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Text С. Acute Cholecystitis
Among inflammatory diseases of bile ducts the most frequent is cholecystitis or the inflammation of the gallbladder. Cholecystitis is known to occur rarely in isolated condition, inflammatory processes both in the intrahepatic and extrahepatic ducts, sometimes with the involvement of the liver being associated with it. The main forms of cholecystitis are the following: catarrhal, purulent and gangrenous.
The patient with cholecystitis is known to complain of intense pain, it being localized in the right hypochondrium and in the umbilical area. An attack of pain is usually preceded by physical and mental overstrain, sharp physical movements or abnormalities in diet, fatty food and alcohol being responsible for the onset of pain. But sometimes pain is observed to appear suddenly in quite healthy persons. Pain may radiate to the right shoulder, right arm, sternum, and lumbar area, its intensity depending on the form of cholecystitis and the patient’s sensitivity. The pain grows much worse when the patient is lying on his right side.
Dryness in the mouth, vomiting, nausea, and constipation are the characteristic clinical manifestations of the disease.
During the attack of pain the face is moist with cold perspiration, the skin is pale, the tongue and lips are dry. Even a slight palpation reveals severe tenderness, it being due to irritation of the peritoneum. Approximately in 40- 50% of cases there is slight jaundice of sclerae. The biochemical blood analysis is known to reveal some changes, they resulting from the effect of toxic substances in the liver.
Purulent form of cholecystitis is highly dangerous to life and requires an emergency operation. An even more severe course is observed in gangrenous cholecystitis. Recovery is achieved by surgical treatment, it being followed by prolonged antibiotic therapy and chemotherapy.
a) Supply words and word combinations having close meaning to the following:
preventive, to rise, about five months, to radiate to, to involve, acute, to result in, to determine, lesion, entire
Supply words of the opposite meaning:
to elevate, to recover, to diminish, approximately, dry, empty, sharp, base, to doubt the diagnosis
Use the verbs in brackets in the appropriate tense of the Indefinite group. Translate the sentences:
1. Products of protein, fat, and carbohydrate digestion (to be absorbed) from the gastrointestinal tract by the liver in which they (to undergo) furthur chemical processes. 2. The liver (to destroy) toxic substances which usually (to be formed) in the intestinal tract as well as some poisons which (to enter) the body from without. 3. Jaundice (to be known) to be the disease which (to be due to) the presence of a large amount of bilirubin in the blood and tissues.
Choose the appropriate form of the Infinitive. Translate the sentences:
1. The patient was known ... stool retention accompanied by nausea a month before his present admission to the hospital. (a) to have; b) to have had;
to be having) 2. Sensitivity to antibiotics was reported ... not only in this patient but in all the other members of the family as well since their early age. ( a) to be present; b) to have been present) 3. Prophylactic vaccination was found... since no cases of hepatitis were diagnosed after its administration. (a) to be effective; b) to have been effective) 4. Skin irritation was revealed... after each parenteral administration of this preparation. (a) to occur; b) to have occurred; c) to be occurring)
Make up sentences of your own using each of the given words first as a subject, and then as an attribute:
heart, blood, lymph, serum, nerve
1. Read-Text D. 2. Entitle it. 3. Say why probing with radio-pill is used:
TextD
It is common knowledge how difficult it is to examine the gastrointestinal tract. Long rubber tubes are used and the process of probing is known to cause
the patient much discomfort. It gives only limited possibilities for the examination of the stomach and none at all for the intestine. Usual physiological methods are often ineffective for studying many important processes in the human intestine.
But a small electronic instrument called a radio-pill (радиокапсула) helps the physician in this matter. It is a small tube less than two cm long and only some millimetres in diameter. A very small transistor—transmitter is inside the tube.
The patient swallows this radio-pill which passes along the gastrointestinal tract sending information on pressure, temperature, gastric secretion, the lever of acidity, etc., thus helping the physician to reveal all the pathologic changes.
LESSON 46
HOME ASSIGNMENTS
I. Напишите глаголы, используя указанные суффиксы. Полученные слова переведите:
-ize: general, local, sterile, character;
-en: thick, wide, deep, strength
П.* Определите, какой союз опущен. Предложения переведите:
1. When the urinalysis was ready the physician received all the findings he had insisted on. 2. The surgeon considered the appendix had to be removed immediately because its rupture might cause peritonitis. 3. Almost everything the physician had determined by physical methods of examination was confirmed by laboratory findings. 4. In all the patients except the one the cardiologist has not yet examined the diagnosis of cardiac insufficiency was made.
* Выберите нужную форму причастия для самостоятельного причастного оборота. Предложения переведите:
1. The abdominal pain ... by nausea and vomiting of 20 hours’ duration, the patient was hospitalized for an emergency surgery. ( a) accompanied; b) being accompanied; c) having accompanied; d) having been accompanied) 2. There ... permanent dryness in the mouth, nausea, and constipation, the diagnosis of acute cholecystitis may be suggested. (a) being; b) been; c) having been) 3. The severity of jaundice..., a considerably elevated amount of bilirubin was found in the blood on the following analysis. ( a) increasing; b) being
А. М. Маслова increased; с) having increased; d) having been increased) 4. The postoperative course was smooth for a week, no recurrence of bleeding .... a) observed; b) being observed; c) having observed; d) having been observed)
Переведите, используя самостоятельный причастный оборот (письменно):
Когда врач пальпировал печень, болезненность отмечалась на три пальца ниже реберного края. 2. Иногда желчнокаменная болезнь сопровождается осложнениями, причем развитие холецистита является наиболее частым.
