i e n t for o n e A: ng vai bnh n h n m t trong su
of th e six ca se s abo ve . In c a s e 5 y o u trng hp trn. Trong trng hp 5
a r e a p a r e n t. You w a n t to k n o w bn ng vai b, m. Bn m un bit
w h y th e in v e stig a tio n s a r e r e v sao cc xt nghim li cn thit, cc
q u ired . w h a t th e in v e s tig a tio n s i n xt nghim lin quan n chuyn
volve, a n d if t h e in v e s tig a tio n s will g v liu c lm au khng.
b e painful.
B: Play th e p a r t o f th e d o c to r. Explain B: ng vai bc s. Gii thch rn g cc
th e in v e stig a tio n s r e q u ir e d a n d xt ng h im l cn thit v tr li mi
a n s w e r a n y q u e s t i o n s raised. cu hi nu.
W hen you h a v e fin ish e d , c o m p a r e Khi bn lm xong, hy so snh nhng

your e x p la n a tio n s w ith th e re c o rd in g . gii thch ca bn vi bng ghi m.
Section 2 Using medical documents

P h n 2 s dng c c ti liu y hc
Task 8 s Bi lm 8
Listen to th is t e l e p h o n e call f r o m a Lng nghe cuc ni chuyn in thoi t
h a e m a to lo g y lab to a d o c t o r ' s su rgery . phng xt nghim huyt hc ti phng
As y ou listen, r e c o r d t h e re s u lts o f th e khm ca bc s. Trong khi nghe, bn cn
in vestig a tio n s in t h e c o r r e c t s p a c e s o n ghi n h n cc kt qu xt nghim vo
the form b elow . T h e p a t i e n t is M r n g cc khong trong m u (li y.
Kevin Hall (see U n it 1, p p. 18 a n d 24). Bnh n h n l ng Kevin Hall (xem Bi 1.
trang 18 v 24).

TELEPHONE REPORT FROM
HAEMATOLOGY LABORATORY
P A T IE N T S N A M E U NIT NO
B L O O D FILM
W B C X 10*/L NEUTRO %
H b g/dl ................. LYMPH %
H cl MONO %
M C V fl E O S I N O .................. %
P late lets X 10*/L BASO %
E S R mm
OTHER INFORMATION
P R O T H R O M B IN R A T I O .......................................................... 1
T IM E M E S S A G E R E C E I V E D ................................4 M /P M
M E S S A G E R E C E IV E D B Y ..................................................
D A T E R E C E I V E D .....................................................
126 - E nglish in M ed icin e

BO CO IN THOI T PHNG
XT NGHIM HUYT HC
TN B NH NHN D n V| S
C N G TH C M U
S L NG B C H C U X 1 0 */L B C H C U T R U N G T N H ............ %
H em oglobin g/dl :............................... L IM P H B O ...................................... %
H e m a to c rite ......................................... B C H C U M T N H N ................ %
T h tch t bo trung b in h ............ B C H C U T O A N T N H ................ %
Tiu cu X 10*/L ............................... B C H C U K I M T N H ................. %
T C L N G M U m m .............
T H N G T IN K H C
T L P R O T H R O M B IN ........................................................................................................................ :1
G I N H N X T N G H I M ........................................................................................ S A N G /C H I U
N G I N H N ..........................................................................................................................................
N G Y N H N ..............................................................................................................................................
Task 9 O Bi lm 9
S tudy th e clinical c h e m i s t r y r e s u lts for Nghin cu cc kt qu ha hc lm sng
Mr Hall w h i c h a r e s h o w n o n t h e fo rm ca ng Hall dc ghi nhn trong mu
below. In a d d i t i o n to t h e s e re su lts , t h e di y. Km th m vi cc kt qu ny,
p a t ie n t 's u r in e s h o w e d : a l b u m e n ++, xt ngh im nc tiu bnh nhn cho
a n d a tr a c e o f glucose. thy: albumin + + , v c vt glucose
(ng).

DEPARTMENT OF CLINICAL BIOCHEMISTRY
SOUTHERN GENERAL HOSPITAL, NHS TRUST
GP 5487 HALL, KEVIN 30/04/62 M

DR WATSON HEALTH CENTRE. NEWTOWN
Date Collected 25/05/94

Time . 00.00
Date Received 25/05/94
Time . 13.15
Spec 74627
No.
S/P1 SODIUM 158

(135-145) mmol/l
S/P1 POTASSIUM 6.2
(3.5-5) mmol/l
S/P1 CHLORIDE 96
(95-105) mmol/l
S/P1 C02 16
(21-26) mmol/l
Serum/P1 UREA 50.1
(3.3-6.6) mmol/l
TOTAL PROTEIN 71
(60-80) S/I
S/P1 CREATININE 0.09
(.07-0.11) mmol/l
S/P1 GLUCOSE 5.1
(3.9 5.0)
COMMENTS
Report printed on 26-May-94 8:38:30
128 - E n g lish in M e d ic in e
KH OA S IN H HA H C LM SN G
B N H V I N T N G Q U T P H A NAM, C N G TY N H S
Bc s tng qut 5487 HALL. KEVIN 30/04/62 Nam

B.s WATSON TRUNG TM SC KHE. NEWTOWN
Ngy thu 25/05/94

Gi thu 00:00
Ngy nhn 25/05/94
Gi nhn 13.15
Chuyn khoa 74627
S'
Huyt thanh/mi lt NATRI 158

(135-145) mmol/l
Huyt thanh/mi lit KALI 6.2
(3,5-5) mmol/l
Huyt thanh/mi lt CLOR 96
(95-105) mmol/l
Huyt thanh/mi lt C2 16
(21-26) mmol/l
Huyt thanh/mi lt UR 50,1
(3.3-6,6) mmol/l
PROTEIN TON PHN 71
(60-80) s/l
Huyt thanh/mi lit CREATININ 0.09
(0.07-0,11) mmol/l
Huyt thanh/mi lt GLUCOSE 5,1
(3,9-5,0)
BN LUN
Bo co in ngy 26 thng 5.94 lc 8:38:30
Identify w h ic h o f t h e s e r e s u lts a r e o u t Xc nh kt qu no trong s l khng

side th e n o r m a l r a n g e a n d d e s c r ib e bnh thng v m t tng kt qu c
e a c h o f t h e s ig n ific a n t r esu lts. T h e s e ngha. Cc t sau y c th hu ch:
w o rd s m a y b e useful:
low thp high cao abnorm al bt thng
red u ced gim raised tng
elev a ted ln c a o
For e x a m p le : V d:
- Blood urea abnorm ally high. Ur m u l cao bt thng.
English in M e d ic in e - 129
Task 10 ^ Bi lm 10
Kevin H all's GP p h o n e s t h e h o s p it a l to Bc s tng qu t ca n g Kevin Hall in
a r r a n g e for h is a d m i s s i o n . Fill in t h e thoi n bnh vin thu xp cho ng ta
g a p s in his call u s in g t h e i n f o r m a t i o n nhp vin. B sung y vo cc on
fro m t h e h a e m a t o l o g y lab, t h e clinical ngt qung ca cuc in m bng cch
c h e m is tr y resu lts, a n d t h e i n f o r m a s dng thng tin t phng xt nghim
tio n given in T a sk 9. A d d y o u r o w n d i huyt hc, cc kt qu ha lm sng, v
ag nosis. thng tin ghi trong Bi lm 9. Chi thm
phn chn on ca ring bn.
DOCTOR: I'm p h o n i n g a b o u t a 32-year- BS: Ti d a n g d i n thoi ni v mt ngi

old m a n . I s a w h im a year ago w h e n he n n g 3 2 tui. C c h y m t n a m li
................... ( 1) o f h e a d a c h e s w h ic h c khm cho ng la ......................... (1 )
h ad b e e n tr o u b lin g h im for t h r e e v n h c d u lm ng ta m t miut
m o n th s . O n e x a m in a tio n h e w as ba thng. Khi khm , Ang ta b
................... (2) to h a v e a b lo o d p r e s ......................... (2) c h u y t p 1 8 0 trn
s u r e o f 180 o v er 120. U rin aly sis w a s 120. X t n g h i m nuc tiu th
....................(3), E C G a n d c h e s t X -rays ...........................(3), i n tm d v ch p
w e r e also n o rm a l. H e w a s c o m X -q u a n g p h i u b in h th n g. B nh
m e n c e d o n a b e t a ..................... (4) an d n h n dc bt du b n g c c h beta
....................(5) b u t h is b lo o d p r e s s u r e ............ (4) v .........(5) nhng huyt p
re m a in e d slightly ............................ (6). ca ng ta vn hi ........................... (6 ).
O n a re c e n t visit h e c o m p la i n e d T rong ln k h m g n y , n g ta ku
o f n a u s e a , v o m it in g a n d h e a d a c h e s. b u n n n , i m a v n h c u . H uyt
His b lood p r e s s u r e w a s 160 o v e r 120, p c a n g ta l 1 6 0 trn 1 2 0 ; xt
u rinalysis s h o w e d .............................(7) n g h i m nc tiu cho t h y ................ (7)
p lu s p lu s a n d a trac e o f glucose. I've c n g c n g v v t g lu c o s e . Ti va n h n
ju s t receiv ed his lab r e su lts. H is h a e c nhng kt qu xl nghim ca
m o g lo b in is ........................(8), ESR ng y. H emoglobin l ................... (8),
..................... (9). B lo o d film s h o w e d tc lng m u ..................... (9). Cng
p o ikilocytosis p lu s and th c m u c h o ih y t b o b i n d n g
..................... (10) cells p lu s p lu s. Blood cng v ................(10) lng l b o cng
urea w as .....................( 1 1 ) raised, cng. Ur m u l .................... (11) tng,
................ (1 2 ) , s o d iu m 158, p o ta s ~ ......... (1 2 ), so d iu m 1 5 8 , Kali 6 ,2 ,
siu m .................6 .2 , b ic a r b o n a te bicarbonat .................. (13).
................. (13).
I'd liKe to a r r a n g e his u r g e n t a d Ti mun thu xp ng ta c
m is s io n for in v e s tig a tio n a n d t r e a t n h p v i n c p cu n h m x t n g h i m
m e n t o f ....................(14). v i u tr v ....................... ( 14).
1 30 - E n glish in M e d ic in e
Task 11 ^ Bi lm 11
Look b a c k a t t h e c a s e o f P e te r G r e e n in Xem tai trng hp Peter Green trong Bi
Unit 1. p. 26. R e re a d t h e l e tte r fro m his 1, trang 26. Hy c li cc ghi ch v
his GP a n d h is c a s e n o te s . List t h e i n trng hp ca ng ta v bc th c a bc s
vestig a tio n s y o u w o u l d c a r r y o u t o n tng qut ca ng ta. Lit k cc xt
this p a tie n t. T h e n s t u d y t h e follo w in g ng h im bn m un tin h n h cho bnh
h a e m a to lo g ic a l, clin ic al c h e m i s t r y n h n ny. Sau nghin cu cc kt qu
an d ECG (V5 only) r e s u lt s for M r xt n g h i m mu, ha lm sng .v in
Green. W rite to his GP, D r C h a p m a n , t m (ch! ring V5) ca ng Green. Vit
an d d e s c r ib e y o u r fin d in g s. th cho B.s Chapm an, B.s tng qut ca
ng ta v m t n h n g iu bn pht
hin.
D e p a rtm e n t of Clinical and Laboratory Haematology
Southern General Hospital
A 15635 26 G R E E N .P E T E R 0 8 /0 8 /5 3 M
D R CH A PM A N H E A L T H C E N T R E . A PPLECRO SS 1
D ate 0 7 /1 0 /9 5
T im e 10.59
S pecim en No. 0462Q
Haemoglobin 148
(120-180 g/i)
Haematocrit 43.1
(40%-54%)
Mean Cell Vol 100
(78-98 fl)
Platelet C ount 264
(150-400 X I O/I)
Total WBC 7.1
(4-11 X 10V1)
D ifferen tial W BC
N eutrophils 7.4
(2.0-7.5 X lO/l)
Lymphocytes 1.7
(1.5-4.0 X lO/l)
Monocytes 0.6
(0.2-0.8 X lO/l)
E o s in o p h ils 0.1
(< 0 .7 -I0 ,/l)
Basophils 0.0
(< 0 .2 X lO/l)
Myelocytes
Promyelocytes
Blast Cells
NRBC/100 WBC
E.S.R.
(lmm-9mm/hr)
Reticulocytes
(10-100 X 10V1)
B lo o d f ilm C o m m e n t / R e s u lt s :
(REMOVE A PPR O PR IA T E PR EV IO U S R EPO R T BEFORE FILING IN CASE N O T E S)
Khoa Huyt hc lm sng v Phng xt nghim Huyt h c
Bnh vin tng qut pha Nam
A I563526 GREEN. PETER 0 8 /08/53 Nam
US. CHAPMAN. TRUNG TM sc KHE, APPLECROSS
Ngy 07/10/95
Gi 10.59
Mu s U462Q
Hemoglobin 148
(120-180 f j I)
Huy sc l' 4.1.1
l4%-54%)
Th lch t bo Irung bnh 100
(78-98 fl)
Lng liu cu 264
(150-400 X 109/l)
Tng lng bdch cu 7.1
(4-11 X 10/1)
Lng bch cu phn bit
Trung linh T,4
12,0-7,5 X 10*71)
Limph bdo 1.7
(1 .5 -4 ,0 X 1 0 /1)
MI nhn 0.6
(0.2-0.8x 1 0 / 1)
Toan linh 0.1
(<0,7-10 9/ll
Kim linh 0.0
(<(),- X 10V/I)
Ty bo
Tin ty Lmo
Nguyn bo
Lng hng cu/100 b<jch cu
Tc d lng mu
(1mm-9mm/gi)
Vng bo
(10-100 X io7n
N hn xt cng thc m u/kt qu:
(LY RA BN BO CO THCH DNG SN c TRC KHI X> VO CHI CH.)
E ng lish in M e d ic in e - 133
DEPARTMENT OF CLINICAL BIOCHEMISTRY !
SOUTHERN GENERAL HOSPITAL, NHS TRUST
GP 1563526 GREEN. PETER 08/08/53 M

DR. CHAPMAN HEALTH CENTRE. NEWTOWN
Date Collected 07/10/95

Time 00.00
Date Received 07/10/95
Time 16.13
Spec 35931
No.
S/P1 SODIUM 137

(135-145) mmol/l
S/PI POTASSIUM 4.6
(3.5-5) mmol/l
S/P1 CHLORIDE 96
(95-105) mmol/l
S/P1 C02 22
(21-26) mmol/l
Serum/P1 UREA 3.6
(3.3-6.6) mmol/l
TOTAL PROTEIN 71
(60-80) S/I
S/P1 CHOLEST'OL 7.2
(3.9-6.2) mmol/l
S/P1 TRIGLYC'DE 1.61
(.8-2.1) mmol/l
HDL CHOLESTEROL 1.09
(.9-1.4) mmol/l
COMMENTS
Report printed on Q7-Oct-95 12:27:30
134 - English in M e d i c in a
KH O A S IN H H A HC LM S N G
B N H V I N T N G Q U T PHLA NAM , CNG TY N H S
Bc s tng qut 1563 GREEN, PETER 08/08/53 Nam

B.s CHAPMAN, TRUNG TM sc khe. NEWTOWN
Ngy thu 07/10/95
Gi thu 00:00
Ngy nhn 07/10/95
Gi nhn 16.13
Chuyn khoa 35931
s'
Huyt thanh/mi lit NATRI 137

(135-145) mmol/l
Huyt thanh/mi lt KALI 4.6
(3,5-5) mmol/l
Huyt thanh/mi lt CLOR 96
(95-105) mmol/l
Huyt thanh/mi lt C2 22
(21-26) mmol/l
Huyt thanh/mi lt UR 3,6'
(3,3-6,6) mmol/l
PROTEIN TON PHN 71
(60-80) s/l
Huyt thanh/mi lt CHOLESTEROL 7,2
(3,9-6,2) mmol/l
Huyt thanh/mi lit TRIGLYCERID 1,61
(0.8-2,1 ) mmol/l
Cholesterol (lipoprotein t trng cao) 1,09
(0,9-1,4) mmol/l
BN LUN
Bo co in ngy 07 thng 10-95 lc 12:27:30.
Before exercise Immediately after exercise

V5 Trc khi vn d n g V5 N gay sau khi vn d n g
English in M ed icin e 135
Section 3 Reading skills: Reading articles 2
P h a n 3 K nng c: c cc bi bo 2
Task 12 ^ Bi lm 12
T h e s e h e a d i n g s a re c o m m o n l y used in Cc ta ny u thng c dng
British m e d ic a l jo u r n a l s . N u m b e r trong cc bo y hc Anh. Hy nh s
th e m in t h e o r d e r y o u w o u l d e x p e c t theo th t m bn d on cc bi
t h e m to fea tu re . c da ra.
R e su lts Kt qu.i
S u m m a ry Tm lt
D iscu ssion Bn lun
P a tie n ts an d m e th o d s Cc b n h n hn v phng p h p
R eferences Ti liu tham kho
In tro d u c tio n N h p
A u th o r s C c tc gi
Title Ta d
Task 13 0 Bi lm 13
T h e s e b r ie f e x tra c ts f r o m a n a r tic le in Cc trch on ngn ny t m t bi bo
The L a n cet a r e lis te d in t h e o r d e r in trong The Lancet c xp th t theo
w h ic h m a n y m e d ic a l r e s e a r c h e r s r e a d nhiu nh nghin cu y hc c
s u c h articles. U se t h e list g iv e n in T a s k nhng bi bo tng t. Hy s dng
12 to id e n tify w h i c h p a r t s o f t h e a r tic le bng lit k Bi lm 12 xc nh
th e y a re ta k e n f r o m s o t h a t y o u can nhng phn no ca bi bo t d cc
work o u t th is r e a d i n g p r o c e d u r e . trch on dc ly ra, nh th bn
c th tm thy quy trnh c ny.
a)
M edical R esearch C oun Hi ng nghin hi y khoa

cil random ised trial o f xc nh th nghim ct ni
endom etrial resection mc t cung thay v ct t
versus hysterectom y in cung trong iu tr rong kinh
m anagem ent o f m enorr
hagia

Background The most frequent indication for Hin trng, c h i d jnh Ihng gp nhi cho vic
hysterectomy is menorrhagia, even though c l l c ung IA rong k in h , k c khi t c u n g vn
the uterus is normal in a large number of pa binh Ihng Irongda scc bnh nhn, c l ni
tients. Transcervical resection of the en m<ic l cung qua c l cung l mt phng Ihc
dometrium (TCRE) is a less drastic alternative. km Iril d hn. nhng mc d thnh cng
but success rates have varied and m enor Ihng ih a y i v rong k in h c th ti ph t.
rhagia can recur. W e have tested the hypothe Chng (i kim tra gi thuyt cho ring s
sis that the difference in the proportion of khc bil trong l l cc ph nkhng dc hi
women dissatisfied and requiring further sur l n g v c n c p h u Ih u l ih rn Iron g v ng 3
gery within 3 years of TCRE or hysterectomy nA m ca k Ih u l c l ni in a c qua c t cung
would be no more than 15% h o c ct t c ung s kh n g V1 q u 1 5 % .
Methods 202 women with symptomatic me Phng php. 202 ph n c triu cling rong
norrhagia were recruited to a multicentre, ran k in h cl dc thu n h n Iron g m l th n g h rm cla
domised. conolled trial lo compare the two n g n h , ckrc xc clnh v k i m Ira d c so snh h ai
interventions. TC R E and hysterectom y were k ih u A l in d . c i n i in a c C|ufl c l c u n g V
randomly assigned in a ratio of two to o n e. The c l t Cling d dc ghi n h n tlic h i n ih e o t l
primary endpoints were wom en's satisfaction 1^ h a i so vi in l. c Ac y e ll l m u c li l (lu Il n l
and need for further surgery The patients' shAi lng ca cc ph I1 v scn thit phu
psychological and social states were moni lliul Ih m na. T n h trn g t m l v x lii ca
tored before surgery, then annually with a bnh nhn dcu dc fcln nhn trc khi phn
questionnaire. Analysis w as by intention (o thut vA sau hng nam qua cc cu hi . Vic
treat. p h n lc h n h m m c c h d cliti In .
Findings Data were available for 172 w o m e n Kt qu. Cc d liu (lu c gi tr cho 172 ph
(56 hysterectomy. 116 T C R E ); 26 withdrew n (5 6 c l t cung v I 16 CI ni mac qua c l
before surgery and (our w ere lost to follow-up cung), ^ 6 n il b p h u Ih ul v 4 khng ih eo di
Satisfaction scores w ere higher for hysterec dc. im s hi lng d CAO hn trong CI l
tomy than for T C R E throughout lollow-up (m e c ung so vi CI ni m ac qua c l c ung q u thi
dian 2 years). but the differences w ere not gidn theo di (lam gbn h 2 n in ) nhng sklicic
significant (at 3 years 27 (96% ] of 2 8 in hyster b it lai khn g c n g lid (cln 3 n .im th 2 7
ectomy group vs 46 [85% ] of 54 in T C R E group (9 6% ) trn 28 ngi lliuc nhm r l tcung 50
were satisfied; p=0 16). 25 (2 2 % ) w om en in vi 4 6 ( 8 5 % ) trn 5 4 ngi ihuc n h m cl ni
the TC R E group and rive (9 % ) in the hysterec m ac clu hi lng, p = 0 ,16). 25 (2 2% ) phu li
tomy group required further surgery (relative ilu i c n h m c i ni m a c qua c li cung v 5
risk 0.46 [95% Cl 0 -2 -1 1 ], p=0 0 5 3 ) T C R E (9 % ) Ihuc nhm c( t cung cn phi c phu
had the benefits of shorter operating time, Ih u tlh m na (ng uy ct ngdi 0 .4 6 |9 5 % C I
fewer complications, and faster rales of recov 0 ,2 -1 ,1 1, p=0.053). C i ni mac qua c l a m g
ery. c nhng thun li l thi gicin in ngn hn,
b i n ch ng l hn, v mc cl hi phc n h an h
ho n.
In terp reta tio n T C R E is an acceptable alter D i n g i i. C t n i ITMC 1|LM c t c u n g l,

native to hysterectomy in Ihe treatm ent of m e phngthcchp nhn dc so vi cl lcung
norrhagia for many w om en with no other Iro n g v i c d i u lr| ro n g k in h il i VI n h i v i p h u
serious disorders. n m khng gy nhng ri loan nghim trng
no khc.
English in M e d ic in e - 137
c)
G r e e n b u r y 25 s h o w e d a h ig h rate Creenburv cho thy c mOr do cao

of p s y c h ia tric m o r b i d i t y in p a t ie n t s v m c bnh tm ihn cc b n h nhn
a t te n d i n g gynaeco lo gical o u c p a tie n t a n g k c c p h n g k h m p h khoa
clinics w ith a c o m p la i n t o f m e n o r ngoai tr vi lfti khai bnh rong kinh
rhagia, w h e r e a s G a t h a n d c o l Irong khi Gth v cng s cho thy in h
le a g u e s s h o w e d th e bcncficial hng tt ca vic ct l cung cc
in flu e n ce o f h y s te r e c t o m y o n p a bnh nhn cng mang chng bnh d.
tie n ts w ith th is d is o r d e r . O u r s t u d y Nghin cu ca chng li xc nhn
has c o n f ir m e d th e se o b s e r v a tio n s nhng nhn xl v cng cho Ihy
a n d has also s h o w n th a t T C R E has rng cl ni m c l cung qua c l cung
an e q u a lly p o sitiv e effect o n p s y d d em I31 m( hiu qu ti ngang bng
chosocial w e llb e in g in w o m e n w ith cho sc khe tm thn d cc phu n b
m e n o rr h a g i a . rong kinh.
So how does T C R E com pare Nh vy so snh ct ni mac qua c

w ith h y s te re c t o m y ? W h e r e a s th e l cung vi ct t cung nh Ih no? Khi
use of T C R E as a n a lte r n a t iv e to vic s dng k thut ct ni mc qua c
h y s te r e c t o m y has been ques t cung nh mt phng thc thay cho
tio n e d ,2728 o u r re s u lts s h o w t h a t fo r ct t cung vn l mt cu hi thl cc kt
m o s t w o m e n w h o hav e m e n o r qu ca chng ti cho thy di vi da s
rhag ia w ith no o t h e r s e rio u s p a t h o l cc ph n bj rong kinh m kh ng km
ogy, T C R E is a g e n u i n e a l te r n a t iv e m t b n h l t r i m tr n g n o kh c th ct
to h y s te r e c t o m y . ni mac qua c t cung l mt phng
th c x c d n g (h a y c h o ct l cu n g .
d)
H y sterecto m y TCRE p value

(n = 56) (n = 116)
N u m b e r o f c a s e s w ith
fo llo w -u p d a ta
Year 1 4 6 / 5 2 (88%) 1 0 4 /1 1 2 (93% )
Year 2 3 8 / 4 5 (84% ) 8 6 /9 8 (88%)
Year 3 2 8 / 3 0 (93% ) 5 4 /6 1 (89% )
S a tis fie d w ith o u tc o m e

o f su rg e ry
Year 1 4 2 / 4 6 (91% ) 9 0 / 1 0 4 (87% ) 0 59
Year 2 3 6 / 3 8 (94% ) 7 4 / 8 6 (86%) 0 22
Year 3 2 7 / 2 8 (96% ) 4 6 / 5 4 (85% ) 0 16
T a b l e -4: F o l l o w - u p d e t a i l s
C t t c u n g C t n i m c t c u n g Tr g i p
(n = 5 6 ) q u a c t c u n g
( n = 1 16)
S c c trng h p k m
thi g ia n th e o d i
NAm 1 4 6 / 5 2 (8 8 % ) 1 0 4 / 1 1 2 (9 3 % )
N m 2 3 8 / 4 5 (8 4 % ) 8 6 / 9 8 (8 8 % )
N am } 2 8 / 3 0 (9 3 % ) 5 4 /6 1 (8 9 % )
H i l n g vi k t qu
phu th u t
NAm 1 4 2 / 4 6 (9 1 % ) 9 0 / 1 0 4 (8 7 % ) 0,59
Nm 2 3 6 / 3 8 (9 4 % ) 7 4 / 8 6 (8 6 % ) 0 ,2 2
NAm 3 2 7 / 2 8 (9 6 % ) 4 6 / 5 4 (8 5 % ) 0,16
Bng 4: C hi t i t t h e o d i
e)
Endometrial ablation w ith e le c tro s u r Ct b ni m c t cung bng din phu

gery, laser, o r o th e r fo rm s of the rm al lliut, laser lioc cc hnh thi khc ca
energy has been in tro d u c e d as a less nng lng nhit u dc s dng nh
invasive alternative to h y ste re cto m y mt phng thc bt hy hoi thay th
in the m a nagem ent of ab n o rm a l u t e r cho vic ct t cung trong iu tr chy
ine bleeding of ben ig n aetiology.1 mu t cung bt thng do bnh cn
Medical trea tm e n t of m e n o rrh a g ia is lnh tnh. iu Ir ni khoa chng rong
often ineffective. H y s te re c to m y is the kinh thng khng hiu qu. c t ( cung
most c om m on major surgical l phng thc phu thut ch yu
thng gp nht.
g)
1 M agos A L . M a n a g e m e n t o f m e n o r M agos AL. iu tri rong kinh. BM ) 1990;

rhagia. B M J 1990; 300: 1537-38. 300: 15 3 7 -3 8 .
2 Vessey MP, Villard-Mackintosh L, Vessey MP, Villard Mackintosh L. McPher

M c P h e rso n K , C o u lte r A. Y eates D . son K, Coulter A, Yeates D. Dich l hc ca
T h e epidem io lo g y o f h y ste re cto m y : p hu thut ct l cung: nhng kl qu trong
findings in a large cohort study. B r ] mt nghin cu cn g ng rogri. BrOb-
Obstet Gynaecol 1992; 99: 402-07 stel G ynaecol 1992; 99: 402-07
3 Magos AL, Baumann R, T urn b u ll Magos AL, Baumann R. Turnbull AC. ct
AC. Transcervical resection of e n ni m a r ( cung qua c l cung ph n
dometrium in women with m enor b rong kinh.AM/ 1989: 298: 1209-12
rhagia. B M J 1989; 298: 1209-12.
4 M a h e r P J, H ill D J. T ra n sce rv ic al e n Mdher P|. Hill DJ. c l ni m ar l cung
d o m e tria l resectio n for ab n o rm al qua c l cung vi chy mu l rung bl
u te rin e bleed in g : re p o rt o f 100 cases thng: trnh by 100 trng hp v binh
an d review o f th e lite ra tu re . A u s t N Z duyt y vn. bo Ausl N z I Obstel Cy-
] Obstet Gynaecol 1990; 3 0 :3 5 7 -6 0 . ndecol 1990; 30: 357-60.
s D e rm a n S G , R e h n stro m J, N e u w irth Derman s c , Rehnstrom I, Neuwirth RS.
R S . L o n g -te rm effectiv en ess of Hiu qu lu di ca
Task 14 ^ Bi lm 1 4
T h is is a n e x tra c t fro m t h e p a r t t h a t a y l m t trch on t m t phn m
r e s e a r c h e r c h o s e to r e a d next. W h ic h m t n h nghin cu chn la c tip.
p a r t is it? C o m p l e t e t h e e x tra c t b y a d d l phn g? B su n g vo trch on
in g o n e w o r d for e a c h gap. b n g cch in th m m t t cho mi ch
trng.
Patienrs were random ly assigned h y s Cc b nh nhn u c ghi nhn

terectomy ..................(I) T C R E at the p h u th u t c t t c u n g ................ (1) cl
time ............. (2) recru itm ent in the ni m c t cung qua c t cung thi
clinic................... (3) most cases several im .......... (2) lip nhn trong phng
w e e k s .............(4) th e ir p la n n e d s u rg e ry. khm, ......... (3) a s cc trng hp
I n d iv id u a ls ...............(5) a ssig n ed T C R E n h iu tun l ............. (4) c u c p h i u thut
and hysterectomy in a ratio of two ca h c ln k hoach. Nhng c
.................... (6) one because little infor n h n ............(5) dc thc h i n ct ni
mation .......................(7) .-lvnilable about m ac qua c t cung v ct t cung theo
the hysteroscopic procedure and mt t s l hai ...............(6 ) mt bi v
................(8) p ro to c o l w as felt to assist qu ! thng l i n .................. (7) c gi tr| v
re c r u itm e n t........................ (9) c o m p u te r lin (rnh soi t cung v ............. .(8) bn
generated ra n d o m -n u m b e r sequence qui c dc xem xt d thu nhn
was used.............................. ( 10) code for ................. (9) m y vi tn h ta o m s d
which was kept .........................( 11) the dc s dng ............... ( 10) m s cho
Royal Free Hospital, London. W hen vn d dc g i ............(1 1 ) bnh
.....................( 12) appointm ents for s u r vin min ph Hong gia, London. Khi
gery, the recruiting physician tele .............(12 ) cc quyt nh cho phu
phoned ................. (13) coordinating ihut, bc si nhn b n h nhn din
c en tre a n d .....................(14) w ere given thoi .................(13) trung tm diu
the next treatment ............... (15) the phi v ............(14) c bit cch iu
tr lip s a u ............... (1 5) k hoch tlic
ran d o m isatio n sch ed u le. P a tie n ts w ere
h i n . Cc1c b n h n h n d u (lc k h u y n
fully counselled ......................... (16)
co dy d .............(16) ct ni mc
T C R E and hysterectomy before
qua c l cung v ci l cung trc khi
.......................(17) w ere asked to give
.....................(1 7) dc hi d lh.1 ihuîn
their consent ......................... (18) ran
......................(18) vic llic hin. Cuc
domisation. T he study was approved
nghin c.u dc ch p ihun
.......................(19) th e e th ic s c o m m itte e s ................(19) Hi dng dao l ti
at .....................(20) th e p a rtic ip a tin g .................. (20) cc b n li v i n tha m d.
hospitals.
Section 4 Case history: W illiam Hudson

P h n 4 Bnh n: W illiam Hudson
Task 15 ^ Bi lm 15
Mr H u d so n h a d a tr a n s u r e t h r a l r e s e c n g Hudson c ct b tuyn tin lp
tion of his p ro state. His d i a b e t e s w as q u a ng n i u do. B nh ti u ng ca
controlled by d iet a n d oral h v p o g ly c a e - ng c kim sot nh ch d n king
mic drugs. H e c o n t i n u e d w ith digoxin. v cc thuc gim glucoza mu. n g tip
The diuretic w a s d i s c o n tin u e d . F o ur tc d n g digoxin. Thuc li tiu dc
m o n th s later h e c o m p l a i n e d o f d i a r ngng li. Bn thng sau, bnh nhn khai
rhoea a n d sic kness ov er a p e r io d o f tw o b tiu chy v m trong hai ngy, n g
days. He w as tr e a te d for this, b u t four c cha tr, n h n g bn ngy sau, ngi
days later a n e i g h b o u r called M r H u d h n g xm mi bc s ca ng Hudson n
son's d o c to r as a n e m e r g e n c y . T h e d o c cp cu. Bc s thu xcp cho nhp vin
tor a rra n g e d a n i m m e d i a t e a d m is s io n ngay v vit m t bc th cho bc s tham
and w rote a le tter to th e h o s p ita l c o n vn bnh vin i km ng Hudson n
sultant to a c c o m p a n y M r H u d s o n to bnh vin. Hy in b sung n h u n g on
hospital. C o m p le t e th e g a p s in th e le t tr n g tro n g bc th tra n g 144 qua vic
ter o n p. 144 w ith th e h e lp of th e GP's s dng cc ghi ch ca bc s tng qut
case n o te s given below. trong phn di y.
English in M edicin e - 141

Diarrhoea and vomiting for 6 Hays.
O /E
G e n e r a l C o n d it io n d eh y d ra ted and semi-comatose
ENT NAD
RS NAD
CVS p irree. 110/min BP

* 60
G IS SI. distension O abdo. No tenderness.

Bowel sounds absent.
GUS N A I1
CNS Oiiiiculty 10 arouse. Responds to painful stimuli.
IM M E D IA T E P A S T H IS T O R Y
Diabetic on metformin 5 00 mg t.d.s
,ind rlipoxin 0.25 mg for CCF. TUR 4/12 ago.
P O IN T S O F N O T E
D IA G N O S IS
? diabetic com a following acute gastroenteritis

Tiu chy v nn ma trong 6 ngy
TH M K H M
T n g tr n g Ml nc v b n hn m
T .M .H N G Khng plil hin bt thng
H .H P Khng pht hin bl thng
T .M C H M arli khng d u 11 o/pht H.A i i i l

60
T .H A Vng cng chu, c n g trng bng; khng mm.
Nhu ng rut mt
N .D C Khng p h t hin bt thng
T.K INH Kh n h thc. C d p ng vi kch thch clau.
TIN S G N Y
Bnli liu n^, l Hung metiormin 500 mp, ngy 3 ln v digoxin 0,25 mg v
suy tim sung huyt, c l b tuycn lin lp c c h d y 4 thang.
GHI C H
X T N G H I M
CHN O N
Hn m tie J ng sau vim da Hy-rut cp?
English in M ed ic in e - 143
Dear Mr Fielding,
Thank you for arranging to admit M r Hudson. He is a 6 6 -year-old

widower w h o has had ......... (1) and vomiting for six days.
He is a diabetic on .....................(2 ), 5 0 0 m g....................~ ..(3 ) times
daily and also takes digoxln for mild ...................... (4 ) failure. When
our nurse visited him four days ago, his general condition was
good but when I called to see him today, I found him
......... (5 ) and ......... (6). He still has diarrhoea al
though vomiting has stopped. He is apyrexlal, blood pressure Is
110/60 and his pulse weak and ......... (7) at 110 per
minute. T h e .....................(8 ) is slightly distended although there is
no ......... (9). Bowel sounds are ......... (10).
Diagnosis: ? acute gastroenteritis leading to .....................(11) dia

betic coma. By the way, he had a .......................(12) four months
ago which was uncomplicated.
Yours sincerely,
UDW-'
Dr Peter Watson

n g F ie ld in g t h n m n .
C m n n g d th J x p c h o n g H u d s o n n h p v i n . B n h n h n 6 0 t u i, g a
v. d c ...................... (1) v nn i trong 6 n g y , n g ta l b n h nhn ti u

d n g khi ..........................(2 ). 5 0 0 m g ..................... (3 ) l n m i n g y v c n g d n g d i-
g o x in vi n h ........................... (4 ) s u y . Khi n g i d i u d n g n t h m b n h n h n
c c h d y b n n g y , t n g t r n g d u t t n h n g khi t i c m i n t h m n g
t a h m n a y . t l t h y n g t a ........................... (5 ) v ............................( ), n g t a v n c n
ti u c h y m c d h t n n i. n g t a k h n g s t. h u y t p l 1 1 0 /6 0 v m c h
y u v .......................(7) m c 110/pht. V n g ........................(8) hi c n g trng

m c d khng c ....................... (9). Nhu d n g ru t th ........................(10).
C h d n o n : V i m r u t d g d y c p ? d n n ........................... (1 1 ) h n m ti u
n g . n g th i, b n h n h n c ........................... (1 2 ) b n t h n g tr c y v
k h n g c b i n c h n g .
Thn i
B.s Peter W atson
Task 16 s Bi lm 16
Work ill pairs. S t u d e n t B s h o u l d start. Lm vic theo i. Sinh vin B bt u
trc.
A: Play th e p a r t of t h e c o n s u l t a n t . Ex A: ng vai bc s tham vn. Gii thch

plain briefly th e i n v e s tig a tio n s y o u tm tt n h n g xt nghim m bn d
in te n d to c a rry o u t o n M r H u d s o n tnh tin h n h cho ng Hudson v
a n d his p r e s e n t c o n d i tio n . tnh trng hin nay ca ng ta.
B: Play t h e p a r t o f M r H u d s o n ' s s o n or B: ng vai con trai hoc con gi ca ng

d a u g h te r . You a r e c o n c e r n e d Hudson. Bn ang quan tm n cha
a b o u t y o u r father. F in d o u t w h a t is bn. Hy tm hiu bnh trng ca cha
w ro n g w ith h im a n d as k w h a t th e bn v hi xem bc s tham vn s lm
c o n s u l t a n t is g o in g to d o to h e lp g d gip cha bn.
y o u r father.
W h e n y o u h a v e f in ish e d , c o m p a r e Khi bn hon tt hy so snh cc gii

y our e x p l a n a t i o n s w ith t h e r e c o rd in g . thch ca bn vi bng ghi m.

Unit 6 Bi 6
Making a diagnosis
Chn on
Section 1 Discussing a diagnosis

P h n 1 Tho lun mt chn on
Task 1 I J Bi lm 1
You will h e a r a n e x t r a c t in w h i c h a Bn s n g h e m t trch on cuc hi
d o c t o r in te r v ie w s a 5 9 - y e a r - o ld office b n h ca bc s cho m t n h n vin vn
w o rk e r. As y o u listen, n o t e t h e p a - phng 59 tui. Trong khi n g h e, hy ch
t i e n t 's p r e s e n t c o m p l a i n t . n li khai bnh hin nay ca bnh
nhn.
SU RNA M E Nlicol F IR S T N A M E S Harvey
O C C U P A T IO N Office worker
H N icol TN H arv ey
TUI 59 G II N am TN H T R N G H N N H N C v
N G H N G H I P N h n vin v n phng
C o m p le te T ask s 2, 3 a n d 4 b e f o r e y o u Hon tt cc Bi lm 2, 3 v 4 trc khi

check y o u r a n s w e r s in t h e Key. bn kim tra cc cu tr li ca bn trong
phn Gii p.

Task 2 Is ] Bi lm 2
Listen to th e e x tra c t a g a in a n d w rite Lng nghe trch on thm ln na v
d o w n several p o ss ib le d i a g n o s e s for vit ra vi chn on c th dnh cho
this p a tie n t. You will b e given f u r th e r bnh nhn ny. Bn s c cung cp
in f o rm a tio n o n h im later. thm thng tin v bnh nhn sau ny.
C o m p le t e T asks 3 a n d 4 b e f o r e y o u Hon tt cc Bi lm 3 v 4 trc kh kim

c h e c k y o u r a n s w e r s in t h e Key. tra cc cu tr li ca bn trong phn Cii
p.
Task 3 ^ Bi lm 3
H ere a r e th e d o c t o r 's fin d in g s o n e x y l cc ghi nhn ca bc s khi khm
a m in a t io n . bnh.
O/E
G en e ra l C ond itio n
Good T' 37.4
ENT
RS
CV S p 80/m in reg. BP 160/95

HS normal left temporal artery palpable
GIS
GUS
CNS No neck stiffness. Fundi normal.

Neck niovts full with no pain.
THM KHM
T ng trn g
TI Nhit 37,4
T.M.HNG
H.HP
T.MCH Mch 80/pht u H/p 160/95

Ting lim bnh thng ng m ch thi dng
tri s thy c
T.HA
N.DC
T.KINH Khng cng gy. y mt bnh ihng

C c ng bnh thng, khng au.
Look bac k at t h e p o s s i b le d i a g n o s e s Xem li cc chn o n c th t ra m

you listed in T a s k 2 . O r d e r t h e m s o t h a t bn ghi n h n trong Bi lm 2. x p li
the m o s t likely d i a g n o s is is first a n d theo th t cho chn don ph hp
the least likely last. E x clu d e a n y w h i c h n h t c xp h n g u tin v chn on
now s e e m very unlikely. km n h t hng cui. Loi b c h n o n
no lc ny c v khng ph hp.
Which in v e s tig a tio n s w o u ld y o u c h e c k Cc xt ng h im no bn kim tra cho

for this p a tie n t? W rite t h e m h e r e . bnh n h n ny? Hy ghi cc xt nghim
vo y.
INVESTIGATIONS
XT NGHIM
C o m p le te T a s k 4 b e f o r e y o u c h e c k Hon tt Bi lm 4 trc khi kim tra cc

your a n s w e r s in th e Key. cu tr li ca bn trong phn Gii p.
English in M ed icine - 149

Task 4 ^ Bi lm 4
The results of so m e investigations for Nhng kt qu ca mt s xt nghim
this patient are given on p. 176. H ow cho bnh nhn ny c n u trang 176.
do these findings affect your d iagno Cc ghi nhn (t nh hng ra sao i vi
sis? Write your final diagnosis here. chn on ca bn? Hy vit chin on
cui cng ca bn vo y.
DIAGNOSIS
CHN ON

Note these expressions used between Ch cc t ng c cc bc s ni vi
doctors in discussing a diagnosis. nhau khi tho lun mt chn on.
Certain Fairly certain Uncertain

Yes is se e m s m ig h t
m ust c o u ld
probably may
likely
No can't u n lik e ly p o ssib ly
definitely n o t
exclu de a possibility
ru le o u t
C h c chn Kh c h c chn K hng ch c chn
C l c v hn
phi c h c c th
c l c h c l
c k h i nng
Khng khng th khng c kh nng c th
dl khot khng
loi tr mt vic c th xy ra
io i b
T he lis te n in g ex tra ct in T ask s 1 a n d 2 Khi nghe trch on trong cc Bi lm 1
p r o v id e s little i n f o r m a ti o n o n w h ic h v 2, ch n g ta ch c t thng tin lm
to b a s e o u r d ia g n o sis. W e a r e still u n c s cho vic chn on. C h n g ta vn
certain. We c a n say: khng chc chn. Chng ta c th ni:
- T h e p a t i e n t m ight h a v e ce rv ica l Bnh nhn hn c bnh t sng c.

s p o n d y lo s is.
- Cervical spondylosis is a possibility. Bnh dl sng c l m t kh nng.
The fin din gs o n e x a m i n a t i o n p ro v id e Cc kt qu thm khm cung cp thm

m o re e v i d e n c e for a d ia g n o sis. S o m e bng ch ng chn on. Mt s chn
d ia g n o s es b e c o m e m o r e likely w h ile on n n ph hp hn trong khi m t s
o th ers b e c o m e less likely. W e c a n say: khc li km hn. C h ng ta c th ni:
- H e seetnslo h a v e t e m p o r a l arteritis. n g ta c v b| vim ng m ch thi
dng.
- T h e r e is n o n e c k stiffness. It's u n Khng c cng gy. K hng c kh nng

likely th a t h e 's g o t c e r v ic a l s p o n d y ng ta b b n h t sng c.
losis.
The results o f t h e i n v e s tig a tio n s p r o Nhng kt qu ca cc xt nghim u

vide s tr o n g e r e v i d e n c e for o u r final d i cung cp bng ch ng r rt hn cho chn
agnosis. W e c a n say: on cui cng ca ch n g ta. Chng ta c
th ni:
- A raised ESR m a k es tem p o r a l ar T l lng hng cu lng chng t rt c

teritis very likely. th c vim ng m ch thi dung.
- N o r m a l MRI s c a n excludes a s p a c e - Chp hlnh nh cng hng t bnh thng
o c c u p y in g lesion. loi tr tn Ihomg chon ch.
- H e can '/h a v e a s p a c e - o c c u p y i n g le n g ta kh n g th c tn thng chon
sion. ch.
Finally, follow ing t h e b io p sy , w e c a n Cui cng, sau sinh thit, ch n g ta c th

say. ni:
- H e must h a v e tem p o ra l arteritis. n g ta phi c vim ng m ch thi
dng.
E nglish in M e d icin e - 151

Task 5 OBI Bi lm 5
Work in pairs. T ry to m a k e a d ia g n o s is Lm vic th eo i. Hy ua ra m t chn
on th e b as is o f t h e in f o r m a t i o n given on da trn th n g tin v tn g bnh
on e a c h p a t ie n t . T h e e x e rc ise is in nhn. Bi tp gm ba giai on, mi giai
th r e e stages. At e a c h s ta g e y o u a r e on bn c cung cp th m thng tin
given m o r e in f o r m a ti o n to h e l p y o u gip bn thc hin chn on cui
m a k e a final d ia g n o sis. D isc u ss y o u r cng, mi liai don hy tho lun cc
d ia g n o s e s at e a c h stage. chn on ca bn.
STAGE A GIAI O N A
1 T he p atien t is a 2 6-year-old w o m a n Bnh n h n l mt ph n 26 tui khai c

co m p lain in g o f s w ellin g o f th e a n sng hai ml c c h n .
kles.
2 T h e p a iie m is a 5-year-old girl w ith Bnh n h n l b gi 5 tui c ban chm
a petechial rash. xut huyl.
3 T he p a tie n t is a 2 8-y ear-o ld m a n Bnh n h n J (hanh nin 28 tui, c

w ith h ea d ac hes, sore th r o a t a n d e n nhc u, au hng v sng lo nhiu
larged glands in th e neck. h c h c.
4 T h e p a tie n t is a 4 0-year-old w o m a n Bnh n h n u ph n 4 0 tui, khai c

co m p lain in g o f n a u s e a a n d e p i bun nn v nhiu ln au vng ha sn
sodes o f pain in t h e rig h t hypo - phi.
c h o n d riu m .
5 T h e p a tie n t is a 4 9 -y ea r-o ld m a n Bnh n h n l n ng, 49 tui c biu

ex h ib itin g R a y n au d 's p h e n o m e n o n h in chng R.iynaud v k m kh nut.
an d w ith difficulty in sw allow in g.
Do n o t look a h e a d u n til y o u h a v e c o n ng xem tip cho n khi bn nu mt

sid e re d a d ia g n o s is for e a c h p a t ie n t . c h n on cho mi bnh nhn.
STAGE B GIAI O N B
1 Preg nancy te st is negative. C h e s t X- Xt nghim c h n on m ang thai l m
ray is n o r m a l. P ulse is n o r m a l. T h e tnh. Chp X-quang phi bnh thng.
liver is n o t en larg ed. M ch bnh thng. G an khng to.
2 Both ankles, th e left e lb o w a n d the Hai mt c chn, khuu tay tri v c lay
rig h t w rist are sw o lle n a n d painful. phi u snj; v au. Bnh s cho thy
T h e h is to ry s h o w s n o in g e stio n o f khng s dng thuc. Ty xng binh
drug s. Bone m a r r o w is norm al. thng.
3 T h e sple en is palpable a n d t h e re is a Lch s thy v c ban sn ln ni khp
m a c u lo p a p u la r rash all over. ni.
4 T h e pain is as sociated w ith dietary Cn au c kt hp vi c h rl cn khng
in discretion. M urphy's sign is p o si king k. Du hiu Murphy dng tnh.
tive. T h e re is m ild jaundice. Vng da nh.
5 T he p a tie n t exhib its c u t a n e o u s cal Bnh n h n c biu hin canxi ha da v

cinosis an d has difficulty in b r e a t h kh th.
ing.
Do n o t look a h e a d u n til y o u h a v e c o n ng xem tip cho n khi bn nu mt

sid ered a d ia g n o s is for e a c h p a t ie n t . chn on cho mi b n h nhn.
STAGE c G IA I O N c
1 Five day fecal fat collection is 15 N m n g y th t m tro n g p h n thu n li n
mmol/1. Jejunal b iopsy is n o rm al. dc l 1 5 m m o l/l. S in h t h i l h n g Ir n g
Lab stick u r in a ry p r o te i n test bnh ihng. Xt nghim protein niu
show s p ro te in + + . S e r u m total cho thy protein ++. Prolein huyl th.mh
p rotein is 4 0 g/1. (on p h n IA 40g/l.
2 T he r a sh is o n th e b u tto c k s a n d e x Ban ni trn mng v mt dui ca cnh

te n so r su rfaces o f t h e a r m s an d tay v chn.
legs.
3 WBC sh o w s ly m p h o c y te s + +. Cng thc boch cu cho thy limph b.io

M o n o sp o t is positive. + + . D u cn la m k n h c k t C|U d ng
lnl.
4 Lab te sts s h o w alkaline p h o s p h a Xt nghim cho thy phosphatase kim

tase 160 units/1. C h o le c y s to g r a p h y l 160 n v/l. Chp X-quang ng mt
sh o w s a n o n - f u n c tio n in g gall b la d cho thy ti mt khng hot dng chc
der. nng.
5 T h e p atien t's face is p in c h ed . Da mt bnh n h n vo dc.

Section 2 Explaining a diagnosis
P h n 2 Gii ngha mt chn on
Task 6 ^ Bi lm 6
Look back at T ask 1 in U nit 3, p. 65. In Xem li Bi lm 1 trong Bi.3. trang 65.
that extract a d o c t o r w a s e x a m i n i n g a Trong trch on bc s khm mt
patien t. Mr J a m e s o n , su ffe rin g fro m b n h n h n , ng Jameson, b dau chn v
leg a n d back pain. An MRI s c a n o f th e lng. Chp hnh n h cng hng t gai
lu m b a r s p in e c o n f i r m e d th a t t h e p a th t lng xc nh b n h n h n b sa a
tient h a d a p r o l a p s e d in te r v e r te b r a l lin t sng. Hy n g h xem b i n g cch
disc. T h in k a b o u t h o w y o u w o u ld e x no bn s gii thch ch n on ny cho
plain this d ia g n o s is to th e p a tie n t. b n h nhn. Hy vit ra n h n g dim bn
Write d o w n th e p o in ts y o u w o u ld i n s nu trong khi gii ngha. L itt k cc
clu d e in y o u r e x p l a n a tio n . List th e dim theo th t n g n h t . Vi d:
p o in ts in th e b es t o rd e r. For e x a m p le :
1 h o w serious the p ro b le m is mc quan trng ca vn d l
Task 7 @ Bi lm 7
You will h e a r th e d o c t o r e x p la in in g t h e Bn s nghe bc s gii ngha chn on
d ia g n o s is to th e p a tie n t. As y o u listen, cho b n h nhn. Trong khi nghe, hy ch
n o te th e p o in ts c o v e r e d a n d t h e o r d e r cc dim dc nu v th t theo
in w h ich th e y a re d e a lt w ith. T h e n ch n g c d CP n. Sau . so snh
c o m p a r e this w ith y o u r o w n list in vic ny vi bng lit k ca bn trong Bi
T a sk 6. lm 6.

W h e n e x p la in in g a d ia g n o s is , a p a t i e n t Trong khi nghe gii ngha m t chn
w o u ld e x p e c t y o u to a n s w e r t h e fo l on, b n h n h n m o n g m u n bn tr li
low ing q u e s tio n s : cc cu hi sau y:
1 W h a t's th e ca u se o f m y p ro b le m ? Nguyn do b n h tt ca ti l g?
2 H o w se rio u s is it? iu quan trng n mc no?
3 W h a t are you going to d o a b o u t it? ng s lm g) cho chuyn d?
4 W h a t are th e ch a n c e s o f a full r e C hy vng hon (on binh phc chng?
covery?
In U nit 7, w e will deal with questions 3 Trong Bi 7, chng ta s cp n
a n d 4. H e r e w e will look at s o m e o f t h e n hng cu hi 3 v 4. y, ta s xem vi
la n g u a g e u s e d to a n s w e r q u e s t i o n s 1 dng ngn ng thng dng tr li cc
and 2. cu hi 1 v 2.
In e x p l a n a tio n s it is i m p o r t a n t to u s e Trong cc gii ngha, iu quan trng l

straig h tfo rw ard , n o n - s p e c ia J is t l a n s dng cch ni thng thn, khng c
guage w ith o n ly s u c h d e ta il a s is i m th ut ng chuyn m n ch km vi chi
p o r ta n t for t h e p a t i e n t 's u n d e r tit quan trng n h m gip bnh nhn
sta n d in g o f th e p r o b le m . T h e l a n .hiu c vn . Ngn ng ca cc sch
guage o f th e te x tb o o k s y ou m a y h a v e gio khoa m bn hc r rng khng
stu died is clearly u n s u i t a b l e for p a thch hp gii thch cho bnh nhn.
tient e x p la n a tio n . C o m p a r e th is e x Hy so snh trch on ny vi cc gii
tract w ith th e r e c o r d e d e x p l a n a t i o n in ngha thu bng trong Bi lm 7.
Task 7.
H e rn ia tio n o f p a r t o f a l u m b a r in- T h o t v mt p h n d a m lin dt
te rv e rte b r a l d isc is a c o m m o n s n g th t lng l m t n g u y n n h n
cause of c o m b in e d b ac k pain a n d th n g g p g y a u lng kt hp
sciatica ... P art o f th e g e la tin o u s vi a u th n kinh (a ... M t p h n
n u c le u s p u lp o s u s p ro tru d e s c a n h n keo ty li n h qu a k rn
th r o u g h a r e n t in th e a n n u l u s fibro- trong v n g si p h n yu nht,
sus at its w e a k e s t p a rt, w h i c h is h i n d i n ti v n g sau b n ... N u
p o s te r o la teral ... If it is la rg e , t h e n h n d ln, p h n li n h thot
p r o tru s io n h e r n i a t e s t h r o u g h t h e q u a d y d ic in g sau v c th c h a m
p o s te rio r ligam ent a n d m a y i m n r ra d y th n kinh v g y n n
p in g e u p o n a n issuing n e r v e to cn a u th n k inh ta.
c a u s e sciatic pain.
(. c . Adams, Outline o f Orthopaedics, (J. c. Adams. Khi lun v chinh hnh. n

10th ed. (Edinburgh: Churchill Liv bn ln 10 (Edinburgh: Churchill Living
ingstone, 1986), p. 217.) stone, 1986), trang 217.)
You c a n m a k e s u r e y o u r e x p l a n a t i o n s Bn c th chc chn rng n h n g li gii

are easily u n d e r s t o o d b y a v o i d in g ngha ca bn u d hiu bng cch
m e d ic a l te r m in o lo g y w h e r e p o s s i b le trnh cc th u t ng y lic mi khi c th
a n d d e f in in g t h e t e r m s y o u u s e in a tr n h uc v dnh ngha cc th u t ng
s im p le way. N o te h o w t h e d o c t o r d e bn d n g theo cch gin n. Hy ch
scribes a disc: cch bc s m t m t a:
- The disc is a liule p a d o f gristle which a l7 m t ci d m nh s n nm gia
lies between the bones in your spine. cc xiang ct s n g ca ng.

Task 8 ^ Bi lm 8
Write s im p le e x p l a n a t i o n s for p a t i e n t s Hy vit n h n g gii ngha n gin ca
of th e s e te rm s. C o m p a r e y o u r e x p l a cc thut ng ny cho b$nh nhn. So
n a t io n s w ith t h o s e of o t h e r s t u d e n t s . snh cc gii ngha ca bn vi cc gii
ngha ca cc sinh vin khc.
1 th e pancreas ly
2 the thyroid tuyn gip
3 fib ro id s u Hng si
4 em physem a dn p h nang
5 arrh y th m ia loan n hp tim
6 b o ne m a rr o w ty xng
7 th e p ro sta te gland tuyn tin liip
8 g astro -o eso phag eal reflux dng ch y ngc da d y - ih c q u in

E x p la n a tio n s o fte n inv olve d e s c r ib in g N hng gii ngha thng bao gm c cc
c a u s e s a n d effects. Look at t h e s e e x nguyn n h n v hiu q u i. Hy xem cc v
am ples : d sau dy:
Cause Effect
Nguyn nhn H iu qu
b en d [he knee t h e te n s io n is ta k e n ofT t h e nerve
gp u gi dy thn kinh khng c ng th in g na
straig h ten it th e nerve goes ta u t
dui dau gi dy thn kinh b ko c n g
We c a n link a c a u s e a n d a n effect like C h n g ta c th kt hp nguyn n h n v

this: hiu qu n h sau:
- I f WI bend the knee, the tension is taken N u ta g p u gi, dAy thdn kinh
o ff th nerve. k h n g cdng th n g na.
- I f we straighten it, the nerve goes taut. N u ta dui u gi, d y th n kinh b
ko cng.
N o te th a t b o t h t h e c a u s e a n d effect a r e Hy ch c i nguyn nhAn v hi<u qui
in th e p r e s e n t t e n s e b e c a u s e w e a r e u t trong th hin ti bi v ch n g ta
d e s c r ib in g s o m e t h i n g w h i c h is g e n e r ang m t i m t s kin n g tht.
ally true.
Task 9 ^ B i l m 9
Write a s u it a b le effect for e a c h o f th e s e Hy vit m t hiu qu tng hp vi mt
causes. T h e n link e a c h c a u s e a n d ef trong s cc nguyn nhn ny. Ri xp
fect to m a k e a s im p le s t a t e m e n t y o u thnh i mi nguyn nh n vi mt hiu
could u se in a n e x p l a n a tio n to a p a qu to thnh m t n h n nh gin n
tient. m bn c th dng trong m t gii ngha
cho bnh nhn.
1 T he sto m a c h p ro d u c e s to o m u c h D dy sn sinh qu nhiu acid.

acid.
2 A w o m a n gets G e r m a n m e asles Mt ph n mc bnh si c trong khi
d u rin g pregnancy. m an g tliai.
3 You v o m it several tim es in q u ic k Bn nn i nhiu ln lin tip nhau.
succession.
4 Your skin is in c o n tac t w ith ce rtain D a b n li p xc vi m t vi cy n o d.
plants.
5 Your blood p r e s s u r e r e m a in s high. Huyt p ca bn vn cao.
6 You give y o u r baby to o m u c h fruit. B n ch o c h u b qu n h i u tri cy.
7 The cholesterol level in t h e b lo o d Mc cholesterol trong mu ln qu C<10.
gets to o high.
8 T here are rep e a te d in ju rie s to a C n h n g t n thng lic n ti p kh p .
joint.
Task 10 H E I I s l B i l m 1 0
How w o u ld y o u e x p la in t h e s e d i a g n o Bn s gii ngha cc chn on ny nh
ses to th e follow ing p a t i e n t s o r th e ir th n o cho cc bnh n h n tip theo hoc
relatives? Work in pairs. S t u d e n t A cho cc thn n h n ca h? Lm vic theo
should start. i. Sinh vin A bt u trc.
A: Play th e p a r t o f t h e d o c t o r . E xplain A: ng vai bc s. Gii ngha cc chn

th e s e d ia g n o s e s to th e p a t i e n t s or on ny cho cc bnh n h n hoc cho
th eir relatives below. cc thn n h n ca h di y.
B: Play th e p a r t of t h e p a t ie n t s . In 2 B: ng vai cc b n h nhn. T ro n g 2 v 6,

a n d 6, play t h e p a r t of a p a r e n t , a n d n g vai cha m v trong 5 ng vai
in 5 play th e p a r t of th e s o n or con trai hoc con gi.
daughter.
1 A 3 3 -year-old s a le s m a n sufferin g Ngi bn hng nam, 33 tui, au vi loet
from a d u o d e n a l ulcer. t tr n g .

