Gyorffy: English for Doctors OBSTETRICS AND GYNAECOLOGY B/HYPERMENORRH(O)EA C/METRORRHAGIA & Before listening to the two dialogues, indicate which statements relate to hyper— menorrh(o)ea, metrorrhagia or both. a) My periods seem to have been getting much heavier recently. b) My periods have been irregular. c) I sometimes have a little bit of spotting. d) There have been big clots. e) It's been soaking right through the pads. 9 Listen to dialogues 3/2/B,C and check your answers. After listening to dialogue B, fill in the gaps in the doctor's questions. . recently? right through the pads? ..than before? a) Have you noticed that your periods have been getting b) Is the flow so heavy that it c) Have your periods been more.. Listen to dialogue C again and note the symptoms which the patient mentions at the time-points and intervals given. a) it varies between two and seven weeks. b) more than six weeks c) for the first couple of days d) between the periods e) for the first couple of days and for the week beforehand, f) until about a year ago Choose the correct meaning for each of these expressions. a) heavy with flooding b) go haywire A. frequent urination ‘A stop completely B substantial blood loss B go out of order Take the doctor's part in the dialogue below basing your questions on the information given by the patient. D: Well, they have been a bit irregular. P: The last was two weeks ago. D: No, everything was fine last year. P: Yes, some spotting after abiout two weeks. 37OBSTETRICS AND GYNAECOLOGY Gyérffy: English for Doctors D/DYSPAREUNIA E/LEUKORRHOEA _ F/ PROLAPSE 7 10 38 9 Listen to dialogues 3/2/D,E,F and name the complaints of the patients in the order you hear them. a) prolapse b) dyspareunia [[] c) leukorrhoea Write in the missing words. D: a). uncomfortable to have sex? P: Yes, Doctor, the last few months b) = D: ¢). every time, or just occasionally? P: Almost every time I d). ache inside. It's becoming so bad e) do it for the last few weeks. The following questions are useful when asking a patient about leukorrhoea, Decide which questions have the same meanings. a) Is it foul smelling? A. Does it sting? b) Do you have any burning? B_ Do you have any discharge from the vagina? c) Can you describe the discharge? C_ What colour is the discharge? d) Do you have any discharge from down —D_ Does it smell quite strong? below? Below are two definitions of a prolapse. Choose the one you would use when explaining it to your patient. Explain why. a) Prolapse is the descent of the uterus from its normal position. b} Prolapse means the womb isn't held in its proper place and drops out of position. Write the first part of the questions below which a doctor would ask concerning prolapse. all the time? a) Is the lump there only sometimes? ) you have been to pass urine? you have a bowel motion? can you push it back up? °) are you unable to push it back up?Gyorffy: English for Doctors OBSTETRICS AND GYNAECOLOGY 1 & Before listening to the gynaecologist's instructions, put these instructions into a logical order by numbering the list. a) drop your knees apart b) relax your bottom down onto the bed ©) pop /go, step/ behind the curtain d) take your pants off e) pull your knees up towards you f) pop up onto the couch 2 9 Listen to dialogue 3/3 and check your order. 3 Connect the correct noun with its verb and then create instructions using nouns and verbs starting with the initial phrases below. Would you mind ...ing pop knees Would you take off curtains If you can cover trousers If you just pull up blanket I'd like you to drop bottom Please relax feet 4. Use the pictures to practise giving instructions to the patient. W4/A EARLY PREGNANCY 1 & What symptoms of pregnancy do you know? 39OBSTETRICS AND GYNAECOLOGY Gyérffy: English for Doctors 2 9 Listen to dialogue 3/4/A and tick the sentences you hear. a)A How long do you think you haven't had —_c) A Are you using any kind of contraception? a period? B Do you always take precautions when B How long has it been since your last having sex? period? C Do you use a condom? C How long did your last period last for? b)A Do you often have sex? d) A Do you think you might not be pregnant? B Do you have a sexual partner? B Is there any possibility that you are C Are you sexually active? pregnant? C Do you think you might be pregnant? 3 Look at this patient's answers. Form the doctor's questions that could have elicited them. I don't seem to have had a period for several months. Q: P: D: P: Well, I think my last period was two months ago. D: P: Yes, Imon the pill. D: P: Well, I think I might have forgotten to take the pill once or twice. 4 List some risk factors for women in which foetal growth and well-being may be impaired. 