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Appendicitis is a condition characterized by inflammation of the appendix. It is classified as a medical emergency and many cases require removal of the inflamed appendix, either by laparotomy or laparoscopy. Untreated, mortality is high, mainly because of the risk of rupture leading to peritonitis.

Acute appendicitis is known to occur in all age groups. Its incidence varies in different sex groups: it’s more frequent in women from 20 to 40 years of age. Cases of appendicitis have been noted to occur even in infants and even in very old age.

On the basis of experimental evidence, acute appendicitis seems to be the end result of a primary obstruction of the appendix lumen. Once this obstruction occurs, the appendix subsequently becomes filled with mucus and swells, increasing pressures within the lumen and the walls of the appendix, resulting in thrombosis and occlusion of the small vessels, and stasis of lymphatic flow.

Acute appendicitis is known to begin suddenly with sharp pain which is at first felt in epigastrium but then becomes generalized in the abdomen. The pain becomes worse on deep breathing in and coughing, it does not radiate but is accompanied by nausea, retention of stools and gases.

The temperature is normal or subfebrile and there is moderate leucocytosis. The ESR is initially normal. With the development of the disease temperature elevation is observed and ESR becomes increased. The pulse is quick but it is found to be not more than 90-100 beats per minute. The tongue is coated and dry.

The attack of acute of acute appendicitis is known to last from 3-4 days. Then the temperature returns to normal, abdominal pains decrease and only a moderate tenderness is felt in the right lower part of the abdomen on palpation.

Acute appendicitis is treated surgically. The surgical procedure for the removal of the appendix is called an appendicectomy. Often now the operation can be performed via a laparoscopic approach, or via three small incisions with a camera to visualize the area of interest in the abdomen. If the findings reveal suppurative appendicitis with complications such as rupture, abscess, adhesions, etc., conversion to open laparotomy may be necessary.

The appendix is removed immediately to prevent its rupture which may result in peritonitis. Such forms of appendicitis as gangrenous and perforating are particularly dangerous to life. But sometimes even a mild form of appendicitis may take a severe course and to result in perforation.

Full recovery from appendectomies takes about four to six weeks, but can be prolonged to up to eight weeks if the appendix had ruptured.

 

VI. Give English equivalents:

Частота випадків, немовля, вдох, кашель, супроводжуватися (2 синоніма), підвищуватися (3 синоніма), язик обкладено, зменшуватися (2 синоніма), розрив, приводити до прободіння.

 

VII. Complete the sentences according to the text:

1. Acute appendicitis occurs mostly in _________ than in ________.

2. At first patient feels _________________________________.

3. The pain becomes worse ______________________________.

4. Further, the temperature ______________________________.

5. The attacks last for _____________________________.

6. While examination the tongue is _______________.

7. After the attack the temperature and the pains ____________

8. If not treated, acute appendicitis may result in _________________________.

 

VIII. Answer the questions to the text:

1. What is acute appendicitis?

2. What predisposes the onset of acute appendicitis?

3. Who can get ill with acute appendicitis?

4. What are the complaints of the patient?

5. What examinations are necessary to make a diagnosis?

6. What can the examination reveal?

7. How can acute appendicitis be treated?

 

IX. Approve or contradict.

1. Appendicitis can be of acute, chronic, gangrenous form.

2. Acute appendicitis occur more in man than in women at the age from 25 to 40.

3. Acute appendicitis begins with pain in substernal area.

4. The pain is accompanied by fever, perspiration and discharge of sputum.

5. Patients with acute appendicitis are administered antibiotics.

6. The rupture of appendix can lead to peritonitis.

 

X. Translate the words in brackets in English.

1. The patient complains of pain (яка супроводжувалася нудотою).

2. The doctor (визначив) subfebrile temperature and (підвищенну) ESR.

3. The operation on acute appendicitis (проводилася) under (загальна) aneasthesia.

4. After the examination the surgeon (поставив діагноз) of acute appendicitis which need surgical operation because it can (привести до прободіння).

