Chronic obstructive pulmonary disease

Phonetic exercise: respiratory [ri’spirətəri; ri’spairərətəri; ‘respirətəri], pulmonary [‘pΛlmənəri; ‘pulmənəri], chronic [‘kr nik], obstructive [ [əb’strΛktiv], pulmonary [‘pΛlmənəri; ‘pulmənəri], disease [di’zi:z], disorder [dis’so:də; diz’o:də], characterized [‘kæktəraizd], bronchus [‘br ŋkəs], bronchi [‘br ŋkai], passages [‘pæsid3iz], airways [‘εəwiz], lungs [lΛŋz], mucous [‘mju:kəs],  mucus [‘mju:kəs], respiration [,respə’rei∫n], bronchitis [,br ŋk’aitis], approximately [ə’pr ksimətli],  diagnosis [,daiə‘gn usis], diagnose [‘daiəgn uz], exposure [iks‘əu3ə], pollution [pə‘lu:∫n], sputum [‘spju:təm], pollution [pə‘lu:∫n], dyspnea [disp’ni:ə], emphysema [,empfi’si:mə], lungs [lΛŋz], cough [k :f], tightness [‘taitnis], rales [r lz], environmental [in,vaiərən’məntl], autoimmunity [, təui’mju:niti], autoimmune           [, təui’mju:n], spirometry [,spaiə‘r mətri], cessation [səs’ei∫n]  

 

Make a report on chronic obstructive pulmonary disease according to the plan below:

Definition: chronic obstructive lung disease (COLD), chronic obstructive airway disease (COAD), chronic airflow limitation (CAL) and chronic obstructive respiratory disease (CORD); chronic bronchitis and emphysema, a pair of commonly co-existing diseases of the lungs in which the airways become narrowed.

Epidemiology: in the United States, the prevalence of COPD is approximately 1 in 20 or 5%, totaling approximately 13.5 million people in USA, or possibly approximately 25 million people if undiagnosed cases are included.

Causes: smoking (80 to 90% of cases of COPD are due to smoking0; occupational exposures (occupational pollutants, intense and prolonged exposure to workplace dusts found in coal mining, gold mining, and the cotton textile industry and chemicals, intense silica dust exposure); air pollution, genetics (a genetic susceptibility); other risk factors: bronchial hyperresponsiveness, repeated lung infections, a diet high in cured meats, an autoimmune component to COPD, etc.

Symptoms, signs, clinical manifestations, clinical features: cough and sputum production (in chronic bronchitis), dyspnea (in emphysema); decreased intensity of breath sounds; prolonged expiration on physical examination; airflow limitation on pulmonary function testing that is not fully reversible and most often progressive; shortness of breath; dyspnea that tends to get gradually worse during milder, everyday activities such as housework, dyspnea that occurs during rest and is constantly present. Other symptoms of COPD: persistent cough; sputum or mucus production; wheezing; chest tightness, and tiredness; respiratory failure in advanced (very severe) COPD, cyanosis, a bluish discoloration of the lips caused by a lack of oxygen in the blood; headaches; drowsiness or twitching; peripheral edema, seen as swelling of the ankles; tachypnea, a rapid breathing rate; wheezing sounds or crackles in the lungs heard through a stethoscope; breathing out taking a longer time than breathing in; enlargement of the chest, particularly the front-to-back distance (hyperaeration); active use of muscles in the neck to help with breathing; breathing through pursed lips, etc.

Evaluation (diagnosis): History: a personal medical history, a medication history, a family history, a smoking history, a history of exposure to risk factors for the disease such as regular tobacco smoking. a social history, an occupational history, an environmental history, etc.

Physical examination: observation, percussion, palpation, and auscultation.

Instrumental evaluation: spirometry, X-ray of the chest, complete pulmonary function tests, a high-resolution computed tomography scan of the chest, blood samples taken from an artery, blood samples taken from a vein, etc.

Management: no cure for COPD; however, COPD is both a preventable and treatable disease.

The major current directions of COPD management: to assess and monitor the disease, to reduce the risk factors, to manage stable COPD, to prevent and treat acute exacerbations and manage comorbidity; smoking cessation and supplemental oxygen.