2 A 6-year-old boy w ith P erth es' d is M t b trai fa lui m c b n h P erlh e, c
ease. a c co m p an ie d by h is parents. c h a m i k m .
3 A 2 1 -year-old p ro fe ssio n a l fo o t C u th b n g d c h u y n n g h i p 21 tui,
baller w ith a t o m m e n is c u s o f th e bi rch m n g s n k h p c a d i u g i ph i.
right knee.
4 A 43-year-old te a c h e r w ith fibroids. MI b g io 4 3 lui crt u d * n g si.
5 An 82-year-old retire d n u r s e suffer MI b gi Ir n g h i htA i. 8 2 tui, m c
ing from d e m e n tia , a c c o m p a n ie d b n h m t tr. c c o n trai v c o n gi i
by her son and d a u g h te r. k m .
6 A 2-w eek-old baby w ith tetralo g y o f B hai lun lui c b n h l c h n g Fallot,
Fallot, a c c o m p an ie d by h e r p are n ts. c ch a m e im dn .
7 A 35-year-old r e c e p tio n ist su ffe r MI n h n v i n t i p tan 3 5 tui, dau vl
ing from h y p o th y ro id ism . th i u n a n g lu y n g i p
W h e n you h a v e finishe d, c o m p a r e Khi bn d lam xong, hy so n h cc gii

yo u r e x p l a n a tio n s w ith th e re c o rd in g . ngha ca bn vi bng ghi m.
Section 3 Reading skills: Reading articles 3

P h n 3 K nng c: c cc bi bo 3
Task 11 Bi lm 11
H e re a r e s o m e e x tra c ts fro m a n a rticle y l vi trch on t m t bi bo trong
in th e B ritish J o u r n a l o f G en e ra l P ra c Tp c h th c h n h t n g q u t A n h gii
tice g iv e n in t h e o r d e r in w h i c h th e y thiu theo th t c c Hy c xc
w e r e read. T ry to id e n tif y t h e m to w o rk nh cc trch on y tim ra tin trnh
out the p ro c e d u re used a n d suggest a c s dng v hy gi m t tiu die
s u it a b le title. T h e c o m p l e t e artic le h a s thch hp. Bi bo hon c h in h c cc
th e s e c o m p o n e n t s : th n h phn ny:

Title Tiu d
A u th o rs C c tc gi
A u th o rs' affiliations Ngun gc cc lc gi
S u m m ary T m tt
In tro d u c tio n N h p
M ethod Phng php
Results Kt qu
Discussion Bn lun
References Ti liu tham kho
a)
B ackground. The proportion o f fa H i n trng. T l cc Ii Ihy thuc

muli! generl practitioners is steadily thc hnh tng iit lun tng cu
increasing. dn.
A im . To conipdre m ale and fem ale M c ti u . So s itli cc thy thuc thc
general practitioners w ith respect to hnh tng qut nam v Ii v s hi
their job satisfaction and professional lng vi cng vic v I tl t n g rng buc
c o m m itm en ts w ithin a nd outside their ngh nghip thuc phm vi trong v
practices. Iioi vic hnh ngh ca h.
M eth o d . A questionnaire w as sent lo Phng pltp. M t b cu hi dc i
all S96 general practitioner principals lin tt c 896 liy thuc thc hnh
with patients ill Staffordshire ill 19SH. lng qut chnh c bnh nhn Sta/ -
T he mailt elem ents were: lob satisfac fordsliire trong nm 1994. Cc im
tion (oil a five-point scale) from eight ch yu l: s hi lng trong cng vic
possible sources; w hether personal re (trn thang Iim ditn) ti! tm ngun
sponsibility was taken fur 12 different kh hu, cn trch nhim c nhn
practice tasks; and professional com dc thu //lp cho 12 nhim v thc
mitments outside the practice. lili khc nhau, v nling rn? buc
ngh nghip thuc phm vi ngoi vic
hnh ngh.
R esults. A total o f 620 (69% ) general K t qu. C tng ctig 620 (09%) cc
prjctitivners responded. Fem ale doc Ihy thuc thc hnh t)I? qut d tr
tors derived more satisfaction than li. Cc bc s n tm thy s hi ltig
m ale doctors from relationships with nhiu hn so vi cc bc s nam trong
putienti (P = 0.002). Fem ale doctors mi quan h vi bnh ihii(P = 0,002).
were more likely to be working 111 train Cc bc s Iic v thch hp nhiu hn
ing practices, and were likely to be on- vi nhng cng vic thc hnh hun
call less and to work fe v e r sessions. luyn, hnh nhdc mi ?i t hn v

Male general practitioiien were m ore lm vic if hn trong cc bui hp. Cc
likely to take lead responsibility for thy thuc t h t hnh tng qut nam c
practice computers, m in o r surger), v thch hp n h iu han cho trch nhim
m eeting external visitors a nd finance, chnh y u trong vi c d i u t n /i m y
whereas fem ale practitioners were lnh, tiu ptvu thut, g p g d cc v
more likely to be responsible for look khch l bn Iigoi, p ti chinh, trong
ing after w om en patients' health. khi cc th Jy thuc th t hnh n c v
thch hp n hiu hn vi trch nJiifm
theo di sc khe ca cc b n h n h in n.
C onclusion. Considerable differences K t lu n . C n h ng khc b ifl ln lao

were fo u n d between Inale and fem ale gia cc th y thuc thc h n h lng
general practitioners. These d iffer qui nam v n. N h n g khc bit d
ences are likely to have an increasing hn h n h c lac n g v n I n g n fn t
ini pact as the percentage o f fem ale g en l plirt trm cc IhAy thuc thc hnh
eral practitioners continues fo rise. t n g qiit n t ti p t c tng.
Keywords: general practitioners; job T kha: cc th y thuc thc hnh
satisfaction; gender differences; work. t n g qut, s hi l n g VI c n g vic,
n h ng khc b it v gii, c n g vic.
b)
W o m e n d o c t o r s d e r iv e d m o r e Cc b c si n tm thy s hi lng
job satisfac tio n th a n m e n f r o m vi cng vic nhiu hn c c bc si
th e ir re la tio n s h ip s w ith p atien ts. n am trong mi quan h ca h vi cc
T h i s ties in w ith r e s e a r c h fro m b n h nhn. iu ny gn vi mt
A u s tr a li a ,lb w h e r e a s u r v e y o f 500 nghin cu c , ti y mt cuc
G P s f o u n d th a t w o m e n w e r e m o r e kho st 500 thy thuc thc hnh
likely to be o r ie n t a te d to r e l a t i o n tng q ui cho thy cc bc s n hnh
s h ip s w ith p a t ie n t s t h a n m e n ,' as nh thch hp trong cc quan h vi
well as b e in g b e t t e r a b le to id e n tif y b nh n hn hn cc bc s n a m , ng
a n d tre a t p a t ie n t s ' p s y c h o so cia l thi c nhiu kh nng ti hn Irong
p r o b le m s . B u t th e la rg e st d i f f e r vic xc nh v iu tri cc vn d
en c es in th e s u r v e y w e r e in t h e r e tm l x hi ca b n h nhn. Nhng
s p o n sib ilitie s for p r a c tic e tasks. c c khc bil ln nht trng cuc kho
W o m e n w e r e m o r e likely t h a n m e n st (h hin trong cc trch n h i m i
to b e r e s p o n s ib le fo r w o m e n p a vi cc cng vic thc h n h C c bc
t i e n t s h e a lth a n d a n t e n a ta l w o rk , s n h ln h n h lh ( c h h p r th i u hn
w h e r e a s m e n w e re m o r e likely to be tro n g tr c h n h i m i v i MJTC k h e
r e sp o n s ib le for p r a c tic c c o m p u te r s , b n h n h n n v c n g v i c tru c sa n h
m inor surgery and several a d m in is hn l bc si nam, cn cc bc s nam
trative tasks. It is d ifficu lt CO d e h n h n h li th ch hp n h iu vi trch
term ine to w hat exten t these nhim trong iu hnh my tnh, tiu
gen d er d ifferen ces have arisen from phu thut v nhiu cng vic hnh
personal ap titu des and p referen ces, chnh khc. Tht kh xc nh nhng
or from con fin em en t in traditional k h c bit v gii [ng ti mc
roles. T h e form er w ould seem to be no l cc kh nng v s ihch c
m ore acceptable chan the latter. n h n h o c t s h n c h tro n g n h n g
H ow ie et a /17 have d em onstrated vai Ir truyn thng. C l nhn nh
that G P s w h o arc forced to d eviate trc d c c h p n h n hn l nhn
from their preferred sty les at work nh sau. Howie v cng s chng
jrc m ore likely to u ndcrpcrform minh rng cc thy thuc thc hnh
and feel stressed. tng qut khi b bt buc i lch
h ng t c h khi n h n g c c h lm vic
a thch ca h hnh nh hot ng
km hn v cm thy b cng thng.
All d octors o f b oth gen d ers Tt c cc bc s thuc hai gii
sh ould be given o p p o rtu n ities to nn c nhng c hi pht trin nh
d evelop as in d ivid u als, so that d i cc c the, nh vy tnh a dng dc
versity is en cou raged and the khuyn khch v sc m anh ca tt r
strengths o f all d octors o f b oth g e n cc bc s thuc hai gii u c tn
ders are fully exp lo ited . dng y .

T able 1. P ractice characteristics of m ale and fem ale general practitioners
P ercen tag e of general practitioners

Male Fem ale
Practice characteristics: (n = 481) (n = 139)
N um ber of partners:
sin gle-handed 13 9
2 - 3 26 32
4 60 58
no response 0 1
Level of seniority
single-handed 13 9
most senior 28 16
2nd 24 22
3rd 15 14
> 4th 16 34
all eq ual 1 4
no resp onse 2 1
O n -call frequency (days per m on th ):
never 2 17
< 4 12 27
5 - 8 55 28
> 9 28 21
no resp o n s e 3 7
H alf-d a ys free from practice work:
none 18 10
1.2 74 51
3,4 2 25
> 5 1 7
not know n 5 6
B n g 1. Nhng (lc (lim h<inh ngh ca cc thy Ihuc Ihc hnh lng qui
nnm v n
T l phn Irm cc thy Ihu

Ihc hnli lng qui
Nam N
0 ( c i m h n li n g h e (n = 4 8 1 ) (n = 1 3 f
b lng ng Iig h i p :
ml m in h 13 'J
2 - 1 20 2
> 4 00 58
k lio n g Ir li 0 1
M r d lli m m en
m l m in h 13 9
(1d S lu nAm 28 16
nAm th hai 24 22
n m ih bd 15 14
nAni ih t 16 (4
U I Cd b n g n h au 1 4
kh n g tr li 2 1
X ul (l m i gi (s n g y Iro n g ih n g ):
kh n g ln no 2 17
< 4 12 27
5 8 55 20
> 9 28 21
kh n g Ir li 3 7
Nd n g y c t d o kh n g , h n h ngh:
kh n g 18 10
1, 2 74 51
i . -4 2 25
> 5 1 7
kh n g bit 5 6

T able 2. Com parison of m ale and fem ale general practitioners' m ean sco res for
satisfaction levels at work
M ean satisfaction score

(range of an sw ers 0 - 4*)
Male F em ale
Aspect of satisfaction (n = 481) (n = 139)
Relationship with patients 2.9 3 -2 t
Ability to treat illness 2.9 3.0
Relationship with practice staff 2.7 2.8
Relationship with other doctors 2.6 2.7
Financial security 2.6 2.6
Public view of profession 1.6 1.6
Own working conditions 2.3 2.3
Prevent illness by health promotion 1.3 1.4
*0 = not a source of satisfaction, ranging to 4 = extrem e so u rce of satisfaction,

t p = 0.002, Mann-Whilney test.
N.B. N on-response yaried betw een 2 and 5% betw een questions.
B in g 2. So snh cc im stf trung binh v mc hi lng trong cng vic ca cc
thy ihuc thc h nh lng qut n am v n
im strung bnh v mc
hi lng (xp hng cc cu
tr li 0 - 4*)___________
N dm N
Kha canh hi lng (n = 481) n = 139)
Q uan h vi c c bnh nhn 2,9 3 ,2 t
Kh nang iu tr b nh 2,9 3 ,0
Q uan h vi ban lnh d ao h nh ngh 2.7 2 ,8
Q uan h vi cc b c s khc 2 ,6 2 ,7
an lon ti chnh 2,6 2 .6
Q uan im d n chng vi ngh n g hip 1,6 1,6
N hng diu kin lm vic ca b n (hn 2 ,3 2 .3
Phng b n h b ng lng cng sc khe 1.3 1.4
0 = khng lm hi lng, xp h ng tin 4 = cc k lm hi lng.

t P = 0 ,0 0 2 p h p kim Mann-VVhitney
Ghi ch: Khng tr li b in i gia 2 v 5% gia cc cu hi.

T able 3. P ercen tag e of male and fem ale general practitioners who report that they
th em selves h a ve lead responsibility for particular practice task s n practices w here
there are partners of both g e n d ers (n = 3 6 3 ).
P e rcen tag e of general practi

tioners claiming personal re
sponsibility
Male Fem ale

Task (n = 2 5 0 ) (n = 1 1 3 ) p
C om pu ters 22 3 < 0 .0 0 0 1
M inor surgery 24 8 0 0005
P ractice finance 20 9 0.0 1
P ractice adm inistration 12 5 0 .0 9
W o m e n s health 1 31 < 0 .0 0 0 1
S taff em p lo ym en t 10 4 0 .0 7
S taff personal prob lem s 12 16 0 .5
A ntenatal work 4 16 0 .0 0 0 5
M e etin g e x te rn a l visitors 16 2 0 .0 0 0 2
A nn ual report 18 7 0 .0 1
H ealth prom otion 16 9 0.1
Buying ea u ip m en t/s to res 10 5 0 .2
P -v a lu e by X2 test
Bng 3. T l p h n tr3m c c (hy Ihuc ihc h nh tng qut n am v n bo co
b n (hn ho c thc hin trch n h im cho nhng cng vic hnh ngh c bil ti
nhng ni c cc dng nghip ihuc c hai gii(n = 363)
T l p h n trm c c (hy thuc

thc h nh tng qui i hi Irch
n h im c n hn________________
N am N
Cn vic (n = 250) (n = 113) p *
Vi lnh 22 3 <0,0001
Tiu phu Ihut 24 8 0,0005
Ti chinh hnh ngh 20 9 0,01
Q un l h nh ngh 12 5 0,09
Sc khe ph n 1 31 <0,0001
S dng nhn vin 10 4 0,07
Cc vn d n h n b 12 16 0,5
(' n g viqc Irc sanh 4 16 0,0005
Tip k hch ngoai lai 16 2 0,0002
Ho co h n g n m 18 7 0.01
Tng cng sc khc ' 16 9 0,1
Mud thit b/cl d tr 10 5 0,2
Tr s p d o p h p k i m x :

d)
he proportion o f fem ale T l c c sin h v i n y k h oa n lai
T m edical stu d en ts in the

U n ite d K in g d o m has risen
steadily over the last 20 years so that
medical school in ta k e s n o w c o m
V ng q u c A n h t n g d u d n sut
20 n m qua n n hin nay s n h p vo
trung y khoa c lng tuong t v nam
v n. MI na l n g s c c th y thu c
prise sim ila r n u m b ers of m e n a n d thc h n h (ng q u i d n g k (thc tp
w o m e n . O v e r half o f all general sinh) hin nay du l n v l l cc thy
p r a c titio n e r ( G P ) re g is tra rs ( t r a i n th u c th c h n h t n g qu t n d t n g t
ees) are now fem a le,1 and the pro- 19% trong n a m 1 9 8 3 ln ti 2 9 % Irong
portion o f fem ale G P s has increased nm 1 9 9 3 .
from 19% in 1983 to 29% in 1993.
W ith the increasing n u m b ers o f Vi n h n g lng l n g c a c c

fem ale G P s, any gender d ifferen ces thy thuc thc h n h lng qut n, gia
betw een m ale and fem ale G P s w ill c c th y th u c n a m v n d , c h n g h
b ecom e m ore im portan t. T h ese c n h n g k h c b i t v gi i s tr n n
gender d ifferen ces m ay in clu d e d if quan trng hn Nhng khc bil v gii
ferences in career p rogression , job nh v y c th hao gm n h n g khc bit
satisfaction, clinical and p ro fes trong tin b n g h n g h i p , s h i lng
sional in terests, m ental health, a s vi c n g v i c , n h n g h n g th l m s n g
su m p tion s o f fam ily r e sp o n sib i v ngh nghip, sc khe tm thn,
lities, exten t o f p art-tim e w ork in g, v i c m n g trch n h i m gia n h ,
and con su ltin g styles. p h m vi lm v i c na n g y v kiu
khm bn h .
S tu d ies follo w in g up d o cto rs Cc nghin cu (heo di c c b c s

w ho have co m p leted their v o c a d h o n tt thi k t p s n g h n g h i p
tional training for general p ractice thc h n h tn g q u i c h o th y r in g hu
hav e f o u n d th a t n e a rly all d o c t o r s o f h t tt c c c b c si th u c c h ai gii d u
both gen d ers co n tin u e to w o rk ,2 but tip tc lm vic n h n g hnh nhgii n
that w o m en are less lik ely to b eco m e k m th c h h p tr th n h b c s c h in h
p r in c ip a ls th a n m e n 3 a n d a re m u c h so vi n a m v c v th c h h p n h i u hn
m ore likely to be w ork in g as part- h ot n g n h m t b c s c h in h lm
tim e p rin cip als.2 T h e s e d ifferen ces v i c na n g y . N h n g k h c b i t d
in the c a r e e r p r o g r e s s io n o f m e n a n d trong s tin b n g h n g h i p c a c c
w om en d octors have b een ascribed b c s nam v n c quv cho l Ho
to g e n d e r - b a s e d s te r e o ty p in g , to k h u n m u C.I g i i, d o S c n g t h i n g
role strain and its im pact on rela c a vai tr v s va c h ^ m trong c c m i
tionship s, and to the lack o f role qu an h v d o ih i u v n g n h n g g on g
m o d e ls for w o m e n .4 5 m u v v a i Ir c h o ph n
W om en G P s have been found to Cc n tli.iy thuc Ihc hnh (ng
have greater overall job satisfaction qut u c ghi nhn c s hi lng
than m ale G P s or to the general lon din v cng vic cao hn so vi cc
p op u lation .6'9 W om en G P s have nam thy thuc ihc hnh tng qui
been found to be m ore satisfied than h oc so vi cng n g d n C. C c n
their m ale colleagu es w ith their thy lliur thc hnh tng qut c ghi
hours o f w ork ,78 recogn ition for nhn l h cm thy hi lng nhiu hn
good w ork ,78 freedom to ch o o se cc ng nghip nam i vi s gi lm
m ethod s o f w ork in g7 8 and p sy c h o vic, s nhn xt v cng vic lm tt, s
social aspects o f care,9 w hereas m ale l do H chn l.1 cc phng php lm
G P s tend to be m ore satisfied w ith vic v nhng kha cnh tm l x hi
the organizational asp ects o f their cd s c h m sc, trong khi c c nam thy
work.9 L ow er rates o f job sa tisfa c thuc ihc hnh tng qui lai c xu
tion are im portant not o n ly from the hng cm thy li lng hn i vi
point o f view o f the in dividu al d o c nhng kha c<inh l chc cng vic ca
tor, but also because o f the a sso cia h. N h n g t l ih p v s hi lng vi
tion w ith m ental and p hysical ill- cng vic u quan trng khng chi trn
health and increased sick le a v e .10 q u a n d i m c a Ct n h n ngi b c s, m
cn vl s kt hp vi tnh (rang sc khe
hoc bnh lt v tm thn v th lc ( ng
nh thi gian nglil bnh lng ln.
L ittle work has been p u b lish ed t cng trnh nghicn cu dc

about the in flu en ce o f g en d er on the cng b v nh ling ca g i i Irong S
division o f practice w ork b etw een phn chia cng vic thc hnh gia cc
G P partners, but m ale G P s a tte n d thy thuc thc hnh tng qui ng hi
ing educational m eetin gs have b een nhng cc nam thy thuc thc hnh
found to elect for service m a n age tng qui tham d c c cuc hp hun
m ent topics, w hereas w o m en are luyn u dc ghi nh n a tim cc
more likely to select health p r o m o ti v diu h n h dch v, trong khi phu
tion m ee tin g s." C on sid erab ly few er n li .1 thch chn cc cuc hp v
fem ale than m ale G P s seem to be in nng C<10 sc khe. R rng c t thy
volved in teaching or tra in in g .3 thuc thc h n h tng qut n hn l
thy thuc llic hnh tng qut nom
mong mun tham gia vic ging dy
hoc hun luyn.
T h is paper p resen ts d ifferen ces Ti liu ny trnh by nhng khc

betw een m ale and fem ale G P s in bit gia cc thy thuc thc hnh tng
their practices, in sou rces o f sa tis qut n a m v n v cng vic thc h n h
faction at w ork, in p rofession al c o m ca h, v nhng ngun gc cho s hi
m itm en ts o u tsid e their practices, lng trong cng vic, v nhng r n g
and in resp on sib ilities for practice buc ngh nghip bn ngoi c n g v i c
tasks. thc h n h ca h, v v nling trch
n h i m l m n o r r r n n n \/i A/- flu i r - li i n k

R. C ham bers, D M . F R C G P . g e n R. C ham bers, DM. FRCCP. ihy thuc
eral practitioner. S to n e, and senior ihc h n h lng qui. Sone vA ging
lecturer in prim ary health care. vin ch n h v r h a m sc sc khe cng
U n iversity o f K eele, I C am p bell. ng. ai hc Keele. I. C am pbell, MD,
M D , F R C S , F R C R , m cd ical sta tis FRCS, FRCR, Iham vn thng k y hc.
tics con su ltant. W irral. VVirral.
S ub m itted : 11 July 1995: accepted: trinh: 11 thng 7 .1 9 9 5 . c h i p

28 N o v em b er 1995. nhn: 28 thng 11.1995.
B ritish Jou rn a l o f G eneral P ractice, Tp ch i ih i h n h lnp qui Anh

1 9% , 46, 2 91-293. 1 9 9 6 , 4 6 . 2 9 1 -2 9 3 .
1. D e p a r t m e n t of H e a lth . S ta tis tic s Khoa sc khe. T hng k v cAc i h y

fo r general medical practitioners in th u c Ihc h.inh l n g q u i A n h v x
E ngland and W ales: 1 9 8 3 -1 9 9 3 . W ales: 1 9 8 -1 9 9 3 . T p san Khoa
D e p a r t m e n t o f H e a l t h S ta tistic a l Thng k Sc khe, ihng 5.1994.
B ulletin, M a y 1994.
2. A llen I. P a rt-tim e working in gen Allen I. l m v ic nn n g y trong thc
eral practice. L o n d o n : Po licy hnh t n g qui. London: Vin Nghin
S tu d ies In stitu te, 1992. cu dng li - 1992.
3. J o h n s o n N , H a s l e r J, M a n t D , et Johnson N, Hasler I, Mant D v cng
al. G e n e r a l p r a c tic e carccrs: s. N hng ngh thc h n h lng qui:
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tute, 1988. li 1988.
5. N o tm a n MT, N ad elso n c. N otm an MT, Narielson c . V khoa: mi
M ed icin e: a career co n flic t for s i khng ngh nghip di vi phu
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1123-1127. 1127.
6. C ooper C L , R ou t u,F a ragh erB . Cooper CL, Rout u . Faragher R. Sc
M ental health, job satisfaction , khe 13m thn, s hi lng v cng vic
a n d job s tre s s a m o n g gen eral v s cSng thng tinh thn do cng
p r a c titio n e r s . B M J 1989; 298; vic cc thy thuc thc h n h tng
366-370. q u i. B M I 1 9 8 9 ; 2 9 8 : 3 6 6 -3 7 0
7. S u t h e r l a n d V J, C o o p e r C L . S u th e rla n d V ), C o o p e r C L . X c d jn li
I d e n ti f y in g d istre ss a m o n g g e n lnh trng ml mi irong c t ihy thuc

eral p rac titio n e rs: p r e d ic to r s of ihc hnh tng qui: nling lin on
psych ological ill - h e a lth a n d job v suy nhc sc khe lm tlin v s
dissatisfaction. S o c S c iM e d 1993; bt mn (rong cng v i c. S o c Sci Mecl
37: 575-581. 1 9 9 3 ; 3 7 : 5 7 5 -5 8 1 .
8. R o u t u , R o u t J K . J o b sa tis f a c R oul u , Rout |K . S li.i l n g Iro n g ( n g
tion, m e n ta l hea lth a n d job stress v i c , sc khe l m than v s Cclng
a m o n g general p r a c titio n e r s b e f th n g tin h th n d o r n g v i t c c th y
ore a n d afte r th e n e w c o n t r a c t - a th u c th c h n h t n g C|UI trc v sau
c o m p a r a tiv e s tu d y . F am P ract hp dng mi - inl nghin cu 50
1994; 11: 300-306. snh. Fam Pracl 1994; 1 1 : 300-306.
9. B r a n th w a ite A, R o s s A. S a tis f a c B r a n th w a ilL A , Ross A . S h i l n p v
tion a n d job s tre s s in gen eral cAng lling do r n g vic cc thy
practice. F am P ract 1988; 5: 83- th u c Ihr h n h lng qu<1(. F<im 1'ici
93 1 9 0 8 ; 5: 3 -9 1 .
10. Rees D W , C o o p e r C L . O c c u p a R ees D W , C o o p e r C L . S Ccng th n g

tional stress in h e a lth serv ice e m ngh nghip cc nhn vin phuc vu
ployees. H ealth S e rv M a n Res sc k h e . H c h h S e rv M o n R es 1 9 9 0 ;
1990; 3:163-172. 3:163-172.
11. M u r r a y , T S . D e m o g r a p h i c c h a r Murray, T5. Nhng r!,ic dim nhn
ac teristics of g en e ral p r a c t i t i o khu hc ca cc lliy lliuc thc hcnli
ners atten ding e d u c a tio n a l l ng q u i d a n g tliam d c c lp gio
m e etin g s . B r J G e n P ra c t 1993; 43: d c . b r I G e n H ra c t 1 9 9 3 ; 4 3 : 4 0 7 -
4 6 7 -4 6 9 469.
12. M o se s L E , E m e r s o n J D , H o s - Moses LE, Em erson |D , Hossem i H.
scini H . A n a ly s in g d a t a f r o m o r D liu phn tch l cc chng loi
d e r e d categories. N E n g l J M ed c xp hng. N Engl J. M e d 1984;
1984; 311: 4 4 2 -4 4 8 . 311: 442-448.
13. A rm ita g e p , B e rr y G . S ta tistic a l A r m ita g e p, B e rry G. C c phng
m ethods in medical research, 2n d p h p thng k trong n ghin cu y h c
ed n . O x fo r d : Blackw ell S cien ce, 2 n d . ecln. O x fo rd : B la c k w e ll S c ie n c e .
1987. 1987.
14. C o o k e M , R o n a ld s c . W o m e n Cooke M, Ronalds c . Cc bc s n
d o c t o r s in u r b a n g en e ral p ractice: tro n g th c h c n li t n g q u i tai th n h
th e d o c to rs . B M J 1985; 290: 755- p h ; c c b c s. B M I, 1 9 0 5 ; 2 9 0 : 7 5 5 -
758. 750.

15. F i r t h - C o z e n s J, W e s t M A . Firth-Cozens J, West MA. Ph n trong
W om en a t work: psychological and cng vic: nhng trin vng v t
organisational perspectives. B u c k chc v lm l. Buckingham: Open
in g h a m : O p e n U n iv e r s it y P ress, U n iv e r sity P ress, 1 9 9 1 .
1991.
16. Britt. H , B hasalc, A . M ile s D A , et Britt. H, Bhasale, A. M ile s DA, v cng
al. The gender o f the g e n e ra l p ra c ti s. Gii ca Ihy thuc Ihc hnh
tioner. Secondary analysis o f data tng qut. D liu phin llch In ih
fro m the A u stra lia n m orbidity and hai t lnh trng mc bnh c v
treatm ent survey in general practice nghin cu diu tr v thc hnh tng
1 9 9 0 -1 9 9 1 . Sydney: F a m il y q u i (rong n m 1 9 9 0 -1991. Sydney:
M ed icin e R esearch U n it, U n i F am ily M e d ic in e R e se a rc h U n it. U n i
versity o f S y d n ey , 1994. v e rsity of S y d n e y , 1 9 9 4 .
17. H o w ie JG , H o p to n J, H ea n ey D , H o w ie )G , H o p to n I, H e a n e y D , Porter
Porter A. A ttitu d es to m edical A. N h n g q u a n i m v c h m s c y
care, th e o r g a n iz a tio n of w o rk , k h oa, c c h l c h c c n g v i c v tinh
a n d s tre s s a m o n g g en e ral p r a c t i trng c a n g th n g c c th y th u c thc
tio n e rs. B r J G en P ra ct 1992; 42: h n h tng qut. Br I G en Pract 1992;
181-185. 42: 1 8 1 -1 8 5 .
A ddress for correspondence a c h li n l c

D r R C ham bers, C en tre for Prim ary H ealth C are, S ch o o l o f Postgraduate
M e d icin e, U n iv ersity o f K c ele , S to k e H ealth C en tre, H on eyw all,
S to k eo n -T re n t S T 4 7JB.
How d o th e resu lts o f th is stu d y c o m - Ve t l cc thy thuc thc hnh tng

p a r e w ith t h e s i t u a t i o n in y o u r c o u n qut nam v n, th cc kt qu ca cng
try r e g a r d in g t h e ra tio o f m a l e to trnh nghin cu ny so snh vi tnh
f e m a le GPs? H a v e a n o t h e r lo o k at t h e trng t nc bn ra sao? Hy nhin li
ta b le s a n d c o n s i d e r h o w t h e y m i g h t mt ln na cc bng v xem cc bng c
com pare. th so snh nh th no.
172 - English in M ed ic in e
Task 12 ^ Bi lm 12
C o m p l e t e this ex tra c t fro m th e Hy in m t t vo mi ch trng d
M e th o d s e c ti o n o f th e s a m e a rtic le by hon chnh phn trch don ny ly t
a d d i n g o n e w o rd for e a c h gap. phn phng php ca cng m t bi bo.
In J u n e 1994. all 896 GP principals Trong thng 6 nm 1994, tt c 896

with patients ...............................( 1) thy thuc thc hnh tng qut chnh
Staffordshire ........................(2) sent a cng vi cc bnh n h n ....................(1 )
questionnaire. This i n d u d e d q u e s Staffordshire..............(2) gi mt bng
tions ................ (3) the n u m b e r of cu hi. Bng ny bao gm nhng cu
partners, the training status hi ....................(3) s lng cc ng
...................... (4) the practice, the nghip, quy c h do to (4)
level .................... (5) seniority, the thc hnh, mc (5) S
number ................... (6) half-days thm nin, s lng ................. (6) s
free of practice o r m e d ica l c o m m it na ngy nghi thc hnh hoc nhng
m ents and the fre q u e n c y rng buc y khoa v xut
.................. (7) on-call duty. Enquiry ....................(7) n h i m v mi gi. C uc
was m a d e ...................(8) w o rk d o n e iu (ra c thc hin ..............18)
outside the p ractice a n d ................. (9) cng vic lm bn ngoi s hnh ngh
participation in a n y professional v .....................(9) 5 lliain gia vo cc
committee(s). S u b j e c t s ................ ( 10) hi ng ngh nghip. Cc c nhn
asked to indicate .........................( 11 ) ......................(10) dc hi chi ra
(if anyone) h a d special responsibility ..........................( 1 1 ) (n u ni d ) c trch
in their p ractice .....................( 12) a nhim c bit trong ngh nghip ca
total of 12 activities, all o f w hich h ..................(1 2), tng s gm 1 2 hot
w ould b e ex p e cted to b e carried ng, tt c nhng hoat ng ny s
...................... ( 13) in e v e ry practice. c lu m a n g v o ................(1 3)
Finally, eight q u e s tio n s ................. (14) trong mi cng tc thc hnh. Cui
GPs' sources of satisfaction at w o rk cng, tm cu hi (14)
w e r e derived .................... ( 15) g ro u p cc ghi nhn thu c t cc thy
discussions and background thuc thc hnh tng qut v s hi
literature. T w o discussion groups, lng trong cng vic u bt ngun
o n e ....................(16) eight w o m e n ........................ (1 5 ) n h n g th o lu n n h m
G P s a n d th e se c o n d (17) v tng quan y van. Hai nhm tho
10 d o cto rs of b o th g en d ers, w e r e lun, mt ......................(16) tm thy
held, th e topic set b e in g GPs' stress thuc thc hnh tng qut n v nhm
a n d job satisfaction. Eight possible th hai .............(1 7) 10 bc s ca c
source s ...................(18) satisfaction hai gii, c mi n , ch l s
....................(19) identified, a n d for c n g th n g tin h th n v s hi lng

ea c h (20) these, subjects trong cng vic. Tm nguAn ghi n h n
w e r e invited to resp o n d ..............(2 1) kh hdu ................... (18) s hi lng
a five-pomt Liken scale, ranging .................. (191 uoc x c dinh, v cho
from 'no' satisfaction to 'extrem e' m i ................. (20) vic d, cc c nhn
satisfaction (scale 0-4). dc yu cu tr li ------- ----(2 1) bc
thang nm im Likert, xp h<ing l
k h n g ' hi lng n 'c c k ' hi lng
(bc thang 0-4)7
Q u estionnaires .........................(22) C c cu hi ................(22) gi dn

d e s p a tc h e d to individual practitio cho tng c n h n thy thuc thc hnh
ners v i a .................. (23) family health tng qut, thng qua (23) h
services authority (FHA) c o u r ie r sys thng th l ca c quan phc v sc
tem and c o m p le te d forms khe gia inh (FHA) v cc Hang hon
(24) r e tu r n e d in freepost chinh (24) gi tr lai trong
envelopes. D e ta c h a b le c o d e n u m cc phong b m in ph bu din. Cc
bers ........................ (25) a p p e n d e d to ch s m h. c th g ri ..........(25)
the q u estio nnaires to allow cha sing nh km iheo cc cu hi cho php
...................... (26) n o n -re s p o n d en ts, theo di .................(26) nhng ngi
w h o w e r e re m in d e d twice. khng tr li dc nhc nh hai ln.
Staffordshire FHSA w a s th e r e Staffordshire FHSA l ni c th m

sponsible authority ...................(27) quyn chu tr.k h nhim (27),
502 of th e GPs. The o th e r 304 GPs in 502 thy thuc thc h n h tng qui. S
clu d ed ..................(28) th e survey 304 thy thuc ihc h n h lng qut
h a d s o m e patients residing in Staf khc bao R m .......................... (28) vic
fordshire........................(29) m ost of nghin cu gm c mt s b n h nhn
their patients lived in n eig h b o u rin g c tr tai S ta ffo r d s h ir e .......................(29)
counties a n d their responsible FHSA a s cc b n h nhn sng trong cc
w as o n e ...................(30) th e n in e o t h qun k cn v c quan FHSA chu
ers n e ig h b o u rin g Staffordshire. tr.ch nhim vi ho l ml
(30) cn chn ci khc du
q uanh Staffordshire.
A Minitab p a c k a g e ...................G l ) MI chng trinh M in ita b ______ (31)

u sed to p ro ce ss th e responses. T a c s dng d x l cc cu Ir li.
bles of u n o r d e r e d categ orical d ata Nhng bng d kin xc thc cha
....................... (32) analysed by the c xp th l .................. (32) c
c hi-squared test. T he M ann W h itn ey phAn tch bng p h p kim chi-
t e s t ...................(33) use d for o r d e r e d squared. P hp kim M ann W hiiney
categorical d ata w h e n tw o groups (33) c s dung cKo cc
were b eing c o m p a r e d ; the Kruskal- d kin xc thc d dc xp th l
Wallis test w a s used (34) khi c hai nhm u doc so snh
1 7 4 - English in M e d ic in e
th ree o r m o r e groups (35) loi p h p kim Kruskal-Wallls r s
being c o m p ared ; these tests in dng .................... (34) ba nhm hoc
c lu d e d an allo w an ce (36) n h iu h n ...................(35) clc so s n h ;
tics. T he P-values calculated for cc ph|j kim d bao gm vic xc
these last tw o tests w e r e two-sided. nh.in ................(36) im. Cc Iri s lJ
C o c h ra n 's te c h n iq u e w as u s e d to in tnh clc cho r hai plicp kim va
vestigate w h e th e r s o m e ...............(37) mi k Irn u tliuc hai pha. K
the gen d e r differences that ........ (38) thut Cochran d dc s dung (l
found w e r e c a u se d by co n fo u n d in g nghin cu xem vi .................... (37)
factors c a u s i n g .................... (39) s p u nhng khc bil v g i i................... (38)
rious association. cl phi hin du c npuyn nhn do
nhm ln c c yu ( g y r i.............(39)
s kt hp gi mo.

Task 13 IGZOI s Bi lm 13
Look b ac k at p. 144 to r e m i n d y o u r s e lf Hy xem li trang 144 bn nh li tnh
of M r.H u d s o n 's c o n d i tio n . T h e n w o rk trng ca ng Hudson. Ri lm vic theo
in pairs. S t u d e n t A s h o u l d start. i. Sinh vin A bt u trc.
A: Play th e p a r t of a s u r g e o n . You A: ng vai m t bc s phu thut. Bn

have p e r f o r m e d a l a p a r o t o m y o n thc hin phu thut m bng cho
Mr H u d s o n . You find o c c l u s i o n of ng Hudson. Bn thy c lp tc dng
the s u p e r io r m e s e n t e r i c a r te ry a n d mch m c treo trn v hoi th rut
g a n g r e n e o f t h e sm a ll b ow el. You non. Bn ct b phn ln on rut
resect m o s t o f th e sm a ll b o w el. non. Hy gii ngha cho con trai/con
Explain to M r H u d s o n ' s s o n or g ca ng Hudson v cng vic bn
daughter w hat you have done. lm.
B: P l a y t h e p a r t o f M r H u d s o n ' s s o n o r B: ng vai con trai hoc con gi ca ng

d a u g h t e r . Ask th e s u r g e o n a b o u t Hudson. Hi bc s phu thut v ca
yo u r fath e ;'s o p e r a t i o n . Ask h i m or phu thut ca cha mnh. Hi ng/b
h er to ex p la in t h e c a u s e o f y o u r bc s gii ngha nguyn nhn bnh
f a th e r's p r o b le m . Also ask h i m or ca cha bn. Cng hi n ^ bc s
h e r w h a t his c h a n c e s a r e for th e v n hng trin vng ca cha bn
fu tu re. trong tng lai.

W h e n y o u h a v e fin ish ed , com p a re Khi bn d thc hin xong, hy so nh
y o u r e x p la n a tio n s w ith th e recording. cc gii ngha ca bn vi bng ghi im .
Task 4 Bi lm 4
R esults o f investigations: Cc k t q u i x t n g h i m :
ESR - 80 m m in first h o u r T l l n g hf>ng c u - 8 0 m m tron g
gi d u ti n
N eu tro p h ils - 85% B c h c u trun g tn h - 8 5 %
Biopsy show ed th e changes o f giant cell Sinh th i t ch o th y c n h ng b i n d i ca
arteritis. tin h tr n g v i r n d n g m a ch ^ i b o .
Unit 7 Bi 7
Treatment iu tr
Section 1 Medical tre a tm e n t
Phn 1 iu tr ni khoa
Task 1 ^ B i l m 1
Look back, a t th e c a s e o f M r J a m e s o n Hy xem li trng hp ca n g Jameson
(see p p . 5 2 - 5 ,6 5 ,6 8 -7 0 ,1 0 0 -1 a n d 154) (xem cc trang 52 -5 , 65, 68-70, 100-1 v
a n d c o m p le te as m u c h as y o u c a n of 154) v b su n g cn g n h iu cng tt vo
th e c a s e n o te s. b n g ghi ch.

SU RNA M E am eson ________________________________F IR S T N A M E S A l.m
AGE 5 ) SEX M _____________________________M A R IT A L S T A T U S M
O C C U P A T IO N CarpcniL-f ________________________________________
Acute b a c k a c h e r e fe r r e d d o w n R s c i.itic n e r v e d is tr ib u tio n .
O /E
G e n e r a l C o n d it io n Fil. w e l l - m u s ( le d.
ENT
RS
CVS
G IS
GUS
CNS
P O IN T S O F N O TE
C arpenter - a c tiv e w ork.
1.7 8m , 6 8 kg - ta ll, s lig h tly -b u ilt.
M y e l o g r a m - p o s t e r io r la t e r a l h e r n i a t i o n o f d i s c .
D I A G N O S IS

H Jam eson TN A lan
TU I 5 . GII N .im TN H T R N G H N N H N C v
N G H N G H I P T h nic
t)<iu l nji l p ln h la n x u n g ih .n k in h ln p l u i i .
TH M KHM
T n g tr n g K li e m a n h , ( bci|i n n a n g
T .M .H N G
H .H P
T.M C H
T .H A
N .D C
T.KINH
TIN S G N Y
C C IM G H I N H N
T h o m c - la o n g n n g
I m 7 8 , Okg - r<io. m n h k h n h
KT N G H I M
T y d - llio t v a sau bn
CHN ON
W h at tr e a tm e n t w o u ld y o u su g g e st? Bn gi cch iu tr no?

Task 2 L Bi lm 2
You will h e a r a n e x tra c t fro m th e c o n Bn s nghe mt trch on t cuc khm
su lta tio n . L isten a n d c o m p le te th e b n h . H y lng n ghe v b su n g phn x
m a n a g e m e n t s e c tio n o f th e c a se tr trong khung ghi ch.
n o te s.
MANAGEM ENT
dihydrocodeine 2 q.d.s. p.c.
x TR
H ihydrocodeine 2 ngy 4 ln. sau khi an

N o te h o w th e d o c to r a d v ise s th e p a C h cch bc s khuyn b n h n h n v
tie n t a b o u t th e fo llo w in g p o in ts : cc im sau y:
T h e d u r a tio n o f th e tr e a tm e n t: Thi gian iu tr:

- I th in k it w ill be so m e w e e k s before T i n g h s phi m t vi tun l na th
y o u c a n g o b a c k to y o u r k in d o f a c ng mi tr li lm vic nhanh nhn dirc.
tiv e w o rk .
H ow th e p atien t m u st c o n d u c t h im se lf Cch b n h n h n phi tun th trong khi

d u rin g th e tr e a tm e n t: iu tr:
- You m ust rest to allow this sw e llin g to n g p hi n g h ngi ch s n g ty ny
g o d o w n ... x p x u n g ...
- I f you get up ... all th e b o d y w e ig h t N u n g d n g d y ... ton b trng lung
a b o v e th e d a m a g e d d isc w ill p re s s c th p h a Ir n a t n th u o n g s l n
dow n o n th e d isc ... d la y...
- You should also try to have your n g C M ig n n c g n g n m k h i d n g b a
m e a ls ly in g d o w n . an.
- Don ' sit up to eat. ng n g i m n.
Task 3 EI t Bi lm 3
H ow w o u ld y o u a d v ise e a c h o f th e s e Bn s khuyn n h mi ngi trong s
p atien ts? W ork in p airs. S tu d e n t A cc b n h n h n ny n h th no? Lm
sh o u ld sta rt. vic theo i. S inh vin A bt u trc.
A: Play th e p a r t o f th e d o c to r. A dvise A: ng vai bc s. Hy khuyn nh tng
e a c h o f th e s e p a tie n ts a b o u t th e ngi o n g s cc b n h n h n ny v
tr e a tm e n t y o u p la n for th e m . cch iu tr m bn d tn h cho h.
B: Play th e p a r t o f th e p a tie n ts . In 7, B: ng vai cc b n h nh n , 7, ng vai

play th e p a r t o f a p a r e n t. cha m.
1 A h y p erte n siv e 5 0 -y ea r-o ld d ire c to r Mt gim c cng ty nh, 50 tui, c

of a sm all com pany. b n h cao huyt p.
2 An in s u lin -d e p e n d e n t 11-y ear-o ld Mt b gi 11 tui c bnh tiu ng

girl ac co m p an ie d by h e r p a re n ts. ph thuc insulin c cha m i km.
3 A 6 5-year-old s c h o o lte a c h e r w ith Mt thy gio 65 tui c bnh v im

o s te o a rth ritis o f th e left hip. xng khp hng tri.
4 A 23-year-old lo rry d riv e r affected Mt ti x xe ti 23 tui c b nh ng

by epilepsy. kinh.
5 A 52-year-old co o k w ith c a rc in o m a Ngi nu n 52 tui c b nh carcinom

o f th e bow el. rut.
6 A 2 7-year-old te a c h e r o f h a n d i Thy gio 27 tui dy tr khuyt tt, ang

cap p ed c h ild re n su ffe rin g fro m a d e c b nh trm cm .
pressiv e illness.
7 A 6 -m o n th -o ld baby boy su ffe rin g MI b trai 6 thng tui c bnh chm d
from a to p ic eczem a, ac c o m p a n ie d ng c cha m b n.
by h is p a re n ts.
W hen y o u h a v e fin ish e d , c o m p a r e Khi bn lm xong, hy so snh li
y o u r a d v ic e w ith th e re c o rd in g . khuyn ca bn vi bng ghi m .
Task 4 CO Bi lm 4
H e r e is t h e p r e s c r ip t io n th a t w a s g i v e n y l toa th u c d n h c h o n g la m eso n :
to M r J a m e s o n :
MR \ MR JAMESON
Surnam fl of paliant - in B L O C K L E T T E R S
MRS 1
M ISS [ ALAN
C h ild J Initials and o n e lull forenam e w herever p o ssible
A g e (1 under
41 Mead Avenue
A d d re s s
12 years
Edinburgh EH3 5EN Pftrm acirs SlAmp

'i'R S m th s
NO OF DAYS TREATM EN T Fo r ft onty by

NP N .B E N S U R E T H A T D O S E IS S T A T E D P r o n g Buraau
R *
Tab. dihydrocode me BP 30mg

Mitte 100 (one hundred tabs)
sig. 2 tablets. 6 hrly for pain. p.c.
Sign atu re of D octor Oslfl

Fo r u se t>y
Pharm acist
IM P O R T A N T R e a d n o te s overleaf B E F O R E going to th p h a rm acy

M e d icin e urgently required m ay b e obtained outside normal
hou rs if p re sc n o iio n IS m arked U rg e n t by the Doctor
18 2 - E n g lish in M ed icin e
0 . JA M ESO N
N G "\
8
1 l IM I>mIi Iihtii. vil b r in g C H IN HOA
C 1
A LA N
B )
'lr -11 I.u V.I IIII ln cl.iv (li* * IM bnh nlicin, nu (loc
ItNM Ill'll l i t rot 1 ) 1.1 ( II I 4 1 n g M EAD

1J l(M)l
E d in b u r g h E H 3 5E N
Tem ca
I I I A N l . I I II
ditoc si
S N G Y l ' TKI Dnh cho

NP 1 B. Cl III V r .l II RO 1 l u L lO N G plng Ai VVI
Rx
T h u c v i n d ih y d r o c o d e in e .
D u c i n A n h 3 0m g .
C h o 1 0 0 v i n .
U n g 2 v i n m i 6 g i , g i m a u ,
s a u k h n .
Ch k ca bc SI Ngy
DAnh ring
d iu dildc SI
CH : oc c ic gi ch Irang sau TRC KHI dn ca hng dc C

lli m u i llioc llieo yu c iu khXn cp ngoAi gi bn nu loa Ihuc c du
K h in do b i r si x i c n lijn .

W h ic h p a rt o f th e p re s c rip tio n g iv e s Phn no trong toa thuc cu n g c ip thng
th e follow ing in fo rm a tio n ? tin di y?
a) h o w often th e ta b le ts s h o u ld be cc vin thuc s dc ung bao lu

ta ke n
b) th e p u rp o se o f th e tre a tm e n t m c ch diu lr|
c) th e a m o u n t p resc rib ed lng thuc k (rong loa
d) th e n a m e o f th e m e d ic in e tn loai thuc
W hat d o th e f o llo w in g a b b r e v ia tio n s Cc ch vit Lt di y ngha l g?

s ta n d for?
e) M itte
0 tab s
g) s 'g
h ) p.c.
Task 5 % [ s ] Bi lm 5
U sin g th e in fo rm a tio n g iv en in T ask 4, s d n g p hn th n g tin ghi tro n g Bi lm
try to c o m p le te th e d o c to r 's in s t r u c 4 h on ch in h n h n g hng dn ca
tio n s to M r J a m e s o n b y p u ttin g o n e bc s ni vi ng Jam eson bng cch
w o rd in e a c h gap. in m t t vo m t khong trng.
D O C TO R : N ow , M r J a m eso n , h e re is a B.S: ng Jameson, y l loa th u c cho

p re sc rip tio n for so m e ................... (1) vi .......................(1) m ng phi
w h ich you are to ta k e ................... (2) ung .......................(2) cho mi
o f every ........................ (3) h o u rs. ........................(3) gi. N h ung
T ry to ta k e th e m ......................... (4) .......................(4) ..................... (5) nu
....................... (5) if p o ssib le in case c th c trong trng hp ihuc
th e y ca u se you in d ig e stio n . You lm n g kh tiu . ng .................(6)
...................... (6) ta k e th e m d u rin g dng thuc vo ban m nu
th e n ig h t as w ell if you are aw ak e tnh gic vl .......................(7).
w ith th e ...................... (7).
W h e n y o u h a v e fin is h e d , lis te n to th e Khi bn lm xong, hy nghe bng ghi

re c o rd in g . m .
Task 6 Q Bi lm 6
Try to m a tc h th e s e tr e a tm e n ts w ith Th xp nhng cch diu tri ny cho by
th e se v e n p a tie n ts d e s c r ib e d in T a sk 3. bnh n h n c m t i trong Bi lm 3.
1 T ab. n a p ro x e n 2 50 m g Thuc vin naproxen 250 mg
M itte 100 Cho 100 vin
sig. 1 cab. t.i.d. ung 1 v i n 3 ln m i n g y (n g y 3 ln)
2 Tab. im ip ra m in e 25 m g Thuc vin im ipram ine 25 mg

M itte 100 Cho 100
sig. 1 tab. t.d.s. ung 1 vin 3 ln mi ngy
3 C o lo sto m y bags Ti m thng i trng

M itte 5 0 Cho 50
4 H u m a n so lu b le in su lin H u m an is o p h a n e in su lin
Insulin ngi ha tan Insulin ngi isophane
100 IU /m l 100 IU /m l
100 dn vj quc t/ml 100 n vj quc t/ml
M itte 1 0 m l X 4 M itte 10 m l X 4
Cho 10 m l X 4 Cho 10 ml X 4
sig. 6 IU a.m . sig. 18 IU a.m .
tim & IU bui sng tim 18 IU bui sng
4 IU p.m . 8 IU p.m .
4 IU bui chiu 8 IU bui chiu
5 Tab. m e to p ro lo l 100 m g Thuc vin m etoprolol 100 mg

M itte 100 Cho 100
sig. 1 b.i.d. ung 1 vin ngy 2 ln
6 H ydrocortisone cream 1% Thuc bi hydrocortisone 1%

M itte 3 0 g Cho 30 g
sig. ap p ly th in ly to th e affec ted are a bi nh trn vng da bnh, ngy 2 ln
b.i.d.
7 Tab. c a rb a m a z e p in e 4 0 0 m g Thuc vin carb am a ze p in e 400 mg
M itte 6 0 g Cho 60 g
sig . 1 tab. b.d. ung 1 vin, ngy 2 ln
W hat d o th e fo llo w in g a b b r e v ia tio n s Cc ch vit tt sau y c ngha g?

sta n d for?
a. b .i.d ./b .d .
b. t.i.d ./t.d .s .
E n g lish in M ed icin e - 185

Section 2 Physiotherapy
P h n 2 Vt l tr liu
Task 7 I sl
L isten c a re fu lly to th e in s tr u c tio n s
Bi lm 7
Lng nghe k nhmg li hng dn ca
th a t th e p h y s io th e r a p is t g av e M r bc s vt l tr liu ni vi ng Jam eson
Ja m e so n for h is s p in a l e x te n s io n e x e r thc hin cc thao tc ko dn dt sng
cises. Try to p u t th e s e d ia g ra m s in th e ng. Xp cc h nh v ny theo th t
c o rre c t o rd e r u s in g th e in s tru c tio n s . n g vi cc hng dn. nh s cc
N u m b e r th e m 1 10 5. h n h v t 1 n 5.
b)
d)
<\
e)

N ote h o w th e p h y s io th e r a p is t m a rk s Ch phng cchbc s vt l tr liu ncu
the s e q u e n c e o f in s tru c tio n s : r trnh t li hng dn:
- First o f a ll y o u lie d o w n ... T r c t i n n g h y n m x u n g
- N ow p la c e y o u r h a n d s o n y o u r B y i h y d t h a i b n ta y tr n l n g ...
b a c k ...
Read th ro u g h th e T a p e s c r ip t fo rT a s k 8 c k bn i thoi cho Bi lm 8 v

an d u n d e r lin e th e m a rk e rs o f s e gch di n h n g ngn t n h n m n h ca
q u e n c e u se d . cu dng.

N o te h o w th e p h y s io th e r a p is t advises Ch phng cch bc s vt tr liu
th e p a tie n t: hng dn b n h n h n :
- Y o u should d o th e s e e x e rc is e s th r e e ng nn lp c c th a o tc n y m i ngy ba
tim e s a d a y , preferably o n a n e m p ty ln, tt nh't l v o hic d i b u n g.
sto m a c h .
- Y ou should try to do th em as slo w ly n g n n c g n g t p th ao tc cng chm
and sm o o th ly as p o ssib le ... v nh nhng cng tt ...
N o te h o w th e p h y s io th e r a p is t c a u Ch phng cch bc si vt l tri iu

tio n s th e p a tie n t: cn dn b n h n h n :
- Y ou sh ou ld try to a v o id j e r k i n g y o u r n g n n c g n g tr n h gt ngut.
body.
Task 8 % Bi lm 8
C o m p le te th e s e in s tru c tio n s to M r D ng ngn ng thch hp d hon chnh
Ja m e so n u sin g a p p r o p r ia te la n g u a g e . n h n g hng dn ny cho Ang Jam eson.
1 ................... on a h ard surface. ....................... trn m t m 4 t p h n g cng.
2 .................... careful w h ile g e ttin g .......................c n th n khi ri khi ging.
o u t o f b e d .......................roll o v er an d ....................... q u .iy ngi n m n g h i n g ri
th e n get u p from y o u r side. m i n gi d y .
3 ..................... b e n d in g fo rw ard , fo r ex ....................... c i ngi v p h a truc, v d
am ple, if you are p ick in g u p s o m e n h n h t dA vt g s n n h .
th in g o ff th e floor.
4 ................... to b e n d y o u r k n ee s an d ....................... g p u g i v g i th ng sn g
keep y o u r back s tra ig h t. lng.
5 ................... liftin g heavy w e ig h ts. ....................... n h c vt n n g .
1 8 8 - E n g lish in M e d ic in e
Task 9 OBI I s ] Bi lm 9
Work in pairs. U sin g th e d iagram s in Lm vic theo i. s dng cc hnh v
Task 7 as cu es, take turns at in stru ct trong Bi lm 7 n h c nh, thay phin
ing Mr J am eson o n ea c h o f th e se sp i hng dn ng Jam eson thc hin
nal exercises. R em em ber to u se tng bi tp ct sng ny. Ch dng
se q u en ce m arkers and th e correct cch nh du tng on v cc dng
verb form s. ng t ng.
W hen you h ave fin ish ed , com p a re Khi bn thc hin xong, hy so snh
your in stru ction s w ith th e recording. cc hng dn ca bn vi bng gh i m.

Section 3 Surgical tre a tm e n t
Phan 3 iu tr| ngoi khoa
Task 10 iQEl B i l m 1 0
W o rk in pairs. M r J a m e s o n 's c o n d itio n Lm vic theo di. Bnh trng ca ng
h as w o rs e n e d a n d h is d o c to r h a s d e Jam eson xu i v bc s ca ng quyt
c id e d to refer h im to a n e u r o s u r g e o n . nh chuyn ng ti m t bc s ngoi
U sing th e c u e s b e lo w a n d th e la n khoa th n kinh. S dng cc cu gi
guag e th a t y ou h a v e s tu d ie d in th is di y v phn ngn ng m a bn hc
a n d ea rlier u n its , ta k e tu r n s at e x p la in tro n g bi ny v cc bi trc, thay phin
ing th e d e c isio n to M r la m e s o n . nhau d gii thch quyt nh trn cho
ng Jam eson.
1 S y m p a th ise w ith th e p a tie n t ab o u t C m (li n g vi b n h n h .n v r n r1,iu k o
ih c c o n tin u in g p ain an d ih e d ev e l di v lnh Irng yu mi bn chn phi
o p m e n t o f w ea k n ess in th e p a c t.1ng d n .
tie n t's rig h t foot.
2 E xplain th a t th is w ea k n ess is d u e G ii llich rn g tinh Irng yu m i n.y IA
10 c o n tin u e d p re ssu re on th e nerv e do stl) lin lc Irn cc r thn kinh
ro o ts su p p ly in g th e m u sc le s o f his H.n li c b<|j cli.in.
leg
E xplain th a t th e p re ssu re is at th e G ii thch rng scl p hin din 1,11 ni
level o f the d is c b etw een the lum da gia cc: dt sng lng.
bar vertebrae.
4 Explain that you think he sh ou ld be Gii Ihcli r n g bn ngh l bnh nhn
referred to a n e u ro s u rg e o n an d nn clc gii thiu li ml b r s riROiii
why. k h o a t h n k i n h v l clo p h i ( h u y c n
b n h nhn.
5 R eassu re th e p a tie n t a b o u t th e o p T r n an b n h n h n v c u c p h u Iliu .t v,
era tio n an d fo llo w -u p tre a tm e n t. c c h d i u lri ti p ih e o .
6 E xplain th e p ro g n o sis if th e p a tie n t C i i th c h VC li n l ong b n h n u b c n h

agrees lo th e o p e ra tio n n l i n d n g m.
7 Explain th e p ro g n o sis if th e p a tie n t G ii llich v lin lng b nh nu bnh

d o e sn 't have th e o p e ra tio n . nhn khng dng m.
8 A sk th e p a tie n t if th e re are any fu r Hi bnh nhn xem cn nhng im no
th e r p o in ts h e w o u ld like e x m un c gii ihich thm na.
p lained.
When y ou h a v e fin ish e d , c o m p a r e Khi bn thc hin xong, hy so snh

your e x p la n a tio n s w ith th e re c o rd in g . cc gii ngha ca bn vi bng ghi m.
Task 11 B i l m 1 1
Study th e M e d ic a tio n s s e c tio n o f this N ghin cu phn cho thuc ca phiu
D ischarge S u m m a ry . T ra n s f e r th is tm t t xut vin. Ghi li phn tm tt
su m m a ry o f th e p a tie n t's m e d ic a tio n thuc ca bnh nh n vo Toa thuc ca
10 th e H o sp ita l P re s c rip tio n S h e e t o n bnh vin trang 194.
p. 194.

THE BOYAL IN F I R M A R Y D IS G H A B O B S T T M M A B T :
To Dr W lnton Dale oi admission 3 0 .8 .9 7 8c 1 5 -9 .9 7 CSOH)

C ardiologist D ata 01 vg B.9 .9 7 * 2 4 .9 .9 7 ( M e m o r i a l )
S o u th ern Q eneral W a rd 14
C onsultant M r A . S w u
Dr W allace
High S treet
E v erto n
Surnam e W ynne Fo re n a m e * John Numor 1 5 6 3 S 2 6

Address 5 N elso n str e e t, E v erto n
C rescen do a n g in a
P rincipal d iagnosis P rincipal operation C A V O X 4,
? recen t m y o ca rd ia l In farct sin g le sa p h gr&fta to LAD,

RCA, se q u e n tia l sa p h g r a ft to
0M 1 a n d 0M 2
Otner conditions D ate 01 opriion 1 7 .9 .9 7
O th ei operations
External c a u sa ol iniury
PM/no P M Tum our type H istological verification
of tum our typ Ven1\*/Hot v n t + o
HISTORY: 58-year-old ca r sa le sm a n w h o h a s b een h y p e r te n s iv e fo r I S y e a r s . Had

an in ferior m yocard ial in fa r c tio n In 1 9 9 3 . For th e paat 3 m o n th s h e h u had In
crea sin g a n g in a p ecto ris w h ic h h a s b een p r e se n t a t rest. R ecen tly ad m itted to
h osp ita l w ith prolonged c h e st pain, fou n d to h a v e p o sitiv e th a lliu m despite
n eg a tiv e acu te ECG or e n z y m e c h a n g e s, o th e r p a st h isto ry o f h y p o th y ro id ism di
agn osed 3 y e a r s ago Stopped sm o k in g 2 0 c ig a re ttes a d a y 5 y e a r s ago.
MEDICATIONS: A sp irin 3 0 0 m g dally, h ep a rin sod iu m 8 0 0 0 u n its t.d .8., dlAmorphlne
5 m g 4 h o u rly p .r.n ., cy cliz ln e 5 0 m g 4 h o u rly p .r.n ., p aracetam ol l g q.d.a., te
m azep am 2 0 m g nocte, QTN pu m p sp r a y 4 0 0 - 8 0 0 g p.r.n ., aten o lol m g dAlly, lso-
sorbide m o n o n itra te m /r 6 0 m g In th e m o r n in g th y r o x in e 0 .1 mg dally,
b en d roflu azld e 2 .5 m g ta b let d a lly , am lod lp ln e 6 m g In tha mnm tn g
EXAMINATION: Obese. P ulse 6 0 regular, BP 1 3 0 /8 0 , no sign s of f&llure. heart
so u n d s n o rm a l. S o ft m ld sy sto llc m u rm u r a t a p e x a n d a o rtic ar
e a s.
INVESTIGATIONS: R o u t in e h a e m a t o l o g y a n d b i o c h e m is t r y n o r m a l. C h e s t X -r a y :
norm al. ECO sh o w ed ev id en ce o f p rev io u s Infarct, Q w a v e s In Tj
AVF, Inverted Tg, In V | - v 8.

b n h x h o n g g ia p h i u t m t t XUT VIN:
Kinh gl: B .s w i n c o n N g iy nhp vin: 3 0 . 8 . 9 7 v 1 5 . 9 . 97
C huyn k h oa T in (BV S o u t h e r n G e n e r a l )
B nh v i n Ngy xu t vln: 5 . 9 . 97 v 2 4 .9 .9 7
S o u th e r n G en era l (BV M e m o r ia l)
B.S W a l l a c e Phng: 14
. B . s tham vn: n g A . Sw an
u n g H ig h
E v o r to n
H: W ynne Tn: J o h n S: 1 5 6 3 5 2 6
|a chl: s dng N e ls o n , E v e r t on
Chn on chinh: C on a u t h c ngc Phu thut chinh: G h p d n g m ch v n h

t& n g d n . t i n h m ch X 4 . C c c h g h p t i n h
M i b n h & i mu c a t im ? mQCh h i n o n t i l c h t r u e t r i ,
n g m ch v i n h p h i , c h g h p t l n h
m ch h i n p h v o n h n h n h 1 v 2 .
CAc tinh trng khc: Ngy p h u thut: 1 7 . 9 . 9 7
Cc p h iu thut khc
Nguytn nhn bn ngoi ca tn thng
Sau t vong/(T thit)/ Loi u Kim tra m hc

Khng t thit lo t 1 u Kim tra/Khng kim tra
BNH S: B n h n h n n a m , 5 8 t u i , l i m n g h m ua b n t . B c a o h u y t p t
1 5 n A m n a y . Nm 1 9 9 3 c n h i mAu v n g d u i c o t i m . T r o n g 3 t h n g q u a , c
COT1 a u t h t n g c t n t r d n v i k h n g g i m l c nAm n g h i . M i d u c n h p
v i n v i a u n g c k o d i i , c k t q u i d u cm g t i n h k h i ch p s c a n t h a l l i u m ,
mc d u d i n t m d c p u m t i n h h o c t h a y d i v e n z y m . T r o n g b n h
a , c c h n o n b n h t h i u n& ng t u y n g i p c c h y 3 nm . N gng h c 20
d i u t h u c 1A m i n g A y , c A c h A y 5 n a m .
THUC DUNG: A s p i r n e 3 0 0 m g m n g i y , h e p a r i n s o d i u m 5 0 0 0 d o n v n g y 3
l n , d i a m o r p h i n e 5 m g 4 l n m i i , n u c n , c y c l i z i n e 5 0 mg 4 l n m i
a i , n u c n , p a r a c e t a m o l l n g A y 4 l n , t e m a z e p a m 2 0 mg v o b a n m ,
B l y c e r y l t r i n i t r a t e b m k h i d u n g 4 0 0 - 8 0 0 n o n u c n , a t e n o l o l mg m i
n g k y , i s o s o r b i t e m o n o n i t r a t e m / r 6 0 m v o b u i s n g , t h y r o x i n e 0 , 1 mg
m i n g y , b e n d r o f l u a z i d o 2 ,5 m g v i n m i n g y , a m l o d i p i n e 5 mg v o b u i
sA n g .
THM kh AM: B o p h . M o ch 6 0 d u . H u y t p 1 3 0 / 8 0 . K h n g d u h i u s u y
t i m , t i n g t i m b i n h t h u n a ; t i n o t h i n h g i a t m t r u n g
mm v i v n g n g m c h c h .
XT NGHIM: Huyt hc v sinh ha hc (theo qui uc) u binh thng . X-
q u a n g p h i : b in h t h u n g . i n t m c h o t h y b n g c h n g r
r t c a n h i mAu c o t i m t r u c d a y . CA c G n g Q T 3 + AVF, T 5
d io n g u c V - v 5 .

