2024

ENGLISH FOR MEDICAL DOCTORS

Curso de lecto-comprensión en Inglés, orientado a las Ciencias Médicas

Autor y docente a cargo:

Prof. Estela M. Ambrosioni
ISBN 978-987-05-4367-1
 APUNTE DE ACTIVIDADES

CURSO de LECTO-COMPRENSIÓN en Inglés orientado a las CIENCIAS MÉDICAS.

OBJETIVOS GENERALES

Valorar la importancia del manejo de una lengua extranjera como instrumento de información.
Adquirir técnicas y estrategias de lectura para extraer en el menor tiempo posible, la mayor
cantidad de información relevante de un texto técnico-científico en las ciencias médicas.
⮚ El OBJETIVO es lograr el abordaje de textos en inglés mediante una lectura efectiva y una
comprensión cabal y precisa del tema.

OBJETIVOS ESPECÍFICOS

Este apunte de actividades está diseñado para que el alumno, al finalizar el período de instrucción se
capacite para:
1-Reconocer la lengua, las diferencias y similitudes básicas entre la lengua materna y la extranjera.
2-Decodificar los códigos morfológicos y sintácticos para interpretar correctamente la información.
3-Construir y elaborar glosarios de terminología técnica.
4-Impulsar a las búsquedas por vía Internet WEB

NOTA: Este APUNTE está compuesto por unidades independientes, las que abordaremos
según las necesidades de cada clase, por lo tanto no seguiremos el orden de las páginas.

CARACTERÍSTICAS DEL CURSO

La carga horaria es de 1:30 horas semanales para las tres comisiones.

Las clases se dictan por la plataforma zoom.*
● Días: MARTES, MIÉRCOLES Y JUEVES
● Horario: 17 a 18:30

ASISTENCIA 80%. Se realizarán exámenes anuales, escritos en forma PRESENCIAL.

Duración del CURSO: primera etapa: JUNIO-DICIEMBRE,

segunda etapa: MARZO-ABRIL

● *REGULARIDAD: ● Aprobar los 2 (dos) exámenes, se recupera uno ● Asistir al 80%

de las clases, ● Aprobar la monografía

● DOCENTES A CARGO:

Prof Estela Ambrosioni, email: ambrosioni@[Link]

Prof María Isabel Aciar, email: mariaisabelaciar@[Link]

1
 CONTENIDOS GENERALES
UNIT 1
● What is Reading comprehension?

A-NOUNS:

● Formation of plural
● Nouns forming suffixes
● Possessive Case
B-VERBS PATTERNS

● VERB To Be, To Have (Aff-Neg-Interrogative form)

● Present Tenses.
● Adverbs of frequency.
● Articles-The –A-An / This-that (Singular) / These-those (Plural)
● “WH” / “HOW” questions.
C-Reading material and Vocabulary.

UNIT 2

A- ADJECTIVES

● ADJECTIVES forming suffixes.

● Comparison of ADJECTIVES: Positive-Comparative-Superlative Degree.
● Gradual Increase-Parallel increase.
● Irregular comparisons
B-VERB PATTERN: Past Tenses.

C-Reading material and Vocabulary.

UNIT 3

A-VERBS PATTERNS

● Modal verbs.
● Future Tenses.
● Verbs with “R” and “S”
● Verbs with “LIKE”
B-NOUN MODIFICATION

● Pronouns.
C- Reading Material and Vocabulary

UNIT 4

A-VERB PATTERNS

● Conditional sentences: 0 Conditional, 1st type-2nd type-3rd type

● Reading resources-Demonstrative Pronouns-Relative Pronouns-Indefinite Pronouns.
B-THE ADVERB

2
 ● Adverbs of manner-Adverbs of frequency.
C- Reading Material and Vocabulary

UNIT 5

A-SOME-ANY-NO- Reading Material and Vocabulary

B-VERB PATTERN

C-Passive Voice

D- Reading Material and Vocabulary Pages Verbs, Connectors, prepositions, phrasal

verbs, medical Vocabulary, reported cases

BIBLIOGRAFIA OBLIGATORIA

● Apunte confeccionado por las docentes de la cátedra. ENGLISH FOR MEDICAL

DOCTORS.

3
4
 UNIT 1

A-NOUNS:
1-What is Reading Comprehension?
2-Formation of plural
3-Nouns forming suffixes
4-Possessive Case

B-VERBS PATTERNS
1-VERB To Be, To Have (Aff-Neg-Interrogative form)
2- Present Tenses.
3-Adverbs of frequency.
4-Articles-The –A-An / This-that (Singular) / These-those (Plural)
5-“WH” / “HOW” questions.

C-Reading comprehension activities and Vocabulary

¿QUÉ ES LA LECTO-COMPRENSIÓN?

En general, el alumno que asiste a cursos de lecto-comprensión tiene:

● Un propósito específico
● Conocimientos sólidos del tema o la disciplina.

Su propósito específico es la permanente actualización dentro de su disciplina mediante la lectura

de artículos originalmente escritos en inglés o traducidos a esa lengua que, como todos sabemos, ha
pasado a ser la lingua franca en lo que atañe a la difusión de la información nueva. Al trabajar
con textos de la especialidad, los profesionales de la salud - como los de cualquier otra
disciplina - encuentran más fácil la tarea de aprender a leer en inglés, a la vez que más
interesante, dado que leen material que es de su especial interés y sobre temas que conocen
bien. Está previsto que sean los alumnos los que, a medida que el curso avance, provean los
artículos que se trabajarán en clase

Leer es una capacidad importante para los estudiantes que se inician en la lectura de una
lengua extranjera, este proceso no quiere decir que sea una traducción textual. La lectura
es el medio primario de aprendizaje Independiente, si la meta es mejorar aprender más
acerca de la materia ([Link]). El lector debe aprender a reconocer
conceptualmente las ideas, supervisado por el docente para que en el menor tiempo
posible, adquiera esas técnicas de lectura frente a los textos técnico-científico. Aprender a
leer palabra por palabra no significa saber el significado de un texto, en general leemos
textos para extraer información o para sacar una opinión crítica, siendo la aproximación
global, la mejor forma de abordar un texto en cualquier lengua. Para LEER es importante:

1-BUSCAR información 3-APRENDER información, reconocer y aplicar

técnicas para facilitar la lectura.
2-COMPRENSIÓN general 4-RESUMIR para hacer una versión más breve y
EVALUAR información.

5
 ⮚ ESTRATEGIAS PARA LEER TEXTOS en Idioma Extranjero

Estrategia es “cualquier secuencia de eventos mentales que requieran toma de

decisiones para alcanzar una meta” (Bruner and Bigge-1976:255). OBJETIVO: entrenar a
leer RÁPIDO, permitiendo al cerebro procesar el input (los datos, la información en general)

1-Empezar por lo que se conoce: PALABRAS TRANSPARENTES (Ej: diabetes, trauma, cardiac,
technique) interpretar el significado de las mismas de acuerdo al contexto, usando sufijos, prefijos

2-CONOCIMIENTO PREVIO ayuda a planificar una tarea de aprendizaje.

3-CUIDADOSA lectura de los TÍTULOS ya que contienen la idea general o integral de un texto.

4-PREDECIR (preview: vista preliminar), para inferir, resaltar o deducir mediante, títulos,
gráficos, conclusiones, es una habilidad de lectura de alta velocidad. A- DA información para hacer
hipótesis, B- AYUDA a comparar la nueva información con conceptos ya conocidos.

5-Especificar el PROPÓSITO (porqué se lee el artículo), ubicar la oración principal.

6-SCANNING: explorar rápidamente buscando información específica.

7-SUBRAYADO consiste en resaltar palabras claves, frases temáticas y conceptos importantes.

8-CATEGORIZACIÓN: identificar para recordar mejor y clasificar o reclasificar el material

lingüístico en unidades o grupos con encabezamiento, el uso de colores ej: palabras (Sustantivos
verbos), temas (términos relacionados: (Surgical emergency), funciones lingüísticas (ej: dar
instrucciones, descripciones), analogías (frío-fresco-helado),contrastes (typical/atypical, pros/cons)

9-ASOCIACIÓN: relacionar conocimientos previos con la información nueva para establecer

críticas.

10-ADIVINAR el significado de palabras desconocidas, si aparecen repetidamente, buscarlas.

11-VISUALIZAR: hacer un cuadro o diagrama para describir lo que dice el texto.

12-RECURSOS: usar diccionarios, libros, revistas científicas y elaborar Glosario:

[Link] (diccionario online),[Link], intranet:UptoDate /HP free.

13-RESUMIR: (sin detalles) discriminar entre las ideas más importantes y las que no lo son para
realizar una versión abreviada del texto original.

14-DEDUCCION/ INDUCCION: implica sacar consecuencias, derivar hipótesis, leer entre líneas
acerca de los significados a partir de los datos usando las reglas / estrategias y técnicas aprendidas.
LEER en forma crítica.

15-AUTOEVALUACIÓN: es la valoración personal del grado en que la tarea se ha completado

con éxito.
1) A continuación encontrará títulos de revistas, libros y publicaciones técnico-científicas.

Lea los títulos y subraye las palabras transparentes, es decir aquellas similares al Castellano.
(Conocimiento previo) Look at these titles and underline the transparencies:
6
 1-Trauma Care, Disaster 2-Mechanisms and Management
Approach of Cardiac Arrhythmias.
& Emergency Medicine Clifford Garratt
Conferences Royal Infirmary, Manchester, UK
3-BLOOD: Principles and Practice 4- EVIDENCE BASED
of Hematology HYPERTENSION
SECOND EDITION USA Journals
5-On Going Strategies and 6-PEDIATRICS
future challenges for PSYCHOPHARMACOLOGY
CARDIOVASCULAR
EMERGENCIES
The Lancet N°10025, March 2022
PRINCIPLES AND PRACTICES.

7-OTOLARYNGOLOGY 8-UPDATED INFECTIOUS

Reviews DISEASES IN CLINICAL
(available free copy) PRACTICE-Seminar

9- CURRENT OPINION IN:

ENDOCRINOLOGY & DIABETES
Kasey, K, MD, PhD, Boston Medical Center,
Boston, MA, USA.
10-100
Questions & Answers IN
CARDIOLOGY-World Report
11-DAWSON’S GASTROINTESTINAL PATHOLOGY
Chapter 3 and 4
School of Medicine, State University of N.Y, USA

12-THE JOURNAL of BONE and JOINT SURGERY-Summary

13-DENGUE MYOCARDITIS: a case report -Lancet Vol 387, April 2, 2024

14-RESEARCH and RISKS FACTORS of CONGESTIVE HEART FAILURE

CLINICAL REVIEW-BMJ-2023

15-Podcast -Vaccine Successes and Vaccine Adverse Events

Supplement to the N Engl J Med 2023; 384:e70-
16-Audio INTERVIEW-EMERGING TOOLS IN THE FIGHT AGAINST COVID-
19 April 9, 2022 N Engl J Med; 382:e39

7
 2- Complete el cuadro con la info de la hoja anterior use solo 6 títulos de las revistas científicas
FUENTE (source) De qué trata cada título
1

A-VERB PATTERNS. "to be" (ser-estar)

AFIRMATIVO (+) NEGATIVO( -) AFIRMATIVO ( +) INTERROGATIVO

(?)

I am I'm not We/ you /they are* Am I…?

You are * You/ they/ we aren't Are we/you /they…?
He / she / it is He / she / it isn't Is she/ he/ it…?
i.e: 1-Are the residents on duty?
2-She is a 35-year-old female. Her lab tests aren’t ready.

8
 B-VERB "have-have got" (tener).
AFFIRMATIVE (+) NEGATIVE (-) AFFIRMATIVE (+) INTERROGATIVE
(?)
I / you have* We/ you/ they haven't We/ you/ they have* Have I/ you/ they…?
He/ she/ it has He /she/ it hasn't Has she/ he/ it…?
1-This 78-year-old woman has (got) diabetes and a heart murmur.
2-The patient admitted this morning hasn’t a diagnosis of pneumonia.
3-Has the patient a predisposition to the condition?
4-Polyarteritis nodosa is one of the rarer vasculitis and has a different natural history and prognosis

Write the rule for the use of HAS-HAVE

RULE:

EXERCISES. (underline:_______, nouns: sustantivos)

A-Translate the following sentences, 1-Underline the verbs, 2-Circle the nouns
1-Myasthenia gravis is not (isn’t) rare with a prevalence rate of 1 in 10,000.
2-MG is a neuromuscular disorder, characterized by weakness and fatigability.
3-10 percent of patients with Myasthenia Gravis have thymic tumors.
4-The treatment of MG is highly individualized and depends on the age of the patient.
5-Myasthenic crisis is characterized by neuromuscular respiratory failure.
6-The thymus is abnormal in approximately 75 percent of patients with MG.
7-Treatment for MG is effective, but it hasn’t any specific cure.
8- In older age groups, men with MG are often affected and the disease is often misdiagnosed.