Risk factor reduction: smoking cessation, the role of anti-smoking health: education of workers and management about the risks, promoting smoking cessation, surveillance of workers for early signs of COPD, the use of personal dust monitors, the use of respirators and dust control, improving ventilation, using water sprays, using mining techniques that minimize dust generation; pollution reduction efforts which should lead to health gains for people with COPD; bronchodilators; β2 agonists, anticholinergics that cause airway smooth muscles to relax; corticosteroids that act to reduce the inflammation in the airways; other medications: theophylline; supplemental oxygen; pulmonary rehabilitation: a program of exercise, disease management and counseling to benefit the individual; nutrition: weight control; surgery in selected cases: bullectomy, surgical removal of a bulla, lung volume reduction surgery, lung transplantation for severe COPD, particularly in younger individuals.

 

MEDICAL HUMOR

*****

A man went to see his doctor because he was suffering from a miserable cold. His doctor prescribed some pills, but they didn't help. On his next visit the doctor gave him a shot, but that didn't do any good. On his third visit the doctor told the man to go home and take a hot bath. As soon as he was finished bathing he was to throw open all the windows and stand in the draft."But doc," protested the patient, "if I do that, I'll get pneumonia.""I know," said his physician. "I can cure pneumonia."

*****

A doctor is listening to his patient’s lungs whispering, “It’s good! It’s good! It’s very good!”

“What do you mean by saying ‘It’s very good”, replies the patient.

“It’s very good I have no disorders of this kind!”

*****

You have a cough? Go home tonight, eat a whole box of Ex-Lax, tomorrow you’ll be afraid to cough.

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Patient: "Doctor, are you sure I'm suffering from pneumonia? I've heard once about a doctor treating someone with pneumonia and finally he died of typhus." Doctor: "Don't worry, it won't happen to me. If I treat someone with pneumonia he will die of pneumonia."

*****

Doctor to his patient, “Those light cigarettes have given you ‘light cancer’.”

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What is the worst thing about a lung transplant? Coughing up the other person’s sputum.

*****

Blue bloater - someone with COPD; particularly someone with chronic bronchitis who has trouble inhaling

 

THE CENTRAL NERVOUS SYSTEM

Phonetic exercise: nervous system [‘n :vəs ‘sistim], peripheral [pə‘rifərəl], nerves [‘n :vz],  control [kən’trəul], behavior [bi’heivjə], cranium [‘kreiniəm], spinal [‘spainəl], substances [‘sΛbstənsiz], neurons [‘njuər nz], frontal [‘frΛntəl], parietal [pə‘raiətəl], temporal [‘tempərəl], occipital [ k’sipitəl], cerebellum [,seri‘beləm], column [‘k ləm], balance [‘bæləns], cervical [‘s :vikl; sə‘vaikl], thorasic                 [θ :’ræsik], lumbar [‘lΛmbə], sacral [‘seikrl], coccygeal [k k’sid3iəl], encephalitis [,ensəfə‘laitis], meningitis [,menin’d3aitis], stroke [str uk], transient [‘trænziənt], ischemic [is’ki:mik], attack [ə‘tæk], tumours [‘tju:məz], polio [‘pəuliəu], paralysis [pə‘ræləsis], etc.

 

Make a report on the central nervous system according to the plan below:

Definition: the part of the nervous system that coordinates the activity of all parts of the body.

Function: to control behaviour.

Structure: the brain and the spinal cord.

Location: the brain: in the cranium (the skull); the spinal cord: in the spinal column

The brain: left and right cerebral hemispheres; grey and white substances; folded surface of the cerebral cortex; 50 billion –100 billion neurons; 4 lobes: functions: the f rontal lobe : is responsible for thought; the p arietal lobe : integration of sensory information; the o ccipital lobe : sense of sight; the t emporal lobe : senses of smell and sound.

Weight of the brain: 1,300 - 1,400 g

The cerebellum: location: at the back; functions: balance and muscle coordination.

The spinal cord: the main pathway for information;

the main function: to connect the brain and peripheral nervous system;

the length: about 45 cm long in men and 43 cm long in women; 3 spinal meninges; 31 (or 25, counting the sacral as one solid piece) spinal cord nerve segments: 8 cervical segments; 12 thoracic segments; 5 lumbar segments; 1 or 5 sacral segments; 1 coccygeal segment.

The most common diseases: encephalitis or inflammation of the brain, meningitis or inflammation of the meninges, stroke or cerebrovascular accident, hemorrhagic stroke, ischemic stroke, transient ischemic attack (TIA), brain tumours, benign brain tumours, malignant brain tumours, polio or poliomyelitis, paralysis, monoplegia, hemiplegia, paraplegia, panplegia, etc.