3/4/B EARLY PREGNANCY 5 ®& You will hear the patient use these words or expressions in the following dialogue. Do you know what they mean? Choose the correct meaning. a) queasy c) I've gone off my food A. slightly dizzy A. Lvomit every time I eat B_ slightly nauseous B I don't want to cook any more C rather sore C I don't feel like eating much b) I felt on edge d) I've been a 32 B cup A. [felt very angry A. this was the size of my panties B_ [felt suicidal B_ this was the size of my bra C I felt rather nervous C_ this was how much tea I drank 6 9 Listen to dialogue 3/4/B about the symptoms of pregnancy. Mark the ones you hear in the dialogue. a) T've missed a period. b) My urine test was positive. c) I've put on a lot of weight. d) Ican feel the baby kicking. 40Gyérffy: English for Doctors OBSTETRICS AND GYNAECOLOGY ¢) I've had morning sickness. f) I've noticed purple lines / stretch marks / on my tummy. g) I get tired easily. h) [ feel very sleepy all the time. i) I've had a tiny drop of milk leaking from my breast. j) My breasts feel very full and sensitive. k) I need to spend a penny a lot. 1) My bust has been getting bigger. ‘m)I want to eat unusual things. 3/4/C LATE PREGNANCY 7 ®& You will hear the following expressions in the dialogue. For each of the four expressions there is only one correct definition. Select the correct definitions from the box. occasional diarrhoea not difficult to treat too painful to touch __ mild infection slight movement dizzy feeling _ secretion from the vagina easily distinguished from any other disease a) fluttering feeling b) a touch of thrush ) itis easily sorted out d) discharge from down below 8 9 Listen to dialogue 3/4/C. 9 Form the questions asked by the doctor concerning the following. Start each question with HAVE YOU .... a) kicks against the abdomen b) burning on urination c) ultrasound d) discharge ¢) baby's sex 41OBSTETRICS AND GYNAECOLOGY Gyérffy: English for Doctors 42 & Below are expressions used when talking to a patient in the gynaecological surgery. For each give a short medical explanation. a) internal examination b) termination c) tubule pregnancy necnessemns _— d) miscarriage _ commonly used for anything other than induced abortion e) stillbirth ‘i i ane f) Caesarean section Listen to dialogue 3/5/A and then say what questions elicited the answers containing the following numbers. a b) c) Co) e) 9 Listen to the second dialogue (3/5/B) about past pregnancies. Underline the correct choice. a) She has one child two children twins b) The children are four and five . three and four three and five ¢) The older child was born premature late on time d) The younger was born —~ early on time late e) The younger was — born by Caesarean induced a normal birthGyérffy: English for Doctors OBSTETRICS AND GYNAECOLOGY RM aA Ae OAL AWM ROC OULAY 1 9 Study the text below about preeclampsia. After listening to the dialogue, underline the signs and symptoms that you heard in the dialogue on complications during pregnancy. Eclampsia is a type of convulsion that occurs shortly before or after childbirth in about one in 500 pregnancies. Good prenatal.care can often, and usually does, prevent full blown eclampsia. The warning signs are headaches, failing vision, dizziness, rising and high blood pressure, and albuminuria. IONS REGARDING PAST PREGNANC! GENERAL QUE 1 & Before listening to the dialogue, match the answers to the questions. a) What kind of anaesthetic did you have during labour? A He was breast-fed. b) Did you start labour by yourself? B_ No, they used forceps. c) How long did the labour go on for? C Yes, it began by itself. d) Was it a normal delivery? D Atleast twenty-four hours. e) Were there any problems after delivery? E. Gas and air and epidural. f) How did you feed the baby? F Yes, he went to the special care unit. 2 Listen to dialogue 3/7 and check your choice. 3 After listening to the dialogue, indicate whether the following are true or false. a) The patient had no painkillers during labour. b) The labour had to be induced. c) The baby was in distress before delivery. d) It was a short labour. e) The baby's neck muscles were strained during delivery. f) The baby was fed exclusively on formula. 4 Find the explanation for the following. a) bottle-feeding c) top him up with bottles ‘A maternal milk fed from a bottle A. supplement his insufficient breast-fed diet with B maternal milk replaced by artificial feeding animal product B keep him warm with hot water bottles C bottled milk C feed him mashed food only b) health visitor d) express milk A health educator A feed him quickly to stop him being hungry B social worker B use only fresh milk and not milk powder C peripatetic nurse C remove milk from the breast by hand or breast pump 43OBSTETRICS AND GYNAECOLOGY Gyérffy: English for Doctors 5 Form the questions asked by the doctor concerning the following: a) anaesthesia b) onset of labour c) duration of labour d) possible complications e) feeding Ait ARRIAG 1 9 Listen to the dialogue and number the list below to indicate the chronological order. a) childbirth delivery + b) childbirth delivery c) termination d) miscarriage 2 Form the correct answers to the questions asked. a) Have you ever been pregnant apart from having these two children? A Thad an abortion between them. B a miscarriage b) How many weeks on were you when you miscarried? A About ix months. B ten weeks. ©) Did you need a D & C? A Yes. B_ No. d) Have you been pregnant at any other time apart from the occasions you have mentioned? A. Yes, when I was twenty nine. B nineteen. e) Do you remember how many weeks on you were when the termination happened? A. Tt was about eight weeks. B three months. 