LOEVA 27 MEDICAL WORDS not so friendly as they look and sound

 Delivery: is when a pregnant woman is giving birth

Miscarriage

Angina is not sore throat: angina pectoris is to describe a pain in the chest related to a difficult heart condition

Stroke is for french AVC

Heart attack is for myocardial infarction

Theatre is for the operating room

Body is for the living body

Corpse is for the dead one

Delay  is not a time interval

Face is not a figure

Marrow: bone marrow

Spinal cord is the cord in the spine: tumour of the spinal cord,  spinal cord wounded etc

Os is not bone of course it comes from latin os -mouth!

Piles is not for pace-maker but for haemorrhoids

Condom is not preservative '(or food)

Rate is the number of beats per mn

Heartburn is not a heart desease

Sensible means it makes sense, does not mean sensitive

Murmur is a kind of noise made by the heart; 

LOEVA 26 PATIENT'S FILE

 1   ADMINISTRATIVE RECORDS: NAME? AGE? DATE OF BIRTH? MARITAL STATUS (MARRIED? SINGLE?) Address and Occupation

2 Present complaint

3 History of present complaint

4 Past medical history

5 Direct questions

6 Examination

7 INVESTIGATIONS  ( to investigate into something)

8 Diagnosis

9 Treatment

LOEVA 25 General examination

 Vital signs:

  heart

pulse

rate (beats/minute)

rythm: regular, irregular

Temperature: 

Blood pressure (BP): high or low.  High blood pressure=hypertension (in english too, same word)

Weight

Height - (mind the pronounciation) 1 foot(ft)=30 cm   1 inch (in)=2,5 cm

how high are you, what is your height?

how much do you weigh? What is your weight?

LOEVA 24 GENERAL EXAMINATION General assessment:

 

-general body build

For example a patient with Parkinson's desease:

general assessment:

 -tremor: rythmic shaking of the hand even when the hand is at rest

-slowed movement: Parkinson's desease, over time, can slow down your movements

-stiffness, muscle stiffness can limit range of motion

-impaired balance; impaired posture

-loss of automatic movements: such as blinking, smiling, swinging arms while walking

-difficulty writing; smaller handwriting

    Parkinson's desease cannot be cured, but medications can help a lot.

Medications can help manage the symptoms.

Surgical interventions may be recommended in some cases; to regulate specific brain regions.

LOEVA 23 Physical examination: Neurological examination and useful sentences

 Neurological examination

-Stand up

-Walk

-Turn back, turn around

-Walk on your heels

- On the tip of your feet=on the toes

-Stand up with feet close together

-Close your eyes

-Touch the tip of your nose alternately with each of your forefingers

-Squeeze my fingers

-Do as I do

Hold this position.

-Make this movement pushing against me.

-Keep your joint fixed while I try to move it.

-Do you feel me touching you?

Do you feel a "buzzing" sensation?

Follow my finger with your eyes

Look straight ahead.

Close your eyes as hard as you can.

Pipe

Puff out your cheeks=blow out your cheeks

Show me your teeth

Swallow

Can you see my finger?

 

USEFUL SENTENCES FOR THE EXAMINATION

-Do as I do

-Show me where it hurts with your finger

-Am I hurting you?

-Take your temperature

-We will do

an electrocardiogram

an x-ray

a chest x-ray

a urine test

a blood test

It's not serious; you can go; I'll give you a prescription

It is a serious condition; you need surgery; you need to be hospitalized

We will put you on a drip

We will put you in a cast

We will give you some pills, some injections.

 

Be sure to see your family doctor if your symptoms persist.

LOEVA 22 EXAMINATION abdomen chest lungs heart genitals

 PRESENTATION


Physical examination

-I'm going to examine you, please undress.

-Please take off your coat, jacket, shirt, trousers, dress, skirt, underpants, briefs and bra. 

 

Examination of the abdomen

-Lie on your back with your knees bent, please. 

-I'm going to examine your abdomen; relax; breathe in and out slowly, with your mouth open. 

-Does it hurt when I press here?
-Take a deep breath and cough;  

-I will examine your back passage 

 

Examination of the lungs

-If the patient was lying down, sit up.

I'll listen to your lungs 

Breathe in and out; cough

Examination of the heart

I'll take your pulse; give me your hand

I'll listen to your heart

I'm going to check your blood pressure: what is it usually?Gynaecological examination

I'm going to examine your genitals

I will practise a gynaecological examination

Lie on your back with your legs apart

Try to relax

I will take a smear from your cervix

I will examine your breasts

I'm going to listen to your baby's heart.