5. The surgeon (видалив) the appendix to prevent its (розрив).

6. Suppurative appendicitis may cause (ускладнення) such as (розрив), abscess, (спайки).

 

XI. Put questions to underlined words:

1. Cases of appendicitis have been noted even in infants.

2. The appendix is removed immediately to prevent its rupture.

3. The rupture of appendix can lead to peritonitis.

4. Acute appendicitis begins suddenly with sharp pain.

5. Patients with acute appendicitis are administered antibiotics.

6. On admission to the hospital the patient complained of a severe pain in epigastria area.

 

XII. Open the brackets and put the verbs in a correct form:

1. The doctor (to study) the patient’s sensitivity to penicillin before the treatment (to begin).

2. The patient (not to operate) yet as not all analyses (to make).

3. The doctor (to write) a prescription when a nurse (to enter) the room.

4. If the patient (to survive) the first week, his chances of recovery greatly (to improve).

5. I never (to suffer) from such horrible headache.

6. All food (to consist) of proteins, fats and carbohydrates.

 

XIII. Open the brackets using the correct form of the infinitive and translate the sentences into Ukrainian:

1. He appears (to know) French.

2. The man doesn’t seem (to recognize) you.

3. He is said (to spend) his youth in Paris.

4. She is sure (to help) you, if you ask her to.

5. They seem (to quarrel) now.

6. She is likely (to forget) al about it. Do you think we should remind her?

 

XIV. Change the following complex sentences into simple using Complex Subject.

1. It is known that infectious diseases are caused by viruses and microbes.

2. They say that a new epidemic of the flu will come soon.

3. It is likely that your son has measles.

4. It is supposed that the operation will be performed next week.

5. It is likely that the wound will heal in about a week.

6. It is likely that the reaction will be prolonged.

XV. Explain the following terms in 5 sentences:

Appendix, appendicitis, peritonitis, abdomen

 

TEST

1. Appendicitis is a condition characterized by _____________.

a) Adhesions in appendix b) inflammation of the appendix c) ulcers in appendix

 

2. Mortality is high because of the risk of rupture leading to

a) Gastritis b) peritonitis c) angina pectoris

 

3. Suppurative appendicitis may lead to complications such as

a) Gastric ulcer b) rupture, abscess, adhesions c) pyelonephritis

 

4. Acute appendicitis is treated

a) by antibiotics b) surgically c) by sulfanilamides

 

5. Acute appendicitis seems to be the end result of

a) Erosions in the appendix mucosa b) obstruction of the appendix lumen

c) inflammation of the intestines

 

6. The appendix is removed to prevent its rupture which may result in

a) Pyelonephritis b) peritonitis c) nephrolithiasis

 

7. The pain in acute appendicitis is accompanied by

a) Diarrhea, belching b) vomiting, heartburn c) nausea, retention of stools and gases

 

8. Acute appendicitis is known to occur

a) Mostly in elderly people b) in all age groups c) in youth

 

9. Symptoms of acute appendicitis are

a) Pains, heartburns, retention of gases b) acute pains, nausea, retention of gases

c) diarrhea, high fever

 

10. Full recovery from appendectomies takes about

a) four to six weeks b) up to 8 weeks c) no more than 3 weeks

 

Acute Cholecystitis – Гострий холецестит

 

Exercise 1. Practice pronunciation of the following words:

cholecystitis [kolisis'taitis], intrahepatic [intrahi'paetik], extrahepatic [ekstrahi'paetik], hyppchondrium [haipo'kondriə m], [mbi'laikal], peritoneum [, perito(u)'ni: ə m], chemotherapy [kemo(u)'θ erapi], irritation [iri'tei∫ n],

approximately [a'proksimitli], emergency [i'mə: dʒ nsi]

 

Exercise 2. Translate the following word-combinations:

Onset of pain, involvement of the liver, intense pain, physical and mental overstrain, umbilical area, fatty food, clinical manifestation, cold perspiration, severe tenderness, irritation of the peritoneum, severe course, to result from the effect of toxic substances, prolonged therapy, sharp physical movement, health person

 

Exercise 3. Translate into Russian paying attention to the Complex Subject

1. Cholecystitis is known to occur rarely in isolate condition.

2. The patient with cholecystitis is known to complain of intense pain, it being localized in the right hypochondrium and in the umbilical area.

3. Sometimes pain is observed to appear suddenly in quite healthy persons.

4. The chemical blood analysis is known to reveal some changes, they resulting from the effect of toxic substances in the liver.

5. The chemical blood analysis is known to reveal some changes, they resulting from the effect of toxic substances in the liver.