1 & You will hear a gynaecologist explaining a D & C to medical students. Before you listen, make up sentences using the two sets of expressions and joining them with the correct verb from the box. 44Gyé6rffy: English for Doctors OBSTETRICS AND GYNAECOLOGY dilated examined grasped. washed evacuated covered visualised a) The perineum and vagina are .. b) The legs are c) The patient is d) The cervix i e) The anterior lip of the cervix is . f) The cervix is ... g) The cavity of the uterus is ... .. with Betadine solution. with sterile drapes. by bimanual pelvic examination. using a Sims's speculum. with a vulsellum, using Hegar dilators. by suction curettage. 9 Listen to the doctor's explanation (3/9) and check your answers. 9 After listening to the doctor's explanation, select the six stages which are important for the patient to know about. Write out how you would explain a D & C to your patient being reassuring, and using words she will understand. Give the explanation clearly, using: First, then, after that, finally. Then listen to our version on the tape (3/9/3). 10 DE A153" 3/10/A BEFORE THE DELIVERY 2 & Name three methods of delivery. ®& Before listening to the gynaccologist's explanation 6f why ke plans to induce labour, fill in the gaps. due date started dates overdue Well, looking at the (a) .. of your pregnancy your baby is really quite (b) . .. now. It should have been here about ten days ago and we really don't like to leave them too much longer than two weeks over the (c) . so what we'll do is try and bring you to hospital tomorrow and get the delivery (4) Listen to the doctor's explanation (3/10/A) and check your answers. After listening, complete the explanation below using © BECAUSE, -SOTHAT or SO AS TO. What will be done? What for? a) We'll get labour started because the baby is overdue. b) We'll put some gel up by the cervix ) We can put a drip up 4) We break the waters 45OBSTETRICS AND GYNAECOLOGY Gyérffy: English for Doctorg 3/10/B DELIVERY 4 5 6 ®& Before listening to the dialogue, tick the phrases that may be characteristic of contractions. a) cause breathlessness b} occur every ten minutes c) they are getting stronger d) they are coming on harder e) asort of dull pain f) last for about a minute g) asort of tight feeling h) they are becoming quite sore i) swelling ) Listen to dialogue 3/10/B. Phrase questions for the patient concerning the following during labour: a) amniotic fluid . Have your waters broken yet?. b) regularity of contraction c) intervals between contractions d) intensity of contraction e) duration of contractions 3/10/C FORCEPS DELIVERY 7 8 & Before listening to how the obstetrician explains forceps delivery to medical students, match the nouns with the relevant verbs using the correct form. a) cervix Awash... down b) Se B deliver. ¢) position of foetal head C dilated 4) perineum should be ~~ D_ determine... e) legs E check... f) placenta F g) rectum G Listen to the doctor's explanation (3/10/C) and check your answers.Gyorffy: English for Doctors OBSTETRICS AND GYNAECOLOGY 9 9 Write out how you would explain to the patient what a forceps delivery will entail under the following headings, then listen to our version on the tape (3/10/9). a) reasons for use of forceps b) preparation c) process PROG anon 1 & Before listening to the explanation about contraception, group the following methods according to whether they are used by males, females or both. males females a) the pill b) coil c) cap d) sterilisation e) coitus interruptus f) condom 2 § Listen to the doctor's explanation of the advantages and disadvantages of the different methods and fill in the table. Methods ‘Advantages Disadvantages mini pill ‘combined pill ‘some side-effects coil /TUD cap/ diaphragm sterilisation very reliable coitus interruptus condom 3 Choose the contraceptive method you would advise the following patients to use. a) a married woman with two children, who does not want any more children b) a married woman, who has delivered a baby, but still wants more children c) asixteen-year-old girl 47OBSTETRICS AND GYNAECOLOGY Gy6rffy: English for Doctors 4 Explain the advantages and disadvantages of the different methods of contraception to your patient. 1 & What are some of the problems associated with the climacteric and the menopause? 