9
 READING MATERIAL
LEA rápidamente (lectura global) y luego realice los ejercicios que están al final.(READ quickly
and then do the exercises that are at the end ) ¿Cómo busca el New England JM en la web?

10
 1- Observe el TEXTO: ¿De dónde proviene esta publicación? (Revista, libro)_______________
2-Lugar y Fecha de publicación________________________________________________
3-Enumere las distintas secciones que presenta esta hoja __________________________
_________________________________________________________________________
4-¿De qué trata el Caso Reportado?_____________________________________________
5-¿Cuántos artículos originales encontró?_________________________________________
6-¿Qué significa SOUNDING BOARD?_________________________________________

NOUNS
ENGLISH RULES of FORMING PLURALS
Read the following examples and state the rule: NOTICE the ending
1
Disease Diseases
Endoscope Endoscopes
Finger Fingers
2
Technology Technologies
Injury Injuries
Ovary Ovaries
Body Bodies
Biopsy Biopsies
3
Process Processes
Loss Losses
4
Sex Sexes
Wax Waxes
Crutch Crutches
Patch Patches
5
Mesh Meshes
Brush Brushes
6 Read the examples and draw the rule:
Half Halves
Calf Calves
Life Lives
Knife Knives
7 a Irregular plural:
Man Men
Woman Women
Mouse Mice

11
Foot Feet
Tooth Teeth
8
Series Series
Species Species

Vertebra Vertebrae
Axilla Axillae
Bursa Bursae
Sclera Sclerae
9 Nouns of Latin Origin
Fungus Fungi
Alveolus Alveoli
Stimulus Stimuli
Meniscus Menisci
Nucleus Nuclei
Streptococcus Streptococci
Bacillus Bacilli
Bronchus Bronchi
10
Bacterium Bacteria
Antrum Antra
Diverticulum Diverticula
Septum Septa
Cerebellum Cerebello
Datum Data
Septum nasal: pared (tabique) que forma pared medial de las fosas nasales.
11 El plural va en ambos términos
Condyloma acuminatum Condylomata acuminate
Placenta previa Placentae previae
Verruca vulgaris Verrucae vulgares
12 Nouns of Greek Origin:
Criterion Criteria
Phenomenon Phenomena
Ganglion Ganglia
13-Draw the rule
Basis Bases
Hypothesis Hypotheses

12
Analysis Analyses
Thesis Theses
Prognosis Prognoses
Testis Testes
Metastasis Metastases
The exceptions to the rule are:
Epididymis Epididymides
Femoris Femora
Iris Irides
Both are accepted
Carcinoma Carcinomas-Carcinomata
Fibroma Fibromas-Fibromata
Exceptions
Embryo Embryos
Placebo Placebos
Ending in YX, AX
Appendix Appendices
Calyx Calyces
Thorax Thoraces

ARTICLES
SINGULAR PLURAL
THE Lab findings-loops-stools-blood flow-samples-
bloodstream-recent surgery-heart sounds-patient
triage.

A Diagnosis-scar tissue-wound-MRI-respiratory
failure-chest X-ray-soft tissue sarcoma.

AN Accident- incision-intolerance-excess-acute
illness-anticoagulation treatment-affected area-
oxygen therapy.

13
 Singular: THIS-THAT
THIS Vessel-effort-intake-lateral wall-benign tumor

THAT Rash-overdose-allergy-cough-bacterial culture

Plural: THESE-THOSE
THESE Surgical techniques-samples-antibodies-
growth factors-loading doses-diagnosis criteria-
seasonal patterns- nasopharyngeal swabs.

THOSE Blood clots-long bones-platelets-clinical

features-
vital signs--treatment options-eating disorders.

Los términos médicos generalmente están formados de radicales (raíz) que es la parte principal del
término, complementado con prefijos y sufijos derivados de los idiomas griego y latín.

II-NOUNS FORMING SUFFIXES (sufijos que forman sustantivos)

-AGE Damage-drainage-bandage-blockage-advantage-average-hemorrhage
-ANT Contaminant-adjuvant-irritant-quadrant-significant
-ANCE Distance-acceptance-performance-intolerance
-ENCE Experience-occurrence-recurrence-incontinence
-ER Practitioner-designer-trimester-disorder
-IAN Mathematician-veterinarian-statistician-technician-physician
-ING Collecting-feeding-consulting-breathing-fainting-clotting-bleeding-spreading
-ICS Electronics-Mathematics
-ISM Metabolism-hypothyroidism-autism-embolism-mechanism
-IST Geneticist-pathologist-physicist-urologist-cardiologist-radiologist
-ITY Quantity-specificity-sensitivity-capacity-availability
-LET Droplet-triplet-platelet-tablet-ultraviolet
-LING Counseling-sibling-sampling-controlling
-LOGY Physiology-pathology-endocrinology-oncology
-MENT Management-experiment-ligament-measurement-development-environment
-METRE Centimetre-barometre-kilometre
-METER Diameter-thermometer-parameter
-NESS Numbness-weakness-stiffness-whiteness-dizziness-postprandial fullness
-OR Respirator-labor-receptor-factor-indicator-quarantine-related factor
-TION Malnutrition-consumption-medication*-ablation-junction-adoption-coagulation

14
-TH Birth-growth-depth-length
-URE Temperature-contracture-pressure-fissure-measure-premature
*HOLD the medication (drug): 1-suspender la medicación (temporalmente), [Link]
hold the medication under your tongue.2-custodiar, guardar

De un verbo se forma un sustantivo

VERB NOUN
Complete Completion
Introduce Introduction
Provide Provision
Fail Failure
Arrange Arrangement
Investigate Investigation
Use Utilization

Which of the following are NOUNS? A) Use a circle to identify them..

1-undergo 8-mixture 15-replaced
2-improve 9-collect 16-failure
3-wear 10-tolerance 17-redness
4-arrangement 11-feeding 18-quintuplet
5-available 12-preference 19-scientist
6-width 13-impairment 20-breathe
7-admission 14-factor 21-respiration

Dictionary work: look up meaning of words. Diccionario online FREE: [Link]

A-USEFUL VERBS-1) Read the verbs, 2) Write their meaning (ONLY if you know them)
1-perform a surgery: 13-metastases spread:
2-delay the diagnosis: 14-relieved by medication:
3-improve after the operation: 15-fall (temperature):
4-increase the night dose: 16-the wound bleeds:
5-the mandible is swollen (swell): 17-become pale:
6-X rays show/disclose: 18-thyrotropin-releasing hormone:
7-is admitted: 19-is discharged:
8-voided brown stools: 20-the surgery lasted 2 hours:
9-complain of acute pain: 21-excise a tumor:
10-renal function impairs: 22-withdraw blood:
11-undergo an angioplasty: 23-refuse to cooperate:
12-*develop otitis media: 24-feel ill:

15
 *Develop: se lo puede traducir como: aparecer, producirse, presentarse, surgir, progresar,
avanzar, evolucionar, desarrollarse es es más frecuentemente usado.
to develop fever: tiene fiebre-to develop an infection: contraer, incubar-develop a pleural
effusion: sufrió un derrame pleural.

RECORDAR: anote cada palabra nueva en el GLOSARIO (cuaderno/libreta INDICE)

B-MEDICAL VOCABULARY
1-lab findings: 13-before ≠ after entry:
2-intestinal run-off: 14-sudden onset:
3-fasting plasma glucose: 15-general malaise:
4-throat swab: 16-chief complaint:
5-multiple-bowel loop: 17-sample/specimen:
6-at rest (in bed): 18-first attack/ seizures/ fit:
7-on exertion (exercise): 19-bowel sounds:
8-pap smear: 20-white cell count:
9-yearly follow up appointments: 21-chest X Ray film:
10-high fever: 22-spinal tap:
11-night sweat and chills: 23-heart murmur:
12-dry cough: 24-easy bruisability:

Underline Verbs & Medical Vocabulary (USE chart A and B above ↑ to check vocab & verbs)
1-Ewing’s sarcoma’s symptoms and signs include local pain, swelling, systemic findings, such as
fever, malaise and chills.
2-The patient passes or voids daily frequent liquid, dark-brown stools which are positive for occult
blood. A rectal swab is obtained for culture.
3- Blood culture specimens yield gram-negative rods.
4-The abdomen becomes distended with diminished bowel sounds, rigidity, guarding, without
rebound tenderness.
5-The doctors on call perform a lumbar puncture and a CT scan of the abdomen and pelvis.
6-There is no history of seizures, illicit drugs, sweat, easy bruisability, cough, rash and stiff neck.
7-The patient is an obese man, mildly ill, the heart sounds are normal and the breath sounds are
decreased in both lungs.
8-According to his *medical history, the liver, pancreas, spleen, the right and left kidney appear
normal.

*medical history: anamnesis, antecedentes médicos / personales patológicos

medical record: historia clínica.

16
 FRASES SUSTANTIVAS

MARCAR con un círculo los NÚCLEOS de 1, 2, y 3.

1-MODIFICADOR + NUCLEO: SURGICAL EMERGENCY

2-MODIFICADOR + MODIFICADOR + NUCLEO: CHRONIC BACK PAIN

3-NUCLEO + POST MODIFICADOR: HIGHER RISK of BRAIN HEMORRHAGE

READING ACTIVITY

READ the info and underline the words you don’t know-Palabras médicas MAS
consultadas durante la pandemia.

1-target, 2-report, 3-condition, 4-support, 5-outcome, 6-screening, 7-severe, 8-management,

9-evidence, 10-test, 11-impairment, 12-ness, 13-develop.14-standard, 15-consistent, 16-care,
17-rate, 18-dosage, 19-disease, 20-baseline, 21-stroke, 22-therapy, 23-monitor, 24-early, 25-
(ly), 26-non-, 27-(-based), 28-(less), 29-(ing), 30-medical record, 31-expect

Expect:
1 esperar, preveer, e.g: some tenderness around the wound is expected.,opposite:Unexpected:
inesperado, imprevisto
2-deber, tener que, e.g. patients are expected to sign a written consent.
3-suponer, imaginarse, e.g. expect you are nervous.

READING MATERIAL
Dengue (Mayo Clinic)
Symptoms typically last 2 to 7 days
High fever — 104 F (40 C) — and any of the following signs and symptoms:
Headache
Muscle, backache or joint pain
Nausea
Vomiting
Pain behind the eyes
Swollen glands
Rash

The warning signs usually include:

Severe stomach pain
Persistent vomiting
Bleeding from your gums or nose
Blood in your urine, stools or vomit
Bleeding under the skin, look like bruising

17
Difficult or rapid breathing
Fatigue
Irritability or restlessness
Symptoms of severe dengue
Belly pain, tenderness
Vomiting (at least 3 times in 24 hours)
Bleeding from the nose or gums
Vomiting blood, or blood in the stool
Feeling tired, restless, or irritable

READING MATERIAL (adapted from [Link])

BUSCANDO en la WEB, www. google .com .A-Realice una lectura rápida (skimming-
lectura global) del resultado de la búsqueda por Internet, B-Establezca cuál es el tema
común a todos.

HYPERTENSION
1-Hypertension: Causes, symptoms, and treatments - Medical News Today
[Link]

2-High blood pressure (hypertension) - Symptoms and causes - Mayo ...

[Link]

3-Hypertension - Wikipedia
[Link] Causes. Risk factors. Treatment. Deaths

4-High blood pressure (hypertension) - [Link]

[Link] Overview.

5-High Blood Pressure | Hypertension | MedlinePlus. Definition.

[Link] › Health Topics

6-Hypertension (High Blood Pressure) Health Center - WebMD

[Link]

7-Hypertension: Homepage
[Link]/

8-Hypertension on Twitter · Role of EETs in vascular calcification. March 13, 2023.

9-High Blood Pressure or Hypertension - American Heart Association

[Link]/.../High-Blood-Pressure-or-Hypertension_UCM_002020_SubHomePa...

10-Hypertension: Practice Essentials, Background, Pathophysiology

[Link]/article/241381-overview

18
11-Hypertension Research [Link] › hypertension research
Articles on Hypertension Research. ... cardiovascular; LV, left ventricular. Kazuomi Kario; Bryan
Williams. Review Article 02 May [Link] Hypertension | Home page.

12-Evidence-Based Medicine - Hypertension Articles-Ad·[Link]

Systematic Reviews, Meta-analysis, Guidelines. Practice-changing Articles in all Specialties, Guidelines
and Reviews. Medical Education. Online Courses and video Medical news.