194 - English
Sheet No. P le a se u s e a b a ll p o in t pen

P R E SC R IP TIO N S H E E T
O R A L a n d O T H E R N O N - P A R E N T E R A L M E D IC IN E S R E G U L A R P R E S C R IP T IO N S
P L E A S E W H E N M E D IC IN E S A R E
UJ Date Tim es of Administration P R E S C R I B E D ON
o M E D IC IN E S (Block Litters) Matted of OOCTO*
Com D OSE
o Admn AU AM AM UD Hi FM rv MM Othar Timtft ** TU*1 Dal*
o m enced InrtnU Fud (Addrtwt Ifadona) PrncnÔon ChAH
1 1 p I I '
in M edicine
A Datotic Chan
B KrUoagufcnf Chwl
c A/ttMtfwt* îmcTin Storf
D RkwU 01 Ubou ShMl
E
F Ar*ru ractton pi0M*4 n*mt
G tft bOM tb w
H MC Die INC ADVEMSC REACTCN
1
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P A R E N T ! r u M. M E D IC IN E S . R E G U L A R P R E S C R I P T I O N S
M I6T
N Dat* D E T A IL S Irwtialt
o
p
Q
OWAL and OTHER MON-PAR ENTERAL MEDICINES ONCE ONLY PRESCRIPTIONS PARENTERAL MEDICINES - ONCE ONLY PRESCRIPTIONS
Dal* M*lhod of Ttn of D O C T O R 'S by Tn I
Data M E D IC IN E
Mrttod d01 DOCTORS by|TfMf
M E D IC IN E DOSE
Mmm Admin S I G N A T U R E
D OSE SIG N A TU RE rxt
HAW 0> f A T M f r r AO* U N IT M U M M W C O W g U L T A jjT KHOW W B B i a f l U D f f l H t t t m r n v r r r

T * ...................... Mit bng but bi
PHIU K TOA
T H U C U N G v T H U C K H N G T I M K H C - TO A TH NG D N G
NH DU / K H I K rn A n u A T D u
Ngy
-<
bt T H U C ( V i l c h in h o a ) Liu C ach J. d n g t hu<k
CMKY Ngng dung
2 DNG dng
u 1 10 ? C c g i k h c CABS Ngy V i ll l
> 1 Brfu d c l r birtg dC* (thuc ung * 1 ,
A Btu bu dng
B M u chcq dng wviu
c P N u gt* thuc m
0 H 0 l * k in
E
F N u ngng thuc tn N n g o phin J n g b t u
G g h iw o u 0 3 /
H TN THUC p m A n n q b J t lo i
1
J
K
T H U C TIM - T O A T H N G D N G
M An k i n g
N Ngy C H I TIT V i i tt
0
p
0
TH U C U N G v T H U C K H N G TIM K H A C - T O A C h I d n g m t ln TH U C TIM - TO A CH D N G M T L N
Ngy TH UC
M u n i iMi- C ch Git) C H K Ngi phi G nu co Ngy THUC LIU D N G C c h l G i C H K Ngi pht |Gid nu o
u t u UUNU dng dng C U A BS (co Itn yil tai) Ihay d dng dng C U A BS (c ln yil t) ihay i j i
English
in Medicine - 195
T N B N H NHN TUl S B N VI B C S T H A M V N MN C A M VI T H U C B BIT

Task 12 ^ Bi lm 12
Study this extract from th e Procedure Nghin cu trich on ny dilpc uy t
section . It is taken from p age 2 o f th e phn th tc thuc trang 2 ca Phiu tm
D ischarge Sum m ary. C o m p le te th e tt xut vin. S dng CC dng t di
g a p s in th e p roced u re u sin g th e se y d in vo ch trng trong bn th
verbs. T he verbs are n ot in th e correct tc. Cc ng t khng xp ng th t.
o rd er.
ad m in iste re d cung cp
an a sto m o se d ni n h n h
c o n tin u e d tip tc
cro ss-clam p ed kp ngang
grafted g h p
o p en ed md
p rep a re d chun b
rew arm ed lm m nng
PROCEDURE: QUY TRlNH:

V e in w a s ............. (1) for use as grafts. TTnh m jc h du c ...................... (1)
Systemic heparin was ...............(2) and dng l m m nh ghp. H e p a rin dc
bypass established, the left ventricle was ........ ........(2) v dung vng dc thc
v en ted , th e a o rta w a s .................. (3) a n d h i n , t m th '( tr i d u c th n g , dng
cold cardioplegic arrest o f the h eart o b m ch ch dc .......................(31 v thc
tained. T opical cooling was .............. (4) h in ngng tim lanh. Vng l*nh khu tr
for th e d u ra tio n o f th e a o rtic cro ss dc ...................... (4) tro n g ih i g ia n kp
clam p. ngang ng m ch ch.
A ttention was first turned to the first TrUc tin, ch dn cc nhnh b
and second obtuse m arginal b ranch es of th n ht v n h n h b th hai ca dng
the circum flex coronary artery. T h e first m ch vnh m. N h nh b iS n h i nm
o b tu se m a rg in a l w as in tra m u s c u la r w ith trong c v c x va o^n gn. Ni lp
proxim al artherom a. It ad m itted a 1.5 tc 1,5 m m dc ....................(5) VI cc
m m o c c lu d e r a n d w a s .................. (5) w ith o n g h p tnh m ach h in , g h p ktu M n
saphenous sequential grafts, side to side - b n b n g p rolene d j c bi< 6/0. c h t liu
using continuous 6/0 special pro len e ny cng duc dng cho lt c cc n hnh
which was used for all subsequent distal ni bn xa. P h in cui ca m in h ghp
anastom oses. T he end of this saphenous tnh m ch hin dc un cong v
graft was recurved and ..................(6) to ...................... (6) vi nhnh b th hai
the second obtuse marginal arou n d a q uanh mt oan l'p lc 1.75 nvn.
1.75 m m occluder.

T h e left a n te rio r d e sc e n d in g was N hnh m ch xung (rc Iri dc
(7) in its distal h a lf a n d ac- ....................(7) phn na xa v c doan
c c p le d a 1.5 m m o c c lu d e r a ro u n d w hich lp lc 1.5 mm, quanh d dc ghp
it w as g rafted w ith a single len g th o f long vi oan duy nhl tinh mach hin rldi.
sa p h e n o u s vein.
Lastly, th e rig h t c o ro n a ry a rte ry w as Cui cng, ng mch vnh phi c
o p e n e d at th e c ru x a n d ag ain g rafted m ni giao im v cCng c ghp vi
with a single len g th o f sa p h e n o u s vein on duy nli di ca lnh mach hin
a ro u n d a 1.5 m m o c c lu d e r w h ilsl (he c ir quanh ni lp lc 1,5 mm Irong khi tun
cu latio n was ............... (8). hon mu dc ........... (8).
C o m p le te T ask 13 b e fo re y o u c h e c k H on t t Bi lm 13 trc khi kim tra cc

your a n s w e rs in th e Key. cu tr li ca bn trong phn Gii p.
Task 13 ^ Bi lm 13
Put th e s e s te p s in th e c o r r e c t s e Xp cc giai on di y theo trn h t
q u e n c e to sh o w h o w th e o p e r a tio n ng ch r cuc phu th u t d dc
was c o m p le te d . S te p 1 is (a) a n d s te p 7 hon tt n h th no. Giai on l l (a) v
is (g). T h e o th e r s te p s a re o u t o f s e giai on 7 l (g). Cc giai don khc
q u en c e. khng ng trnh t.
a) R elease ao rtic cro ss d a m p a n d v en t Tho g kp ngang dng m ach ch v

air fro m th e left h e a rt an d a s c e n d thng kh t tim tri v ng mch ch
ing ao rta . ln.
b) A d m in is te r p ro ta m in e s u lp h a te Dng protamine sulate v iu chnh th
a n d a d ju s t b lo o d v o lu m e. tch mu.
c) D efib rillate th e h e a rt a n d w ean Loai b rung tim v thc hin tun hon
h e a rt o ff bypass. ngoi tim.
d) R em ove c a n n u la e a n d re p a ir can- Tho b ng thng (cannulae) v sa li
n u la tio n a n d v en t sites. v tr ng thng v thng kh cc v tr.
c) C o m p le te p ro x im a l vein a n a s to m o H on tt cc n hnh ni tnh m ch gn
ses to th e asc e n d in g aorca. vo ng mqch ch ln.
0 A sce rtain h a e m o sta sis , Kim tra vic cm mu.
g) In se rt d rain s. t cc dn lu.
W h en y o u h a v e o r d e r e d th e m c o r Khi xp cc giai on ng th t. bn
rectly w rite y o u r o w n v e rs io n o f th e fi hy vit ra don cui nhng ghi ch quy
nal s e c tio n o f th e p r o c e d u r e n o te s like trnh phu th u t theo kiu sau:
this:

- The aortic cross clamp was released and K ( p n g a n g n g m a ch c h d xtjc th o g
air vented from the left heart and as- v thng kh ditjc thc hin t tim tri
cending aorta. v n g m ch c h l n .
C h eck y o u r a n s w e rs to th is ta s k a n d Kim tra cc cu tr li ca bn i vi bi

T ask 12 u s in g p a g e 2 o f th e D isc h a rg e lm ny v Bi lm 12 bog cch s dng
S u m m a ry in th e Key o n p. 314. trang 2 ca Phiu tm tt xut vin
phn Cii p trn trang 314.
Task 14 ^ Bi lm 1 4
U sin g p a g e 2 o f th e D is c h a rg e S u m s dng trang 2 ca Phiu tm tt xut
m a ry in th e Key (o n p. 314), w o rk o u t vin phn Gii p (trin trang 314)
th e m e a n in g o f th e s e a b b re v ia tio n s . tm ngha ca cc ch vit tt sau y.
CABG G h p dng vng ng m ch vnh

LAD N h n h x u n ; trc tr i
RCA ng m ch vnh phi
OM1 N h n h b ih nht
LV T h t tri/vng th t
Task 15 G E ItS ] Bi lm 15
W ork in p a irs. S tu d e n t A s h o u ld s ta rt. Lm vic theo i. Sinh vin A bt du
trc.
A: Play th e p a r t o f th e s u rg e o n . Ex A: ng vai phu thut vin. Gii ngha
p la in to d ie p a tie n t in s im p le te rm s cho bnh nhn vi nhng thut ng
th e p u r p o s e o f th is o p e r a tio n a n d n gin m c ch ca cuc phu
h o w y ou w ill a c c o m p lis h it. thut ny v vic bn s thc hin
cuc phu thut nh th no.
B: Play th e p a r t o f th e p a tie n t. Ask B: ng vai bnh nhn. Hi v mi iu
a b o u t a n y p o in ts y o u d o n o t u n m bn cha hiu r.
d e rs ta n d .
W h en y o u h a v e fin ish e d , c o m p a r e Khi bn thc hin xong, hy so snh

y o u r e x p la n a tio n w ith th e re c o rd in g . cch gii ngha ca bn vi bng ghi m.
Section 4 Reading skills: Using an index
Phan 4 K nng c: s dng bng ch dn
Task 16 2 Bi lm 16
H ere is th e in s id e c o v e r p a g e from y l trang ba trong ca M c lc h i n
C u rren t C o n ten ts. S can th e p a g e to nay. Xem k trang in pht hin:
find o u t:
1 What it is. l g).
2 W h e re it is p u b lish ed . Ni xut bn
3 H ow o fte n it is p u b lish ed . N hp d xut bn
4 T he a d d re ss th ro u g h w h ich you a ch c|Ufi d bn c th dt mua bo.
w ould be able to o rd e r it.
CURRENT CONTENTS MC LC HIN NAY

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Task 17 ca Bi Tm 17
S can th e a d v e r tis e m e n t b e lo w to Find Xem xt p h n q u in g co di y i tlm
out: ra:
] T h e n u m b e r you w o u ld p h o n e to get S in thoai b an s gi d n d t mua

a su b sc rip tio n to Current Contents. M c l c hin nay.
2 W h a t th e a b b re v ia tio n is i s ta n d s for. Ch vit tt isi c ngha g)?
3 T h e w eb site n u m b e r. S w eb site
(If you have access to a w e b site , you (N u b n c vo w eb site, ban c th th
m ig h t like to try callin g it u p .) gi ngay by gi).
READ THE UNCUT VERSION! HY C BI VlT c h a b CT!

GET YOUR OWN SUBSCRIPTION TO HY DT MUA BO CHO RNC BN
CURRENT MC LC
CONTENTS HIN NAY
As a pass-along read er, you know N h m t bn c tin h cd, bn bit
th a t Current Contents9 is often ed ited rng M c lc h in n a y lun c xut
before it reaches you. Im p o rtan t arti bn trc khi n n tay bn. Khiu bi
cle s. w hole pages, o r en tire sections bo quan trng, c i ton b vi trang bo,
may have been rem oved. And th a t hoc nhiu phn trn vn u c th b
m eans youre not getting the full value ct b. V iu c ngha l bn khng
Current Contents offers. nhn c dy ton gi tr m M c lc
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To receive your ow n u n ab rid g e d c o p y nh n c cho ring bn bi vit

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S-C C -6906
Task 18 Q Bi lm 18
H ere is a n In d e x o f J o u rn a ls fro m a y l m t Bng ch dn cc bo ly t
co p y o f C u rre n t C o n ten ts. N o t all jo u r m t bn in ca M c lc h i n nay. Khng
nals c o v e re d b y C u r re n t C o n te n ts are phi tt c cc bo hin din trong M c
p u b lis h e d w eekly so th e y a r e n o t all lc h i n n a y u xut bn hng tun do
listed h e re . S c a n th e p a g e s to fin d o u t: vy khng phi tt c cc bo du c
trn dan h m c ny. Hy xem xt cc
trang tm ra:
1 W h e re you w o u ld g et a co m p lete Ni u bn s c dc bng danh muc
List o f Serials an d th e la te s t P u b lish hon chinh cc tp ch k v Bng hng
er G uide. dn mi nhl ca nh xut bn.
2 W h e re you w o u ld fin d th e la te s t T ri Ni u b<jn s tm thy Bng clii dn
an n u a l C u m u lativ e Index. Tng hp ba nm mt ln mi nht.
3 H ow m an y in d e x es Current Contents M c lc h in na y c bao nhiu bng chl
has. dn.
4 O n w hich page you w o u ld find th e Bn s tm thy Tp ch y h c A n h trn
British Medical Journal. trn n g n o .
VOLUME February 19, 1996 Not a|| journals covered by C u rren t C o n ten ts are
39 m ? 19 ,hn 2 n<Sm published weekly. Therefore, in any given issue
T^p your favorite journal may not be listed. However,
it will be included as often as it is issued. For the
39 com plete List of Serials covered and the latest
Publisher Guide see issue # 1 , January 1, 1996.
F or the latest Triannual Cumulative Index see is
sue # 4 , January 22, 1996.
NUMBER K hng p h i tt c c c tp c h trc thuc M c lc

g hin na y u c xut bn ling tun. Do vy
50 Irn mt n bn nht nh, tp ch a thch ca
ban c ih khng c nu dan h . Tuy nhin,n s
8 c ghi nhn cng thng xuyn n h c in
n. c d anh mc hon chinh cc tp ch k v
Bng hng dn mi nht ca nh xut b<in, hy
xem n bn 1 ngy 1 thng 1 nin 1996. c
being chi dn Tng hp ba n im mt ln mi nht,
xem n bn 4, 22 thng 1 nm 1996.

FEATURED IN THIS ISSUE OF CURRENT CONTENTS9 /LIFE SCIENCES
C NU TRONG An bAn my CA MC LC HIK HAY/KHO* HC s SHQ
FEATURES B I C B I T 13? HimtfWW

5 The Scientist*
146 PtrytMogy
150 Endocnr*ogy t u n t o k n
9 Current Book Contents*
1&5 E p m B c o g r ll*o n
1M Clinical ' I l l K m
DISCIPLINE GUIDE NGNH 243 N * u ro c n cM 4 B M mo>
11 Multidisciplinary
268 Animal I p%rt S o a n e s
21 Chemistry
32 Bioctwntstry & Biophysics
INDEXES CC BNG CH DN
66 Molecular Biology & Gntcs
278 TM Wo-t) m an
82 Microbiology
341 Author I n d n 1 W i n Dwsoory
94 Can & Developmental Biology
402 Pubk*n't A d d r n j D naen/
111 Pharmacology
C u rren t C o n te n ts processes all journal M c l c h in n a y x l ti c i c c in bn

issues within two w eeks of th eir receipt bo chf trong; vng hai tu in l sau khi
and m akes every reasonable effort to in n h n c v thc h in moi c gng tha
sure their prom pt delivery to ISI. Please n g bo d m gi ch n g Ih j( sm dn
note that the cover dates of som e jo u r Vin Thng tin Khoa hc (ISI). Xin lu
nals do not correspond to th e actual pub rng nhng ngy th n g ghi trn bla ca
lication dates. vi ( bo khng tong ng vi nhng
ngy th n g xut b n h in thi.
If a journal is covered in m ore than one Nu mt ( bo duc ghi n h n nhiu hn

cc*, a le tte r code appears in p aren th e mt ln trong Mc lc hin nay thl mt
ses next to the volume and issue num ber ch m ha s xut h i n tro n g n goc dn
to identify which editions: k li n vi s l p v s n b i n n h m xc
n h lo i xu b n :
(L) = Life S c ie n c e s : (P) - P h y s ic a l. C h e m ic a l & E a rth S s n c e s ; (S) S o c ia l & B a h a v n r * S o a n c M . (A) - Agri
culture. B io lo g y & E n viro n m e n ta l S c ie n c e s ; ( O C lin ic a l M e d ic in e ; (E) E n g m a a n n g . C o m p u tin g & T e c h n o l
ogy; (H) = Arts & Humanities
JOURNALS APPEARING IN THIS ISSUE: CC TP CH HIN DIN THONG An BN NAY:

94 A C T A H I S T O C H E M C Y T O C H E M . 28 (4) 194 A M E R J R O E N T G E N O L . 166 (2)
186 A C T A O R T H O P S C A N D . 66 (O C T ) S266 196 A M E R J S U R G .1 7 0 (A)S
111 acta P H A R M A C O L SIN. 17(1) 96 A M E R J S U R G P A T H O L . 20 (1)
146 A C T A P H Y S IO L S C A N O . 155 (1995) S31 32 A N A L B IO C H E M . 233 (1)
112 A D V A N D R U G D E L I V E R Y R E V . 18 (1) 197 a n esth esio lo g y . S4 0 )
112 A L IM E N T P H A R M A C O L T H E R A P E U T . 9 (6) 155 A N N B IO M E D E N G . 24 (1)
186 A M E R J C A R D IO L. 77 (2) 106 A N N INTERM M E D 124 (3)
94 A M E R J CLIN P A T H O L . 105 (1) 200 A N N S U R G . 223 (1)
190 A M E R J E PID EM IO L. 143 (2) 200 A N N T R O P M E D P A R A S rrO L . (O E O S l
190 A M E R J E P ID E M IO L 143 (3) 114 A N T I-C A N C E R D R U G . 6 (DC*S
113 A M E R J H E A L T H -S Y S T P H A R M . 53 (2) 33 ANTIVIR C H E M C H U O T h R 7 (1)
191 A M E R J H E M A T O L . 51 (1) 82 APM IS. 103 (1995)S54
66 AM ER J M E D G E N E T . 61 (3) 82 A P M IS 103 (1995)SS5
192 AM ER J M E D SCI. 311 (1) 62 A P M IS 103 (1999)S96
155 AM ER J P H Y S A N T H R O P O L . 99 (2) 34 A R C H B IO C H E M B iO P M V S 323 (7)
192 AM ER J P U BLIC H E A L T H . 66 (1) 201 A R TH R ITIS R H E U M . 30 0 )
96 A M EA J RESP1R C E L L M O l E C BKDL.14 (1) 156 A T H ER O S CLER O SIS 11 (1)

132 AU TO IM M UN ITY. 21 (4) 99 E U R J C E L L BIOL. 69 (1)
35 B B A -M O L cell r es . 1310 (1) 22 E U R J M E D C H E M . 31 (1)
3 B 0 A -P R O T E IN S T R U C T M O L E N Z Y M . 1292 (1) 117 E U R J P H A R M A C O L . 295 (1)
97 BIO C E LL .8 4 (3) 249 E U R N E U R O P S Y C H O P H A R M A C O L 5 (1995)S
37 B IO C H E M B JO P H Y S R E S C O M M U N . 2 ie (2) 99 E X P C E L L R E S . 222 (1)
66 B IO C H E M G E N E T .33 (1 M 2 ) 165 E X P LU N G R E S . 22 (1)
30 B IO C H E M J. 313 (JAN 15)P2 101 E X P M O L P A TH O L. 62 (2)
41 B iO C H E M IS T R Y -U S A . 35 (2) 250 E X P N E U R O L . 137 (1)
43 B IO C H E M IS T R Y -U S A , 35 (3) 15 E XP ER IEN TIA . 52 (1)
45 BIOCHIMIE. 77 (10) 16 F A S E B J. 10 (1)
45 BIOCHIMIE 77 (11) 52 F E B S L E T T . 378 (3)
46 B IO E L E C T R O M A O N E T I C S . 16 (6) 53 P E B S LE T T . 379 (1)
243 BIOL P S Y C H IA T . 39 (2) 84 FOLIA M ICR OBIOL P R A G U E 40 (2)
157 BIOL R E P R O D . 54 (2) 118 FU N D A P P L T O X IC O L. 29 (1)
21 BIO M EO C H R O M A T O G R . to (1) 119 FU N D A M CLIN P H A R M A C O L . 9 (6)
158 B IO M ED R E S . 7 (1) 212 G A S T R O E N CLIN BIOL. 19 (11)
13 B IO M E TR IC S. 51 (4) 69 G E N E . 167 (1-2)
47 B IO P O LY M E R S . 38 (2) 72 G E N E D E V E L O P .10 (1)
47 B IO S C IE N C E R E P 15 (5) 72 G E N E T IK A . 31 (12)
67 B IO S Y S T E M S . 37 (1-2) 73 G E N O M E R E S . 5 (5)
67 B IO S Y S T E M S . 37 (3) 54 G I Y C O B I O L O G Y . 5 (8)
82 B IO T E C H N O L B IO EN G . 49 (3) 152 G R O W T H R E G U L A T . 5 (4)
B3 B IO T E C H N O L L E T T . 18 (1) 101 H I S T O P A T H O L O G Y . 28 (1)
203 BLO O O . 87 (2) 153 H O R M O N E R E S . 44 (1995)S3
159 B LO O D C O A G U I A T FIBRINOL. 6 (8) 120 HU M E X P TO X IC O L. 15 (1)
159 B L O O D R E V , 9 (4) 214 HU M R E P R O D . 10 (12)
133 B O N E M A R R O W T R A N S P L A N T . 17 (1) 137 IM M U N O LO G Y . 87 (1)
268 B O T A C T A . 106 (6) 166 INDIAN J M E D R E S . 102 (D EC)
244 BRAIN. 11 e (D C)P 6 138 IN FE C IMMUNITY. 64 (2)
245 BRAIN R E S . 705 (1-2) 120 IN FIAM M R E S E A R C H .45 (1)
205 BRIT J D E R M A T O L . 134 (1) 166 INT J C A N C E R . 64 (6)
247 BRIT J P S Y C H IA T . 168 (1) 216 INT J C A R D IO L. 52 (3)
207 BRIT M E D J. 312 (7024) 121 INT J PH A R M .12 6 (1-2)
160 B U L L C A N C E R . 82 (1995)S5 217 INT J RAOIAT O N C O L B lO l P H Y S . 34 (2)
160 B U L L C A N C E R . 83 (1) 167 INT J S P O R T M E D , 17 (1)
14 c R A C A D SCI S E R Ill-VIE. 318 (12) 167 IN V ES T O P H T H A L M O L VISU AL SCI. 37 (1)
114 C A N J P H Y S IO L P H A R M A C O L 73 (11) 169 J A C O U S T s o c A M ER . 99 (1)
161 C A N C E R . 77 (2) 219 J A L L E R G CLIN IM MUNOL. 96 (6)P2. s
163 C A N C E R M E T A S T R E V . 14 (4) 220 J A M E R A C A D D E R M A T O L . 34 (1)
163 C A N C E R R E S . 56 (3) 122 J A N A L T O X IC O L. 20 (1)
98 C E L L . 84 (2) - 141 J A U T O IM M U N . 8 (6)
134 C E L L IM M U NOL. 167 (1) 04 J B A C T E R I O L . 178 (3)
96 C E L L P H Y S IO L B IO C H E M . 5 (6) 171 J B IO C H E M B IO P H Y S M E T H . 31 (1-2)
246 C E R E B R O V A S C DIS. 6 (1996)S1 55 J B IO C H E M T O K Y O . 119 (1)
115 C H E M -0 IO L INTER . 98 (3) 56 J BIOL C H E M . 271 (4)
210 CIR C U LA TIO N . 93 (3) 221 J B O N E JOINT S U R G -A M E R V O L . 7BA (1)

48 CLIN C H E M . 42 (1) 222 J 8 0 N E JOINT SU R G -B R IT VO L. 7BB (1)
116 CLIN D R U G IN V ES T. 11 (1) 102 J C E L L B IO C H E M . 1995. S23
150 CLIN E N D O C R IN O L . 44 (1) 103 J C E L L BIOL. 132 (1*2)

135 CLIN E X P IM M U NOL. 103 (1) 23 J C H E M s o c PER KIN T R A N S 1. 1996 (1)
248 CLIN N E U R O P H A R M A C O L .1 9 (1) 23 J C H E M s o c PER KIN T R A N S 1 1996 (2)
116 C U N P H A R M A C O K I N E T . 30 (1) 24 J C H R O M A T O G R A. 719 (1)
147 CLIN P H Y S IO L. 16 (1) 25 J C H R O M A T O G R A. 719 (2)

137 C U R R OPIN IM M U NOL. 7 (6) 141 J CLIN IM M UNOL. 16 (1)
212 D E U T M E D W O C H E N S C H R . 121 (1*2) 172 J CLIN IN V EST. 97 (1)

01A B E T E S . 45 (JAN)S1 87 J CLIN M ICR OBIOL. 34 (2)
151
d ia b e t e s M ETAB r ev . 11 (4) 104 J CLIN P A T H O L . 49 (1)
152
D N A C E L L BIOL. 15 (1) 224 J CLIN P E R IO D O N T O I . 23 (1)
68
116 D R U G M E T A B D ISPO SITIO N . 24 (1) 250 J C O M P N E U R O L . 363 (4)
66 E M B O J. 15 (2) 251 J CO M P NEUROL 364 (1)
50 E U R J B IO C H E M . 235 (1-2) 251 J C O M P N E U R O L . 364 (2)

105 J C O M P P A T H O L. 114 (1) 00 M TAT R H S- N V W O N UJTAGN R s 35 0}
123 J C O N T R O L R E L E A S E . 38 (1) so M U TA T R E S - R J O A I r f M O L <1)
153 J E N D O C R IN O L IN V EST. 1S (10) 01 M U TA T F* S -G *ETC TO JO C O LO Q Y. 345 (3-4)
123 J E T H N O P H A R M A C O L .4 9 (3) 11 n atu r e . 379 (0964)

174 J E X P BIOL. 199 (1) 259 n eu r o lo g y . 45 H7>sa
269 J E X P B O T . 46 (293) 260 N E U A O t-O G Y 45 <12)58
147 J G E N P H YS IO L. 107 (1) 260 N E U R O P M M C X APPV. N 0 6 K X . 21 (6)
175 J h y per ten sio n . 13 (0 E C )S 4 261 N E U O O P M Y S IO L C U N . 25 (5)

142 J IM M UNOL. 156 (3) 261 N E U R O P S Y C H O P M A flM A C C X O G Y 14 (1)
106 J LIPID M E D IA T O R S C E L L SIG N A L. 13 (1) 262 N E U R O P S Y C H O P H A P M A C O l O O Y . 14 (2)
27 J M A S S S P E C T R O M E T R Y . 31 (1) 262 N E U A O R E P O flT 6 118)

28 J M ED C H EM 39 (2) 264 NEUROSURGERY 36 (7)
270 J M E D P R IM A T O L 24 (4) 107 ONCOGENE 12 (?)
106 J M E M B R A N E BtOL 149 (1) 23 o s t e o a r t h r it is C A P T * J k G E . 3 (4)
\2 J M I C R O E N C A P S U L 13 (1) 148 P A N C R E A S . 12 (2)
74 J M O L BIOL. 255 (5) 108 P A T H O L BIOL. 43 (9)
175 J M O L C E L L C A R D IO L. 28 0 ) 236 P ED IA TR IC S. 7 CD
176 J M Y C O L O G IE M E D IC A IE . 5 (4) 127 P H A M A C O P lA L f0 9 U U . 77 (1)
124 J N AT P R O D -LL O Y D IA , 58 (11) 63 P H O T O C H E M P H O T O e iO L . 82 (6)
252 J neural T R A N S M IS S IO N -S U P P L . 1995 (46) 271 PHOTOSVT^ TH r e s . 45 (3)
254 J N E U R O B IO L. 29 (2) 271 P H O T O S Y N T H R E S . 46 (1-2)
254 J N E U R O C H E M . 6 (2) 182 P H Y S M E D B K X . 41 (1)
257 J N E U R O E N D O C R IN O L . 7 (12) 273 P H Y S K X P i.A N T 95 (4)
257 J N E U R O S C I. 16 (3) 149 P H Y S IO L R E S . 44 (6)
60 J N U TR . 126 (1) 149 PH YSKX 20CX, (1)
62 J N U T R B lO C H E M . 7 (1) 103 P L A C E N T A . ie (8)
224 J PED IA T. 128 (1) 274 P LA N T M O L BIOL. 29 (5)
226 J P E R IO D O N T O L . 67 (1) 275 P LA N T SC I. 112 (2)
177 J PIN EAL R E S . 19 (4) 238 P R E N A T A L DIAG.16 (1)
259 J S L E E P R E S ; 4 (D E C )S2 238 P R E S S E M E D IC A R E. 25 (1)
227 J T H O R A C C A R D I O V A S C S U R G . 111 (1) 17 P R O C N A T A C A D S O U S A . 93 (2)
125 J T O X IC O L E N V IR O N H E A L T H . 47 (1) 183 P R O C R O Y s o c L O N D O N S R B 262 (135)
62 J T R A C E E L E M M E D BIOL. 9 (4) 64 P R O C E S S B IO C H E M . 31 (3)
229 J A M A -J A M M E D A S S N . 275 (5) 239 P R O G C A R D I O V A S C D iS . 30 (4)
74 J P N J H U M G E N E T . 40 (4) 267 P R O G N C U R O B K X 7 (6)
230 KID N EY INT. 49 (JAN)S53 184 P R O S T A G L A N O L E U K E SSEW T FA TTY. 53 (6)
231 KID N EY INT. 49 (2) 185 P R O S T A G L A N O IN S 50 (4)
233 L A N C E T . 347 (8996) 185 P R O S T A T E . 28 (1)
177 LE U K E M IA . 9 (12) 239 O JM -M O N J A S S O C P H YSIC IAN 89 (1)
126 LIFE SCI. 50 (7) 240 RAOIOL CLIN N A M E R . 34 f l)
235 LU N G . 174 (2) 240 R E S P M ED 90 n )
75 M A M M G E N O M E . 7 (1) 20 s A F R J SCI. 91 (11-12)
17 M A T H BIOSCI.131 (2) 5 SC IE N TIST. 10(1)
235 M A T U R IT A S . 22 (0 E C )S 6 S C IE N TIS T 10 (2)
106 M E C H A G E D EV . 85 (1) 185 S E X T R A N S M D lS 23 (1)
179 M E D SCI S P O R T E X E R C I S E . 28 (1) 267 SLEEP 18 (10)
181 M E D IC IN A -B U E N O S A IR E S . 55 (6) 241 S T A T M 6 0 . 15 O )
126 M E T H FIND E X P CLIN P H A R M A C O L . 17 (N O V )S C 65 S T E R O ID S . 61 (!)
89 M I C R O B lO L O G Y -U K . 142 (JA N )P l 127 STP PH ARM A S C IE N C E S 5 (S)
90 M ICR O B IO S. 83 (337) 109 S T R U C T U R E . 4 (1)
91 M I C R O S C R E S T E C H N IQ U E . 33 (3) 241 S U R G E R Y . 119 (1)
91 M O L B IO C H E M P A A A S IT O L . 75 (1) 268 SYN APSE. 22 (2)
76 M O L B lO L - N G l TR . 29 (6)Pi 30 tetr ah ed r o n . 52 f4j
82 M O L C A R C IN O G E N . 15 (1) 31 TETRAHED RO N LETT 3? 4)
76 M O L C E L L BIOL. 16 (2) 128 T H E R A P IE . 50 ()
54 MOL C E L L E N D O C R IN O L . 116 (1) 129 TOXICCX. A P P L P H A B M A C O l 138 (1)
78 MOL C E L L P R O B E 9 (6) 130 T O X lC O C 'D G v 105 IV
79 MOL M ICROBIOL. 19 (1) 130 TOXICOt-'D GY 105 '? -?
270 m o lpu n t m ic r o b e in t e r a c t io n . 9 (1) 144 T R A N S P lA N T A T lC n g f t .
MUTAT r e s L E T T . 348 (4) 65 T R E N D S 9K3CM EM s o J-
79

109 UITRASTRUCT PATHOL 20 (1) 93 Y E A S T . 11 (16) ;>
110 VET PATHOL. 33 (1) 2 I KARDIOL, 84 (1995IS4
92 VIROLOGY. 215 (2) 93 ZBL BAKT-INT J M E D M I C R O B lO l 283 (2)
132 y a k u g a k u Z A S S H I.J p h a r m soc J. <16 11)
T he publisher's name appears with the Tn nh xut bn xu h in cng vi

journal title of each contents page. The liu t bo ca mi Irang muc lc.
address of each publisher is provided at a chi ca mi nh xu bn rlc nu
the end of this issue. cui n bn ny.
CURRENT CONTENTS)996 br ISI LS, V.39, #8, FEB. 19,1996
Task 19 ^ Bi lm 19
Look at th e In d ex o f J o u rn a ls a g a in Hy xem li Bng chi dn cc bo v nh
an d p u t a m a rk a g a in s t th e o n e s th a t du bn cnh nh ng t bn quen bit. So
you are fam iliar w ith . C o m p a r e n o te s sn h cc ghi ch vi ngi k bn bn.
w ith y o u r n e ig h b o u r.
C o n sid er w h ic h jo u r n a ls y o u m ig h t Lu tm ti n h n g t bo no bn c th
c o n su lt if y o u w e re lo o k in g fo r a rtic le s th am kho nu bn ang tm kim nhng
c o n c e rn e d w ith m a la ria . N o te d o w n bi bo lin quan n m alaria. Hy vit ra
the title s a n d th e C u r re n t C o n te n ts cc tiu ' v cc ti liu tham kho trn
page re fe re n c e s. trang M c lc h i n nay.
Task 20 Bi lm 2 0
C u rren t C o n te n ts h a s a T itle W o rd I n M c lc h i n n a y c m t Bng ch dn T
dex. W h a t d o y o u th in k th is is a n d o n Tiu . Bn n g h bng l g v bn s
w h ich p a g e o f th is c o p y o f C u rre n t tm thy n trn trang no ca bn in ny
C o n ten ts w o u ld y o u Find it? ca M c lc h i n nay}
E nglish in M ed icin e - 2 0 9
Task 21 c a Bi lm 21
Look at the text b elo w to find out: Hy xem bi di tim ra:
1 W hat the T itle W ord Index is. Bng ch d n T Tiu d u g.
2 W h e th e r th e w o rd s a re lis te d u n d e r C c t c dc x p vo d a n h m c theo
B ritish o r A m eric an spellin g . c c h vit ca A nh h o c ca Hoa K
k h n g.
3 H ow w o rd s th a t fre q u e n tly a p p e a r C c t th n g xut h i n c n g nh au d
to g e th e r are s ta n d a rd ise d . c q u y c h a ra sa o .
4 W hat c c Pg and J Pg refer to. Cc ch c c Pg v J Pg c ngha gl.
C o m p le te th e follow ing: in b su n g vo cu sau y:

T he ex a m p le given in th is te x t w as VI d n u trong b i n y d c tim th y
fo u n d on p a g e ...................... (1) o f Cur tr a n g .......................... (1) ca M c lc h in
rent Contents a n d p a g e ................... (2) o f nay v tra n g ...... ........... . (2) ca
(3). ....... (3).
CURRENT CO N TENTS MC LC HIN NAY

Life Sciences______________ K h o a h c s sn R _____________________
TITLE WORD INDEX BNC CH DN T T I U D
The Title Word Index is a com puter- Bng chl dn T Tiu d l mc danh mc
produced alphabetic listing o f the sig chci dc :<l vi tnh gm cc lc
nificant w ords in every article an d book ngha Irong mi tiu d bi bo v sch ghi
tid e in d e x e d in e ach issue o f Current nhn trong mi n bn ca Mc lc hin
Contents . T his index helps you quickly nay. Bng chl dn ny gip ban nhanh
lo c a te Ite m s o f in te r e s t to y o u a n d is e s chng xc nh vj tr cc vn m bn
p e c ia lly u se fu l w h e n y o u r s e a r c h in quan tm v bng cng d^c bi< hu ch khi
v o lv e s n e w te r m in o lo g y o r te c h n ic a l vic nghin cu ca ban c Itn quan n
jargon. T o m ake sure your search is danh php mi hoc bi< ng k ihuji.
com plete, rem em b er to look for syno bo m chc chn cho vic nghin cu
nym s, acronym s, alternative spellings, c hon ho, hy nh tim cc t dng
and related term s. ngha, cc lgm ch vit lt. cc cch v i
thay i, cc thut ng lin qun.
T o facilitate your use of the Title Word In cho bn s dng Bng ch i d in T
dex, w ords are listed u n d er the A m erican Tiu d c d dng, cc l d dc
rather than the British spelling. For ex xp theo cch vit Hoa K hon l theo
ample, uraem ic" in a title app ears as cch vit Anh. V d 'uraem ic* [rong mt
urem ic in the index. Title w ords w hich tiu s xu'l hin l 'i r e r m c ' trong
a re m e a n in g le s s a s s e a rc h te r m s h a v e bng ch d n . C c l tiu d khng c
been omitted. W hen both the singular ngha nh cc thut ng nghin cu du
and plural forms o f a w ord occur in ihee bj loi b. Khi c hai dng s 1 v snhiu
index, they are com bined and app ear in1 ca mt t xut hin (rong bng ch dn,
the index u nder the singular form. cc dng u c kt hp v xut
hin di dng sl Irong bng chi d ln .
W ords lhal frequently app ear togetherr Cc t ihng xut hin cng nhau Irong
in lilies arc com bined to form phrasesi cc tiu u c kt hp hnh
that are listed as single entries in the Title! thnh cc nhm l v c xp nh cc
Word Index. For exam ple, the w ords mc l n trong Bng ch dn T Tiu
m onoclonal and antibodies wouldI d nh mt mc t. V d: cc l "n
appear as it single term - m onoclonal- dng" v "khng th" s xul hin nh
antibodics. W hen phrases arc indexed ml thut ng dn c - "n {lng khng
in the Title Word Index, the w ord o rd er is th". Khi nhng cu c ghi Irong Bng
standardized in a m anner that keeps re ch dn T Tiu d, th i t dc quy
lated conccpts together alphabetically. c xp l sao cho vn gic cc khi
For exam ple, acute m yocardial infarc nim c lin quan vi nhau, ghi theo vn
tion and im pending m yocardial in ch ci. V d "nhi m u c tim cp" v
farction" will app ear in the index as; "nhi mu c lim xy n" u xul hin
m yocardial-infarction, acu te andI trong bng clil dn "nhi mu c tim,
m y o c a rd ia l-in fa r c tio n , i m p e n d i n g . cp" v "nhi mu c tim. xy n".
An exam ple o f how to use the Title Wordi Di y l mt v du v cch s dng

Index appears below. Bng ch dn T Tiu d.
T H O R C _______ TICKS________ Cc cp s xut hin di mi

Num ber pairs a p p e a r b e
neath each word or word cc Pg J Pg c c Pg J Pg [ h o c mi nhm t. Mi cp
phrase. Each pair identi b i u t h m t t i u b i b o .
fies an article title. THORACIC 1TICKS
102 76 34 1266
The number on the led, 179 35 1TL-201 S bn tri, 102, l s trang ca
102. Is the c c page on / THROMBOEM 58 9 M c lc hin nay trn d bng
which the table of contents BOLISM 'I
32 67 T 0 * C (|B O O K 1 1 c c m c l c b!l d u ' n b a
begins that includes the
word thoracic in one ol the
THYROIDEC 1TOMOGRAPHY, ) g m t t h o r a c ic t r o n g m t ti u
TOMY COMPUTED / (l c a c c ti u d b o . S b n
article titles The number
84 90
on the nghl. 76. is the arti 54 62 / phi. 76. l s trang bi bo.
cle page number To find -I
BOOK relers to Mun tm bi bo, gi n
the article, turn to the c c a0 book title. trang Mc lc hin nay v tm
page and scan the table of BOOK c ngha xem j^n g cc m C | C vj bi
co n te n ts for th e a rtic le o n Il tiu ca sch. b o t r a n g 76.
l<
page 76.
The first word of each column appears enlarged1 T th nht ca mi ct xut hin phng to
at th e to p o l th e c o lu m n to fa c ilita te e a s y s c a n n g a y t r n d u m i c t t o t h u n t i n c h o
n in g of the a lp h a b e tic listin g lo r the w o rd o r w o rdi v i c t m k i m d a n h m c c h c i d i v i t
phrases ol interest. hoc nhm t dc quan tim .

AMER COLL VET Tndng Th Y M
PATHOLOCISTS Bit i Bfnh hc
VETERINARY PATHOLOGY Bnh hc Th Y

ARTICLES AND ABSTRACTS IN ENGLISH BI BO VA TrtCM YU BNO T1NO ANH
VOL.3 2 NO. 1 JANUARY 1 9 9 8 (L.A) TP 32. s 1 THKO OlSNO 1908
Identification of a spontaneous pleo- Xc inh m t rcom c vn dong

m orphlc rhabdom yosarcom a in the t pht cc kho>ng|t h o f c lc |v bng
thoracicand abdom inal c avities of a fe- ca chut W istar ci
m a le W istar rat.
P.J. Kerry, J.G. Evans. E C. Pearson. H. C o le m a n ...................................................... 76
D issem inated Rhizopus infection w ith N h im R hizopua lan ta km tn

ocular involvem ent in a calf. thng mt b.
D Y Vasconcelos. B H. G ra h n ..................................................................................................78
102
This is th e cc
page By sc a n n in g the table of
num b er to which you are c o n te n ts for p a g e 78,
referred by th e Title Word you find an article with
Index. thoracic in th e title.
y l s trang M c lc Q ua xem xl b in g mc
h in nay m b n c lc tran g 76, b n tlm
hng d ln th am kho do thy b i b o m ang l
Bng c h i dn T T i u d 'th o r a c ic ' trong t lu d 6.
Task 22 Bi lm 22
H ere a r e tw o p ag e s fro m th e T itle y l hai trang ca Bng ch dn T Tiu
W ord In d ex fro m C u rre n t C onten ts. d ly M c lc h in nay. Hy r sot cc
S can th e p a g e s to fin d th e re fe re n c e s an g tm ra cc ti liu tham kho v
for m a la ria . N o te d o w n th e cc
Pg a n d m alaria. Hy vit ra .cc ti liu tham
J Pg re fe re n c e s. kho c s a n g ca Mc lc hin nay v
bo.
LIGAND LIGHT- LIMIT LINEAR- LIPID LIPOAR LIPOPR LIQUID-
C C P fl J P g C C P g J P g cc p 0 J Pfl cc P g J P g cc Pfl J Pg cc Pg J Pg cc P g J P g cc P g J Pg
LJGANO-IINUNG LIGHT- LIMIT (C O M ) UNEAR- UP1D (com) UPOAR- UPO PROTEIN LIQUID-
50 9 DEPENDENT 132 263 MODEL 60 225 ABINOMANNAN LOw-OENsmr CHROMATO-
IIGAMO-BOUND 79 171 LIMITATION 13 1429 04 209 138 399 34 242 GRAPHY(cont)
109 97 274 933 79 153 1494 104 19 UPOEDEMA 106 19 27 37
LJ0AM0- LIGHT- 63 25 241 323 106 1 205 1 134 18 112
EXCHANOC HARVESTING 194 277 IMEAR- 121 49 UPOFUSCIN 156 107 32 36
43 824 63 1035 LIMITING PROGRAMMING 138 674 63 1005 172 154 108
LIGAND-GATED 271 195 13 1543 82 247 147 69 IIPOIC 231 488 27
122
47 363 363 121 179 LINEARLY 150 59 53 74 UPOPAOTIM,
38
IIGAMO-INDUCED LIGHT-INDUCE0 133 19 30 1399 172 65 LIPOIDICA PLASMA
132 59
41 31 79 171 137 119 LINER 156 77
179 13 238 25 186 203
221 80 UPOPROTEIN-
52 235 LIGHT- 271 227 233 261 UPOOLIGOSAC- LISTENER
IMG LIPASE
99 45 MICROSCOPIC LM0N 262 2446 CHARIDES 169 22
217 519 56 2139
U6AMD- 110 55 275 139 LIPID. PLASMA 32 15 LISTERIA
LINK 154 97
RECEPTOR LIGHT- UNAC 164 401 UPOPHIUCITY 78 423
184 385 LIPOSOMAL
14 1191 MICROSCOPY 160 s 81 LIPID. SERUM 28 508
163 563
LSTERIA-
LI6AN0- 6 18 UNCOMYCIN- 236 112 LIPOPHOSPHO* MONOCYTO
156 57 UPOSOME-
LINKAGE GLYCAN
STIMULATED LIGHT- TREATD 210 450 MEDIATED GENES
69 141
98 277 REGULATED 271 239
72 27
UP1-A 200 11 43 1027 78 <23
UGAMOfD 271 235 UNOAU
75 68
134 8 UPOPOLYSAC- UPOSOMES 89 173
74 726 LIGHT- 107 365 175 197 CHARIDE 99 246 137 15
71
IIQASE RESPONSIVE LINE UP1D- BILAYER 35 5 121 41 138 569
4 906 182 82 13 1325
99 1 106 41 39 519 49 USTRIOIYSIN
123 69
LIGATION IIGHT- 1494 121 49 79 37 235 13fl 674
130 403
43 704 TMNSDUCTION 37 461 UPID- 134 8 LIPOXYGENASE LISTERIOSIS
138 460
212 909 9 57 72 1671 CONTAINING 138 637 184 423 137 21
175 79
914 LIGHTIY 75 42 23 139 653 UPOYl LITERATURE
UNKED
238 17 169 106 60 63 84 745
UPID-LOWERING 657 91 87 6 16
LIGATURE LIGNANS 99 218 156 57 142 1157 UPPIA- 133 115
131 665
194 464 25 353 107 253 188 225 167 77 INTEGRIFOLIA 152 228
207 140
LIGHT 30 1303 134 99 UPID- 172 37 124 1713 264 402
233 251
63 960 LIGNIN 135 24 METABOLISM UPOPOLYSAC- UQUID- 406
IMKER CHROMATO-
76 513 83 105 182 70 149 353 CHARIDE- 407
41 433
94 311 LIKELIHOOD- 18S 1 ENHANCED GRAPHIC 267 919
545 216 207
151 254 710 254 466 21 29 TMIC
125 77 BASED 201 LMOLEATE 24
67 37 13 1543 203 472 IS4 405 LIPID- PR0XI- UPOPOIYSAC- 155 363
IM UM 756 LINOIE 1C-ACID DAT10N CHARIDE-
25
LITHIUM
221 . 98 309 207 138 62 16 34 145 INDUCED 248 48
235 s 35 LIMB 219 1083 LIONS 60 27 245 302 249 109
275 139
250 532 155 345 269 1833 11 441 106 9 UPOPOIYSAC- 254 517
LIQUID-
259 70 LIMB, LOWER 275 231 LIP 116 81 CHARIDE- UTHHJM-
CHROMATO
269 1867 197 14 UNEAGE 169 595 UP1D-S0LUBIE S1MULAD POTASSIUM
GRAPHY
271 203 222 5 68 310 LIPASE 171 1 142 1207 30 1433
21 19
227 IMS* 177 2023 82 320 IIP10D0L UPOPROTIN UTHOBIOHTiC
24 15
239 LENGTHENING UNEAGE- 83 73 194 470 104 19 27 268 474
277 221 20 SPECOTC 79 UPIODOL- 138 637 105 irTWOKE-
LIGHT. VISIBLE LIMBIC 94 23 IIP*) TARGETED 172 65 149 LYPHOPEDION
63 1041 250 615 UNEAR 24 121 120 81 UPO- 171 194 462
LIGHT- 254 589 13 1440 39 669 LIPO-OLIGO- PROTEIN(A) 213 LIVE
ADDRESSABLE 257 1230 1*02 683 SACCHARIDE 156 99 245 13 1418
in 17 LIMIT 25 462 41 488 89' 57 LIPOPROTEIN 307 112 73
LIGHT-CHAIN 11 385 64 793 47 289 LIPOPROSTAG HIGH-OENSITY 321 138 576
36 106 390 64 50 267 LANDIN-E(1) 106 73 450 VEBORN
177 2127 13 1570 241 2S3 56 2023 120 61 190 151 66 269
E n g lish in M ed icin e - 2 1 3
LIVER LIVER- LOBE LOCAL IY LONG- LOS- ISO LUNG-
c c Pg J Pg c c P fl J P g c c Pg J P g c c Pg J P g c c Pa CCPg J * c c * C C F fl J * 9
LIVER UVEA- LOtE LOCALLY L0N6-TIMI LO S-M C U! ISO LlIM*
32 100 ENRICHED 262 2453 217 309 (CNI) 190 1 122 rr
34 159 56 2323 IM U UTtt 445 144 31 tosses ism M 1
36 177 UVER-FAJIURE 101 94 LOCATED 125 110 104 41 41 201 110
149 399 186 in iv - 1 UN*m ane
39 479 245 345 93 75 52
124 154 67 lOVASTATW MS M 27J
48 24 LIVER* LOCAL 92
GLYCOGEN 17 547 1*3 448 165 65 IM 1M lit lU M -n w o M
SO 173
186 172 126 554 250 517 175 s 35 254 710 245 741 96 u
55
UVERMJURY 79 101 LOO 183 313 IOW-AFFMTY LIB lir a
56 2112
245 13 1252 197 A 27 84 721 14 1777 141 771
2341 120 81 121
134 36 142 1182 84 745 16? Low om au- U M CM TT ?01 23
62 215
144 99 147 S3 13a 460 205 130 TRATtOH in 57 07 160
72 70
84 163 99 111 w 117 l u c r o u i f 3 0 1 II
94 3 UVER-LESIONS 200
044 134 122 38 M lUPUt*
65 194 379 207 134 ?69 1005 212
24 241 lu c m IKTTHtMA-
341 LIVER- 214 3280 LOCOMOTION 224 149
273 511 1C 177 l o t US
98 321 METABOLISM 217 297 155 345 227 IS
14 LOCUS 4 LOW-OOSi 1 11? 77
101 75 116 28 222
144 173 271 114 134 0
115 223 UVER- 12 14 124 233 227
ISO 23 154 135 74
116 7 IAJCROSOMES 257 CP 4 17 690 245 241 m
165 21 224 1 1*4 301
120 81 34 174 LOCAL*M U G 69 179 250 151
201 171 2U 40? 201 9
129 1 116 126 210 615 72 1637 252 213
1664 33
210 59 406 205 123
130 237 UVER-SPCOFC LOCALIZATION
214 3124 407 185
133 63 17 726 14 1245 75 2 275 197
217 445 U M E fl m 312
135 99 UVCR-mSUES 17 796 16 lOM-TERM-
497 llfTtA l
142 1151 120 13 828 52 IFFCCT1 1 115
235 s 41 157 339
144 1 UVR- 013 76 609 245 105 LJM N U .
241 11 347
61 TRANSPLANT 37 514 79 193 LONG-TERM 47 307
LOW-EMERGY M
66 200 70 506 I SO 63 FOLLOW-UP If* MS
27 M 1I 201
168 230 s 77 SO 18 B4 611 200 S3 U M
LOW- ll/TEAL'PHAftE
155 25 UVER-TRAMS 55 B 182 70 221 17 72 0
HIEQUUCY 157 453
194 459 PLANTATION 56 2332 251 32 233 215 7 I ts
9 15 LTMI2ED
468 144 99 68 9 270 S5 LONG-TERM 94 17
213 35 10
212 899 146 69 25 74 RESULTS 96 S3
169 196 214 3206
240 61 241 20 313 LOCUS' 153 35 1
LOW-fiKAD um M ZM M -
241 112 UVER-TUMOR 75 77 COCRULEUS LONG-TERM 70
94 31 HOfUiONE
118 212 960 76 548 243 112 212 9 106 M
96 21 13 B06
119 LIVESTOCK 84 801 251 363 LONGER 109 33
LOW-IMPACT 157 310
LIVER. HUMAN 110 104 91 28* LOCUS- 174 225 110
179 41 3S7
39 373 207 181 94 291 CONTROL LONGEVITY 74
LO W -U ftl ?14 3110
LIVER, RAT UVMG 299 191 12 269 183 1 2J7
SO 262 3117
36 99 9 245 341 LOCUST LONQfTUOOIAl 7 3317
87 404
39 581 84 131 97 139 123 29 106 15 142 llt l
120 67 LYAPUNOV
56 2287 185 167 LOGICAL 190 144 144 22
130 251 113 377
60 61 99 36 99 10 48 81 231 525 lOtff. 155 a LTAtf
I 1
69 267 192 62 " 16 LOOST1C LONSfTUOMAl* 5 13 14 625

i
129 87 207 153 171 94 115 STUDY 5

84 721 270 14
144 20 243 121 103 77 LOGUNEAR 192 67 LOW- 194 2t3 274 MS
149 415 UVING-REUTD 101 13 1502 201 M 17 ISA
POTENTIAL ITCO P*
LIVER-BIO PSY 241 20 211 LOMC 230 s 103 271 IBS 242 21 43
224 149 LLC-PK1 152 IBS 48 61 LOMICCRA ?o
LOW- ITC&ftUKOII
UVER-CELLS 231 355 163 599 LONG-CHAIN JA PONICA PR08AMUTY 1 w it a iiE in u M
35 67 413 169 272 39 407 124 1756 191 J70
194 285 63 1011
81 181 IM 177 2162 175 171 LOOP 217 4
LAW- 271 301
if
120 83 174 201 186 162 LONG- 47 235

i
IN K
LIVER- LNCAP 231 382 CIRCULATING 1 56 2199 149 164 m 45 7 237
CIRRHOSIS 99 103 251 290 112 113 13b 133 LOW-VOlUME 2S3 190 117
126 551 LOAD 324 121 41 140 159 167 12 LTHI-OaiASI
UVERDISEASE 60 303 254 262 LOMG-DISTANCE 162 64 LOWER-SOOT 241 1 7 364
104 53 172 47 257 931 149 191 252 67 192 57 M 1 34
129 87 244 1601 939 167 56 L005tNING LOWERS LU KL 267 91?
141 41 LOADED 259 s 47 174 57 222 1 156 99 91 IS lNNAEA-
UVER- 121 275 275 149 LONG-RUN s 167 142 111 u ITAfiHAUS
MSEASE 124 25 LOCALIZED 67 39 66 LOZENGi: LU M . U T ?S4 202
CHRONIC LOADING 53 38 LONG-TERM LOfUKPAM 17 1637 94 i tttt
94 134 222 66 133 111 66 389 127 486 LFC 165 SI
341 235 99 194 465 04 817 LORIKEETS 163 44 in r H - M O H
120 83 236 275 2S4 127 91 26? 149 117 u 97 m 17 700
198 369 10BAR 273 627 92 203 lOAMOnCAM 1M 1 u w s c a '1 ii
370 200 77 142 957 116 11 217 21 31
2 1 4 - English in M ed icin e
LYM PH . LYM PH O LYSINE M A CAQ U E M AGE- M AJOR- MALIG MAMMAL
c c Pg J Pg c c pg J pg c c P g J Pfl c c P g J Pfl C C P f l J Pfl c c P g J Pfl c c P g J Pg c c P g J Pg
UMTH- LYMPHO LYSME MACAQUI MAGE-V-4B MAJOR- MALIG MAMMALS
NOO (CM) GRAPHY 24 195 69 185 166 388 SURFACE- NANCY 174 201
05 51 194 467 in n 110 99 MAOIC PMTEIN-3 133 5 211
no 9 LYMPHOID 36 2133 152 190 194 356 87 270 153 73
1(0 5 569 96 64 134 99 167 125 MAGNESIUM MAKINGS 161 49 101 65
Hi 1 133 111 13a 569 245 tos 31 455 109 u 7 203 638
221 106 144 76 142 1055 250 545 50 438 MALABSORP MALIGNANT GRAMS
2 s 159 234 159 718 * 615 74 726 TION 87 369 194 465
94 177 2138 LYSOPHOSPHA* 642 220 29 116 60 94 132 MAMMO-
241 07 2140 note 260 529 MAGNETIC MALAOAPTA 101 77 GRAPHIC
LTMfNAOCIflTIS 203 734 103 101 261 67 174 29 T10N 64 194 347
96 130 LYMPHOID-CELL 254 537 270 258 244 1437 259 70 106 799 349
101 41 99 218 H9 271 MAGHETTCFIELO MALARIA 109 55 MANAGED
105 31 LYMPHOID- LYSOSOMAL MACHINE 9 245 50 345 133 39 94 11
IYMPHAD( NO- TISSUE 32 36 11 387 46 343 10S 745 161 <20 MANAGEMENT
PATHY 105 23 35 1 MACHINERIES 356 137 29 177 2087
176 217
105 31 235 127 LYSOSOME 103 63 365 138 535 179 53 191 95
LYMPHATIC IYMPHOKME- 56 2139 MACRO-SCALES 183 249 194 323
377 196 s 1
205 1 SECRETING 13 668 103 335 381 233 223 205 190
s 16
IYMTN0BLASI3 270 271 LYS0YMC MACROCYCUZA* - MLARIA, MAUGNAMT-
387 s 60
172 73 LYMPHOMA 16 35 T10N - 409 FALCIPARUM RAMSFORMA
222 105
LYMPHOCYTE 34 217 159 23 7 60 109 119 576 TION
154
74 319 37 58? 25 327 21 177 189 MALATt 240 53 224 158
SO 43 94 31 41 531 MACROMO 182 71 DEHYDROGE MALMO 230 s 68
94 38 96 103 55 145 LECULES 190 105 NASE 191 32 s 93
101 15 101 15 157 129 1 129 66 389 MALNUTRITION 235 s 31
106 788 55 LYSA-TYPE MACROPHAGE MALAYAN 60 113
133 239 291
34 199 MAIONAMIOE
130 81 104 72 84 881 103 49 135 241 46
MALATdlAn 132 50
134 106 153 817 LYSYL 105 31 MAGNETIC-
1( 1
248 IS
135 61 163 448 60 51 106 89 RESONANCE MAlONATt
25
MALE 4/4
137 64 177 2123 LZ(75V) 126 21 82 348 259 62
17 705 MAlONATt-
66 200 53 72 1637 551 155 139 260 s 5
809 INDUCID
138 69 203 423 LI 127 447 249 37 264 3?9
66 253 2bA 537
141 31 839 254 779 135 155 MAGNETIC- 337
87 286 MIPUECH
142 922 - 841 LI 4 142 1143 RESONANCE- 338
116 34 74 335
997 212 935 109 55 1196 IMAGING
118
MANOAAINS
: 102 MALT
1089 220 69 L3 149 369 15 51 273 613
130 237 94 31
167 60 238 20 177 2093 156 107 153 8 1014 m an d ibu u r
142 MLTOOLIGO-
177 2123 LYMPHOMA L4 165 101 172 47 217 333
157 470 SACCHAfllDES
188 170 NON-HODGKINS 69 141 167 77 207 180 MANOUCA-
163 532 84 823
201 52 101 15 L5 201 115 264 329 SEXTA
175 33MALVACEA-RUM
137 25 251 211 MACROPHAGE- 337 267 254 233
183 270 14
203 465 148 205 254 834 COLONY- 338 297 m anganese
MAMMALIAN
217 459 181 675 M(1) STIMULATING MAGNIFICENT . 11 jAn 60 27
329
226 33 lym ph oprolif - 254 877 112 711 174 93 184 405 . 94 389
464
LYMPHOCYTE. ER1VE (2) 157 478 MAILLARD 18S 24 m anganese
32 31
B100D 137 108 36 99 MACROPHAGE' 34 152 192 25 433 STABILIZING
37
176 225 166 281 197 155 DERIVED 60 195 214 3124 43 874
454
LYMPHOCYTE, 177 2087 M(3) 135 67 MAINTAINED 3195 MANIA
39 455
HUMAN 181 727 197 155 MACROPUS- 207 180 236 122 249 89
41 513
39 529 203 706 M-PHASE RBUSTUS MAINTAINING 245 10S 56 1849 MANICOl
80 7 .YMPHOTROPIC 103 125 75 74 207 188 MALEMICE 68 1 31 525
127 220 69 268 467 MACULA 25 685 81 167 75 79 m a n ip u la tio n
LYMPHOCYTE* lYM 269 1887 231 430 MAINTENANCE 114 1SB2 91 25 17 934
CULTURES 50 1 18 NUBS MAD 69 343 MAIEATE 99 11 64 583
259 s 30 lYNX 134 1 109 11 112 673 30 1389 135 83 149 357
LYMPHOCYTE- 11 407 MAC-T MAOINOARBY 126 51 121 79 147 1 221 111
REACTION LYOAVAILABI 60 232 39 597 142 1126 127 476 254 151 254 637
137 80 LITY MACACA- 56 2029 MAIZE MALEIMIDOBEN- 260 480 257 964
144 133 127 466 FASCICULAR IS 98 371 50 338 ZOYL MAMMALIAN MANNAN
LYMPHOCYTE* lyophilization 152 190 172 263 269 817 55 151 CELL 90 229
RESPONSES 121 155 270 252 MAGE-1 270 22 MALFORMA 14 1207 MANNAN-
134 150 LYOPHILIZED MACACA- 166 388 MAJOR - TION 39 441 SPECIF1C
LYMPHOCYTIC 84 198 FUSCATA MAGE-2 HISTOCOMPA 264 412 46 381 134 8
101 94 122 43 110 99 166 3*8 TIBILITY- 414 407 MANNER
95 LYSATIS ftUCACA- MGE-/t COMPIEX- 415 408 55 200
203 717 41 554 MULATTA 166 388 ENCOOED MALI 99 16 MANNHEIM
212 948 1 103 153 152 190 50 404 205 114 117 93 242 11
MANNI MAP M A A)- MARKER MASK M ASS' H A T -ALPHA MATING*
c c pg J p g c c Pfl J pg c c Pg J P g c c P g J P g c c Pfl J P g c c Pg J Po c c Pg CCF* J p f
MANNITOL MAP (coot) MAA)UNOING M A M fR (*) MASK M M s-sm - M M U M MATW6- m
48 71 75 89 163 457 159 765 19? 239 TM MfTRT 7 57 n 657
83 35 99 11 MARCH 161 292 MASKER <*) M A IO tfl MftTMCft
MANNOSE 163 490 160 s 510 1M A 1 169 517 27 47 90 7*3 Its m
56 2162 174 211 MAACKS 1 in M 3S n m m anm
2171 * 219 52 281 14 MASOUfRAttNG 13 M AToenH It? V
259 s 15 274 1081 MAAGMAL 80 236 115 5 1M 777 mmm
MANNOSE MAPPED 94 31 84 MASS 101 m ro m 13 1344
SENSITIVE 66 201 MARGMS 121 16 137 112 144 151 u 9
138 460 138 644 264 308 142 39 479 32 IS UATCMMf 77 77
MANOMETRY MAPPING 317 144 172 14 M 43 104 2176
227 107 11 434 MARGUUS.L 147 194 3I M m n 4 319
112 56 1817 11 409 141 46? 43 779 133 127 99 7
MANTIOAE 2225 MARINE 156 ?70 236 )27 27 m iB U L 171
251 199 . 2249 83 111 166 MASS-SPfCTIU MASS-TRANSFER 17 70S 101 13
MANTIE 37 84 591 176 27 16 64 24 60 14 121 57
75
11 436 47 817 205 25 MASSFIER 132 277 147
MANUAL . CQ
3a
MARITAL 211 M A S S S f f c n u i 251 279 150 17 in 19
247 94 Ti 19? 35 ?05 123 27 115 M A S T-ca i 152 IfiO 1 39
/1
MANUFACTURER on MARKED 238 29 MASISPCT*0> 53 1 157 4 1C3 351
197 190 46 76 240 39 METRIC 96 17? 20? 457
92
233 255 109 67 251 219 24 131 101 1 1*3 7t It? 20
79 91
MAP MARKER 275 231 27 10 lit S31 23 19
17 690 89 79 13 1514 MAMET MSSSPCC- 120
35 49
37 500 142 1038 17 669 207 1S9 THOMETAY 137 141 247
V 71
50 317 183 335 770 MAMkOW
11 466 262 1604 MATUBK ISO
52 207 203 557 48 102 133 13 16 93 MASTECTOMY
n u t 151
66 377 210 603 73 444 55 24 251 160 46 7U J217 ?05 112
72 118 227 36 75 16 91 25 M3 MAITOCYTOStt MATNQMTKM. 1 114
73 427 259 s 33 71 ?03 574 474 212 M l M ooa HA TUB
75 1 270 6 SO 63 MARSUPIAL 27 1 HAITDfAnAM 155 n AUttTEO
47 275 207 94 23 75 74 25 35 60 NA1M BM TC* 77 101
134 56 MARTINIQUE 31 MASTOf A/lAM-B 4
153 754 244 1573 37 36 1 Its 30

CURRENT CONTNTS 1996 by ISI
Task 23 ^ Bi lm 23
U se th e T itle W ord In d ex to c h e c k Hy s dng Bng ch dn T Tiu d
w h e th e r a n y o f th e jo u rn a ls th a t y o u kim tra xem c bi bo no m bn
listed for T ask 19 a re re fe rre d to by lit k trong Bi lm 19 c nu tham
ch e c k in g th e cc
Pg r e fe re n c e s a g a in s t kho khng bng cch kim tra cc s
yo u r list. List th e jo u r n a ls th a t a re r e trang tham kho ca Mc lc hin nay vi
ferred to. bng lit k ca bn. Vit danh m c cc
bo c nu tham kho.
Task 24 iCQl B i l m 2 4
T he list o f jo u rn a ls re fe rre d to in th e Danh m c cc bo c nu tham kho
T itle W ord In d ex in c lu d e s a r e fe re n c e trong Bng chi dn T Tiu bao gm
from The L ancet. S can th e p a g e a n d m t ti liu tham kho ly ca The L a n
n o te dow n: cet. Xem k trang bo v vit ra:
1 The Volume, N um ber an d date. T p , s vA ngy ih n g .
2 The title of th e article th a t relates to T iu c a bi b o c lin q u an n m a

malaria. laria.
( ttom ) la n c e t LANCET LTD

A R T I C L E S A N D A B S T R A C T S IN E N G L I S H
V O L 347 N O 89 96 JA N U A R Y 27 1996 (L.C)
EDITORIAL
W a lk in g o n t h e m o o n 207
COMMENTARY
Reflections on the saven countries study. A G Shaper 208
G e s t a t io n a l d i a b e t e s a n d b e y o n d , p . K o p e lm a n 2 08
A c e llu la r p e r t u s s is v a c c in e s : N e w v a c c in e s fo r a n o ld d is e a s e . G A. P o la n d 209
W a t e r c h a n n e l s in h e a lth a n d d is e a s e . D .L. C on n o lly. C.M . S h a na h an . P.L. W eissbe rg 210
M t d lc ln e s m is m a t c h . J. C o llie r 2 12
ARTICLES
D e t e c t io n o f v i r u s in v e r t i c a l l y e x p o s e d H I V - a n t ib o d y - n e g a t iv e c h i l d r e n . M L N ew ell. D D unn.
A D e M a ria A F e rra zm . A D e R o s si. c G ia qu m lo . J. Levy. A. A lim e n ti, A. E hm st.
A B B o h lin . e t al. 213
Long-term follow-up of patients with Crohnt d lia a i* treated wtth authioprkw or *
mercaptopurln*. V Bouhnik. u Lemann. J Y. Mary. G Sctmatna. R Tm. c. ktmnxhamky,
R Modigliani. J c . R a m b a u d ....................................... .... 215
Chronic granulomatous d l*at In aldults. J G LieM . V Jnmsst. . J w u on.

