Solving the clinical problem

Based upon the patient's symptoms, which cerebral artery was blocked?

The loss of all sensation on the right face and arm, coupled with the paralysis of muscles in these regions suggests that this woman suffered damage to the lateral portions of her left frontal and parietal lobes. Specifically, damage to the face and arm regions of the left somatosensory and primary motor cortices would cause these deficits. Damage on the left side of her brain causes right-sided symptoms since the motor and sensory tracts cross the mid-line as they travel between the cerebrum and the spinal cord. The language disorder that this patient has is called Broca's (expressive) aphasia, and it may result from damage to the dominant Broca's motor speech area, a control center that sits just anterior to the face portion of the primary motor cortex in the left frontal lobe. The artery that supplies blood to these regions is the superior division of the left middle cerebral artery. Blockage of this artery by a thrombus or embolism could cause all of this patient's signs and symptoms.

1) Which lobe of the brain, the right or the left one, was damaged? What symptoms indicate that?

2) Damage to what portion of the left lobe caused the language disorder? How is the area responsible for the language function called?

3) What artery was blocked?

Exercise 12. Explain the terms

Stroke

Ischemia

Thrombosis

Paralysis

Aphasia

E P I L E P S Y

Exercise 1. Practice the pronunciation:

Epilepsy [ ̍epilepsi]

Seizure [ ̍si: ȝə]

Partial [ ̍pɑ: ʃ(ə)l]

Unconscious [ʌn ̍kᴐnʃəs]

Cease [si:s]

Bisynchronous [bai ̍siƞkrənəs]

Posture [ ̍pᴐsʧə]

Awareness [ə ̍weənes]

Hallucination [həlu:si ̍neiʃn]

Idiopathic [idiə ̍pᴂθik]

Exercise 2.

Topic vocabulary:

Seizure- епілептичний припадок

Tonic-clonic – тонічно-клонічний

Unconscious - непритомний

Confusion – часткове потьмарення свідомості

Bisynchronous spike discharges – бісинхронічний імпульсні викиди

Throughout – усюди, скрізь

Scarring – той, що має рубець

Focal – фокусний, фокальний

Exercise 3.

Match the medical terms with their definitions:

Epilepsy a perception in the absence of stimuli

Unconsciousness a sudden involuntary contraction of a muscle, a group of

muscles, or a hollow organ

Cyanosis a transient symptom of abnormal excessive or

synchronous neuronal activity in the brain

Seizure complete or partial lack of responsiveness to people or

other environmental stimuli

Spasm a common and diverse set of chronic neurological

seizures

Hallucination the appearance of blue or purple coloration of the skin

due to the lack of oxygen

Exercise 4.

Translate the following word combinations:

Recurrent seizure, sudden onset, structural damage, partial and generalized seizures, to fall to the ground, result in cyanosis, urinary incontinence, to cease movements, state of confusion, brief spells of unconsciousness, bisynchronous spike and wave discharges, intermittent photic stimulation, clouded awareness, temporal lobe, focal lesions.

Exercise 5.

Complete the words in the following sentences by adding a prefix. Choose from the following: un-, in-, im-, ir-, dis-.

1. An epileptic seizure is ___controlled, chaotic electrical activity in the brain. It alters consciousness and may bring on ___ involuntary movements. Epilepsy may be the result of chemical ___balance but more often the cause is ___known.

1. In a grand mal epileptic seizure, the victim falls to the ground___conscious and makes twitching movements which may last for several minutes. In a petit mal seizure, the victim may be__aware of things around him for up to thirty seconds but seldom loses consciousness.
2. In temporal lobe epilepsy, a seizure may result in the victim having ___rational feelings of anger or fear.
3. Following a stroke, many patients are left with some sort of ____ability.
4. Brain cells starved of blood are _____able to communicate with the parts of the body they are responsible for.

Exercise 6.

Read and translate the text:

Epilepsy

Epilepsy is a disorder of brain function characterized by recurrent seizures that give a sudden onset. Epilepsy may be the result of disturbed chemical balance but more often the cause is unknown.

