La acidez estomacal es una sensacion de ardor en el pecho o garganta, ocurre cuando el acido del

estomago regresa hacia el esófago, el tubo que transporta la comida desde la boca hasta el
estomago.

Si tiene acidez mas de 2 veces por semana, es posible q tenga enferm x reflujo gastroesofágico,
erge, aunque es posible que sufra erge aun sin tener acidez estomacal

El embarazo, algunos alimentos, las bebidas alcohólicas y algunas medicinas pueden provocar
acidez estomacal. El tratamiento de la acidez es importante, porque con el transcurso del tiempo,
el reflujo puede dañar el esófago, las medicinas sin receta medica pueden ayudar si la acidez
persist, es posible que necesite medicinas con receta medica o una cirugía.

La conjunt causa hinchazón, picazón, ardor y enrojecimiento en la zona de los ojos. La membrana
delgada que recubre la parte blanca del ojo y el interior de los párpados. Las causas pueden ser
infección bacteriana o viral, alergias, sustancias que causan irritación, o productos que se usan
para lentes de contacto, que incluyen gotas para los ojos o ungüentos.

La conjunt en general no afecta la vista. La conjunt infecciosa se contag facilm de pers a pers. La
infec desapar por si sola sin tratam, pero la conjunt bacteriana necesita tratam con gotas o
ungüentos antibióticos.

El alzh comienza lentamente. Primero afecta las partes del cerebro que controlan el pensamiento,
la memoria y el lenguaje. Las personas con esta enferm pueden tener dific para recordar cosas que
ocurrieron en forma reciente o los nombres de las personas que conocen.

Un problema relacionado con el alzh. El deterioro cognitivo leve causa más problemas de memoria
q los normales en personas de la misma edad. Muchas personas pero no todas con deterioro
cognitivo leve desarrollaran alzhe.

La enferm de alzh es la forma mas común de demencia entre las personas mayores. La demencia
es un trastorno cerebral que afecta gravemente la capacidad de 1 persona de llevar a cabo sus
actividades diarias.

El alzh suele comenzar después de los 60 años, el riesgo aumenta a medida que la persona
envejece. El riesgo es mayor si hay personas en la fam que tuvieron esta enfermedad.
Spina bífida is a neural tube defect, A type of defect from the brain, spine or spinal cord. It
happens if the spine of the fetus does not close completely during the first month of pregnan. This
can damage the nerves and the spinal cord. Screening tests during pregnancies can check for spina
bifida. Sometimes it is only discovered after the baby is born

The symptoms of spina bifida vary from person to person. Most people with spina bifida are of
normal intelligence, some ppl need assist devices such as braces, crutches or even wheelchairs.
They may have learning difficulties, urinary and bowel problems, or hydrocephalus which is a
buildup of fluid in the brain.

The exact cause of spina bifida is unknown. It seems to run in families, taking folic acid can reduce
the risk of having a baby with spina bifida. It is in most multivitamins. Women who could become
pregnant should take it daily.

La presion arterial es la fuerza de su sangre al empujar contra las paredes de las arterias. Cada vez
que el corazón late bombea sangre hacia las arterias. Su presión art es mas alta cuando su coraz
late bombeando sangre, esto se llama presión sistólica. Cuando su corazón esta en reposo su
presión arterial baja, esto se le llama presión diastólica.

La lectura de su presión arterial utiliza 2 num. Por lo gen el num sist se coloca prim y luego el num
diast. Por ejm 120/80 signific una presi sist de 120 y una pres diast de 80.

Una alergia es una reacción del sistema inmune hacia algo que no molesta a la mayoría de
personas. Quienes tienen alergias suelen ser más sensibles a mas de una cosa, las sustancias que
suelen causar reacciones son: polen, ácaros del polvo, esporas de moho, caspa de animales,
alimentos, picaduras de insectos, o medicinas.

Normalmente el sist inmunológico combate los gérmenes. Es el sistema de defensa de nuestro

cuerpo, sin embargo, en la mayoría de las reacci alérgicas. Este responde a una falsa alarma, los
genes y el medio ambiente probabl tienen un rol en las alergias

Allergies can cause a variety of symptoms, such as runny nose, sneezing, itching, rashes, swelling
or asthma. Allergies can range from minor to severe. Anaphylaxis is a severe reaction that can be
life threatening. Doctors use skin and blood test to diagnose allergies. Treatments include
medicines, allergy shots and avoiding the substance that caused the reaction.
Hola doctorcito soy petrolina Alvarado, ay es un gusto conocerlo está bien guapo. Oiga le cuento
que me he sentiod muy mal estas ultimas semanas doctor.