Stroke

Phonetic exercise: nervous system [‘n :vəs ‘sistim], neurological      [,njuərə’l d3ikl], encephalitis [,ensəfə‘laitis], meningitis [,menin’d3aitis], stroke [strəuk], transient [‘trænziənt], ischemic [is’ki:mik], hemorrhage [‘hemərid3], hemorrhagic [,hemə’ræd3ik], accident [‘æksidənt],  attack [ə‘tæk], tumours [‘tju:məz], polio [‘pəuliəu], paralysis [pə‘ræləsis], ultrasound [‘Λltrəsaund], magnetic [mæg’netik]; resonance [‘rezənəns], imaging [‘imid3iŋ], thrombus  [‘θr mbəs],   thrombosis [θr m’bəusis],   interruption [,intə’rΛp∫n], obstruction [əb’strΛk∫n], cholesterol [kə‘lestər l], supply [sə‘plai], area [‘eəriə], hemiplegia [,hemi’pli:d3iə], numb [nΛm], numbness [‘nΛmnəs], obesity [əu’bi:səti; əu’bi:siti], vibratory [‘vaibrətəri], dysphasia [dis’feiziə], aphasia [ə’feiziə, æ’feiziə], vertigo [‘və:tigəu], consciousness                 [‘k n∫əsnəs], arteriography [a:,tiəri’ grəfi], electrocardiography [,ilektrok di‘ grəfi], ultrasound [‘Λltrəsaund], angioplasty [‘ænd3i ,plæsti]

Make a report on stroke according to the plan below:

Definition: a cerebrovascular accident (CVA), the rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain.

Definition of the World Health Organization: a "neurological deficit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours".

Classification: two major categories: ischemic stroke and hemorrhagic stroke.

Causes of ischemic strokes: interruption of the blood supply. Blood supply to part of the brain is decreased, leading to dysfunction of the brain tissue in that area. In an ischemic stroke, there are four reasons why this might happen: thrombosis (obstruction of a blood vessel by a blood clot forming locally), embolism (obstruction due to an embolus from elsewhere in the body), systemic hypoperfusion (general decrease in blood supply, e.g. in shock), venous thrombosis.

Cause of hemorrhagic strokes: rupture of a blood vessel or an abnormal vascular structure.

Epidemiology: Stroke could soon be the most common cause of death worldwide. Stroke is currently the second leading cause of death in the Western world, ranking after heart disease and before cancer, and causes 10% of deaths worldwide. 87% of strokes are caused by ischemia, and the remainder by hemorrhage.

Risk factors:  high blood pressure, atrial fibrillation, high blood cholesterol levels, diabetes, cigarette smoking (active and passive), heavy alcohol consumption, drug use, lack of physical activity, obesity and unhealthy diet.

Symptoms, signs, clinical manifestations, clinical features: Stroke symptoms typically start suddenly, over seconds to minutes, and in most cases do not progress further.

The symptoms: sudden-onset face weakness, arm drift (e.g. if a person, when asked to raise both arms, involuntarily lets one arm drift downward), abnormal speech, hemiplegia and muscle weakness of the face, numbness, reduction in sensory or vibratory sensation, altered smell, taste, hearing, or vision (total or partial), drooping of eyelids (ptosis) and weakness of ocular muscles, decreased reflexes: swallowing, pupil reactivity to light, balance problems, altered breathing and heart rate, inability to turn head to one side, weakness in the tongue (inability to protrude and/or move from side to side), aphasia (inability to speak or understand language), apraxia (altered voluntary movements), visual field defect, memory deficits (involvement of temporal lobe), disorganized thinking, confusion, altered movement coordination, vertigo and or disequilibrium; associated symptoms: loss of consciousness, headache, and vomiting, etc.

Evaluation: History: a personal medical history, a medication history, a family history, a social history, an occupational history, an environmental history, a neurological status history, an alcohol consumption history, a tobacco consumption history, etc.

Physical examination: observation, percussion, palpation, auscultation, neurological examination.

Instrumental evaluation: CT scans or MRI scans, Doppler ultrasound, and arteriography; no commonly used blood tests for the stroke diagnosis itself, though blood tests may be of help in finding out the likely cause of stroke; an electrocardiogram (ECG) and echocardiogram (to identify arrhythmias and resultant clots in the heart which may spread to the brain vessels through the bloodstream); a Holter monitor study to identify intermittent arrhythmias, an angiogram of the cerebral vasculature (if a bleed is thought to have originated from an aneurysm or arteriovenous malformation), etc.