T Petropoulou, s Kloos, M Gahr. B.H. Belohradsky 220
Clinical algorithm for treatmtnl of Plasmodium falciparum malaria In cM dran s c Rtd.

p N Kazembe. s p Luby. o Nwanyanwv. A w Hightower, c ta. J J. Mhmm. L CIKmto,
c Franco. M Olivar 223
Long-term diabetogenic effect of single pregnancy in womn with pervious gestational diabe
tes mellltus R K Peters, s L K/os. A Xiang, T.A Buchanan 227
EARLY R E P O R T S
Preliminary description of focal segm ental g lo m *ru lo cl*ro t* In patlanta wHti rvnovM cular
disease. R Thadhani. M Pascual. V Nickeleit, N. TotkotfRubin, R Colvin 231
Comparison of Tc-B9m Infecton Imaging with radlolaballcd whlt-cll Imaging In tha valua
tion of bacterial Infection, s Vinjamurt, A V Hall, K K So/anki. J Boman/i. 0 S n .
E OShaughnessy. s s D as. K E Britton 233
CASE R EPO RT
Dementia In a 58-year-old woman. F Seltal. M Mohr, M Collard 23
ADDICTION
Myths about the treatment of addiction, c.p. OBrien. A T. McLellan 237
STATISTICS
How to deal with regression to the mean In Intervention atudlm. P L. Yukin.
IM Stratton ............................................................................. 241
E SSA Y
Medical evacuation from Mostar. D p Southall. J. Ellis, p McMaster. H UcM ailer A WMock.
M P lu n k e tt 244
____________________________ CONTINUED
CURRENT CONTENTS 1996 by 19 IS, V. 39, # , Ft I. I*, i m 1
Task 25 Bi lm 25
Here are five o f th e ab stracts and s u m y l nm bn trch yu v tm t t xp
m aries listed under th e h ea d in g m a trong danh m c chnh di m c
laria. D ec id e w h ich o n e w as taken m alaria. Hy quyt nh xem bn no
from The Lancet. dc ly t The Lancet.
a)
W e investigated th e kinetics o f Chng ti nghin cu cc ng lc

tissue-specific m R N A expressio n hc ca biu liin m clc hiu mRNA
a n d system ic p ro d u ctio n o f tu m o r v s sn xui hng lot yu t hoi lu
necrosis factor alpha (TN F -a) an d alpha (TNF-a) v cc ng lc hc v
th e kinetics o f splenic expressio n o f biu hin ti lch ca cc mRNA ca
m R N A s o f gam m a interferon (IFN- gam m a interteron (INF-a) v inter
y) an d interleukin-4 (IL-4). cytokines leukin 4 (IL-4), cc cytokin c th diu
that m ay regulate T N F -a p ro d u c ha s sn xut TNF-a, trong giai on
tion, during th e early p h ase o f sm ca nhim khun mu do Plas
blood-stage infection w ith Plasmo m o d iu m chabaudi AS. Phn tch du
dium chabaudi AS. N o rth e rn blot chng Northern cho ihy cc chul
analysis rev ealed th a t resistant C57BL/6 c d khng v ht nhim
C 5 7 B L /6 m ice, w h ich clear th e in khun Irong 4 lun l cu c mc TNF-
fection by 4 w eeks, h ad higher levels a mRNA sm trong khi nhim khun
o f T N F-a m R N A in th e sp le en a n d lch v gan cao hn nhng chut A/J
liver early during infection th a n did nhy c im , v nhng con ny s cht v
susceptible A/J m ice, w hich sue bnh 10 ngy sau khi khi bnh. Vic
cum b to th e disease 10 days after diu tr bng khng th a dng kling
initiation o f infection. T re a tm e n t o f TNF-a cho cc chut khng d xc
resistant m ice w ith a polyclonal anti- nhn vai tr bo v ca TNF-U sm
T N F-a an tib o d y co n firm e d th e p r o trong qu trnh nhim khun. Hn na,
tective role o f T N F -a early d u rin g cc chut C57B6 khng cng c
th e co u rse o f infection. F u rth e r nhng mc cao v mRNA ca IFN-y
m ore, resistant C 5 7 B L /6 m ice also (cht nh du T h i) v nhng mc thp
expressed high levels o f m R N A o f v mRNA ca IL-4 (cht nh du Th2)
IFN-y (a T h I m arker) a n d low levels lch, trong khi cc chut A/J nhy cm
o f m R N A o f IL-4 (a T h 2 m ark er) in u c n h n g m c th p v IF N -y m R N A
th e spleen, w h e re a s suscep tib le A /| nhng li c nhng mc cao v IL-4
m ice h ad low levels o f IFN-y m R N A mRNA lch sm trong lc nhim
b u t high levels o f 1L-4 m R N A in th e khun. Ngc li, cc chut A/J nhoy
spleen early d uring infection. O n th e cm li c nhng mc cao v TNF-a
o th e r hand, susceptible A/J m ice e x inRNA gan v c nhng mc cao v
p ressed high levels o fT N F -a m R N A TNF-a protein [rong huyt thanh, qua
in th e liver an d h ad high levels o f vic o lng c h i h p th m in dch
T N F -a p rotein in serum , as m e as gn vi enzym , thi im mun ca
u red by enzym e-linked im m u n o qu trnh n h i m khun, n g a y lc truic
so rb en t assay, later d u rin g infection t v o n g . N h n g lci q u i d c h n g m inh
just b efo re d e a th o c c u rre d T h ese re rng lin h trang gia tn g c h t kl hp
sults d e m o n stra te th a t a T h l- T hi trong TN F-a mRNA lch giai
associated increase in T N F -a m R N A d a n sm trong n h i m k h u in d toong
expression in th e spleen early d u rin g ng vi kh nng d k h n g d vi p.
infection correlates w ith resistance chabaudi AS. trong khi nhng mc Ung
to p chabaudi AS, w h e r e a s increased TNF-ct mRNA gan v nhOhg mc qu
T N F-a m R N A levels in th e liver an d cao protein TN F-a ca huyt thanh
excessive levels o f th e T N F -a p r o giai d o n m u n hn lchi n h i m khun
tein in serum later d uring infection li tng ng vi tnh lr*ng d nh$y
correlate w ith susceptibility. T hus, cm . N h vy, vai tr ca TN F-a trong
th e role o f T N F -a d uring m alaria a p bnh st rl r rng phv thuc vo thi
pears to d e p e n d o n th e tim ing an d gian v v tr xut h in ca n v s hin
site o f its exp ressio n a n d th e p re s d i n c a c y to k in e d i u h a qu trnh
en c e o f cytokines regulating its p r o sn xut ch t d .
duction.
b) Summary Tm tt
B a c k g r o u n d Id en tific atio n o f c h il Q u trinh xc nh cc tr em c i n dc
d re n w ho need an tim alarial tr e a t iu tr chnp, b n h st rt tht kh tin
m ent is difficult in se ttin g s w h ere hn h nhn ni m v i c xt n g h im
co n firm ato ry lab o rato ry te stin g is chng thc thng khng c gi tri, nh
not available, as in m u c h o f sub- li nhiu ni vng chu Phi di Sa
Saharan Africa. T h e cu rre n t national hara. Chin lc quc gia hin nay
policy in M alaw i is to trea t all c h il Malawi l diu tr tt c i cc tr em c
d ren w ith fever, usually d e fin e d as st, thng dc xc nh n qua li k
the m o th e r's re p o rt of fever in the ca ngi m v ttnh trang st ca a
child, for p resu m e d m alaria. T o a s b, do phng on m c b nh st rt.
sess this policy an d to fin d out n h gi ch in lc v d tlm xem
w h eth e r a b e tte r clinical case d e fin i liu c th xc nh duc mc nh
tion co u ld be devised, we stu d ie d ngha trng hp lm sng tt hn
acutely ill ch ild ren p re se n tin g to tw o chang, chng ti nghin cu cc tr em
hospital o u tp a tie n t d e p a rtm e n ts in m c bnh cp tnh hin din hai khoa
M alaw i. ngoi tr ca bnh vin Malawi.
c) SUMMARY TM TT
A lth o u g h y T cells are fo u n d in in M3c d cc t bo T yclc tm ihy vi
creased n u m b ers in the spleens of nhng s lng lng cao lch ngi v
h u m an s and m ice infccted w ith m a chut nhim bnh SI rl, ngi la vn
laria, It IS n o t k n o w n i f th e s e c e lls a re cha bit liu cc t bo c phi l
necessary com ponents of an effec nhng (hnh phn nht thit ca mt
tive im m une response. T h e surface dp ng min dch c hiu qu. Ngi
p hen o ty p e of spleen cells o btain ed ta quan st b mt phenotyp cc t
from m ice infected w ith aviru len t bo lch ly l chui nhim Plasmo
Plasmodium chabaudi adami o r v iru dium chabciudi adam i khng c hoc
lent Plasmodium chabaudi chabaudi Plasm odium chnbiubi chabaudi dc
were exam ined using anti-5 or anti- bng cch s dng cc cht phn ng
a P T -cell-specific reagents an d flow khng hoc khng C-P t bo T rlc
cytom etry. L evels o f p arasitaem ia, hiu v do l bo trong lung. Cc mc
red blood cell (RBC ) co u n ts, an d nhim k sinh trng trong mu, s lng
survival tim es w ere follow ed in m ice hng cu, v thi gian sng ihm clu
depleted o f tu m o u r necrosis factor dc (heo di chut c gim thiu yu
(T C R )y5+ or T C R a P * T cells. l liOi l u (TCR) * hoc cc l bo T
N u m b ers of y T cells increased in TCR a[3+. S lng c c l b o T y u
the spleens o f con tro l an tib o d y - tang lch ca chut nhim khun
treated infected m ice, b u t not in c iu tr bng khng th tl kim
mice d ep leted of T C R * o r T C R chng nhng khng tang cliul c
aP* T cells. M ice d ep lete d of Y T gim thiu cc t bo T TCR y~ hoc
cells had levels o f parasitaem ia, TCR p*. Cliut b| gim thiu cc t bo
RB C s, an d survival rates sim ilar to T Y clu c nhng mc nhim k sinh
control a n tib o d y -tre a te d mice. Irng trong mu, s lng hng cu v l
H ow ever, m ice d ep lete d o f T C R l sng thm lng t nh chul dc
a3 * T cells had h ig h er levels of para- diu tr khng th d kim chng. Tuy
sitaem ia, low er R B C co u n ts, a n d d e nhin, chut b gim thiu cc t bo T
creased survival rates. T h e se results TCR a[T clu c nhng mc nhim k
indicacc th a t T C R a P ' buc not T C R sinh trng trong mu cao hn, s lng
y* T cells play an essential role in hng cu thp hn v ty l sng llim
host defense against p . chabaudi in cng sul gim. Nhng kt qu (l cho
fection ill mice. thy rng cc t bo T TCR ap* ch
k h n g ph.ii TCR y5* dng vai tr ch
yu tro n g vic bo v cli th chng lai
vic nhim p. c h a b a u d i chut.

d) T h e use o f g lu ta th io n e red u ctase Vic s dung cc c h t c c h glu
inhibitors in ch e m o th e ra p y is th e rai tathione reductase trong Sa in liu l l
son d 'etre for this study. T w o e n do ln tî ca d (Ai nghtn cu ny. Hai
zym es w e re purified to h o m o g e enzym c linh khit n mc
neity from th e in traerythrocytic m a thun nht v duc ly t k sinh Irng
larial parasite Plasmodium faldparum: b nh st rt P lasm odium (alcipsrum
g lutathione disulfide reductase, an hin din trong hng c iu : glutahione
antioxidative enzym e, w hich a p disu lfid e reductase, m ! loai enzym
pears to play an essential role for chng oxyha c vai Ir ch yu cho s
parasite g ro w th a n d d ifferentiation, tang trng v bit ha ca k sinh trng
and glu tam ate d e h y d ro g e n ase , an v glutam ate dehydrogenase, mt I03
enzy m e not occurring in th e host enzym khng hin din trong hng cu
erythrocyte. T h e tw o pro tein s w ere ca ch th. Hai cht protein Hu c
copurified a n d se p arate d b y gel e le c dng tinh khtf'i v p h n tch b ng k
tro phoresis w ith yields o f a p p ro x i thut din di i;el vi hiu su khong
m ately 20% . M alarial g lu ta th io n e 20% . M en glutathione reductase ca k
reductase, a h o m o d im e r o f I 10 k D a sinh trng t rt l mt ng nh phn
w ith a pH o p tim u m o f 6.8 a n d a t c 110 kDa vi pH ti IAJ l 6 ,8 v
high p re fe re n c e for N A D P H o v er tfnh u i cao vi NADPH trn NADH
N A D H , w as sh o w n to c o n tain FAD v c cha FAD nh mt thnh phn
as its pro sth etic group. T h e N- protein khng |>eptid. Chui N tn cng,
term inal se q u en c e, V Y D L IV IG C C - VYDLIVIGGGSGGMA, c th xp
SG G M A , w h ich can b e aligned w ith hng vi nhng cn 2 0 34 ca men
residues 2 0 - 3 4 o f h u m a n glu glutathione reductase ca ngi v cng
ta th io n e reductase, rep rese n ts th e biu th on p u lin cng nhchui
first (3 stran d an d th e d ip h o sp h a te - xon c nh diphosphate ca vng
fixing helix o f th e FAD d o m ain . G lu FAD. G lutam ate dehydrogenase c
ta m a te d eh y d ro g e n a se w as c o n xc nh l mt hexam er c doan N ln
firm ed as a h e x a m e r w ith block ed cng b tc n(;hn, d l ml enzym
N -term ini; it is an e n z y m e th a t is m ang tnh c hiu cao vi NADP v
highly specific for N A D P an d NADPH. Q u trinh ng tinh khit hai
N A D P H . T h e copurification o f th e cht protein v tim nang ca m en glu
p ro tein s a n d th e p o ten tial o f p falci tathione reductase ca k sinh trng p.
p a ru m g lu ta th io n e re d u c ta se as a falciparum nh mi duc ph m d ch d
drug target are discussed dc bn lun.
Keywords: drug targets; glutam ate T kha: drug targets; gluiam aie d eh y
d eh y d ro g en ase; g lu ta th io n e r e d u c drogenase; glutathione reductase; m a
tase; malaria; Plasmodium falciparum laria; Plasm odium falciparum enzyme*,.
enzymes.
2 2 2 - E nglish in M edicine
e> SUMMARY TM TT
M eth o d s are derived for estim a tin g Cc phng p hp dc xc nh nhm
th e m ean n u m b e r o f clones o f th e nh gi s' lng [rung binh cc dng
haploid m alaria p ara site Plasmodium v lnh ca k sinh Irng cin bi Plas
falciparum from sam ples o f blood o f m o d iu m falciparum gy bnh st rt ly
infected h o sts w hich have been . ( cc mu mu ca cc ch th nhim
te ste d for th e p resence o f alleles at khun c kim tra v s hin din
m a rk er loci. For exam ple, at a locus cc alen locus n h du. V d, locus
w ith th ree alleles th e sam p le m ight vi 3 alen, mu c th ch cha Ai,
co n tain only A 1. o r A ! and A 2, o r A I. lioc A| v A2, hoc c A |, A2 v Aj,
A 2 and A3, w ith m u ltip le allele loai a alen thng thy nhiu hn cc
classes being m ore co m m o n at high mc nhim khun cao. Thc hin cch
infection rates. A ssu m in g e ith e r a p hn chia cc s liu v nhim khun
Poisson o r negative binom ial d is tri trn tng ch th theo kiu Poisson hoc
butio n o f n u m b e rs o f in fectio n s per kiu ln kp m tnh, (l tm ra cng
host, form ulae are deriv ed for th e thc v xut ca cc nhm mu mu
frequency o f different classes o f khc nhau v c c phng p h p c th
blood sam ples, and m a x im u m like ng ti a dc s dng nhm (lnh
lihood m e th o d s are u sed to e stim a te gi s lng trung binh cc dng v tnh
the m ean n u m b e r o f clones an d al v c c tn xut cilen. H ai i m ci kin,
lele frequencies. T w o d a ta sets, each mi ci Irn hai locus, d dc phn
on tw o loci, are analysed. O n e d ata tch. MI im d kin dc ghi nhn l
set w as from th e sam e locality in cng mt vng ca Tanzania, ti d
T anzania from w h ich o o cy sts o f th e non bo ca k sinh trng trong mui
p arasite in m o sq u ito v ecto rs w ere truyn bnh dc kim tra lm dng
te ste d for clonality (i.e. d ip lo id u n v lnh (ngha l c c kt hp lng bi
ions o f g am etes from th e sam e cc giao t ly t cng dng v tnh)
clone) u sin g gen etic m ark ers. G ood bng cch dng nhng cht nh du
arg ree m en t w as o b ta in ed b etw e en g e n . g h i n h n dc S ph hp kh
th e observed clonality in oocysts quan gia dng v lnh d C)u<in s.t ihy
and th a t expected from th e n u m b e r trong non bo vi dng d on l s
o f infections per h o st (m ea n ap lng cc nhim khun cho tng ch
proxim ately th ree). th (trung bnh l khong ba).
Task 26 Q Bi lm 26
H ere a re th e title s o f th e a rtic le s in y l cc ta ca cc bi bo bng
E nglish th a t a rc liste d u n d e r th e title ting Anh c xp trong danh sch di
w o rd m alaria. Skim th e a b s tra c ts t m c ''malaria". Lt qua m t ln
ag a in a n d try to m a tc h e a c h o n e to th e na cc trch lc v th xp tng ng
a p p ro p ria te article . mi trch lc vo bi bo thich hp.

G lu ta th io n e re d u c ta se a n d g lu ta Glulathione r e d u c ta se v glutamate de
m a te d e h y d ro g e n a se o f Plasmodium hydrogenase ca P la sm o d iu m falcipa
falciparum, th e ca u sa tiv e ag e n t o f rum , yu l gy b n h st rl nhit di
tropical m a laria
2 E x acerb atio n o f Plasmodium chau- T ng c a o k sinh trng Plasmodium
badi m alaria in m ice by d e p le tio n o f ch a u b d i b n h i rt chut do ihiu
T C R aP* T cells, b u t n o t TC R y5+ T ht c c l b o T T C R aP* c h k h n g phi
cells c c t bo T TCR *
3 E stim a tio n o f n u m b e rs o f m a laria n h g i c c s l n g c c d n g v tinh
clo n es in b lo o d sa m p le s ca bn h st rt trn cc m u mu
4 A T h 1-asso c ia ted in c re a se in t u T inh trng ta n g T h i kt h p Irong biu
m o r n e c ro sis facto r alp h a e x p re s hin ca yu t hoai l u alpha lch
sion in th e sp leen c o rre la te s w ith (hng tng n g vi s c d k h n g vi
re sista n c e to b lo o d -sta g e m a la ria in b n h st rl th u c g ia i rioan m u ca
m ice chut
5 C linical a lg o rith m for tr e a tm e n t o f T hut ton l,1m sn g ch o vic diu tr
Plasmodium falciparum m a la ria in b n h st rt do P la sm o d iu m falciparum
ch ild ren tr e m
Task 27 ^ Bi lm 2 7
You d ecid e to re q u e s t a reprint o f The Bn quyt nh yu cu m t bn in li ca
Lancet article . D esign a re q u e s t c a rd bi bo n tp ch The Lancet. Hy phc
for y o u rse lf b a s e d o n th e m o d e l o n th e tho m t thip yu cu cho bn da theo
n e x t p ag e . C o m p le te it w ith th e a p p r o m u trang sau. B su n g th ip vi cc
p ria te d e ta ils. chi tit thch hp.
2 2 4 - English in M edicine
N ow lo o k b a c k to th e J o u r n a ls In d ex By gi hy xem li Bng chi dn bo
o n p p . 206-209 a n d m a k e a n o te o f tran g 206-209 v ghi ch v tr bn s tm
w h e re y ou w o u ld fin d th e a u t h o r 's a d thy a ch ca tc gi.
d re ss.
Tapescript Bn i thoi
Unit 1 Bi 1
Taking a history 1 L M B N H N 1
Task 1 Bi lm 1
DOCTOR: G o o d m o r n in g , Mr H all. BS: Cho ng Hall. C chuyn g m hm
W h a t's b ro u g h t y ou alo n g to nay ng phi d n y?
day?
PATIENT: W ell, y o u se e , d o c to r , I've b e e n BN: Tha bc s, ti b nhc d iu hoi, bc
h av in g th e s e h e a d a c h e s , y o u s thy v ...
s e e , a n d ...
DOCTOR: A ha, a n d h o w lo n g h a v e th ey BS: , th ng b bnh t bao lu?
b e e n b o th e rin g you?
PATIENT: Er, well, th e y s ta rte d a b o u t, BN: , cng (lau khong, chc phi c ba
w ell it m u s t h av e b e e n a b o u t thng nay.
th re e m o n th s ago.
DOCTOR I s e e . A nd w h ic h part o f y o u r BS: Ti hiu. T h n g au u ch no?
h e a d is a ffected ?
PATIENT: W ell, it's, it's right a c r o ss th e BN: Vng, , ng ch n gang trn ny.
fro n t here.
DOCTOR: M m . A nd ca n y o u d e sc r ib e th e BS: Hm, th ng c th m t i kiu au
p a in ? ra sao?
PATIENT: Erm, it's a so r t o f d u ll, d u ll an d BN: , kiu au m i, m i v nhoi nhi.
th r o b b in g k in d o f p ain .
DOCTOR I s e e , an d d o th ey c o m e o n at BS: Ti bit, Ih au c r r^t vo lc no
a n y p a r t ic u l a r tim e ? khng?
PATIENT: T h ey s e e m to b e, th ey 're u su - ' BN: Hnh nh au nhiu hn vo bui
ally w o rse in th e m o rn in g . I sng, ti n hn bit vy khi tnh gic.
n o tic e th e m w h e n I w ak e u p.
DOCTOR M m . A nd is th ere a n y th in g BS: T h c cch gi lm bt au c
th a t m a k e s th e m b e tte r? khng?
PATIENT W ell, if I lie d o w n for a w h ile , BN: D, nu ti nm xung m t lc th C
th e y se e m to get, th e y go aw ay. v bt ri h t au.
DOCTOR: Yes. a n d h a s th e r e b e e n a n y BS: c ri, th cn chuyn g khc
th in g e ls e a p a r t fr o m th e s e ngoi chng au u khng
h ea d a c h e s?
PATIENT: Well, th e w ife, m y w ife , s h e BN: D. b x, b x ti ni ti c v hi
says th a t I se e m to be g e ttin g a nghnh ngng.
bit deaf.
DOCTOR: O h? Well, M r HaJl, I th in k at BS: c ri, ng Hall. Ti ngh n y
th is sta g e I'll s ta rt by c h e c k in g ti c th khm tai cho ng xem c
y o u r ea rs to see if th e re 's a n y cht ry tai no chng ...
w ax ...
Task 8 Bi lm 8
DOCTOR: C o m e in. Mr G reen. C o m e an d BS: Mi ng Green vo y. Mi ng ngi
sit d o w n h ere. I've h a d a le tte r xung, ti c m t bc th ca bc s
fro m y o u r d o c to r a n d s h e tells chm sc ng y ny, b ta k rng
m e th a t y o u 'v e b e e n h av in g ng b au vng ngc.
p ain , p a in in y o u r ch e st.
PATIENT: Yes, a n d in m y arm , a n d a lso BN: Vng, c cnh tay v cng rm ran
tin g lin g in m y fin g ers a n d ... cc ngn tay na v ...
DOCTOR: Yes, n o w w h e n d id y o u first BS: c ri, vy ng cm thy au nh
n otice this pain? th t bao gi?
PATIENT: Er, w ell, I s u p p o s e a b o u t six BN: , d, ti c chng su thng nay.
m on th s ago.
DOCTOR: A nd c a n y o u r e m e m b e r w h e n BS: V ng c nh au ln u tin vo
it first c a m e on? khi no khng?
PATIENT: Y es, w e ll I r e m e m b e r , I g o t a BN: D, ti nh xem, ti au nhiu
b a d p a in in m y c h e s t w h e n I trong ngc khi ang di mua sm. Lc
w as sh o p p in g . It w as so b a d I au nhiu n mc ti khng th
cou ld n't b r e a th e a n d ... c v ...
DOCTOR: A nd w h ere, in w h ic h part o f BS: Vy ng cm thy au ch no trong
y o u r c h e s t d id y o u feel th e ngc?
p ain ?
PATIENT: W ell, right a c ro ss m y c h e st. BN: ng ngang qua ngc.
DOCTOR: A nd h o w lo n g d id it last? BS: V au nh vy bao lu?
PATIENT: O oh , a b o u t te n m in u te s. BN: y khong mi pht.
DOCTOR: A nd w h a t d id y o u d o w h e n it BS: V khi au nh vy th ng lm g?
happened?
PATIENT: I h a d to s to p a n d w a it for it to BN: Ti phi dng li v ch cho ht au.
go aw ay.
DOCTOR: So, h a v e y o u h a d th is, th e p a in BS: c ri, th t khi ng c b au
a g a in sin c e th e n ? li na khng?
PATIENT: Yes, I o fte n g e t it w h e n I o v e r d o BN: D c, ti thng au nh vy khi lm
things, and w h en I ... vic qu sc v khi ti ...
DOCTOR: W ell, I th in k at th is s ta g e I'd BS: c ri, ti ngh by gi ti phi
like to e x a m in e y o u , y o u r khm bnh cho ng, khm c vng
c h e st. So if y o u c o u ld s trip to ngc. Vy ng vui lng ci o ra nh.
y o u r w aist.
PATIENT: R ight. T h ere w e go. BN: Vng, ti lm y.
DOCTOR: T h a t's fin e. I'll ju st c h e c k y o u r BS: Tt ri. Trnc tin ti J bit m ch cho
p u lse first o f all. F in e. T h a t's ng. Tt. Nh vy l i tL Hon ton
fine. It's q u ite n o rm a l, se v en ty bnh thng, nhp b iy mi mt
p e r m in u te . pht
PATIENT: Er, right. BN: X. c.
DOCTOR: N o w y o u r b lo o d p ressu re. BS: By gi l huyt p. Tt- Cng hon
Fine. T h a t's q u ite n o rm a l too. ton bnh thng. 130 trtn 80.
130 ov er 80.
PATIENT: O h, I'm p le a s e d to h ea r it. BN: . ti tht mng khi nghe bc si ni
th.
DOCTOR: N o w I'm g o in g to lis te n tQ you r BS: By gi ti s nghe tm Ang. vy ng
h e a rt, so I w a n t y o u to b r e a th e hy ht th bnh thng... , tim ng
n o rm a lly ... M m , y o u r h e a rt p hon ton bnh thng.
s o u n d s q u ite n o rm a l.
PATIENT: W ell, th a t's a relief. BN: Tt qu, nh th cng bt lo lng.
DOCTOR: W ell n o w , I w a n t y o u to take BS: c ri, by gi ti mun ng ht vo
d e e p b r e a th s in a n d o u t w h ile I th ra tht su d ti khm phi cho
c h e c k y o u r lu n g s. In. O u t. In. ng. Ht vo. Th ra. Ht vo. Th ra.
O ut. Fine. T h e y 're c o m p le te ly T t ri. Hai phi u trong su i c
clear. W ell, M r G re en , th e p a in ri, ng Creen ny, cn au ca ng
y o u 'v e b e e n h a v in g s o u n d s ging ht nh con au m chng ti
very m u c h like th e p a in o f gi l cn au th t ngc, v tnh trng
w h a t w e call a n g in a , a n d this, ny xy ra khi khng c oxygen
w ell, th is o c c u rs w h e n n o t n tim. By gid ti mun lm mt
e n o u g h oxygen is g e ttin g to vi xt nghim, ri sau ti c th
th e h e a rt. N ow I'd like to c h e c k khuyn ng iu tr ra sao ...
a few te sts, an d , fo llo w in g th a t
I'll b e a b le to ad v ise s o m e
treatment for you ...
Task 12 Bi lm 12
DOCTOR: Ah g o o d m o rn in g , M r H u d so n . I BS: , cho ng Hudson. Ti c xem danh
se e fro m y o u r c a rd th a t y o u 'v e thip ca ng nn mi b it ng va
ju s t m o v e d in to th e a r e a a n d chuyn n vng ny, c l ng cho
p e rh a p s y ou c o u ld tell m e a lit ti bit i cht v sc khe trc y
tle a b o u t y o u r p re v io u s h e a lth ca ng, v ti khng c cc d liu v
as I w o n 't get y o u r re c o rd s for ng cho ti mt hi thng na, v lc
a n o th e r m o n th , m o n th o r tw o. mi c th gii quyt vn hin
an d th e n w e c a n d ea l w ith y o u r nay ca ng.
p re se n t p ro b le m .
PATIENT: Well, I've actu ally , i'v e alw ays BN: D hin nay, cho n lc ny ti vn
b e e n v e r y f i t u p t i ll n o w b u t ... rt khe ninh nhung _
DOCTOR: H ave yo u ev er b e e n in h o s p i BS: T h ng c nm bnh vin ln no
tal? cha?
PATIENT: O h, o n ly w h e n I w a s a ch ild . I BN: , chi c m t ln khi cn b, lc 8 tui
h a d an a p p e n d ic itis w h e n I ti c b vim m t tha.
w as eight.
DOCTOR Aha, a n d w h a t's y o u r job, w h at BS: , th ng lm ngh g, lm cng vic
d o you do? g?
PATIENT: WeU, Im a. I w ork for th e p o st BN: D, ti l, ti lm vic bu in. Ti
office. I'm a p o stm a ste r. l trng phng bu in.
DOCTOR: A nd I s e e that y o u 're w h at, 58, BS: , ti bit tui ca ng, by gi l .58,
now , a n d h av e y ou ...? th ng c ...?
PATIENT: Yes. BN: Vng.
DOCTOR: H ave y o u a lw a y s b e e n w ith th e BS: T h ng lun lm vic bu in
p o st office? ch?
PATIENT: Yes, w e ll apart fro m m y tim e in BN: Vng, ngoi tr thi gian ti trong
th e a rm y you k n o w ... qun i, bc s bit y.
DOCTOR: I se e . A nd y o u 're m arried . A ny BS: Ti hiu ri. V ng c v. Cn gia
family? nh ra sao?
PATIENT: Yes, tw o girls a n d a boy. BN: Vng, ti c hai gi v m t trai.
DOCTOR: F ine. T h at's fin e. N o w ca n y o u BS: Tt. Nh vy l tt. By gi ng c th
tell m e w h a t s e e m s to b e th e k cho ti nghe hm nay ng cm
p ro b le m today? thy ra sao?
PATIENT: W ell, it's th is terrib le p a in . I've BN: D, ti au d di, au rt nhiu
got th is te rrib le p a in in m y vng lng, ti au th hn mt
back. I've h a d it for m o re th a n tun l ri v ...
a w eek n o w a n d it's ...
DOCTOR: I s e e , an d ca n y o u s h o w m e e x BS: Ti bit, vy ng c th ch tht chnh
actly w h e re it is? xc ch no au khng?
PATIENT: It's d o w n h ere, h ere. BN: di ch ny, y ny.
DOCTOR: A n d d o e s it go a n y w h e r e else? BS: Ri au c lan dn ni no khc
khng?
PATIENT: Yes, it g o e s d o w n m y left leg. BN: D c, au lan xung chn tri. V ti
A nd I feel p in s a n d n e e d le s in cm thy nh c kim chm bn
m y foot. chn.
DOCTOR: I s e e , a n d is it th ere ail th e BS: Ti bit, m cdau y lin tc sao?
tim e?
PATIENT: Yes, y e s it is. It's k e e p in g m e BN: Vng, vng ng th. au lm ti
aw ak e, a w ak e at n igh t a n d 1 thc gic, tnh ng vo lc m v ti
c a n 't g e t o u t in to th e g a rd en . khng th i ra ngoi vn c. Ti
I've b e e n ta k in g a sp ir in s b u t phi ung aspirin nhng cn au c
th e p ain , it ju st c o m e s b ack tip tc tr li mi.
ag a in .
DOCTOR: A nd w a s th ere a n y th in g that BS: Th cn au khi du ra sao?
sta rted it off?
E nglish in M edicine - 2 2 9
PATIENT: Well, yes. yes. I've b e e n trying BN: Vng. vng. Ti ang c gln gdn dcp
to sort ou t th e g a r d e n at m y vn tc ni nh mi v ti khng
n ew h o u s e a n d I d o n 't know, I r. c th' ti lm vic hi q u i sc
m ay h a v e b e e n o v e r d o in g m t chi.
th in g s a bit.
Unit 2 Bi 2
Taking a history 2 L M B N H N 2
Tasks 1 and 2 Cc bi lm 1 v 2
DOCTOR Now, M rs B row n, c a n y ou tell BS No, b Brown, b c th ni cho ti
m e, h av e you an y tro u b le w ith bit b c b ri lon d dy hoc
y o u r sto m a c h o r bow els? ng rut khng?
P A T IE N T Well, I s o m e tim e s get a bit of BN: Vng, i khi ti n kh tiu mt
in d ig e stio n . cht.
DOCTOR: I see, a n d co u ld y o u tell m e BS: Ti hiu, b c th ni r hn c
m o re a b o u t that? ch?
PATIENT: Well, it only c o m e s o n if I h av e BN: Vng, chi kh tiu nu ti i n d nng,
a h o t. so m e th in g spicy, you cay nh c nhiu gia v. bc s bit
know , like a curry. y, v d n h c-ri.
DOCTOR: I see. well th a t's q u ite n o rm a l BS. Ti hiu, nh vy tht ra cng bnh
really. And w h a t's y o u r a p p e thng thi. Nhng b n c ngon
tite like? m ing khng?
PATIENT N ot bad. BN: Cng kh.
DOCTOR A nd an y p ro b le m s w ith y o u r BS: T h tiu tin c vn d g khng?
w aterw orks?
PATIENT: No. th e y 're , th e y 're all right. BN: Khng. tt c diu binh thving.
DOCTOR And are y o u still h av in g y o u r BS: Vy b vn cn kinh nguyt u n
p e rio d s regularly? ch?
PATIENT No, th ey s to p p e d , m u st h av e BN: Khng, ti tt kinh cng phi nm
b ee n five y ea rs ago. nm ri.
DOCTOR: Any p a in in th e c h e st, a n y p a l BN: B khng b au ngc, khng nh
p ita tio n . sw ellin g o f th e a n trng ngc hoc ph haj m t c chn
kles? ch?
PATIENT: N ot really, d o cto r. BN: Tha bc s, hon ton khng.
DOCTOR: A nd w h a t a b o u t c o u g h s o r BS: T h b c ho. th kh kh hoc kh
w h e e z in g or s h o r tn e s s o f th khng?
b rea th ?
PATIENT: Only w h e n I've g ot a cold. 8N: Ch khi ti b cm lnh thi.
DOCTOR H ave y o u n o tic e d an y w e a k BS: B c cm thy chn Uy mi yu
n e s s or tin g lin g in y o u r li.n b s? hoc nhi but khng?
PATIENT: No. n o I c a n 't say th a t I have, BN: Khng, khng, ti khng hiu tht s
really. c vy khng.
DOCTOR W h a t s o r t o f m o o d h a v e y o u BS: Cn y tinh thn b ra sao?
b e e n in recen tly ?
PATIENT I've b e e n feeling a bit dow n . BN: Ti thy hi xung tinh thn mt
You know , I'm n o t sle e p in g cht. Bc s bit y. ti ng khng
well. ngon.
Tasks 5 and 6 and Language Cc bi lm 5 v 6 v Trng tm

focus 5 ngn ng 5
DOCTOR: A nd h o w lon g , h o w lo n g h a v e BS. T hng st nh vy bao lu ri?

you h a d this te m p e ra tu re ?
PATIENT O h. I d o n 't k n o w exactly. BN: , ti khng bit chn h xc lm,
A bout tw o m o n th s o n a n d off. khong hai thng nay. lc c luc
khng?
DOCTOR: A nd d o e s, is th e te m p e r a tu r e BS: T hnhvy, c st lin tcsut ngy
th e re all th e tim e or d o e s it hay chi st vo mt thi im dc
c o m e o n at a n y p a rtic u la r bit?
tim e?
PATIENT W ell, s o m e tim e s I'm all right BN: , di kh i sut c ng y ti u b n h
d u rin g th e d ay b u t. I w ak e u p thng nhng c lc tnh gic ban
at n ig h t a n d I'm d r e n c h e d in m ngi ti y m hi. t dm v
sw eat, d re n c h e d , a n d s o m e i lc rt ru n c ngi v ...
tim e s m y w h o le b o d y sh a k e s
a n d ...
DOCTOR A nd h o w h a v e y o u b e e n fe e l BS: Th ni chung th ng cm thy
in g in gen eral? trong ngi ra sao?
PATIENT: W ell. I d o n 't k n o w , I've b e e n BN: 0 , ti khng r lm, ti cm thy hi
feeling a bit tired , a bit tired mt, i cht m t mi v yu. Tht ra
an d w eak. A nd 1 ju st d o n 't ti cm thy chng cn cht nng
se e m to h av e an y energy. lng no na.
DOCTOR: A nd h a v e y o u n o tic e d an y . any BS: V ng c thy au cht t c bp
p a in in y o u r m u scles? khng?
PATIENTYes. well, ac tu a lly I h av e a bit, BN: V n g , h i n n a y n g l c au c h t t!
yes.
DOCTOR A nd w h at a b o u t y o u r w eight? BS: Th ng cn nng bao nhiu. ng c
H ave you lost an y w eight? st cn khng?

PATIENT Yes, yes. I h ave, a b o u t a stone.* BN: Ving. c. ti st khong 6.4 kg.
DOCTOR I s e e . an d w h a t a b o u t y o u r a p BS: Ti hiu, t h ng i n ung c ngon

petite? W h a t's y o u r a p p e tite m ing khng? n g cm thy n ra
b e e n like? sao?
PATIENT W ell, Iv e really b e e n o ff m y BN: , th t s hi n iy ti chng thch
food th is last w hile. I ju st m n no c, ng ra l c h in g thch
h a v e n 't felt like eating. n na.
DOCTOR A nd h ave y o u h ad a c o u g h at BS: Th ng c bj ho khng?
all?
PATIENT Oh yes, I h ave. N early all th e BN: Vng, c. Ti c ho, h iu n h lin tc.
tim e. I s o m e tim e s b rin g u p a i khi ti c ch t dm nhy.
lot of phleg m .
DOCTOR A nd is th e re , h av e y ou n o tic e d BS: T h trong m ng c i thy dnh
any b lo o d in it? cht m u khng?
PATIENT N o, n o t a lw a y s b ut y e s, s o m e BN: Khng, khng phi lc no trong
tim es. dm cng c m iu , nhng vng, i
khi c mu.
DOCTOR H ave y o u h ad a n y p a in s in BS: n g c th y au trong ngc khng?
y o u r ch est?
PATIENT O nly if I take a d e e p b reath . BN: Chi khi no ti th th t su mi dau.
Tasks 15 and 16 Cc bi lm 1 5 v 1 6
GP Hello, Jim. I w o n d e r if y o u BS tng qut: Cho Jim, bn c th khm
c o u ld see a p a tie n t for m e? m t bnh n h n gip ti c khng?
CONSULTANT: C ertain ly. John. W h a t's Bc s tham vn: uc ch. John. Th
th e story? bnh s 13 sao?
GP Well, it's a M r A lan Ja m e so n , a BS: , l ng Alan Jam eson, th mc,
5 3 -y ea r-o ld c a rp e n te r. H e's 53 tui. Trc y. i lc, ng ta c
b e e n an in f re q u e n t a tte n d e r in n nh ti chm sc nhng sng
th e p ast b u t h e c a m e to se e m e nay ng tit n ch ti than p h i n au
th is m o rn in g c o m p la in in g of chn phi v vng lung.
p a in in his rig h t leg a n d in his
back.
CONSULTANT: A nd w h e n d id th is start? BS tham vn: V au t khi no?
*In the UK patients often talk abou t their Lin hip Anh. bnh nhn thong m t i cn
weight in stones. nng c th bng none.
1 stone = 14 pou n d s o r 6.4 kg. 1 Slone = 14 pound hoc 6.4 kg.
I pound = 454 gram s 1 pound = 4 5 4 gam .
In the USA people give iheir w eight in Hoa K dn chng dng pound d ni v
pounds. cn n$ng c th*.
2 3 2 - E n g lish in M ed icin e
GP Well, it c a m e o n a b o u t six BS: , Cn au bt du khong su tun
w e ek s a g o a n d it's b e c o m e nay v ngy cng au nng hn trong
g rad u ally m o re se v e r e o v er th e khong hai tun l nay.
p a st c o u p le o f w eek s.
CONSULTANT Was the pain localised? BS tham vn: Cn au c khu tr khng?
GP No. poorly. Al first h e th o u g h t BS: Khng, cha r. Lc u, ng ta ch
h e d ju st p u lled a m u sc le . But ngh rng c ko git m t bp c.
it's g o t so bad th at h e h a sn 't Nhng ri au nhiu n mc ng ta
b e e n ab le to d o h is w ork p r o p khng th lm cng vic hon ho
erly. It's also b e e n g e ttin g to c. Ri dn dn n mc au lm
th e sta g e w h ere th e p a in is ng ta tnh gic ban m , au nng
w a k in g h im up at n ig h t, it's lm v ng ta cng n hn thy nh c
b e e n so se v ere, a n d h e 's a lso cht g nga ran bn chn phi.
n o tic e d so m e tingling in his ng ta cm thy kh khn khi tip tc
right foot. H e's h a v in g d iffi cng vic. ng ta st cn ti ba kg
cu lty in carrying o n w ith h is v tr nn hon ton suy sp.
work. H e s a lso lo st th r e e k ilo s
a n d h a s b e c o m e q u ite d e
p ressed .
CONSULTANT: H as h e h a d a n y th in g s im i BS tham vn: T h trc y, c chuyn
lar in th e past? g tng t nh th khng?
GP: N o, n o t ex a ctly , b u t h e h a s s u f BS: Khng, khng r lm, nhng ng ta
fered from in te r m itte n t p a in c b dau tng cn gin on vng
in back. P a ra c e ta m o l gave lng. Paracetamol c lm d chu i
s o m e r e lie f b u t d id n 't s o lv e th e ch t n h n g chng gii quyt hon
p ro b le m c o m p le te ly . ton c vn .
CONSULTANT: A part fro m th a t, a n y o th e r BS tham vn: Ngoi chuyn th trc
p r o b le m s w ith h e a lth in th e y cn c nhng vn g khc v
past? sc khe khng?
GP: No, p erfectly OK. BS: Khng, hon ton tt c.
CONSULTANT: D id y o u Find a n y th in g e ls e BS tham vn: Cn khi khm bnh, anh
o n ex a m in a tio n ? c pht hin iu g khc na khng?
GP Yes, as w ell as th e p a in h e h as BS: C, ngoi chng au, ng ta cn cm
n u m b n e s s in h is to e s o n th e thy t cng cc ngn bn chn
right foot. phi.
Tasks 19 and 20 Cc bi lm 1 9 v 2 0
DOCTOR: G o o d a fte r n o o n , Mr H u d so n . BS: Cho ng Hudson. Xin mi ngi. Lu
Ju st h av e a se at. I h a v e n t se e n qu ri khng gp ng. Th hm nay
y o u for a g o o d lo n g tim e. ng n c chuyn g vy?
W h a t's b r o u g h t y o u a lo n g h ere
today?

PATIENT: Well, doctor. I've been having BN: Tha bc s i ti mi bi nhc u vi
th e s e h e a d a c h e s a n d 1 s e e m to cng st cn cht it v ...
h av e lo st so m e w eight an d ...
DOCTOR I s e e . an d h o w lo n g h a v e th e s e BS: Ti hiu ri. th ng nhc diu nh
headaches been b o th e rin g vy bao lu ri?
you?
PATIENT: W ell, I d o n 't k n o w . For q u ite a BN: , ti khng r. D. cng mi dy. B
w h ile n o w . T h e w ife p a ss e d x ti mi m t bc i bit . khong
aw a y y o u k n o w , a b o u t four bn thng nay. T dn gi, ti cm
m o n th s ago. A nd I'v e b e e n thy suy sp cht l
fe e lin g d o w n sin c e th en .
DOCTOR And w h ic h part o f y o u r h ea d is BS: Th ng au ch no trn u?
affected ?
PATIENT: lu st h ere, lu st h ere o n th e top . BN: Chnh ch ny. Ngay inh diu
It fee ls as if th ere w e r e s o m e y. Ti cm thy nh c gi nng, c
th in g h eavy, a h ea v y w e ig h t vt nng ln diu.
p ressin g d o w n o n m e.
DOCTOR I se e . an d h a v e th ey a ffec ted BS: Ti hiu, th ch u y n c nh hng
your v isio n ai all? dn th lc ca ng khng?
PATIENT N o. n o I w o u ld n 't say so. BN Khng, khng, ti khng mun ni
th.
DOCTOR N o t e v e n s e e in g lig h ts o r b la c k BS: n g cng khng nhn th y chi sng
sp ots? hoc dicm den ch?
PATIENT: N o, n o th in g lik e that. BN: Khng, khng c n h vy.
DOCTOR: A nd th ey h a v e n 't m a d e y o u BS: Th chuyn d c lm ng bnh
feel sick at all? khng?
PATIENT: No. BN: Khng.
DOCTOR. N o w . y o u to ld m e th at y o u ve BS: T h n g ni l C st cn cht t. T h
lo st s o m e w e ig h t. W h a t's y o u r ng n c ngon m ing khng?
a p p e tite b e e n like?
PATIENT W ell, a c tu a lly 1 h a v e n t really BN: . hin nay tht S ti khng thich n
b e e n fe e lin g like e a tin g . I've cht no c. Lc ny. tht s ti
really b e e n o ff m y fo o d for d ie chng n gi c i v ...
m o m e n t a n d ...
DOCTOR: A nd w h a t a b o u t y o u r b o w e ls, BS: Th cn rut ng ra sao, c vn d gi
an y p ro b lem s? khng?
PATIENT N o, n o th ey 're, I'm q u ite all BN: Khng, khng sao. ti hon ton bnh
right, n o p r o b le m s. thng. Khng c v in d g ci.
DOCTOR A nd w h a t a b o u t y o u r w a te r BS: Th ng di tiu ra sao?
w orks?
PATIENT W ell, I've b e e n h a v in g tr o u b le BN: , ti c kh khn h k bt d iu tiu
g ettin g s ta rte d a n d I h a v e to, 1 tin v ti bt buc p h ii. ti c im thy
s e e m to h a v e to g et u p d u rin g phi thc dy vo ban m hai hoc
th e n ig h t, tw o or th re e tim e s at ba ln mi m.
night.
DOCTOR: A nd h a s this c o m e o n recently? BS: Do ny c nh vy khng?
PATIENT. Well, n o , n o t e x a c tly . I th in k BN: y, khng, khng hn vy. Ti ngh
I've n o tic e d it g rad u a lly over chuyn d xy ra trc y, cch
Che p a s t, th e p a s t few m o n th s . nay vi thng.
DOCTOR: A nd d o you get an y p a in w h en BS: V khi i tiu ng c cm thy au
y o u 're p a ssin g w ater? cht no khng?
PATIENT No, n o . BN: Khng, khng.
DOCTOR; A nd h av e y ou n o tic e d an y BS: Th ng c nhn thy ch t mu, cht
blood, an y tra c e s o f b lood? vt mu khng?
PATIENT: No. no, I c a n 't say th a t I have. BN: Khng, khng, ti khng th chc l
c mu.
Unit 3 Bi 3
Exam ining a p a tie n t K h m b n h n h n
Task 1 Bi lm 1
DOCTOR: W ould y o u slip o ff y o u r top BS: ng vui lng ci o ra nh. By gi ti
things, please. N ow I ju st w a n t m un xem ng ng thng, n g t
to see y ou sta n d in g . H a n d s by hai tay ln hng. C v ng hi gang
y o u r side. Y o u 're stic k in g th a t gng ch hng, phi khng?
h ip o u t a little bit, a r e n 'ty o u ?
PATIENT: Yes, well, I c a n 't s tra ig h te n u p BN: Vng, ng vy, ti khng th gicho
easily. thng d dng c
DOCTOR: C o u ld y o u b e n d d o w n as far as BS: ng c th ci gp ngi xung ht
y o u c a n w ith y o u r k n ee s sc m vn gi du gi thng va ch
stra ig h t a n d s to p w h e n y o u 'v e ngng li khi gng ht mc c
had enough. khng?
PATIENT: O h, th a t's th e lim it. 8N: i. n y l h t m c ri.
DOCTOR: N ot very far, is it? S ta n d up BS: Khng ci c thp lm nh? n g li
again . N o w I w o u ld lik e y o u to ng ln. By gi ti mun ng n
lean b a c k w a rd s. T h a t's n o t ngi ra pha sau. Cng cha c
m u c h e ith e r. N ow s ta n d u p nhiu lm. By gi li ng thng
stra ig h t ag ain . N ow first o f all, I ln. By gi ti mun ng th bn tay
w o u ld like y o u to slid e y o u r phi trt xung pha i bn phi.
rig h t h a n d d o w n th e rig h t sid e coi ng lm c xa n u. Th
o f y o u r thigh. S ee h o w far you l tt. By gi ng li lm nh vy
c a n go. T hat'S fine. N ow d o th e pha bn kia. Tt. By gi hy ng
sa m e th in g o n th e o p p o s ite thng tr li. By gi li chm hai
side. Fine. N ow ju s t c o m e b ack chn nh vy. Gi cht hai du gi.
to s ta n d in g s tra ig h t. N o w k e e p By gi hy c gng quay c hai vai v