 

Exercise 4. Read and translate the text:

Acute Cholecystitis

Among inflammatory diseases of bile ducts the most frequent is cholecystitis or the inflammation of the gal bladder. Cholecystitis is known to occur rarely in isolate 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 physic 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 cc perspiration, the skin is pale, and the tongue and lips are dry. Even a slight palpation reveals severe tenderness, it being due to irritation of the peritoneum. Approximately in 50% of cases there is slight jaundice of sclerae. The chemical 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.

 

Exercise 5. 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.

 

Exercise 6. 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; c) 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)

 

Exercise 7. Translate the sentences paying attention to the construction Complex subject:

1. This diet seems to be good for the patients and should be recommended.

2. The basic mode of action is thought to be the same.

3. An ECG-based diagnosis may prove to be extremely difficult in patients with re-infarction.

4. A new imaging system is expected to give radiology additional information to guide biopsy recommendation.

5. Coronary patients are established to be at an increased risk of cardiac infarction.

6. Environmental factors are known to of significance.

7. Additional studies are required to determine the precise role of protein.

 

Exercise 8.Match the explanations with the terms.

1. A condition in which bowel evacuations occur infrequently and cause difficulty or pain.	a. inflammation
2. A yellowing of the skin or whites of the eyes, indicating excess bilirubin in the blood.	b. gall-bladder
3. The process of examining part of the body by careful feeling with the hands or fingertips	c. constipation
4. A pear-shaped sac lying underneath the right lobe of the liver, in which bile is stored	d. palpation
5. The body’s response to injury, which may be acute or chronic. It is characterized by five signs: swelling, pain, redness, warmth and dysfunction	e. jaundice

 

Exercise 9. Answer the questions to the text:

1. What is cholecystitis?

2. What are the main forms of cholecystitis?

3. What are the manifestations of cholecystitis?

4. Where is the pain localized in attack of cholecystitis?

5. When does the pain grow worse in acute cholecystitis?

6. Where can the pain irradiate in case of acute cholecystitis?

7.

Exercise10. Put questions to the underlined words:

1. Hydrochloric acid is greatly diminished or absent in untreated cases of chronic gastritis.

2. Cases of appendicitis have been noted even in infants.

3. Tuberculosis may affect not only the lungs but also other organs.

4. The pain often occurs between meals and early in the morning.

5. Blood pressure involves two measurements.

6. The blood analysis revealed moderate leucocytosis and an elevated ESR.

7. People with ulcers may experience serious complications.

8. The bacterium produces substances that weaken the stomach’s protective mucosa.

9. Symptoms vary with the severity of the inflammation.

10. On admission to the hospital the patient complained of a severe pain in the epigastrium.

 

Exercise 11. Explain the terms:

Cholecystitis, inflammation

TEST

1. Cholecystitis is an inflammation of ….

a) bladder b) gall-bladder c) liver d) bile ducts

 

2. The patient with cholecystitis complains of pain in the ….

a) right shoulder b) lower abdomen c) right scapula d) right hypochondrium

 

3. The pain grows worse when the patient is lying….

a) on his back b) on the right side c) on the left side d) on this abdomen

 

4. Purulent form of cholecystitis is dangerous to life and requires ….

a) conservative treatment b) intake of a lot of drugs

c) emergency operation d) cleansing enema

 

5. Usually even a slight palpation of the gall-bladder … severe tenderness.

a) reveal b) is revealing c) reveals d) has revealed

 

6. Approximately in … of cases there is slight jaundice of sclerae.

a) 30% b) 40% c) 50% d) 60%

 

7. In cholecystitis pain may radiate to ….

a) the right shoulder b) the upper arm c) the groin d) the right leg

 

8. The chemical changes in blood result … the effect of toxic substances in the liver.

a) in b) from c) by d) through

 

9. An attack of pain is usually preceded … physical and mental overstrain, fatty food, etc.

a) in b) with c) from d) by

 

10. The intensity of pain depends … the form of cholecystitis and the patient’s sensititvity.

a) at b) on c) in d) from

 

 

Atherosclerosis - Атеросклероз

 

Exercise 1. Learn the active vocabulary:

thicken [ˈ θ ɪ kə n] згущувати(ся) accumulation [ə ˌ kjuː mjʊ ˈ leɪ ʃ ə n] нагромадження, накопичення cholesterol [kə ˈ lɛ stə ˌ rɒ l] холестерин hardening [ˈ hɑ ː də nɪ ŋ ] твердіння furring [ˈ fɜ ː rɪ ŋ ] утворення нальоту multiple [ˈ mʌ ltɪ pə l] численний

plaque [plɑ ː k] кров'яна бляшка enable [ɪ nˈ eɪ bə l] робити можливим, полегшувати, давати змогу overstrain [ˌ ə ʊ və ˈ strein] перенапруження cumulative [ˈ kjuː mjʊ lə tɪ v] сукупний rupture [ˈ rʌ ptʃ ə ] розриватися