1-Indicar con el número correspondiente la respuesta correcta de cada enunciado del cuadro que
sigue a continuación

Buscar la siguiente INFORMACIÓN Nº DE ENUNCIADO

a-Definición de Hipertensión
b-Diagnóstico y síntomas de Hipertensión
c-Enumere otros sitios para búsquedas bibliográficas
acerca del tema
d-Causas de Hipertensión
e-Factores de riesgo

HOW TO UNDERSTAND READING INSTRUCTIONS IN ENGLISH

Marque con una X las que conoce

1-READ THE FOLLOWING SENTENCES

2-ASK AND ANSWER QUESTIONS ABOUT THE TOPIC
3-CIRCLE THE NOUN PHRASES
4-FIND THE WORDS ENDING IN "NESS" AND LIST THEM IN THE CHART BELOW
5-REWRITE THE FOLLOWING
6-DRAW CONCLUSIONS
7-LOOK FOR THE MAIN IDEA AND THEN WRITE A SUMMARY
8-UNDERLINE THE CORRECT ANSWER
9-ODD ONE OUT
10-WRITE THE SYNONYM FOR DIMINISH
11-USE THE CHART FOR THE ADJECTIVES
12-PROVIDE THE MEANING OF THE WORDS ON THE RIGHT OF THE LIST
13-MATCH THE TITLES TO THE GROUPS OF QUESTIONS
14-FOCUSING ON WORDS WITH THE PREFIX “UN”
15-READ THE TEXT, DO NOT WRITE THE MISSING WORD
16-LEARNING VOCABULARY
17-WRITE ANOTHER WORD THAT HAS THE SAME MEANING
18-FILL-IN-THE-BLANKS
19-ADVANTAGES AND DISADVANTAGES
20-PROS AND CONS

19
 POSSESSIVE CASE
Se agrega s (‘s) singular o apóstrofo (s’) plural para mostrar posesión, en especial de
personas, no de cosas.
Rule: si el sustantivo singular muestra posesión, se agrega el apóstrofe s (‘s), si el sustantivo
termina en s nurses (plural), solo se agrega (‘) después del mismo, eg: (nurses’classes).
eg: the baby’s gastrointestinal symptoms, the arm and leg muscles’ contractions, beta-
blockers’treatment, liver disease’s symptoms

SINGULAR PLURAL
1-Surgical‘s instructions 7-The optic disks’ exam
2-Sjögren’s syndrome 8-Loop diuretics’intake
3-Koplik’s spots 9-Treatments’disadvantages
4-Parkinson’s disease 10-The papers’goals
5-A donor’s kidney 11-The babies’pulse rate
6-The patient’s non-Hodgkin’s lymphoma 12- Covid patients’condition

5-HOW MANY ORGANS DO YOU REMEMBER?

1-Heart: 5-Skin: 10-Right lung:
2-Spleen: 6-Brain: 11-Gall bladder:
3-Bladder: 7-Liver: 12-Large intestine:
4-Gut: 8-Left kidney: 13-Small intestine:
Bowel: 9-Pancreas:

READING MATERIAL
A-Observe la siguiente información y deduzca a partir de elementos visuales. LEA el
título rápidamente y conteste las preguntas.

20
 B-Una vez leído, NO se detenga en el vocabulario que no conoce ya que este no es la meta de la
actividad, aplique skimming (LECTURA GLOBAL) y conteste las siguientes preguntas.

1-Nombre del producto, para que se usa y presentación del mismo._________________________

2-¿Qué término/s son familiares o se deducen como palabra transparente- marcar con un círculo?

3-Vocabulario específico.
1-burning: 2-itching: 3-stinging: 4-tingling:

4-Contraindicaciones del producto.____________________________________________

21
 5-Escriba 2 PALABRAS CLAVES relacionadas con el tema.
1- 2-

Escriba 2 frases sustantivas relacionadas con el tema

1-
2-

Provide the meaning and the infinitive of the following verbs:

1-develops a rash 9-improves his condition
2-undergoes a CT 10-bleeds profusely
3-relieves after the medication 11-complains of colicky pain at night
4-draws the oral anticoagulants 12-performs Fasting Plasma Glucose (FPG)
5-voids dark brown stools 13-discloses hyperplasia of all cell lines.
6-yields normal white cell count 14-becomes dizzy after blood withdrawal
7-suffers from headaches 15-impairs his renal function
8-releases (enzymes) 16-refuses to follow the treatment

THERE IS/ ARE (HAY-present)-THERE WAS/ WERE (HUBO-HABIA: past)

El verbo “to be” equivale a HABER cuando se le antepone THERE.

THERE IS-THERE ARE (singular y plural)
e.g: There is (hay) a large number of diseases of the pericardium and diseases affecting the heart.
THERE IS-THERE ARE: presente-singular y plural, se las traduce como HAY
THERE WAS-THERE WERE: pasado-singular y plural: HUBO-HABÍA.

Translate the following on the right side

1- Meningitis is a serious disease in which there is inflammation of the meninges.---------------------
—------------------------------------------------------------------------------------------------------------------
2-There was no history of fever, chills, sweats, change in bowel habit, dyspnea, wheezing or other
indication of allergy.---------------------------------------------------------------------------------------------
3-There are some abnormalities in the routine* analysis.--------------------------------------------------
4-Are there any new vaccines against meningitis?.---------------------------------------------------------.
5-Is there a vaccine to prevent coronavirus disease (COVID-19)?----------------------------------------
6-There are no specific contraindications for collecting specimens with nasopharyngeal swabs.------
-------------------------------------------------------------------------------------------------------

*Routine: habitual, ordinario, corriente, sistemático, reglamentado, periódico, establecido, e.g.

people who exercise routinely (regular), routine vaccination schedule: calendario
sistemático/oficial de vacunación.

REMEMBER: los nexos pueden unir ideas dentro y entre oraciones además de párrafos

22
 Repasando NEXOS
NEXOS Nexo lógico/ EXPRESA
SIGNIFICADO
1-SUCH AS Ejemplo
2-THEREFORE Resultado o consecuencia
3-ALTHOUGH Contraste
4-AND Adición
⮚ BOTH…AND: indican AMBOS…Y: He is both a hypertensive and diabetic patient.

“WH” QUESTIONS “HOW” QUESTIONS

1-What---? 1-How often? (frequency)

2-What---like? 2-How far? (distance)
3-a) What---for? B) to + infinitive 3-How long? (time)
4-Who? Whom? 4-How much? (uncountable)
5-Who---with? 5-How many? (countable)
6-Who---for? 6-How tall? (height)
7-Whose + noun? 7-How old? (age)
8-When? 8-How do /can I get to---?
9-Where? 9-How many times a day / per week…?
10-What time? 10-How high? (¿a que altura?)
11-a) Why? b) Because 11-How thick? (¿que grosor / espesor?)
12-Which? 12-How deep? (¿a qué profundidad ?)
13-What kind of / type/ sort of---? 13-How wide? (¿que ancho / diámetro?)

A-TRANSLATE the following sentences using the information above

1-What is the difference between preventing a disease and healing the patient?
2-How many types of Streptococcus pneumoniae are there?
3-If a patient bleeds a lot during an operation, how can the lost blood be replaced?
4-How is meningitis diagnosed and treated?
5-Why is the use of aspirin important in acute myocardial infarction?
6-What are Beta blockers used for? How long are they advisable to take them?
7-What are you allergic to? Which types of drugs do you take?
8-What are thyroid hormone therapy’s symptoms like?
9-Who and what does he research for?
10-Whose samples are the Pathologist analyzing?

23
 CASE HISTORY/ MEDICAL RECORD
PERSONAL INFORMATION
1-What’s your name/surname?
2-Where do you live?
3-Have you always lived in this place?
4-What do you do?
5-Who do you live with?
6-Which religion do you associate with?
7-Are you aware of your own diseases? When were they diagnosed?
8-When was the last time you were admitted?
9-What medication do you take regularly? Do you take aspirins? oral contraceptives? (AINES
NSAID Non-Steroidal Anti-Inflammatory Drug / AINE (AINES)?
10-What about your family background? Is your father/mother alive? What did they die for? How
old was he/she when he/she was diagnosed with…?
11-How many siblings do you have? Are they healthy?
12-How many sons/daughters have you?

CASE HISTORY FOR WOMEN

1-Were your sons/ daughters born by cesarean delivery (C-section) or vaginal delivery?
2-Any complications during your pregnancy?
3-When was your last menstruation date?
4-When was your last gynecological control?
5-Have you ever been operated on? What kind of anesthesia did you receive? Local/ general? Any
particular complication during the anesthesia?
6-Are you allergic to any medication? (if they say: to penicillin), what reaction did you have with
the medication? Was your throat tightened?
7-Do you smoke? How many cigarettes per day? How long have you been smoking?
8-Do you drink? How often in a week? More than a liter of beer or wine?
9-Are you a social drinker? Do you smoke marijuana? Cocaine? Stimulants?

VACCINES
1-If patients are older than 65, have you been vaccinated against influenza or B hepatitis?
against pneumonia?
2-Do you exercise regularly?How many blocks can you walk without stopping?
3-Can you climb stairs without getting tired?
4-Have you traveled recently? Where? How long have you stayed?
(Source: Dra Weber) INTERNAL medicine resident.

● REMEMBER: anotar las palabras nuevas en el GLOSARIO-APRENDER a usar el

diccionario [Link]

24
 ADVERBS OF FREQUENCY
Estos adverbios indican frecuencia, tiempo, modo y lugar y están ubicados entre el sujeto y el verbo
1-Always 3-Never 5-Seldom / Rarely / Frequently
2-Usually /Generally/ 4-Sometimes / 6-Often
Regularly Occasionally

1-Traduzca estas oraciones, 2-Haga un círculo al adverbio de frecuencia.

1-This patient is a middle-aged-woman, she generally has pain in her stomach after meals.

2-The surgeon always sees the patient in the EW (emergency ward) when he is on duty.

3-They rarely refuse to give her the treatment because she feels better.

4-The male patient’s chest pains seldom last from 5 to 10 minutes.

5-Does he sometimes suffer from an allergic condition?

6-The baby often has shortness of breath with bottle feeding.

VERB PATTERN
1-SIMPLE PRESENT
Se usa para expresar: 1-acciones habituales, 2-para verdades universales y postulados
científicos.
S + VERB (1era columna)
Se usan Adverbios: ALWAYS, NEVER, OFTEN, RARELY, SOMETIMES, SELDOM
● Agrega s ó es al verbo ( HE-SHE-IT-3rd person singular)
● DO-DOES auxiliares del presente, se usan para negativo e interrogativo ( no se traducen)

AFF: She always avoids fluid intake.

INT: Does she take medication or drink alcohol daily?
NEG: She doesn’t smoke anymore.

REMEMBER: AUXILIARES DO/ DOES ( Simple Present) se usan en el negativo o interrogativo.

25
 PRESENT TENSE
1-Affirmative Form (+)
I Classify Hemoglobin as a protein in red blood cells
You Measure The pulse’s heartbeat
We Treat an illness Successfully
They Identify The cause and condition
He/ She/ It Notices An infectious disease.
Identifies The signs and symptoms.

2-Negative Form (-)

I / you / we / they DO NOT Take The medication regularly
DON’T Examine The out-patients
He / she/ it DOES NOT Feed The baby every 3 hours
DOESN’T Have Night duties on Sundays
NOTE: the negative & interrogative form of HAVE can also be formed with DO/ DOES.

Translate 1 , 2 and 3
1-Meningitis does not have a lot of effective antibiotics.

2-Treatment of mild cases of viral meningitis usually includes: bed rest, fluids, over-the-
counter pain medications to help reduce fever and relieve body aches.

3-Who is at risk for meningitis?

Infants, teens, young adults, and older adults are at risk.

3-Interrogative Form: (?)

DO I / you / we / they Feed The baby every 2 hours?
Take The tablets regularly?
DOES He / she / it Examine The outpatients?

A-1-TRANSLATE the following sentences, 2-UNDERLINE the verbs and medical vocabulary.
1-She denies fever, night sweat, malaise, cough and wheezing.
2-Hypertension is a lifelong condition*.
3-The patient remains afebrile and gradually becomes less confused.
4-There is a history of heart disease in both parents, but there isn’t in the other six siblings.

*DOS significados importantes:

CONDITION: 1-enfermedad, proceso, docencia, afección, cuadro clínico (cefalea), trastorno,
anomalía-bronchial condition (padecía una enfermedad bronquial)
2-proceso patológico, problemas de salud (health condition), skin conditions (enfermedades
cutáneas)

26
 2-PRESENT PROGRESSIVE
Señala que las acciones han comenzado pero no han sido completadas y son de duración limitada.

S + BE (is-am-are)+ VERB “ING”

Se usa con: NOW, AT THIS MOMENT, IN THIS MONTH, DURING THIS YEAR

Negative: (isn’t-aren’t) i.e: She isn’t feeling dizzy right now

Interrogative: Are you complaining of acute pain?

3-PRESENT PERFECT
Denota una acción que comenzó en el pasado puede continuar hasta el presente.
S + HAVE (HAS) + VERB 3era columna
Se usa con EVER, NEVER, SINCE, FOR, JUST, ALREADY

NEG: (Hasn’t. HE-SHE-IT–haven’t: I, you, we, they)

AFF: The panoramic tomography has shown one clear calcification.
INT: Has the pathologist confirmed the initial diagnosis after the incisional biopsy?

