English for medical purposes

Taking a history from a patient

Exercise 1: questions relating to pain

Below is a list of types of the main questions (1-11) relating to pain. Match each

one with one or more questions (A-M) in the right-hand column. One has been

done for you as an example.

2. Duration

3. Site

4. Nature of onset

5. Radiation

6. Nature of the pain

7. Aggravating factors

8. Alleviating features

9. Previous episodes

10. Triggering factors

A. Can you tell me what the pain is

like?

B. Have you had it before?

C. Can you show me where you get

the pain?

D. When did it start?

E. Does anything relieve it?

F. Did it come on slowly or

suddenly?

G. Does it spread anywhere else?

H. Are you aware of anything that

brings the pain on?

I. How long have you had the pain?

J. Does anything make it better?

K. Where do you get the pain?

L. Does anything special bring it

on?

M. Does anything make it worse?

Exercise 2

Insert the following questions in the appropriate spaces in the dialogue below:

Question list

A. Where did it start?

B. Does it go anywhere else?

C. When did it come on?

D. And do you still have it?

E. Can you show me where it is?

F. Can you describe the pain for

me?

G. How severe is it at the moment?

H. Is it constant?

I. And have you had the pain

before?

J. How severe was the pain?

K. Can you tell me what the problem

is?

History

DOC: Good morning, Mr Fitt

PAT: Good morning doctor.

DOC: How can we help you?

PAT: I’ve not been feeling very well.

DOC: ______1______

PAT: Well, I’ve got this terrible pain.

DOC: ______2______

PAT: Yesterday evening.

DOC: ______3______

PAT: Yes, but it’s not as bad as it

was.

DOC: ______4______

PAT: Yes just here [at the top of my

tummy].

DOC: ______5______

PAT: Yes. It feels as if it’s going

straight through to my back.

DOC: ______6______

PAT: Well. It feels as if it’s boring

right through me.

DOC: ______7______

PAT: Yes

DOC: ______8______

PAT: It’s eased off a bit, but it’s still

bad.

DOC: ______9______

PAT: Just after dinner.

DOC: What did you have to eat?

PAT: The usual, steak and chips.

DOC: And to drink?

PAT: A couple of beers.

DOC: Pints?

PAT: Yes.

DOC: Do you have a couple of pints

every evening?

PAT: Yes, more or less.

DOC: And do you ever have more

than a couple?

PAT: Oh, yeah, especially at weekends

DOC: ______10_____

PAT: Yes. But not as bad as this.

DOC: ______11_____

PAT: I don’t know, it was really bad

DOC: Did it make you double up?

PAT: Yes.

DOC: Does anything make the pain

better?

PAT: No, not really. Well, maybe if I

don’t eat.

Exercise 3: dialogue practice

Pair work practice. Take turns at practising the doctor in the dialogue bellow.

When you have done this once each, role-play the dialogue without looking at the

text.

Student A Student B

PAT: Good morning doctor.

PAT: I’ve not been feeling very well.

PAT: Well, I’ve got this terrible pain.

PAT: Yesterday evening.

PAT: Yes, but it’s not as bad as it

was.

PAT: Yes just here [at the top of my

tummy].

PAT: Yes. It feels as if it’s going

straight through to my back.

PAT: Well. It feels as if it’s boring

right through me.

PAT: Yes

PAT: It’s eased off a bit, but it’s still

bad.

PAT: Just after dinner.

PAT: The usual, steak and chips.

PAT: A couple of beers.

PAT: Yes.

PAT: Yes, more or less.

PAT: Oh, yeah, especially at weekends

PAT: Yes. But not as bad as this.

PAT I don’t know, it was really bad.

PAT: Yes.

PAT: No, not really. Well, maybe if I

don’t eat.

DOC: Good morning, Mr Fitt

DOC: How can we help you?

DOC: Can you tell me what the

problem is?

DOC: Where did it start?

DOC: And you still have it?

DOC: Can you show me where it is?

DOC: Does it go anywhere else?

DOC: Can you describe the pain for

me?