Ok can u tell me what kind of symptoms uve been showing

Ay doctor Bueno he tenido fiebre, mucho dolor al momento de sentarme y ya se ha vuelto

insportable

OK any health issues such as diabetes, HBP, asthma, also r ur kidneys working fine

Ay doctorcito no se preocupe, no tengo esas cosas. Yo soy mas fuerte que el odio doctor nunca me
enfermo y hasta sigo usando condon con mi esposo

OK do u or any fam members hv health issues like the ones prev mentioned

Ay si doc mi mama sufria de HBP y fallecio de un stroke, de un derrame, pero el resto están sanos

All right, tell me a lil bit more bout the problema that brought u 2 me 2day

Ay Bueno doc hace unos dias me fui a la playa a Miami beach, y ud sabe queria ponerme biki
nuevo

Ok, and what happened

Bueno me afeite y todo ya sabe para estar limpiecita jiji

What bout after

Ok maam since when exactly u feel sick

Mmm poco dsps del viaje vera me picaba mucho ahi atras y huele muy feo doc, ademas estoy muy
preocup porque no se lo que sera pero estoy botando como una cosa blanca

Mmm ok, now tell me how long ago did the trip take place

Hace 10 dias, al 2do dia comenzo el dolor en esa zona

Ok i will need u 2 take ur clothes off from the waist down and putt he gown that is behind the
restroom door
Also I need u 2 lie on the examination table facing down 2 examine the area that has been
botering

Si doctorcito

Alright

Now I can see what the problem is now, need u to get dress so sit down nd discuss the treatment

Ay doc tan rapidito

Yes it was simple to dsicover what was going on after ur story and the examination, ill be back in
couple of mins

Bu

Well u have perianala abscess this was causexd bc one of hair follicles got infected after u shaved
and immediately got inc onctact withs seawater

Ay ya veo doc no debi entrar al mar tan rapido

That is correct u shouldve waited 4 atleast 1 more day b4 going into sea, also by using a new
bathing suit the chemicals used to make it help the infection greow

Ay doc se puede curare s que me duele mucho y huele muy mal, mi esposo no quiere dormer
conmigo

Of course, i ll send a prescription 2 ur pharmacy 4 antibio u have 2 take them once a day 4 seven
days, and also send u 2 our farmacy downstairs 2 get the suppls to drain ur abscess right away.

Ok doctor thank u, so I just leave or what do I have to do

Well u wait here for the nurse okay, shell be giving u instructions for draining the supplies, and
shell tell u where to go after getting them
Oiga y dsps que me voy a morir de un ataque cardiac o que

Mmm idk yet mr carrillo that is why im ordering this test, unfrotunately u are describing symptoms
that suggest early warning signs of heart attack but the good news is that u r here now and if
there’s something wrong well be able to take steps 2 get u on a fast recovery

Bueno doc yo pongo mi vida en sus manos

Ur welcome sir, interpre

Anelectrocardiogram is test helps check electrical acitivty of heart. It ll help us find the source of
the chestpain and shortness of breath that uve been experiencing

Hello ms Navarro im glad u made it to this appoint I kno u hv been having hard time dealing wth
diagnosis, I promise u will feel better after receiving this info

Eso espero doc ha sido muy dificil aceptar todo esto, solo tengo 33 años, nisiq como dulces o
azucar en exceso, como es possible que tenga diab

Well ms navarro the answers arent always that simple, sometimes we r genetically predispo to
certain diseases, sometimes its due to our diet. Diabet is serious dise but its highly manageab

Weno y que es lo que

Well based on ur test results u have type 2 diabet which means tht ur body is not producing
enough insulin to regulate the level of glucose in ur body

Entonces que debo hacer como

The key 2 managing ur dise is simpl eat healthy plenty of exerc and plenty of rest, ull also need to
test ur blood sugar level b4 every meal