EXERCISES

UNDERLINE VERBS in the PRESENT and state if they are 1, 2 or 3 according to the verb
pattern above.

1-For end-stage cirrhosis, transplantation has been a successful treatment with high survival rate.
2-A 55-year-old patient is complaining of severe headaches with nausea and vomiting.
3-The patient has felt well one year earlier, after a first episode of spontaneous venous
thromboembolism and the withdrawal of oral anticoagulants.
4-She has not had a history of gastrointestinal symptoms, gait disorder or incontinence of bladder.
5-X-rays films of the right thigh disclose a questionable calcification with central radiolucency.

CHECKING Vocabulary
1-end-stage: 2-gait disorder: 3-withdrawal: 4-right thigh:

CHECKING Verbs
1-complaining: 2-disclose: 3-has been: 4-has felt:

READING MATERIAL
OBSERVE la información gráfica y conteste lo siguiente en CASTELLANO:
1-¿De qué tipo de información se trata? ¿Cúal es la fuente?

2-Identifique 4 frases sustantivas con la palabra KIDNEY? In ENGLISH!!!!!!

1- 3-
2- 4-

27
 3-Explique en castellano que es un HORSESHOE KIDNEY.......................................................
4-¿Qué puede escribir acerca del comentario (comment)?.............................................................
5-Escribir dónde puede encontrar otros términos referidos a riñón…………………………………...
………………………………………………………………………………………………………
6-¿Qué significa lo siguiente?
a-Removing waste matter from the blood………………………………………………………..
b-Both kidneys are joined
together…………………………………………………………………….
Taken from Dictionary of Medical Terms ( Peter Collins) page 192.

USING YOUR DICTIONARY

Algunas palabras pueden tener 5 o más significados y tienen un menú con números para facilitar el
significado que se busca.
● Bleed/ bli:d/ past tense and past participle bled /bled /verb*(sb:somebody, sth: something)
1 when blood flows out sb 3 make sb pay money 5 take blood from sb
2 when color spreads 4 take liquid/ gas from sth
1 BLOOD to lose blood from an injury, eg: from a cut: I cut my knee and it’s bleeding, bleed
profusely/ heavily, the victim was unconscious and bleeding profusely. + From he was bleeding
from a wound in his leg. Bleed to death (: die from losing blood) she would have bled to death if
we hadn’t found her.
● 2 COLOR, to spread from one area of cloth or paper to another. run: Wash it in cold water
so the colors don’t bleed.

28
 PENSANDO EN VOZ ALTA
1-Que necesito REEVER?_________________________________________________
2-¿Descubrí cuales son mi fallas?___________________________________________
3-¿Entendí todo?____Vocabulario____Frases sustantivas____Verbos_____________
4-¿Anoto las palabras nuevas en el glosario?_______Uso el [Link]?____
5-¿Qué incorporé en esta unidad?_______________________________
6-Vocabulario nuevo
____________________________________________________________

WORDS WITH OUT

1-OUTCOME: 4-OUTLOOK:
2-OUTFLOW: 5-OUTPUT:
3-OUTPATIENT:

�SUCH AS (tales como) es un nexo que ejemplifica / enumera.

READING MATERIAL

READ this info, underline new vocabulary

WARNING SIGNS OF
DEEP VEIN THROMBOSIS (DVT) PULMONARY EMBOLISM (PE)

1-SWELLING of the leg or calf. 1-SUDDEN BREATHLESSNESS that can’t

be explained.

2-PAIN that may worsen when standing or 2-Sudden sharp CHEST PAIN.
walking.

3-WARMTH and REDNESS of the leg. 3-COUGHING UP blood.

29
30
 UNIT 2

A-ADJECTIVES
1-ADJECTIVES forming suffixes.
2-Comparison of ADJECTIVES: Positive-Comparative-Superlative Degree.
3-Gradual Increase-Parallel increase.
4-Irregular comparisons

B-VERB PATTERN
Past Tenses

C- Reading activities and Vocabulary

ADJECTIVES
¿CÓMO RECONOCEMOS UN ADJETIVO?

A-Por el orden de las palabras. En Inglés se usa: Adjetivo + sustantivo, son invariables en género
y número. NUNCA lleva la forma plural, es el sustantivo el que determina la pluralidad.
eg: greenish sputum, large deep scars.
B-Por su terminación. Existen sufijos y los mismos tienen un significado especial.

-ful: que tiene Colorful- careful- skillful- harmful- successful

e.g: useful-useful tool, useful approach.

-ish: tendencia / matiz Yellowish-reddish-feverish-whitish-bluish

e.g: brownish stools

-less: que no tiene Useless-colorless-painless-tasteless-careless

e.g: useless medication.

-like: similar, parecido a Net-like erythema /lupus-like / wedge-like /rosacea-like

dermatitis/stroke-like episodes
e.g: thread-like, Flu-like symptoms, Parkinsonian-like signs. Electric shock-like sensation in
the neck.

-ed / -d Colored-sized-shaped-released enzymes/ altered bowel habits

�Se usa-ed /-d agregado a un sustantivo para convertirlo en adjetivo.
e.g: elevated liver enzymes / presumed diagnosis of myalgia / weakened muscle/ increased risk
of mortality / reddened area/ unrelated donors/ generalized anxiety disorder.

Verb + ing Bleeding pattern , swelling area, triggering factor

e.g: burning pain, surrounding soft tissues.

31
 1-TRANSLATE THESE NOUN PHRASES, marque el NÚCLEO con un circulo
1-underlying cause: 11-clinical benchmark:

2-acute renal failure: 12-painful oral lesions:

3-broken ankle: 13-autoimmune disorders:

4-end-stage disease: 14-burned patients:

5-throbbing headache: 15-handicapped children:

6-visual loss: 16-swollen tonsils:

7-deep wound: 17-local skin damage:

8-graft rejection: 18-trial and error assay:

9-skillful and well trained surgeon: 19-heart apex beat:

10-attention-deficit disorder: 20-dyspepsia-like symptoms:

2-FORMATION OF ADJECTIVES
● SUFFIXES: suitable, useful, active, feverish, lifeless, logical, sensory, infectious, sufficient,
articular, friendly, board-like, possible, affectionate.

● PREFIXES: uninteresting, impossible, disadvantage, misdiagnosed, anti-virus, illegal, atypical

irrational, overweight, asymptomatic, underlying, prevention, indifferent, non-diagnostic,
subclinical, misunderstanding, dysfunctional, bilateral, anti-inflammatory, premenstrual,
postnatal, misleading, unsteady (gait).

Los términos médicos generalmente están formados de radicales (raíz) que es la parte
principal del término, complementado con prefijos y sufijos, que son partículas que
preceden o se agregan a una palabra, haciendo variar su significado y función y son
derivados de los idiomas griego y latín.

ADJECTIVES FORMING SUFFIXES-(sufijos que forman adjetivos)

-ABLE/-IBLE/-UBLE Suitable-movable-incurable-digestible-audible-soluble-reliable
-AL Spinal-surgical-behavioral-anatomical-costovertebral-epidural-atrial-cerebral
-AR Nuclear-regular-muscular-angular-granular-macular-malleolar
-ARY Secondary-voluntary-axillary-biliary-necessary
-ENT /-ANT Transparent-pregnant-intoxicant-resistant-important-appetite suppressants
-IC toxic-intrahepatic-obstetric-hemolytic-astigmatic-antiemetic-celic-somatic
-IVE Digestive-operative-infective-progressive-congestive-myeloproliferative

32
-OUS Bilious-infectious-nervous-contagious-anomalous-delirious
-ORY Circulatory-obligatory-secretory-respiratory-satisfactory
-Y Watery-auxiliary-sedentary-sleepy-wheezy-pulmonary-coronary
-ED /-D Reduced caffeine intake / right-sided mass / raised triglycerides
-LESS Harmless-colorless-toothless-useless
-LIKE Fibroblast-like cells/ plaque-like areas / endometrium-like tissues/
tube-like/ cyst-like cavity/ poliomyelitis-like paralysis
⮚ REMEMBER: La forma “ING”puede cumplir distintas funciones en la oración.

ING FORMS
USE

VERB + ING

A-Como sustantivo (noun) Como adjetivo (adjective)

1-Intermenstrual bleeding 1-Imaging techniques
2-Mucosal thickening 2-Loading doses
3-Hypertension developing 3-Overlying causes
4-Infectious disease testing 4-Binding agent

“ING” FORM

El sufijo “ING” se añade a la forma del verbo. (follow-following / add-adding) Puede cumplir
distintas funciones dentro de la oración: verbo, sustantivo, adjetivo o adverbio.

LEA las siguientes oraciones de diferentes revistas médicas y complete el cuadro

1-Von Willebrand disease is a common inherited bleeding disorder that affects both sexes.

2-Upper gastrointestinal imaging revealed normal motility and a small hiatal hernia.

3-The elderly patient has a constant crampy non-radiating pain* in the epigastrium.

4-He is a 45-year-old man with a chief complaint of vomiting of 3 days duration and denied having
fever at follow-up.

5-Symptoms of pulmonary hypertension may include dizziness and fainting, ankle swelling, bluish
lips and skin and others.

6-Heartburn is a burning sensation caused by reflux of acid from the stomach into the esophagus.

33
 COMPLETE el siguiente cuadro relacionado con las oraciones de arriba.
VERBO + ING TRADUCCION FUNCIÓN en la ORACION
1-BLEEDING
2-
3-
4-
5-
6-

PAIN-TENDER-ACHE-SORE
*pain: dolor
*tender: sensible, dolorido, hipersensible, dolor no espontáneo, provocado por la palpación.
*ache: dolor espontáneo. dolor sordo ( dull pain), difuso, poco intenso, se utiliza para la cabeza,
espalda, oídos, muelas y estómago-headache -it aches: dolor difuso y de naturaleza urente, it´s
painful: bien definido y localizado.
*sore: dolorido, inflamado, difuso, a veces urente.

READ the chart and find the “ING” form

LEA el cuadro, individualice la terminación"ING" , escriba su significado y qué función cumple
en la oración.

Source: JAMA May 2, 2023

A recently published meta-analysis looking at breakfast’s effect on weight and
energy intake concluded that skipping the meal rather than eating it might help
people lose weight. The conclusion challenges the widely held notion that skipping
breakfast slows metabolism and leads to overeating later in the day.

34
 READING MATERIAL
OBSERVE el texto que acompaña a la siguiente ilustración y luego conteste las preguntas. Observe
como está escrito, ej; las letras mayúsculas y minúsculas, los espacios, abreviaturas etc.

35
 1-¿A qué se refiere el título?-----------------------------------------------------------------------------------
2-¿Propósito del texto? marque con un círculo

1-información general 2-información científica 3-texto de estudio

4-resúmen 5-publicidad 6-otro…

3-¿Qué CLASE de producto es DIFLUCAN (Fluconazole)? ¿Para qué se usa?..............................

………………………………………………………………………………………………………
4-¿Tiene contraindicaciones?........................................................................................................
5-¿Qué criterio se aplica a pacientes que están en riesgo?..............................................................

� IRRESPECTIVE OF: es un nexo que se lo traduce como: INDEPENDIENTE de

THE COMPARISON OF ADJECTIVES

1-SHORT ADJECTIVES

Positive Comparative Superlative

Big Bigger than The biggest

Easy Easier than The easiest

�Flat bones are found covering softer body parts eg shoulder blades, ribs and pelvic bones.
�Constipation responds well to changes in lifestyle. The easiest way to treat it is to increase the
amount of liquid and fiber in your diet.
� Lower risk patients for CHD (Coronary Heart Disease) are treated with dietary therapy and
physical activity, which are safer and less expensive.
�The patient reported severe pain, which he rated at 7 on a scale of 0 to 10 (being 10 the highest).

2-LONG
Effective More/less effective than The most /least effective

Reliable More /less reliable than The most /least reliable

NOTE: a los adjetivos de 2 o + sílabas se le agrega MORE/ LESS (comparativo) y The MOST/
LEAST (el +/ el menos) en el superlativo.

1-Chest CT is an accessible and rapid test and is considered the most sensitive imaging test for
detecting COVID 19,
2-Fasting plasma glucose (FPG) and the 75-g oral glucose tolerance test (OGTT), are both suitable
tests for [Link] former is strongly preferred because it is easier and faster to perform and
more convenient and suitable to patients and less expensive, as well.
3- Childhood leukemia is a cancer of white blood cells and is the most common type of childhood
[Link] Internal Medicine
4- The most common cause of cholecystitis is the obstruction of the cystic duct due to a gallstone.
5-Is melanoma the least common skin cancer

36
 READING MATERIAL

1-READ the following paragraph and answer the questions.