The term idiopathic is used to describe epilepsy that is not associated with structural damage of the brain. Seizures may be generalized or partial. Generalized epilepsy may take the form of tonic-clonic or absence seizures. In tonic-clonic seizures the patient falls to the ground unconscious with the muscle in a state of spasm. The lack of any respiratory movement may result in cyanosis. The tonic phase is replaced by convulsive movements when the tongue may be bitten and urinary incontinence may occur.

Movements gradually cease and the patient may rouse on a state of confusion, complaining of headache, or may fall asleep. Absence seizures consist of brief spells of unconsciousness lasting for a few seconds. During which posture and balance are maintained. The electroencephalogram characteristically shows bisynchronous spike and wave discharges during the seizures and at other times. Attacks are sometimes provoked by overbreathing or intermittent photic stimulation.

In partial seizures, the nature of the seizure depends upon the location of the damage in the brain. Symptoms may include hallucinations of smell, taste, sight, and hearing, and paroxysmal disorders of memory. Throughout an attack the patient is in a state of clouded awareness and afterwards may have no recollection of the event. A number of these symptoms are due to scarring and atrophy affecting the temporal lobe.

The different forms of epilepsy can be controlled by the use of antiepileptic drugs (anticonvulsants). Surgical resection of focal lesions in the brain is appropriate in a strictly limited number of cases.

Exercise 7.

Answer the following questions:

1. What is epilepsy characterized by?

1. What is the term idiopathic used for?
2. What types of seizures are there?
3. What may be observed in the tonic phase?
4. What does the ECG usually show?
5. How can seizures be provoked?
6. What are the symptoms in partial seizures?
7. How can epilepsy be controlled?

Exercise 8.

Translate the following word combinations: повторювані епилептичі припадки, мимовільні рухи, несвідомий стан, неусвідомленість того, що відбувається, cтруктурне пошкодження мозку, генералізована і часткова епілепсія, заснути, гарячковий спазм, зберігати рівновагу, світлова стимуляція, що переривається, помутніння свідомості, оcередкові пошкодження, вискова доля, протисудорожні препарати, пароксизмальні порушення пам’яті.

Exercise 9.

Translate into English:

1. Відомо, що тонічно-клонічні судоми наявні у 60% пацієнтів, які страждають від епілепсії.

2. Приступ абсанса, що звичайно виявляється в дитячому віці, зникає з настанням дорослого віку.

3. Протисудорожні препарати eфективно знижують, як частоту, так й тяжкість епілептичних судом у більшості хворих.

4. Вважають, що найбільш розповсюдженими причинами епілепсії є пуxлини мозку, судинна патологія мозку, енцефаліт і обмінні порушення.

5. Було встановлено, що епілепсія –спадкова хвороба.

6. Поставивши точний діагноз і визначивши тип епілепсії, лікар почав лікування протисудорожними препаратами.

Exercise 10.

Put the questions to the underlined words:

1. Attacks are sometimes provoked by overbreathing.

1. The patient may rouse in a state of confusion.
2. In tonic-clonic seizures the patient falls to the ground unconscious.
3. Absence seizures often subside spontaneously in adult life.
4. A simple partial seizure consists of convulsive movements that might spread to the thumb.
5. After the seizure the patient may have no recollection of the event.

Exercise 11.

Use the verbs in brackets in the appropriate tense form.

1. The patient stated that the onset of epilepsy (to be preceded) by the brain damage during an accident.

1. This woman (to suffer from) encephalitis before epilepsy developed.
2. If epilepsy (to be treated) properly, it may (to subside) gradually.
3. The doctor (to prescribe) him some anticonvulsive drugs.
4. This patient (to experience) seizures since his childhood.
5. The EEG (to take) during the attack (to show) bisynchronous spike and wave discharges.

Exercise 12.

Give the definitions to the following terms: epilepsy, seizure, hallucination.

Exercise 13.

Speak about:

- types of epilepsy;

- an epileptic seizure.