Y como se hace esa prueba

Ur going 2 use a gluc monito like this 1, and u ll need to prick ur index finger then ull place a drop
of the blood on the test strip and ull get a result, a number after seconds

Donde consigo todos los aparatos de los q usted habla sabe si mi seguro de salud lo cubre

Most of em aren’t covered by ur health insurance, so dw well teach u how to use them. Also ull
need to record ur reading in the register

Doc q tipo de comidas puedo comer xq me dijeron q iba a tener q dejar las cosas q me gustan

Im gonna refer u to a nutricionist 4 a complete guide on the types of food u should avoid and
include in ur diet

Otra pregunta ud sabe si me voy a tener q poner inyecciones, algunos diabeticos lo hacen
Well the good news are that ur condition is such that u wll not req insulin rn,

En este momento,entonces en el future podria necesitar insul

Teres now way for me to tell rn, ms navarro, ur best bet is to follow the diet tht ur nutri provides 4
u and follow my instruct, u wont b deprved of sugar completely, the key is motivation

Ok thsx 4 ur answers, those were all my question

Ur welcome, im glad 2 hear that, on ur way out, pls set up a FU appont in month at front desk so I
can monitor how ur treatment is going

We’re on the ER right now, im with mr Oviedo, introduce urself and come back 2 me

Mr Oviedo I got a record from the er doctor bout what happened but id like 2 hear directly from u
in ur own words, what happened this morning that brought u to er

Weno me sentia muy ansioso

When did it all start

Pues empece a sentirme peor hace unos dias pero anoche me puse muy mal

Pues la cosa es que me sentí nervioso fijese no podía relajarme oiga mi esposa estaba preocupada,
intente irme a dormir pero no pude entonces de repente pues sentí q me faltaba el aliento, estaba
jadeando x aire como si me estuviera ahogando

Did u h vany other

Si mijo tuve dolor de cabeza terrible aquí enla nuca aca papa detrás del cuello

Ok mr Oviedo uvsa y uve been feling bad during these days, wht u been feeling

Pues en el trabajo no podia focus en absolute, taba irritable con todos, mis nervios taban
destrozados, cualquier cosa asustaba no tenia apetito, cada vez que comia nauseas, peor no podia
dormer nada

I see on ur chart tht u were seen by psych for ur anx in the past, were u ever prescribed meds for
anxiety or depress

Well in work pues no podia concentrarme asi que si me dieron 2 pastillas, una era para depress,
soloft,

Ok what bout the

Es la pastilla pequeña, lorazal

Could it be lorazepill
Me lo quito el doctor

Lorazepin is usually just taken short term bc it can cause dependency so it makes sense doc took it
away, wb antidepress, why did u stop takin that

Pues doc el caso es q lo tome durante gvarios dias pero literalmente no parecia ayudar me sentia
cansado y entumecido todo el tiempo no c como describirlo oiga era dificil concentrarse en el
work tenia miedo despidieran no podia permitirme perder el trabajo so stopped taking it

Well antidepr can take several weeks 2 hacve an effect so u need 2 stick w them, it ll be good 4 u
to follow up w psych again, there are many kinds of antidepr, mayb he can try dioff 1 2 see if it
helps better

Pero es q me sentia horrible y andaba triste sin razon tdo el tiempo no podia estar asi

Ok so thing is alth sometim ppl when they start taking meds 4 depress, at the beginn they can feel
worse, sometimes even suicidal, this is why u will need 2 stay in touch with doctor and dont miss
ur FU apps

Bueno pues

Ok now they gave u a dose of valum or diazepam here in ER 4 ur anx but they don’t like to give u a
prescription from ER so ull need 2 see psych on an outpatient basis within a day or 2so they will
give u the prescr u need

Oiga el pobrlema es q falte a algunas citas, supuestamente el psiq no quiere verme mas

Ok so if u give me a coup of mins i can make some calls ill msee if u can b seen again, at this point
mr Oviedo, for u is that u get regular outpatient care 2 get ur anx under control, give me a few
mins 2 make some calls and ill let u know what i find, sounds good?