 

Exercise 2. Match the words from the active vocabulary with their definitions:

1) cholesterol 2) hardening 3) plaque 4) rupture 5) overstrain 6) accumulation

a) a fatty deposit inside an arterial wall b) excessive tension c) a white crystalline substance, found in animal tissues and various foods, that is normally synthesized by the liver and is important as a constituent of cell membranes. Its level in the bloodstream can influence the pathogenesis of certain conditions, such as the development of atherosclerotic plaque and coronary artery disease. d) to break or to tear e) gradual gathering of something f) the process of becoming hard or harder

 

Exercise 3. Translate the following word combinations:

Arteriosclerotic vascular disease, accumulation of fatty materials, hardening or furring of the arteries, formation of multiple plaques within the arteries, remain asymptomatic for decades, meta­bolic disturbances, disturbances of cholesterol exchange, external evidence of the disease, preven­tive measures, follow a certain regimen, sound sleep, enable the nerve cells to rest, exclude mental and physical overstrain, incidence of atherosclerosis, insufficient physical activity, affect unfavourably, sufficient amount of proteins, take in limited doses, dilate peripheral vessels, improve general condition, advanced atherosclerosis.

 

Exercise 4. Read and translate the text:

Atherosclerosis and Its Treatment

Atherosclerosis (also known as arteriosclerotic vascular disease or ASVD) is a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol. It is commonly referred to as a hardening or furring of the arteries. It is caused by the formation of multiple plaques within the arteries. Atherosclerosis is a chronic disease that remains asymptomatic for decades. There is a num­ber of factors which may determine its development.

Atherosclerosis of the blood vessels results from meta­bolic disturbances and particularly from disturbances of cholesterol exchange. These disturbances begin long before there is any external evidence of the disease. Therefore the doctor must prevent its appearance beginning preven­tive measures and treatment as early as possible.

Prevention and treatment of atherosclerosis consist mainly of a certain regimen for the patient, which he must strictly follow. The patient must get up, eat, work, and go to bed at exactly the same time every day.

Sound sleep is very important since it enables the nerve cells to rest. The patient with the signs of atherosclerosis must sleep not less than 7-8 hours and walk before going to bed. Mental and physical overstrain must be excluded.

The incidence of atherosclerosis is high in professional groups with insufficient physical activities. So physical exercises must be part of the prescribed regimen for such persons.

Smoking affects unfavourably the walls of the blood vessels and can result in their spasm, that is why patients suffering from atherosclerosis must not smoke.

The diet of the patients with atherosclerosis must contain sufficient amount of proteins, but fats and carbohy­drates must be taken in very limited doses.

Vitamins are widely used in the treatment of atherosclerosis because some of them improve the metabolic pro­cesses and others dilate the vessels, particularly the periph­eral ones.

Other drugs administered in treating atherosclerosis are the so-called lipotropic substances, which prevent fat from accumulating in the organism.

Since the nervous system affects the metabolic processes in the human body the patients with atherosclerosis are prescribed such drugs as bromide and valerian to improve its general condition.

Complications of advanced atherosclerosis are chronic, slowly progressive and cumulative. Most commonly, soft plaque suddenly ruptures, causing the formation of a thrombus that will rapidly slow or stop blood flow. It will lead to death of the tissues fed by the artery in approximately 5 minutes. This catastrophic event is called an infarction. One of the most common recognized scenarios is called coronary thrombosis of a coronary artery, causing myocardial infarction. The same process in an artery to the brain is commonly called stroke.