Treatment: admittion to a "stroke unit", a ward or dedicated area in hospital staffed by nurses and therapists with experience in stroke treatment.

Treatment of ischemic stroke: thrombolysis, or thrombectomy; treatment with medications such as aspirin, clopidogrel and dipyridamole to prevent platelets from aggregating; control of blood sugars, ensuring the patient has adequate oxygenation and adequate intravenous fluids; intra-artial fibrinolysis, where a catherter is passed up an artery into the brain and the medication is injected at the site of thrombosis; mechanical thrombectomy; angioplasty and stenting; therapeutic hypothermia; secondary prevention of ischemic stroke: anticoagulation. Patients may be positioned with their heads flat on the stretcher, rather than sitting up, to increase blood flow to the brain. It is common for the blood pressure to be elevated immediately following a stroke.

Treatment of hemorrhagic stroke: anticoagulants and antithrombotics, oxygenation

Care and rehabilitation: the cornerstones of the rehabilitation process: physiotherapy and occupational therapy; a wheelchair, walkers, canes, and orthoses, devices which support or correct the function of a limb or the torso; speech and language therapy, good nursing care, etc.

 

SCHISOPHRENIA

Phonetic exercise: schizophrenia [,skitsəu’fri:niə], serious [’siəriəs], average [‘ævrid3], environmental [in,vaiərə’mentl], urban [‘ə:bən], racial [‘rei∫l], experiences [ik’spiəriənsiz], abuse [(n) ə’bju:s, (v) ə’bju:z], psychosis [sai’kəusis], hallucinations [hə,lu:si’nei∫nz], delusions [di’lu:3nz], bizarre [bi’za:], strange [‘strein3], persecutory [‘pə:sikju:təri], severe [si’viə], isolation [,aisə’lei∫n], withdrawal [wið’dr :əl], auditory  [‘ :ditəri], chaotic [kei‘ tik], behavior [bi‘heivjə], behavioral [bi‘heivjərəl], abnormalities [,æbn :‘mælətiz], catatonic [,kætə’t nik], psychotherapy [,saikəu‘θerəpi], cognitive [‘k gnətiv]

Make a report on schizophrenia according to the plan below:

Definition: a serious mental illness characterized by a disintegration of the process of thinking, of contact with reality, and of emotional responsiveness.

Mortality: a higher than average suicide rate associated with schizophrenia.

Epidemiology: Schizophrenia occurs equally in males and females.

Causes and risk factors: genetic and environmental factors, prenatal factors, urban environment, poverty, racial discrimination, family dysfunction, unemployment or poor housing conditions, childhood experiences of abuse or trauma, unsupportive dysfunctional relationships, alcohol-induced psychosis, etc.

Symptoms, signs, clinical manifestations, clinical features: hallucinations (most commonly hearing voices), delusions (often bizarre or persecutory in nature), and disorganized thinking and speech, word salad in severe cases, lack of responsiveness or motivation, social isolation, social withdrawal, irritability and dysphoria in the prodromal period, psychosis, auditory hallucinations, poverty of speech (alogia), inability to experience pleasure (anhedonia), lack of desire to form relationships (asociality), and lack of motivation (avolition). chaotic speech, thought, and behavior.

Evaluation: History: a personal medical history, a medication history, a family history, a family history of schizophrenia, a social history, an occupational history, an environmental history, a neurological status history, a psychiatric history, a symptom profile history, a history of self-reported experiences of the person, a history of abnormalities in behavior reported by family members, friends or co-workers, etc.

Physical examination: observation, percussion, palpation, auscultation, neurological examination, some forms of mental status examination, etc.

Analysis of characteristic symptoms: delusions; hallucinations; disorganized speech, which is a manifestation of formal thought disorder; disorganized behavior (e.g. dressing inappropriately, crying frequently) or catatonic behaviour; lack or decline in emotional response, lack or decline in speech, lack or decline in motivation; social/occupational dysfunction; duration: continuous signs of the disturbance persist for at least six months.

Management: antipsychotic medications: Risperidone (trade name Risperdal), Clozapine Chlorpromazine; hospitalization in case of severe episodes of schizophrenia; drop-in centers; psychological and social interventions: visits from members of a community mental health team; supported employment, patient-led support groups; psychotherapy; cognitive behavioral therapy; family therapy or education, which addresses the whole family system of an individual with a diagnosis of schizophrenia; other treatments: electroconvulsive therapy, regular exercise, etc.