ANTIBIOTICS

Exercise 1. Practice the pronunciation and give the translation of the words:

Microbe ['maikrəub], bacterium (pl. -a) [ bæk'tiəriəm/-ə], fungus (pl. -i) ['fʌɳgəs/- ʤai], pathogenic [ˏpæθə'ʤenik], fatal ['feitl], meningitis[ˏmenin'ʤaitis], scarlet fever ['ska:lit 'fi:və], de­cline [di'klain], livestock ['laivstᴐk], grain [grein], feed [fi:d], damage ['dæmiʤ], various ['vɛəriəs], add [æd]

Exercise 2. Active vocabulary:

fungus – бот. гриб; пліснява, цвіль; деревна губка;

soil – земля; ґрунт;

harmful – шкідливий, згубний;

to fight – боротися; (з кимсь - against, with; за щось - for);

to damage – пошкоджувати;

to cure – лікування; виліковувати, зціляти(ся);

to de­cline – відкидати;відхиляти(пропозицію.);відмовляти(ся);

drastically – надмірно;

livestock – худоба; живий інвентар; поголів'я худоби;

feed – давати їжу; годувати (чимось - on); їжа, харч;

growth – ріст, зростання; розвиток.

Exercise 3. Read the following words paying attention of the letter combinations in the bold type:

-age- [iʤ]: damage, cabbage, marriage, passage, cartilage, storage;

-ous- [əu]: various, dangerous, fibrous, nervous, simultaneous, gangrenous.

-um- [əm]: bacterium, sputum, fungus, septum, tetanus, serum.

-au [ᴐ:]: August, trauma, automobile, audience, autopsy, auscultation.

-o [ʌ]: come, become, accompany, some, love, honey.

-a [ə]: pneumonia, insomnia, edema, anuria, malaria, cholera.

-i (pl.) [ai]: cocci, calculi, fungi, bacilli, glomeruli, streptococci.

Exercise 4. Form adverbs from the given adjectives and translate them:

Model: slow (повільний) + ly = slowly (повільно)

Complete, quick, rapid, obvious, hard, easy, quiet, bright, correct, dangerous, cautious, late, absolute, serious, chief, intramuscular, intravenous, oral, subcutaneous.

Exercise 5. Find words or word combinations in the text denoting the following:

a) any of various chemical substances, such as penicillin or streptomycin, produced by various microorganisms, esp. fungi, or made synthetically and capable of destroying or inhibiting the growth of microorganisms, esp. bacteria;

b) any microscopic organism too small to be visible to the naked eye, esp. a disease-causing bacterium;

c) a very large group of microorganisms comprising one of the three domains of living organisms. They are prokaryotic, unicellular, and either free-living in soil or water or parasites of plants or animals;

d) any member of a kingdom of organisms that lack chlorophyll, leaves, true stems, and roots, reproduced by spores, and live as saprotrophs or parasites. The group includes moulds, mildews, rusts, yeasts, and mushrooms;

e) a malignant tumour which is caused by the uncontrolled division of cells that then invade and destroy the surrounding tissues;

f) a highly infectious disease caused by Streptococcus bacteria; one of the prominent symptoms is a strawberry-coloured tongue;

g) an inflammation of the mental membranes due to infection by viruses, bacteria, or fingi.

Exercise 6. Read and translate the following word combinations:

Certain microbes; antibiotic sub­stances; live in the air, soil, and water; to fight various diseases; harmful to the cells; bacterial diseases; streptococcal bacteria; to attack human cells; the process of dividing; to treat infectious diseases; livestock feed; to stimu­late the animals’ growth; pathogenic microbes.

Exercise 7. Read and translate the text:

Antibiotics

Antibiotic is a drug produced by certain microbes. Antibiotic sub­stances are obtained from bacteria and fungi that live in the air, soil, and water. Most antibiotics are used by physicians to fight various diseases caused by harmful microbes. A few are used to treat certain types of cancer.

Antibiotics are selectively toxic – that is, they damage certain types of cells, but do not damage others. Many antibiotics are harmful to the cells of pathogenic (disease-causing) microbes, but they do not normally damage human cells. Physicians use these types of antibio­tics to treat a variety of bacterial diseases, including gonorrhea, syphi­lis, and tuberculosis, and infections caused by staphylococcal and streptococcal bacteria. A small number of antibiotics, however, were developed to attack human cells. Some of these are used to treat can­cer. They are selectively toxic mostly because they only damage cells that are in the process of dividing.

