Unit 2 Myocardial Infarction

Estimados estudiantes,

En esta sección podrán practicar muchas de las actividades planificadas para ser realizadas en el aula de forma presencial. Esta variante que tomaremos hoy les va resultar muy interesante y provechosa. Entremos en materia:

Habíamos dejado dos ejercicios de tarea, por tanto, las respuestas me la envían al correo heribo@infomed.sld.cu que en cuanto los reciba, los reviso y les doy la retroalimentación necesaria.

Unit 2. Myocardial infarction (MI)

Objectives:

By the end of the unit you should be able to talk about heart diseases in general as well as their management & treatment. [1]

Lesson 2.

Objectives: Students should be able to:

1. Define what MI is.
2. Describe the heart and the circulatory system
3. Describe, define, and reporting about pain
4. Practice to develop the macro-skills of the language (listening, speaking, reading and writing)

Language functions

1. Defining medical terms; describing parts of the human body; reporting on medical cases
2. Verbalizing medical abbreviations
3. Asking for and giving information

Warm up

1. Write down the meaning of each abbreviation. Read them aloud in class
2. HBP ___________________________________________
3. HPI ___________________________________________
4. ACE ___________________________________________
5. C/C ___________________________________________
6. FH ___________________________________________
7. PMH ___________________________________________
8. SH ___________________________________________
9. HTN ___________________________________________
10. HR ___________________________________________
11. T ___________________________________________

ANSWER:

1. How many chambers are there in the heart? Describe the heart.

_______________________________________________________________.

1. This activity provides you with word phrases that are particularly useful when talking about the heart. Combine them using a word from each box. Some words could be used more than once. Then compare with a partner. (page 38 of the students’ book)

 

a)    cardiac b)    heart c)    blood d)    muscular e)    right f)     left

pressure muscle atrium ventricle beat relaxation organ vessels rate contraction cycle pump

1. Now, using word combinations from the box and others of your own, work out a definition of the heart together with your partner. Then compare your answers with other pairs.

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________. (This exercise can be used as a written question). Thus, work on it with passion!

Ya están en condiciones de leerlas en voz alta, repetirlas y decirlas refiriéndose al corazón. Combínenlas y formen nuevos términos. Sugiero que escriban al menos una oración con cada una de esas combinaciones. Deben consultar las “Medical Notes” sobre la unidad de Myocardial Infarction que está en la página 6 de las Medical Notes que se les dio en clases. No obstante, pueden descargarla pinchando el siguiente vínculo.

Practice the pronunciation of the following terms:

Diagnose – Diagnosis – Diagnoses – Diagnostic

(remember to put a noun after the term “diagnostic”. For example: diagnostic techniques. Mention some others from the text that may have the same structure as “diagnose”. I mean, subject / verb / adjective

 Task 2.

The following extracts are all in keeping with top priority topics included in the talks delivered during the World Health Report 2003. (ITEMS A, B, C, AND D (THE STUDENTS’ BOOK – PAGES 39, 40, 41)

Exercise: Complete the ideas given below…

1. Systolic and diastolic pressure are __________________________
2. Hypertension is due to ____________________________________.
3. The main modifiable causes of high BP _______________________
4. According to its constitution, Cholesterol is said to be ____________
5. A healthy diet is mainly composed by _________________________
6. ______________________________is said to be increased by physical activity.
7. Chronic conditions generally _______________________________.

DICTATION

This activity is going to be done in a face2face session.

Items b, c, and d of are going to be done in class.

Task 3 (you have this audiotext in your mobiles)

a) You will hear a brief account of a medical case report. Work in pairs and be ready to answer these questions.

1. What was Mr. Hanna’s number one complaint?
2. What is relevant about his previous history?
3. Is there any significant ECG finding?
4. Does he have a positive family history?

b) Now listen to the case again and discuss the answers to these questions in groups.

1. What do you suspect? _______________________________________________________________________________________________________________________________.
2. What features from the history point to a diagnosis or diagnoses?

_______________________________________________________________________________________________________________________________________.

 

Case report

A 53-year-old man whose name is Mr. Hanna was admitted to the hospital complaining of a sudden excruciating, knife-like pain located in the front of the chest. During the course of the examination, he said that he could also feel the pain in his back between the shoulder blades. On close questioning he said he felt pain down the inner side of the arm. The patient had been well until three months earlier, when he began to have increasingly severe exertional dyspnoea, without chest pain. On the day of admission, he had been at work, lifting and transporting heavy objects, when a sensation of “heaviness” developed across his chest, accompanied by dyspnoea. An electrocardiogram obtained at the time of his arrival at this hospital showed elevated ST segments in leads V1 through V4, with depressed ST segments in leads II and III.