your feet together just as they pha bn phi. Nhn cho thing. Ci
are. Keep your k nees firm. iuu iu gi v bn chn cho vng.
N ow try and turn both sh o u l
ders round to the right. Look
right round. Keep your k n ees
and feet steady.
PATIENT O h, th a t's sore. BN: i, nh vy au qu.
DOCTOR G o b a c k to t h e c e n t r e a g a in . BS: Quay tr li chnh gia. Li lm ng
N ow try the sam e thing and go nh vy v quay v pha b in tri.
round to the left sid e. Fine. c li. By gi ti quay v chinh
N ow back to the centre. That's gia. Th l tt. By gi ng vui lng
fine. N ow w ould you like to get nm ln giudng v nm sp xung,
o n to the cou ch and lie o n your c ch? By gi ti s i c gng th
face? Im just goin g to try and tm xem im dau ch no.
find ou t w here the sore sp ot is.
T a s k s 2 and 3 Cc bi lm 2 v 3
DOCTOR: W ould y ou like to lie d o w n BS. n g c th nm trn ging v nm
h ere on the cou ch , on your nga c ch?
back?
PATIENT: OK. BN: Vng c
DOCTOR: I'm g o i n g to t e s t y o u r r e fle x e s BS: Ti s th cc phn x ca Ong bng
by tapp ing you w ith this little cch g nh vi chic ba nh ny.
h am m er. I tw o n th u r ty o u . Let Khng au u. Hy ti nm cnh
m e h old your right arm. Let it tay phi ca ng. Hy th gin hon
go q u ite relaxed. Try not to ton nh. ng c cng Uy ln. c
tighten up. There. N ow the ri. By gid cnh tay bn kia. ti
other on e. Just let m e have nm c tay ng. C mm mi hon
your wrist. Let it go quite ton nh. Th l tL By gi ti s g
floppy. That's right. I'm goin g vo khuu tay. Tt. By gi n pha
to tap your elbow . Fine. N ow bn tri, c ch?
the left on e. OK?
PATIENT: Fine. BN: Vng, c.
DOCTOR: I'll ju st g iv e y o u a little tap h e r e BS: Ti s g nh trn c tay ch ny y.
on the wrist. N ow the other By gi dn bn kia. By gi ng
o n e. N ow le t y o u r legs go c o m cho hai chn hon ton th gin. Ti
p le tely relaxed. I'll h o ld th e m s cm chn ng ln. Nh th ny.
up with m y hnd. There. I'm Ti s xoay chn ng ra pha ngoi
just go in g to turn your leg out mt lt. C th gin nh. Dc ri.
to the sid e for a m om en t. Just By gidn bn chn kia. Tt Um.
relax. T h a t's it. N o w th e o th e r
one. Fine.
2 3 6 - E n g lish in M edicine
Task 4 Bi lm 4
1
Firstly I'd like you to kneel on that Thot tin ti m un ng qu gi trn
straight-backed chair so that your feet chic g h lng ta thng ny sao cho hai
are just slightly hanging over the edge. chn ng th ng ch t xu ra ngoi m p
That's right. N ow I'm goin g to tap them gh. c ri. By gi ti s g vo chn
behind your heel with this hapim er. pha sau gt bng ci ba ny. y ch l
This is just a m ethod o f testing for your phng php th phn x m t c chn
ankle jerk. That's fine. ca ng thi. Tt ri.
2
Now I'd like you to sit w ith y o u r legs By gi ti m un ng ngi v hai chn u
just dangling over the edge o f the cou ch a ngoi m p ging ti c th th cc
so th a t I can te st y o u r k n e e jerks. N ow phn x u gi. By gi chng c g qu
nothing very m uch is h ap p en in g here, m c xy ra y, n h vy iu ti mun
so what I'd like you to do is to clasp your ng lm l m c cht hai bn tay bng cc
hands together with the fingers and try ngn tay v c ko ri cc ngn tay ra. Hy
to pull your fingers apart. Pull as hard ko m n h n m c ng c th lm c
as you c a n a n d c o n c e n t r a t e o n p u llin g . v tp trung suy ngh vo vic ko. Tt ri.
T hat's fine. T h a t m a k e s it a lo t e a s ie r to Nh vy s lm i cht d dng hn
produce your knee jerk. to c phn x u gi ca ng.
3
Now finally I w a n t y o u to lie d o w n o n By gi ti m un ng nm trn ging v
the bed w ith your legs stretch ed out in hai ch n dui thng theo ngi. By gi
front o fyou. N ow I'm g o in g to p la c e m y ti s t tay trn u gi ng v bng
hand o n y o u r k n e e a n d w ith th is key chic cha kha ny ti s c st vo gan
I'm going to s o k e the so le o f your foot bn chn ng xem ngn chn ci quay
to see w hich way your big toe w ill turn. v pha no. y gi l phn x lng bn
This is called th e p la n ta r reflex. You chn. ng s khng thy au tuy c hi
shouldn't find it painful althou gh it n h t m t cht. c ri. By gi ti s
m ay tickle a little. Fine. N o w I'll c h e c k kim tra bn chn kia. Rt tt. By gi cc
the other foot. Very good . T hat's your phn x ca ng c th xong. Cm
reflexes all fin ish e d now . T h a n k you. n ng.
Task 5 Bi lm 5
DOCTOR: W o u ld y o u lik e to g e t o n to th e BS: ng vui lng ln ging v nm nga,
c o u r h a n d lie o n y o u r back, c ch? By gi ti s cm chn
please? N ow I'm g o in g to take i ca ng v th xem c th nhc
y o u r left leg a n d s e e h o w far w e cao dn m c no nh. HygidugOi
c a n raise it. K eep th e k n ee tht thng y. Nh th c dau cht
straigh t. D o e s th at hu rt at all? no khng?
PATIENT Yes, ju st a little. Just slightly. BN: C, chi cht t. au nh thi.
DOCTOR: C an I d o th e sa m e with this leg? BS: Ti c th lm nh vy vi chn ny
H ow far will th is o n e go? N ot ch? Xem chn ny gi cao n u?
very far. N ow le t's see w h a t Khng cao lm nh. By gi th xem
h a p p e n s if I b e n d y o u r to e s s c chuyn g nu ti gp nga cc
back. ngn chn ca ng.
PATIENT: O h, th a t's w o rse. BN: i, t h th au n h iu .
DOCTOR: I'm g o in g to b e n d y o u r k n e e. BS: Ti s gp U gi ca ng nh. ng
H ow d o e s th a t feel? cm thy ra sao?
PATIENT: A little b etter. BN: C kh hn.
DOCTOR N o w le t's s e e w h a t h a p p e n s BS: By gi th xem s c chuyn g khi
w h e n w e stra ig h te n y o u r leg ti li dui thng chn ca ng ra.
again.
PATIENT: T h a t's s o r e . BN: T h th au y.
DOCTOR: I'm ju st g o in g to p r ess b e h in d BS: Ti ch n m n h pha sau u gi ca
y o u r kn ee. ng thi.
PATIENT: O h, th at h u rts a lot. BN: i, nh th c au y.
DOCTOR: W here d o e s it hurt? BS: Vy au u?
PATIENT: In m y back. BN. ch lng ca ti.
DOCTOR: R ight. N o w w o u ld y o u roll o v e r BS: c ri. By gid ng vui lng quay
o n to y o u r tu m m y ? B e n d y o u r ngdi ri nm xp dc khng? Gp
rig h t k n ee . H ow d o e s th a t feel? u gi phi, n g cm thy t h no?
PATIENT: It's a little bit sore. BN: C hi dau m t cht.
DOCTOR: N o w I'm g o in g to lift y o u r BS: By gi ti nhc bp i ng cao
th ig h off th e c o u c h . hn m t ging y.
PATIENT: OhT that really hurts. BN: i, c au tht ri.
T a s k 6 an d L a n g u a g e fo c u s 7 Bi lm 6 v Trng tm ngn
ng 7
DOCTOR: N o w , M r M cLeod, I k n o w BS: No ng McLeod. Ti bit ng c au
y o u 're in s o m e p a in but there cht t nhng c vi chuyn ti phi
are a few thin gs I'll have to kim tra xem sao. Ti s lm nhanh
check. I'll be as q u ic k as I can . thi. Ti s bt m ch cho ng. Hm.
I'll ju st ta k e y o u r p u lse . M m . By gi n lt bn kia. TL By gid
N ow th e o th e r side. OK. N ow l huyt p. Trc y ng c
y o u r b lo o d p re ssu re . Y ou've khm ri. By gi ti cng li khm
h a d th a t d o n e befo re. Im g o bn kia na. Mt ln na. Tt. By gi
in g to c h e c k th e o th e r sid e too. ti s nghe tim ng. C tM bnh
O n ce m o re . Fine. N ow I w a n t thng. ng c ngi ln m t lc
to liste n to y o u r h e a rt. Just khng? Ti m un kim tra phi ca
b r e a th e n o rm ally . C ould you ng.
sit u p a little? I ju st w a n t to
check y o u r lungs.
PATIENT: Right, d o c to r . BN: Vng, tha bc sL
DOCTOR That's it. N ow Id like you to BS: c ri. By gi ti mun ng th ra
take b ig b reath s in a n d o u t ht vo bng m ing tht su y. Tt
th ro u g h y o u r m o u th . OK. You lm. By gi ng c th nm xuYig
c a n lie d o w n again. c ri.
PATIENT: It's bad. BN: C au .
DOCTOR: I'll b e q u ick . I'll ju st tak e a lo o k BS: Nhanh thi m. Ti s chi khm d
at y o u r sto m a c h . T ak e d e e p dy cho ng thi. Hy th ra ht vo
b re a th s in a n d o u t. N ow I'm g o tht su nh. By gi ti s kim tra
in g to c h e c k th e p u ls e s in y o u r . nhp m ch c hai bn hng na.
g r o in s too. W e ll ju st roll y o u r By gi ng b hai ng qun pyjama
p y ja m a tro u sers d o w n . T h at's xung nh. c ri. Chng ta sp
it. W ere fin ish e d now . Well M r xong ri. Ny ng McLeod, ti ngh
M cLeod. I th in k y o u 'v e got rng ng c i ch t ri lon mt
s o m e tro u b le w ith o n e o f y o u r trong cc ng m ch v huyt p ca
arteries b e c a u se o f y o u r h ig h ng cao. Ti s tim cho ng gim
b lo o d p ressu re. I'll g iv e y o u an au ri thu xp d ng n bnh vin
in jec tio n to relie v e th e p a in a n d lm thm cc xt nghim na.
arrange for y o u to g o in to h o s p i
tal for further te sts.
Task 10 Bi lm 1 0
DOCTOR: H o w are y o u , M rs W allace? BS: B Wallace, sc khe b th no?
PATIENT: I'm fin e. BN: Ti thy khe.
DOCTOR: H ave y o u b r o u g h t y o u r u rin e BS: B c m ang theo mu nc tiu
sa m p le? khng?
PATIENT: Yes, h e r e it is. BN: D C, mu y .
DOCTOR: I'll ju st c h e c k it. F ine, ju st slip BS: Ti s kim tra mu xem nh. Tt, b
off y o u r c o a t ... U rin e is all hy b o khoc ra ... Nc tiu hon
clear. N ow if y o u 'd like to lie ton trong sut. By gi nu b nm
d o w n o n th e c o u c h , I'll ta k e a trn ging, ti s coi xem a b ra
look a t th e bab y . I'll ju s t m e a s sao. Ti ch o xem a b c chiu
u re to se e w h a t h e ig h t it is. cao bao nhiu. c ri, hnh nh n
Right. T h e b a b y s e e m s slig h tly hi nh m t cht.
sm all.
PATIENT: H ow d o you know that? BN: Bng cch no m bc s bit nh
vy?
DOCTOR: I m e a su r e from th e to p o f y o u r BS: Ti do t y t cung n xng mu
w o m b to y o u r p u b ic b o n e . T he ca b. S o centim t xp xi bng s
n u m b e r o f c e n tim e tr e s is tun l b m ang thai. Trong trng
ro u g h ly e q u a l to th e n u m b e r hp b, s o y l 29 centim t nhng
o f w e e k s y o u 're p re g n a n t. In b m ang thai 32 tun l.
y o u r c a se it's 29 c e n tim e tr e s
b u t y o u 're 32 w ee k s p re g n a n t.
PATIENT W hy d o y o u th in k th e b a b y 's BN: Ti sao bc s li nghi l da b nh?
small?
DOCTOR It m ig h t b e b e c a u s e y o u r d a te s BS: C th li vi cc n g iy thng ca b b
are w rong. R e m e m b e r y ou sai lch. Nn nh rng b khng
w e re n 't su re o f y o u r la st p e r i chc ch n lim v i k kinh cui cng.
od. T h e b est th in g w o u ld b e to Cch tt n h t s l lim thm mt
have a n o th e r sc a n d o n e . I'll chp scan na. Ti s ly cho b mt
m a k e a n a p p o in tm e n t for you bui hn vo tun sau.
n ex t w eek.
PATIENT W h ich w ay ro u n d is th e b a b y BN: Th a b ang nm cong trn ra
lying? sao?
DOCTOR: T h e b a b y 's in th e right p o s i BS: a b nm t th dng. N s lt
tio n . It's c o m in g h e a d first. u ra truc. By gi ti i t nghe tim
N ow I'm g oing to lis te n fo r th e a b p ra sao. Tt dy. B c th
b a b y s h e a rtb e a t. T h a t's fine. nghe thy n p khng? Ting tim
C an y ou h e a r it? It's q u ite dp r lm. B c n h n thy hi ph
clear. H ave y o u n o tic e d an y cc mt c chn khng?
sw elling o f y o u r ankles?
PATIENT N o t rea lly . BN: Khng l rng lm.
DOCTOR: L et's h a v e a q u ick lo o k . N o , BS: ti xe-m qua mt chL Khng, cc
th e y se e m to b e all right. N ow , mt c chn c v hon ton binh
w o u ld y o u like to sit u p a n d Ill thng. By gi b vui lng ngi ln
ta k e y o u r b lo o d p re ssu re . v ti s o huyt p ca b.
PATIENT R igh t. BN: c ri.
DOCTOR: It's q u ite n o r m a l. N o w I'll take BS: Gn nh bnh thng. By.gi ti s
a sa m p le of b lo o d to ch e ck ly mu mu kim tra hemoglobin
y o u r h a e m o g lo b in . Fine. You ca b. TL By gi b c th i giy
c a n g et y o u r sh o e s a n d c o a t o n v mc li o khoc ri.
a g a in now .
T a sk 13 Bi lm 13
DOCTOR: I'll ju st c h e c k a fe w th in g s to BS: By gi ti s kim tra mt s vic
see if w e c a n g et to th e b o tto m xem liu chng ta c th gii quyt
o f th e se p ro b le m s. F irst o f all n tn cng cc vn ny khng.
Ill ch e c k y o u r p u lse a n d th e n Trc ht, ti s kim tra nhp mch
I'll d o y o u r b lo o d p re s s u re . I'd ca ng v sau ti i t o huyt p
like y o u to ta k e off y o u r ja ck e t ca ng. Ti mun ng ci b o
a n d roll u p y o u r sleeve. khoc ngoi v xn cao Uy o ln.
PATIENT: H o w is it d o c to r ? BN: Vn r sao, thua bc s?
DOCTOR: It's ju st a little a b o v e n o rm a l, BS: C di cht trn mc binh thng,
b u t th a t d o e s n 't m e a n ,ri0 nhng chng c ngha nhiu lm
m u c h . If y o u 'd like to roll u p u. Nu ng vui lng ko cao o s
y o u r sh irt, I'm g oing to ch eck mi, ti s kim tra tm v phi. By
your heart and lungs. N ow just gi ng hy th bnh thng nh.
breathe norm ally. Good. N ow Tt. By gi ti mun ng ht vo v
I'd like you to take d eep th ra tht su bng ming. T h l
breaths in and out through tt. By gi nu ng vui lng nm
your m outh. That's fine. N ow trn ging, ti s khm d dy cho
if you'd like to lie d ow n o n the ng.
cou ch , ru exam in e your sto m
ach.
PATIENT: Right. BN: Vng c .
DOCTOR: Take a d e e p b reath in an d ou t. BS: Ht vo v th ra tht su nh. Thm
And again. Aha. N ow I'll just ln na. . By gid ti s xem liu c
see if there's any sign o f a h er du hiu no ca b n h thot v
nia. Could you slip your trou khng. ng c th tt qun xung
sers down? That's fine. Give a c ch? Nh th c ri. Vui lng
cough, please. Again, p lease. ho m t ting xem no. Thm ting
N ow b ecau se y ou 've b een na. By gi v ng c cht ri lon v
having trouble w ith your w a tit niu nn ti mun khm vng
terworks, I'd like to exam in e hu mn. Nu ng nm quay ngi
your back p assage. Ify o u ' roll sang tri v co hai u gi ln cao.
over on to your left sid e and ng c th cm thy i cht kh
bend your k nees up. You chu, nhng s khng lu qu u.
m ight find this a bit u n c o m Nh th l c. Xong xui tt c ri
fortable, but it w on 't take long. y. By gi ng c th mc li qun
That's it. All finished. You can o ri.
get your clo th es on now.

Unit 4 Bi 4
S p e c ia l exa m in atio n s THM k h m c b i t
T a sk s 1, 2 and 3 Cc bi lm 1, 2 v 3
DOCTOR: G o o d a fte r n o o n , M r P riestly, BS: Cho ng Prkstly, xin vo y v mi
c o m e in a n d h a v e a seat. ng ngi xung.
PATIENT G o o d a fter n o o n , M r D a v id BN: Xin ch o ng Davidson.
son .
DOCTOR N o w I've had a letter fro m y o u r BS: y, ti c bc th ca bc s ca ng
d o c to r say in g th a t y o u 'v e b e e n ni rng ng c vn d v th gic.
h av in g p ro b le m s w ith y o u r
sight.
PATIENT Y es. th a t's rig h t d o c to r . BN: Vng, ng vy tha bc s.
DOCTOR C ou ld y o u tell m e h o w lo n g th e BS: ng c the ni cho ti bit mt tri
left eye h a s b e e n b a d for? ca ng yu t bao lu ri?
PATIENT O h , g o in g o n for a b o u t a y e a r BN: , ti ngh C l khong m t nm nay.
now , I su p p o se .
DOCTOR M m , an d w h a t d o y o u do? BS: H, th ng lm g?
PATIFNT I'm a p o s t m a n . I d e liv e r le tte r s BN: Ti l nhn vin bu in. Ti pht
a n d th a t so rt o f thing. th v lo i c n g v i c nh vy.
DOCTOR H ow is you r w ork b e in g a f BS: T h cng vic ca ng b nh hng
fected? ra sao?
PATIENT O h . it's r ea lly b a d . I c a n h a r d ly BN: th t ti t. Ti c c ic ch kh
see th e le tte rs let a lo n e th e a d k h n ch cha ni n cc da chi.
d resses. have to g et m y m a te s Ti phi nh bn b gip ti trong
to do th a t so rt o f th in g for m e vic y v nay n lc tht s ti
a n d it's g e ttin g to a sta g e chng cn lm c na.
w h ere I ju st c a n 't c o p e really.
DOCTOR I see, yes. I'd ju s t like to e x a m BS: Ti hiu, vng. Ti ch khm mt cho
in e y o u r e y e s a n d p e r h a p s w e ng v c l ta bt u bng bng biu
co u ld sta rt w ith th e ch a rt. d th lc. n g c nhn vao bng cho
C ould y o u ju st look a t th e c h a rt ti nh. n g c nhn thy ch no
for m e? C an y o u see a n y le tte rs khng?
a t all?
PATIENT: N o, n o th in g . BN: Khng, c h n g c gi c.
DOCTOR OK. Well, w i t h t h e r i g h t e y e BS: c ri. Bng m t p h ii ng c nhn
ca n y ou see an y th in g ? thy g khng?
PATIENT: N' H T A. T h a t's a b o u t all. I'm BN: N H TA. Ti s ch c uoc tt c th
afraid. thi.
DOCTOR: N ow d o e s that m a k e a n y d if BS: By gi lm th c k h ic gi khng
ference?
PATIENT: N o , n o n o t h in g . BN: Khng, chng c gi ci.
DOCTOR W hat a b o u t th a t o n e? D oes BS: Cn mt ny? C gy hiu qu g
th a t h av e a n y effect? khng?
PATIENT: Not really, I can't reaUy say it BN: Khng hn, tht s ti khng th ni
does. c hiu qu khng.
DOCTOR: Right, OK, th an k y o u very BS: c ri, tt, cm n ng nhiu nh.
m u c h in d e ed .
Ta sks 7 and 8 Cc bi lm 7 v 8
DOCTOR: N ow , D eb b ie, ca n I h a v e a look BS: No Debbie, bc c th khm xem
ai yo u to find o u t w h e re y o u r v u chu ho nhiu th c khng?
b a d c o u g h is c o m in g from ?
PATIENT: (Nods) BN: (Gt u)
DOCTOR: W o u ld y o u lik e to s t a y s it t in g BS: Chu c th ngi trn u gi m
on M u m 's knee? c khng?
PATIENT (Nods) BN: (Gt du)
DOCTOR: T h at's fine. N o w le t's ask M u m BS: Tt lm. No by gi ni m ci o
to take off y o u r ju m p e r a n d khoc v o cho chu nh. y chu
blouse. You'll n o t be co ld in khng b lnh du. (B m ci quan
here. (M o th e r rem o ves D eb o Debbie). By gi bc l ci vt
bie's clothes) N ow I'm g o in g to ny ln ngc chu nh. Ci ny gi l
p u t th is t h in g c n y o u r c h e s t . chic ng nghe. C l hi lnh mt
It's called a s te th o s c o p e . It cht y. Bc s lam n m ln. Chu
m ig h t be a bit cold. I'll w a rm it cm nhn thy u ng nghe y
up. Feel th e e n d th e re . OK? ny. c cha? Thot tin bc nghe
First of all I liste n to y o u r fro n t pha trc ri sau d pha lng
a n d th e n y o u r back. chu.
MOTHER: S h e 's h a d th a t d o n e lo t s o f B m. Chu dc bc s Stuart khm
tim e s by D r S tu art. nhiu ln ri y .
DOCTOR: G o o d , w e ll d o n e , y o u d id n 't BS: Tt, gii lm, chu ch n g hc ca quy
m o v e at all. N ow I'd like to see g c. By gi bc khm d dy cho
y o u r tu m m y , so will y o u lie o n chu nh. vy chu c th nm tin
th e b e d for a m in u te ? Will 1 ging m t lc c khng? Bc on
gu ess w h a t's in y o u r tu m m y xem sng nay chu c ci gi trong
th is m o rn in g ? I b et it's Rice bng nh? Bc nh cuc la cm
K rispies. chin y.
PATIENT (Nods) BN. (Gt du)
DOCTOR: N ow w h ile y o u 're lying th e re , BS: By gi trong khi chu nm y, bc s
1*11 feel y o u r n ec k a n d u n d e r s c v nch nh. Chu c b nht
y o u r arm s. Are y ou tickly? N ow khng? By gi l pha trn i. Tt c
th e to p o f y o u r legs. T h a t's all u rt nhanh thi, c ch? B
very quick, is n 't it? M rs T h o m Thomson, chu Debbie li ngi trn
so n , co u ld D eb b ie sit o n y o u r u gi b, c ch? Ti mun b c
k n e e again? I'd like y ou to h o ld gi chu th ny trong khi ti khm tai
E nglish ill M ed icin e - 243
h e r th e re w hile I e x a m in e h er v hng cho chu. c ri. Debbie.
ea rs a n d th ro a t. Right, D ebbie. y l ci n nh d nhn vo trong
H e re 's a little light to look in tai chu. N c th nht m t chi
y o u r ears. T his will tickle a b it nhng khng au iu . Chu gi
b u t w o n 't be sore. G o o d girl. ngoan tht. Ci tai ?p qu. By gi
W hat a nice ear. N ow le t's see bc xem tai kia na. Cn m t cht na
th e o th e r o n e N ow n ea rly th e thi. Chu h m ing ra. bc xem
last bit. O p en y o u r m o u th . Let rngchiiunh. By gi chu h ming
m e see y o u r te e th . N ow o p e n it cng to c.injj tt nh. Tt. Debbie, bc
as w ide as you can. G oo d . I murtn bit c h iu cao bao nhiu. Chu
w o n d e r h o w tall voti are, D e b n y v ng thng ngi bc o
bie. C ould von c o m e a n d s ta n d chu dtfiic khng7 ng th in g ngi.
over h ere a n d I'll m e a su re Tt lm. Chu co dng trn bn cn
y o u 7 S tan d straig h t. T h a t's bao gi cha? Hy n ng y ny
fine H ave you ev er b e e n o n a chng ta xem chu cn nng bao
w eighing m a ch in e ? Just sta n d nhiu. Tt, chng ta sp xong by gi
up h ere an d w e'll see how y. Chu ngoan lim . Bc s ni
heavy you are. Well, w e 're all chuyn vi m chu v chu c th
fin ish e d now . Y ou've b e e n chi cc d chi m t lt nh.
very good. I'll h av e a talk w ith
y o u r M um a n d y o u c a n play
w ith th e toys for a m in u te .
Task 9 Bi lm 9
5 fo o t 5 chn
DOCTOR W e'll just ask M u m m y to take BS: C hng til s ni vi m chu ci b c
off y o u r sh o e s a n d socks so I giy v v ra bc c th coi qua i
ca n h av e a q u ic k look a t y o u r bn chn chu nh. C th hi nht
feet. It m ig h t b e tickly b u t it nhng khng au u.
w o n 't b e sore.
6 n asal passage 6 ng m i
DOCTOR Can y o u sit o n M u m m y 's BS: Chu c th ngi ln iu gi ca m
k nee? I'm g oing to h av e a look c ch? Bc s xem m i chu bng
a t y o u r n o se w ith th is little chic n nh ny. Chu s hon ton
light. You w o n 't feel a n y th in g khng c im thy cht gi d iu . Chu c
at all. C an you p u t y o u r h e a d th nga u ra pha sau gip bc dc
b ac k to h elp m e 7 khng?
Tasks 11, 12, 13 and 14 Cc bi lm 1 1 , 1 2 , 1 3 v 1 4

DOCTOR: H ello, M r W a lt e r s . H o w a r e BS: Cho ng; Walters. Hm nay ng kht
you today? ch?
PATIENT: O h, I'm fine, very well, th a n k BN: Vng, tikhe, rtkh*. c im n n g .
you.
DOCTOR: You know w ho I am, don't BS. n g c bit ti l ai ch?
you?
PATINT: N o w , le t m e s e e n o w . I k n o w BN: No ti xem. Ti bit m t ng
y o u r face, b u t I c a n 't q u ite nhng khng th xc nh c ng
p la c e w h o y o u are. I th in k I l ai. Ti ngh l ti b i t Ti ngh l ti
know . L th in k I s h o u ld k n o w bit ng l ai.
w h o y o u are.
DOCTOR. Well, that's right. I'm Dr BS: Thi c ri. Ti l bc s Williams.
W illiam s. I've m e t y o u severaJ Ti gp ng nhiu ln trc y,
tim e s b efo re, y o u know . ng bit y.
PATIENT: O h, y o u 'r e th e d o cto r . W ell, I BN: , ng l bc s. Ny ti nh bc s
re m e m b e r old Dr H o rsb u rg h Horsburgh trc kia kh r. Ti nh
q u ite well. I r e m e m b e r w h e n hi ng y c phng m di vng
he h ad a su rg ery d o w n in th e Kirkgate c xa, nhng ti khng nh
old Kirkgate, b u t I d o n 't r e gn y c thy ng y khng.
m e m b e r s e e in g h im rec en tly .
DOCTOR: No, Dr H orsburgh's b e e n r e BS: Khng, bc S Horsburgh ngh hu
tired for a g o o d n u m b e r o f nhiu nm nay ri. Ti nhn
y ears now . I to o k o v e r h is p r a c phng mch ca ng y v trc y
tice a n d I've se e n y o u b efo re. ti c gp ng. C th ng khng nh
M aybe y ou d o n 't rec all th a t. chuyn . n g dy lu cha?
H ave y ou b e e n h e re long?
PATIENT: W here, w h e re d o y o u m e a n ? BN: u, u ngha l sao?
DOCTOR: In th is h o u s e , h a v e y o u b e e n BS: trong cn nh ny, n g y lu
h e re long? cha?
PATIENT: Oh, I've b e e n h e re s o m e tim e I BN: 0, ti ngh l ti dy c mt
think. thi gian ri.
DOCTOR: D o y o u r e m e m b e r w h e r e th is BS: ng c nh c y l u khng?
is? W h ere is th is place? Ch ny l ni no?
PATIENT: T h is'll b e th e H ig h S tre et, is n 't BN: y l ng High, phi vy khng?
it?
DOCTOR: Yes, th is is th e H igh S tre et. BS: Vng, y l ng High, n g
H ow lo n g h av e y o u b e e n living sng ng High c bao lu ri?
in th e H igh S treet?
PATIENT: O h , it m u s t b e a g o o d n u m b e r BN: , d phi nhiu nm nay ri. Ti, m
o f y ea rs now . I, m y m o th e r ti thng di pha Bc ng
u se d to stay d o w n in N o rth High, tt nhin l nh vy, v ti
H igh S tre e t o f c o u rse , a n d I cng thng vi b c, nhng khi
u s e d to Slay w ith her, b u t w h e n ti ly v th ti chuyn n y. . d
I g o t m a rrie d I m o v e d u p h ere . phi nhiu nm nay ri. Ti khng
O h, th a t m u st b e a g o o d th nh chc thi gian.
n u m b e r of years. I c a n 't q u ite
r e m e m b e r t h e tim e .

DOCTOR: D o y o u r e m e m b e r w h e n y o u BS: n g c nh ng sinh ra khi no
w ere b o rn ? W h at w as th e y ear khng. Nm sinh ca ng l nim
o f y o u r b irth ? C an yo u re m e m no? n g c nh c khng?
b e r th at?
PATIENT: O h. y es. I w a s b o rn in 1913. BN: c. Ti sinh n im 1913.
DOCTOR: Oh, w h a t m o n th w er e y o u b o m BS: , th Ong sinh vo thng my? ng
in? Do y ou re m e m b e r that? c nh c khng?
PATIENT: o h , y es. I'm an April b a b y . I BN: , c. Ti l da b thng tu. Ti d
w as alw ays an April b ab y . N ot lun lun l a b thng t. Khng
an April fool, n o t th e 1st of phi l mt thng ngc thng t du,
April you know . khng phi l ngy-1 thng t. ng
bit .
DOCTOR D o y o u re m e m b e r w h a t tim e BS: n g c nh ngy no trong thng
o f th e m o n th ? W hat w as th e khng? Ngy my?
d ate?
PATIENT: O h , it w a s th e 17th o f A p ril. BN: , l ngy 17 thng t.
DOCTOR: W ell, h o w o ld w ill y o u b e n o w , BS: T h nay ng sp bao nhiu tui ri,
d o y o u t h in k ? ng c bit khng?
PATIENT: Oh, I've retired n o w . I m u s t b e BN: , by gi ti ngh hu. Chc phi
a b o u t 69. I th in k . I'll b e a b o u t 69 tui, ti ngh vy. Ti sp 69 ri.
69.
DOCTOR: W ell, th e r e 's no doubt th e BS: , chng cn nghi ngd gi l nm thng
years go by. W hat y ea r is it th is tri qua n h anh tht. T h nm nay l
year? Do y o u k n o w th at? nm no? n g c bit khng?
PATIENT: W ell, th is'll be about 1989 BN: 0 , ti c chng c l khong 1989.
now , I su p p o se .
DOCTOR Fine, and w h a t m o n th are w e BS: Tt, th by gi l thn g my?
in?
PATIENT O h , n o w le t m e s e e . It'll b e . th e , BN: , ti xem. L thng, ti chu, ti
I c a n 't, c a n 't re m e m b e r, d o c khng nh ni, bc si .
tor.
DOCTOR W ell, tell m e, is it su m m e r or BS: c ri, th ng ni xem by gi l
w inter? m a h liay m a ng?
PATIENT O h. w e ll I s u p p o s e its so c o ld it BN: , ti thy kh lnh, d p h ii l ma
m u s t b e th e w in te r tim e. It'll ng. C l l thng g iin g dng lch,
be Jan u ary . Is th a t right? c ng khng?
DOCTOR: W ell, a c tu a lly it's F eb ru ary BS: c, by gi ng l thng hai,
now , b u t it feels as th o u g h it nhng vn c cm gic nh l thng
w as Ja n u ary , d o e s n 't it? Do ging, phi khng? Th ng c nh
you re m e m b e r w h a t d a y o f th e ngy hm pay l th my trong tun
w eek it is? Or d o th e d ay s n o t khng? Hoc l cc ngy cng chng
m e a n a g rea t deal to y o u n o w c ngha nhiu i VI ng khi ng
th a t y o u 're n o t w orking ? khng cn lm vic n n h 5
PATIENT: O h, y o u 're right th e d ays se em BN : , bc s ni ng y, n g y li ni
to ru n in to ea c h o th e r, b u t tip ngy thi, nhng ti ngh c l l
th is'll b e T u esd ay . I think. No, th ba. Khng, khng u, hn l th
n o it'll b e W e dnesday, is n 't it? t ch, phi khng?
DOCTOR W ell, I s u p p o s e th at W e d n e s- BS: Ti ngh l th t hoc th nm, ngy
d ay o r T h u rsd ay , o n e d ay ny ri li cng ging ngy kja khi
te n d s to b e c o m e m u c h th e chng ta khng cn lm vic, c
sa m e as th e o th e r w h e n w e 're ng vy khng?
n o t w orking. Isn 't th a t right?
PATIENT: Oh, y o u re right th ere. BN: , ng li ng y.
Task 16 and Language fo cu s 11

Bi lm 1 6 v Trng tm ngn ng 11
Pari 1 P hn 1
DOCTOR: [ n o w w a n t to test h o w w ell y o u BS: By gi ti mun lm trc nghim d
c a n feel th in g s o n th e skin. I'm xem ng cm nhn ra sao i vi cc
going to ask y o u to clo se y o u r vt chm trn da. Ti s yu cu ng
eyes a n d say 'y es e a c h tim e nhm m t v ni c mi khi ng cm
you feel m e to u c h in g th e skin thy ti chm vo da chn bng cc
o f y o u r legs w ith th is sm all bng gn nh ny.
p ie ce o f c o tto n w ool.
PATIENT: U h u h BN: ,
DOCTOR: Ill to u c h th e b ack o fy o u r h a n d BS: Ti SC dng vt chm vo mu ban
w ith it now . Do y o u feel th at? tay ng. ng c cm nhn thy
khng?
PATIENT: Yes, d o c to r. BN: D c, tha bc s.
DOCTOR: W eil every tim e y o u feel m e BS: Tt, mi ln ng cm nhn thy ti
to u c h y o u r legs say 'y es'. chm vo chn th ni c nh.
Part 2 Phn 2
DOCTOR. Well, th at w as q u ite e a sy BS: c, lm nh vy d y ch. phi

w a s n 't it? N ow I'm g o in g to try khng? By gi, ti s th khc i mt
so m e th in g a little d iffe ren t. I cht, ti c chic kim ny vi mt u
h av e th is s h a rp n e e d le w ith nhn mt 'u ty, ti mun ng ni
th is b lu n t en d . I w a n t yo u to nhn hoc ty mi khi ti chm vo
say 's h a r p ' o r 'b lu n t' e a c h tim e ng.
y o u feel m e to u c h .
Part 3 Phn 3
DOCTOR: T h e o th e r se n s a tio n . I w a n t to BS: Cm gic khc m li m un trc
te s t is w h e th e r y o u fe e l th is nghim l xem ng c im n h n thy ci
tu b e h o t or th is o th e r tu b e ng ny nng hay ci ng kia lnh.
w h ic h is cold. R e m e m b e r I Nh l tAi m un ng n h m cht c hai
w a n t y o u to k e e p y o u r eyes m t v mi khi ti chm vo da ch n
clo sed , a n d e a c h tim e I to u c h ng, ti m un Ang ni xem d l nng
th e skin o f y o u r legs I w a n t yo u hoc lnh.
to tell m e w h e th e r it's h o t or
cold.
PATIENT: Right. BN: Vng, c.
P art 4 P hn 4
DOCTOR: N ext I'm g o in g to test y o u w ith BS: Tip theo ti m un trc nghim ng
th is v ib ra tin g fork. I'm g o in g to bng ci Am thoa ny. Ti s n n
p ress it o n th e a n k le b o n e a n d I vo xng m t c chn v ti mun
w a n t y o u to tell m e w h e th e r ng ni xcm ng c cm nhn thy
you feel it v ib ratin g , a n d if y o u n rung khng v n u ng c cm
do, to say 's to p ' w h e n y o u feel n hn c thi li ni n g n g khi ng
it's sto p p e d . cm nhn thy n h t rung.
T a sk 18 Bi lm 1 8
P art 5 Phn 5
DOCTOR: I'm now g o in g to te st th e BS: By gi ti s kim tra nhp m ch
p u lse s in y o u r legs. F irst w e'll hai chn ng. Thot tin chng ta s
p r ess o n th e b lo o d v e s s e l h er e n vo m ch m u y, ti vng
in th e gro in . A nd n o w b e h in d hng. V by gi pha u u du gi.
th e knee. C ould y o u b e n d it a n g gp chn li m t ch t c
little for m e? khng?
PATIENT:M m , sorry. BN: , xin li.
DOCTOR: A nd h e r e b e h in d th e a n k le BS: V ch ny pha sau xing m t c
b o n e . A nd n o w a t th e to p o f th e chn. V by gi trn m u bn chn.
foot. A nd n o w th e o th e r leg. V by gi n chn kia.
Unit 6 Bi 5
In vestiga tio n s X T N G H IM
Task 2 Bi lm 2
DOCTOR: N o w I'm g o in g to ta k e s o m e BS: By gi ti s ly ra m t cht dch
fluid o ff your back to find out lng ng tim xem ti sao ng bj
w h a t's giving y ou th e se h e a d nhc u. C y t s gip ti. Vic ny
ac h es. N u rse will h e lp m e. It khng lu lm u. By gi ti mun
w o n 't take very long. N ow I ng nhich qua pha phi n st mp
w a n t y o u to m o v e rig h t to th e ging. Nh th. c ri. Nm
e d g e o f th e bed. T h a t's it. nghing bn tri. By gi ng c th
Right. Lie o n y o u r left side. co hai u gi ln cng cao cng tt
Right. N ow c a n y o u b e n d b o th c khng? Th l cao y. Ti s t
your knees up as far as they'll mt ci gi gia hai u gi cho
go? T h a t's great. I'll ju s t p u t a ng thoi mi nh. C th nh. ng
pillow b e tw e e n y o u r k n e e s to ci u tht thp st vi hai du gi,
k eep y ou c o m fo rta b le . T h e re co trn li. Ti s lau lng ng bng t
you go. P ut y o u r h e a d rig h t thuc st trng. Ti ngi rng ng s
d o w n to m e e t y o u r k n ee s. C url cm thy hi lnh. By gi ti s gy
up. N ow I'm g o in g to w ip e v cm (gy t) ti ch nh th s
y o u r b ack w ith s o m e a n tis e p khng au na. ng chi cm thy
tic. Y ou'll feel it a bit cold, I'm mt ci chc nh thi. c ch? Th
afraid. N ow Im g o in g to give y. Chng ta s i vi pht dc thuc
y ou a local a n a e s th e tic so it c hiu qu. Ngay by gi hy nm
w o n 't b e so re. Y ou'll feel ju s t a yn, iu ny quan trng y.
slig h t jab , OK? T h e re . W ell
w ait for a few m in u te s fo r th a t
to ta k e effect. R ight now , lie
still, th a t's very im p o rta n t.
Task 4 Bi im 4
1 ECG 1 in tm d
DOCTOR: Y our p u ls e is a b it irregular. BS: Nhp m ch ca ng hi bt thng.
I'm n o t q u ite c e rta in w hy this Ti khng bit chc chn ti sao li
is b u t I th in k w e ll h av e to g et a nh vy nhng ti ngh chng ta s
tra c in g o f y o u r h e a r tb e a t. 1 cho ghi m t ng v nhp Um ca
w a n t y o u to strip d o w n to th e ng. Ti m un ng ci b o v cng
w aist a n d also ta k e off y o u r tho lun c giy v v na. Trc
sh o e s a n d socks. F irst o f all. tin, y l m t quy trnh hon ton
th is is a c o m p le te ly p a in le ss khng au. n g c cm thy thoi
p ro c e d u re . Are y o u q u ite c o m mi khng? n g s cm thy d chu
fo rtab le? It's b e tte r if y o u 're as hn nu th gin cng nhiu cng tt
relax ed as p o ssib le b e fo re I trc khi ti bt u ly in tm ky.
start to take the cardiograph. It Chi mt c vi pht i lim xt
o n ly ta k es a few m in u te s to d o nghim ny thi nhng cn phii c
th e a c tu a l te st b u t it ta k es a b it thi gian lu hn i jt c ic dng
longer to get you wired up. I'm dy cho ng. Ti dang bi t thuc mfl
just putting so m e cream on ln cc c tay v mt c ch n ca ng.
y o u r w rists a n d an k les. T h a t's By gi mi vic n sng, n g hy
ev e ry th in g ready . N ow ju st r e th gin cng nhiu cng tt nh.
lax as m u c h as y o u ca n .
7 B a riu m m e a l 2 Ung thufc cn quang (c brium )

DOCTOR: Good m o r n in g , M iss Jones. BS: Cho c Jones. Xt nghim ny l
This test is to help m e get a p ic gip ti c mt hnh nh < bn trong
ture o f the in sid e o f your gullet thc qun v d dy ca cA chng
a n d y o u r s to m a c h so th a t w e ta c th pht hin xem d c ci gi
c a n find o u t w h a t's c a u sin g lm c b au. Ti mun c dng
you th e se p a in s th e re . I w a n t y trong khi ti a cho c mt ly
y o u ju st to s ta n d h e re w h ile I nc d ung. Cht nc ny s hin
give y o u a c u p of liq u id to r sau khi c ung v c th cho ti
drink. T h is liq u id w ill sh o w u p bit nu c c mt vt lot d dy
afte r y o u ve d r u n k it a n d will hoc t trng. Ti mun c ung cht
b e ab le to tell m e if y o u h a v e an dch lng lc ny v ti chp hnh
u lc e r in y o u r s to m a c h o r d u o khi nc chy xung. Tt ri. Cm n
d e n u m . I'd like y o u to d rin k c.
th e liq u id n o w a n d I'll b e ta k
ing p ic tu re s o f it as it goes
d o w n . T h a ts fine. T h a n k you.
3 C rosby ca p su le 3 B a o C rosby
DOCTOR: N o w I'm just g o in g to g iv e y o u a BS: By gi ti s cho c mt mi chch
little jab to h elp y o u r tu m m y r e nh gip thc quin c c th
lax. Just a little prick. OK? T h a t's gin. Ch cht au nhi nh thi.
fine. G ood girl. N ow I w a n t you c ch7 Tt ri. c b ngoan. By
to o p e n y o u r m o u th for m e so gi ti mun c h to ming ti c
th a t I c a n p ass th is little tu b e th a qua chic ng nh ny xung
d o w n in to y o u r tu m m y . T h a t's di trong thc qun. Tt ri. C b
fine. G ood girl. N o th in g to ngoan. Khng c g phi lo lng ci.
w o rry ab o u t. H ead b ac k a little. Nga du m t cht ra pha sau. Tt
T h a t's fine. N ow ca n y o u sw a l ri. By gi c c th nut cho ti
low for m e? A nd again? G ood c khng? Thm ln na ch? c
girl. N ow I w a n t you to try an d b ngoan. By gi ti mun c c gi
keep as still as possib le. tht yn, cng yn cin g tL
4 U ltrasound scan 4 Chp hnh siu m
DOCTOR: I'd like yo u to lie d o w n o n th is BS: Ti m un b nm trn chic bn
table here. T his gel h e lp s to gel y ny. Cht dng ny gip cho
a contact so th a t th e p ic tu re is vng tip xc tt cho hinh nh
d e a r . W e'll ju st ru b in th e gel a dc sng r. Chng ta s c xt vo
little bit and n ow I'll put on the c h t n g m t l c v by gi t i s t
eq u ipm en t. Try to k eep as still u my ln. Hy c gi tht yn nh,
as you p ossibly can. That's cng yn cng tt. c ri. By gi
g o o d . N o w if y o u turn your nu b quay u sang tri b c the
h e a d to th e left, y o u 'll b e ab le thy hnh nh nh ti ang chp y.
to s e e th e sc a n as I'm tak in g it. B thy y, tht ging nh nh trn
As yo u see, it's ju st like a te lev i m n truyn hnh. P h n en dy la
sio n p ic tu re. T his black p a rt u da b cn y l thn m nh no.
h e re is th e b a b y 's h e a d a n d Nh b thy y, n ang di chuyn
this is th e body. As you c a n see. vng q u an h rt tt. N hng im
it's m oving a ro u n d very well. chm ny cho phcp ti o a b d
T h ese d o ts allow m e to m e a s chng ta c th tnh ton xem khi no
u re th e b ab y so w e c a n w ork a b dc ... By gi th mi vic
o u t w h e n y o u r b a b y is d u e ... u xong xui c ri.
T h a t's e v e ry th in g fin ish e d
now.
5 M yelogram 5 Ty d
DOCTOR: W e're g o in g to p u t a little n e e d le BS: By gi chng ti s cm mt cy kim
in y o u r back. W ell in je ct so m e nh vo lng ng. Chng ti s bm
fluid in, p u t y o u o n to th e tabic cht dch vao , t ng ln chic
th e re an d take so m e X -ray p ic bn kia v s chp vi hnh X quang.
tures. T h ese will h elp us to know iu s gip chng ti bit chinh
exactly w h ere th e tro u b le is. xc v tr c tn thng. By gi ng
N ow roll o n to y o u r left side. quay ngi sang bn tri. c ri.
T h a t's it. I w a n t y o u to roll u p Ti mun ng cun trn thnh mt
in to a little bail, to b rin g y o u r i banh nh, ko hai u gi ln cao
knees u p a n d tuck y o u r h ea d v ci gp u xung. Tt ri. By gi
dow n. T h a t's fine. N ow I'm g o ti s lau vng lng ca ng. ng s
ing to sw ab y o u r back. You'll cm thy hi lnh. By gi ng s
feel it a bit cold. N ow y o u 'll feel cm thy ti n mnh trn lng.
m e p ressin g o n y o u r back. All c ch? By gi s co xt dy. By
right? S cratch c o m in g u p now . gi ng s cm thy ti n mnh vo
N ow you'll feel m e p re ssin g in. trong. c ri. Th l tt. By gi ti
OK. T h a t's fine. I'm ju st in je c t li bm cht thuc vo. ng chng
ing th e stu ff in. You sh o u ld n 't cm thy cht g u. c ri. Tt.
feel it at all. T h a t's it. OK. I'll just By gi ti rt cy kim ra y. By gi
take th e n e e d le o u t now . Now ng dui thng ngi tht thoi mi
ju st stra ig h te n o u t gently a n d lie v nm xp nh. Chng ti s chp
o n y o u rfro n t. W e'll take th e p ic hnh ngay y.
tu res now.

Task 5 Bi tm 5
DOCTOR 1: An ECG is e sse n tia l b e c a u se it BS1: in tim d l c n thit v n s cho
will sh ow any changes in the thy bt k thay i n io tm: trc,
heart: axis, ischaem ia. left thiu mu, ph i tht tri.
ventricular hypertrophy.
DOCTOR 2 I th in k a c h e st X -ray is also BS2: Ti ngh chp X-quang phi cng rt
very im p o rta n t to see th e quan trng xem tm v mc ph
h eart an d th e ex ten t o f th e h y i. Ti cng kim tra creatinin
p ertro p h y . I w o u ld also ch eck xem c tn thung no thn chSng.
th e c re atin in e to see if th e re 's
any d am ag e to th e kidneys.
DOCTOR 3: An in a v e n o u s p y elo g ra m is BS3: Chp b thn qua ng tinh mch
e ssen tia l b e c a u se a renal cng cn thit v rt c th nguyn
ca u se is very likely. nhn do thn.
DOCTOR 2 As an initial in v estigation ? BS2: Nh l m t xt nghim (u tin ?
DOCTOR 3: N o, after urea and e le c tr o BS3: Khng, sau khi th u r t m u, cc in
lytes an d after th e c rea tin in e. gii v sau kh th creatinin.
DOCTOR 2: It's e sse n tia l if th e crea tin in e BS2: Xt nghim cn th it nu thcre-
sh o w s so m e th in g w ro n g w ith atinin cho thy c iu gi khng n
th e kidneys. hai thn.
DOCTOR 3: Yes. BS3: ng.
DOCTOR 1: Yes. b o th c rea tin in e a n d urea BS1: Phi ri, c creatinin, ur mu v cc
an d electro ly tes a re req u ired . in gii (u cn th i t Trong trng
In th is case I th in k th e y 're hp ny ti ngh l cc xt nghim d
m o re im p o rta n t th a n d ie cn quan trng hn c in tm ,
ECG a n d c h e st X -ray b ec au se chp X-quang phi bi vi b<nh nhn
th e p a tie n t is young, 43, an d cn tr, mi 43 tui v huyt p rt
th e h y p e rte n sio n is very high. cao.
DOCTOR 3: U rin alysis to o in th is ca se. It's BS3: Xt nghim nc tiu cng vy trong
very im p o rta n t. trng hp ny. iu rt quan
trng.
DOCTOR 2: Yes, it's rou tin e. BS2: Vng, y l thdng quy m.
DOCTOR 3: W e ca n s e e if th ere's any BS3: Chng ta c th bit nu c tn
g lo m e ru lar d am ag e. We m ay thng cu thn. Chng ta c th tim
find blood, a lb u m en , c a s ts ... thy mu, a lb u m ia cn tr\i.
DOCTOR 1: Yes, it's very im p ortan t. BS1: Phi ri, iu ny rt quan trpng.
DOCTOR 2: W hat about ra d io iso to p e BS2: T h cn cc nghin cu dng v
stu d ies o f th e kidneys? phng x \i thn thi sao
DOCTOR 3: N ot essen tia l, but w e co u ld BS3: Khng cn thit, nhung chng ta c
do this to check th e fu n ctio n th l m x t n g h i m r y lo m tra
of the kidneys. chc nng hai thn.
DOCTOR 1 : We can se e that from the crea- BS1: Chng ta c th bit iu qua xt
tin in e an d urine. nghim creatinin v nc tiu.
DOCTOR 3 I know. It's n o t essenaaJ, but BS3: Ti bit. iu khng cn thit
it could be useful. nhng c th hu ch.
DOCTOR 2. S erum cholesterol? BS2: T h cn cholesterol huyt thanh?
DOCTOR 1: N ot essential. We re thinking BS1: Khng cn thit, y ti ngh n
o f a n o th e r type o f h y p e rte n m t dng cao huyt p kiu khc.
sion here. But possibly useful. Nhng cng c th hu ch.
DOCTOR 2. MRI scan of th e brain? . BS2: T h cn chp hnh cng hng t
ca no th sao?
DOCTOR 3: N ot required. It's of no value BS3: Khng cn. Trong trng hp ny th
in this case. chng c gi tr g.
DOCTOR 2: S erum thyroxine? BS2: Th cn thyroxine huyt thanh?
DOCTOR 1: A bsolutely n o co n n e c tio n B S1: Hon Lon chng c lin quan g ti
w ith h y p erten sio n . huyt p cao.
DOCTOR 2: Barium meal? BS2: C cho ung thuc cn quang (bar
ium) khng?
DOCTOR 3: N ot required. BS3: Khng cn thit.
DOCTOR 2: Uric acid? BS2: T h cn acid uric?
DOCTOR 1: N ot necessary. If th e u ric acid BS1: Khng cn thit. Nu acid uric tng
is raised, th e re w o u ld b e o th e r cao, hn s c nhng triu chng
sy m p to m s. khc.
Task 7 Bi lm 7
1 M r G u m ley 1 . G um ley
DOCTOR: M r G um ley, y o u 'll h a v e to BS: n g Gumley, ng s phi lm vi xt
h av e som e in v e stig a tio n s n g h i m p h t h i n c h n h xc xe m
d o n e to find o u t ex actly w h a t's nguyn nhn no gy rc ri cho
c a u sin g y o u r p ro b le m . Firstly ng. Trc tin, chng ti cn chp X
w e n e e d to get y o u r c h e st X- quang phi ca ng. Sau trong ba
rayed. T h e n for th re e m o r n bui sng lin ti mun ng mang
ings ru n n in g I'd like y o u to m u m ri ho khc ra lc bui sng
b rin g to th e su rg ery a sa m p le n phng phu th u t Chng ti s
o f th e p h le g m th a t y o u c o u g h gi mu n phng th nghim d
u p in th e m o rn in g . W e'll be kim tra xem ng c m ang mm
s e n d in g th a t off to th e lab for bnh c bit no khng. Tip theo
te stin g to se e if y o u h av e an y , n h t thit ng phi c soi ph
p a rtic u la r g e rm s p re s e n t. F o l qun. y l m t cch nghin cu
low ing th a t, it'll be n e c e s sa ry nhn su vo hai phi ca ng qua
for y o u to h av e a b r o n c h o m t ci ng. Chng ti phi cho ng
sco p y d o n e . T h is is a n in v e s ti nhp vin trong ngy e lm chuyn
g a tio n w h ich in volves loo k in g d. Dy khng phi l mt cch
d o w n in to y o u r lu n g s th ro u g h nghin cu c bit thu v nhng
a tu b e. W e'll h av e to a d m it you chng ti i bm khj dung gy t (v
to h o sp ita l for th e day to d o it. cm) trc khi dt ng vo trong phi
It's n o t a p a rtic u la rly p le a sa n t ng. Thng thng, chuyn khng
in v e stig a tio n b u t y o u 'll b e cn qu vi pht n hng cng phi lu
given a n a n a e s th e tic sp ra y b e f hn nu cn ly vi m u m ca phi
o re th e tu b e is p a s se d d o w n ng - c th ti 20 pht, n g phi lm
in to y o u r lungs. U su ally it xt nghim ny lc d dy rng, vi
d o e s n 't ta k e m o re th a n a few vy ngy ng khng dc n sng.
m in u te s b u t it m ay la st lo n g e r if ng c th tr v nh lun sau lc xt
they n e e d to ta k e sa m p le s of nghim , nhng ng phi i dn khi
th e tis s u e in y o u r lu n g s - m a y b e thuc t tan bin ht mi dc n.
u p to 20 m in u te s. You h av e to
take th is test w ith an e m p ty
sto m a c h , so you w o n 't h av e
an y b rea k fa st th a t day. Y ou'll
be ab le to get h o m e a g a in after
th e test, b u t y o u 'll h av e to w ait
u n til th e a n a e s th e tic h a s w o rn
off b efo re you e a t an y th in g .
2 M rs E m m a S h a rp 2 B E m m a Sharp
DOCTOR B ecau se o f y o u r h e a v y p e r i BS: Do b c nhng k kinh nguyt ko
ods, M rs S h arp , w e m u s t find di, b Sharp . chng ti phi tim
o u t if y o u 'v e b e c o m e a n a e m ic xem liu b c b thiu m u khng
so I'll h av e to take a b lo o d test. nn ti s lm xt nghim mu.
PATIENT: O h , right. BN: Vng, c .
DOCTOR: th ink it w ill a lso b e n e c e ss a r y BS: Ti ngh l cng cn th it di vi b
for y ou to h av e a D&c d o n e in kh lm th thut nong v no ti
h o sp ital. W e c a n p ro b a b ly d o bnh vin. C l ch n g ti c th lm
th is as a d ay case. It's a very vic trong ngay. ch la mt quy
sim p le p ro c e d u re a n d ju s t i n trnh g i n n v chi lin quan n
volves re m o v in g a sm a ll p ie ce vic ly m t m nh nh lp nim mc
of th e lin in g fro m in sid e th e ph bn trong t cung tim xem ti
w o m b to fin d o u t w hy y o u r p e sao k kinh nguyt ca b li ko di
rio d s h av e b e c o m e so h e a v y . It th. Cng vic cng cho chng ti
will also give u s a b e tte r m t c m ay tt hn khm bnh
c h a n c e to e x a m in e y o u u n d e r cho b trong lc gy m. iu c
th e a n a e s th e tic . It m ig h t also th cng cn thit thc hin mt
be n e c e s sa ry to d o a p elvic u l hnh siu m vng chu y chi l
tra s o n o g ra p h . T h is is a v e r y m t xt nghim gin n ly mt
sim p le te st w h ic h ta k es a s p e h n h n h c b i t ca p h in di v n g
cial p ic tu re o f th e lo w er e n d of bng ca b d xem liu t c u n g c b
y o u r a b d o m e n to se e if th e phnh to khng.
w o m b is e n la rg e d .
2 5 4 - E n g lish in M e d ic in c
3 M iss Grace D o n a ld so n 3 C Grace Donaldson
DOCTOR: F rom y o u r s y m p to m s it w o u ld BS: T cc triu chng ca c, c th c
se e m th a t you h av e a n o v erac- c m t tuyn gip hot ng qu
tive th y ro id glan d . W e c a n te st mc. Chng ti c th kim tra vic
th is q u ite sim p ly by d o in g a ny r't n gin bng cch lm xt
b lo o d test to c h e c k th e lev el o f nghim mu kim a mc cc
h o rm o n e s in y o u r b lo o d . hormon trong mu c.
<1 Mr P ritt 4 . Pritt
DOCTOR B eca u se y o u 'v e b e e n h a v in g BS: Do ng c ri lon ny kem au bng
this trou b le w ith a b d o m in a l sau khi n nhiu m nn ti nghi
p ain after fatty foods i th in k you c th ng c si ti mt. n g s cn
m ay h ave s o m e s to n e s in you r phi chp m t phim X quang c
gall b ladder. You'll n e e d 10 h av e bit. Ci ny c gi l chp hnh t
a special X-ray d o n e. T his is tr n g -t i mt, v chuyn ny i hi
caJIcd a ch olecystogram . a n d it ng ung vi vin thuc trc khi n
will involve you tak in g so m e khoa X quang. u tin h s chp
tablets before a tte n d in g th e X- mt phim X quang thng thng ri
ray d e p a rtm e n t. T hey'll ta k e an hp s cho ng n mt chut cht m.
o rd in ary X-ray first a n d th e n Sau h s chp phim vung ti mt
give you s o m e th in g fatty to eat. d xem liu ti m t ca ng c hot
After w hich they 'll take p ic tu re s ng tt v liu c nhng SI y
of th e gall b la d d e r a re a to see if chng. H cng c the chp mt
y o u r gall b la d d e r is w ork in g hnh nh siu m. y l cch thm
p roperly a n d if (h ere are an y khm vng bng cn ng nh s
sto n e s p rese n t. T hey m ay also dng m t loi my c bit cho
do an u ltra s o n o g ra p h . T his is a chng ti nhng hnh nh ca d day
way of ex a m in in g y o u r a b d o - v ti m t ca ng qua cc du hiu
m e n u sin g a sp ecial m a c h in e m thanh. Cng vic ny hon toan
w hich c a n sh o w us p ic tu re s of khng lm au v chi cn trn nm
y o u r sto m a c h a n d gall b la d d e r hoc mi pht l xong,
u sin g so u n d signals. It's n o t
pain fu l at all a n d it d o e s n 't take
m o re th a n five or te n m in u te s to
perform .
s B arry Scott 5 Barry Scott
DOCTOR: M rs S c o tt, 1 feci c e r t a i n t h a t BS: B Scott ny, ti chc c h n la Barry
B arry h a s G e r m a n m e a s l e s . m c b n h si. i khi c h n g ti lm
S o m e tim e s w e d o a b lo o d te st xt nghim mu d xc nh r rng
to p ro v e th is d efin itely , b u t b e- vic ny, nhng vi chu c hai tui
c a u se h e 's only tw o a n d a half, ri nn ti bo m rng chu
I'm su re he w o u ld n 't like to khng thch lm xt nghim mu v
h a v e a b l o o d te s t d o n e a n d it chc sc lot hn khi khng lm g c.
w o u l d b e s a f e r to d o n o t h i n g .
6 Mrs M ary Lock 6 B M ary Lock
DOCTOR M rs L ock . I th in k it's p o s s i b l e BS: B Lock n iy . ti n g h c th b m ic
th a t y ou h av e a c o n d itio n m t loi b $n h gi l g l c m , gy ra do
called g la u c o m a w h ic h is t i n g p lc b n tron g m L Mun
c a u se d by in c re a se d p re ssu re c h n g m in h v i c n i y th n h t thit
in sid e th e eye. In o rd e r to i vi b l phi d o p lc b n trong
p rove th is it will b e n e c e s sa ry hai mL C hng ti dng m t dng
for you to h av e th e p re s s u re in c n h tr n d c th u d c ch ia d do
sid e y o u r eyes m e a su re d . W e p lc. C h n g ti s n h vi git
u se a sm all in s tru m e n t w ith a thuc gy t (v cam) ti ch vo m t
sc ale o n it to m e a s u re th e p r e s b, n h th b s k h n g c m thy gi
sure. W e'll p u t a few d ro p s o f c i . Cuc kim tra c h i c n vi giy
local a n a e s th e tic o n y o u r eye n g h thi.
so y o u s h o u ld n 't feel an y th in g .
T h e te st o n ly ta k es a few s e c
o n d s.
Ta sk 8 Bi lm 8
LAB TECH: T his is th e h a e m a t o lo g y la b a t K th ut vln (KTV) (p h n g xt nghlm):
th e Royal. I h av e a re su lt for y l p h n g x t n g h i m m u bnh
you. v in H on g Gia. T i c k t qu cho
n g y.
DOCTOR: R ight, I'll ju st g et a form . OK. BS: T t Ti m u n c p h iu tr li. c
ch?
LAB TECH It's for Mr H all, Mr K evin Hall. KTV: y l k t qu ca n g Hall, ng
K evin Hail.
DOCTOR: R igh t. BS: c ri.
LAB TECH: W h ite b l o o d c e lls , s e v e n p o in t KTV: B ch cu, by chm hai; lng hng
tw o; RBC, th re e p o in t th re e cu, ba ch m ba hai; hem oglobin,
tw o; h a e m o g lo b in , tw elve m i hai ch m ch n . l mi hai
p o in t n in e . T h a t's tw elv e p o in t ch m ch n . H em atocrit, k h n g chm
x n in e . H a e m a to c rit, p o in t th re e ba ch n . T h tch t bo trung bnh,
n in e ; MCV, e ig h ty -o n e ; p la te tm m i m t; tiu cu, hai su bn.
lets, tw o six four.
DOCTOR: Sorry? BS: Xin li, ti n g h e k h n g r?
LAB TECH: T w o six four, tw o h u n d r e d a n d KTV: Hai su bn, hai tr fm v su mi
six ty -fo u r. bn.
DOCTOR: Right. BS: c ri.
LAB TECH: ESR, fo r ty -th re e m illim e tr e s. KTV: Tc lng mu, bn mi ba mili-
mt.
DOCTOR; OK. I've g o t that. BS: c. Ti ghi ri.
Blood film s h o w e d : n e u tr o -
LAB TCH: KTV: Cng th c m u c h o th y : trung tn h ,
phils, sixty p e r ce n t; ly m p h o - su mi phn trm ; limph bo, b
cytes, th irty p e r ce n t; m o n o - mi phn trm ; m t nhn, nm
cytes, five p e r c e n t; e o sin o - phn m ; a toan, bn phn trm;
phils, fo u r p e r ce n t; b a s o p h ils, a kim, m t phn trm,
o n e p e r ce n t.
DOCTOR: Fine. A nything else on the BS: Tt. C ci g khc trn cng thc
film? mu khng?
LABTECH: Yes, th e re a re burr cells p res- KTV: C, c thy nhng t bo khuyt (li
e n t p lu s plus. lim) hai cng.
DOCTOR: Right. T h an k s very m u c h . BS: Tt. c m n nhiu.
Task 16 Bi lm 16
CONSULTANT: Y our fath er's c o n d it io n is Bc s tham vn: Tinh trng ca cha ng
q u ite p oor. It se e m s th a t h e 's hon ton xu. H nh nh c nh c
h a d d ia rrh o e a for six d a y s a n d tiu chy trong su ngy v chuyn
th is m ay h av e affe c te d h is d ia ny c th tc ng n bnh tiu
betes. As y o u know , a n y in fe c ng ca c. Nh ng bit y, mi
tio n c a n c a u se d ia b e te s to get nhim khun u c th lm cho
o u t o f c o n tro l. F irst w e h a v e to bnh tiu ng khng cn kim sot
ch e c k h is b lo o d su g a r, k id n ey c na. u tin, chng ti phi
fu n c tio n a n d level o f salts. B e kim tra ng ong mu c, chc
c a u se h e 's v ery d e h y d r a te d nng thn v mc cc loi mui. V c
w e'll also b e giving h im s o m e b m t nc qu nhiu nn chng ti
fluid. H e'll h a v e a n X -ray d o n e cng phi cho c m t cht dch. C
o f h is c h e s t a n d a b d o m e n . s phi chp phim X quang vng
L astly w e'll b e c h e c k in g to see ngc v bng. Cui cng, chng ti
w h ic h p a rtic u la r g e rm c a u s e d s kim a xem liu c m m bnh
his d ia rrh o e a . c bit no gy tiu chy khng.
Unit 6 Bi 6
M akin g a d ia g n o s is CHN o n
DOCTOR: H ello, Mr N icol, I h a v e n 't s e e n BS: Cho ng Nicol, lu lm ti cha
y o u for a lo n g tim e. W h a t gp ng. C vn e g vy?
se e m s to b e th e p ro b le m ?
PATIENT: I've b e e n h av in g th e s e h e a d BN: Tha bc s, ti b nhc u hoi.
ac h es, d o c to r.
DOCTOR: W h ic h p a r t o f y o u r h e a d ? S: ch no trn u?
PATIENT: M ostly a lo n g h ere, a lo n g th e BN: Phn Idn l dc tho ch ny. dc
side. ha n.
DOCTOR O h, I se e . t h e left s id e . H o w SI ti bit, pha bn tri, n g kh chu
lo n g h a v e th e y b e e n b o th e r in g n h vy t bao lu ri?
you?
PATIENT W ell, th e y sta rted a b o u t th ree BN: , C l khong t ba tun l nay.
w eeks ago. At first I felt as if I Thot tin ti c cm tung nh b
had th e flu b e c a u s e m y cm c m v c i hai vai au nhc, bc i
sh o u ld e r s w ere a c h in g , y o u bit y. au c cc khp v c t t i
know , p a in s in th e jo in ts a n d I ch t.
had a bit o f a te m p e ra tu re.
DOCTOR I se e , an d d id y o u tak e a n y BS: Ti hiu, th ng c dng th gi i i
th in g for th e h ea d a c h e s? cha nhirc u khng?
P ATIEN T I took so m e a sp irin b u t it BN: Ti c ung cht aspirin nhng hnh
d id n t s e e m to m a k e m u c h d if n h khng lm thay di gi ht.
fe r e n c e to m e.
DOCTOR W h en d o th ey c o m e on? BS: Thng nhc u khi no?
PATIENT: T h e y s e e m to b e th e r e all d a y BN: H nh n h sut c i ngy v ban dm ti
lo n g , a n d at n ig h t 1 ju st c a n 't khng th ng c.
g e t t o s le e p .
DOCTOR S o th e y are b ad e n o u g h to BS: N h th u nhc n mc tn h ng?
k eep y o u aw ake?
PATIENT: Yes. BN: Tha vng.
DOCTOR: A nd h o w d o y o u feel in y o u r BS: V ngcm th y trong ngi ra sao?
self?
PATIENT: Very w eak , an d I'm tired o f BN: Yu lm, v d nh in l ti mL Ti
co u rse . I th in k I'v e lo st s o m e ngh l c st cn.
w eight.
DOCTOR: H ave y o u h a d h e a d a c h e s in BS: T h trc y ng c bj nhc du
th e past? khng?
PATIENT Just o n e or tw o , b u t n e v e r a n y BN: Chi c m t hai ln, nhng cha bao
th in g lik e th is. gi ging nh th ny.
Ta sk 7 Bi lm 7
DOCTOR: W ell, Mr J a m e so n , th e re's a BS: No ng Jam eson, y c m t dy
n erv e r u n n in g b e h in d y o u r thn kinh chy pha sau u gi, hng
k n e e a n d y o u r h ip a n d th ro u g h v qua t sng.
y o u r s p in e .
PATIENT: u h u h . BN: h.
DOCTOR W h e n y o u lift y o u r leg , that BS: Khi ng i\a chn ln. dy thn kinh
n erv e s h o u ld slid e in a n d o u t s d i c h u y n vo ra c t s n g hon
o f y o u r s p in e q u ite freely, b u t ton t do, nhng chn ng th dy
w ith y o u r leg, th e n e r v e w o n t li khng di ng duc xa. Khi ng
slide very far. W h e n y o u lift it, gichn ln, dy th in knh b chn
th e n erv e gels (ra p p e d a n d it's li v rt au. Khi ti gp u gi ng
very sore. W h en I b e n d y o u r li th sc cng m t h in v lm gini
knee, th a t takes th e te n sio n off au. Khi chng ta dui thng u gi.
a n d ea se s th e pain. If w e dy thn kinh b ko cng v li au.
stra ig h te n it, th e nerv e ges
ta u t a n d it's p ainful.
PATIENT Aye. BN: i.
DOCTOR: N o w w h at is tra p p in g the BS: By gi ci g chn dy thn kinh
nerve? Well, y o u r MRI sc an vy? y, phim hinh cng hng t
c o n fir m s that y o u 'v e g o t a xc nh ng c m t a t sng b
d a m a g e d d isc in th e lo w e r part tn thng phn di lng.
o f y o u r back.
PATIENT:O h, I see. BN: Vng, ti c thy.
DOCTOR: T he d isc is a little p a d o f gristle BS: a l m t ci m nh bng sn nm
w h ich lies b e tw e e n th e b o n e s in gia cc xng ca ct sng. By
y o u r spine. Now. if you lift gi, nu ng nhc cc vt nng khng
heavy loads in liie w ro n g way. ng cch, ng c th lm thng
you ca n d a m a g e it. A nd th a ts tn a . Chnh iu ny xy ra
w h a t's h a p p e n e d to you. Y ou've vi ng y. n g lm thng tn
d am ag e d a disc. It's p re ssin g on m t a m. N p ln mt dy
a nerve in you r sp in e so that it thn kinh ct sng nn dy khng
ca n 't slid e freely a n d that's th e th di ng t do v chinh l
c a u se o f th e s e p a in s y o u 'v e nguyn nhn gy nhng cn au m
b een h aving. ng ang chu y.
PATIENT: u h u h . BN: h.
DOCTOR: N o w w e'r e g o in g to try to so lv e BS: By gi chng ta s c gng gii quyt
th e p r o b le m first o f all w ith vn , trc tin bng cch nm
b ed rest to let th e d isc get back ngh trn ging cho ci a m
to n o rm a l a n d w ith d ru g s to tr li bnh thng v bng cch dng
take aw ay th e p a in a n d h e lp thuc lm ht au v gip cho a
th e d isc reco v er. W e'll a lso giv e m hi phc li. Ti cng cho ng
y o u s o m e p h y sio to e a s e y o u r dng phng php vt l tr liu
leg a n d back. I c a n 't p r o m ise cha chn v lng. Ti khng th ha
th is w ill b e e n tir e ly s u c c e s s fu l rng vic tr liu s hon ton hiu
a n d w e m a y h a v e to c o n s id e r qu v sau ny chng ta c th phi
a n o p e r a tio n at a later d a te. tnh n phng php phu thut.
Task 10 Bi lm 1 0
I A 33-yea r-o ld sa le sm a n su ffe r 1 Mt ngi bn h n g 33 tui b dau
ing fr o m a d u o d e n a l ulcer lot t trng
DOCTOR Y our s to m a c h h a s b e e n p r o BS: D dy ca ng sn sinh qu nhiu
d u c in g too m u c h acid. T his acid. icu ny gy vim m t vung
h a s in f la m e d a n a re a in y o u r trong rut ng. C th l cng vic
bow el. It's p o ssib le th a t y o u r ca ng c nhicu chn ng tinh
E nglish in M ed icin e - 2 5
stressful job has aggravated thin nn Um tnh trng nng hn.
th e situ a tio n . T h is is q u ite a y ch u mt bnh thng thng
c o m m o n c o n d itio n a n d th e re thi v c6 cch iu tri hOu hiu. Vic
is an effective treatment. It ny khng i hi phiu thut.
d o e s n 't involve surg ery .
2 A 6-year-old boy u/ith Perthes' 2 Mt b trai 6 tui mc bnh Perthe,