1. Прочтите текст Е. 2. Скажите, при каких заболеваниях может наблюдаться желтушность. 3. Выпишите английские эквиваленты следу ющих словосочетаний:
принимают желтоватую окраску, сильный зуд, в запущенных случаях, обычное осложнение
Text Е. Jaundice
Jaundice is a symptom common to many disturbances and diseases of the liver, such as obstruction of the bile ducts, cancer, etc. In jaundice the skin and the sclerae take on a yellowish colour which may vary in its intensity. Even the serum of the blood is bile coloured. Jaundice is frequently accompanied by severe itching. The pulse is usually slow, and there is a tendency to haemorrhage. In advanced cases nervous symptoms may develop. Jaundice being caused by obstruction, the bile cannot pass to the intestines and the stools are of a white colour. The urine is deeply coloured. In toxic jaundice the stools may be of normal colour or deeply bile coloured.
Infectious jaundice in adults has been found to be due to a virus. It is characterized by fever, vomiting, jaundice and haemorrhage from the nose, intestines, etc., Jaundice is not a rare complication in case of severe intoxication.
Приготовьте сообщение на тему “Infectious Hepatitis” на основании текстов А, В, Е.
CLASS ASSIGNMENTS
Translate the words with the same root:
strong, strength, strengthen, strongly; continue, continuous, discontinue, discontinuous, discontinuation; digest, digestive, digestion, indigestion; sense,
sensitive, sensitivity, senseless, hypersensitivity; thick, thickly, thickness, thicken, thickened; local, locate, localize, localized, localization, location, locality; wide, widely, width, widen, widened
Memorize the reading and meaning of the medical terms: diabetes [,daia’bi:tis] диабет, сахарнаяболезнь
biopsy [‘baiapsi] биопсия (диагностическое исследование ткани, взятой из живого организма)
pigmentation [,р1дтэпЧе1/п]окрашивание stasis [‘steisis] застой, стаз rash [raej] сыпь
Finish the following definitions and answer the questions:
1. The disease of the endocrine system caused by a large amount of sugar in the blood is.... 2. The colouring of the skin caused by some disturbances in the body is.... 3. The diagnostic examination of the tissue taken from a living body is.... 4. An unusual eruption (высыпание) on the skin mostly caused by some infectious disease is ... . 5. The disturbance of blood circulation that causes blood to stop at a certain portion of a vessel is....
What is: a) pigmentation; b) rash; c) diabetes; d) stasis; e) biopsy?
1. Read Text F. 2. Translate the second paragraph; a) name the findings of the physical examination; b) state the abnormalities revealed by laboratory analyses. 3. Summarize the essence of each paragraph in a sentence so as to make the plan of the case history:
Text F. Hepatic damage due to Chemotherapy
A 50-year old woman had been known to have diabetes for 20 years. Her condition had been controlled by diet and administration of 100 units of insulin preparation daily. In an effort to improve the intensity of her control she had been given in addition 1 gr of chlorpropamide1 per day.
About three weeks later she noted general malaise, weakness and loss of appetite, followed in a few days by the discovery of dark urine, light stools and rash on her trunk. With the passage of an additional week by which time she had taken a total of 27 gr of chlorpropamide, she noted jaundice. There was no pain, fever, nausea, or vomiting. Her past history did not reveal liver or bile duct diseases. She was hospitalized on October 10 for further studies.
The findings of the physical examination showed the presence of jaundice and diffuse rash on the chest and abdomen. The liver was enlarged and there was tenderness on palpation.
The blood analysis revealed serum bilirubin to be at the level of 8.9 mg%, the hemoglobin level was 11.6 gr% and the white blood cell count 7,600 per cubic millimetre. Platelets averaged to 490,000 per cubic millimetre. Urinalysis revealed the presence of bile.
The biopsy of the liver performed on October 16 showed normal liver structure. There was mild pigmentation of Kupffer cells2 and slight capillary bile stasis. Some inflammatory reaction in the portal tracts was noted, but no inflammatory or degenerative changes were observed in the hepatic cells.
The patient was discontinued chemotherapy with chlorpropamide and her diabetes was controlled by a diet containing 150 gr of carbohydrates, 75 gr of proteins and 80 gr of fats and the administration of 80 units of insulin preparation daily.
Her symptoms having been relieved after a month’s treatment, the patient was discharged on November 14. She complained of neither jaundice nor any other symptoms when she was seen for a follow-up examination three months later.
Notes
chlorpropamide — хлорпропамид (название препарата)
Kupffer [‘kupfs] cells—купферовские клетки в печени
LESSON 47
HOME ASSIGNMENTS Revision
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