Mr Oviedo I called em and theyre not able to see u again in that clinic, we have a clinic associated
2 our hospital, ill make an appointment at that clinic if thats okay w u we use interpreters there
too, okay

Pos deberia estar bien, hare lo major que pueda para llegar a mi cita, dios lo bendiga.
MR lopez is just waking up, mr lopez im roxie, one of nurses hr, do not quot on that tube, we have
inserted catheter to help u urinate, ik u r uncomfortable rn but its important u leave it in place

Que es lo q esta pasando oiga

So sir u r at the ER of the okalhoma trauma center, uve been in a motor vehicle accident and we r
taking care of it, u were incontinent of urine on ur way here, so weve inserted a catheter to help u
on ur time here

A catheter what u mean and whats this on my face

Mr lopez that is ur oxy mask u need to keep it on, just relax and take a deep breath, we r at
hospital here to help

Tengo q orinar oiga dejem ir ahora, tengo que ir por favor ayudeme

No sir u hv to lie still a lil bit longer ok uve been in car accident and were doing some assessmt to
see u okay we have a urin catheter in place

Pero aun no me dicen que ese so no c que pasa mijo

Its a small tuve that weve inserted thr penis it goes thr ur urether and into ur bladder, it will drain
ur bladder for u, so u dont hv to worry bout going 2 bath, just relax, and when u feel u need 2 void,
the catheter wll take care of emptying bladd 4 u

Ah weno ta bien ahora se lo q quiere decir, yo he tenido antes 1 de estos tubos a traves del pene

As u could see it is hooked through a bag here so teres a catheter bag hung just at the side of ur
bed below u, and im going to move it to take a small simple of urine for a urine culture, also later
ull be taken downstairs on a Wheel chair for a CT scan

Weno puez tons puedo descansar me duele la cabeza toy mareado

Ofc interpreter thatd be all

Ask them whats going

Oiga doc mi papa empezó a toser mientras hacia una caminata alrededor del jardín y no podía
respirar por eso lo traje
Is this the 1st time this is happening is he asmathic does he have a chronic diseas hes been treating

Pos si soy hipertenso recibo un tratamiento nunca antes me habia suced algo asi aunque siempre
he tenido tos

But últimamente la tos se le esta haciendo casi constante

Weno hace años fumaba casi 3 paquetes de cigarr al dia pero ahora no fumo mas de 5 cigarr al dia
ud cree q todo esto sea prod del habito de fumar

So by the symps u hv it s prob that smoking is a part of probl well do x ray of ur torax nd a EKG

Hace mucho tiemp el doctor le recom que dejara de fum definit creo q debio de haberlo hecho en
aquel entonc soy el hijo x siacaso

So u c the results of ur xray indicate u have pulm enph and the ekg show a largely slow heart

Y seran muchos dias de tratamiento para mejorar lo sp

Mmm pulm emp doesnt cure itself but it can b control and i recomm that u give up smok 4 good

Ta weno doc no hay probl me podria por favor hacer un favor

Sure ting what u need

Le podría decir al doc Mike wazawski

Go ahead intr. 2 pati and then ask em what brough them 2 my off today

Sra sho le traigo a mi hijo xq lo he notado atontado y no puede sostenerse ni para caminar

When did his problema begin

Sho diría q hace 6 meses dsps de q nos mudamos a la casa donde vivimos ahora

Hv u noticed anything els eunusual in ur son?

Weno ahora con frec tiene esreñimiento se toca la barriga y c queja como si tuviera dolor yo
pienso q tiene algo q ver ocn q el sle gusta meterse todo a la boca

Mmm ok the house u r living in rn is it new and how long uve been living there

No doc es una casa de los años 50 hemos estado viviendo ahi x 9 meses

Ok let me examine him oh since when does he have this

La verdad es q no c hace 2 semanas tmb lo note pensaba q era algo q habia comido y q
desaparecia por si solo

Mmm ok im gonna req a lead level test and a complete

Nivel de plomo no entiendo a que se refiere

The rsn why isa ll houses have Paint made w lead, wht the boy

Mmm weno doc y hay soluc pa esto

Well have 2 see after the test

Ok in

Hello interp intr ur self 2 my pat ask them what is going

Doc hace 1 mes cuando volvimos del bosq el me dijo q algo le habia picado en la pierna se rascaba
x la picaz en el lugar donde le pic

Unos días después empezó a enrojecerse la zona y luego tuvo manchas como círculos rojos en el
centro mas claro y cambiaban de lugar se movían