1-Measles: significado____________________________2-¿cómo se contagia?_________
3-¿A quienes se los considera inmune?__________________________4-Traduzca lo que está
en negrita.

JAMA, Journal of the American Medical Association

JAMA Patient Page: Recognizing Measles (March 2023)

Measles is one of the most contagious diseases known. This means that it spreads easily from an
infected person to others who are not immune to the disease. People who are fully vaccinated
against measles, who have had the disease, or who were born in the United States before 1957 are
considered immune. [Link]

2-READ the following and 1-Underline comparatives and superlatives, 2-Find connectors

Annals of Internal Medicine By American College of Physicians,

Dec 2023

PROSTATE CANCER is the second most commonly diagnosed type of cancer in the U.S and the
fifth most common cause of death from cancer. However, most cases are clinically insignificant,
and prevalence increases rapidly with age. Prostate cancer is found in over half of U.S men older
than 50 years. Primary treatment methods often cause sexual, urinary as well as bowel dysfunction.
Patients who undergo radical prostatectomy (RP) have better prognosis and less comorbidity, so
their survival will be longer regardless of treatment.

3-PARALLEL INCREASE (Incremento paralelo) (Cuanto /Mientras), Underline from 2 to 6

1+ High-tech procedures save money and the faster the cure, the shorter the hospital stays.
2+ The greater the number of risk factors present in an individual, the greater the chance of that
individual developing or having diabetes.
3+The longer a patient remains in a coma, the poorer his chance of recovery.
4+The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.
5+The greater the impairment of the left ventricular system function, the worse the prognosis.
6-Inactivity is one of the main factors of Type 2 Diabetes, the less active you are, the greater your
risk.
_________________________________________________________________________
4-AS + Adjective + AS (Comparativo de igualdad, tan…como).Neg…NOT AS +adj + AS

● The pain occurred as strong as eight times daily without relation to meals.
● Several days before admission, the patient began to cough up, green, foul-smelling sputum and
her temperature was as high as 38.5 C without chills or sweats.

�BUT / HOWEVER ( pero/ sin embargo) son nexos que se usan para oponer ideas

37
 IRREGULAR COMPARISONS
ADJECTIVES COMPARATIVES SUPERLATIVES
Good Better (than) (The) best
Bad Worse (than) (The) worst
Little Less (than) (The) least
Many/much More (than) (The) Most

IDENTIFY IRREGULAR comparisons

1-Chest radiography is the best imaging technique to evaluate pulmonary signs-symptoms.
2-Uterine Fibroids (leiomyomas) represent the most common tumors in women.
3-Transient Ischemic attack is a neurological deficit lasting less than 24 hours.
4-Mortality rate from Fat embolism syndrome is 10 % or less, it’s lower than 50% for most causes
of the adult respiratory distress syndrome.
5-Ascites is the most common complication of cirrhosis and is associated with a *poor quality of
life, increased risks of infections and a poor long-term outcome.
6-COVID-19 less common symptoms are aches and pains, sore throat, diarrhea, and conjunctivitis.

NOTE: *poor- mala-precaria-deficiente-baja

1-WRITE the COMPARATIVES and SUPERLATIVES of these adjectives-(Use the columns)

1-Bad 9-Narrow

2-Light 10-Painful

3-Hard 11-Shallow

4-Hot 12-Effective

5-Flat 13-Little

6-Tiny 14-Scanty

7-Large 15-Supple

8-Wet 16-Good

2-Escriba cuales son (número) las Comparaciones irregulares relacionadas al cuadro

anterior

38
 3-SAME
MACRO LARGE
MICRO SMALL
TACHY FAST
BRADY SLOW
HYPER EXCESSIVE
HYPO DEFICIENT

3-PUT THE FOLLOWING ACTIVITIES IN CHRONOLOGICAL ORDER (1 to 5).

____________TAKE A CASE HISTORY.
____________PRESCRIBE THERAPY.
____________EXAMINE THE PATIENT.
____________ORDER MEDICAL TESTS.
____________MAKE A DIAGNOSIS.

4-REVISION ON ADJECTIVES, 1-Translate the following phrases, 2-Circle the noun (núcleo).
1-Red swollen eye: 12-Bone marrow necrosis:
2-Sharp muscular pain: 13-First-line therapy:
3-Iron-deficiency anemia: 14-Low-molecular-weight heparin:
4-Low-fat diet: 15-Unspecified pain medication:
5-Throbbing headache: 16-Zika virus outbreak:
6-Shared-decision making: 17-Graft-versus-host disease:
7-Fast growing tumor: 18-Long-term outcome:
8-Overall survival rate: 19-Complete surgical excision:
9-Small dark nuclei: 20-Sudden cardiac death:
10-Pear-shaped thymoma: 21-T-wave inversion:
11-Over-the counter drugs: 22-Lower facial weakness:

� BECAUSE OF es un nexo que significa a CAUSA DE, POR , PORQUE

�HOWEVER: sin embargo: NEVERTHELESS, NONETHELESS

�BOTH…AND: indican AMBOS…Y: He is both a hypertensive and diabetic patient.

39
 1-Let’s MAKE DIFFERENCES- (write the meaning of the following)
● Thought (think) verb: ● Thorough-Thoroughly:

● Though-Although: ● Through-throughout:

● Throw-threw-thrown (verb): ● *Trough:

1-Read and 2-TRANSLATE this paragraph. Use the chart above.

Although some strokes occur without warning, most stroke victims have prior risk factors. It is
thought that the best way to prevent it, is to identify at-risk patients thoroughly and once they are
identified, control as many risk factors as possible.

*Trough levels:(trof) niveles mínimos, find another meaning in [Link]

eg: drug trough level (lowest concentration) opp peak level (highest concentration)

2-WRITE their meaning:

1-Acute pain: 2-Severe pain: 3-Fair/Moderate:

4-Slightly enlarged liver: 5-Mild headache: 6-Steady labor pain:

7-*Rare disease/disorder: 8-Poor appetite: 9-wax and wane:

*Rare disease: enfermedad de muy escasa prevalencia, minoritaria o infrecuente, se usa

enfermedad rara. [Link] tropicales

3-Complete the missing words

ADJECTIVE COMPARATIVE SUPERLATIVE
Better The best
Bad
Far The farthest
Little Less
More

�LIKE / AS: se los traduce “como”. It is important for people with celiac disease to read
product labels, as gluten is used as an additive in some medications, vitamins, and lipstick.

40
 VERB PATTERN
PAST TENSE (Regular Verbs)
Affirmative. (List of regular verbs at the back)
I Worked On Barrett’s esophagus.
You Discovered A gynecological device.
He Improved His condition in a different way.
She Refused To speak about the severity of the lesion.
It Denied A malignant tumor.
We Researched About Reye’s syndrome and its treatment.
They Evaluated The degree of the dislocation of the joint.
*NOTE: verbs ending in “e” add “d”, eg: improve-improved.
IRREGULAR VERBS ◎
AFFIRMATIVE
I Fell Down the stairs and broke her arm.
You Felt Dizzy and fainted.
He Led A survey on diuretics.
She Took Three tablets daily.
It- Withdrew A sample of his blood.
We Began A three-months’course on Drugs.
They Became Obtunded after the operation.
◎NOTE: Check list of irregular verbs at the end of the booklet

NEGATIVE (-)
I, you, he Did not see The outpatients daily
She, it, they, we Didn’t bring The samples from the lab, yesterday
REMEMBER: After DO /DOES / DID /WILL, + INFINITIVE

QUE observa en estas oraciones?

-He didn’t feel the pain
-He doesn’t feel the pain
-He won’t feel the pain

INTERROGATIVE (?)
Did You-he-she find the data on fat Embolism syndrome?
They know the chemical causes?
A-1-Underline verbs in the Past tense , 2-Circle medical vocabulary.
1-Two weeks before entry, progressive low back pain developed.
2-Later in the day, her legs became weak and her lumbar pain resumed.
3-The illness started with malaise, wheezing and an unproductive cough.
4-A lumbar puncture yielded normal cerebrospinal fluid and specimens of blood and throat swabs
were obtained for culture.
5-Cardiac examination disclosed a grade 2 systolic ejection murmur that radiated to both carotid
arteries.

41
 VERB PATTERN
1-SIMPLE PAST
● Se usa para referirse a acciones que sucedieron en el pasado y terminaron.
S + VERB (2da columna)

Se usan adverbios: YESTERDAY / 2 DAYS AGO / THE DAY BEFORE YESTERDAY/

LAST WEEK / MONTH / YEAR

*DID se usa para todas las personas y para negativo e interrogativo pero no se traduce.
AFF: She avoided fluid intake.
Int: Did she take medication or drink alcohol last night?
NEG: She didn’t smoke two weeks before the operation took place.

AUXILIAR del pasado:DID- después de DID el verbo que sigue va en INFINITIVO.

-She didn’t see a doctor, yesterday
-What drugs did she take before she came here?

● 2-PAST PROGRESSIVE
● Se usa con acciones pasadas.
S + WAS / WERE + VERB “ING”

Se usa con WHEN / AS / JUST AS

Aff: The patient was taking the medication when the nurse saw him.
Neg: (WASN’T/WEREN’Tt) i.e: She wasn’t feeling drowsy when the Doctor saw her.

● 3-PAST PERFECT
● Expresa que una acción en el pasado ha ocurrido con anterioridad a otra.
S + HAD + VERB 3era column

Se usa con EVER, NEVER, SINCE, FOR, JUST, ALREADY.

NEG: (Hadn’t) i.e: The panoramic tomography had shown one clear calcification.
INT: Had the pathologist confirmed the initial diagnosis after the incisional biopsy?
●REMEMBER: después de los auxiliares DO /DOES / DID/ WILL el verbo va en
infinitivo.
EXCERCISES
UNDERLINE and translate the verbs in the past and state if they are 1, 2 or 3 according to the
verb pattern.

1-Recent studies had demonstrated that ankylosing spondylitis and psoriatic arthritis are disabling
diseases.

2- A 55-year-old overweight man had had frequent heartburn for more than 10 years.

3-A 65-year-old patient was complaining of acute abdominal pain when the doctor wrote down his
case history.

4- Physical exam showed that the patient was afebrile and seemed well between fits of crampy pain.

42
� THEREFORE es un nexo que indica resultado o consecuencia, se lo traduce (por lo tanto)

� CONSISTENT WITH es un nexo, se lo traduce COMPATIBLE CON

�As well as/ besides/ in addition to /moreover/ also/ furthermore/ likewise son nexos que
indican adición (ASI COMO TAMBIEN, ADEMAS)

READING MATERIAL
1-READ the following paragraph and then, 2-ANSWER the questions below
Authors: Suzanne, Rose, MD-Annals of Internal Medicine-7 April, 2023
_________________________________________________________________________1.Const
ipation is a symptom-based disorder and therefore the diagnosis relies on subjective [Link].
Constipation can be defined by bowel movement infrequency, defecatory symptoms, [Link]/or stool
consistency. Although practitioners have tended to focus on frequency to define [Link],
patients often focus on other symptoms, such as difficulty voiding, a sensation of [Link]
evacuation, hard stools and excessive straining. Diagnosis includes differentiating [Link]
constipation as either primary (arising from the gastrointestinal tract) or secondary (due to 7.a non
gastrointestinal cause). It is important to distinguish chronic constipation from the irritable [Link]
syndrome (IBS), in which abdominal pain is a central feature. However, there is a great [Link]
between these two disorders in clinical practice. It is also clue to differentiate chronic [Link]
constipation from disorders that may require specific therapy (e.g., colon cancer, [Link] cancer,
neurological diseases). Risk factors that could contribute to constipation include [Link]
conditions, medications as well as lifestyle factors. Management is focused on a [Link]
approach to testing and a reflexive use of prescription and nonprescription treatments.

Read the paragraph and then complete the chart and vocabulary underlined in the text
1-topic’s name /source 4-management
2-constipation definition 5-connectors
3-vocabulary (in bold)

REMEMBER: los nexos pueden unir ideas dentro de la oración, entre oraciones y párrafos

CONNECTORS MEANING
1-AND Usado para expresar ADICIÓN.
2-BUT / HOWEVER Usado para OPONER IDEAS:
3-SUCH AS Expresa EJEMPLOS, ENUMERA
4-THEREBY / THEREFORE RESULTADO o CONSECUENCIA
5-ALTHOUGH/ THOUGH Expresa CONTRASTE o CONCESIÓN
6-HENCE Expresa CONSECUENCIA
7-EITHER ….OR Expresa ALTERNATIVA.
8-THUS Expresa EFECTO

43
9-DESPITE/ IN SPITE OF Expresa CONTRASTE
10-IF/ WHETHER Expresa CONDICION
12-AS / LIKE Expresa COMPARACION
13-WHEREAS Expresa CONTRASTE
14-UNLESS
Ways to say BUT
NEVERTHELESS NONETHELESS HOWEVER

IN CONTRAST WHEREAS ALTHOUGH / THOUGH

OTHERWISE ON THE one/other HAND

�THE FORMER: nexo que indica el primero, THE LATTER: el segundo

● SINCE: se lo traduce como DESDE / YA QUE

READING MATERIAL
Read the article. 1-Define Kawasaki disease, 2-Symptoms, 3-In order to evaluate children, what
criteria must they meet to make a diagnosis? 4-Studies doctors can ask and treatment.

