7. BASIC EXAMINATIONS
Before examining the patient, the physician has to take a history. It means asking
questions about patient s condition in order to obtain as much information as possible. The
questions refer to patient s past and present complaints, their duration and location,
childhood diseases, operations, and family history (diseases present in the patient s
family). Also, the physician is usually interested in the patient s occupation, marital
status, living and working conditions and his lifestyle because such facts may affect his
health status. After obtaining the history, the physician performs a physical examination.
Depending upon patient's condition and suspected medical problem, a physician may
include one or more of the following four phases of the physical examination:
Inspection: During inspection, the physician inspects or looks at different parts of the
patient's body. For example a pale appearance could indicate a low level of hemoglobin.
Palpation or "hands-on examination": During palpation, the physician uses his hands to
examine the patient. For example, the physician can feel the heart beat and diagnose
enlargement.
Percussion or Tapping: During percussion the doctor taps patient s body with fingers,
hands, or small instruments. The physician uses this technique to determine if various
organs such as heart, liver, etc. are enlarged or not.
Auscultation or listening with a stethoscope: During auscultation, the physician listens to
the patient's heart beat and lungs. Abnormal heart sounds may indicate heart disease.
Listening to the lungs the physician can diagnose such conditions as asthma, bronchitis,
or pneumonia.
The physician may order various clinical and laboratory tests such as X-ray pictures, X-ray
contrast medium pictures, endoscopic examinations, electrocardiograms (ECG),
sonography, computed tomography (CT), magnetic resonance imaging (MRI), and positron
emission tomography (PET). Laboratory tests include: complete blood count (CBC),
examination of urine, stool, and cerebrospinal fluid.
EXERCISE 1 Taking a history. Put the following questions in the dialogue below.
A) And since that accident?
B) Now, can you tell me about your lifestyle? Do you smoke or drink?
C) Have you experienced any problems in your legs at all?
D) What s the problem with your chest?
E) Can you describe the pain?
F) What seems to be the trouble?
G) And how long did the pain last?
H) Do you think the weather affects it?
I) And what about your family? Is there any history of heart problems or blood
pressure problems?
J) I see, and how is business at the moment?
K) Can you tell me a bit more about these pains?
L) Have you got a job?
D: Good morning Mr Lin. My name s Dr Frank. 1)____________________________________
P: It s my chest, doctor.
D: 2) _______________________________________________________________________
P: Well, I sometimes get pains in it.
D: I see. 3) __________________________________________________________________
P: Well it started when I was on holiday and I had to climb a steep hill from the town to
our hotel. I got a bad pain in my chest.
D: 4) _______________________________________________________________________
P: It was across the front of my chest and sort of up into my neck. My arms felt heavy
and I couldn t get my breath.
D: 5) _______________________________________________________________________
P: Only a few minutes and then I was OK again.
D: 6) _______________________________________________________________________
P: I ve felt several times recently, usually when I m lifting things or rushing. I just can t
get my breath.
D: 7) _______________________________________________________________________
P: Yes. On cold days it s worse.
D: 8) _______________________________________________________________________
P: I smoke the occasional cigar and I like a dram in the evening. But I m not a heavy
drinker.
D: Of course not! 9) __________________________________________________________
P: I have my own business. A small printing company.
D: 10) ______________________________________________________________________
P: Not very good, actually. There s too much competition from the big companies.
D: Mm! 11) ___________________________________________________________________
P: no, not that I know of.
D: 12) ______________________________________________________________________
P: No, I haven t.
D: OK. Thank you Mr Lin. Now I d like to examine you if you don t mind.
EXERCISE 2 Family and social history. Write doctor s questions to the following answers.
1 A I m fifty-five.
2 B Twenty-five years. It s our silver wedding this year.
3 C My husband uses a condom.
4 D I cycle to work normally.
5 E Yes, but it was a long time ago.
6 F They re both dead now.
7 G I m not sure, just old age I think.
8 H Yes, I worked in East Africa for two years.
9 I Nothing more than the usual daily problems.
10 J I work in a clothing factory.
11 K About twenty a day.
12 L One or two glasses of wine each day.
13 M When I was fifteen, I think.
14 N I think I only had measles.
EXERCISE 3 Match the disease names with their phonetics.
AIDS /daiY bitiz/
beriberi /mY lµYriY/
BSE /eidz/
diabetes / gTitY/
epilepsy / reibiz/
goiter /ru bµlY/
hemophilia / bYri beri/
leukemia /tYbµkY loÅsYs/
malaria / bi  esi /
measles /lu kimiY/
pneumonia /epi lepsi/
rabies / rikYts/
ricket / skµvi/
rubella /himY filiY/
scurvy /nju moÅnjY/
tuberculosis / mizYlz/
EXERCISE 4 Which symptoms indicate those diseases.
1. anemia a. a cough, a runny nose, sneezing
2. the common cold b. dizziness, shivering, a headache, fever
3. food poisoning c. spots
4. flu (influenza) d. swelling under the ears
5. migraine e. rapid heart beat
6. mumps f. sickness, stomach-ache, vomiting
7. pneumonia g. weak pulse rate, fainting
8. measles h. fainting, double vision, paleness
9. high blood pressure i. high fever, pain in the chest, a strong cough
10. shock j. splitting headache, sickness