 

Exercise 5. Answer the following questions:

1. What is atherosclerosis?

2. What is atherosclerosis caused by?

3. What does prevention and treatment of atherosclerosis mainly consist of?

4. Why is sound sleep important for patients with atherosclerosis?

5. In which professional groups is the incidence of atherosclerosis high?

6. What must the diet of the patients with atherosclerosis contain?

7. Why are vitamins widely used in the treatment of atherosclerosis?

8. What drugs are administered in treating atherosclerosis?

9. What can advanced atherosclerosis lead to?

10. What does sudden rupture of soft plaque cause?

 

Exercise 6. Find the equivalents of the following word combinations in the text:

Кількість випадків атеросклерозу; запущений атеросклероз; покращувати загальний стан пацієнта; розширювати периферичні судини; впливати на метаболічні процеси; призначати ліки; приймати у дуже обмежених дозах; містити достатню кількість білків; несприятливо впливати на стінки кровоносних судин; недостатня фізична активність; міцний сон; давати змогу нервовим клітинам відпочити; неухильно дотримуватися певного режиму; порушення холестеринового обміну; зовнішні прояви хвороби; накопичення жирових матеріалів; формування численних бляшок в артеріях.

 

Exercise 7. Insert the missing prepositions into the gaps:

1) Patients suffering … atherosclerosis must not smoke.

2) Other drugs administered…treating atherosclerosis are the so-called lipotropic substances.

3) Atherosclerosis is commonly referred … as a hardening or furring of the arteries.

4) Atherosclerosis is caused … the formation of multiple plaques … the arteries.

5) Atherosclerosis is a chronic disease that remains asymptomatic … decades.

6) Sound sleep is very important … it enables the nerve cells to rest.

7) The diet … the patients with atherosclerosis must contain sufficient amount … proteins.

8) Smoking affects unfavourably the walls … the blood vessels and can result … their spasm.

 

Exercise 8. Put questions to the underlined words:

1) The same process in an artery to the brain is commonly called stroke.

2) It will lead to death of the tissues in approximately 5 minutes.

3) Smoking affects unfavourably the walls of the blood vessels.

4) Atherosclerosis is caused by the formation of multiple plaques within the arteries.

5) Mental and physical overstrain must be excluded.

6) Atherosclerosis remains asymptomatic for decades.

7) Atherosclerosis of the blood vessels results from meta­bolic disturbances.

8) These disturbances begin long before there is any external evidence of the disease.

 

Exercise 9. Open the brackets with the appropriate forms of the verbs:

1) The diet of this patient (to contain) sufficient amount of proteins.

2) The same process in an artery to the brain (to call) stroke.

3) The nervous system (to affect) the metabolic processes in the human body.

4) The patient (to sleep) 8 hours last night.

5) Lipotropic substances (to administer) in treating atherosclerosis.

6) Lipotropic substances (to prevent) fat from accumulating in the organism.

7) He (to go) to bed at the same time every day.

8) Coronary thrombosis of a coronary artery (to cause) myocardial infarction in this patient.

 

Exercise 10. Explain the terms in 5 sentences:

1) Atherosclerosis

2) Plaque

3) Cholesterol

GRAMMAR

REPORTING COMMANDS AND REQUSTS

To report commands or requests we use a reporting verb (advise, ask, beg, offer, order, tell etc) followed by a to-infinitive or a not to-infinitive. Examples: Direct Speech Reported Speech She said to me, “Come with me.” He said to her, “Please, don’t tell anyone about it! ” She told me to come with her. He asked her not to tell anyone about it.

 

Exercise 1. Report the doctor’s recommendations to the patient with atherosclerosis:

1. The doctor said to the patient, “Go to bed at exactly the same time every day.”

2. The doctor said to the patient, “Walk before going to bed.”

3. The doctor said to the patient, “Do not smoke.”

4. The doctor said to the patient, “Follow the prescribed regimen strictly.”

5. The doctor said to the patient, “Do not eat a lot of fatty food.”

6. The doctor said to the patient, “Avoid mental or physical overstrain.”

7. The doctor said to the patient, “Do not drink too much coffee.”

8. The doctor said to the patient, “Come for the next check-up in a month”

 

Exercise 2. Translate the sentences into English:

1. Лікар порадив пацієнту дотримуватися певної дієти.

2. Лікар наказав санітарам відвезти хворого на рентген.

3. Лікар сказав пацієнту не рухатися.

4. Лікар попросив медсестру зробити хворому ін’єкцію.

5. Він сказав їй не хвилюватися.

6. Вона благала лікаря не казати про це її матері.

7. Медсестра попросила хворого лягти на живіт.

8. Вона сказала нам залишатися тут і чекати на неї.

 

TEST

1. Atherosclerosis is a condition in which an artery wall thickens as a result of…

a) high blood pressure b) the accumulation of fatty materials such as cholesterol