KAWASAKI DISEASE
Data Source: Ann R. Punnoose, MD; Suman Kasturia; Robert M. Golub, MD, JAMA. 2022

Kawasaki disease is a type of vasculitis that can affect many organs. Its cause is unknown, but
symptoms usually start with fevers as high as 105.8°F in children younger than 5 years. It occurs
most often in children of Japanese origin. Kawasaki disease can result in coronary aneurysm .
This is the most serious complication.
Diagnosis
No tests definitively diagnose Kawasaki disease, so physicians have to evaluate whether children
meet certain criteria. They must have had a fever for 5 or more days as well as any 4 of the
following:
[Link] whites of both eyes appear red, with no discharge or a clear discharge from the eyes
[Link], cracked lips; inflamed tongue and throat
[Link] of the hands and feet and desquamation, especially near the fingernails, toenails, and
diaper area.
4.A red rash that can be widespread (usually not on the face).
[Link] lymph nodes, most often on one side of the neck.

Treatment
[Link] immunoglobulin (IVIG) Treatment is given in the hospital intravenously.
[Link] doses of aspirin may be given, followed by a course of low-dose aspirin after the fever
subside.
[Link] severe cases not responsive to IVIG, corticosteroids or other anti-inflammatory
medications may be used.

44
 FINDING UNRELATED WORDS-CIRCLE the one that is UNRELATED

1-VAST-HUGE-TINY

2-STEADY-CONSTANTLY-INTERMITTENTLY

3-SLENDER-THIN-FLABBY

4-BASICALLY-DEFINITELY-FUNDAMENTALLY

5-INCREASE-RISE-TAPER

6-CARRY OUT- RULE OUT-UNDERTAKE

45
46
 UNIT 3
A-VERBS PATTERNS
1-Modals.(Verbos defectivos)
2-Future Tenses.

B-NOUN MODIFICATION
1-Pronouns.2-Verbos con “R” y con “S”, 3- Verbos con “LIKE”

C-READING COMPREHENSION ACTIVITIES

USING MODALS
Estos verbos “especiales” por llamarlos de alguna manera, no siguen un patrón gramatical, por ej:
no agregan “S” en la tercera persona del singular, no utilizan auxiliar para formar su negativo e
interrogativo y SIEMPRE van seguidos del infinitivo de otro verbo, además tienen la característica
de agregar a la oración una DENOTACIÓN, tal como: posibilidad, probabilidad, habilidad,
obligación, necesidad, deducción, consejo, sugerencia, etc.

REMEMBER: todos van con el verbo en infinitivo, ej: CAN + VERBO INFINITIVO

VERBO Modal INDICA Significado

CAN: Capacidad, habilidad, permiso, probabilidad
MAY: (Formal) probabilidad.
MIGHT. Probabilidad remota
COULD: Posibilidad en el pasado (pudo-podía), se usa
podría en futuro
SHOULD / OUGHT TO: Sugerencia, consejo
MUST: Obligación (en el presente), deducción
HAVE TO / HAD TO: HAD TO en el pasado (tenía que)
DARE:
MUSTN’ T Prohibición
NEED/ NEED TO: Necesidad
WOULD: Invitación, preguntas

WILL: Expresa futuro, como verbo modal, también

expresa la intención de hacer algo.

47
 READING MATERIAL
Provide the title, A-Read the following paragraph, B-Underline and Identify modals, C-WORDS
in bold (NEGRITA), write their meaning (in the text)

……………………………………….Title
1-People with infectious pneumonia can often have a cough producing greenish or yellow sputum
[Link] may be accompanied by high fever and shaking chills. People with pneumonia could cough
[Link] blood, and experience headaches. Other possible symptoms might be loss of appetite, fatigue,
[Link] of the skin, vomiting, nausea, mood swings and joint pains or muscle aches.
[Link] may cause only weight loss and night sweats. In elderly people, manifestations of
[Link], can be seldom typical. They may develop a worsening confusion or might
[Link] unsteadiness, leading to falls. If pneumonia is suspected on the basis of the patient’s
[Link] and findings from a physical exam, further investigations are needed to confirm the
[Link]. The presence of an infiltrate on plain chest X ray is considered the gold standard and it
[Link] be obtained in patients with suspected pneumonia. (Up-to-date on line 2023)

�DUE TO/ OWING TO: nexo, que significa DEBIDO A

INTERROGATIVE FORM

COULD I/You
CAN / MAY He / She Examine The patient?
MUST I
SHOULD We/ you / they

1- Skin vasculitis can be itchy, burning or painful, flat or raised red or purple spots, blisters
or ulcers may develop and these marks might take a long time to fade.

2-The Doctor will explain the diagnosis deeply.

3-How often should I take the pills?

VERB PATTERN

● 1-SIMPLE FUTURE
● Iindica DETERMINACIÓN. Se emplea para predecir un evento futuro. Para expresar una
decisión espontánea. Para expresar voluntad o disposición para hacer algo.

SUJETO + WILL (‘LL) /WON’T (negative) + INFINITIVE-time references: tomorrow, next

Tuesday, the following /ensuing week

i.e: He will bring a specimen of his water tomorrow morning.

48
 ● 2-FUTURE (going to)
● Expresa INTENCIÓN. Se emplea para expresar una acción futura programada con
anterioridad. Para expresar una conclusión lógica acerca del futuro.

SUJETO + BE (is-am-are) GOING TO + INFINITIVE

i.e: He doesn’t feel well, he is going to faint.

● 3-FUTURE PROGRESSIVE
● Se emplea para expresar continuidad o duración de una acción futura y para una acción futura
que se da por hecho que sucederá.

SUJETO + WILL BE + V ING

i.e: Some residents will be finishing their training in 4 years’ time.

Eg: This virus will be spreading only within the limits of the endemic area.

EXERCISES
B-Find in these sentences Simple Future-Future continuous-Future Perfect.
1-In about 20 days, the residents will finish their course on Drugs.
2-The researchers will be finishing the article on AIDS in one hour.
3-In a day or two he is going to feel better after drug withdrawal.
4-A large number of the patients with failed renal grafts will return to regular dialysis treatment.
5-After one month’s diet, the patient will lose some weight and will feel better.
6-If he undergoes the treatment, he’ll relieve soon.

�EITHER…OR: nexo que indica uno u otro, NEITHER…NOR: ni uno ni otro

⮚Regarding/ as regards: nexos que indican considerando,con respecto a ≠ regardless

/disregard: pasar por alto, omitir, no tener en cuenta

VOCABULARY WORK

1-WRITE 3 “NESS” WORDS.

____________________________________________________________________________________

2-WRITE 3 WORDS starting with“OUT”.

____________________________________________________________________________________

3-WRITE 5 ORGANS.
____________________________________________________________________________________

4-WRITE 4 DIFFERENTwords related to BLOOD.

____________________________________________________________________________________

5-WRITE 3 ILLNESSES
_________________________________________________________________________

49
 6-WRITE 3 verbs with “S and 3 with “R”
_________________________________________________________________________

READING MATERIAL
A-FAT EMBOLISM SYNDROME. (Cecil Book- CHAPTER 3)-Read and write exercises below.

[Link] Features: In the typical patient with the fat embolism syndrome, tachycardia of 140 beats
[Link] minute, tachypnea of 30 or 40 breaths per minute and fever up to 39º are noted two or three
[Link] after the fracture. The patient may or may not appear cyanotic, rales could be heard and
[Link] are generally common, particularly around the axillary folds, the neck and upper chest.
[Link] often develops restlessness or increasing irritability. The mayor features of the fat
[Link] syndrome are: A-respiratory insufficiency, B-cerebral involvement, C-retinal changes,
7.D-jaundice, E-renal changes, F-anemia, G-thrombocytopenia and also H-elevated sedimentation
8-rate.

1-Clinical characteristics

2-FES most important presentation

3-Can you recognize the words in bold

4-Find Modals

READING MATERIAL

B-MYASTHENIA GRAVIS-CLINICAL FEATURES (From Cecil Book)

Directions: READ the paragraph, DO NOT write the missing word, FILL in the chart below.
[Link] Gravis is not rare, with a prevalence rate of at least 1 in 10,[Link] may ____
[Link] in any age group, but there are ____of incidence in women in their twenties and 30s
[Link] in men in their fifties and sixties. Overall women are ____more frequently than men with a
[Link] of about 3:2.The_____features are weakness and fatigability of muscles. The_____increasess
[Link] repeated use (fatigue) and may improve_____rest or sleep. The_____of MG is often
[Link] may_____, mainly during the first few years after the_____ of the disease.
[Link] can be rarely complete or permanent. Unrelated infections or systemic_____ often
[Link] to increased myasthenic weakness and may_____ so-called crisis.

INCIDENCE
Man Women Features Remissions

50
 3-FOCUSING on VERBS WITH “S”: write their meaning-Dictionary work
1-scatter: 2-schedule: 3-seek: 4-seem:
5-shake: 6-skip: 7-spread: 8-stand:
9-stretch: 10-subside: 11-swallow: 12-swell:
13-share: 14-shift: 15-shiver: 16-stain:
17-smell: 18-snore: 19-spit: 20-split:
21-stay: 22-struggle: 23-suck: 24-support:
25-sweat: 26-submit: 27-supply: 28-swing:

4-FOCUSING on WORDS WITH “R”: write their meaning-Dictionary work

1-Reach: 2-Recall: 3-Recur: 4-Refer:
5-Realize: 6-Replace: 7-Recollect: 8-Record:
9-Reject: 10-Relapse: 11-Release: 12-Relieve:
13-Repair: 14-Resect: 15-Resolve: 16-Restore:
17-Resemble: 18-Resign: 19-Restart: 20-Resume:
21-Retain: 22-Reassure: 23-Retrieve: 24-Restrain:
25-Rely on: 26-Require: 27-Reply: 28-Refuse:
29-Remain: 30-Rise: 31-Rub: 32-Rule out:

SAME or DIFFERENT
1-resume-summary-resumé 9-though-through-although
2-begin-benign-become 10-die-dye
3-sibling-wheezing-relatives 11-feel-fill
4-subside-ceased 12-weak-week
5-should-ought to 13-aims-goals
6-warn-warm 14-give up-quit
7-some-same 15-release-free
8-start-onset-initiate 16-relieve-alleviate

51
 PRONOUNS

PERSONAL PRONOUNS, POSSESSIVE PRONOUNS AND ADJECTIVES.

Personal Objective “SELF” Possessive Possessive
pronouns pronouns Pronouns pronouns adjectives
I Me Myself Mine My
You You Yourself Yours Your
He Him Himself His His
She Her Herself Hers Her
It It Itself Its Its
We Us Ourselves Ours Our
You You Yourselves Yours Your
They Them Themselves Theirs Their

1-READ and TRANSLATE these examples, 2-IDENTIFY the pronouns (use the table).
1-Sixteen patients died, eight from fat embolism syndrome and eight from the trauma itself.
2-Although fibromyalgia does not cause serious, long-term target damage, its negative impact on
life quality is similar to rheumatoid arthritis.
3-Patients present to their physician describing their chief complaint as uncomfortable.
4-Guillain-Barré syndrome is the most common type of evolving, generalized peripheral nervous
system disorder. However, several of them can be mistaken for GBS, particularly early in its course.
2- Checking LIKE
1-Like (verb): 2-Dislike (V): 3-Alike:
4-Look like: 5-Be likely to: 6-Likelihood:
7-Likewise: 8-Unlike: 9-Lupus-like:

Exercises related to LIKE, 1-underline them

1-People with a family history of depression, eating disorders or substance abuse are more likely to
experience* an eating disorder.
2-All her symptoms are flu-like but there is a lack of fever.
3-Among patients who were initially treated with antibiotics for uncomplicated acute appendicitis,
the likelihood of late recurrence rate within 5 years was 39.1%.
4-The patient is feeling painful, however it is very unlikely that other opioid medication will appear.
5-Five years after oral anticoagulation withdrawal, the likelihood of recurrent venous thrombosis was 30.7%
among men.
6-Great minds think alike.

*Experience: as a noun: suceso, hecho, vivencia.

*to experiment: verb: experimentar, notar, sentir, tener, presentar, padecer, sufrir, soportar, e.g. the
patient experiences some difficulties in hearing (dificultad para oir).