El tmb tuvo fiebre pero no fue muy alta unas 2 o 3 veces

What do u mean the spots where changin locat

Puess se iniciaban cerca de la lesion original y poco a poco se

Ok is he compl rn of any

Tiene malestar y dolor de cabeza hoy empezo a tener hinchazon y dolor n la rodill derec

Ok its poss tht he was bitten by a tick im gonna order serology for lyme diseas

Mmm la enfermedad de lyme

Well its an illness produced by bite of certain ticks do to bacteria called

Y si el tiene

In the early stages yes as this is the case for ur son he only req treat with antibio

Muy bien tons podemos comenzar con el tratam ahora

No we need to wait 4 serology results that can take up to 2 month

Tanto tiempo dco y que

So for now he can get a lot of rest a lot of foods and ill give him a prescr 4 a medicin that can help
the symp

Patient and mother intr urself ask them what is going on

Doc le traigo a la niña porque tiene mensturaciones muy irregulars unas veces les viene todos los
meses luego 2 o 3 meses sin period

How long ago did she have her 1st menstr hasit always been irreg like this

Hace 2 años q empece con mis periodos al princ venian todos los meses pero desde hace 8 mes
empez a ser ire

Además toy preocup xq el vello el cabello se me esta haciendo mas grueso en la cara y me tan
saliendo granos

Ok hv u gained w

Weno en realidad si en estos ult meses he aumentado 5 libras

Y me parece raro x q estoy comiendo lo mismo q antes mi dieta no ha camb

Im gonna order a blood hormonal profile and a pelvic ultrasound some girls can have this disord
due to horm imbalance called polyc

Y es x eos q tengo

Yes Dw once the diagnosis is made ill prescr t

reatment by the means of horm which wll regul periods 4 u and will also impr ur skin cond

more yellow how long has it been tht way can u

en real desde q nacio doc nacio en la casa hace 1 sem al princ era solo 1 poco pero ahora el col es
mas intense yo le doy de amamantar y esta empe a tom mejr

i unders at any point did u have any prenatal care

si al princ pero lueg no contin xq me mude a esta city durante emb y no tengo seguro de salu una
comad amiga de mi mam me ayud con part

did u kno if u or the father of león have diff bloo typ im gonna order a test 2 see the lvl of bilirr in
the blood is also 2 see what bl ty it is and compl blood count

no c nada de la sangr del papa apenas qued embar

well this yellow col is col jaund and it looks sever ill keep him in the hosp ill begin 2 give him IV
fluids by the way and hell be light thera

no entiendo doc esto es m

so the symps suggest high lvls of a subst called bilirr if it acum 2 much it can pro dan illns called
kernic which can caus perman neurolo dmg

u need to get those tests asap so pls go 2 lab then well fig how to help u
hello so I have my patin here Gabriel and I have his fath and moth here so u may go ahead and intr
ur say hello to fam, im doc stewart ill be helping u guys 2day tell me what prob

doc le traigo a gariel porq hace 3 dias tiene algo duro aqui en la barriga

mmm ok let me xamine him yes its true has he compl of anyth since u noti thi

ocass se queja cuando le toco ahi ayer vi q su orin taba rojiza

that is concerning indeed so has he had fev cough or any oth symp

no no nada de eso

ok this seems 2 be a bump a mass not ver hard and it is not adhered to the diaphragm bc it doesn’t
move with respire

usted cree q sea un tumor doc

well the blood p is slightly elevated it could be a tumoral lession probably renal well wait 4 results
of the Doppler ltrasound 2 see where the lession is located and other structures were affected in
add ill order blood and urine tests

yes the ultra sound shows a renal tumor we must finish the exams with ct scan with contrast and a
biopsy to determ the ext and the typ of tum

yes one of the most freq cancer in children is a kidn tumor known as the willms tumor depending
on the ext and type of cells the type of treatm will be decided

intr urself bernardo and his father, well its not his father really but the director of the shelter

doc quisiera que evalúe a bernardo el es un indigente quien hace dos dias fue traido x serv soc a
vivir al refug q yo dirijo

what

pues el tose con frec a vec con algo de sangr esta muy delgado y palido y parece q tiene fiebre
cada noche no quiero q vaya a contag de algo a las otras pers del ref

yo lo que tengo es gripe xq en la calle no es fácil conseguir comida siempre hace frio