Major depressive disorder

Phonetic exercise: major [‘meid3ə], depression [di’pre∫n], disorder [dis‘ :də,        diz‘ :də], recurrent [ri‘kΛrənt, ri‘kə:rənt], experiences [ik’spiəriənsiz], abuse          [(n) ə’bju:s, (v) ə’bju:z], isolation [,aisə’lei∫n], withdrawal [wið’dr :əl], behavior [bi‘heivjə], behavioral [bi‘heivjərəl], abnormalities [,æbn :‘mælətiz], psychotherapy [,saikəu‘θerəpi], cognitive [‘k gnətiv], encompassing [in’kΛmpəsiŋ], accompanied [ə‘kΛmpənid], pleasure, [‘ple3ə], events [i’vents], adverse [‘ædvə:s, æd‘və:s ], spouse [spaus], syndrome [‘sindrəum], estrogen [‘i:strəd3ən], current [‘kΛrənt, ‘kə:rənt], circumstances [‘sə:kəmstənsiz, ‘sə:kəmstænsiz], exposure [iks‘pəu3ə], hyperthyroidism [,haipə‘θair idizm], electrolytes [i’lektrəlait], unconscious [Λn’k n∫əs]

 

Make a report on major depressive disorder according to the plan below:

 

Definition: recurrent depressive disorder, clinical depression, major depression, unipolar depression, or unipolar disorder); a mental disorder characterized by low mood accompanied by low self-esteem and by loss of interest or pleasure in normally enjoyable activities.

Causes: stressful life events, adverse events, negative thoughts composed of cognitive errors, early maternal loss, lack of a confiding relationship, responsibility for the care of several young children at home, unemployment, changes in relationships with a spouse or adult children, inability to realize full potentials, poverty and social isolation, depression, severe marital conflict or divorce, death of a parent, or other disturbances in parenting, social rejection, absence of social support, neighborhood social disorders, adverse conditions at work, particularly demanding jobs with little scope for decision-making, alcoholism or excessive alcohol consumption, withdrawal syndrome; low serotonin levels, abnormalities in the biological clock, low levels of estrogen, etc.

Epidemiology (prevalence): Depression is a major cause of morbidity worldwide. Lifetime prevalence varies widely, from 3% in Japan to 17% in the US.

Evaluation: History: a personal medical history, a medication history, a history of current circumstances, a biographical history, a family history, a family history of depression, a history of biological and psychological factors, a history of exposure to toxins, a social history, an occupational history, an environmental history, a neurological status history, a psychiatric history, a history of declining cognitive function, a history of self-reported experiences of the person, a history of abnormalities in behavior reported by family members, friends or co-workers, a history of alcohol consumption, etc.

Physical examination: observation, percussion, palpation and auscultation.

Instrumental investigations:a selected investigations to rule out other causes of symptoms: blood tests measuring TSH and thyroxine to exclude hypothyroidism; basic electrolytes and serum calcium to rule out a metabolic disturbance; and a full blood count including ESR to rule out a systemic infection or chronic disease; a CT scan to exclude brain pathology in those with psychotic, rapid-onset or otherwise unusual symptoms; cognitive testing and brain imaging can help distinguish depression from dementia. .

Management: psychotherapy, medications, and electroconvulsive therapy; physical exercises, etc.

Psychotherapy: cognitive behavioral therapy (CBT) that teaches clients to challenge self-defeating; interpersonal therapy, or family therapy; psychoanalysis, which emphasizes the resolution of unconscious mental conflicts; logotherapy, etc.

Medication therapy: antidepressants; selective serotonin reuptake inhibitors (SSRIs), etc.

Electroconvulsive therapy (ECT): for cases of severe major depression which have not responded to antidepressant medication or, less often, psychotherapy or supportive interventions.

Deep brain stimulation: a neurosurgical treatment that has been used especially to treat movement disorders such as Parkinson's disease. It requires a neurosurgeon to drill a hole in the skull and insert an electrode into the patient's tissue. Then, a device located in the chest transmits a signal to the implanted electrode through wires located underneath the scalp.

Physical exercise: gardening, washing a car or taking the stairs instead of the elevator, etc.

Prevention: behavioral interventions, such as interpersonal therapy; the "Coping with Depression" course (CWD), psychoeducational interventions, etc.

 

Дата: 2018-09-13, просмотров: 53.