DOC: Is it constant?

DOC: How severe is it at the

moment?

DOC: When did it come on?

DOC: What did you have to eat?

DOC: And to drink?

DOC: Pints?

DOC: Do you have a couple of pints

every evening?

DOC: And do you ever have more

than a couple?

DOC: And have you had the pain

before?

DOC: How severe was the pain?

DOC: Did it make you double up?

DOC: Does anything make the pain

better?

Exercise 4: a patient-centred approach

History

Here is the beginning of the dialogue:

DOC: Good morning, Mr Fitt

PAT: Good morning doctor.

DOC: How can I help you?

PAT: I’ve not been feeling very well.

In the history below, you have three choices to make about what is the most

patient-centred approach to taking the history. Choose the best question in each

case. Why would you not use the other alternatives?

Column A Column B Column C

1. DOC: A Can you tell me

a bit more about how you

feel?

What’s the matter?

Yes?

PAT: Well, I’ve got this terrible pain in my tummy …., it came on just

like that yesterday evening after I finished eating.

2. DOC: You got this

terrible pain in the

tummy after you

finished eating? In the

evening? And is it still

there?

So it started yesterday

evening. And you still

have the pain?

And it’s gone now?

PAT: Yes, but it’s not as bad as it was.

3. DOC: Show me

where it is.

OK. Can you show

me where it is?

Point to it.

4. DOC: Does it

radiate anywhere

else?

Radiate anywhere

else?

Just at the top of your

tummy. Does it go

anywhere else?

PAT: Yes. It feels as if it’s going straight through to my back.

5. DOC: Can you

describe the pain for

me?

What does the pain

look like?

Describe the pain.

PAT: Well. It feels as if it’s boring right through me. It’s there all the

time and very seldom leaves you.

6. DOC: So it’s very

severe.

It’s very severe, isn’t

it?

Right. When you say

it’s going right through

you, is it very severe?

PAT: Yes. It made me double up last night.

7. DOC: And does

anything make it

better?

And does anything

ameliorate the pain?

Anything make it

better?

PAT: No. Not really. Well, mmm maybe if I don’t eat a big meal.

8. DOC: This is the

first time you have

ever had it?

And is this the first

time you have had it?

You’ve never had an

episode before.

PAT: No. I’ve had it several times before but not quite as bad as this.

I just thought it was indigestion and took something, but they didn’t

do anything.

9. DOC: Apart from

the tablets, did you

take anything else?

Taken anything else?

What else did you

take? Anything?

PAT: No.

10. DOC: Nothing.

Can you just tell me

what you had to eat

yesterday evening?

Tell me what you ate

then.

What did you eat?

PAT: The usual, steak and chips.

11. DOC: And did you

have any alcohol?

And to drink? And what alcohol did

you have to drink?

PAT: A couple of beers.

11. DOC: You drank

several pints.

Was this pint-size?

Pints?

PAT: Yes.

DOC: Do you have a couple of pints every evening?

PAT: Yes, more or less.

DOC: And do you ever have more than a couple?

PAT: Oh, yeah, especially at week-ends

.

A. When you come to, you will be in the recovery room.

B. When you come round, you will be in the recovery

room.

C. He came down with flu the week before last.

D. Everything he eats just keeps coming up.

E. When I took the medicine, I came out in little red spots.

F. The leg looks as if it’s coming along nicely.

G. I came over all dizzy when I was walking along the

street.

H. When did the pain first come on?

I. When did you come in?

J. He has come through the operation rather well.

K. She was very shy at first, but she has come out of

herself a lot recently.

L. I feel as if my whole life is coming apart.

Exercise 5: Colloquial language – phrasal verbs with come

Match the meaning in the boxes Ii-xi) with the text underlined in the sentences

(A -L). One has been done for you as an example.

x) were you hospitalised

ix) became covered

with

vii) had a

sudden

attack of

vi)

breaking

into pieces

v) start

iv) making progress

ii) regain consciousness

i) caught

viii) being

vomited

iii) recovered from

xi) become more

confident