 

LOEVA 21 NERVOUS SYSTEM

 MOTOR DISTURBANCES = motor disorders

PARALYSIS

-Can you use your arms and legs normally ?

Are you paralysed?

Did you have a stroke?=Have you had a stroke?

Do you have any muscle weakness?

 

Was the onset sudden ? or little by little ?

Did you lose consciousness ?

Is it less severe?

Is the paralysis getting any worse?

Prior to the paralysis, did you have

high temperature

or headaches

or loss of consciousness - did you faint?

or vomiting?

Do you have any difficulty

speaking

smiling, whistling, frowning, swallowing, chewing ?

No I have no difficulty speaking, no difficulty whistling...

Do you get any shaking of your limbs?

and does it happen when you rest; or when you try to reach something?

===Do your limbs shake?
And does it happen when you are resting; or when you try to reach for something?

 

 

LOSS OF CONSCIOUSNESS

Did you ever faint ,  pass out  or  lose consciousness ? 

==
Have you ever fainted, blacked out or lost consciousness?

Did you ever have epileptic fits? How old were you at the first seizure?

==Have you ever had epileptic seizures? How old were you when you had your first seizure?

Do they occur during sleep?

FITS AND CONVULSIONS=SEIZURES AND CONVULSIONS

Can you tell when the fits are going to happen?== Can you tell when the seizures will start?

Has anyone told you that before the attack...

=Has anyone told you that before the seizure ...

-you staggered around

-you were confused

--you made noises that could not be understood

Is the onset sudden or gradual?=Is the seizure sudden or gradual?

Do you become rigid?

Are convulsions present?=Are there convulsions?

During the fit, do you fall?

Have you ever hurt yourself?

Do you bite your tongue?

Do you micturate?

Do you soil yourself?

Do you see things that are not there?

Do you hear things that are not there?

Do you taste things that are not there?

Did you ever had a head injury ?=Have you ever had a head injury?

SENSORY DISTURBANCES

Do you have headaches?

Where does it hurt?

When did the pain start?  Did the pain start gradually or suddenly?

Is the pain severe? Type of pain, progression, end, duration, relieving or aggravating factors

Radiation

Asociated factors: do you feel sick?

Do you vomit?

Do you get visual symptoms?

Do you have a numbness? did you lose any cutaneous sensation?

Do you get any sensation of pins and needles in you limbs ?

 

DISTURBANCES OF THE SENSES==SENSORY DISTURBANCES

Is your eyesight good? do you wear glasses?=Do you have good vision? Do you wear glasses?

Do you have double vision?

Do you have blurred vision?

Can you hear normally?

Do you complain of any deafness?

Do you have a buzzing in you ears?==Do you complain of any ringing in your ears?

Do you have ringing in your ears?

Do you have trouble in smelling or in tasting?

BALANCE PROBLEMS

Do you complain of dizziness? =Do you complainof vertigo?

Do you feel like things are spinning around you?

Do you lose your balance when walking or standing?

Do you always fall on the same side?

Do you feel nauseous?

Do you feel like vomiting?

Do you vomit?

 

 

LOEVA 20 DRUG HISTORY

 words: drugs, medications, medicines, pills, tablets, capsules, suppositories

Are you on any treatment? =Are you taking any medication?

Can you show me the medicine containers ?

-antibiotics

-insulin

-antihypertensive drugs

-diuretics

-steroids

-anticoagulants

-contraceptive pills

-others 

If you are not on any treatment now, have you ever been under medication in the past? =
If you are not currently taking any medication, have you taken any in the past?

tablets or injections? date?

Are you allergic to any drugs?

-penicillin

-aspirin

-other antibiotics?

-other medicine: codein, paracetamol, tramadol etc

Are you up-to-date in the immunizations against hepatitis, tetanus, poliomyelitis, typhoid, small pox, tuberculosis, diphteria, HPV ?

LOEVA 19 FAMILY HISTORY

-Are your parents alive?

If not, at what age did they die; what was the cause of their death?

-Have you any children? How many; their age

-Are your children healthy?

-Do you have any brothers or sisters? =Do you have siblings?

HABITS

-Do you smoke?

if so: how many cigarettes a day?

Since when?

If you don't smoke now, have you ever smoked? -Date of start and end of the habit)

 

-Do you drink alcohol?

How many glasses a day of wine, beer, whiskeys, spirits

Since when?

If you don't drink now, have you ever drunk; how many glasses a day...

 

-Are you a drug addict ?

Are you a shoot addict?

Since when?

If you are note a drug addict now, were you ever one? (or have you ever been one?)