Bernardo how long uve been coughing was some1 else in the Street coughng blood like u

Si doc varios tosian pero yo era el unico que siempre temblaba x las noches

Además todos me decían q estaba perdiendo mucho to

So the lung examd emonstr there are some nois that sugg illnesses gonna req a chest x ray and lab
test

Y todo esto x gripe doc

So u ll have a skin test called ppd purified protein derivative and when u cough were going to need
to collect part of that to analyze in the lab we’ll have to rule out tuberculosis

Y el tratam

Well once we have the definit results we can decide on the treatm itll prob b neces to separ him
from the rests of the resid for a while

Hello interpreter pls do not introduce urself 2 client and please say how can I help wheres the
emergency

Xfa ayudeme

Ah since when has

Hace pocos mins cuando tabamos en el carro me dijo q se sentia un poco mareado empezo a
hablar ocn dific y ahora no puede mover un lado del cuerpo

Ok has he had any

Mmm no siempre ha sido muy sano pero hace una semana su doc le encontró el colest muy
elevaod y le indico trata

Mmm ok in this momento his BP is a lil bit high and the symps suggest a stroke

Va a quedar paraliz va a necesitar

Well order a head CT scan to see if theres some type of leisure depending on this we ll know if
there’ll be a sequel well give him prevented treatment with anticoag

Doc mire parece q ya ta mejorando ta recuperando el habla y empezo a mover el brazo y pierna

Mmm yes the ct scan shows that it was a transient schemic attack prob due to abnormal blood
level

First well order an mra to study the cerebral vessels and to estimate if theres any significant
stenosis thatll determine his treatm and subs FU

Intr ur whats going wrong with lupita

Si me di cuenta que tiene varios dientes negros

Ok let me c her, lupita open ur mouth like this

Oiga ud sabe q el año pasado sus dientes

Mmm la vdd es q mi esposo y yo le cepill los dient pero a veces llora y se resista si q es difícil y ella
no quiere hacerlo sola

Mmm that needs 2 change asap here i see that she has many cavities

Ay pobrecita solo tiene 3

Oh well u c the cav tells us that teeth are weakened and some are alr totally damage does she
drink milk from baby bott

Ahora mismo ta usando un vasito de entrenam pero nos costo mucho hacer q deje el bib para
quedarse dormida

Ok when did she stop using the bb for sleeping

Hace unos 3

Ok so the residue of milk and food must b avoided children teeth must be brush espec b4 sleep

Tons no fue Bueno dejarla tanto tiempo con el bib al irse a dormer

Que hay del agua hay alguin problema bc we have

Oh well im gonna prescribe 4 her fluoride in drugs bc well wáter lacks fluoride and it is necessary
for teeth addit it s important to teach her to brush her teeth after eating and b4 going to bed

Y q podemos

Well well have fu APPS

3 preguntas
what is the name of the person we’re calling

in case this person picks up the phone how would u like me to introduce

in case we reach a voicemail would u like me to leave a message

Ms velasquez my name is doctor perez and in case she picks up the phone to doctor perez
shouldn’t.

Hello ms velasquez I want 2 speak w u abou the results of the lab test that we did for manuel alst
week when he came for his rout check

Pero xq doctor

Oh no, well he has anemia due to lack of iron in the diet and we must treat him 4 dat

Anemia pero eso no es cuando los niños tan palidos

U see whats happ w manuel is that his cond is moderate therefore he has not sympt

Mmm pero tons si es moderada y no tiene sintomas xq necesita

To avoid probs w his mental develop the red blood cells of manuel are small and palid and iron lvls
are reallyu low

Mmm probs del desarrollo pero ya tiene 2 años y ta creciendo tan bien

Yes but the iron deff persists and he could have learning difficulties when hes in school does he
drink lot milk

Si claro lo unico q toma es leche a toda hora

The Access of milk is contributing to the anemia does he eat enough red meat and chick

Ay doc eso si es dificil no le gust aninguna de las carnes

Mmm well thats the explan of theproblem im gonna prescribe iron 4 him whats the name in
telephon of ur pharm

Aqui lo tiene doctor

Good addit when u feed him try to feed him more meat and green veget also less milk return here
in 2 months so we can do tests again, agreed’

Si doc gracias por llamarme