chapter1 Anaemia 贫血(pínxuè)

1. Anaemia 贫血(pínxuè)

Woman, Age 39 (女性(nǚxìng)，39岁(suì))
（D=Doctor 医生(yīshēng)， P=Patient 病人(bìngrén)）

D：我知道你一直贫血(wǒzhīdàonǐyìzhípínxuè)，去年五月份还验过血(qù nián wǔ yuè fèn hái yàn guò xuè)。还有别的症状吗(háiyǒubiédezhèngzhuàngma)？
I see you’ve been anaemic and you had a blood test last May. Has anything else troubled you?
P：我一直耳鸣(wǒyìzhíěrmíng)，头晕(tóuyūn)。
I’ve kept getting a roaring in my ears and giddiness.
D：还(hái)有(yǒu)别(bié)的(de)症(zhèng)状(zhuàng)吗(ma)？
Anything else?
P: 有(yǒu)，我还气短(wǒháiqìduǎn)。
Yes, I am breathless.
D：一天到晚都不好吗(yìtiāndàowǎndōubùhǎoma)？
All the time?
P：大部分时间(dàbùfenshíjiān)。
Most of the time.
D：你是做什么工作的(nǐshìzuòshénmegōngzuòde)？
What do you do ?
P：我是厨师(wǒshìchúshī)。
I’m a cook.
D：这些症状持续多久了(zhèxiēzhèngzhuàngchíxùduōjiǔl)？
How long has all this goes on?
P：大概有(dàgàiyǒu)6个月了(gèyuèle)。
About 6 months.
D：自从你服用了铁剂就这样吗(zìcóngnǐfúyòngletiějìjiùzhèyà)？
Since your treatment with iron ?
P：是的(shìde)，我的头晕经常是周期性的(wǒdetóuyūnjīngchángshìzhōuqīxing de)。
Yes, I keep getting dizzy spells.
D：说详细些(shuōxiángxìxiē)。多久发作一次(duōjiǔfāzuòyícì)？
Tell me about them. How often do you get them?
P：它时好时坏(tāshíhǎoshíhuài)，最近一次非常厉害(zuìjìnyícìfēichánglìhài)。
They come and go but last time I fell badly
D：什么情况会促使头晕发作(shénmeqíngkuànghuìcùshǐtóuyūn)？
Does anything bring them on?
P：突然跑动时(tūránpǎodòngshí)。
Rushing about.
D：会发生什么情况(huìfāshēngshénmeqíngkuàng)？
What actually happens?
P：我总摔跤(wǒzǒngshuāijiāo)（跌倒(diēdǎo)）
I keep falling down
D：你知道你要跌倒了吗(nǐzhīdàonǐyàodiēdǎolema)？
Do you know you’re going to fall?
P：我知道要跌倒(wǒzhīdàoyàodiēdǎo)，但我就是站立不住(dànwǒjiùshìzhànlìbùzhù)。
I know I’m falling but I can’t stop myself.
D：双腿不听使唤吗(shuāngtuǐbútīngshǐhuànma)？
Do you legs give away?
P：是的(shìde)。
Yes.
D：是(shì)按(àn)某(mǒu)种(zhǒng)特(tè)定(dìng)的(de)方(fāng)向(xiàn)跌倒吗(diēdǎoma)？
Do you fall in any particulars way?
P：总(zǒng)是(shì)朝(cháo)前(qián)摔(shuāi)倒(dǎo)。
I keep falling forwards.
D：你摔伤不止一次吧(nǐshuāishāngbùzhǐyícìba)？
You’ve hurt yourself more than once?
P：是的(shìde)， 我经常头晕(wǒjīngchángtóuyūn)，我觉得冰箱朝我冲过来(wǒjuédebīngxiāngcháowǒchōnggu)，并很快旋转去来(bìnghěnkuàixuánzhuǎnqùlái)。
Oh yes. I go giddy. The fridge comes to meet me and whizzes round.
D：如果你站着不动你能站稳吗(rúguǒnǐzhànzhebúdòngnǐnéngzhà)？
If you stand still, do you hold on?
P: 能(néng)。
Yes.
D：躺在床上感到头晕吗(tǎngzàichuángshànggǎndàotóuyū)？
Do you feel giddy in bed?
P：是的(shìde)。
Yes
D：两次发作期间你感觉好吗(liǎngcìfāzuòqījiānnǐgǎnjuéhǎo)？
Are you all right between spasms?
P：还行(háixíng)，
Yes
D：对你听力有什么影响吗(duìnǐtīnglìyǒushénmeyǐngxiǎng)？
Does it affect your hearing?
P：双耳耳鸣(shuāngěrěrmíng)。
I get roaring in my ears
D：像什么东西(xiàngshénmedōngxī)？
What does it sound like?
P：像哗哗的流水声(xiànghuāhuādeliúshuǐshēng)。
Like whooshing
D：多长时间(duōchángshíjiān)？
How long?
P：几分钟(jǐfēnzhōng)？
Minutes.
D：你感到恶心吗(nǐgǎndàoěxinma)？
Do you feel sick
P：一大早就恶心(yídàzǎojiùěxin)，太难受了(tàinánshòule)。
Yes. First thing in the morning. Terribly
D：常呕吐吗(chángǒutùma)？
Have you been sick?
P：是的(shìde)。
Yes.
D：头痛吗(tóutòngma)？
Do you suffer from headaches?
P：我每次月经只来半天(wǒměicìyuèjīngzhīláibàntiān)，来月时头痛的非常厉害(láiyuèshítóutòngdefēichánglìh)。
My periods are only for half a day and get terrible headaches.
D：你月经多长时间来一次(nǐyuèjīngduōchángshíjiānláiyí)？
How often do you have your periods?
P：不一定(bùyídìng)，每阁(měigé)2～3周(zhōu)。
It varies. Every two or three weeks.
D：一直这样吗(yìzhízhèyàngma)？
Is it always like that?
P：是的(shìde)。
yes
D：何时开始的(héshíkāishǐde)？
When did they start?
P：我十一岁来月经(wǒshíyīsuìláiyuèjīng)，然后(ránhòu)9年前中断了(niánqiánzhōngduànle)3年(nián)。5天前来过月经(tiānqiánláiguòyuèjīng)。
When I was eleven. Then nine years ago they stopped for three years. I saw five days before that.
D：你说过你有气喘(nǐshuōguònǐyǒuqìchuǎn)，是吗(shìma)？
You say you are breathless?
P：是的(shìde)。我一爬楼就喘不过气来(wǒyīpálóujiùchuǎnbúguòqìlái)。
Yes, I get puffer if I go upstairs.
D：你有消化不良病吗(nǐyǒuxiāohuàbùliángbìngma)？
Do you suffer from indigestion?
P：没有(méiyǒu)。
No.
D：有肠胃病症吗(yǒuchángwèibìngzhèngma)？
Bowel trouble?
P：没有(méiyǒu)。
No
D：排尿有问题吗(páiniàoyǒuwèntíma)？
Water?
P：没有(méiyǒu)。
No
D：夜间起来上厕所吗(yèjiānqǐláishàngcèsuǒma)？
Do you get up at night?
P：不(bú)。
No
D：胃口怎么样(wèikǒuzěnmeyàng)？
How’s your appetite?
P：还好(háihǎo)。
Fair.
D：你抽烟吗(nǐchōuyānma)？
Do you smoke?
P：每天抽(měitiānchōu)15～20支(zhī)。
Fifteen to twenty a day.
D：喝酒吗(hējiǔma)？
Do you drink?
P：喝的不多(hēdebùduō)。
Not a lot