● AT LEAST: al menos, opp AT THE MOST

�IF/ WHETHER ( Si ) son nexos que indican una condición

52
 READING MATERIAL
Sjögren’s syndrome
[Link] Sjögren’s syndrome (SS) is a systemic disorder characterized by both lymphocytic
[Link] and progressive destruction of exocrine glands. The inflammatory process can,
[Link] affect any organ. As a result, clinical features may be divided into two facets:1-benign
[Link] disabling manifestations such as dryness, pain, and fatigue, affecting almost all patients; and
5.2-severe systemic manifestations that affect 20-40% of patients.
[Link] former occurs due to the lack of another underlying rheumatic disorder, whereas secondary
[Link]ögren syndrome is associated with another underlying rheumatic disease such as systemic lupus
[Link] (SLE), rheumatoid arthritis or scleroderma. Given the overlap of SS with many
[Link] rheumatic disorders, it is sometimes difficult to determine whether a clinical manifestation
[Link] either solely a consequence of SS or is due to one of the overlapping disorders.

TYPICAL PRESENTATION
[Link] typically presents as both dry eyes and dry mouth, also referred to as xerophthalmia or
[Link] sicca (KCS) and xerostomia, respectively. In a large prospective cohort
[Link] of 400 patients with SS, 98% presented with xerostomia and 93 with xerophthalmia.
[Link] symptoms include: dryness, grittiness, itching and foreign body sensation. Oral symptoms
15. include difficulty speaking, eating, as well as swallowing.
[Link] physical examination, the patient’s eye may disclose conjunctival injection because there
[Link] be ocular swelling independent of lacrimal gland involvement. The more severe cases
[Link] in an individual, the earlier oral findings and clouding of the cornea may be
[Link]: for short term therapy of severe manifestations of keratoconjunctivitis sicca,
[Link] steroid containing eye drops could be used, nevertheless, carefully monitoring
[Link] cataracts and increased intraocular pressure is required owing to the finding of these
[Link] in patients receiving therapy for more than several weeks. In patients with
[Link] severe keratoconjunctivitis sicca the use of autologous sera diluted and used as artificial
[Link] might be helpful. Data Source: Uptodate.2023

● Marcar lo siguiente, 1-Nexos con un círculo y su significado, 2-Verbos defectivos,

● READ the article above and provide an answer in Spanish with references from the text
1-(SS) presentation
2-Translate line 17-18
3-Name (3) eye and (3) oral symptoms
4-Difference between patients with short term therapy of severe manifestations versus patients
with acute severe keratoconjunctivitis sicca.

READING MATERIAL
Read the article, 1-Write main ideas about heart failure, 2-Name HF signs & symptoms, 3-
Diagnosis.
HEART FAILURE
DEFINITION
HF is a complex clinical syndrome identified by presence of current or prior characteristic
symptoms, such as shortness of breath and fatigue, and evidence of cardiac dysfunction as a cause
of these symptoms (eg, abnormal left ventricular [LV] and/or right ventricular [RV] filling and
elevated filling pressures) .
There is no single, noninvasive diagnostic test that serves as a gold standard for HF, since it is
largely a clinical diagnosis based upon a careful history, physical examination, laboratory and
imaging data. While most patients with suspected HF do not require invasive testing for diagnosis,
the clinical gold standard for diagnosis of HF is identification of an elevated pulmonary capillary

53
wedge pressure at rest or exercise on an invasive hemodynamic exercise test in a patient with
symptoms of HF.

CLINICAL PRESENTATION
Symptoms and associated conditions Identification of symptoms of HF is a key step in
diagnosing HF. While a history alone is insufficient to make the diagnosis of HF, a detailed history
remains the single best discriminator to determine the acuity, etiology, and rate of progression of
HF, and the history often provides important clues to the cause of HF.
Symptoms of HF include those due to excess fluid accumulation (dyspnea, orthopnea, swelling in
the feet and ankles, sudden unintentional weight gain or loss, pain from hepatic congestion, and
abdominal discomfort due to distention from ascites) and those due to a reduction in cardiac output
(fatigue, weakness) that is most pronounced with exertion.
Advanced heart failure (HF) occurs when patients with HF experience persistent severe symptoms
that interfere with daily life despite maximum evidence-based medical therapy. A number of risk
factors, such as ischemic heart disease, hypertension, smoking, obesity, and diabetes, among others,
have been identified that both predict the incidence of HF as well as its severity

Diagnosis
The diagnosis approach to the patient with suspected heart failure includes history, physical
examination, and diagnostic tests to help confirm the severity of HF and rule out alternative causes
of refractory symptoms. The initial tests are blood tests, chest radiograph (in patients with dyspnea
to assess for pulmonary edema), electrocardiogram (may be helpful to identify a precipitating factor
such as atrial or ventricular arrhythmia), transthoracic echocardiogram (to evaluate for serial
changes in biventricular and valvular function), exercise testing.

Differential diagnosis
It is important to rule out other causes that may need different treatments, such as hyperthyroidism
or hypothyroidism, severe anemia, sleep disordered breathing or kidney, lung or liver disease,
among others.

Data Source: J. Curr Cardiol Rep.2022-Uptodate 2024 .

VERBS of SENSES
VERBS of SENSES. (verbos referidos a los Sentidos). Read the chart and write their meaning:
1-SMELL 2-TASTE 3-FEEL: 4-HEAR: 5-SOUND: 6-LOOK 7-SEE:

Read the sentences and circle the VERB SENSE

1-There are alterations in smell or taste in mildly symptomatic outpatients with SARS-CoV-2
Infection.
2-If you have a cold and a blocked nose, food seems to lose its taste.

3-The doctor heard he had a bruit over his carotid artery.

4-The patient’s lungs felt as if she had pneumonia.

5-He doesn’t hear well, he must be getting deaf.

6-The physicians have not seen signs of improvement in the patient’s condition.

54
 UNIT 4

A-VERB PATTERNS
1-Conditionals sentences-Zero Conditional, 1st type-2nd type
2-Reference material- Demonstrative Pronouns-Relative Pronouns-Indefinite Pronouns.

B-THE ADVERB
1-Adverbs of manner-Adverbs of frequency.

C-Reading comprehension and Vocabulary

ADVERBS
El ADVERBIO es una palabra que puede modificar o describir a un verbo, a un adjetivo, a
otro adverbio o a la oración completa. Los adverbios se usan para expresar MODO ( cómo
sucede algo), GRADO ( la intensidad con la que sucede), TIEMPO (cuándo), LUGAR
(dónde), FRECUENCIA (cuán frecuente sucede algo) CONFIRMACIÓN y
NEGACIÓN, PROBABILIDAD, PROPÓSITO.

ADV. DE MODO quietly- loudly- beautifully- honestly

ADV. DE GRADO very- enough- almost- too- nearly-

extremely

ADV. DE TIEMPO yesterday- today- tomorrow- last year- now

ADV. DE LUGAR here- there- everywhere- down- up- outside

ADV. DE FRECUENCIA always- often- never- regularly- never

ADV. DE PROBABILIDAD maybe- perhaps- possibly-

ADV. DE PROPÓSITO to- for- because

ADVERBS OF MANNER
Adjective + -LY in a...manner”. Regularly /Easily/ Brightly
NOTE:
Normal Normally
Probable Probably
Easy Easily
1-Crystalloids are less expensive and typically accomplish the same goal.
2-Status epilepticus should be suspected in critically ill patients.
3-Seizures may be convulsive or non-convulsive and may be initially focal.
4-Patients with primary biliary cirrhosis should be carefully monitored.

55
 Adjective: Adverb
1-Researchers work hard and require fast training.
2-Early diagnosis is always important in suspected appendicitis.
3-He could hardly (barely) speak, this is the worst fit he has ever had.*hardly: escasamente
4-This 55-year old female hardly ever goes to the Doctor, she does not rely on them (very seldom) .
5-She hardly ever coughs since she gave up smoking.
Adjective ≠ adverb
The hypertensive patients undergoing a low-fat and low-salt diet are well adapted soon.

A-Identify the adverbs from the following list (Dictionary work)

Probably Community Readily Largely
Relatively Already Basically Efficiency
Individually Quality Necessity Heavily
Uniformly Irregularity Particularity University

B-Identify the following as a NOUN (N), a VERB (V), an ADJECTIVE (A) or an ADVERB
(Adv).
1)----------childhood 6)------------improve 11)----------steadily
2)----------suitable 7)------------fellowship 12)----------successful
3)----------hardly 8)------------specialist 13)----------computerized
4)----------ability 9)------------performance 14)----------subtle
5)----------tenderness 10)-----------icteric 15)----------available
A-Reminder of irregular comparisons-ADVERBS-
Well Better Best
Badly Worse Worst
Late Later Last
Little Less Least
Much More Most
Far Farther Farthest (distance)
Further Furthest (distance-time)

READING MATERIAL
1-READ the following paragraph carefully and do the exercises below.

Treatment of community-acquired pneumonia in

adults in the outpatient setting-UpToDate 2024

INTRODUCTION
Community-acquired pneumonia (CAP) is defined as an acute infection of the pulmonary
parenchyma in a patient who has acquired the infection in the community, as distinguished from
hospital-acquired (nosocomial) pneumonia (HAP).
CAP is a common and potentially serious illness . It is associated with considerable morbidity and
mortality, particularly in older adult patients and those with major comorbidities.

56
 DEFINITIONS
CAP is defined as an acute infection of the pulmonary parenchyma in a patient who has acquired
the infection in the community, as distinguished from hospital-acquired (nosocomial) pneumonia
(HAP).Health care-associated pneumonia (HCAP; no longer used) referred to pneumonia acquired
in health care facilities (eg, nursing homes, hemodialysis centers) or after recent hospitalization.
The term HCAP was used to identify patients at risk for infection with multidrug-resistant
pathogens. However, this categorization may have been overly sensitive, leading to increased,
inappropriately broad antibiotic use and was thus retired

INITIAL MANAGEMENT
Obtaining an accurate diagnosis, determining the treatment setting, and starting antibiotic treatment
promptly are essential early steps in CAP management.

Establishing the diagnosis –The diagnosis of CAP generally requires the demonstration of an
infiltrate on chest imaging in a patient with a clinically compatible syndrome (eg, fever, dyspnea,
cough, and sputum production). Because clinical features alone are nonspecific, obtaining a chest
radiograph improves diagnostic accuracy and is considered a requirement for diagnosis by the
Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS).

1-CAP definition, CAP versus HCAP

2-Diagnosis

RECURSOS PARA LEER

Cuando hablamos o escribimos utilizamos diferentes recursos para transmitir nuestro mensaje más
claro, más comprensible y menos repetitivo usando, ESTE, AQUÉLLOS, EL CUAL, CUYO, LAS
CUALES.
● 1-Demonstrative Pronouns
● 2-Relative Pronouns
● 3-Indefinite Pronouns

1-DEMONSTRATIVE PRONOUNS
This These
That Those

1-Cyclosporine‘s mechanism in the treatment of glomerulonephritis is not known. Side effects of

this drug are hypertension and nephropathy.
2-The first trial of immunosuppressive treatment in adults with glomerulonephritis was carried out
with prednisone. That trial confirmed that some kinds of glomerulonephritis responded better to
immunosuppressive therapy.

2-RELATIVE PRONOUNS
That Which
Who Whose
1-A 58-year-old man,who had been hypertensive for 10 years, had an inferior myocardial infarction.
2-A hallmark of fibromyalgia is reduced pain thresholds, which can be demonstrated by palpation.
3-As COVID-19 spreads globally, populations who survive their illness will become immune.
4-A red eye is the most common ocular disorder that primary care physician’s encounter.

REMEMBER: es clave identificar el referente cuando está WHO-WHICH-THAT-IT-THEM-

57
THEIR-ITS para saber a que/ quien reemplazan para lograr una mejor traducción e
interpretación.

3-INDEFINITE PRONOUNS.
The one The ones
This one These ones
That one Those ones
The (small) one The (small) ones

Few-A few-Some-Several-Many-Both-Such-Other (s)

Translate the following sentences.
1-In some patients, the primary response to stress is fatigue, whereas in others it is myalgias.
2-Many drugs are only available by prescription, some are addictive, and others are effective
against a variety of bacterial infections.

�ALTHOUGH / THOUGH/ ALBEIT: indican contraste, concesión-AUNQUE

TYPES OF CONDITIONAL SENTENCES

La condición la expresa el nexo IF o WHETHER (Si)

-Zero Conditional (type 0)

Usada para describir reglas o situaciones donde un evento siempre sigue a otro es verdadero.

IF +PRESENT SIMPLE +PRESENT SIMPLE

If I take the medication, I improve * si tomo la medicación, mejoro

If you inject insulin to a person, the glucose blood levels decrease.

If it rains, I cancel the meeting.

______________________________________________________________________

-1st type conditional

IF+ PRESENTE / FUTURO SIMPLE

Se usa para posibles eventos en el futuro.