2 Listen to dialogue 3/12 and circle the correct information. a) A Her last period was about three years ago. B Her last period was about eleven months ago. b) A. The symptoms seem to have improved. B_ The symptoms seem to be getting worse. ©) A The hot flushes sometimes interrupt her sleep. B Her sleep is disturbed every night. 4) A She has a problem with vaginal dryness. B She has no problems with sexual intercourse. 3 Read the following phrases which tell you what information to obtain from your patient. Formulate questions and write them out below. a) cessation of menstruation b) problems c) frequency of hot flushes d) sex life 48Gyérffy: English for Doctors OBSTETRICS AND GYNAECOLOGY 3/13 HYST Oy 3/13/A 1 Listen to the doctor's explanation of a hysterectomy (3/13/A) and fill in the gaps. .. your womb, to give you a hysterectomy. We'll (b) ... under a general anaesthetic. We'll either (c). .... im your tummy or perform the operation through the vagina. In your case, unfortunately, we'll (d).. . not only the womb but also the fallopian tubes and ovaries. I'm afraid we have to do this to prevent the disease ©). After the operation you won't have any periods and sadly you (f. . any children. Because we have to remove the ovaries there is a possibility that you (8). hot flushes, night sweats and dryness of the vagina — all symptoms of the menopause, but this doesn't always happen. This is because your estrogen and progesterone hormone levels (h). (Your ovaries produce these hormones.) If you do have problems we can always help by giving you hormone replacement therapy in the form of pills or a (i... .. However, to prevené osteoporosis we recommend this HRT also to patients without symptoms. You (j 2 bit low and depressed but usually it soon passes, and you may also (k). . a problem with your weight - a lot of people seem to put on weight after a hysterectomy. We need to (a) You will have to stay in hospital for about six days where we can (I)... with pain killers if necessary. Then you will have to take it easy for a while and get plenty of rest. You can gradually (m). .. again, It takes about 6-8 weeks (n)... the operation. After six weeks I'll want you to (0) just to see that everything is OK. If you have any questions regarding this operation, (p)... asking me. Using the phrases below, explain to the patient what a hysterectomy entails. removal of the uterus > We'll remove your womb a) carried out under a general anaesthetic b) abdominal incision c) menstruation ceases 4) no possibility of pregnancy e) requires a two-week hospital stay f) painkillers are given to relieve pain g) rest and relaxation are necessary h) gradual build up of activities i) return for check-ups to check wound is healing j) slight weight gain k) climacteric symptoms 49OBSTETRICS AND GYNAECOLOGY Gyérffy: English for Doctors 3/13/B WHY IS HYSTERECTOMY NECESSARY? 3 & Before listening to 3/13/B, match the definitions below to the gynaecological problems given. cancer endometriosis fibroids menstrual disorders pelvic infections prolapse a) growths in the uterus b) descent of the uterus due to loosening of the pelvic muscles c) the growth of endometrial tissue outside the uterus d) inflammatory diseases of the female reproductive organ e) excessive bleeding f) malignant tumour in the uterus and / or ovary 9 Listen to the description of some gynaecological problems (3/13/B). Underline the correct word in brackets. a) What you have is fibroids. These are (gross / groans /growths) in the womb. They can be very large but yours aren't too bad. That's what's causing your pain and the heavy bleeding, but don't worry it is not cancer. b) You have a (dripping / dropped / drooped) womb. What has happened is that the muscles in your pelvis aren't holding it in place any more and it has slipped down into the vagina. c) The problem is called endometriosis. The (lining / laying / listing ) of your womb, that's called the endometrium, has started to grow outside the womb itself. d) I'm afraid you have a pelvic infection. Your ovaries are infected and (inferred / inflamed / enforced). Sometimes it can affect the fallopian tubes and the womb as well, but in your case it's just the ovaries at the moment. e) With all this excessive bleeding it looks like you have a real menstrual (disorder / display / dislike). f) The biopsy shows that there is cancer of the uterus and possibly the ovaries are (infected / affected / effected). Praetice telling the patient what their problem is. Complete each sentence with a simple explanation of the problem. You have fibroids, What you have is a prolapse. The problem is called | endometriosis. I'm afraid you have | a pelvic infectionPAEDIATRICS Unit 4 Contents 52 Gyérfly: English for Doctors P(A)EDIATRICS NEONATAL HISTORY BABY'S CONDITION AT BIRTH NEWBORN COUNSELLING NEWBORN DISEASES FEEDING PSYCHOMOTOR DEVELOPMENT INFANT COMPLAINTS FEBRILE CONDITION PYLORIC STENOSIS DIARRH(O)EA ASTHMA ACCIDENTS MENINGITIS FEBRILE CONVULSIONS HENOCH-SCHONLEIN PURPURA BEDWETTING