●Clinical Examination (临床检查(línchuángjiǎnchá))
（在临床检查时(zàilínchuángjiǎncháshí)，医生和病人进行了如下的对话(yīshēnghébìngrénjìnxínglerúxi)）
（During the clinical examination the doctor made the following remarks）

D: 请伸出胳膊(qǐngshēnchūgēbo)，让我给你量血压(ràngwǒgěinǐliàngxuèyā)。除了铁集(chúletiějí)=剂以外(jìyǐwài)，你还服用过什么药吗(nǐháifúyòngguòshénmeyàoma)？
Can I have your arms? I’ll take your blood pressure. Apart from iron tablets, are you taking anything else?
P：服用过安眠药(fúyòngguòānmiányào)。
Yes. For sleeping.
D：让我检查一下你的胸部(ràngwǒjiǎncháyíxiànǐdexiōngbù)。大口呼吸(dàkǒuhūxī)。你脸上有斑是怎么回事(nǐliǎnshàngyǒubānshìzěnmehuís)？
Let me look at you chest for a moment. Take a big breath. What are these pale patches on your checks?
P：服用安眠药后就有了(fúyòngānmiányàohòujiùyǒule)。
They come from taking sleeping pills
D：请张嘴呼吸(qǐngzhāngzuǐhūxī)。你牙齿什么时候拔掉的(nǐyáchǐshénmeshíhòubádiàode)？
Breathe through your mouth. When did you have you teeth out?
P：四年以前(sìniányǐqián)。
Four years ago.
D：两肩放松(liǎngjiānfàngsōng)。大便颜色有变化吗(dàbiànyánsèyǒubiànhuàma)？
Let your shoulder go loose. Have your motions changed in colour?
P：有(yǒu)，大便发黑(dàbiànfāhēi)。服铁剂后我还腹泻(fútiějìhòuwǒháifùxiè)。
Yes, they are very dark. The iron tablets give me diarrhea.
D：我现在检查你的眼睛(wǒxiànzàijiǎnchánǐdeyǎnjīng)。看我手指(kànwǒshǒuzhǐ)，头不要动(tóubúyàodòng)。眼睛随着我的手指转动(yǎnjīngsuízhewǒdeshǒuzhǐzhuǎn)。张开嘴(zhāngkāizuǐ)。你有针扎的感觉吗(nǐyǒuzhēnzhādegǎnjuéma)？我还找不到引起贫血的主要原因(wǒháizhǎobùdàoyǐnqǐpínxuèdezh)，请你做个胸部(qǐngnǐzuògèxiōngbù)X光摄片(guāngshèpiàn)、头部(tóubù)X光摄片(guāngshèpiàn)、脑电图(nǎodiàntú)，再做进一步的血液化验(zàizuòjìnyíbùdexuèyèhuàyàn)。
I’ll look at your eyes now. Look at my finger. Keep your head still and follow it with your eyes. Open your mouth. Can you feel this pin? I can’t find any serious cause for anaemia. I’d like you to have your chest X-rayed, a skull X-ray, an EEG and some further blood tests

Great job. hope to see some more post...thanks for such useful post.