disease, accom panied by his c cha >n cng di
parents
DOCTOR: W h at's h a p p e n e d to y o u r BS: iu xy ra d vng hng con trai
so n 's h ip is c a u s e d b y a d is tu r ng b l do ri lon vic cung cp
b a n c e o f th e b lo o d su p p ly to mu cho phn xcmg ang pht triln.
th e g ro w in g b o n e. T h is c a u se s Chuyn ny lm cho tng m m i.
th e b o n e to so ften . W h e n h e Khi chu bc di, n to p lc trn
w a lk s , i t p u t s p r e s s u r e o n th e xng v lm thay di hnh dng. N
b o n e a n d it c h a n g e s sh a p e . It's gy au v chu i khp khing. vn
p ain fu l a n d h e lim p s. T h is ny khng phi l bt thng tr
p ro b le m is n 't u n c o m m o n trai nh v nu chng ti diiu tr
w ith y o u n g b o y s a n d if w e treat ngay by gi th khng gy mt tn
it n o w , it w o n 't c a u s e a n y p e r thng no vnh vin c.
m a n e n t d a m a g e.
3 A 21-year-old professional 3 Cu th bng chuyn nghip 21

footballer with a torn m enis tui b nch mng sn khp ca du
cus o f the right knee g i phi
DOCTOR: T h e c a r tila g e , w h ic h is th e BS: Sn l m dm gia cc xung ca
c u s h io n in g tissu e b e tw e e n th e u gi anh, sn y b rch khi u
b o n e s o f y o u r k n ee, h a s to rn g anh xoay trt.
w h e n y o u r k n e e w as tw istin g .
PATIENT: Right. BN: Tha ng vy.
DOCTOR: W e n e e d to d o s o m e fu r th e r BS: C hng ti cn lm th m vi xt
te sts - a n MRI s c a n a n d n g h i m - ch p h n h c n g h n g t v
p o ssib ly a n a rth ro sc o p y . c l c soi khp.
PATIENT: S o r r y ... BN: Xin li, ti khng hiu ...
DOCTOR: T h a t m e a n s lo o k i n g in t o d i e BS: iu c ngha l nhn vo trong
jo in t w ith a k in d o f te le s c o p e . khp vi m t loi ng soi xa. Nu c
If th e re is to rn ca rtila g e, w e sn rch, lc chng ti c th ly
c a n re m o v e it th e n . F o o tb a ll ra. Cc cu th bng thng c
ers o fte n g et th is k in d o f p r o b vn nh kiu ny v vi eich iu
le m a n d w ith tr e a tm e n t a n d tr v vt l tr liu, anh s c th li
physio, y o u w ill a b le to play chi tip tc
again.
PATIENT. O h, right. BN: i, tt qu.
4 A 43-year-old teacher u/ith 4 Mt b gio 43 tui c u dng si
fib r o id s
DOCTOR. Er. w elj y o u r h e a v y p e r io d s are BS: y ny, kinh nguyt ko di ca b l
c a u s e d by a c o n d itio n k n o w n do m t loi bnh gi l u dng si. u
as fibroids. F ib ro id s are a type dng si l m t kiu pht trin trong
o f g ro w th in th e w om b. t cu n g. N khng lin quan vi ung
T h e y re n o t re la te d to c a n c e r th v rt thng gp. Khi b c thay
a n d th e y 're q u ite c o m m o n . i trong cuc sng, u c th nh bt
W hen y o u get to th e c h a n g e o f v khng gy ri lon no nhng
life, they m ay b e c o m e sm a lle r tui b v do tnh trng chy mu lm
a n d ca u se you n o tro u b le b u t cho b b thiu m u th cch iu tr
at y o u r age a n d b e c a u s e th e tt n h t l phu thut.
b le ed in g h a s m a d e y o u a n a e
m ic. the best treatm ent is an
o p e ra tio n .
5 A n 82-year-old retired nurse s u f 5 B g i tr n g h i hu, 82 tui, m c

fe rin g fr o m d em e n tia , a c c o m p a bnh m t tr, c con trai v con gi di
nied by her son a n d d a u g h te r k m
DOCTOR: Your m o th e r is in th e early BS: C thn sinh ca anh ch ang giai
sta g e s o f d e m e n t ia w h ic h is a don sm ca bnh m t tr, y l
c o n d itio n of th e b ra in in o ld e r m t tnh trng ca no nhng
p eo p le w h ich c a u se s loss of ngi n h i u tu i gy m t tr nh, dc
m em ory, p articu la rly re c e n t bit l dn g tr nh gn. i khi ngi
m em ory. S o m e tim e s p e o p le m t tr cng c chng o gic. Nhn
w ith d e m e n tia a lso h a v e d e lu cch ca c c th thay i, vi d c
sions. H er p e rso n a lity m ay c th tr nn cc cn hoc gy g.
ch a n g e, for e x a m p le s h e m ay Tnh tnh ca c c th tr nn thay
b e c o m e ru d e o r aggressive. H er i tht thng, giai don ny c c
m o o d m ay b e c o m e very u p a n d th nh vi vi cch tr gip nhng
dow n. At th is sta g e sh e c a n stay tnh trng ca c c th xu i v c
at h o m e w ith so m e h elp b u t h e r s cn c s chm sc v lu di.
c o n d itio n will d e te rio ra te a n d
sh e will n e e d to go in to c a re in
th e lo n g term .
6 A 2 -w eek-old baby with te 6 B 2 tun tui c bnh t chng Fal

tralogy o f Fallot, a c c o m p a n ie d lot, c cha m m n.
by her p a rents
DOCTOR: Your b aby h as a heart c o n d itio n BS: Chu b ca ng b c m t bnh tim
w h ic h d e v e lo p e d w h e n sh e w a s hnh thnh t khi chu cn ang
grow ing in th e w o m b . S om e pht trin trong t cung. C vi chu
b a b ie s w ith th is c o n d itio n are m ang bnh ny c mu xanh ti t
bo rn lo o k in g b lu e b u t it's also lc lt lng nhng tnh trng xanh ti
p o ss ib le for th e b lu e n e s s to cng c th pht trin sau vi tun
d ev e lo p after a few w eeks. T h e l. D n g m u tron g tim tr n n bt
b lo o d f lo w in t h e heart b e th n g v i"u r y l i m c h o chu cu
c o m e s a b n o rm a l a n d th is n h u v kh nu i dng. May Ihay di
c a u se s y o u r b a b y to grunt a n d c m t ph ng php phu thut rt
h av e difficulty in feed in g . F o r h iu q u i i vi b^nh ny. c rt
tu n a te ly th e re is an o p e ra tio n n h iu k h i n n g l i ch u b ca ng b
for th is c o n d itio n w h ich is very s tr li m t c u c s n g bn h thng.
su ccessfu l. It's e x tre m ely
likely y o u r b a b y will go o n to
lead a n o rm a l life.
7 A 35-yea r-o ld re ce p tio n ist s u f 7 M t n h n v i T tip t n 3 5 tui dau v

fe rin g fr o m h yp o th y ro id ism thiu n n g tu y n gip
DOCTOR T h e c a u s e o f y o u r p r o b l e m is BS Nguyn nhn gy tinh trng bnh ca
your thyroid glan d w h ich is n g ltu y n g ip c v tri d y tro n g c
situ a te d h ere in y o u r neck. T he ca ng. Cc horm on ca tuyn ny
h o rm o n e s from th is glan d affect tc dng dn mi vng ca c th ng.
all are as o f y o u r body. If th e Nu tuyn khng hot dng ng n,
gland isn 't w orking properly, nhiu vn d c th b xiu i. V d nh
m a n y th in g s ca n go w ro n g . For lm sl cn v rng tc. Dy l mt th
exam ple, it ca n c a u se w eight bnh thng thng v cch iu tr
gain a n d h air loss. T his is a c o m cng dn gin.
m o n c o n d itio n a n d th e tr e a t
m e n t is sim ple.
PATIENT G ood. BN: c .
T a sk 13 Bi lm 1 3
SURGEON: W e've o p era ted o n y o u r father Phu thut vin: C hng ti phu thut
a n d d iscovered th a t h e 'd h a d a cho cha ca anh v pht hin c b tc
blockage of th e b lo o d su p p ly to nghn ng dn m u dn rut
his sm all bow el. T his ca u se d th e non. Tinh trng ny lm cho rut
sm all bow el to b e c o m e g a n g re non b hoi th v phi c it b i. C
n o u s an d it h ad to be rem o v ed . vn c th hot ng khi khng c
He'll b e able to m a n a g e w ith o u t on m t nh u n g y la mt phu
i( but it is a fairly m ajor o p e r a thut kh ln v nhin tinh trng
tio n an d naturally h is c o n d itio n ca c l trm trng. Tinh trng tc
is serious. T h e blockage o f b lo o d nghn ng d ln m u gy tiu
su p p ly ca u se d his d ia rrh o e a chy vii do tiu chy nn bnh tiu
a n d b e c a u se o f th e d ia rrh o e a ng ca c khng cn kim sot
his d ia b e te s w e n t o u t o f co n tro l c na nn c m t kh nhiu
as h e lo s t s o m u c h f lu id a n d s a lts dch v mui ca c th^. iu gii
from his body. T h at explains ngha v sao c b hn m.
why h e w en t in to a com a.
Unit 7 Bi 7
T rea tm en t i u t r
Task 2 Bi lm 2
PATIENT: H ave I g o t to res t? I w a s h o p in g BN: Ti vn phi ngh ngi ? Ti hy vng
y ou co u ld give m e so m e th in g ng c th cho ti cht g lm gim
to e a se th e p ain so th a t I co u ld dau n h vy t i c th tr l i l m v i c
get back to work. c.
DOCTOR: W ell. Cm afraid g oing b a c k to BS: . ti s rng tr li lm vic l
w ork is o u t of th e q u e s tio n just chuyn ngoi tm tay chng ta lc
now . I (hink it will be so m e ny. Ti ngh rrig cn phi vi tun
w eeks before you c a n go b ack to l na ri ng mi c th tr li vi
y o u r kind of active w ork. Y ou're cng vic nng dng y c, ng
g o in g to h a v e to re s t a n d to b e tip tc phi nghi ngi v t nht cng
g in w it h a t le a s t t w o w e e k s o f phi c hai tun l nm nghi hon
co m p lete b ed rest. ton.
PATIENT: I see. BN: Vng, ti bit.
DOCTOR: You m ust rest to allow this s w e l BS: ng phi nghi cho ch sng ny
ling to go d ow n an d be ab sorb ed xp xung, tiu i, lm gim p
to reduce th e p ressu re on die lc ln dy thn kinh v bt au.
nerve an d lessen th e pain. M ove C ng chi lm tng p lc d.
m e n t will only increase th e p re s Nu ng ng ln. k c ngi trn
sure. Ifyou get up, even to sit o n a gh, ton b sc nng c th trn
chair, all the body w eight above ci a m b tn thng s d
the d a m ag e d disc will press p ln a pha di gy thm p
do w n o n the disc below causin g lc km nguy c y thm ra ngoi
m o re p ressu re w ith th e risk of phn trung tm a mm v li lm
p u sh in g o u t m o re o f th e soft disc cho tinh ng ti t hn. Nghi ngi
cen tre a n d m aking th e p ro b lem cng gip lm gim cn co ca c
w orse. Rest also helps to relieve bp cng thng. Nhu vy trong
the tight m uscle sp a sm . So, for tun l u tin s nn nm nghi
the first w eek it sh o u ld be c o m hon ton trn ging c nm
plete b ed rest o n a firm, hard chc, cng, mt chic gi thp. tt
m attress, a low pillow, b etter still, hn l khng gi. ng cng nn c
no pillow. You sh o u ld also try to gng nm m dng ba n. ng
have your m eals lying dow n. ngi dy n. Ti s cho ng
D o n 't sit u p to eat. I'll give you thuc lm gim au v tr cng
drugs to relieve the p ain a n d stiff c. Khi cn au v co cng tng, ti
m uscles. W hen th e p ain an d s nh bc s vt l tr liu hng
stiffness im prove. I'll get the dn ng cc bi tp tng cng
physiotherapist to instruct you in cc c lng v gip ng mm mi
exercises to s e n g th e n your back hn v dn dn s gip ng vn
m u scles, a n d to m a k e you m o re ng, ng ng dy mi ngy
su p p le a n d w e'll th e n g r a d u mt lu hn, ty thuc vio cii au mi
ally m o b ilise you. le ttin g y o u ng ang chu dng.
get u p for lo n g e r e a c h day, b e
ing g u id e d by th e p a in y o u 're
ex p e rien c in g .
PATIENT: OK. BN: c .
DOCTOR: So this will have to be the pro BS: Nh vy dy chinh l k hoch thc
gramme. It's not a condition hin. Ti e rng khflng phi l tnh
w h ich y o u c a n g et u p a n d w o rk trng m ng c th dng dy v di
off, I'm afraid. lm.
Ta sk 3 Bi lm 3
1 A h yp e rte n siv e 5 0 -ye a r-o ld d i 1 Mt gim dc cng ty nh, 50 tui, c
rector o f a s m a ll c o m p a n y bnh cao huyt p
DOCTOR: T h e c o n d itio n y o u h a v e re BS: Tnh trng bnh ca ng i hi phi
qu ires to. b e c o n tr o lle d to p r e c kim sot phng tn thng
v en t futu re d a m a g e to th e b o d y , sau ny di vi c th. c bit l cc
especially th e b lo o d vessels. If mch mu. Nu bnh khng c
it's n o t c o n o lle d , y o u c a n h ave kim sot ng c th b mt s bnh
ce rta in se rio u s illn esses s u c h as nng nh cn au tim hoc t quy.
a h e a rt a tta c k o r a stroke. T re a t V vy, <liu tr l nhm phng
m e n t is th e re fo re to p re v e n t ill bnh phit trin bi v ti chc chn
n ess d e v e lo p in g b e c a u s e I'm rng hin nay ng khng cim thy
su re th a t y ou d o n 't feel ill a t d ie au bnh g ci. ng s phi dng
m o m e n t. You'll h av e to take thuc vin hoc thuc khc nhng
tab lets, o r m e d ic in e , b u t y o u ll ng cng phi thay di vi thi quen
also have to modify som e of ca ng. V d nh ng phi ngng
y o u r h ab its. F or in sta n c e , y ou ht thuc.
m u s t s to p sm oking.
2 A n in su lin -d e p e n d e n t 11-year- 2 Mt b gi 11 tui c bnh tiu dung

old g irl a c c o m p a n ie d by h er p a r ph thuc insulin, c cha m di km
en ts
DOCTOR: N ow E lizabeth, th e t r o u b le w ith BS: No, chu Elizabeth. b^nh ca chu
y o u is th a t y o u 're n o t m a k in g a l ch chu khng c h to ra c
s u b s ta n c e th a t y o u n e e d to c o n m t cht cn thit kim sot lung
trol th e a m o u n t o f su g a r in y o u r ng trong mu ca chu. Nu
b lo o d . If y o u h av e to o m u c h chu c qui nhiu ng hoc qu t
su g a r o r too little su g ar, it'll ng, diu s lm chu cim thy
m a k e y o u feel very ill a n d w e'll au bnh v chng ti u p h ii thay
h av e to re p la c e th is ea c h day. It th cht hng ngy. Nh th c
m e a n s th a t yo u 'll h av e to h av e a ngha l chu s cn phii c tim
jab b e c a u s e it d o e s n 't w ork bi vi cht khng hot ng hu
p ro p e rly if w e give it to y o u in a hiu nu chng ti cho chu cht
(ab let. N ow y o u r m o th e r h e re trong m t vin thuc. By gi m
will go w ith y o u to se e th e chu y s cng i vi chu n gp
n u rse a n d sh e 'll sh o w y o u h o w c y t v c y s hng dn cho chu
to d o it. M an y o th e r bo y s an d cch lm nh th no. Nhiu bn trai
girls, s o m e m u c h y o u n g e r v gi, m t s cn b hn chu u
than you. so o n learn to d o it, so bit cch lm rt nhanh, v vy chu
yo u n e e d n 't feel frig h ten e d . chng phi s hi g c.
3 A 65-year-old schoolteacher 3 M t thy gio 65 tui c bnh uim
with osteoarthritis o f the left xng khp hng tri
hip
DOCTOR: T h is c o n d itio n is really lik e th e BS: Tinh trng bnh ny tht s ging
w ea r a n d te a r o f a hin g e. T h e nh m t o khoc v vt rch ca mt
jo in t is b e c o m in g stiff a n d xoay. Khp tr nn cng v au
p ain fu l b e c a u s e it's ro u g h v b vim lm th rp. May thay
e n e d by in fla m m a tio n . F o rtu hin gi c ngh hu, c c th
nately, as y o u 're n o w re tire d , thay i cch sinh hot lm cho
y o u ll be able to m odify your tnh trng y khng gy phin toi
life so th a t it d o e s n 't tro u b le nhiu qu.Ti s k toa thuc vin
you so m u c h . Ill p re sc rib e ta b gip gim au v cng , v mc d
lets w h ich will h e lp th e p a in cch ny khng cha khi bnh
a n d stiffn ess a n d , a lth o u g h nhng s gim bt kh chu.
th is w o n 't c u re it, it will c o n tro l
th e d isc o m fo rt.
PATIENT: Right. BN: c .
DOCTOR: if. in th e fu ture, it g e ts m o re BS: Nu trong tng lai vn cn i cht
tro u b le so m e , w e c a n alw ays kh chu, chng ta vn c th tnh
c o n s id e r a n o p e r a tio n w h ic h n cch phu thut loi b hn
will get rid o f th e p ain . cn dau.
4 A 2 3 -yea r-o ld lorry driver a f 4 M t ti x xe ti 2 3 tui c bnh dng

fected. by ep ilep sy kinh
DOCTOR: U n fo rtu n a te ly , th e a tta c k s BS: T ht khng may l nhng cn au
y o u 'v e b e e n h av in g a re sh o w n bnh ca anh li c v tht nng.
to b e q u ite se v ere. T h e y 're Chuyn c nguyn nhn do hot
c a u s e d by a b n o rm a l e le c tric a l ng in bt thng trong no anh.
activ ity in y o u r b ra in .T h is is Bnh gi l ng kinh. Nhng
c a lle d ep ilep sy . B ut w e c a n chng ti c th gip anh ngng
h e lp y o u to s to p h a v in g th e s e nhng cn bnh . Ti s k toa
fits. I'll p re sc rib e ta b le ts for thuc vin cho anh. N s gip kim
you. T h ese will c o n tro l th e sot tnh trng bnh tht lu sut
c o n d itio n as lo n g as y o u 're ong thi gian anh dng thuc.
ta k in g th em .
PATIENT: Right. BN: c .
DOCTOR: N o w its m o s t im p o r ta n t that BS: By girt iu quan trng nht li anh
you take th e m regularly a n d phi dng thuc u n vi khng
d o n 't forget. The problem as c qun vic . vn lin quan
far as y o u re c o n c e r n e d is th a t n anh v liu di l anh khng c
y o u 're n o t p e r m itte d to drive php li xe trong ti thiu mt nm
for at least o n e y e a r a fte r y o u r sau cn au bnh cui cng. Anh phii
last attac k . Y ou'll h a v e to c o n nghi n chuyn thay di vic lm.
sid e r c h a n g in g y o u r job. You Anh phi ni vi ngi ch ca anh
m u st tell y o u r e m p lo y e r a b o u t v tnh trng ca anh.
y o u r c o n d itio n .
5 A 5 2 -year-old cook w ith carci 5 Ngi n u dn 5 2 tui c bnh carci-

n o m a o f th e bow el n o m rut
DOCTOR T h e te sts s h o w that y o u 'v e got BS: Cc xt nghim cho thy ng c mt
a n asty g ro w th in th e bow el khi u c trong i trng v u d phi
w hich will h av e to b e rem o v e d . m ct i.TKt rt nguy him nu d
It's far to o d a n g e ro u s to leave li khi u . Phiu thut c c may d
it. T he o p e ra tio n h a s every ly i cn bnh. Tuy nhin, kiu phu
c h a n c e o f re m o v in g th e d is thut chnh xc s ty thuc diu m
ease. T he e x a c t ty p e of ngi phu thut quan st thy trong
o p e ra tio n , how ev er, will d e lc m. C th l ng phi chu mt
p e n d o n w h a t th e su rg e o n ng rch trn da bng. y l
finds in th e o p e ra tio n . T h e r e s chuyn m nhiu ngi c th chp
a p o ssib ility th a t y o u m a y h av e nhn v n c th chi t$m thdi thi.
to h av e an o p e n in g m a d e o n
th e skin o f y o u r a b d o m e n .T h is
is s o m e th in g a lot o f p e o p le
ca n c o p e w ith a n d it m ay o n ly
be te m p o ra ry .
6 A 2 7 -yea r-o ld tea ch er o f 6 Thy gio 2 7 tui d y tre kh u y t tt,

h a n d ic a p p e d ch ild re n s u ffe r dang c bnh trm cm .
in g fr o m a d ep ressive illness
DOCTOR: 1 k n o w th a t y o u feel th is illn ess BS: Ti bit l anh cm thy bnh ny l
is s o m e th in g w h ic h affects iu nh hng n c cuc i anh.
y o u r w h o le life. I t's ca lle d d e Bnh c tn l b m ut v chng ti
p re ssio n a n d w e th in k it's d u e nghi rng nguyn nhn l do nhng
to c h e m ic a l c h a n g e s in th e thay i ha hc trong no. By gi
b ra in N ow its n o t s o m e th in g khng phii l chuyn anh c th t
y o u ca n p u ll y o u rs e lf o u t o f - ko mnh ra khi y - anh cn s
y o u 'll n e e d h e lp in th e w ay o f gip bng cch tm f tri liu cng
p s y c h o th e ra p y a n d d ru g s as nh dng thuc Anh c th ngh
well. You m a y th in k th a t n o rng khng ai khc tng cim nhn
body else h a s ev er felt like ging nh anh ang cim nhn hin
y o u 're feeling, b u t lei m e a s nay, nhng ti bo m vi anh rng
su re you th a t th is is q u ite a y ch l mt tinh trng bnh thng
c o m m o n c o n d itio n . You will thng m thi. Anh s li cm thy
get well again, a lth o u g h it will m nh khe, m c d chuyn ny s
take so m e w eeks to feel im qua vi tun l mi cm thy tin
p ro v e m e n t. O ften it's p o ssib le trin tL Thng vn c th tip tc
to c o n tin u e in y o u r ro u tin e o f cng vic hng ngy ca anh bi vi
w ork b e c a u se th is gives you iu ny li khch l anh tip tc
so m e th in g re w a rd in g to d o trong khi anh cm thy ngi khe
w hile y o u 're g e ttin g b etter. khon hn. Anh s dng thuc v
You'll get a m e d ic in e to take cng cn vi tun l thuc mi c tc
w hich will take so m e w eeks to ng, do vy ng nn lng nu thot
w ork, so d o n 't b e m o re d e u thuc c v cha tr gip g.
s p o n d e n t if a t first it d o e s n 't
se e m to b e h elp in g .
7 A 6 -m o n th - o ld b a b y b o y s u ffe r 7 Mt b trai 6 thng tui c bnh
ing fr o m a to p ic eczem a , a c chm d n g c cha m b n.
c o m p a n ie d by his p a re n ts
DOCTOR: T his s k i n p r o b l e m y o u r b a b y BS: Cn bnh da ca chu khng phi l
lias is n 't a n in fe c tio n so h e nhim khun nn chu khng th ly
c a n 't give it to a n y b o d y else. truycn cho ngi khc u. y l
It's a c o n d itio n w h ic h affects m t tnh trng lm tn thng da v
th e skin a n d will re q u ire o in t i hi lu lu cn bi thuc m. I
m e n ts fro m tim e to tim e. khi n c v kh lt ri li bng ln.
S o m e tim e s it w ill s e e m b e tte r Khng th chc c h n xc nh iu gi
a n d th e n it m ay flare u p again. gy bnh nhng c th l do di
It's n o t a b s o lu te ly c e rta in truyn.
w h a t c a u se s th is p ro b le m b u t
it c a n be h e re d ita ry .
Task 5 Bi lm 5
DOCTOR: N ow M r Ja m e so n , h e re is a- BS: By gi ng Jam eson ny, y l toa
p re sc rip tio n for s o m e ta b le ts thuc vin v c su gi ng phi
w h ich you are to ta k e tw o o f dng hai vin. Nu c th. hy ung
every six h o u rs. Try to take sau ba n trong trng hp thuc
th e m after m e a ls if p o ssib le in gy kh tiu, n g c th ung thuc
c a se they c a u se y o u in d ig e s lc d m nu ng b tnh gic v cn
tio n . You c a n ta k e th e m d u rin g au.
th e n ig h t as w ell if y o u are
aw ak e w ith th e p ain .
T a sks 7 an d 9 BAi lm 7 v 9
PHYSIO: First o f a ll, you lie d o w n o n Bc si vt l Irl liu Truc tn ng nm
your rum m y o n a h a rd su rface. sp trn m t m t p h in g cng. Sn
The floor will do. N ow p la ce nh cng uc. By gt. dt hai b in
your h an d s on your back and tay tr n lng v nhc th in g m t ch n
lift o n e leg u p s tra ig h t w ith o u t ln cao m khng gp d iu gi. Ri li
b e n d in g y o u r knee. T h e n chn xung v li nhc c h n kia
bring it d o w n a n d lift th e o th e r ln nh vy ri li t xung. Tp nh
leg u p in th e s a m e w ay a n d th nm ln, hai chn lun phin
th e n b rin g it d o w n . R e p ea t th is nhau.
ex ercise five tim e s d o in g it a l
te rn a te ly w ith e a c h leg.
K eeping th e s a m e p o s i Ci yn t th n h vy, t hai
tion, p la c e y o u r h a n d s o n y o u r bn tay tr n lng v nng ngc ln
b ac k a n d lift y o u r c h e s t u p off cao khi sn nh ri li h thp xung
th e floor, a n d th e n b rin g it t t. Tp bi ny nm ln.
d o w n slow ly. R e p ea t th is e x e r
cise five tim es.
N ow k e e p in g y o u r h a n d s at By gi t hai tay Kn hng v
y o u r sid e s a n d lying o n y o u r nm sp, hy nhc chn v cnh tay
tu m m y , lift a lte rn a te leg a n d lun phin nhau - v d chn phi v
a rm s im u lta n e o u sly - for ex cnh tay tri - ri li h xung. Sau d
a m p le y o u r rig h t leg a n d left li nhc chn v cn h Uy kia lun
arm - and then bring them phin nhau ri li h xung. Tp bi
d o w n . N ext lift y o u r o th e r a l ny nm ln.
te rn a te leg a n d a rm , a n d th e n
b rin g th e m d o w n . R e p ea t th is
ex ercise five tim es.
K eep y o u r h a n d s o n y o u r t hai bn tay trn lng Ti nhc
back a n d th e n lift y o u r c h e st cao ngc v hai chn cng m t lc,
a n d legs u p s im u lta n e o u sly , ri li t t h xung. Cng tp nh
a n d th e n b rin g th e m d o w n vy nm ln. y l m t bi tp kh
slow ly. R e p ea t th is ex e rc ise nhng khi tp quen, ng c th lm
also five tim es. T h is is a d iffi ng cch.
cu lt ex e rcise b u t w ith p ra c tic e
y o u 'll b e a b le to d o it properly.
N ow y o u h a v e to c h a n g e By gid ng phi i t th. Vy
p o sitio n . So lie o n y o u r b a c k hy nm nga v t hai bn Uy Itn
w ith y o u r h a n d s o n y o u r sid e s hng v co gp hai u gi li, vn gi
and ben d your knees up, k ee p hai bn chn trn sn. By gi nhc
ing y o u r feet o n th e floor. N ow cao m ng ln ri li h th p t t. Tp
lift u p y o u r b o tto m a n d th e n nh vy nm ln
b rin g it d o w n slow ly. R e p ea t
th is ex e rcise five tim es.
You sh o u ld d o th e se e x e r ng n n tp cc bi ny mi ngy
cises th re e tim e s a day, p re f ba ln, tt n h t vo lc i b n g trc
e ra b ly o n an e m p ty sto m a c h ba n. Ri ty theo s tin b, sau
b efo re m eaJs. T h e n d e p e n d in g khong hai tu n l c h n g ta s tng
o n y o u r p ro g re ss, afte r two th m s ln n g tp cc bi ny. n g
w eeks o r so w e ll in c re a se th e nn c gng tp cc bi ny cng
n u m b e r o f tim e s y o u d o th e se ch m v nh n h n g cng tt v c
exercises. You sh o u ld try to d o g ng trn h git m n h thn mnh.
th e m as slow ly a n d s m o o th ly
as p o ssib le a n d try to avoid
je rk in g y o u r body.
Task 10 Bi lm 1 0
DOCTOR: Well, M r Ja m eso n . I a m sorry BS: , ng Jameson, ti tht tic khi thy
to see th a t y o u r b ac k is still lng ng vn lm ng b au v by
ca u sin g you p a in a n d th a t you gi ng li cm thy yu mi bn
h ave n o w d e v e lo p e d a w e a k chn phi. Tnh trng yu mi l do
n ess in y o u r rig h t foot. T h e s p lin tc ln cc r thn tanh
w ea k n ess is d u e to th e c o n tin phn phi vo cc c bp chn ng.
u e d p re s s u re o n th e nerv e D nhin, s p ny c v tr
ro o ts s u p p ly in g th e m u sc le s o f ngang on a gia cc xng t
y o u r leg. T h is p re ssu re , of sng lng. Do tinh trng bnh ngy
co u rse , is ta k in g p la c e at th e m t xu them, ti ngh lc ny t
level o f th e d isc b e tw e e n th e nhiu kh nng ng cn phi c mt
lu m b a r v e rte b ra e . D ue to this phu thut vng lng ct ly
w o rse n in g o f th e c o n d itio n , I on a ni p trn dy thn
th in k th a t th e re is n o w a s tro n g kinh.
p o ssib ility th a t y o u re q u ire an
o p e ra tio n o n th e b a c k to r e
m o v e th e d isc w h e re it's p r e s s
ing o n th e nerve.
PATIENT: I see. BN: Ti hiu.
DOCTOR: T h e o p e r a tio n w ill n e e d to be BS: Phu thut cn c tin hnh bi
c a rrie d o u t by a s u rg e o n s p e m t phu thut vin chuyn khoa v
c ialised in th is w ork, a n e u r o cng vic ny, l bc s ngoi khoa
s u rg e o n . T h e o p e r a tio n itself thn kinh. Bn thn cuc phu thut
will only im m o b ilise y ou for a ch lm ng bt ng trong vi ngy
few days, a n d y o u 'll s o o n b e u p ri ng li ng dy c v sau
a n d a b o u t a g a in a n d b a c k to phi tr li bc s vt l tr liu tng
th e p h y s io th e ra p is t to im cng sc khe cc bp c, c lng
p ro v e th e s tr e n g th o f y o u r v chn. Nu ng khng chu phu
m u sc le s, b o th in y o u r back thut ny, th c nguy c l bn chn
a n d this leg. If y o u d o n 't h av e phi ca ng s thng xuyn yu
the operation, the risk is th a t mi. Bng mi gi chng ti mun
your right foot will be perm a trnh chiiytn ny. Cn nhng cu
nently weak. We want to hi no ng mun t cho ti khng?
avoid this at all costs. Are
there any q uestions you
would like to ask me?
Task 15 Bi lm 15
SURGEON. The d ia m eter o f o n e o f y o u r Phu thut vin: ung kinh ca mt
co ro n ary a rte rie s is re d u c e d , tro n g s cc ng m ch vn h ca ng
so o n e p a rt of y o u r h e a rt m u s b gim nh, do vy m t phn c tim
cle is sta rv e d o f oxy g en a n d ca ng b thiu h t oxygen v cc
o th e r n u trie n ts. If y o u d o n 't cht nui dng khc. Nu ng
have a n o p e ra tio n , y o u will kh n g c p h iu th u t, n g s tip
c o n tin u e to h av e p a in in y o u r tc au ngc v ng cn c th b
c h e st a n d y ou m ay e v e n h av e thm cn au tim na. Trc khi xy
a fu rth e r h e a rt a ttac k . B efore ra t n thng nng, c h n g ti phi
se rio u s d a m a g e is d o n e , w e th tng cng dng m u dn tim.
m u st try to im p ro v e th e flow C hng ti s ct ly m t tinh m ch
of b lo o d to th e h e a rt. W ere chn ng v dng on m ch d thay
g oing 10 re m o v e a v ein fro m th m t phn ng m ch vnh ca
y o u r leg a n d u se it to re p la c e ng. C may hi phc s rt tt v ti
p a rt o f y o u r c o ro n a ry artery . thnh tht tin l ng s c im thy d
T h e c h a n c e s o f rec o v ery are chu hn nhiu sau cuc p h iu thut.
very g o o d a n d I'm c o n fid e n t
y o u 'll feel a lo t m o re c o m fo r t
ab le a fte r th e o p e ra tio n .
Key Gii p
Unit 1 Bi 1
Taking a history 1 Lm b n h n I
Task 1 B i l m 1
SU RNA M E Hall F IR S T N A M E S Kevin
O C C U P A T IO N Lorry driver
fronl.il head ach es J/ i 2
worse in a.m . - "dull, throbbing"
relieved by lying dow n
also 7 o deafness
H H all TN Kevin
T U I 32 G I I N am T N H T R N G H N N H N C v __________
NGH N G H I P Li xe li_______________________________________________ _
LI K HAI B N H H I N N A Y
Nhc u vng trn t 3 th n g nay. N hc nhiu vo bui sng, "m I, dau nhi".
G im khi nm . Cng khai: i c
1 m a le nam
2 married c V
3 for th ree m o n th s (similarly 3 /5 2 = t 3 (hng nay (tng t 3/52 = 3 lun lc.

th ree w eeks; 3 /7 = th re e days) 3/7 = 3 ngy)
4 m orning bui sng
5 T hey are th e p atien t's o w n w ords. y l n h n g t c a chnh bnh nhn,
6 com plains of khai b n h l

Task 4 Bi lm 4
U se this d iag ram to tell y o u w h e re to in S dng s ny i ni cho bn chl ng
d ic ate in each case. v tr trong mi trung hp.
Bi lm 5
T a sk 5
B: U se th is a d d itio n a l in fo rm a tio n to B: S dng thng tin b sung ny

a n sw e r an y q u e s tio n s th e d o c to r asks. li mi cu hi m bc s nu ra.
1 C reasy food, like fried eggs, upsets Thc n bo, nh trng ch in , lm ban
you m ost. T h e pain lasts several b ri lon nhiu n h t. Cn dau ko di
hours. nhiu gi.
2 T h e pain w akes y o u at night. Cdn au lm bn thc gic trong m.
A ro u n d 2 o r 3 in th e m orning. Khong 2 hoc 3 gi bui sin g . Thc an
Spicy food brings o n th e pain. T o o c gia vj lm dau. u n g qu nhiu cng
m uch to drink also m akes it w orse. lm au hn.
3 T h e pain is really bad. Y ou've b ee n Dau tht nng. Bn lun ho khc dm
coughing u p b row nish s p it Y ou've nu. Bn b st.
had a te m p eratu re .
4 Y ou've h ad a cold. Y o u 're n o t Bn b cm lnh. Bn khng So ra dm.
coughing u p phlegm .
D iagnoses Chn on
1 gall b la d d er ti m t
2 d u o d e n a l ulcer lot t Irng
3 p n e u m o n ia vim phi
4 tracheitis vim kh qun
Task 6 Bi lm 6
(A full list o f a b b re v ia tio n s is g iven in (Ton b danh sch cc ch vit tt u c
A p pendix 2.) trong Ph lc 2.)
O /E o n ex am in atio n ang thm khm
BP b lood pressure huyl p
CNS central n ervous system h thn kinh trung ng
-ve negative m tnh
? q u ery /p o ssib le cu hi/c th
1/52 o n e w eek m t tun l
Task 7 Bi lm 7
Suggested q u e stio n s: Cu hi gi :
1 W h ats y o u r o ccu p atio n ? n g lm ngh g?
W hat d o you do? ng lm g?
W hat's y o u r job? C ng vic ca ng l g?
2 W hereabouts w as th e pain? au ch no?
Show m e w h e re th e pain was. C hl ch o ti x e m au c h no.
3 W h en did th e pain first h a p p e n ? Cn au xut hin u tin t khi no?
5 Did anything m a k e it b e tte r 7 C ci g lm kh ln c khng?
6 D oes anything special bring it o n ? C ci g c b i t g y ra c h u y n d
khng?
7 A re y o u r p are n ts aliv e7 Cha m anh cn sng khng?
H ow old w as y o u r fath e r w h e n he C h a a n h q u a i lc b ao n h iu tui?
died?
W h at age did y o u r fath e r d ie at? Cha anh m l vo lc bao nhiu tui?
Task 8 Bi lm 8
1 G reen G reen
2 42 42
3 Salesm an D oanh n hn
4 C entral trung tm
5 10 m ins 10 pht
6 clea r/n o rm a l trong sut/bnh thng
7 p (pulse) m ch
8 BP (blood pressure) huyt p
9 HS (heart sounds) ting tim
Task 9 Bi lm 9
P ossible q u estio n s: Cu hi c th t ra:
a) W hat's y o u r nam e? T n ng l gl?
H ow old are you? n g bao nhiu tui?
A re you m arried? ng c v cha?
W hat's y o u r job? Cng v i c c a ng l gl?
W h a ts b ro u g h t y o u h ere today? H m nay ng d n y c vn gl?
W here exactly is th e pain? au ng ch no?
H ow long have y ou h ad it? ng dau nh vy lu chua?
Did anything special bring it on? C ci gi d ac bit d s gy ra chuyn d
khng?
Is It w orse at an y p articu lar tim e? C huyn d c ti t hn vo ml thi
im d c bit no khng?
D oes anything m a k e it b e tte r or C ci g) lm chuyn d tt hn hoc xu
w orse? hn khng?
H ave y ou any o th e r p roblem s? ng c vn no khc na khng
H ave you tak en anything for it? n g dng thuc no cha?
Did th e p ara cetam o l help? D ng paracetam ol c d khng?
b) H ow long have yo u b e e n suffering ng b nhc u n h v y d bao lu ri?

from th ese head ach es?
H ow long d o they last? N h c u ko di bao lu?
H ow often d o y ou get th em ? Sau bao lu li thy nhc u?
D o they e v e r m ak e y ou feel sick? N h c u c lm ng c m th y ng
b n h khng?
H ave you no ticed any o th e r p ro b n g c th y cn nhng v n A n o khc
lems? khng?
H ow d o es th e pain affect you? Cn au in h hng n ng ra sao?
Task 11 Bi lm 11
1 b u s d riv e r ti x xe but
2 cough an d general m alaise ho v kh chu lon ihn
3 u p p e r resp irato ry tract infection n h im khun ng h h p trn
4 barely ro u sab le a n d b reath less at d tinh gic v ht hi khi nm nghi
rest
5 severe ch est infection n him khun nng phi
6 tw o w eeks hai tun l
7 m yocardial infarction nhi m u c tim
8 d rank little alcohol ung l ru
Task 12 Bi lm 12
SU R N A M E H udson F IR S T N A M E S W illiam Henry
AGE 58 SEX M M A R ITA L S T A T U S M
O C C U P A T IO N Postm aster
'/o 'e v e r e low back pain. V 52 radiating (o left leg. A ccom panied by parasthesia.
U nable (0 sleep because 0 pain. U nrelieved by paracetam ol. May have started af
ter gardening.
H Hudson TEN W illiam Henry
TUI Stt GII N am T fN H T R N G H N N H N C V
N G H N G H I P Trng phng liifu in
au nhiu vng lng di. 1 lun l l.in lod xung ch.in Iri. Km bin di cm
gic. Khng ng c v au . Khng bl Hau khi dn^ paracetam ol. C l phi
bnh sau khi lm vn.
Unit 2 Bi z
Taking a history 2 Lm bnh n 2
Tasks 1 and 2 Bi lm 1 v 2
System Com plaint No complaint Order
ENT
RS 4
CVS 3
CIS 1
cus 2
CNS 5
Psychiatric 6

H th n g Khai c b n h K hai k h n g b n h T h t
T .M .H N G
H. HP 4
T. MACH
T. HA 1
N. DC 2
T. KINH T. UNG 5
Tm thn 6
Task 3 Bi lm 3
1 c 2 f 3b 4 d 5a 6 e
Task 4 Bi lm 4
In fo rm a tio n for S tu d e n t B (p atien t): Thng tin cho Sinh vin B (b<nh nhn):
1 You are a 60-year-old electrician B n l th d i n 6 0 tui (n a m ).
(male)
You have coughed up b lood sev B n h o ra m .u n h i u l i n tron g v i tun l
eral times over the last few v a qua.
w eeks.
You have noticed that you're losing B n n h n t h y c st c n . Q u n o
weight. Your clothes don't fit you k h n g m c v a.
properly.
You sm oke 3 0 cigarettes a day. B n ht 3 0 d i u th u c l m i n g y .
2 You are 68. You are a retired B n 6 8 tui. B n l g i o v i n n g h i hu
schoolteacher (male). (nam ).
You have been getting m ore and B n n g y c n g t o b n trong vi thng
m ore constipated over the past V3 q u a. B n n h n t h y c m u trong
few m onths. Y ou've noticed phn.
blood in your stools.
You've b een losing weight. B n d st c n .
3 You are 45. You are a housew ife. B n 4 5 tui. Hn l n i tr. B an c 3 con .
You have three children.
You get a pain in your stom ach B n c a u d d y sau c c ba n . D i
after meals. Som etim es you feel khi b n c m th y b u n n n . T h c n
squeamish. Fried and oily foods c h i n v c d u d n g n h lm b n h
seem to be worst. (l n g n h t.
4 Y o u a r e a 2 4 -y e a r -o ld typ ist B n l m t n h n v i n n h m y 2 4 tu i,
(female). (n).
Y o u h a v e p a in w h e n y o u a r e p a s s Bn au mi khi i tiu. C mu trong
in g w a te r. T h e r e is b lo o d in y o u r nc tiu.
urin e.
Y o u h a v e t o p a ss w a te r m o r e fre Bn ph i i tiu (hng xu yn hn trc
q u e n tly th a n u su al. dy.
5 Y o u a r e a s tu d e n t o f 19 (m a le). Bn l m t sin h v i n 1 9 tui (nam ).

Y o u h a v e a h e a d a c h e at t h e fro n t Bn b nhc u vng trn, d c iheo
o f y o u r h e a d , a lo n g th e b r o w . l n g m y .
Y ou r n o s e k e e p s ru n n in g. Mi b n c h i y nc (s mi).
Y ou r h e a d a c h e is w o r s e in th e C n au u thng nng nhiu hn vo
m o r n in g w h e n y o u g e t up. bu i sng khi bn tnh dy.
It a lso g e ts w o r s e w h e n y o u b e n d Cn au cng ti t hn khi bn ci ngi
dow n. xung.
Diagnoses Chn on
a) c a n c er o f t h e c o lo n ung th i trng
b) fib ro id s u dng si
c) cancer o f th e lung ung th phi
d) cystitis vim b ng quang
e) b ro n ch itis vim ph qun
f) ch o lelith ia sis si ng mt
g) sinusitis vim xoang mi
Solutions p n
See foot o f page 282. Xem cui trang 282.
FEVER duration chills

freq uency WHtl
2 tim e 3 ntghl (w eals
4 rigor
5 m a la is e 7 w t lo s s 8 nori
GENERAL
SYMPTOMS w eakness d ro w a m a ss vomiting
6 m y a lg ia d e liriu m photophobi*
bleeding "> nose

skin
urine
ACHES AND head abdoman

PAINS leeth ch a d back
eyes neck pubtc
m uscle
joints
bone
SKIN rash CVS ctytpnoaa

pruritis palpitations
b r u is in g Mt irregularity
GIS diarrhoea RESPIRATORY j/J E coogh

m e la e n a c o ry
ic te rnroal
(Jy*pno
URINARY ysuna 11 p**urmc pain
freq uency tp u tu m
strangury 10 h m o p ty *is
discolouration
NEUROLOGICAL vision
p h otoph obia
blackouts
diplopia

ST th i g ia n lnh rt
l n x u t ra m6 hi
_*^2_ l n 3 ra m hi dm
4 rt run
TR IU CHNG 5 kh chiu 7 s l cn 8 chn n

TNG QUT yu m l u oi nn i
6 au c m sng s nh sng
xut huyt? mi
da
nc tiu
NHC V AU du bng thl lung

rng ngc lng
mt c vng mu
c
khp
xng
DA ni ban H TIM MCH kh th

nga nh trng ngc
tim dp khng
bm Um
du
H TIU HA (lu chy H HP ho

phn mu s mi
au hong
c kh thd
11 dau mng phi
TIT NIU kh i m
ln xut 10 ho mu
di sn dau
i mu
THN KINH thi gic

so anh sng
hoa ml
song thj

Language fo c u s 5 Trng tm ngn ng 5
w eight c n n n g
cough ho
b lood m u
chest ngc
T ask 7 Bi lm 7
(O ther q u e s tio n s are also p o ssib le.) (Nhng cu hi khc <ftu c th c.)
3 D oes th e pain c o m e o n at any Cn d au c xy ra vo m l thi d im no

particular tim e 7 d c b il khng?
4 A part from th e pain, d o y ou feel N goi cn dau, ng cn c m thy

anything else w ro n g 7 chuyn gl khng n chang?
5 D o you sm o k e 7 H ow m u c h d o y o u ng c ht thuc khng? ng ht bao

sm oke? n hiu iu?
6 W hen did y ou first notice th e pain? ng d th y ln d u tin dau khi no?
7 H ave you n oticed any c h a n g e in th e ng c nh n th y cht thay i no trong

frequency o f th e pain? n hp cn (lau khng?
8 H ow has y o u r w eig h t b e e n ? D o ny ng c n nn g bao nhiu?
9 D o you ev er b e c o m e aw a re o f y o u r C lc no ng n h n th y tim d p qu
h eart b eatin g to o quickly? n h anh khng?
10 H ave y o u h ad an y p ro b lem w ith ng c vn g lc sng hai m t c

swelling o f th e an k les7 c h n khng?
T h ere are m a n y p o ssib le o rd e rs for th e C nhiu cch xp th t cho cc cu hi

q u e s tio n s d e p e n d in g o n th e p a tie n t's ty thuc vo cc cu tr i li ca bnh
re sp o n se s. nhn.
Ta sk 10 Bi lm 10
lk 2 c 3 f 4 j 5 l 6 d 7 i 8 b 9 a lO e llg 12 h
Task 11 Bi lm 11
In fo rm a tio n fo r S tu d e n t A (p atien t): Thng tin cho Sinh vin A (bnh nhn):
N am e: M r P eter W ilson T n: n g Peter W ilson
Age. 48 Tui: 48
Sex. M Gii: Nam
Marital status: M Tnh tr n g hn n h n : C v
O ccupation: S teelrope w o rk e r N gh nghip: Cng n hn dy
c p th p
You h a d a n a tta c k o f c h e st p a in last Bn c m t cn au ngc m qua. au

night. T h e p a in w as b e h in d y o u r b r e a s t pha sau xng ngc. Bn cng c au
bone. You aJso h a d a n a c h in g p a in in nhc c v cnh tay phi. Cn au ko di
your neck a n d rig h t arm . T h e p a in la ste d 15 pht. Bn cm thy kh chu v khng
for 15 m in u tes. You w ere very re stle ss th ng c. Bn cng b ho ra m mu
and c o u ld n 't sleep. Y ou've also b e e n st g.
coughing u p ru sty c o lo u re d spit.
For th e p a s t y ea r y o u 'v e su ffe re d Nm va qua bn bj kh th khi leo i

from b re a th le s sn e ss w h e n y o u w alk u p hoc tro thang. Bn b ho vi nm nay.
hill or clim b sta irs. Y ou've h a d a c o u g h i lc bn c m ri. Ba tun l va qua
for so m e years. You o fte n b rin g u p ba ln bn cm thy c cn au nhi
phlegm . In th e p a s t th re e w eek s o n th re e gia vng ngc. Cn au lan ta xung
occasions y o u 'v e felt a tig h t p a in in th e cnh tay phi. Nhng cn au xut hin
m iddle of y o u r ch e st. T h e p a in h as khi bn ang lm vn. Cc cn dau ko
spread to y o u r rig h t arm . T h e se p a in s di vi pht. Hai m t c chn bn sng
h a p p e n e d w h e n y o u w ere w o rk in g in phng. Bn nhn thy i giy b cht
the g arden. T h ey la ste d a few m in u te s. cng vo lc bui ti mc d tnh trng
Your an k les feel puffy. You fin d th a t y o u r sng phng li tan ht sau khi bn ng
shoes feel tig h t by d ie e v e n in g a lth o u g h m . Bn b chut rt bp chn phi
this sw elling g oes aw ay afte r y o u 'v e h a d trong thng va qua mi khi bn di b mt
a n ig h t's rest. Y ou've h a d c ra m p p a in s in qung ng. Nu bn ngh ngi, cn au
y our right calf for th e la st m o n th w h e n li ht.
ever you w alk an y d ista n c e . If y o u rest,
the p a in s go aw ay.
Y ou've b e e n in g o o d h e a lth in th e Trc y bn vn m nh khe mc d
past a lth o u g h y o u h a d w h o o p in g bn b ho g v vim ph qun dng hen
cough a n d w h ee zy b ro n c h itis as a khi bn cn nh. Bn ht 20 n 30 iu
child. You sm o k 20 to 30 c ig a re tte s a thuc l mi ngy. M bn vn cn sng,
day. Y our m o th e r is still alive, a g e d 80. 80 tui. Cha bn qua i lc 56 tui vi
Your fa th e r d ie d o f a h e a rt a tta c k w h e n m t cn au tim . Bn c m t ch gi. Ch
he w as 56 You h av e o n e sister. S he h a d gi ny b lao lc nh tui.
TB w h e n sh e w as y o u n g er.
Task 12 Bi lm 1 2
1 breathlessness ht hi (k m th)
2 productive c dm
3 o ed e m a p h
4 in term itten t claudication b c k h p k h n h cch s i
5 retro stern al/cen tral sau xng c/trung tm
6 rusty g
Ta sk 13 Bi lm 1 3
7 sh o rt th p
8 orth o p n e ic kh th khi n m
9 cyanosis tm ti
10 clubbing di trng
II regular u
12 oedem a ph
I3 som e c h t t
I 4 venous tn h m c h
I 5 clavicular xng n
16 h e a rt tim
17 crepitations ran n
18 right phi
19 IV ti m tn h m c h
2 0 IM ti m b p
Solutions to Task 4 (page 277) p n cho Di lm 4 Itn n g 277)

lc 2 a 3f 4d 5g
Task 15 Bi lm 15
SU R N A M E Jameson F IR S T NAM ES Alan
AGE 53 SEX M MARITAL STA TU S M
OCCUPA TIO N C arpcnler
P R E S E N T COM PLAINT
Acute backache referred dow n R sciatic nerve distribution. Began b/52 ago and b e
cam e more severe over past 2/s 2. Affecting work and w aking him at night. Also c/o
tingling in R fool. Wt loss 3 kg. D epressed.
IMMEDIATE P A S T H ISTO RY
Paracetam ol helped a little with previous interm ittent back pain.
H Inmeson TN Alan
TUI 53 GII N am TNH TR N G HN NHN C V
N G H N G H I P Th m c

au lng c p tnh lan ta xung d y th n kinh ta phi. Bl u 6 tun nay v
ngy cng nn g hn trong 2 lun va qua.
nh hng n cng v i c v lm b n h n h n thc gic trong dm . Cng khai l
ddu nhi b n c h n p h ii. St c n 3kg. Suy nhc tinh thn.
TIN S GN Y
Paracetam ol c lm gim cht t cn dau lng cch hi trc dy.
Task 16 Bi lm 16
I W h at's 8 th a t/th is
2 w hen 9 o th e r
3 did 10 w ith
4 W as/Is lI in
5 Has 12 Did
6 had 13 find
7 in 14 on

Task 17 Bi lm 17
(O th er a n s w e rs a re p o ssib le .) (Nhng cu tr li khc u c t h dc)
a) W hat's b ro u g h t you h ere to d a y 7 Chuyn g lm ng phi n dy hm nay?

W h ere is th e p a in 7 au u?
c) D oes the pain affect y o u r sleep? Cn au c lm n h hng d n gic ng
ca ng khng?
d) A part from th e pain, have y ou n o Ngoi au, np cn n h n thy c nhng
ticed any o th e r p ro b lem s vn d khc khng?
e> Is it affecting y o u r w o rk 7 au c lm nh hng n cng vic ca
ng khng?
0 H ave you n oticed any c h a n g e in ng c nh n thy cht thay di no v
your w eig h t1 c3n n n g khng?
g) H ave you ever had any p ro b lem like Trc d y ng c vn d g nh th ny
this b e fo re 7 khng?
h) Did you take anything for it? ng d dng thuc no cha?
Did it h e lp 7 Thuc c hiu qu khng?
T h e c o n s u lta n t is p r o b a b ly a n e u r o lo Bc s th am vn c th l m t bc s khoa
gist or a n o r th o p a e d ic s u rg e o n . th n kinh hoc phu th u t vin chinh
h n h .
Task 18 Bi lm 1 8
A ngina Pericarditis
Site left-sided o r cen tral c h e s t, r etro stern a l
chest pain a n d left precordial
R adiation neck, jaw, arm s, wrists, b ack and tra p eziu s ridge,
so m e tim es h an d s s o m e t im e s e ith e r o r b o th arm s
D uration a few m in u tes persistent

Precipitating exertion, e x p o s u re to cold, inspiration, co u g h in g a n d
factors heavy m eals, in te n se em o tio n , ch an g es in b o d y position
lying flat, vivid d rea m s
Relief o f pain rest, sublingual nitrate sitting u p an d leaning
forw ards
A ccom panying choking sensatio n , pericardial friction rub
sym p to m s an d breathlessness,
signs o ften n o physical signs
Cn d a u th t ngc Vim ngoi lm m c
V (r pha tri hoc (rung tm ngc, sau xng c
au ngc v bn tri (rc tim
Lan ta c, hm , cn h lay, c tay lng v b c thang, i khi
i khi bn tay mt hoc c hai cn h tay
Thi gian vi pht dai dng
Cc yu t gy dt g n g s c ,c m l n h ,3 n d k h ht vo, ho v thay i i th
pht tiu, cm xc m an h , n m d i, thn ngi
gic m kch ng
G im dau nghi ngi, nitrate di li ngi ln v ng ngi ra trc
Triu chng v du cm gic ch o n g (sc) ting st sot c xl ngoai
hiu km theo ht hi tm m c
thng khng c du hiu
thc th
Task 19 B i l m 19
SU R N A M E H udson F IR S T N A M E S W illiam Henry
O C C U P A T IO N Retired postm aster
H ead ach es for 4 m ths. W i loss. H ead ach es feel "like a heavy w eighi".
No nausea or visual sym ptom s.
No appetite.
Diff. starting to PU. N octuria x3.
TUI 65 G II N am T N H T R N G H N N H N Ga v
N G H N G H I P Trng phng bu in hu tr
au u trong 4 ihng. St cn. au u nh "c vt nng d p .
Khng bun nn h o c triu chng th gic
Khng thm an
Kh khan lc bt u tiu tin. i m 3 ln.
Task 20 Bi lm 20
O n the re c o rd in g th e d o c t o r d o e s n o t Trong bng khng phi bc si hiAn lun
alw ays sp e a k in s e n te n c e s . S o m e tim e s ni d cu. i khi ng y ngng gia
h e sto p s in th e m i d d l e o f w h at h e is chng cu ni v m hoc ri nhc li
saying, sa y s 'u m ' o r 'cr' a n d re p e a ts diu va ni. y l kiu ngn ng ni
h im self. T h is is ty p ical o f s p o k e n la n in hnh v gip bc s c thi gian suy
g u ag e a n d gives th e d o c to r lim e lu n g h i.
th in k .
Unit 3 Bi 3
Examining a patient Khm bnh nhn
Task 1 Bi lm 1
le 2 c 3 a
Task 2 Bi lm 2
Id 2 b 3 e 4 a 5 c
Task 5 Bi lm 5
1 lie nm 6 press n
2 raise/lift nng/nhc 7 hurt au
3 ben d ci. gp 8 roll tr
4 bend ci, gp 9 feel cm nhn
5 straighten dui thng JO lift/raise n h c /n n g
Ta sk 6 Bi lm 6
1 radial pulses n hp m ch qu.iy
2 BP huyt p
3 h eart so u n d s ting (im
4 lungs phi
5 abdom en bng
6 fem oral pulses nhp m ach i
Task 8 Bi lm 8
THE FIRST EXAMINATION

THM KHM LN AU
1. Heighl C h i u cao
2. Weight* 0 C 5n n n g 12
3. Auscultation of heart and lungs N ghe tim v phi
4. E xam ination of b r e a sts and K h m v v n m v
nipples
5. Examination of urine 0 Xt nghim nc tiu [7]
6. Examination of pelvis K h m v ng c h u
7. Exam ination of le g s 0 Khm hai ch n 0
8. In s p e c tio n o f te e th K h m r.lng
9. Estimation of blood pressure [Z1 o huyt Ap 0
10. Blood sample (or blood group Ly m u m u d lm n h m m u
11 Blood sample lor haemoglobin Ly m u m.u d lm h em o g lo b in
12. Blood sample for serological test lor Ly m u m u d xt n g h i m huyt
syphilis lli.m il tm giang mai
13. Blood sample for rubella antibo Ly mu mu d tm khng th bnh
dies si
14. Examination of abdom en to a s s e s s K hm b n g d xc n h kch thc t
size of uterus 0 cung 0
15. Examination of vagina a n d K hm m d oo v c l cung
cervix
* In the U K , w e ig h t IS no lo n g e r m e a s u re d as T<ji nc A n il, v i c c n Ih Iro n g k li iig cn
ro u tin e o n s u b s equent visils. dc thc h i n thng q u y trong cc 1.111 Ih m
k h m sau.
a 5 b 9 c 11 d 7 e l4
Task 9 Bi lm 9
S uggested o rd e r: Th t d ngh:
la 2 e 3d 4b 5c
Task 11 Bi lm 11
1 gentam icin
2 benzylpenicillin, ery th ro m y cin
3 am picillin
4 cefuroxim e
5 benzylpenicillin
6 gentam icin, benzylpenicillin
7 erythrom ycin, tetracycline
8 phenoxym ethylpenicillin. benzylpenicillin
9 tetracycline
!0 erythrom ycin
Ta sk 12 Bi lm 1 2
PU pass urine tiu tin
?AF possible atrial fibrillation rung n h i ( h t c th ^ ( x i y ra)
HS h eart sounds ti n g tim
ab d o abdom en bng
p.r. p er rectu m q u a (dng) trc trn g
NAD n o abnorm ality d e te c te d , k h n g p h i h i n b t th n g
n o th in g ab n o rm a l d e te c te d
4 / 12 four m o n th s bn thng
Ca. carcinom a, can ce r c a r c i n o m , un g th
Task 14 Bi lm 14
H o t p ita l
ue Day H o s p ita l
O n ly C lin ic O a ts T im e No. GP112
Ambulance lYell>/1 REQUEST FOR MIT-MIIHT COMULTATHM Urgtnt [^ j
R e q u ir e d Appointment fN^~l
S itt in g / S tr e t c h e r H o s p ita l E a s te rn OEN1RAL D s to 7 Required
P l e u e a rr a n g e lo r this p a tie n i lo a tte n d the ................. ........ clin ic o f O f/M r riE L D IN Q
P a tie n t's S u r n a m e ...... HUDSON

e ...
I
< Q.
F lf il Nam e* .......... T O I X i A M H K N R Y ................................ ...........
Addrisi ..........14 .P .. NORTHCOTT.....................