The patient had a 40-pack-year history of cigarette smoking; he drank little alcohol. He had hypertension and hyperlipidemia and took medications for both. There was no history of diabetes mellitus or previous chest pain and no family history of coronary disease. On physical examination, the temperature was 38.3°C, the pulse was 85, and the blood pressure was 115/80mmHg. The patient was alert and comfortable. The jugular venous pressure was 8 cm of water. Bibasal crackles were present. A grade 1 systolic murmur was heard, with a third heart sound. The abdomen was normal, and there was no peripheral oedema.

c) Now, read the information in the case report and find in the text the words or expressions that match the definitions provided. Consult your answers with a partner.

1. Coming unexpectedly, abrupt: ___________________
2. A broad flat body part also known as scapula: ___________________
3. To a greater degree: ___________________
4. Effort related: ___________________
5. Perception of increased work of breathing: ___________________
6. Quality of being oppressive: ___________________

 e) Doctor – patiequestioning is of key importance in history taking. Practice forming questions using the information given. Begin your question with the question word specified after each sentence. You may address the questions to the patient as in history taking.

1. … 53-year-old … admitted to the hospital for evaluation and treatment.

How old…?

____________________________________________________

2. …. a sudden excruciating, knife-like pain located in the front of the chest.

What…like?

___________________________________________________

How bad…?

__________________________________________________

Where…?

__________________________________________________

 

3. … 40-packs a year.

How much…?

________________________________________________

HOMEWORK

Task 4

1. a) Medical examination is normally carried out in four stages: inspection, palpation, percussion and auscultation. Read the list of clinical signs and decide which of the stages they belong in. Some of the findings may be elicited through more than one clinical procedure.

Inspection	Palpation	Percussion	Auscultation

1. b) Underline the verb in each item that does not belong in the italicized

Inspection	look	examine	watch	inspect	take
Palpation	number	feel	palpate	check
Percussion	percuss	check	tap	measure
Auscultation	listen	observe	hear	auscultate

 

NOS VEMOS PRONTO / SEE YOU SOON

Hay contenidos aún en los que ustedes tienen que profundizar, por ejemplo:  el uso del artículo –“THE”. Aquí les presento algo muy interesante sobre el tema.

DEFINITE ARTICLE “THE”

DO NOT USE “the”  

• with symptoms (coryza, diarrhea, and sore throat)

Example:

Children may present with coryza, sore throat, hoarseness, and cough.

• with diseases (hypertension, A.I.D.S, broncholitis)

Example:

If bronchiolitis or pneumonia develops, progressive cough accompanied by wheezing, tachypnea, and intercostal retractions may occur.

• with substances (ozone, alcohol, tobacco)

Example:

In girls, tobacco use is predictive of subsequent substance use

• with subject fields (Dermatology, Genetics, Embryology)

Example:

The issues involved in this problem are complex, are not unique to genetics, and will continue to be debated.

• with specialties (Surgery, Neurology, Anesthesiology)

Example:

Dr. Harris published his findings in the “Annals of Neurology”.

• with medications (Penicillin, Tetracycline, Aminophylline)

Example:

Aminophylline and theophylline are available for intravenous use.

• when referring to groups in general (patients, women, children, persons)

Example:

Persons under the age of 18 should consult a doctor before using this product.

DO USE “THE”

• with parts of the body (the liver, the stomach, the leg)

Example:

The liver is enlarged, yellow, greasy, and firm.

PRACTICE

– Put “the” in the blanks ONLY WHEN NECESSARY.

1.____most common clinical manifestations of rhinovirus infections are those

of the common cold.

2. In children, ____bronchitis, _____bronchiolitis, and ____bronchopneumonia

have been reported.

3.____ throat is frequently sore, and in some cases ____sore throat is the initial

complaint.

4. Rhinoviruses also may cause exacerbations of ____asthma and

____chronic pulmonary disease in adults.

5. _____Physical examination shows nasopharyngeal discharge and

oropharyngeal injection.

6. ____Mebendazole is effective against a spectrum of intestinal and tissue

nematodes.

7. ____ vast majority of rhinovirus infections resolve without sequelae.

[1] Recuerden que ‘management’ aunque implica el tratamiento es más abarcador porque hay que hablar de procederes, investigaciones, conductas a seguir, etc., mientras que ‘treatment’ como su contenido semántico indica es solo tratamiento que puede ser medicamentoso o no medicamentoso (quirúrgico, etc.)