LOEVA 18TH ARTICLE past medical history

 PAST MEDICAL HISTORY

 

Have you had all your childhood illnesses?

Yes, I think I've had them all: except for the ones we are vaccinated against nowadays.

Children are vaccinated against at least 11 diseases in the first year of life.

 

Have you ever had an operation? Have you ever been hospitalised?

Well, I had my appendix and tonsils removed and two teeth.

No hernia, no tumour, just this scar from my appendicitis.

 

Do you suffer from:

-diabetes mellitus

-High blood pressure

-Rheumatic fever

-Gout

-Asthma

-Sexually transmitted diseases

-Tuberculosis (TB)

-tropical diseases such as malaria if you have travelled abroads

-high blood pressure

-rheumatic fever

-gout

-asthma

-sexually transmitted deseases

-tuberculosis (TB)

-Tropical deseases such as malaria if you have travelled abroad...

 

 

 

 

Loéva 17 th Quiz General health questions when EXAMINING a new patient

 How much do you weigh?

Has your weight increased, or decreased? Did you put weight on? -more familiar and usual!

Do you feel a lack of energy?

Do you have any fever? How much; since when ; have you been taking any medication to fight it ?

PAST MEDICAL HISTORY

FAMILY HISTORY

HABITS

DRUG HISTORY

IMMUNIZATIONS

LOEVA 16 ABDOMEN

abdomen: the part under the chest (stomach; to lie on one's stomach)

Do you feel comfortable in your abdomen ?
do you fell uncomfortable after eating ?

SITE
Show me with your hand where it hurts; where does it hurt? Show me with your index finger where it hurts.
When does it happen? Does it happen after eating; just after eating, or later far from the meal? Or straight after meal, or an hour after, two hours after?
How does it start? Does it begin little by little or does it happen suddenly ?

SEVERITY
Does the pain prevent you from carrying out your activities?
Does it force you to go to bed?
Does it wake you up at night? Does it prevent you from sleeping?
Does it force you to lie still-on your back?  On your stomach? On your side?
or to scroll around seeking a comfortable position?
Does any medication ease the pain ?
or any action you tried: drinking water, eating something...

HOW LONG does it last?

When you get it? how long does it last?   
How long have you had this pain?

KIND of pain
-mild discomfort, unease
-a burning sensation
-a nagging pain
-a stabbing pain; a sharp pain "like a knife"
-a throbbing pain
-a constricting pain; like a tightness
or a colic-- a pain that comes and goes and migrates

THE END of the pain: spontaneously? or as the result of some action by yourself?
Gradually or suddenly?

DOES ANYTHING EASE THE PAIN?
-Lying still in bed
-Crouched, foetal position
-Rolling around
-medicines: aspirine (!); antiacid medication;  pain killers? Are you on any medication currently?
-food, bread, milk, water
-going to the toilets, defecation, passing gases; belching, vomiting ?

DOES ANYTHING increase or cause the pain?
-coffee, tea
-stress
-food
-what brings it on
what makes it worse?

RADIATION
Does the pain spread
...to the back
...to the shoulder
...to the jaws
...to the arms
...upwards
...lower down to the genitalia ?

CAUSES
stomach ulcer; gallstone; appendicitis; kydney stone; heart; aorta; backpain; hepatitis; reflux ( from the stomach to the oesophagus to the throat)

HABITS
Do you have diarrhea? Or are you constipated?
How ofte do your bowels move per day?
How often do your bowels move per week?
When did you hve your last bowel movements

STOOLS
What do your stools look like?
color:brown black pale white silver
Smell: is it offensive; is the smell offensive?
Its consistence: is it hard, soft, watery, frothy ?
Its size: bulky, moderate?

BLOOD in the stools
-Did you ever pass any blood in your stools?
What was it like? On the surface, mixed with the stools, or happening after passing the stools?
Is defecation painful? I the pain related to defecation, does it start during defecation or after defecation?
-Di you ever pass mucus or pus in your stools?

Loéva 15th PAIN

 From top to bottom:

head:   headache, migraine

sinusitis

sorethroat; 

other ailments not necessarily painful: blocked nose, blocked ear, cold, shingles, herpes virus...

chestpain

-from the heart: angina, heart attack---less painful : palpitations, thumps...

-from the lung: embolism, pneumonia, pneumothorax; along with difficulty breathing, cough...