6 ,ntHo /Ma>nod/ W id o w e d /0 < tw
Date 0| B|rth 30/3/32
oS P a tien t's O ccupa tio n I>9 3T M A S.T?'R

si (R etired )
P ostal C o d e T e le p h o n e N o ...........................
35
5
H a t the patient attended hospital b e lo re Y E S / N O ? If " Y E S " p le a se state
1 z Nam e of H ospital . .. N O R T H E I U * G E N E R A L ........................
Y e a r of A tten d an ce ...A.7.3............. H o sp ita l N o ................

N am e. A d d re s s and Telephone
If the p a re n t's n am e and/or a d d re s s h a s/h a v e ch a n g ed
N u m ber of M E D I C A L / D E N T A L
sin ce then p le a s e give details:
P R A C T IT IO N E R
DR PETER WATSON
HEALTH CENTRE
NORTHCOTT
Ple a se u se rubber stamp
I would be grateful for your opinion and advice on the above named patient. A brief o utline of
history, sym ptom s and sig n s is given below:
This recently retired p o itm w iflr com plains of difficulty Blurting to paaa u rin e and Increased
frequency. He h u n o c tu ria x3 R*ct*l MMLmlnaLlon show s m oderate enlargem ent of th e pros-
l a u . also discovered th a t he h&a a tria l fibrillation w hich 1 u n d e r treatm en t w ith digoxln
0.25 mg and w arfarin. Ther Id n o cardiac enlargem ent and his BP la 100/ 103- H*3 PSA 15 within
th e norm al range This Qbrlil&uon la presum ably due to lachasm lo h eart disease, but I feel th at
he would folrly soon req u ire som e su rg ery to th e p ro state and th is may become u rgent
D ia g n o s is / p ro v is io n a l d ia g n o s is .U . P r ot * t Isch<usml!: h e a r t d w e 4 se
P re s e n t drug treatm ent and potential s p e c ia l hazard s: ..... 9.?...1? ? ! .w a rfa x ln do8e
variable depending on INK
R e le v a n t x - r a y s a v a ila b le Iro m ..................................................................... N o . (if k n o w n ) ..............
S ig n a t u r e .. ...................................................................
Dnh cho Lm Th Gi Bnh vin BS
bnh vin sng Ngy S lng q u tl 112
IN RI
Xe cu rC W l YU CU u Am b n m a n K8I rai S
CH
thng C4f c * lttH
Gh/Cing Bnh vin EASTERN GENERAL Ngy 7
BANG
Vu lng xp bnh nhn ny thm khim ......... Khca cut M M it n g FIELDING

Ho bnh nhn ............. HU D SON ....................... Ho (nhO d a rh )............ ..........
GHI CH
Tn bnh nhn WILLIAM HENRY...........
Q j, ch| 14 LINDEN LEA, NORTHCOTT
Ngy nh ... 30/3/32

NHN
M Bu in 3LH S d4n thoî ..................... Nohi nohip ..........NHM V,M.

BU CXM (*HJU trl)
BNH
Bnh nhn <19 d in khm K n h Iruc y: C/KMUC

Nu "C , v lng ghi r:
Tn bnh vin ..... NORTHERN GEN ER AL...........................
CA
Nm dn khm ............... !?.?.?...... Bnh vl<n s ...............

Tin. dia eK 6 **n thon c k
IM
Nu tn v/hoc a ch! bnh nhn t d thay di. xln

ghi chi tit: BCsl TNGaut r/NHAKHOA
C
BS P E T E R W ATSON
NHNG
H E A LT H C E N T R E
MORTHCOTT
Vui lng dng con u cao su
Ti xin cm on v kin v li khuyn ca Ngi lin quan n bnh nhn c ln trtn y Dutt
y l tm tt bnh s. triu chng.v du hiu ca bnh nhn:
Nh&n vin bu in va n g h i hu n y than p hi n v tinh trng k h khA n khl b it u tm n n v tiu
nhi u ln. ng ta di tiu ban m 3 ln. Khm trc trng ch o t h y tuyn tin lp phlni lo. T51 c n g pht
h i n rng ng ta c rung U m n h v (U n g c diu trj bng d lgoxln 0 .2 5 m g V* r a f a r m K M f ig c du
hiu tm to vA huyt &p ca ng ta IA 160/105. Nhp ng mch trong mc Mnh iOag TWfch trng
rung tm n y c l do b nh thlu m *u c tim .n h h g tl n g h rng n g ta c i n t m Jc km thut tuyn
tin l p vA u ny c th tT nn k h n c p .
Chn don/chn on O m thi: ..... (>> T u y f n , l n l p ph lnh to (2) B nh t h u m u c o Itm
Thuc iu tr hin nay v nhng bin ii k h nng dc bit: ...... d iflo iln 0.25 mg varlartn
lu lng tha d<4i ty thoc yu t INR
Phim X quang c gi tr t ................................................................. S (nu bt)
Ch k V tC ft ________

Unit 4 Bi 4
Special examinations Thm khm c bit
Task 1 Bi lm 1
SURNAM E Priestly F IR S T N A M E S John
O C C U P A T IO N Postman
Failing sight. L eye has d eteriorated over past year.

Seriously affecting his w ork - "can 't cope".
H Priestly TN John
TUI 50 G I I N am T N H T R N G H N N H N C v
N G H N G H I P N h n v in bu in
Th lc gim . M t tri suy g im khong nm ngoi.

Lm n h hng rt nhiu d n cng vic. "Khng i ph c.
T he p a tie n t h a s b e e n r e fe rre d to th e B nh n h n c chuyn n khoa Mt

O p h th a lm o lo g y D e p a r tm e n t (th e Eye (Bnh vin Mt).
Clinic).

Task 2 Bi lm 2
a) all
b> can
c> anything
d) that
e) any
f) that
g) that
(d) and (0 re fe r to lenses (d) v (0 l c c m i l Itn h .
Task 3 __ Bi lm 3
1 C an you see any letters at all? Vy ng c th nhln thy cc ch ny
khng?
2 Well, w ith th e nftht eye, can y ou see No, b in g m t p h i, ng c ih nhin thy
an y thin g 7 g khng?
3 N ow d o es that m ake any d if f e r By gi, th ny c gy khc bit g)
ence7 ____ khng?
4 W h at ab o u t th at o n e 7 D o es th a t Cn ci ka I. sao? N c gy hiu q u i
have any effect7 no khng?
Task 4 Bi lm 4
Id 2 c 3b 4 f 5a 6 e
P o ssib le in str u c tio n s: Cc ch dn k hi hu:

2 I'm going to e x a m in e y o u r ears. Ti s khm tiai (ai ng. ng c th
C o u ld y o u tu rn y o u r h e a d this quay u pha ny dc khng?
w ay7
3 I'd like to e x a m in e y o u r chest. Ti m un khm ngc ng. ng c th
C o u ld you re m o v e y o u r to p c lo th ci b o trn c khng?
ing7
4 I'll just ch eck y o u r back. W o u ld Ti s ch kim tra lng ng thi. ng
y o u sta n d up, p le a se 1 vui lng ng ln, c ch?
5 W o u l d y ou like to t k e y o u r sh o e n g vui lng ci b g iy v v v (I
and sock off an d I'll e x a m in e y o u r s khm b n ch n ng.
fo o t
6 If you'd like to tilt y o u r h ea d back. N u n g vui lng nga u ra M U, li
I'll just e x a m in e y o u r nasal passage. s khm dng mi ca ng.
Task 5 Bi lm 5
1 lim b p o w e r kh nng ca chi
2 lung vital capacity dung tch sng ca phi
3 consolidation o f th e lungs s ng c ca hai phi
4 eye m o v e m en ts cc chuyn dng ca mt
5 te m p e r a tu r e nhit
6 re c tu m trc trng
7 co o rdination o f th e right lim b s phi hp ca chi phi
8 throat/tonsils hng/am idan
Task 6 Bi im 6
C om pare your version w ith th e T ape- So sn h bi son ca bn vi bn i
script for T ask 1. thoi cho Bi lm 1.
Task 7 Bi lm 7
RS, GIS, g la n d s, ENT, h e ig h t a n d H h hp, h tiu ha, cc tuyn, tai mi
w eight. hng, chiu cao v cn nng.
P aediatric. Nhi khoa.
The p a tie n t is a 4 -y e a r-o ld girl (w ith Bnh nhi l m t b gi 4 tui (c m di

h er m o th e r). km).
Task 8 Bi lm 8
a) going i) so
b> called j) y o u 're
c> m ight k> I'll
d) of I) tickly
e) to m) N ow
f> th e n n) all
g) done o) isn't
h) like
Ta sk 9 Bi lm 9
For p a e d ia tric e x a m in a tio n o f th e Cho vic thm khm nhi khoa vng
th r o a t (1), e a r s (2). c h e s t (3) a n d hng (1), tai (2), ngc (3), v lng (4k
b a c k (4) se e th e T a p e s c r ip t fo rT a s k 7 . xem bn i thoi cho Bi lm 7.
5 foot 5 bn c h in
We'll just ask M u m m y to ta k e off C h n g la s n h M e (h o b g i y v

y our shoes a n d socks so I c a n have'a v c a chu d xem qu a b in chSn
quick look at y o u r feet. It m ight be c h u n h . C th n h i m t cht
tickly b u t it w o n 't be sore. nhng kh ng dau du.
6 nasal passage 6 dng m i

C a n you sit o n M u m m y 's k n e e I'm C hu nî ln d i u gi M dc
going to have a look at y o u r nose kh ng? H c s x e m m i c h u b n g
with this little light. You w o n 't feel c i d n n h xu n y . C h u kh ng
anything at all. C a n y o u p u t y o u r c m th y c h t gl c i d u . C h u c th
h ead back to help m e? nga u ra sau d c kh ng?

Test question Order Patient's score
Cu hi trc nghim Th t S6 dim ca bnh nhn
l l I
2 8 0
3 7 0
4 6 0
5 5 0
6 3 I
7 4 I
8
9 2 0
T o ta l sc o r e 3 / 8
= s e v e r e im p a ir m e n t
S i m l n g c n g 3 /8
* suy nh c n n g
T a sk 13 Bi lm 13
1 W h a t w as th e year o f y o u r birth? N m sin h c n n g l n m no?
2 C a n y o u r e m e m b e r that? n g c th nh n m kh ng?
3 W h a t was th e d a t e 7 N g y th n g no?
4 H o w old will y ou b e now , d o yo u B y gi n g b a o n h i u tui, n g b i l ch?
think?
5 D o y ou k n o w that? n g c b i t i u kh ng?
(3 Well tell me, is it s u m m e r o r winter? V y n g n i c h o ti b i t, d l m a h
h oc ma dng?
7 / 8 O r d o th e days n o t m e a n a great H o c n g y th n g c h n g c n n h i u
deal to y o u n o w that y o u re not n g h a d i v i 6 n g l c n y k h i n g k h n g
working? c n l m v i c na?

b) q u e s t io n 7 cu hi 7
c) question 5 cu hi 5
d> question 4 cu hi 4
e) question 3 cu hi 3
0 q u e s tio n 2 cu hi 2
Task 14 Bi lm 1 4
1 W h a t w a s th e y e a r o f y o u r b irth ? N m s in h c a n g l n m no?
2 C an yo u r e m e m b e r that? n g c th n l n m kh n g?
3 W hat w as th e d a t e ? N g y th n g n o
4 H o w o ld w ill y o u b e b y n o w , d o B y R n g b a o n h i u tu i, n g b i t
you think? ch?
5. D o you kn o w th a t? n g c b i t d i u kh n g?
6 Well, tell me, is it Slimmer or V y n g n i c h o t i b i t l m a h
w inte r? ho c m ua_dong?
7/8 O r d o th e days n o t m e a n a great H o c n g y th n g c h n g c n n h i u
deal to you n o w that y o u 're not n g h a d i vi n g l c n y k h i n g
w orking? k h n g c n l m v i c na?
Task 15 Bi lm 15
1 W h a t is this place called7 C h n y gi t n l g?
W h e r e are w e n o w ? By gi c h n g ta a n g u nh?
2 W hich day is it today? Hm n a y l n g y m y?
W hat d ay is this? N a y l n g y g nh ?
3 W h a t is this m o n th called T h n g n y gi l ih n g g?
W h a t m o n th are w e in no w ? B y gi c h n g ta a n g th n g m y?
4 W h a t y e a r a r e w e in? C h n g ta d a n g n m no?
W h a t is th e y e a r N a y l n m g?
5 H o w old are you? n g b a o n h i u tui?
W h a t is y o u r a ge? T u i n g l b a o n h iu ?
6 W h e n w e re y ou b o r n 7 n g s in h ra k h i no?
W h a t w as y o u r y ea r o f b ir th 7 N m s in h c a n g l n m no?
7 W h a t is y o u r d a te o f b irth 7 Ngy t h n g sinh ca ng l n ^y no?

W h a t m o n th w e r e y o u b o m in? n g s in h ra v o th n g no?

8 W hat's th e time? My gi ri nht?
C a n you tell m e th e tim e? ng c Ih cho ti bit m y gi ri?
9 H o w m a n y years hav e y o u b e e n liv ng sng dy c bao nhiu n m ri?
ing here?
For h o w long have you stayed here? ng H y bao lAu ri nhl?
Task 16 Bi lm 16
lb 2 a 3 c 4 d
Task 20 Bi lm 20
1 Title Ta d
2 Authors Cc tc gi
3 Editor's note Ghi ch bin tp
4 Sum m ary Tm lt
5 Introduction N h p d
6 Materials a n d m e th o d s Cc vt liu v phng p h p
7 Results Cc kt qu
8 Com m ent Bn lun
9 References Ti liu Iham kho
Task 21 Bi lm 21
Title - h Ta d - h
A uthors - a Cc tc gi - a
Editor's n o te - e Ghi ch bin lp - e
Introduction - g N hp - g
Materials a n d m e th o d s - b Cc vt liu v phng p h p - b
Results d Cc kt qu - d
Com m ent - f Bn lun - f
References - c Ti liu tham kho - c
T h e typeface an d linguistic features Cc c dim ngn ng v kiu ch nht/

such as key w ords a n d tenses help cc t kha v thi dng l gip xc d|n h
identify th e parts. cc phn.
Task 22 Bi lm 22
I Objective(s) Mc tiu
2. M e th o d s Phng p h p
3. Resulti Kt qu
4 Conclusions Kt lun

Task 23 B i lm 2 3
1 O bjective 7 for 13 who
2 to Che 8 Results 14 Conclusions
3 Methods 9 to the 15 of
4 of the 10 of 16 H o w ev er
5 of the 11 than 17 not
6 by 12 nor 18 to
Task 24 B i l m 2 4
. ----------
Dear Dr W atson. .
Y our p atient, Mr H u d son , w a s adm itted as an em ergency o n 2 3 February
w i t h a c u t e r e t e n t i o n o f u r i n e d u e t o h is e n l a r g e d p r o s ta te for w h ic h h e w as
aw aiting elective surgery. I
On a d m ission to th e w ard h e w a s still In rapid atrial fib rilla tio n a n d h is
blood p ressu re w as 1 8 0 /1 2 0 . The bladder w as d is te n d e d to th e u m b ilicu s
and p.r. sh ow ed an en larged soft prostate. He w as s e d a te d a n d c a th e te r-
lsed. U rin a ly sis sh o w e d 3 + g lu c o se a n d OTT sh o w ed a d ia b etic cu rv e. He
w as therefore started o n d iet and m etform in 5 0 0 mg t.d.s.
Dr W ilson, ou r p h y sic ia n , Is d ea lin g w ith the cardiac sid e of th in g s before
w e go ahead w ith th e op era tion .
Y ours sin cerely.
---------------- ---------------------------------------------------------------------------------------------
K in h gvli B . s W a tso n ,
B n h n h a n c a b i c B , n g H u d s o n , a c nh p v i n k h n c a p n g a y 23
t h n g 2 v b i t i u c p t i n h d o t u y n t i n l p t o , m n g Ca d a n g c h
c phu th u t ch n l c .
K hi n h p v i n n g t a v n c n t r o n g t i n h t r n g r u n g n h i v c h u y t ap
1 4 1 8 0 / 1 2 0 . B& ng q u a n g r n r n g t i r n v ( ju a n g h u m n k h a m
t h y t u y n t i n l p t o v mm. B n h n h n d c d n g t h u c g i m a u v
dt n a t h n g . X t n g h i m n c t i u c h o t h y c g l u c o s e +++ v x t
n h i m d u n g n p g l u c o s e c h o t h y c d n g c o n g t i u d n g . Do d ,
bnh nhan c a n k i n g v d i u t r b n g m e t f o r m i n 5 0 0 mg n g y 3 l n .
B . s W ils o n t h u c b n h v i n c h n g t i a n g t h e o d i v t im m ch t r c
k h i chung t i t i n h n h p h u thut.
K in h Ch,
You s h o u l d a d d to th e D ia g n o s is se c- Bn nn b sung vo phn chn on:

tion: (3) ? D iab e te s. (3) ? Tiu dng.
English in M edicine - 2 97
Unit 5 Bi 8
Investigations Xt nghim
Task 1 Bi lm 1
2 y o ur left/right side b n tri/bn phi
3. knees h ai d i u gi
4 dow n xung
5. up l n
6. still yn
Ta sk 3 Bi lm 3
1. d 5. g
2. c 6. e
3. a 7. b
4. f
Task 5 Bi lm 5
chest X-ray radioisotope studies b a n u m meal

creatinine se ru m cholesterol MRl scan of th e brain
ECG se ru m thyroxine
lVP (lVU) uric acid
urea a n d electrolytes
urinalysis
Cn th i t C th h u ch K hng cn rhit
X-quang phi; nghin cu ng v ung ban

creatinin phng x c h p hnh i n h cng
in tm cholesterol huyt thanh hng t no
c h p b thn qua tnh m ach thyroxine huyt thanh
(chp ng niu qua tnh m ch) acid uric
ur v cc cht in gii
phn tch nc tiu

Task 6 Bi lm 6
1 chest X-ray, bronchoscopy, sp u tu m ch p X-quang phi, soi ph qun, cy
culture m
2 pelvic ultrasonograph, Hb, EUA a n d siu m vng chu, Hemoglobin, khm
D& c c gy v cm (gy m), v nong& nao
3 serum thyroxine, TSH (hyroxine huyt thanh v ti l h p th
hormon kch tuyn gip
4 cholecystogram, a b dom inal ultra c h p X- quang - (i mt, siu m bng
sonograph
5 Norm ally n o investigations are r e Bnh Ihng khng c n c c xl nghim.
quired. In a hospital situation a p h y Trong iu kin b n h vin, bc si c th
sician m ay choose to give throat chn yu cu ngoy hng, du n trn
swab, m onospot, viral antibodies, lam ktnh, khng th chng virus, ciig
full blood count. ihc mu ton phn,
6 tonom etry do nhn p
Task 8 Bi lm 8
TELEPHONE REPORT FROM

HAEMATOLOGY LABORATORY
P A T IE N T S N A M E U N IT N O
HALL Key in
B L O O D F IL M
W B C X 10/L ................ 7 .2 ........................... N E U T R O .............<?p%.

Hb g/dl .......................... 1 2 .9 ........................ LYM PH .................. 3 0 %
Hcl ................................. 0 , 3 9 ....................... MONO .....................5/o.
MCVfl ............................8 1 ....................... EOSINO..................4%
P late lets X 109/L ........2 6 4 ........................... B A S O ................................
ESR mm ...................... 43 ........................
OTHER INFORMATION
R B C 3 .3 2
burr cells ++
PROTHROMBIN RATIO ..........................................................................................................1

TIME MESSAGE R E C E IV E D .............................................................................. AM/PM
M ESSAGE RECEIVED B Y .................................................................................................
DATE R E C E IV E D .................................................................................................................
BO CO IN THOI T
PHNG XT NGHIM HUYT HC
TN BNH NHN N V| s
HALL Kevin.................................................................................
C N G TH C llAu
S L N G B C H C U X 1 0 * /L . 7 , 2 B C H C U T R U N G T lN H .6 0 %
H em og lob in g / d l ........... . .2 L IM P H B O ......................... 3 0 %

H em ato crite .................Q /.}? ........ B A C H C U M T N H N .. 5%
T h tch t bo trung b in h ....... 81 B A C H C U T O A N T N H . 4%
Tiu cu X 10*/L .......... 2 6 4 ..... B A C M C U K I M T iN H ... 1%

T C L N G M U mm 43
THNG TIN KHC

LNG .H N G .CU 3 ,3 2 ..........................
h ng c hnh khyt ++
T L PR O T H R O M B IN ...................................................................................................... :1
GI NHN XT N G H I M ........................................................................ SANG/CHIU
NGI NHN ...........................................................................................................................
NGY NHN ............................................................................................................................
T ask 9 Bi l m 9
(O th er a n s w e r s a re possible.) (Cc cu tr li khc u c th dc.)
Sodium is elevated. Natri mu cao.

Potassium is raised. Kali mu tng.
Bicarbonate is low. Bicarbonate thp.
Plasma urea is abnorm ally high. Ur mu cao b Ihdng.
T a s k 10 Bi l m 1 0
I co m plained khai l 8 12.9 12,9
2 found n hn thy 9 43 m m 43 miliml
3 normal bnh thng 10 burr hnh (trng) khuyt
4 blocker vi chen II greatly/very nhitVri
5 diuretic li niu 12 50 I 50.1
6 elevated/high/raised ln/cao/lng 13 16 16
7 albumen albumin 14 chronic renal suy t h i n m n tnh
failure
Task 11 Bi lm 11
D ear D r C h a p m a n .
Thank y o u for referrin g th is p leasan t 42-year-old salesm an . T hese ep i
s o d e s o f central ch est p&ln w h ich h e describes w ith radiation to th e L a r m
and Angers so u n d very typical o f angina. P hysical exam in ation w as unre-
v e & lln g .
I have checked v a riou s blood p aram eters Including se ru m c h o le s te r o l, t r i

glyceride and HDL ch olesterol. CXR w as norm al but ex e rc ise ECO sh o w ed
ST depression.
Serum cholesterol w as elevated at 7 .2 mmol/1.
I w ill be seein g him again n ex t w eek to le t h im h av e th e s e r e s u lts . I s h a ll a r
range for him to be seen by th e d ieticia n and p re s c rib e s im v a s ta tin 10 m g at
night. In view o f th e fam ily h isto ry I am s u r e th is w ill be w o rth w h ile .
Yours sin cerely,
Dr Paula Scott
K in h g i B c 81 Chapman
c & m o n b A c a l a c h u y n n n g t h u c m a g l a 4 2 t u i n g ch vl y n y . C c
c o n a u v n g g i a n g c mA n g t a m t k m l a n t a x u n g c n h t a y t r i
v c c n g n t a y c v i n h n h 1A c o n a u t h c n g c . Khm t h u c t h
cha ph&t h i n g c .
T i & k i m t r a c c t h n g 8 0 k h i c n h a u v m u k c A c h o l e s t e r o l h u y t
th a n h , t r i g l y c e r i d e V c h o l e s t e r o l t t r n g c a o . x-qruang n g c b n h
th n g nhung d i n t m d c h o t h y S T g i Am t h l u .
C h o l e s t e r o l h u y t c h a n h c a o t i 7,2 m m o l/1 .
Ti a gp I ng ta VO tu n sa u ch o b i t c c k t qu n y . T i 8
t h u x p n g t a n khdm m t bA c B l v d i n h d u n g v c h o n g t a d * n g
s i m v a s t a t i n 1 0 mg v o b a n m . Xem x t b n h s g i a n h , c i chc
r n g g i i phAp nAy 8 t h i c h h p .
K in h Ch,
Paola G
B . s P a u la S c o t t

Task 12 Bi lm 12
1 Title Ta
2 Authors C c t c gi
3 Sum m ary T m tt
4 Introduction N hp d
5 Patients a n d m e th o d s C c b n h nhn v phuong php
6 Results C c k l qu
7 Discussion Bn lun
8 References Ti liu th am k h o
Task 13 Bi lm 13
a) Title Ta
b) S um m ary T m tt
c) Discussion Bn lun
d) Results C c kt qu
e) Introduction N h p
f) A uthors C c tc gi
g) References Ti liu th am kho
Task 14 Bi lm 14
T h e e x tra c t is fro m P a tie n ts a n d m e Phn trch on ly t cc Bnh nhn v
th o d s . cc phng php.
I or 9 A 17 they
2 of 10 th e 18 fo r/to
3 in II at 19 by
4 before 12 m aking 20 all
5 w ere 13 th e
6 to 14 patients
7 w as I5 on
8 this 16 about

Task 15 Bi lm 15
1 d ia r rh o ea tiu chy
2 m etform in (Glucophage) metformin (Glucophage)
3 three ba
4 cardiac lim
5 d eh y d ra ted mt nc
6 sem i-comatose b n hn m
7 irregular khng d u
8 abdom en bng
9 tenderness mm
10 absent khng c (thiu vng)
I I possible c th dc
12 TUR transurethral resection C11 q u a d n g n iu
Task 16 Bi lm 16
The investigations: Cc xt nghim l:
X-ray c h e s t/a b d o m e n ch p X-quang phi/bung
blood urea a n d electrolytes ur mu V.) c c cht din gii
blood sugar dng trong mu
stool culture cy phn
Unit 6 Bi 6
Making a diagnosis Chn on
Task 1 Bi lm 1
SU R N A M E Nicol_____________________F IR S T N A M E S Harvey
O C C U P A T IO N Office worker__________________________________
c/o h eadaches, L side for 3/ s 2, unrelieved by aspirin.

Initially flu-like symptoms. U nable to sleep.
Slight weight loss. Feels "weak a n d lired".
H Nicol TN Harvey
TUI 59 GII Nam_________ TlNH t r n g h n n h n c v
NG H N G H I P N hn vin vn phng

K h a i c nhc u. Nhc bn tri Irong 3 tun nay, dng aspirin khng khi.
T h o i du ging cc (riu chng b n h cm. Khng ng dc.
Hi sut cn. Cm thy yu v mt".
Task 2 Bi lm 2
(O th er a n s w e r s a re po ssible.) (Cc cu tr li khc u c th c.)
space-occupying lesion tn (hng clion ch
migraine nhc na u
viral fever st nhim virus
aneu ry sm phng m ch
tem poral arteritis v i m n g m c h th i d ng
d epression suy nhc
cervical spondylosis thoi ha t sng c
Task 3 Bi lm 3
tem po ral arteritis v i m n g m c h th i d o n g
migraine nhc na du
d epression suy nhc
unlikely space-occupying lesion, - tn thuong chon ch, st
khng c v viral fever, an e u ry sm nhim virus, phng m jc h
excluded cervical spondylosis - thoi ha dt sng c
loi tr
Investigations full b lo o d c o u n t a n d ESR - cng thc m u ton p h n v
Cc xt nghim t l lng hng c i u
- MRI scan - c h p h ln h n h c n g h ng t
- superficial left te m p o ral - sinh thit ng m *ch nng
artery biopsy thi dong tri

Task 4 Bi lm 4
Raised ESR and polym orphs strongly T l lng hng cu cao v nhiu bch cu
indicate and the biopsy confirm s that n h n mi cho thy v sinh thit xc nh
the patient has temporal cell arteritis. rng bnh nhn b vim ng m ch thi
dng.
Normal MRI scan excludes space- Chp hnh n h cng hng t bnh
occupying lesion. thng loi tr tn thng chon ch.
Task 5 Bi lm 5
1 nephrotic sy n d ro m e hi chng thn h
2 H enoch-Schonlein s y n d ro m e hi chng Henoch-Schonlein
3 mononucleosis, glandular fever tang b ch cu mt nhn, st sng hch
4 cholelithiasis si ng mt
5 scleroderma x cng b
Task 7 Bi lm 7
1 explanation o f cause gii thch nguyn nhn
2 proposed tre a tm e n t iu tr c d ngh
3 warning o f possible o p e ra tio n bo trc v kh n3ng phi phu ihut
Task 8 Bi lm 8
1 T he pancreas is a gland n e a r the t y l mt tuyn gn dy gip cho s
stom ach w hich helps digestion a n d tiu ha VI cng sn sinh insulin.
also m akes insulin.
2 T he thyroid is a gland in th e neck Tuyn gip l mt tuyn vng c v
w hich controls th e rate at w hich ' kim sot mc c th hoat ng ra sao.
y our b o d y works.
3 Fibroids are grow ths in th e w o m b u d an g si l khi u trong l cung khng
w hich are n o t c a n ce ro u s b u t cause phi l ung Ih nhng gy xut huyt
heavy bleeding. nng.
4 E m phy sem a is a co ndition in w h ich Dn p h nang l loi bnh trong cu
the structure o f the lung IS d e s o y e d trc phi b hy hoi v gy kh th.
an d m ak es breathing difficult.
5 An arrhyth m ia is a n irregularity of Lon nhp tim l tnh trng lim p khng
the heartbeat, for e x a m p le w h e n u, vi d nh khi bn c tim p thm
y o u have an extra beat. ting na.
6 Bone m a rr o w is w h e r e th e various Ty xng l ni cc loai t bo mu khc
types o f b lo o d cells are m a d e n h a u c s n x u t.
7 T h e prostate gland p r o d u c e s s o m e T u y n ti n l p s i n x u t m t s d c h c h
of th e secretions w h ich mix w ith se tit d ha l l n vi tinh drch. I khi
men. S om etim es it b e c o m e s e n tuyn d b to ra v gy kh k h in khi tiu
larged a n d causes trouble in passing tin .
water.
8 This is w h a t h a p p e n s w h e n acid y l tin h trn g x y ra khi a c id t
from y o u r s to m ac h c o m e s b ack u p d y b ^ n tro n g c l n th c q u n . iu
into the g u llet It causes heartburn. ny g y ch ng nng.
Task 9 Bi lm 9
1 If th e s to m a c h p r o d u c e s t o o m u c h N u d d y s n xut q u i n h i u acid ,
acid, it m ay cause sto m a c h pain. d i u d c th g y a u d a d y .
2 If a w o m a n g e ts G e r m a n m e a s le s N u p h n m c b n h s i c trong khi
during pregnancy, th e b aby m a y be m a n g th a i, d .1 b c th ra di km
born w ith deformities. nhiu d tt.
3 If you vom it several tim es in quick N u b n n n i n h i u l n li n tip
succession, y ou m ay burst a b lo o d n h a n h , bn- c th l m rch v m a c h
vessel in th e gullet. m u th c q u n .
4 If y o u r sk in is in c o n ta c t w ith c e r ta in N u d a b n ti p x c v i m t s c y , ban
plants, y o u can d e v e lo p dermatitis. c th b v i m da.
5 If y o u r b loo d p ressure rem ains high, N u h u y t p c a b a n v n c a o , b a n c
y ou m a y hav e a stroke. th b t quy
6 If y o u give y o u r b aby t o o m u c h fruit, N u b a n c h o c h u b q u i n h i u tri cy,
h e or sh e will get diarrhoea. c h u bj tiu c h y .
7 If th e cholesterol level in th e b lo o d N u m c c h o le ste r o l trong m i u l n qu
gets t o high, y ou m a y h ave a h ea rt c a o , b n c th l} m i c n a u tim .
attack.
8 If th e re are r e p e a te d injuries to a N u c tn thng li n ti p kh p , d iu
joint, it m a y d e v e lo p arthritic c th lm p h i trin n h n g b i n di
changes. v i m khp.
Task 11 Bi lm 11
a) S u m m ary T m tt
b) Discussion Bn lun
c) Results C c kt qu
d) Introduction N hp d
e) A uthors' affiliations Ngun gc cc lc gi
f) R eferences Ti li u th am k h o
The title of the article is Gender dif Tiu ca bi bo l Nhng khc bit v
ferences in general practitioners at gii c c bc s th c h n h t n g q u t d a n g
work". cng tc.

Task 12 Bi lm 12
I in 14 about 27 for
2 were IS from 28 in
3 about 16 with 29 but
4 of 17 with 30 of
5 of 18 of 3 1 w as
6 of 19 were 32 were
7 of 20 of 33 w as
8 about 21 on 34 w h en
9 about 22 were 35 were
10 were 23 the 36 for
11 who 24 were 37 of
12 for 25 were 38 w ere
13 out 26 of 39 a
Unit 7 Bi 7
Treatment u tr
Ta sks 1 and 2 Cc bi lm 1 v 2
S URNAM E Jam eson____________________ F IR S T N A M E S A lan_______________
AGE 53 SEX . M________________ M A R IT A L S T A T U S M_____________
O CCUPATION Carpenter_________________________________________________
Acute backache referred dow n R sciatic nerve distribution. Began 6/s2 ago and
b ecam e more severe over past 2/52- Affecting work and w aking him al night. Also
c/o tingling in R foot. Wl loss 3 kg. Depressed.
O /E
G e n e r a l C o n d itio n Fit, w e l l- m u s c le d .
ENT NAD
RS NAD
CVS Normal pulsations at femoral popliteal, posterior tibial + dorsalis pedis.
G IS NAD
GUS NAD
CNS Loss of lu m b a r lordosis, s p a s m of R e re c to r sp in a l.
S tra ig h t le g r a is in g R r e s tr ic te d to 4 5 .
Reflexes present & equal. Neurol - depressed R ankle jerk.
Paracetamol helped a little with previous intermittent back pain.
P O IN T S OF N O TE
Carpenter - active work.
1.78 m, 6 8 kg - tall, slightly-built
MRI scan - narrowing of disc sp a ce b etw e en lumbar 4 & 5.
M y e lo g r a m - p o s te rio r la te r a l h e r n ia tio n o f d is c .
D I A G N O S IS
Prolapsed imervertebral disc.
M ANAGEM ENT
dihyrlrocodeine 30 mg 2 q.rl.s p.c.
Bed resl, physio
H Ja m e so n TN Alan
Tui 53 G I I N am T N H T R N G H N N H N C v
N G H N G H I P Th m c
LI K HAI B N H H I N N A Y
au lng c p tnh lan xung vng d y thn kinh ta phi. Bt du l 6 lun l nay
v ngy t n g nng hn t 2 lun nay. Lm n h hng n cng vic v lm thc
gic ban m . Cng khai c au nhi b n ch n phi. St c n ti 3 kg. Suy nhc.
THM KHM
Tng trn g Khe m n h - C b p n nang.
T.M.HNG Khng ph t hin b t thng
H.HP K hng p h t h i n b t thng
T.MCH M ch bnh thng vng khoeo i, sau xng c h y +

mu b n chn.
T.HA Khng p h t hin bt thng
N.DC K hng p h i h i n bt thng
T.KINH Mt cong vng tht lng, co cng c sne lng phi.

N n g c h n phi dui th n g b gii hn 45 .
Cc p hn x c & cn bng. Gim phn X git gt c h n ph 1
T I N S G N Y
Paracetamol c hiu qu cht t vi cn au lng c ch hi trc dy.
G HI C H
Th mc - lao ng nng.
1,78 m, 68 kg, cao, m n h khn h
X T N G H I M
Chp hnh nh cng hng t - H p khoang a m gia cc t sng lng 4 & 5.
Chp ty sng: thot v a b n sau.
CHN ON
Sa da lin t sng.
X TR
dihydrocodeine 30m g 2 vin ngy 4 ln sau khi n.
N m nghi ti ging. Vl l tr liu.
Task 4 Bi lm 4
a) 6 hrly mi 6 gi
b) for pain vl au
c) 100 tablets 100 vin
d> d ih y drocode ine BP dihydrocodeine Dc d i n Anh
e) give cho
f) tablets thuc vin
g) write/label vit/dn n hn
h) a fte r fo o d / m e a ls sau khi 3n/sau ba an
Task 5 Bi lm 5
1 tablets thuc vin
2 tw o hai
3 six su
4 after sau
5 f o o d /m e a ls thc n /b a n
6 can c th
7 p a in dau
Task 6 Bi lm 6
1 Patient 3 Bnh n h n 3
4 Patient 2 Bnh n hn 2
7 Patient 4 Bnh nhn 4
a) twice a day ngy hai ln

b) th ree tim es a day ngy ba ln
Task 7 Bi lm 7
Id 2b 3 e 4c 5a
Task 8 Bi lm 8
1 You should lie o n a h ard surface. ng nn n m trn mt mt p h ln g c n g .
2 You should b e careful w hile getting ng nn cn thn khi ri khi ging, c
o u t o f bed. Try to roll ov er a n d then gng quay ngi n m nghig r6i mi
get u p from y o u r side ngi dy.
3 1 0 - English in M ed ic in e
3 You should (try to) avoid bending ng nn (c) trnh ci ngi v pha
forward, for exam ple, if y o u are trc, v d nh khi nh t vt g sn
picking u p som e thing o ff th e floor. nh.
4 You should try to b e n d y o u r knees ng nn c gng gp u gi v gi
a n d k e e p y o u r back straight. thng sng lng.
5 You should (try to) avoid lifting ng nn (c) trnh n h c vt nng.
heavy weights.

Task
------------T
\
S h e e t No. , Please use a ball p o in t p en
P R E SC R IP T IO N S H E E T
11
O RAL and OTHER NON PARENTERAL MEDICINES - REGULAR PRESCRIPTIONS PLEASE / WHEN M EDICINES A R t
ui Dale fcfeftodo' T im e t of Adm inistration (>*continued PRESCRIBED OH
o Com M EDICINES (Block Letters) DOSE DOCTO01
o Ah A M AM MO PM MN tCMAiunf
o menced 1t 1J J 10 12 Other Times Daw kwtiftU Ffcjd |Aid<* pftscnptcn cttoi
A 16/9/57 ASPIRIN 300 mg po X D6tx Cun
B PARACETAMOL po X / X *n:<o*pa*nj Cfwl
Ifl
c TEMAZEPAM 20 mg po X Anmth*t( Pinaptcn SNd
D ATENOLOL 100 my po X *cad ol lAtcu S*Ml
E 1SOSORBIDE MONONITRATE m /i 60 eng .J t A
CM*
F THYKQXJNE 0 1 000 po /< Bvmtt tc*on P<M* *m**
p 1D m tea tmtom
G TN PUMP SPRAY 400-800 MO aL
H AMLODIPINE 5 mg po MEDICINE ADVERSE REACTION
A
I BE NDROFLUAZIDE 2 5 mg po
J
K
I
PARENTERAL MEDICINES REGULAR PRESCRIPTIONS

M HEPARIN SODIUM &0U A jX 1 DIET
Bi lm
N D1AMORPHINI 5 mo IM 4 h r lj p j D D a l* DETAILS tntiato
o CYCLIZihiE SO mg IM 4 h i hi p i n
p
o
ORAL and OTHER MON-PARENTERAL MEDICINES ONCE ONLY PRESCRIPTIONS ORAL and OTHER MOM-PAREMTERAl MEDICINES ONCE ONLY PAKftCIMPTlOMt
11
Tana * LFmnuF * frX *9 1 r
*DCINE rv x g I
^ W ,
OCC T o w t
- ~V j-* \JrVi <
N A M I O f PATH NT UNfT N UM ftCR CONSULTANT K N O W N DRUQ/IACDICIMI t t M t m v r T Y
W YNNE. Jo h n 58 1563626 MR SW AN
To s ^ V/f Mng bt tu
PHIU K t TOA
TH U C UNG v i TH U C K H N G T I M K H C T O A THNG D N G
DNH d u V VU I V * r /M
Ngay G <JUi>g t\U k CHKY Ngung dung
-< LIU CcA OA t r n
TH U C ( V I ii c/1 J in ftoa; CUA B s Hgy
du 1 1 n 6 ti Cac g n khac Vt lit v d cin t a g *ch (th &
A 15/9/9 7 ASPIRIN 300mg u in g X Biu (lu duOng
B paracetam ol 1a / X / / B4u 06 dng miu
c TEMAZEPAM 20m j / Ptwfa 9|| tttk m
0 ATENOLOL 100mg X H i sa unh tn
E IS0S0R8IDE MONONITRATE n g jm 60m g f
F THYROXINE 0,1 mg / ngng muc * ngn ng c p/n Jno d u t
G iT N BOM KHI DUNG 4 00 '8 00 ug Dock k A thao y*n du 0 * o * d du*
H a m l o d ip in e 5mg / TN THUC PHN UNG BT LOl
1 BENDRORUAZIOE 2.5mg
J
K
I
TH U C TI M TO A THNG D U N G
M HEPARIN SODIUM SOOOu Duo da f N k i n g .
N OIA MORPHINE 5m o Trong CO f> ft* ciu Ngy CHI TIT vtf| UI
0 CYCUZINE 50m q if * ift |M I*<i du
p
Q
THUC UNG v i THUC KHNG TIM KHC TO A CH DNG MT LAN THUC UONG v i THUC KHNG TIM KHC - TO* CH DNG UT LM
LIU Cch C tf K Ngui p h i! G*> Llu Cach Gi dng c ^ o KY Ngi/i pht G
Ngay THUC
OUNG dung G rt dng CUA BS (c n vtl UI) (nu c Ihay d) Ngay TMUC
ONG dng CUA BS (co n v 4 l UI) (n4u c tiay 6>)
English
in Medicine - 313
.
TUI MAN CAM VUI HUOC A BIET
WYNNE. John 58 1563526 SWAN

Discharge Summary (page 2) Phiu tm tdt xut vin (trang 2)
O P E R A T IO N : CABG x4. single sa PHU THUT: C h p dung vng .

phenous grafts to LAD and RCA, s e ng mch vnh x4 lin , ghp Hnh
quential saphenous graft to OM1 and m ch hin dn hng lch trvKT tri v
OM2. ng mch v^nh phi, ghp linh mach
h i n n h n h v a o n h n h th n h t b 1 v i
nhnh th nht b 2.
SURGEON: A. Swan Assistant: PHU THUT VIN: A. Swan . Tr

Mr Dickson GA: Dr Wood Ih: . Dickson Cy m: B.s Wood
IN C IS IO N S : Median sternotomy and NG M : Cl rach gia xang c

right thigh and leg. v di phi v.t chn.
F IN D IN G S : Dense inferior left ven PHT HIN: Seo dy vng th l Irii

tricular scarring, less marked scarring di, s e o khng r vng tht phi di .
of inferior right ventricle. Fair overall Cn co thl tri tt. Bnh dng mach
left ventricular contraction. Diffuse vnh lan ta.Tt c cc m ach u c
coronary artery disease. All vessels kch thc ng k(nh khong 1,5 mm.
measuring about 1.5 mm in diameter.
P U M P P E R F U S I O N DATA: Mem S LIU BM TRUYN: My xy

brane oxygenator, linear flow, aortic mng, dng chy thng, ng thng ng
SVC and IVC cannulae, LV apical vent. mach ch tnh mach ch Irn v lnh
Whole body cooling to 28c, cold cardio- mch ch di, ihng mm thl Iri. H
plegic arrest and topical cardiac hypo thn nhit li 28c, ngng tim lanh v
thermia for the duration of the aortic h nhit do (im gii hn trong thi gian
cross clamp. Aortic cross clamp time 54 kp ngang dng m*ch ch. Thi gian
minutes, total bypass time 103 minutes. kp ngang dng mach ch l 54 pht,
tng Ihi gian ni n g an g l 103 pht.
P R O C E D U R E : Vein was prepared for QUY TRNH: Chun bi tnh m ach lm

use as grafts. Systemic heparin was ad mnh ghp. Dng heparin K iS6ng v
ministered and bypass established, the thc hin dng vng lm th Iri doc
left ventricle was vented, the aorta was thng, dng m^ch ch duc kp ngang
cross-clamped and cold cardioplegic ar v thc hin ngng tim lanh. Tip tyc
rest of the heart obtained. Topical coof- lm lnh khu tr trong thi gian lcep
ing was continued for the duration of the ngang ng m<ich ch.
aortic cross clamp.

Attention was first turned to the first Trc tin, ch n cc nhnh b
and second obtuse marginal branches Ih nht v nhnh b th hai ca ng
of the circumflex coronary artery. The mch vnh m. Nhnh b th nht nm
first obtuse marginal was intramuscular Irong c v c x va o^n gn. Ni lp
with proximal artheroma. It admitted a lc 1,5 mm c ghp vi cc on ghp
1.5 mm occluder and was grafted with sa lnh mch hin, ghp kiu bn-bn bng
phenous sequential grafts, side to side prolene c bit 6/0, cht liu nAy cng
using continuous 6/0 special prolene c dng cho lt c cc nhnh ni bn
which was used for all subsequent distal xa. Phn cui ca mnh ghp tnh mch
anastomoses. The end of this saphenous hin c un cong v ni nhnh vi
graft was recurved and anastom osed nhnh b lhhai quanh mt on Ip tc
to the second obtuse marginal around a 1,75 mm.
1.75 mm occluder.
The left anterior descending was Nhnh mch xung trc Iri c m
opened in its distal half and accepted a phn na xa v c on lp lc 1,5 mm,
1.5 mm occluder around which it was quanh c ghp vi oan duy
grafted with a single length of long sa nht tnh mch hin di.
phenous vein.
Lastly, the right coronary artery was Cui cng, dng mach vnh phi
opened at the crux and again grafted with c m ni giao im v cng dc
a single length of saphenous vein around ghp vi on duy nht di ca tnh mach
a 1.5 mm occluder whilst the cculation hin quanh ni lp tc 1,5 mm Irong khi
was rewarmed. tun hon mu c lm nng li.
The aortic cross clamp was released Kp ngang dng mch ch c tho
and a vented from the left heart and as g v khng kh thng ttim tri v ng
cending aorta. Proximal vein anastomoses mch ch ln. Hon tt cc nhnh ni
to the ascending aorta w ere completed us bn n ng mch ch ln bng pro-
ing continuous 5/0 prolene The heart was lene lin tc 5/0. Tim c kh rung
debrUated into sinus tnythm with a thnh nhp xoang bng chng sc dn v
single counter shock and weaned off ngng lt mch ni ngang bng liu
bypass with minimal adrenalin support. adrenalin ti thiu. Dng protamine sul
Protamine sulphate was administered and fate v iu chnh lng mu. Tho b
blood volume was adjusted. Cannulae ng thng v sa li cc vj (r t ng v
were removed and cannularion and vent thng kh. Bo m t vic cm mu.
sites repaired. Haemostasis was ascer t cc ng dn lu mng ngoi tim v
tained. Pericardial and mediastinal argyle trung tht.
drains were inserted.
C L O S U R E : Routine layered closure NG NGC: ng ngc nhiu lp

with ethibond to sternum , dexon to nh thng l bng ethibond cho xng
prestem al and subcutaneous tissues, c, dexon cho vng Irc c v m di
subcuticular dexon to skin. da, dexon di bao cho dd.
A. Swan A. Swan
Task 14 Bi lm 14
1 coronary artery bypass graft g hp dng vng dng m a c h vnh
2 left anterior descending n h n h xung Iruc (ri
3 right coron ary artery dn g m c h vnh p h i i
4 first o b tu se marginal n h n h b th nht
5 left ventricle/ventricular tht tri/vng tht
Ta sk 16 Bi lm 16
1 A weekly m agazine that gives the Mt tp chl xut bn h n g lun d n g cc
contents pages o f leading scientific (rang ni dung ca nhng l bo khoa
journals hc h ng dti
2 Published in th e USA by th e Institute c xut b n ti Hoa K do Vin Thng
for Scientific Information Inc., Phila tin Khoa hc, Philadelphia
delphia
3 W eekly H n g tun
4 D e p e n d e n t o n co untry - see section Ty theo quc gia - xem p h n chl d n
o n h o w to o rd e r c c h d t mua
Ta sk 17 Bi lm 17
1 l - 8 0 0 - 3 3 6 - 4 4 7 4 (US, C a n a d a an d 1-800-336-4474 (Hoa K, C anada v
Mexico) Mexico)
+ 4 4 - 18 9 5 - 2 7 0 0 16 (E u r o p e , A frica + 4 4 -1 8 9 5 -2 7 0 0 1 6 (chu u. ch u Phi
a n d th e M id d le East) v Trung ng)
2 1 5 - 3 8 6 - 0 10 0 (o th e r parts o f th e 21 5 -386-01 00 (cc vng khc c a th
world) gii)
2 Institute for Scientific Information, Vin Thng tin Khoa hc
Inc.
3 h ttp://w w w .isin et.co m
Ta sk 18 Bi lm 18
1 issue # l, January I, 19 9 6 s # 1, thng ging 1, 1996
2 issue # 4, January 22, 19 9 6 s # 4, thng ging 22, 1996
3 three ba
4 page 2 0 7 o f Current Contents Irang 207 ca M c l c h i n nay
Task 20 Bi lm 20
page 276 trang 276

Task 21 Bi lm 21
1 A c o m p u te r - p ro d u c e d alphabetic Mt bng lit k ch ci qua m y vi tnh
listing o f key w ords in every article ca cc t kha trong mi bi bo v tiu
a n d b o o k title in d e x ed in ea ch issue sch c xp vo b ng clil d n trong
of cc w hich allows you to find mi s ca Mc lc hin nay gip ban
items o f interest lm thy cc mc c quan lm.
2 A m e r ic a n Hoa K
3 W ords that frequently a p p e a r t o C c t thng xul hin cng nhau u
gether are listed as single entries; dc lit k nh nhng muc t n; cc
phrases are standardised to k e e p re cu c quy chun d b o m gi
lated concepts together dc c c khi nim lin quan cng vi
nhau
4 cc Pg = C u rre n t C o n te n ts page; c c pg = trang Mc lc hin nay;
I Pg = Journal page ) Pg = trang bo
1 10 2
2 76
3 Veterinary Pathology Vol. 32 B n h h c Th Y T5p 32 s 1, thcng

No. I January 19 9 5 (L, A) 1.1995 (L,A)
Task 22 Bi lm 2 2
cc Pg I Pg
Trang mc lc liin nay Trang bo
50 34 5
10 8 745
137 29
138 535
183 249
233 22 3
I 19 576
Task 23 Bi lm 23
50 European Journal o f Biochemistry T p c h S in h H a h c c h i u u
10 8 Pathologie Biologie B n h h c S in h H c
I 37 Immunology M i n d c h h c
138 Infection and Im m unity N h i m k h u n v M i n d c h
183 Proceedings o f the Royal Sodety o f B i n b n l u C3 H i H o n g G ia Lon
London, Series B don, Nhm B
2 33 The Lancet T h e Lancet
Ta sk 24 Bi lm 24
1 The Lancet, Vol. 3 47, No. 8 9 9 6 , T h e L a n cet, T p 3 4 7 , s 8 9 9 6 , ngy 27
lanuary 2 7 1996 thng 1 n3m 1996
2 Clinical algorithm for tre a tm e n t of T h ut T o n lm s n g c h o vi c d i u tr st
Plasm odium falciparum malaria in rt d o P la s m o d iu m f a l c ip a r u m d tr e m
children
Ta sk 25 Bi lm 25
b
Ta sk 26 Bi lm 26
Id 2 c 3 e 4 a 5 b
Task 27 Bi lm 27
page 34 I trang 341
Appendix 1 P h lc 1
Language functions Cc chc nng ngn ng
Case-taking Nhn bnh

General information / Personal details Thng tin tng q u t/C c chi tit c nhn
What's y o u r nam e? Tn ng l g?
How old are you? n g bao nhiu tui?
What's y o u r job? Cng vic c a n g l g?
Where d o y o u live? ng sng ti du?
Are you married? ng lp gia nh cha?
Do you sm oke? ng c ht ihuc khng?
How m any d o you s m o k e e a c h day? ng ht bao nhiu iu mi ngy?
Do you drink? ng c ung ru khng?
Beer, w ine or spirits? (UK) U ng bia, ru vang h o c ru m nh
(nc Anh)?
Beer, w ine o r alcohol? (US) Ung bia, ru vang h o c ru m a n h
(H oa K)?
PRESENT ILLNESS BNH HIN THI

Starting the interview Bl du hi bnh
What's b ro u g h t y ou along today? V sao hm nay ng d n dy?
What can I d o for you? Ti c th gip g cho ng no?
What seem s to b e th e p r o b l e m 7 Vn ra sao nhi?
How can I help? Ti c th gip g y?
Asking about duration Hi v thi gian bnh

How long have th e y /h a s it b e e n T bao lu b n h / lm ng kh chu?
bothering you?
How long have you h ad th e m /it? ng b nh th bao lu ri?
W he n did they/it start? Bnh bt u t khi no th?
Asking about location Hi v v tr cn bnh

W h e re d o es it hurt? T h au ch no?
W h e r e is it s o r e 7 T h au u?
S how m e w h e r e the p ro b le m is. Chl cho ti xem au ch no.
W hich part of y our (head) is af (u) ng au ch no?
fected1
D oes it stay in o n e place or d o e s it au n h ih m l ni h a y n h iu r*i k h ic
go a n y w h e re else? na?
Asking about type o f pa in a nd severity Hi v kiu dau v mc trm trng CIO

o f problem bnh
W hat's the pain like7 n g a u ra sao?
W hat kind o f pain is it? ng au kiu g?
C a n y o u describe the p a in 1 ng c th m t cn dau uc ch?
Is It bad e n o u g h to (w ake y o u up)? a u d d n mc lm lng linh dy) ?
D oes it affect yo u r w o r k 7 au c nh ht/ng d n cng vic ca ng
khng?
!5 It c o n tin u o u s o r d o e s it c o m e a n d ng bj au lin lc hay lc c lc khng?
go
H ow long does it last? Cn dau ko di bao lu?
Asking about relieving or aggravating Hi v cc yu l' lm gim hoc tng

factors bnh
Is there anything that m akes it b e t C ci gl lm b nh kh lnAi i khng?
t e r/w o r s e 7
Does anything m a k e it b e t te r /w o r s e 7 Ci g lm bijnh kh ln/ti ii vy?
Asking about precipitating factors Hi v cc yu t thc bnh

W hat seem s to bring it o n 7 Ci g) lm b<Jnh xut hin th?
Does it c o m e o n at any particular Bnh c xy ra vo mt thi Him no
tim e 7 c bil khng?
Asking about medication Hi v tltuc

H ave you tak^n anything for it? ng dng thuc no cha?
Did (the tablets' h e l p 7 Thuc (ung) c hiu qu khng?
Asking about other symptoms Hi v cc triu chng khc

Apart from y o u r (headaches) are Ngoi chng (nhc du) cn c vn l (>
there any o th e r p r o b le m s 7 khc na khng?
Previous health / Past htory Sc khe trc y / Tin s

How have you b e e n k eep ing u p to T trc n nay, ng gi sc IchAe bng
now1 c c h no?
Have you ever b e e n a d m itte d to n g d c ln no n h p vin cha?

hospital7

Have you ever had (headaches) bef Trc y ng d c khi no bi (nhc
ore? u ) cha?
Has there b e e n any change in y our T ln khm trc d n nay, r g (hay di
health since yo u r last visit v sc khe ca ng khng?
Family hulory Bnli s gia dinh

Are your parents alive a n d well? Cha m cu cn sng v khe mnnh
ch?
What did h e /sh e die o P C ng/c b mt v sao vy?
How old was h e /sh e ? C ng/c b dc bao nhiu tui?
Does a n y o n e else in y o u r family suf C ai trong gia dinh cu b bnli ny
fer from this problem ? khng?
Asking about systems Hi v cc h thng

Have you any trouble with (passing ng c kh kh.in khi (cli tiu) khng?
water)?
Any problem s with (your chest)? C vn g (vng ngc) khng?
What's (your appetite) like? ng n thy (ngon ming) ch?
Have you noticed an y (blood in y o ur ng c nhn thy chi (mu Irong phn)
stools)? khng?
Do you ever suffer from (h e a d a c h e s)7 C khi no ng d b (nhc u) chn?
Do (bright lights) b o th e r y o u 7 (n sng) c lm ng kh chu khng?
Have you (a cough)? ng c (ho) khng?
To r e p h r a s e if th e p a t i e n t d o e s n o t u n Nu bnh nhn khng hiu r, nhc li

d ersta nd, try a n o t h e r w a y o f e x p r e s s nn c d n g m t cch ni khc c cng
ing th e s a m e fu nction , for e x a m p le : n gh a, VI d:
W hat caused this? Ci g gy ra chuyn ny?

W hat brought this o n 7 Ci g d n n chuyn ny ih?
Was It so m e thing y ou tried to lift? C phi do ng c nng nhc vt g y
khng?
Examination Thm khm

Preparing the patient Chun b bnh nhi
I'm lust going to (test y o u r reflexes). Ti s (th c c p hn x ca ng).
Id just like to (exam ine y o u r m outh). Ti chl mun (khm ming cho ng).
N o w i'm going to (tap y o u r arm). No ti s (g nh vo cnh tay ng).
I'll lust check y ou r (blood pressure). Ti s k i m (ra (huyt cp) c a ng.
English in M edicine 321

Instructing the patient H u tn g d in ngth bnh
W ould you (strip to the waist), ng vui lng (ci (r in ) duoc c M
please?
C a n you (put y o u r h an d s o n y ou r ng C (h (Hjt hai Uy ln hng) dc
hips)? ch?
C ould you (bend d o w n a n d to u c h ng c th (ci gp ngi v c h j m tay
your toes)7 vo ngn chn) duc khng?
N o w I just w a n t to see y o u (walk By gi ti mun xem ng (di lai) ra sao.
ing)
Lift it up as far as y ou can go, will ng c ih nh c ca o ln hl sc dc
you khng?
Let m e see yo u (standing). No d ti xem ng (ng thng).
Checking i f information is accurate Kim tra xem Ihng tin c chnh xc

khng
That's te n d e r 7 y m m yu p h i i khngf
D o w n here? Di y ?
T h e back o f y o u r leg7 Phta sau c n g c h n ng ?
Confirming information you know Xc nhn thng tin d bit
That's tender. 3y m m yii nhl.
D o w n here Di dy ny.
T h e back o f y o u r leg. Ph(a sau c ng ch n ng d y .
Commenting/reassuring Gii thch/trn an

I'm checking y o u r (heart) now. By gi ti s kim tra (tim) ng.
Thai's fine. Tt ri.
OK, w e've finished now. c ri, xong ngay by gi.
Investigations Cc xt nghim
Explaining purpose Gii ngha m c ch
I'm going to (take a sa m p le o f y o u r b o n e Ti s (ly mt mu ty xiiong ng) d tlm
marrow) to find o u t w h a t s causing nguyn nhn lm ng (thiu mu).
(your anaem ia)

Reassuring Trn an
It w o n 't take long. S khng lu u.
It w on't be sore Khng au u.
I'll be as quick as I can. Ti s lm nhanh ht sc.
Warning Cnh bo
You m ay feel (a bit uncom fortable). ng c th cm thy (khng thoi mi t
cht) dy.
Youll feel a (jab). ng s cm thy (chc nhi) thi.
Discussing investigations Tho lun cc xt nghim
sh o u ld could n e e d not
must
be + required be + not necessary
essential not required
im portant not im portant
indicated
Essential not to do
should not
m u st n o t
be + contraindicated
c n ihici C (h e h u ich Khng cn thit
nn c th khng cn
phi
l + cn th it l + khng cn thit
thit yu khng i hi
q uan trng khng quan Irng
clil nh
N ht th i t khng lm
khng nn
khng duc
l + chng chi nh

M a k in g a d ia g n o s is C hn on
D iscuuing certainty Tho lun mc d ng
Certain Fairly certain Uncertain
Yes is se em s might
m ust could
p r o b a b ly m ay
likely
No can't u n lik e ly p o ssib ly
definitely not
exclude a possibility
rule out
Chc chn Kh c h c chn K hng ch c chn
Cn l c v hn
phi c h c c th
c l ch c l
c kh n1ng
Khng khng th khng c k h n a n g c th
dirt khoi khng
loî tr mi vic c th x iy ra
lo i b
EXPLAIN IN G THE D IA G N O S IS G II T H C H C H A N ON
Sim ple definition Diih ngla di! yin

T he (disc) is a (little p ad o f gristle Ci (dia) l mt (m in h nh sun gia cc
b e tw e e n the b o n es in y o u r back). xng ni sng lng ca ng).
Cause and (fftct N g u yn nhn v hu q i

If" w e b e n d the knee, tension is Nu ch ng la Rp du gi. thi dy ihn
taken off the nerve. kinh khng b cng thng.
W h e n w e straighten It. the nerve Khi chng ta ui thng ra thi dy thn
goes taut kinh b ko cng ra.

