Anglický jazyk

11.3 Medical English - Medical examination and hospital care

Patients in need of medical treatment usually go to see the GP – the general practitioner. In order to make the patient's diagnosis the GP must learn about common symptoms, the subjective manifestations of the patient's chief complaint. He or she may complain of sore throat, cough, nausea, weakness, tremor or pain. The physician will want to know if the patient has a high temperature and will measure it with a thermometer. The most common symptoms include sweating, general body ache, headache, backache, muscle or joint ache, diarrhoea or constipation, and breathlessness.
On examination the doctor may find rash, swelling, distension or tumor. These belong under objective findings called signs which also include the results of routine laboratory examination of the blood, sputum, urine, stools and sometimes even the cerebrospinal fluid. For example the blood or erythrocyte sedimentation rate (BSR or ESR) and blood count, simple or differential, are important guides for a reliable diagnosis. So is the examination of sputum for bacilli of tuberculosis, pneumococci, staphylococci, pus or blood. The urine is analyzed for the presence or exact proportions of albumin, sugar, acetone, blood, bilirubin as well as for colour, specific gravity and total quantity per 24 hours.
In order to obtain a clear clinical picture, the doctor may want to have the patient x-rayed or send him or her for ECG or EEG test. Perhaps gastric juices might be analyzed ar a bronchoscopy etc. performed. Usually these examinations are carried out in a hospital rather than in a GP's consulting room.
  
 
A normal ECG
Source: Glendinning, Howard, 2007.
 
In the GP's office they are likely to use the four classical methods: inspection to observe visible signs of the patient's condition, palpation to feel tumors, swelling etc., percussion – tapping on the chest or other parts of the body and listening to the quality of the sound, and auscultation to hear chest sounds, irregularity of the heart beat or peristaltic sounds in the abdominal cavity.
In examining the patient the doctor proceeds top down, from the head over the chest and abdomen to the limbs. Together with the patient's past history and family history the examinations help establish a reliable diagnosis and determine what kind of treatment the patient needs. The GP then writes a prescription for drugs, recommends bed rest or hospitalization, or refers the patient to a specialist.
  
Symptoms and patients' expressions.
Source: Glendinning, Howard, 2007.
  
Hospital care
The practice of medicine is concerned with the prevention, investigation, diagnosis and treatment of diseases, the alleviation of suffering and promotion of medical knowledge and education. The career system in the United Kingdom is different from the Czech system. In the UK there are GPs – general practitioners also called family doctors. Doctors engaged in specialist practice (surgery, pathology, radiology etc.) are referred to as specialist. The specialists who hold consultant posts in hospitals are called consultants. This is the most senior grade in medical posts. Doctors occupying medical assistant's posts have many years of experience but lack the appropriate training to become consultants. Doctors who have the highest degree of their chosen specialty hold medical or surgical registrar posts. A house officer or houseman is a junor doctor who si gaining experience in a hospital. He or she is often resident in the „house“, that is the hospital. A nursing officer or ward sister is in charge of the ward administration. These workers are responsible to the medical staff and the head nurse. Nursing officers are assisted by fully qualified staff nurses, enrolled nurses with shorter training, student nurses, pupil nurses, nursing auxiliaries and ward orderlies. Links with the community are provided by health visitors and medical social workers who help the patients with their problems. In addition to these there might be other people working in allied professions, for example chiropodists, dieticians, physiotherapists, laboratory technicians etc., referred to as paramedical staff.
 
general practitioner
praktický lékař
chief
hlavní
sweating
pocení
constipation
zácpa
swelling
otok
distension
roztažení
specific gravity
specifická váha
palpation
pohmat
percussion
poklep
tap
poklepat
establish
ustanovit
determine
určit
bed rest
klid na lůžku
alleviation
úleva
houseman
sekundář
enrolled nurse
ošetřovatelka
ward orderly
sanitář
allied
příbuzný, připojený