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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.


VIII. 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

b) Supply words of the opposite meaning:

to elevate, to recover, to diminish, approximately, dry, empty, sharp, base, to doubt the diagnosis

IX. 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.

X. 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)

XI. 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

XII. 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.

III.* 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

8 A. M. 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)

IV. Переведите, используя самостоятельный причастный оборот (письменно):

1. Когда врач пальпировал печень, болезненность отмечалась на три пальца ниже реберного края. 2. Иногда желчнокаменная болезнь сопровождается осложнениями, причем развитие холецистита является наиболее частым.

V. 1. Прочтите текст Б. 2. Скажите, при каких заболеваниях может наблюдаться желтушность. 3. Выпишите английские эквиваленты следу­ющих словосочетаний:

принимают желтоватую окраску, сильный зуд, в запущенных случаях, обычное осложнение






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