Antibiotics are sometimes called "wonder drugs" because they can cure many diseases that once were often fatal. The number of deaths that are caused by meningitis, pneumonia, and scarlet fever has de­clined drastically since people began using antibiotics.

Antibiotics are also used to treat infectious diseases in animals and to control bacteria and fungi that damage fruits and grains. Farmers sometimes add small amounts of antibiotics to livestock feed to stimu­late the animals’ growth.

Exercise 8. Answer the questions:

1. How are antibiotics obtained?

2. What diseases may antibiotics be used in?

3. What cells are many antibiotics normally harmful to?

4. What is selective toxicity?

5. Why do we call some antibiotics as "wonder drugs"?

6. Where may antibiotics be also used to treat infectious diseases?

7. Why do farmers sometimes add small amounts of antibiotics to livestock feed?

Exercise 9. Translate the following word combinations into English:

Бактерії та гриби; шкідливі мікроби; мікроби, які викликають хворобу; бактеріальні хвороби; стафілококові та стрептококові бактерії; уражати клітини людини; «дивовижні ліки»; пошкоджувати фрукти та овочі; корм для худоби; стимулювати ріст тварин; поділ клітин; лімфатична система; дуже поширені хвороби; хвороби, які передаються через контакт; вірусна інфекція; венерична хвороба.

Exercise 10. Compete the following sentences using the words and phrases from the text:

1. Antibiotic is a drug produced by certain….

2. Antibiotic sub­stances are obtained from bacteria and fungi that live in the ….

3. Most antibiotics are used by …. to fight various diseases caused by harmful microbes.

4. A few are used to treat certain ….

5. Antibiotics are selectively toxic – that is, they damage certain types of …, but do not damage others.

6. Many antibiotics are harmful to the cells of … (disease-causing) microbes, but they do not normally damage human cells.

7. Antibiotics are sometimes called "wonder drugs" because they can … many diseases that once were often fatal.

Exercise 11. Fill in the prepositions where necessary:

1. The first antibiotic was discovered … Alexander Fleming in 1928 in a significant breakthrough (прорив) … medical science.

2. Some antibiotics are “bactericidal”, meaning that they work … killing bacteria. Other antibiotics are “bacteriostatic”, meaning that they work … stopping bacteria multiplying.

3. Some antibiotics can be used to treat a wide range … infections and are known … “broad-spectrum” antibiotics.

4. The most common side effects … antibiotics are diarrhea, nausea, vomiting.

5. Some people are allergic… antibiotics, particularly penicillin.

6. Allergic reactions cause swelling … the face, itching and a skin rash and, … severe cases, breathing difficulties.

7. The type … antibiotics you take depends … the type of infection you have and what kind of antibiotics are known to be effective.

Exercise 13. Put questions to the underlined words:

1. The discovery of antibiotics greatly improved the quality of human life in the twentieth century.

2. Antibiotic drugs are made from living organisms such as fungi, molds.

3. Antibiotics can also be produced synthetically (artificially).

4. Prontosil was discovered in 1935 by German chemist Gerhard Domagk.

5. Bacterial resistance occurs when some bacteria survive attack by the antibacterial drug.

6. In 1928, British bacteriologist Alexander Fleming discovered the bacteria-killing property of penicillin.

7. The antibiotic works by blocking the formation of the bacterial cell wall, thus killing the bacteria.

Exercise 14. Open the brackets using the necessary form of the infinitive:

1. This is the patient (to give) a painkiller.

2. She wanted (to send) to the conference in medicine.

3. My friend appears (to recover) rapidly.

4. (To operate) this patient we will have to give him a general anesthesia first.

5. The nurse brought the blood (to transfer) to the patient (to operate).

6. The sutures (to remove) on the 4^th day.

7. The patient (to take) to an operating room immediately to prevent the rupture of the appendix.

Exercise 15. Read the additional text. Before reading it answer the following questions:

1) What are the main ways of taking antibiotics?

2) Is it important to complete the whole course of the medication?

3) What will happen if a patient doesn’t complete the course of antibiotics?

4) How should some antibiotics be taken?

5) What is it necessary to do if you want the medication to be effective?

6) When do most antibiotics start having an effect on an infection?

7) What must be avoided when taking certain types of antibiotics?

Дата добавления: 2015-11-16