-from the oesophagus, the stomach:  "heartburn" (reflux), gastritis, pancreatitis

-from e broken rib or a broken vertebrae

abdomen

-stomach pain

-pain in the side: from kydneys, from colitis, appendicitis, pancreatitis

-dysmenorrhea -pain from the ovaries

-endometriosis

-pain from the colon: irritable bowell syndrome, colitis

 

pain in the pelvis

-ovary, uterus, urinary tract: bladder, cystitis

- appendicitis sometimes, peritonitis

Pain in the leg:

-from arteries: arteritis: blocked artery

-from nerves: sciatalgia (backpain spreading to the heel, or to the big toe)

-from the hip: spreading to the inner side of the knee

Pain in the ankle:

-sprained ankle

-thrombo-phlebitis

-etc etc

muscle pains; bone pain;

- Verbs: to hit, to hurt, to arm, to wound

Expressions: to suffer from sth

to ache

 

Severity of pain: stabbing pain

excruciating pain

a pain like a tightness

a dull pain

numbness

pins and needles (French :fourmillements) 

 

Duration of pain

permanently

it comes and goes

it happens suddenly, 

or gradually

Loéva 14th Respiratory system Chronic bronchitis and Asthma

 

John suffers from chronic bronchitis , he coughs all day all night; he is used to his condition. He had been a heavy smoker for many years. Of course he quit when the doctor told him to stop.

John brings up sputum when he coughs, a moderate quantity, sometimes it is white, sometimes it is yellow or green.

He spits mostly when lying flat, he has to stand up and get rid of his sputum. In hospital he had a cup by his bedside for the doctors to know exactly what his sputum was like. And the quantity ?. It was a large quantity of sputum he would bring up before he was started on his new medications. 

John decided to do something when he coughed blood -haemoptysis is the name for this symptom-for the first time; he used to be breathless when exercising, when walking, when climbing up stairs. John was short of breath even at rest, doing nothing.

He could not sleep flat. He needed pillows to prevent getting short of breath.

-----------------------------------------------

Marie suffers from asthma.  She is allergic to dust and some pollens. You can hear her wheeze, mostly when she is exercising. And it is eased with Ventolin spray. Ventoline spray stop the wheezing not the desease.

------------------------------------------------

One can have chest pain from abcess, pneumonia, embolism, pneumothorax, heart attack, and a few other deseases.

Complementary examinations are required:

x ray examination

MRI scan

etc..

other examinations beyond MRI, 

1  Gas Exchange Studies 

These studies evaluate how oxygen (O₂) and carbon dioxide (CO₂) are exchanged between the lungs and the blood. They help assess respiratory efficiency and identify any abnormalities in gas exchange.

2 Pulmonary Function Tests (PFTs):  PFTs measure lung capacity, airflow, and gas exchange. They include spirometry, lung volume tests, and diffusion capacity assessments. These tests provide valuable information about lung function and any impairment

3  Arterial Blood Gas (ABG) Analysis:

• ABG tests directly measure the levels of oxygen and carbon dioxide in arterial blood. They also assess
  
• blood pH and bicarbonate levels. ABGs help diagnose respiratory and metabolic disorders...
  

 

Loéva 13th Infectious deseases Respiratory system

 It's wintertime and infectious deseases are spreading all over the countries. Flue is very catching. All sorts of viruses are circulated by people, mostly by children.

These deseases affect mostly the respiratory system. From the nose to the throat, to the lung.

The patient says "I'm going down with something...with the flue,, or  is it covid ?

I've got to fight it off!

I've taken some paracetamol or acetaminophen  to bring my temperature down. Because I'm feeling hot and unwell. 

I don't want to stay ill; I can't afford to stay ill long because I have work to do.

I hope the doctor, or the pharmacist will help me feel better.

Yes I cough I've been coughing for three days; it is a dry cough, it happens during the night and during the day; it comes in bouts; it is even painfull and tiresome because I can't sleep.

I feel cold all day. I'm shivering. Sometimes I feel too hot etc..

I need a test at the pharmay because I've heard of covid infections recently. But it is just flue probably. 

I need to get over it all rapidly.

************************

Fortunately I don't have a wet cough; I don't bring up any sputum, I don't spit for the time being; but I know that within a few days, I will probably spit a little bit.

I have no pain in the chest; no chest pain. (Chest pain is a bad symptom; it comes with pneumonia, and other deseases of the lung or the heart...(next quizz!

I have a blocked nose and I sneeze a lot and I cough a lot. I have a headache as well and I feel tired, exhausted !. I have had muscle pains as well (myalgias).

Quizz:

1 When I have a fever I need antibiotics straight away, as soon as possible.

2 Antibiotics are useful when I bring up lots of sputum, and I have a fever, and I cough, and X ray examination shows pneumonia.

3 Steroids (cortisone) can cure infection.