TREATM EN T IU TRI
Advising Khuyn co
I advise you to give u p smoking. Ti k h u y n n g n n b hul thuc.
You'll have to cut d o w n o n fatty ng p h i ngng hn cc thc <1n bco.
foods
You m ust rest. n g p h i n g h i ngi.
You should sleep on a hard mattress ng n n ng trn ml ci nm cng.
If you yet up. all y our w eight will N u n g d n g dy, lt c sc n n g c
press d o w n on the disc. th s d xung ci da m .
Don't sit up to eat. D ng ngi m n.
Expressing regret T tic

I'm afraid that (the op era tio n has not Ti e r n g (p h u ih u t ci k h n g th n h
bee n successful). cng).
I'm sorry to have to tell y o u that T i r t bun kh i p h i n i v i a n h rn g
(your father has little chance of ( c h a a n h c t c m a y b in h p liu c ).
recovery)
Appendix 2 P h lc 2
Common medical abbreviations
Cc ch vit tt y khoa thng thng
AB apex beat ling d i p mm lim

abdo. abdom en bong
abdm s(M )tH o) a b d o m e n w ith o u t bng khng c khi u, m m .
m asses, te n d e rn e ss , tang lo (Hoa K)
o r g an o m e g aly (US)
a.c before meals tn/c khi n
ACTH a d r e n o c o r tic o tro p h ic h o r m o n e adrenocorticotrophic hormon
AF atrial fibrillation rung nh
AFP alp h a fo e to p ro te in alphdloetoproiein
A:G a lb u m e n globulin ratio l s albumin globulin
AHA Area H ealth A uthority (UK) s y l khu vc (niic Anh)
AI aortic in c o m p e te n c e h Vdn ng m ach ch
AJ ankle jerk (p h in X) git gn gl
a.m. m o r n in g bui s in g
AN a n te n a ta l trc sinh
AP a n te ro -p o s te rio r In/c-sau
APH a n t e p a r tu m h a e m o r rh a g e chy m<u trc sinh
ARM artificial r u p tu re of m e m b r a n e s rch m ng n hn lao
AS a lim e n tary system h lid ha
ASD atrial septal defect di lt (thng) vch nh
ASHD a r t e r io s c le r o t ic heart dise ase (US) bnh x cng dng m ach lim
(Hoa K)
ASO an tistreptoly sin 0 khng streptolysin o
ATS an tite ta n ic se ru m huy thanh chng un vn
A&w alive an d well sng vA m anh khe
AMA A m e ric a n M edical HI y hc Hoa K
A ssociation
BB bed bath; b la n ket b a th tm xng hoi

BC b o n e c o n d u c tio n dn Iruyn xng
b.d. twice a day ngy hai ln
BF brea st fed b sa
BI b o n e injury ln thng xong
BID b ro u g h t in d e a d chl khi n h p vin
b.i.d. twice a day ngy hai ln
BIPP b is m u th io d o f o r m a n d paraffin b is m u th io d o fo rm v
p a s te b t do p a ra ffin
BM bowel m o v e m e n t nhu ng rui
BMA British Medical Association Hi y hoc nc Anh

BMR basal m e tab olic rate mc chuyn hd c bn
BNF British N ational F orm ulary Cng thc quc gia Anh
BNO bowels no t o p e n e d rul khng m
BO bowels o p e n e d rut m
BP blood pressure huyt p
BPC British P h arm ac eu tica l Codex Dc in nc Anh
BPD bi-parietal d ia m e te r ng knh hdi inh
BS b rea th so u n d s ting th, ph m
BUN blood urea n itrogen (US) nil ur-huy (Hoa Ky)
BWt birth weight trong lng khi sinh
c with vi, km
c h ead p re se n ta tio n ngi u (chm)
Ca. cancer, c a r c in o m a ung th, carcinom
CAD c o ro n a ry artery dise ase bnh ng mch vnh
Capt hea d p r e se n ta tio n ngi u (chm)
CAT coaxial or c o m p u te r is e d axial chp ct lpin ton true ho<
to m o g ra p h y ng true
CABC c o ro n a ry artery bypass graft ghp tnh ng mdch vnh
CBC c o m p le te blood c o u n t (US) cng thc mu lodn phn (Hod
Ky)
CCF congestive ca rd iac failure (UK) suy tim sung huyt (nc Anh)
Chr.CF c h ro n ic ca rd iac failure suy lim mn tnh
Cf. first certificate (UK) chng chi u tin (nc Anh)
CF final certificate (UK) chng ch cui cng (nc Anh)
CFT c o m p le m e n t fixation test xt nghim c inh b th
CHF c h ro n ic h ea rt failure: congestive suy tim mn, suy tim sung huyt
heart failure (US) (Hoa K)
CNS ce n tral n erv o u s system h Ihn kinh Irung ng
CO casualty officer (UK) nhn vin phu Irch thng
vong (nc Anh)
c/o c o m p la in s of khai bnh l
COAD c h ro n ic o b stru c tiv e airways bnh lp lc ng h hp mn
d isease (UK) tnh (nc Anh)
COP c h a n g e o f p la ste r (hay thch cao (b bt)
COPD c hronic o b stru ctiv e p u lm o n a r y bnh lp lc phi mn tnh
disease (US) (Hoa K)
CPN c o m m u n ity psychiatric . n u r s e y t lm Ihn cng ng (nc
(UK) Anh)
creps c re p ita tio n s (UK) (rles US) ran n (nc Anh) (ran Hoa K)
C-section ce sa re a n se ctio n (US) m cesar, m l y th ai (H o a K)
CSF c e re b ro sp in a l fluid dch no ty
CSSD Central Sterile S upply D epot (UK) Kho Cung ng Til Trng Trung
ng (nc Anh)
c su c a th e te r s p e c im e n of urine mu nc liu qiM ng Ihng
English in M ed icin e - 3 2 7
CT cerebral tu m o u r; c o ro n a ry u no. huyl khi mtch vnh
th ro m b o sis
cv cardiovascular lim m ach
CVA ca rdio vasc ula r accident; tai bin lim m ach; tai bin
ce re b ro v a sc u la r a c c id e n t m$ch m u n i o
CVS ca rdio vasc ula r system; h lim m ch; h m ach mu no
ce re b ro v a sc u la r system
Cx cervix c (t cung)
CXR ch est X-ray X-quang phi
D divorced li di
D&c dilatation a n d c u re ttag e nong v nô
DD d a n g e r o u s d rugs thuc nguy hai
DDA D a n g e ro u s D rugs Act (UK) Lut thuc nguy Ha 1(nc Anh)
decub. lying do w n t h nm
DSS D e p a r t m e n t of Social Security Khoa Bio him X hi (nc
(UK) Anh)
D ie d r u n k in cha rg e say ru khi lm vic
dl decilitre dxild
DN District N urse (UK) y t qun (nc Anh)
DNA did n o t a tte n d khng tham d
DOA d e a d o n arrival cht lc n h p vin
DRO D isa b le m e n t R e settle m en t Office vn phng ti inh c ngi
(UK) khuyt tt (nc Anh)
DS d is s e m in a te d sclerosis x cng lan la
DTs deliriu m t r e m e n s cn m s in g c p phi
DU d u o d e n a l ulcer lot l Irng
DVT d e e p v e n o u s th r o m b o s is liuyt khi tinh mch su
D &V d ia rr h o e a a n d v o m itin g tiu ch y v nn I
A diagnosis ch n on
E electrolytes cc cht in gli 1
ECF extracellular fluid (lch ngoi l bo
ECG/EKG (US) ele c tro c a rd io g ra m din lm
ECT electroco nvulsive th e ra p y din tri liu gy co gil
EDC ex p e cted d a te of ihi im d on sinh
c o n f in e m e n t
EDD ex p e cted d a te o f delivery thi im d on s thrfi
EDM early diastolic m u r m u r ling thi lm chng sm
EEG e le c tro e n c e p h a lo g r a m (lin no
ENT ear, n o se an d thro at lai, mi v hong
ESN e d u c atio n ally s u b - n o r m a l hc vn di mc binh thng
ESR erythrocyte s e d im e n ta ti o n rate tc lng mu
ETT exercise to le ra n c e test th nghim dung n ap tp luyn
EUA e x a m in a tio n u n d e r khm bnh co gy v cm Igy
a n a e s th e s i a m)
3 2 8 - English in M e d icin e
F female n
fb finger b rea d th khoi ngn tay
FB foreign body vt la
FBC full blood c o u n t (UK) cng ihc mu lon phan (nc
Anh)
FH foetal heart tim (hai
FHH foelal heart hea rd tim ihai nghe ihy
FHNH foetal heart no t h ea rd tim thai khng nghe thy
fl femtolitre em tolil (= 1 0 15 lt)
FMFF foetal m o v e m e n t first felt thai my (cng) ln u cm
n h jn dc
FPC family p la n n in g clinic (UK) bnh vin k hoch ha gia
nh (nc Anh)
FTAT fluorescent tr e p o n e m a l an tib o d y xl nghim khng ih xon
test khun bng hunh quang
FTBD fit to be detained; full term born c in phi giam gi, thai Ihng
dead cht khi sinh
FTND full te rm n orm al delivery sinh binh thng ihrvg
FUO fever of u n k n o w n origin sl khng r nguyn nhn
g gram gram
GA general a n a es th etic gy m (on Ihn
GB gall b la d d e r ti mt
GC general c o n d itio n lng trng
GCFT gonococcal c o m p le m e n t fixation xt nghim c nh b th lu
test cu khun
CIS g a s tro -intestinal system h d dy-rut (liu ha)
GOT glu ta m ic oxaloacetic transam i glutamic oxaloacelic transami
nase nase
GP G eneral P ractitio ner (UK) thy thuc thc hnh tng qut
(nc Anh)
GPI general paralysis of the insane lit ton thn ca bnh nhn
tm thn
GPT glutam ic pyruvic tra n sa m in a se glutamic pyruvic transaminase
GTN glyceryl trinitrate glyceryl trinitrate
GTT glucose tole ran ce test xt nghim dung np glucose
GU g a stric u l c e r lol d.j dy
GUS genito -u rin a ry system h niu dc
Gyn. gynaecology p h khoa
H b/H g b h ae m o g lo b in hem oglobin
HBP high blood p re ssu re huyt p cao
Hct h a e m a to c rit hematocrit
H &p history a n d physical exam in a tio n b n h s v khm thc th
HP h o u se physician (UK) b c s c quan (nc Anh)
HR heart rate s nhp lim
HS heart so u n d s ting tim
English in Medicine - 329

ICF intracellular fluid djch trong l bAo
ICS intercostal sp a ce khoang lin sn
ID infectious d isease bnh ly nhim
!M in tra m u sc u la r trong c
10 KB intra ocular foreign bo dy vt la trong mt (nhn cu)
IP in -patient: in te rp hala n gea l bnh nhn ni tni: lin d ngn
lay
IQ intelligence q u o tie n t !l S thng minh
ISQ in statu q u o Irong tinh trng hin ihi,
nguyn trang
IU inte rn atio n a l unit n v quc t
IV intrav enou s Irong lnh m ach
IVC inferior vena cava tnh mach ch di
(VP in tra v en o u s p yelog ram chup l) lhAn qua diiftng lnh
mdch
IVU in tra v e n o u s u ro g ra m chup niu qua dng linh m a rh
IZS insulin zinc su sp e n s io n vn dich (hn dich) insulin km
IVD ju g ular v en o u s d istention (US) cng lnh m^ch c (Hoa K)
IVP jugular v en o u s pressure (UK) p lc lnh m ach c (nc Anh)
KUB kid n ey, u r e te r a n d bladder thn, niu qun v bng quang
L left tri
LA left atrium ; local anaesthetic nh tri, gy v c i m (gy t)
UD left axis deviation: left a n te rio r lch Inic tri; n h nh xung Iri
d e s c e n d in g Irc
LBP low bac k pain: low blood p re ssu re dau vng di lung, huy p
thp
LDH lactic d e h y d ro g e n ase lactic dehydrogenase
LE cells lup u s ery th e m a to su s cells t bo lpt ban d
LFTS liver fu n c tio n tests th nghim chc nng gan
LHA Local H ea lth Authority (UK) S y t'ja phng (nc Anh)
L1F left iliac fossa h chu (ri
LIH left inguinal hernia thoi VI ben tri
LKS liver, kidney an d spleen gan, thn v lch
LLL left low er lobe thy di (ri
LLQ left low er quadrant phn lu di ir i
LMN low er m o t o r neurone nron vn ng di
LMP last m en stru al period; left m e n t o chu k kinh rui.ngi thai cm
p o s t e r i o r position of foetus sau tri
LOA left occipito-anterior positio n of ngi thii chm Iruc Iri
foetus
LOP left occipito-posterior position of ngi thai chm sau [ri
foetus
LP l u m b a r p u n c tu re chc lv sng
LSCS lo w e r s e g m e n t caesarean section ct m ( cung oan dkJi
3 3 0 - English in M ed icine
LUA left u p p e r arm cnh lay trn tri
LUQ left u p p e r q u a d r a n t phn t Irn Iri
LV left ventricle; lu m b a r vertebra tht Iri.l sng tht lng
LVE left ven tricular en la rg e m e n t dn to Ih tri
LVF left v en tricula r failure suy tht tri
LVH left v en tricu la r h y p e r tr o p h y ph dai tht tri
M male nam
M/F: M/W /S m a le/fem ale; m a rr ie d / nam/n, c v chng/gcVc
w idow (er)/single (hn
MCD m e an c o rp u sc u la r d ia m e te r ng knh laing bnh t bo
mu
MCH m e a n c o rp u sc u la r hae m o g lo b in hemoglobin trung binh ca
hng cu
MCHC m e a n c o rp u sc u la r h ae m o g lo b in nng hemoglobin trung binh
c o n c e n tra tio n cd hng cu
MCL m id-clavicular line ng gia xng on
MCV m e a n c o r p u s c u la r volu m e th tch trung binh l bo mu
MDM m id diastolic m u r m u r ling thi gia lm Irng
mg milligram miligrdm
Ml m it r a l in c o m p e t e n c e in s u f fi h van hai l, nlii m<u ctim
c ie n c y ; m y o c a r d ia l in fa r c tio n
Mine give cho
ml m illilitr e mililt
MMR m ass m in ia tu r e rad io g rap h y chp X-quang khi thu nh
MO Medical Officer (UK) nhn vin y l Inr Anh)
MOH Medical Officer of H ealth (UK) nhn vin phc vu sc khe
(nc Anh)
MOP m edical o u t- p a t ie n t bnh nhn ngodi (ru
m/r m odified release Ihay i khi gim nhe
MRC Medical Research Council (UK) Hi ng nghin cu y hoc
(nc Anh)
MRI m a g n etic re s o n a n c e im aging hnh nh cng hng t
MS mitral stenosis; m ultiple sclerosis; hp hai l, x cng nhiu ni. c
m u sc u lo skeletal xng
MSU m id - s tr e a m u rin e nc tiu gia dng
MSSU m id - s tr e a m s p e c im e n of u rin e mu nc liu gia dng
MSW Medical Social W orker (UK) nhn vin y t x hi (nc
Anh)
MVP mitral valve p ro lap se sa van hai l
NA not app lica ble khng ng dung dc
NAD no a b n o r m a lity d e te c te d khng phi hin bd thng
NBI no b o n e injury khng ln thng xng
ND n o rm a l delivery s in h th n g

NE not engaged khng k)l (ngi), khng lin
quan
NIC National I n su ra n c e Certificate chng chi b i o him quc gu
(UK) (nuc Anh)
NND n eo natal d e a th chi ngay sinh
nocte at night trong m
NP not p alp ab le khng s thy
NPU no t p as sed urin e khng tiu dJPC
NS nerv ous system h thn kinh
NSA no significant a b n o rm a lity khng c bt thung ng k
NSI'CC N ational Society for th e P re v e n Hi quc gia phng chng bao
tion ofC ru elty to C hildren (UK) lc di vi Ir e m (nc Anh)
NYU not yet d ia g n o sed cha ch n don dc
OA on adm ission: oste o -a rlh ritis lc nhAp vin, vim xng-

khp
OAP old age p e n s io n e r ngi hun Irl gi
OBS organic brain s y n d r o m e hi chng thc th no
O/E o n e x a m in a tio n lc khm bnh
oed. oedem a ph
OM otitis m e d ia vim tai gia
OR o p e ra tin g ro o m (US) phng m (Hoa K)
OT o p e r a tin g th e a tr e (UK) phng m (nc Anh)
p pulse; protein nhp mach/prolein

Para. 2 + 1 full te rm p r e g n a n c ie s 2. a b o rtio n s sinh thng 2 ln + ph thai 1
1 ln
PAT paroxysm al atrial ta chycardia nhp lm nh nhanh kch phi
PBI protein b o u n d iodine lode gn proiein
p.c. after food sau khi n
PDA p a te n t d u c tu s a rte riosus c.n ng ng mach
PER LA pupils equal an d reactive to light ng l hai bn rlu nhau c
and a c c o m m o d a t io n phn xa V I nh vA diu
tit
PET p r e-ec lam p tic toxaem ia nhim c thai 1ln sn giAt
PID p rolapsed iruervertebral disc; p e l sa a d m lin dt sng.bnh
vic in fla m m ato ry d isease vim vng chu
PI. pla sm a huyl lng
p .m . afternoon 1'Ui Ird
PM p o stm o rte m SHU ehi
PMB p o s tm e n o p a u s a l bleeding ch;v rndu U u m<in kinh
PN p ostna ta l sau <mh
PN D p o stna ta l d e p r e s s i o n ; paroxvsm al suy nhc u sinh. ( nn kh) th
n o c tu rn a l d y s p n o e a k c h p h i t r o n g (im
P02 p ressu re of oxygen cp suAl oxv
P.O.. by m o u th qua ming ( ung)
POP plaster of Paris Ih^ch Cd0 Paris
PPH p o s tp a rtu m h a e m o r rh a g e chy m<iu sau sinh
p.r. p e r rec tu m qua trc Irng
p.r.n. as requ ired Iheo yu cu
PROM p r e m a tu r e r u p tu re of m e m b r a n e s rch mng sm (non)
PSW Psychiatric Social Worker (UK) nhn vin lm thn x hi
(nc Anh)
PU passed urine; pep tic ulcer i tiu; lot ming ni liu ha
PUO pyrexia of u n k n o w n or u n c e rta in st khng r nguyn nhn
origin
p.v. per vaginam qua m dao
PVT paroxysm al ventricular n hiptm th nhtinh kch phi
tachycardia
PZI p r o t a m i n e zinc insulin protamine zinc insulin
q.d.s./q.i.d. four tim e s a d ay ngy bn ln
R right; respiration; red bn phi, h hp. d-

K, take (used in prescriptions) dng (ghi Irn loa thucl
RA r h e u m a to id arthritis; right atrium vim khpdang Ihp, nh phi
RAD right axis d ev iatio n lch Irc phi
RBC red blood cell cou n t; red blood s lng hng cu, hng cu
co rpu scles
RBS ra n d o m b lood sug a r ng Irong mu ngu nhin
RCA right c o r o n a ry artery ng mch vnh phi
ref. refer tham kho
reg. regular u n
RGN Registered G eneral N urse V ( (ng qut ng k
Rh. R hesus factor; r h e u m a tis m yu t Rhesus; vim thp
RHA Regional H ea lth A uthority (UK) S y t vng (nc Anh)
Rl respiratory infection nhim khun ng h hp
RIF right iliac fossa h chu phi
RIH right inguinal hern ia thot v bn phi
RLL right lower lobe Ihy di phi
RLQ right low er q u a d r a n t phn t di phi
RMO Regional o r R esident Medical nhn vin y t ni tr hoc vng
Offier (UK) (nc Anh)
ROA right occipital a n te rio r chm trc phi
ROM range of m o tio n tm vn ng
ROP right occipital p oste rior chm sau phi
RS respiratory system h thng h hp
RTA road traffic ac cident lai n<jn giao ihng tlng b
R TC return 10 clinic Ir li nhp vin
RUA right u p p e r arm phn (rn cnh lay phi
RU right u p p e r q u a d r a n t phn l Irn phi
English in Medicine - 333
RTI respiratory tract infection nhim k huin ung h hp
RVE right v e n tric u la r e n la r g e m e n t d i n to th l phi
RVH right ven tricu la r h y p e n r o p h y phi d*i thl phi
s single; sugar (lc thn/dung

SAH su b a ra c h n o id a l h a e m o r r h a g e xul huyt doi mng nhn
SB still-born cht lc ra di
SBE su b - a c u te bacterial e n d o c a rd itis vim ni lm mac VI khun bn
Cp
s.c. s u b c u ta n e o u s (li da
SEN State Enrolled N u rs e (UK y l bin ch quc gia (nc
Anh)
sep. s e p a ra te d phn cch, lch ri
SG specific gravity Irng lng ring (d c hiu)
SHO S enior H o u se Officer (UK) nhn vin y t c p cao (ru/c
Anh)
SI sacro-iliac vng cng-chu
sig. write / label (in prescriptions) vit/nhn (trn loa thuc)
s.l. sublingual di li
SM systolic m u r m u r ting (hi lm Ihu
SMR s u b - m u c o u s rese ction ct dui nim mac
SN stu d e n t n u r s e (UK) hc sinh y l (nc Anh)
SOB sh o rt of b re a th hl hi, kh thd
SOBOE sh o rt of b r e a th o n exertion hl hi khi gng sc
SOP surgical o u t- p a tie n ts bnh nhn phu thut ngoai lni
SRN State Registered N urse (UK) y l dang Ic quc gia (nc Anh)
SROM s p o n ta n e o u s r u p tu r e of rch m ng l pht
m em branes
STs san itary towels bng v sinh ph n
SVC su p e rio r v e n a cava tnh m ach ch trn
SVD s p o n t a n e o u s vertex delivery i ngi inh l nhin
SWD s h o r t w av e d i a t h e r m y din nhit sng ngn
T te m p e r a t u r e nliil
tabs tablets thuc vin
T &A tonsils a n d a d e n o id s am idan v V.A. (hach hng)
TB tu b e rc u lo sis b<)nh lao
t.d.s./t.i.d. th ree tim es daily n(;y ba ln
T1 tricuspid in c o m p e t e n c e h(i van ba l
TLA tran sien t isc h ae m ic attack cc/n bnh thong qua
TMj te m p o r o m a n d ib u la r joint khp thi ding hm di
TNS tr a n s c u ta n e o u s nerve stim u la to r my kch thch thn kinh qua
da
TOP te rm in a tio n of p re g n a n c y kt ihc thai k
TPHA tr e p o n e m a p a llid u m h a e m a gg lu- xl nghim mu kt dinh Irepo-
tinatio n nem a pallidum u on khun)
TPR te m p e ra tu re , pulse, respiration nhit d. nhp mch, h hp
TR te m p o r a r y resid e n t (UK) ni tr tam thi (nc Anh).
TS tricuspid stenosis hp van ba l
TSH thyroid stim u la tin g h o r m o n e hormon kch luyn gip
TT te ta n u s toxoid; tu b e rc u lin tested dng c ( un vn, Ih
nghim tuberculin
TV tr ic h o m o n a s vaginalis trichomonas m ao
TUR tran su re th ra J p r o s ta t e rese ction ct tuyt tin lpqua niu o
u urea ur
u &E urea a n d electrolytes ur v cc cht in gii
GS urogenital system h niu-(sinh) dc
UMN u p p e r m o to r n e u r o n e nron vn ng trn
URTI u p p e r respiratory tract infection nhim khun ng h hp
trn
USP U nited States P h a rm a c o p e ic Dc in Hoa K
UVL ultra-violet light tia cc lm
VD venereal d isease bnh hoa liu

VDRL venereal dise ase rese arch la b o ra phng xt nghim nghin cu
tory bnh hoa liu
VE vaginal e x a m in a tio n khm m o
VI Virgo in ta cta (hiu n cn Irinh
VP ven o u s p re s s u r e p xut tnh mach
VSD ven tricu la r se p tal defect d ll vch lm tht (thng lin
tht)
w varicose vein(s) gin lnh mch
Vx vertex inh u
w w id o w /w id o w e r ga v/ga chng
WBC w hite b loo d cell c oun t; white s lng bch cu/bch cu
blood c o rp u sc les
WNL w ithin n o r m a l limits trong cc gii hn bnh thng
WR W a s s e r m a n n rea ctio n phn ng Wassermann
XR X-ray X-quang
YOB year of birth n m sinh
Appendix 3 PH L C 3
Whos who in the British hospital system
Cc chc danh ong h thng bnh vin Anh
CO N SU LTA NT BC Si THAM VAN

T h e m o s t s e n io r p o s it io n h e ld b y phy V tr cao n h t c m n h i m bi mt
s ic ia n s o r s u r g e o n s w ith t h e h ig h e s t thy thuc hoc m t thy thuc ngoi
qu a lific a tio n s, e.g. FRCS, M RCP, a n d khoa c vn b ng cao nht, v d FRCS,
w h o h a v e c o m p l e t e d a p r o g r a m m e of MRCP, v n h n g ngi hon tt
higher s p e c ia list training.* chng trnh o to chuyn vin cp
cao.
SPECIALIST REGISTRAR BC Si CHUYN KHOA TRONG NGCH

(BIN CH)
A p o s itio n h e ld b y a d o c t o r w ith th e V tr c m n h i m bi m t bc s c
highest d e g r e e in a c h o s e n s p e c ia lity vn bng cao n h t o n g m t chuyn
w h o is fo llo w in g a p r o g r a m m e o f khoa chn la v theo m t chng
h ig h e r s p e c ia list tr a i n i n g to e n a b l e trnh o to chuyn vin cp cao d c
h im or h e r to b e i n c l u d e d o n t h e S p e th c xp vo Ngch chuyn vin, xp
cialist Register. I n c lu s i o n o n th is r e g is h n g vo ngch ny gip cho bc s c th
ter m a k e s t h e d o c t o r eligible for c chn vo v tri bc s tham vn.
c o n s u l t a n t po sts.
ASSOCIATE SPECIALIST BC S CHUYN KHOA PH T

A s e n io r p o s it io n w h e r e t h e h o l d e r is V tr cao nn ngi v tr ny c ju
r e s p o n s i b le t a n a m e d c o n s u l t a n t . trch n h i m vi m t bc s c chc danh
A ssociate S p ecialists m u s t h a v e at th a m vn. Bc s chuyn khoa ph t i phi
least 10 y e a r s e x p e r i e n c e s in c e r e g is c ti thiu 10 n m kinh n gh i m k t khi
tra tio n b u t a r e n o t r e q u ir e d to h a v e a vo ngch n h ng khng i hi phi c
.higher q u a lif ic a tio n a n d d o n o t p r o m t ch ng n h n cao hn v khng vo
c e e d to c o n s u l t a n t level. dc m c tham vn.
'N o t e that C o n su ltan ts an d S p ec ialis t R eg is c n ch rAng cc BAc si th a m v n vA BAc s

trars w h o are surgeons d ro p th e title D r an d c h u y n k h o a Irn n g n g a c h IA ih A y Ih c n g o i
are addressed as M r / M r s / M s / M i s s khcw th khng cn m ang hm bc si na mA
c nti danh IA n g/B /C
STAFF D O C T O R BC S IU TR|
A d o c t o r w h o e x e rcise s a n i n t e r m e d i Bc s thc hin m c trung gian v trch
ate level o f clinical r e s p o n s ib ility as n h im lm sng nh m t ngi c y
d e le g a te d by c o n s u lta n ts . S taff d o c q u yn bi bc s tham vn. Bc s iu tr
tors d o n o t p r o c e e d to c o n s u l t a n t khng vo c mc tham vn.
level.
SENIOR HOUSE OFFICER BC S TRNG THC TP

A o n e year a p p o i n t m e n t (usually r e s i V tr ch nh trong m t nm (lm
dential) h e ld by a d o c t o r w h o is s t u d y thng tr) c m n him bi m t bc
ing for a h ig h e r q u alifica tio n . s ang theo hc m t vn bng cao hn.
HOUSE OFFICER BC S THC TP

A p o sitio n h e ld by a d o c t o r w h o h a s V tr c m n h i m bi mt bc s
c o m p le te d t h e p r e - r e g is tr a t io n year. hon tt m t nm chun b nhp ngch
(bin ch).
PRE-REGISTRATION HOUSE OFFICER BC Si DANG THC TP

A p o sitio n h e ld by a n e w ly q u a lifie d V tr trong m t nm c m nhim bi
d o cto r for o n e year, p r io r to full r e g is m t bc s mi tt nghip, trc khi c
tration. chnh thc nhp ngch (bin ch).
DIRECTOR OF NURSING SERVICES TRNG V T BNH VIN

The m o s t s e n io r p o s it io n in n u r s i n g V tr cao n h t trong ngnh y t.
a d m in is tra tio n .
SENIOR NURSE Y T TRNG

A se n io r m a n a g e m e n t p o s itio n . V tr cao cp trong diu hnh.
DEPARTMENTAL SISTER Y T T RU N G CP
A s e n io r p o s itio n for a n u r s e w ith e x V tr cao d n h cho y t c kinh nghim v
p e r ie n c e a n d e i t h e r SRN o r RGN ( th re e l SRN hoc RGN (ba nm o to).
years' trainin g).
WARD SISTER Y T TRI (KHU) IU TR

A qualified a n d e x p e r i e n c e d n u r s e , Mt y t c vn bng v kinh nghim chu
w ith overall r e s p o n s ib ility for a w a r d . trch nhim ton b tri (khu) iu tr.
STAFF NURSE Y T H N H C H N H
First p o s t for a S R N /R G N q u a lifie d V tr u tin d n h cho y t c vn bng

n u rse . SRN/RGN.
STATE ENROLLED NURSE Y T CHUYN KHOA
A p o s t h e ld b y a n u r s e w h o h a s c o m V tr dm n h i m bi m t y t hon tt
p le te d a tw o - y e a r tr a i n i n g c o u rse . hai n m do to n gn hn.
NURSING AUXILIARY/NURSING H L/Y C N C

ASSISTANT
U n t r a i n e d n u r s i n g as s is ta n ts . Nhn vin tr gip y t cha c o to.
Appendix 4 P h l c 4
A broad equivalence of positions in the NHS and us

hospital systems
Bng tng ng cc chc v trong cc h thng
bnh vin Anh v Hoa K
N H S Hospital US Hospital
C onsultant A ttending Physician
Specialist Registrar Senior Resident
Associate Specialist
Staff G rade
Senior H o u se Officer Resident
Pre-registration H o u se Officer Intern
B n h vin A nh B n h uin H oa Ky
Bc si th a m vn Thy th u c diu h n h
Bc si c h u y n k h o a Trng T hng Ir
Bc si c h u y n k h o a p h l
Bc si Trung k h o a
Bc si Trung T hc tp T hng tr
Bc si a n g th c tp Ni tr
Appendix 5 P h lc 5
Useful addresses Cc a chi hu ch
British A nh
British Medical Association Hi y hc Anh
BMA H o u se
Tavistock S quare
L o n d o n W C I H 9|R
Council for Postgraduate Medical Educa- Hi dng Gi.o d c Y khoa sau dai hoc
tion in England and W ales nc Anh v x W ales
7 M a ry le b o n e Road
L o n d o n N W I 5H H
D epartm ent of Health y ban sc khe

R ic h m o n d H o u se
7 9 Whitehall
L o n d o n S W I A 2NS
General Medical Council Hi ng y khoa tng q u i

17 8 G re at Portland Street
L o n d o n W I N 6|E
United Kingdom Central . Council for Hi ng Trung ng ca ndc Anh v Y

Nursing, Midwifery and H ealth Visiting t, H sinh v c h m sc sc khe
23 P ortland Place
L o n d o n W I N 3 AF
Medical Defence Union Hi bo v y khoa

3 D ev o n sh ire Place
L o n d o n w 1N 2EA
Medical and Dental Defence Union of Hi B io v y khoa v nha khoa vng

Scotland Scotland
M ackintosh H ouse,
120 B lythsw ood Street
G lasgow G 2 4 EH
Medical Practitioners' Union Hi thy thuc h n h ngh

7 9 C a m d e n R oad
L o n d o n N W I 9ES

Medical Protection Society Hip hi bo v y khoa
50 Hallam Street
L o n d o n W I N 6D E
Medical Research Council Hi ng nghin cu y khoa

2 0 Park C rescent
L o n d o n W I N 3 PA
Royal College of General Practitioners Trng Hong gia cc ihy thuc llic
hnh tng qut
14 Princes C a te
H y d e Park
L o n d o n SW 7 I PU
Royal College of Midwives Trng Hong gia cc n h sinh

I 5 Mansfield Street
Lon d on w 1M OBE
Royal College of Physicians of London Trng Hong gia cc thy thuc ca

London
I I St A n d re w 's Place
Regents Park
L o n d o n N W I 4LE
Royal College of Surgeons of England Trng Hong gia cc thy ihuc ngoi
khoa ca nc Anh
3 5 - 4 3 Lincoln's Inn Fields
L o n d o n W C 2 A 3PN
American M
American Medical Association Hi y hc M
5 1 5 N State Street
C hica go IL 6 0 6 1 0
A merican A ca d e m y of Family Physicians Vin h n l m cc Ihy thuc gia n h M

8 8 8 0 W a rd Parkway
Kansas City M O 64 I 14
American College of Physicians Trng cc thy thuc M

6 th & Race Sts
I n d e p e n d e n c e Mall w
Philadelphia PA 1 9 1 0 6

American College of Surgeons Trung c c ihy thuc ngoai khoa M
55 E Ene Street
Chicago IL 6 0 6 1 I
American Federation for Clinical Re- Lin hi p nghin cu lm sAng M

search
University o f W a shington
Children's O rth o p e d ic Hospital a n d Medical C e n te r
P O Box C - 5 3 7 1 Seattle W A 9 8 1 0 5
American Hospital Association H ip hi b n h vin M

8 4 0 N Lake S hore Drive
C hicago IL 6061 I
Educational Commission for Foreign y ban gio <}c c c b c si y khoa ngooi

Medical Graduates . quc
3 6 2 4 M arket Street
Philadelphia P E N N 1 9 1 0 4 - 2 6 8 5
Southern Medical Association Hi V hoc m in N am

35 L ak eshore Drive
P O Box 6 3 6 5 6 Birmingham AL 3 5 2 1 9 0 0 8 8

Supplementary activities
C c hot ng b sung
1 Exploiting case histories K/iai thc cc bnh n

C ase histo rie s p ro v id e a rich s o u r c e of Cc bnh n cung cp ngun p h o n g ph
m a teria ls a n d c a n b e f o u n d in jo u r n a l s vt liu v c th tim thy trong cc bo
acro ss a w id e ra n g e o f s p e c ia lisa tio n s. trn lnh vc rng ln ca cc chuyn
T hey c a n also be f o u n d in p r a c tic e khoa. Cc bnh n cng c th tm thy
boo klets for Royal college ex a m s. T h e y trong cc cun sch nh thc hnh dng
can b e exp lo ite d in m a n y ways. As a cho cc k thi ca Trng Hong gia. Cc
startin g p o in t for a u t h e n t i c p r o b l e m bnh n c th c khai thc theo nhiu
solving activity th e y le n d th e m s e lv e s cch. Nh m t im xut pht cho hot
naturally to ta s k - b a s e d le arn in g . ng gii quyt vn d tht s, bn thn
chng ng gp t nhin vo cch hc
da trn bi lm.
Here are a few su g g e s tio n s : y l m t vi gi :
To develop reading skills pht tnn k nng dc

For e x a m p le , a s im p le s c a n n i n g a c ti V d, m t hot ng xem xt bnh n
vity (see U n it 1 T a s k 11). n gin (xem Bi 1 Bi lm 11).
As a starting point for information- N h m t i m x u t p h t cho cc h o a i

transfer activities n g d i cliu y n th n g tin
O n e m o d e of text is tr a n s f e r r r e d to Mt kiu bi dc di chuyn thnh mt
a n o t h e r lext type, for e x a m p le , w h e r e dng bi khc, v d, thng tin t mt bo
i n f o rm a tio n fro m a c a s e r e p o r t is co trng hp dc chuyn dng thnh
t r a n s f o r m e d in to c a se n o t e s o r vice cc ghi ch trng hp hoc ngc li,
versa, or u s e d as a s o u r c e of i n f o r m a hoc c dng n h ngun thng tin
tion for th e c o m p l e t i o n o f a fo rm o r a hon chnh m t m u n hoc m t bc
le tter (see U n it 5 T a sk 15). th (xem Bi 5 Bi lm 15).
As the basis for a role-play N h co s cho vic n g v a i

For ex a m p le , p airs o f s t u d e n t s are V d, n h ng di sinh vin c trao cc
given diffe ren t c a s e r e p o r t s from bo co trng hp khc nhau h ly
w h ic h th e y take c a s e n o t e s a n d u se cc ghi ch trng hp nh l c s cho
th e m as ilie b a s is for d o c t o r / p a t i e n t vic dng vai bc si/bnh nhn. Ngi
role-play. T h e p e r s o n ta k in g th e role dng vai bc s ly cc ghi ch c th so

of th e d o c t o r ta k e s n o t e s w h i c h c a n b e s n h cc ghi ch ny vi cc ghi ch ca
c o m p a r e d with the "patients notes" b n h nhn* vo lc kt th c cuc hp.
at th e e n d o f t h e se s s io n . At t h e e x a m i giai on khm b n h bc s cho chi
n a tio n s ta g e t h e " d o c to r " gives a n i n nh v cc cuc khm b n h v cc xt
d ic a tio n o f t h e e x a m i n a t i o n s a n d n ghi m tht thch hp v n h n c cc
in v e stig a tio n s felt to b e a p p r o p r i a t e kt qu yu cu. Ri chn on v diu
a n d is given t h e re su lts r e q u e s t e d . D i tr c bn lun v giai on gii ngha
ag n o s is a n d t r e a t m e n t a r e t h e n d i s ng vai. Thng c hiu q u i hn nu c
c u s s e d a n d t h e e x p l a n a t i o n s ta g e role- n h n g giai on chun b cho vic ng
played. It is u su a lly m o r e p r o d u c t i v e if vai. iu ny i hi cc sinh vin s dng
th e r e a r e p r e p a r a t i o n s ta g e s to t h e cng loi vai lm vic ch u n g vi nhau v
role-play. T h is involv es s t u d e n t s w h o ngn ng v cc cu hi trc khi bc
will play t h e s a m e role w o r k i n g t o vo giai on ng vai, n h vy to nn
gether on the language an d q u estio n s m t cch tip cn tp trung hn cho vic
b e f o r e e n t e r i n g t h e r o le - p la y s ta g e as s dng ngn ng thch hp.
this allow s for a m o r e f o c u s e d a p
p r o a c h to th e u s e o f a p p r o p r i a t e l a n
guage.
2 Using tht learner as a source S d n g ng i hc n h m l ngun

D o c to rs c a n p r o d u c e th e ir o w n c a s e Cc bc s c th to ra n h n g b nh n
histories to w o rk f r o m . T h e s e p r o v id e a ring ca h d t lm vic. Cc bnh
b a n k of m a te r ia l w h ic h c a n b e u s e d n ny cung cp m t ngn h n g vt liu
w ith f u tu re g ro u p s. T h e s t u d e n t role- c th c s dng cho cc n h m sau.
plays c a n also b e v i d e o e d or r e c o r d e d Sinh vin ng vai cng c th c quay
for u s e in lis te n in g ac tivitie s w ith o t h e r video hoc ghi m s d n g cho cc
s tu d e n ts . hot ng nghe vi cc sinh vin khc.
R e co rd in g s o f d e s c r i p t i o n s / i n s u c - N hng bng ghi m v' cc m t/hng
t i o n s / e x p l a n a t i o n s o f d if fe r e n t e x a m i dn/gii ngha v cc cuc khm bnh
n a t io n s d o n e in p a irs ( p e r h a p s in khc nhau thc hin theo i (c th
a n o t h e r ro o m ) c a n b e p la y e d b a c k to trong m t phng khc) c th c quay
th e class for lis te n in g p u r p o s e s , for e x li cho lp hc n h m cc m c ch nghe,
am p le , d e c id in g w h a t t h e e x a m i n a v d, quyt nh xem loi khm bnh/xt
tio n / in v e s t i g a t i o n is, t h e k in d of n g h i m no, loi tinh trng c th dc
c o n d i tio n s t h a t m i g h t b e b e i n g c o n quan tm, b nh n h n c th c chm
sid e re d , h o w t h e p a t i e n t m i g h t b e s c ra sao v .v ...
m a n a g e d , etc.

3 Other language work activities based Cc liot dng ngn ng khc da trn
on form or case notes cc mu dan hoc cc bnh n
For ex a m p le , a b b r e v ia ti o n w o rk (see V d. hot ng v t vit tt (xem Bi 1
Unit 1 Task 6) a n d q u e s t i o n f o rm s (see Bi lm 6) v nh n g dng cu hi (xem
Unit 1 T ask 2. U nit 2 T ask 7). Bi 1 Bi lm 2, Bi 2 Bi lm 7).
4 Cloze exercises Cc bi tp (tin ch trng

See U nit 6 T ask 12. Xem Bi 6 Bi lm 12.
5 W ork on m edical articles Lm vic trn cc bi bo y khoa

Sec U nit 5 T asks 13 a n d 14, U nit 6 Xem Bi 5 Cc bi lm 13 v 14, Bi 6 Cc
Tasks 11 a n d 12. bi lm 11 v 12.
The s a m e t e c h n i q u e s c a n b e a p p l ie d Nhng k thut tng t c th c p
to an y jo u r n a l articles. It is also useful dng cho bt k mi bi bo. Cng tht
to e x a m in e th e d iffe re n t s t r u c t u r e of hu ch khi xem xt cu trc khc nhau
articles a n d th e criteria a d o p t e d . ca cc bi bo v tiu chun chp
nhn.
6 Videos and audio cassettes Video v bng; nghe

T hese c a n b e b o r r o w e d fro m m e d ic a l Nhng loi ny c th mn cc th
libraries a n d e x p lo ite d in a v a rie ty of vin y khoa va s dng theo nhiu cch
ways, for e x a m p le , as a b a s is for role- khc nhau, v d, n h lm c s c h o cc
plays, n o te - t a k in g a n d r e p o r t- w r itin g . dng vai, ly ghi ch v vit bo co.
7 C om puter program m es Cc chicng tiiih my VI lnh

A uthoring p a c k a g e s s u c h as G a p m a s - Nhng hp tc gi n h G a p m a ste r (Wida
ter (Wida Softw are) allow y o u to p u t Software) cho php bn t n hng bi
short texts, e.g. c a se h isto rie s o n disk ngn, v d, cc bnh n trn a v to ra
an d c re a te cloze p a s s a g e s w ith as s is n hng on din ch trng km phn tr
ta n ce a n d a s c o rin g sy stem . T h e s t u gip v h thng cho dim. Cc sinh vin
den ts find th e s e ex ercises very m o t i n hn thy n h ng bi tp ny rt thc y
vating a n d it c a n w o rk very well as a v iu ny c th lm vic rt tt nh
group activity. D ifferent g r o u p s c a n m t hot ng nhm. Cc nh m khc
work o n different c a se s a n d o n c e th e nhau c th lm vic trn nhng trng
texts are c o m p le t e th e y c a n b e u s e d like hp khc nhau v m t khi cc bi hon
any o th e r text, for e x a m p le , as th e basis tt th li c th s dng ging nh mt
for n o te -ta k in g activities, role-plays bai khc, v , n h lm c s cho nhng
a n d in f o r m a ti o n - tr a n s f e r activities. hot ng ly ghi ch. cc ng vai v cc
hot ng di chuyn thng tin.

8 Jigsaw reading and listening activi C r hoi Ang Ac t i m g p h n v
ties nghe
A text c a n b e d iv id e d in to tw o o r t h r e e Mt bi c th chia th n h hai hoc ba
p a r ts a n d e i th e r p h o t o c o p i e d o r r e p h n , v sa o c h p h o c g h i S m . M t t
co rd e d . A c o m m o n w o r k s h e e t p r o cng vic ch u n g cu n g cp c s cho mt
vides t h e b as is o f a task w h e r e t h e texts bi lm trn c c bi d u c hoc
are e ith e r lis te n e d to or r e a d in d iffe r n g h e h o c c tr o n g c c n h m khc
e n t g ro u p s. T h e g r o u p s a r e t h e n r e o r nhau. Ri cc n h m c ti lp li
g a n ise d for a n i n f o r m a ti o n e x c h a n g e trao i th n g tin n h m h o n tt bi lm .
to allow for task c o m p l e t i o n .
9 R e a d a n d report Dc v bo co
S t u d e n t s a re e i th e r g iv e n o r a l lo w e d to C c s in h v i n h o c c n h n h o c c
c h o o s e s h o r t texts w h i c h th e y t h e n p h p c h n la n h n g bi n g n ri h
s u m m a r i s e for o t h e r s t u d e n t s to ta k e t m tt c h o c c s in h v i n k h c da v o
n o te s on. ly g h i c h .
10 Triads C c b ba
T h e se d e v e lo p s k im m in g , s c a n n i n g , C ch n y p h t tr i n c c k n n g d c lt,
n o te -ta k in g , lis te n in g a n d p r e s e n t a x e m x t. ly g h i c h , n g h e v trn h by.
tion skills.
S t u d e n t s a r e g iven a p ile o f jo u r n a l s Cc sin h vin nh n m t thng bo v h
a n d th e y h a v e t e n m i n u t e s to se lec t c mi ph t d la chn v tm tt mt
a n d s u m m a r i s e a n a rticle o r p ie c e o f bi bo hoc m t on bi. Gii hn thi
text. T h e t i m e lim it is critical a n d th e y gia n l i m th th c h v h d c k h u yn
s h o u l d b e e n c o u r a g e d to c h o o s e s h o r t n n c h n c c bi bo n g n . Ri h c
articles. T h e y a re t h e n o r g a n i s e d in to xp th n h cc n h m ba n g i v c
g r o u p s o f t h r e e a n d a s c r i b e d a role. g ia o n h i m v.
Phase 7 K 1
S tu d e n t A is p r e s e n t e r Sinh vin A l ngi trinh by
S tu d e n t B is r e p o r t e r S in h v i n B l ng i b o co
S tu d e n t c is o b s e r v e r Sinh vin c l ngi quan st
S tage 1 A p rese n ts B a n d c tak e Giai on 1 A trnh by B v c ly ghi
n o te s ch
Stage 2 B gives a s u m m a r y o f A's Giai on 2 B nu tm Lt p hn trinh
p r e s e n t a t i o n w h ile c lis by ca A trong khi c nghe
tens
Stage 3 c com m ents
on B's sum Giai on 3 c bnh lun v tm tt ca
mary and adds anything B v b sung thm iu d
th a t h a s b e e n m is s e d o u t b thiu ht
Stage 4 All th r e e c o m p a r e n o te s Giai don 4 c ba u so snh cc ghi
ch
Phase 2 K 2
S tu d e n t c becom es presenter Sinh vin c tr th nh ngi trnh by
S tu d e n t A b e c o m e s r e p o r t e r Sinh vin A tr th nh ngi bo co
S tu d e n t B b e c o m e s o b s e r v e r Sinh vin B tr th nh ngi quan st
T he p r o c e d u r e is r e p e a t e d follow ing Quy trnh c lp li theo bn giai on
the four sta g e s listed above. d nu trn.
Phase 3 K 3
S tu d e n t B b e c o m e s p r e s e n t e r Sinh vin B tr thnh ngi trnh by
S tu d e n t c b e c o m e s r e p o r t e r Sinh vin C tr thnh ngi bo co
Student A b e c o m e s o b s e r v e r Sinh vin A tr th nh ngi quan st
Although it is r a th e r tricky to se t this a c Mc d c th phc tp trong vic xy

tivity u p th e first tim e, i f i t IS d o n e o n a dng hot ng ny ln u tin, nu
regular basis th e s t u d e n t s b e c o m e c thc hin trn c s u n, cc
m u c h m o r e efficient in follow ing the sinh vin s tr nn c nng lc hn
pro ce d u re s. T h e r e is alw ays a m a r k e d nhiu khi theo tip cc quy trnh. Lun
im p r o v e m e n t in their p r e s e n ta t io n lun c s tin b r rt trong cc k nng
skills w h ich m a k e s it a really w o r t h trnh by ca h, vic ny lm cho bi tp
while exercise. T h e r e is also a n o t i c e tht s c gi tr. Cng c m t tin b r
able im p r o v e m e n t in t h e article s e le c rng n hn thy trong vic la chn bi
tion, as a n a w a r e n e s s o f a u d i e n c e i n bo, nh m t nhn bit v mi quan tm
terest a n d m o tiv a tio n in creases. nghe v thc dy c tng ln.
11 Group presentations C c b i n h b y n h o m
T hese usually w ork b e t te r t h a n in divi Nhng cch ny thng tt hn l nhng
dual p r e s e n ta t io n s as th e y t e n d to be trnh by c n h n v c xu hng sng
m o r e lively a n d active. It is also q u ite ng v hot ng hn. Cng tht hu
useful to video t h e m so th a t fe e d b a c k is. ch khi quay video n h ng cch c
m o r e in stant. T h e u se o f a n o v e r h e a d th quay li tc thi hn. Vic s dng
p rojec tor or slides is also in v a lu a b le for my chiu qua u hoc phim dng bn
this k ind o f activity. E n c o u r a g in g th e cng u v gi cho kiu hot ng ny.
a u d i e n c e to p a r tic ip a te in n o te -ta k in g Khuyn khich ngi nghe tham d vo
English in M edicine - 3 4 7
activities o r s o m e kin d o f o b serv a tio n cc hot ng ly ghi ch hoc kiu bi
task h e lp s to m a k e th e w h o le experi- lm quan st s lm cho ton b cuc din
n c e a m o r e fruitful o n e . tp c hiu qu hn.
12 Project presentations C c tr in h b y d n
T h e s e a r e b e c o m i n g a very i m p o r t a n t N hng cch ny ang tr th n h m t con
w ay of s h a r in g r e s e a r c h a n d d e v e l o p dng rt quan trng th a m gia n g h in
m e n t id e as at n a t io n a l a n d i n t e r n a cu v pht tritn cc tng ti cc hi
tional c o n f e re n c e s . If t h e s t u d e n t s a r e ngh quc gia v quc t. Nu cc sinh
divid e d in to g r o u p s th e y h a v e t i m e for vin c p hn chia th n h n h m h s c
d a ta co lle c tio n th r o u g h r e a d in g , q u e s thi gian thu thp d kin qua vic dc,
tio n n a ir e s . v ide os, a u d i o t a p e s o r i n hi, xem video, b ng ghi m hoc cc
terview s. T h e y t h e n p r o d u c e a p o s t e r cuc ph n g vn. Ri h to c mt
w h ic h m a y b e o f a v ery v isu a l n a t u r e . bng p phch c th rt b t mL Cc p
T h e s e a re p u t u p a r o u n d t h e r o o m for phch ny c treo q u an h phng mi
all to view in a d v a n c e o f t h e p r e s e n t a ngi xem trc cc bui trinh by. Cc
tions. T h e p r e s e n ta t io n se ssio n s s h o u ld bui trnh by nn t chc tht ngn v
b e k e p t v ery b r ie f a n d s h o u l d in v olve n n li cun ton n h m ln lt tham gia
th e w h o le g r o u p ta k in g it in t u r n s to p h t biu. Tip sau d l m t cuc hp hi
sp e ak . T h is is f o llo w ed b y a q u e s t i o n v dp. T h t hu ch nu c i nhm c i
a n d a n s w e r s e s s io n . It is h e l p f u l if t h e ch t thi gian trc d xem xt cc cu
g r o u p h a v e s o m e ti m e b e f o r e to a n hi v bn lun xem h c th tr li cc
tic ip a te q u e s t i o n s a n d d i s c u s s h o w cu hi d ra sao trc cc bui hp. Kiu
th e y m i g h t a n s w e r t h e m b e f o r e t h e hot ng n h m ny l rt tt cho vic
se ssio n s. T h is k in d o f g r o u p ac tiv ity is xy dng n im tin ca sinh vin v hon
very g o o d for b u i l d i n g s t u d e n t s ' c o n f i ton xng ng' d c gng. T hm na.
d e n c e a n d is well w o r t h t h e effort. nu cc bui hp ny c th c quay
Again, if t h e s e s e s s io n s c a n b e video, vic chiu li c th thc hin c
v id e o e d , f e e d b a c k c a n b e im m e d ia t e ngay lp tc v cng cc k hu ch. Cc
a n d e x t r e m e l y usefu l. V id e o e d s e s bui hp c C|uay video cng gip cho
s io n s also m a k e v ery g o o d lis te n i n g vic nghe ti liu tr nn rt tt cho cc
m a te r ia l for f u t u r e g r o u p s . nh m sau.
13 Case presen ta tio n s C c tr n h b y b in h n

It is p o s s ib le to g et h o ld o f t a p e d a n d C th gi li cc trnh by b^nh n trn
v id e o t a p e d c a s e p r e s e n t a t i o n s . A n o bng ghi m hoc bng ghi hnh. Mt
t h e r g o o d s ta r t in g p o i n t w o u ld b e to im xut pht khc cng tt l cc
get s t u d e n t s to w o rk o n c a s e p r e s e n t a sinh vin lm vic trn n h n g cch trnh
tio n s o f W illiam H u d s o n , t h e c a s e h i s by b nh n ca William Hudson, bnh
tory t h a t r u n s t h r o u g h E n g lish in n c gii thiu sut cun T ing A n h
M edicine. trong Y khoa.
3 4 8 - E nglish in M ed icine
14 Diagnostic problems and quizzes C c v n c li n d u v v u kim tra
vn p
M a n y m a g a z in e s s u c h a s GP M a g a Nhiu tp ch n h Tp ch B c s thc
zin e. P ulse a n d M im s, w h i c h a re p r o h n h t n g qut, N hp m ch v M im s c
d u c e d for British d o c t o r s h a v e s h o r t xut bn cho cc bc s Anh u c nhng
p r o b le m s a n d q u iz z e s w h ic h c a n b e vn d ngn v cc kim tra vn p,
p u t o n t o c a r d s for se lf-a cce ss, role- nh ng chuyn m c ny c th c ghi
play, or s im p ly as s tr a i g h tf o r w a r d trn th dnh cho c n hn s dng, cho
p ro b le m -s o lv in g activities. M a n y of vic ng vai hoc ch l nhng hot dng
th e m h a v e g o o d p h o t o g r a p h i c in p u t gii quyt vn trc tip. Mt s cc tp
w h ic h c a n b e very g o o d for v o c a b u la r y ch c ti liu nh tt c th dng rt
d e v e lo p m e n t. tt cho vic pht trin t vng.
15 A u th e n tic docum ents C c t i li u x c th c

T h e r e a r e q u i t e a few o f t h e s e in E n g R rng c vi ti liu d trong sch Ting
lish in M ed ic in e a n d th e y c a n b e u s e d A nh trong Y kh o a v chng c th dc s
in d iffe ren t c o n t e x ts a n d in d if fe r e n t dn g o n g cc vn cnh khc nhau v
ways. M a g a z in e s p r o d u c e d for n a tiv e trong nh ng cch khc nhau. Cc tp ch
s p e a k e r d o c t o r s c a n also b e a g o o d xut bn cho cc bc s ni ting bn ng
s o u r c e for these. cng c th l m t ngun tt cho cc ti
liu .
16 C urrent C ontents C c m c l c h i n n a y
C u rren t C o n te n ts p r o v id e s a rich Cc m c lc h i n n a y cung cp mt
s o u r c e for r e s e a r c h - b a s e d activities, ngun phong ph cho cc hot dng da
a n d as it c a n b e c a lle d u p o n t h e w e b it trn nghin cu, v do chng c th c
o p e n s u p all k in d s o f in t e r e s t i n g a c tiv i truy tim n web, diu ny m ra tt c
ties for a n y o n e w h o h a s ac ce ss. mi dng hot ng th v cho bt k ai
nhp c vo .
English in Medicine
(ti bn )
E r ic H . G le n d in n in g
B e v e r ly A . s. H o lm s tr m
'S iu dc U d )ii
GS. BS. TRN PHNG HANH
Chu trch nhim xut bn

TRN lNH v it
Bin tp O TRNG C
Trinh by sch PHM VN VINH
Sa bn in VN ANH
NH XUT BN TNG H0P t h n h p h h c h m in h
62 Nguyn Th Minh Khai - Qun 1

8225340 - 8296764 - 8222726 - 8296713 - 8223637
Fax: 8222726
E-mail: nxbtphcm@vnn.vn
Thc hin lin doanh
PHM TH THANH TM
In 1.000 cun kh 14,5x20,5cm Li Xi nghip In MACHINCO - 21 B] Thi Xun -

Qun 1 - Thnh pho, H Chi Minh. So xut bn: 112-07/CXB/128-01/THTPHCM
In xong v np lu chiu thng 3-2007.
Ti Li u Do
Note

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English

GS. BS TRN PH ONG H M

GS. BS TRN PHNG HNH

Bnh n c cp nht Tham kho mi v

To the t e a c h e r Gi ging v i n ................................................ 5

T h is b o o k is for d o c t o r s , m e d i c a l s t u - Cun sch ny l dnh cho cc bc s, cc

It a i m s to d e v e lo p s p e a k i n g a n d lis Cun sch n h m m c ch trc tin

T h e b o o k is d iv id e d in to s e v e n Cun sch c chia th n h by bi,

T h is b o o k is t h e p r o d u c t o f m a n y Cun sch ny l kt qu ca nhiu

T h e key c h a n g e s are: N hng thay i ch yu l:

Histories updated Bnh n c c3p nht

New reference texts and journal articles Tham kho mi v sch v bi bo

Listening tasks rerecorded Ccbi l m v ng hed cghibn gli

Full tapescript Bn di thoai y

Tasks coded according to skill Cc bi lm c m ha ty thuc k

Photographs added Nhiu hlnh nh b sung

Useful addresses updated Cc a ch hu ch c c p nht

New UK hospital gradings Cc chc v mi trong b n h vin nc

T he h isto rie s, b a s e d o n a u t h e n t i c Cc b n h n, da trn cc trng hp

T h e o r g a n is a tio n o f t h e b o o k a n d Cch sp xp cun sch v nhng

T his b o o k a i m s to h e l p y o u c o m m u n i Cun sch ny n h m gip bn giao tip

T h e b o o k is d iv id e d in to s e v e n Cun sch ny c chia lm by bi.

T h e first six u n i t s h a v e f o u r s e c Su bi u tin c bn phn. Phn

T h e la n g u a g e activ ities in th is b o o k Cc hot ng ngn ng trong cun

Listening tasks I S J Cc bi lm v nghe

T h e tasks a re v a rie d b u t all h a v e at Cc bi lm u a dng n hng tt c

W h ile -liste n in g ac tiv itie s o f te n i n Cc hot ng trong kh i n g h e thng bao

English ill M e d icin e - 9

A fte r-liste n in g ac tivitie s fo c u s o n u s . Cc hot ng sail k h i nghe t$p trung vo

1 Try to do as m uch o f the activity as C gng thc hin c c hoai n g cng

T h e s p e a k in g tasks for p a irs i n Cc bi lm v ni cho tng di bao

T h e g u i d e d - p r a c t i c e activ itie s a re Cc hot ng thc h n h c hng

T h e g a p ac tivitie s r e q u i r e as a first Cc hot ng thiu i hi trong

For t h e ro le-p la y s, y o u r t e a c h e r Cho vic ng vai, thy gio ca bn

In all t h e s e activities, t h e r e will b e Trong tt c cc hot ng ny, s c

T h e r e a d in g p a s s a g e s in c lu d e : a Cc on c bao gm: bnh n, cc

R e a d in g ac tivitie s c o ve r: lo c a ti n g Cc hot ng c gm: xc nh

As w ith lis ten in g , t h e r e a d i n g a c Cng n h vi cch nghe, cc hot

! Using whatever clues are provided, S d u n g bl k d u mi no c, v du

Activities w h ic h fo c u s m a i n l y o n N hng ho t ng c trng t m ch

Language focus Trng tm ngn ng

AGE 32 SEX M MARITAL S TA T U S M

OCCUPATION Lorry driver

O th e r w ays o f s ta r t in g a n in te rv ie w Nhng cch khc bt u hi bnh l:

N o te h o w th e d o c t o r asks h o w lo n g th e Chi nh cch bc s hi thi gian bnh

A n o th e r w a y of a sk ing a b o u l this is: C cch hi khc nh sau:

DOCTOR Well, M rs Black, w hat's Bc s: No, b Black. V sao h m nay

P ra ctise this d ia lo g u e . Y o ur p a r t n e r Thc h n h on i thoi ny. Vi m t

Language focu s 2 Trng tm ngn ng 2

O th e r w ays of fin d in g th is o u t are: N hng cch khc tm v tr au l:

N ote h o w th e d o c t o r asks a b o u t t h e Ghi n h cch bc s hi kiu au:

O th e r w ays of as k in g th is are: N hng cch khc d hi vn d trn l:

Hurt i s a v e r b . W e use It like this: M y fo o t hurts. Hurt l ng l. Ta thng ni nh th ny:

Language fo cu s 3 Trng tm ngn ng 3

S im ilarly h e c a n ask: Bc s c th hi tng t n h th:

D o c to r s o f te n as k if a n y t h i n g els e a f Cc bc s thng hi xem c iu g lm

B tller m e a n s 1mprovcd o r relieved. It d o e s n o t B e tte r c ngha l Wi< hn hoc g i m bt. T

It) this e x a m p le , th e p a Trong v d ny. n h n g

Now try e a c h of th e s e four c a s e s in th e By gi bn hy thc h n h c bn trng

1 DOCTOR- ............................................... Bc s: .............................................

2 DOCTOR: ........................................ Bc s: .................................

3 DOCTOR: ................................................. Bc s: ..............................................

A: Play th e p a rt of th e d o cto r. R e p ea t A: ng vai bc s. Nhc li Bi lm 4

- Does anything make it w orse? C iu g lm au n n g hn khng?

GENERAL malaise wi loss n o rn a