If he resumes with medication, he will improve( *Si continua con la medicación, mejorará)

Residents get a certificate if they will attend the course regularly.

If you don't wear gloves, you will get a virus.

_______________________________________________________________________

-2nd type conditional

58
IF + PASADO / CONDICIONAL SIMPLE (WOULD* + VERBO INFINITIVE)*or using
a modal: can, may, might
IF +were you/ him/ them +WOULD + INFINITIVE

Se usa para hablar de eventos imposibles o improbables e irreales.

If he took the medication, he would improve *Si tomara o tomase la medicación,
mejoraría

If I found something new about the treatment of Heart failure I would tell you.

If I were her, I ‘d continue working in the Lab.

If I were them, I would go to the annual meeting of Cardiology.

A-1-TRANSLATE the following sentences, 2- WRITE ( ) type of conditional

1-If he went under treatment earlier, he would feel better.

2-If I were him, I ‘d continue working in the Lab.

If carcinoma in situ is untreated, it will progress to invasive carcinoma.

3-If he were allergic to penicillin, what other drug would you use to prevent the infection?

4-If patients achieved proper Diabetes control, through diet and exercises, people with Type II
diabetes would not take insulin.

5-If there is acid regurgitation into the esophagus, a burning sensation behind the sternum will
occur.

6-If patients with prostate cancer undergo a radical prostatectomy, they will have a better prognosis.

7-The risk of type 2 diabetes increases if your parent or sibling has type 2 diabetes.

8-If carcinoma in situ is untreated, it will progress to invasive carcinoma

. 11
B-Complete these sentences using CONDITIONALS, B- Write if they are Zero, 1st, 2nd type.

1-If he didn’t smoke 20 cigarettes daily, he__________________________________________

2-If the pain resumed,________________________________________________________
3-If you get a rash, __________________________________________________________
4-If I were him, I____________________________________________________________
5-If she does not take any exercises regularly, she_____________________________________
6-If there were bacteria, the gastroenterologist______________________________________
7-If you don't eat, you________________________________________________________
8-If she worked less hours, she_________________________________________________

� CONVERSELY, contrariamente, ON THE CONTRARY, ON THE OTHER HAND: por

otro lado

59
 READING MATERIAL

1-Read the following information, 2-Define what the METABOLIC SYNDROME is LIKE

MAYO CLINIC, 2024

METABOLIC SYNDROME DEFINITION

METABOLIC SYNDROME (MetS) Metabolic syndrome is a cluster of conditions that occur

together, increasing your risk of heart disease, stroke and type 2 diabetes. These conditions include
increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal
cholesterol or triglyceride [Link] just one of these conditions doesn't mean you have
metabolic [Link] it does mean you have a greater risk of serious disease. And if you develop
more of these conditions, your risk of complications, such as type 2 diabetes and heart disease, rises
even higher.

Metabolic syndrome is increasingly common, and up to one-third of U.S. adults have it. If you have
metabolic syndrome or any of its components, aggressive lifestyle changes can delay or even
prevent the development of serious health problems.

PREVENTION

A lifelong commitment to a healthy lifestyle may prevent the conditions that cause metabolic
syndrome.
A healthy lifestyle includes:

-Getting at least 30 minutes of physical activity most days

-Eating plenty of vegetables, fruits, lean protein and whole grains

-Limiting saturated fat and salt in your diet

-Maintaining a healthy weight

-Not smoking

60
 UNIT 5

A-SOME-ANY-NO

B-VERB PATTERN
Passive Voice
Reading Material
Gynecology vocabulary

C-READING MATERIAL AND VOCABULARY

SOME-ANY-NO
● Some: +? ● Any: - ? ● No: +

Somebody-someone. Something-somewhere.
Anybody-anyone. Anything-anywhere.
Nobody Nothing
Everybody Everything
These ADVERBS are used with ANY
Barely Hardly Scarcely

TRANSLATE the Following sentences, identify SOME, ANY, NO + BODY+ THING

1-Have you got any pain? Have you had anything similar to this before?
3-Has anybody written him the prescription?
4-He has some pain in his chest, but we could not find any striking abnormality.
5-Please tell me something about your parents, relatives and siblings.
6-There is no family history of carcinoma and nobody in her family suffers from neither
hypertension, nor diabetes.
7-Everybody in his family suffers from asthma or eczema.
8-Are you allergic to anything? Are you taking any medication in particular?

PASSIVE VOICE
Es la función gramatical que se usa cuando queremos dar más importancia a lo que pasó (la acción),
que a quién realizó la acción ( el sujeto) o cuando no queremos decir quien la realizó.
La Voz Pasiva en inglés. Como en español se forma con el verbo 'to be' (ser) conjugado (is, are,
am, was, were) y el participio pasado de un verbo. El sujeto de un verbo en pasiva corresponde al
objeto de un verbo en activa.
El tiempo de la oración en voz pasiva lo marca el verbo “to be”.

La VOZ PASIVA también puede estar compuesta por un verbo modal (can/ could/ may/ should
seguido del verbo “to be” y el pasado participio del verbo principal.
El pasado participio es la forma del verbo que, en español tiene las terminaciones "ado" ó "ido".
Siempre se usa con un verbo auxiliar. El pasado participio de los verbos regulares en inglés se
forma igual que el pasado del inglés agregando __ed ó __d al final del verbo y en los verbos

61
irregulares, se encuentran en la 3° columna de la lista de verbos [Link] dos posibilidades
de traducción:

1-Literal: The patient was operated by an expert on Gynecology (el paciente fue operado por un
experto en ginecología)

2-Con la forma impersonal que comienza con “SE”. The patient 's diagnosis was performed. (Se
realizó el diagnóstico del paciente). Es muy frecuente encontrar la VOZ PASIVA con “IT”.

Read and translate the following sentences-OJO muchas con it

1-IT IS BELIEVED that her diagnosis of Polycystic ovary syndrome (PCOS) was wrong (SE
CREE QUE…………………………………………………………………………………………
2-IT HAS BEEN SAID that Acute lymphoblastic leukemia (ALL) is the most common cause in
children………………………………………………………………………………………………
3-Chronic Obstructive pulmonary disease (COPD) is a major risk factor for any surgical procedure,
IT HAS BEEN ASSOCIATED with longer hospital stays and the occurrence of complications
following surgery……………………………………………………………………………………
4-IT WAS STATED that Diabetes reduces life expectancy by five to 10
years…………………………………………………………………………………………………
5-Chest X Ray is more useful than we think and SHOULD NEVER BE REPLACED by more
advanced methods. …………………………………………………………………………………
6-IT HAS BEEN DISCUSSED* that Chemotherapy and radiation therapy were
administered………………………………………………………………………………………….
7-IT HAS BEEN SUGGESTED that drug withdrawal was clue in her
recovery……………………………………………………………………………………………
8-Cardiac arrhythmias MUST BE RULED OUT, mainly in elderly, who have a higher incidence
of syncope……………………………………………………………………………………………

*to Discuss:
1-considerar, examinar, analizar, explicar, exponer o tratar (libros, artículos, conferencias) eg,
Treatment complications associated with the use of loop diuretics are discussed above, (arriba se
exponen las…..)
2-debatir, deliberar, intercambiar opiniones, referirse a, tratar de, eg we will meet next week
to discuss the matter (nos reuniremos la semana que viene para discutir acerca del asunto)

Complete las FRASES de la Columna B con el participio correspondiente de la Columna C

A B C
1-se mostró A-It INDICATED
is…………………………
2-se ha realizado B-It was……………………… RULED OUT
3-se pensó C-It has PERFORMED
been………………….
4-se sugiere D-It DISCLOSED
is…………………………
5-se descarta E-It was……………………… THOUGHT
6-se indica D-It is SUGGESTED

62
 Find and translate PASSIVE VOICE, DRAW A circle
a) Sjögren’s syndrome is thought to be the most common autoimmune disease next to
rheumatoid arthritis. It has been reported in children, adolescents as well as elderly. It is
encountered more often in women than in men (at a rate of 9.1)
b) The cause of cluster headache is unknown, the intense pain is thought to relate to malfunction
of descending pain control centers in the hypothalamus and brainstem regions.
c) Magnetic Resonance Imaging (MRI) of the head was scheduled, however the severity of the
patient’s headaches increased and she was evaluated at another hospital.
d) Once a woman is diagnosed with gestational diabetes mellitus(GDM), 2 strategies are considered
for management: life-style modifications and pharmacological therapy.

⮚ REMEMBER: el tiempo de la VOZ PASIVA lo marca el verbo TO BE

ACTIVE: Fleming (sujeto) discovered penicillin.

PASSIVE: Penicillin was discovered by Fleming.

Exercises: PASSIVE VOICE-DRAW a circle to identify from 1 to 6

1-Patients with aphasia may be thought to be delirious or demented.
2-It was discovered that tamoxifen remains the only systematic therapy evaluated to date as a
treatment for preventing recurrence of DCIS (Ductal carcinoma in situ)
3-The patient’s disease must be reported by the pathologist.
4-The X Ray disclosed at least two areas of density that were believed to be calculi.
5-A 51-year-old man was known to have chronic obstructive pulmonary disease since the age of 46.
6-Before admission he was transferred from another hospital with respiratory failure, his trachea
was intubated and he had been admitted to an intensive care unit.

�IN SPITE OF / DESPITE: indica contraste: A PESAR DE

�WHEREAS: indica contraste. MIENTRAS QUE

READING MATERIAL
A-Read the paragraph and find out the following:
1-Marcar VOZ PASIVA /VERBOS DEFECTIVOS y NEXOS
2-Marcar dos características de GDM

Management of Gestational Diabetes Mellitus

Abstract: Once a woman is diagnosed with gestational diabetes mellitus (GDM), two strategies are
considered for management; life-style modifications and pharmacological therapy. The
management of GDM aims to maintain a normoglycemic state and to prevent excessive weight gain
in order to reduce maternal and fetal complications. Lifestyle Modifications Include Nutritional
Therapy and exercise. Calorie restriction with a low glycemic index diet is recommended to avoid
postprandial hyperglycemia and to reduce insulin resistance. Blood Glucose Levels, HbA1c levels,
and ketonuria are monitored to analyze the efficacy of conservative management. Pharmacological
treatment is initiated if conservative strategies fail to provide expected glucose levels during
[Link] has been the first choice for the treatment of diabetes during pregnancy.
Recently, metformin has been used more commonly in diabetic pregnant women in cases when

63
insulin cannot be prescribed, after its safety has been proven. Nevertheless, a high percentage of
women, which may be up to 46% may require additional insulin to maintain expected blood glucose
levels. The evidence on the long-term safety of other oral anti-diabetics has been lacking yet.
Women with diet-controlled GDM can wait for spontaneous labor expectantly in case there are no
obstetric indications for birth. However, in women with GDM under insulin therapy or with poor
glycemic control, elective induction at term is recommended by [Link] women who have
GDM during pregnancy should be counseled about the increased risks of impaired glucose
tolerance, type 2 diabetes mellitus, hypertensive disorders, cardiovascular diseases, and metabolic
syndrome. Source:Pubmed 2024

Keywords: Delivery; Diet; Exercise; Gestational diabetes mellitus; Glucose Monitoring; Insulin;
Labor; Metformin; Nutritional Therapy; Postpartum Counseling; Pregnancy.

READING MATERIAL
B-READ this paragraph and do the exercises: Marque y traduzca: 1-Nexos, (use flecha con su
significado), 2-Identifique dos oraciones en VOZ PASIVA con su traducción , 3-vocabulario en
negrita , 4-Conteste las preguntas debajo del texto.

INTRODUCTION
CARDIOGENIC SHOCK
Cardiogenic shock is a clinical condition of inadequate tissue (end-organ) perfusion due to the
inability of the heart to pump an adequate amount of blood. The reduction in tissue perfusion results
in decreased oxygen and nutrient delivery to the tissues and, if prolonged, potentially end-organ
damage and multi-system failure.
Acute myocardial infarction (MI) is the most common cause of cardiogenic shock and is defined as
a clinical event consequent to the death of cardiac myocytes (myocardial necrosis) that is caused by
ischemia (as opposed to other etiologies such as myocarditis or trauma).
Cardiogenic shock is the leading cause of death in patients with acute MI, with hospital mortality
rates approaching 50 percent. Short-term prognosis is directly related to the severity of the
hemodynamic disorder.
CLINICAL PRESENTATION
The cardinal features of shock, irrespective of shock type, include clinical manifestations of
hypoperfusion such as hypotension (which occurs in most patients), oliguria, abnormal mental
status, cold clammy skin, and evidence of metabolic acidosis on laboratory testing (eg, arterial
lactate >2.0 mmol/L).The "classic" patient with cardiogenic shock has severe systemic
hypotension, signs of systemic hypoperfusion (eg, cool extremities, oliguria, and/or alteration in
mental status),and respiratory distress due to pulmonary congestion. However, not all patients
present with this syndrome.
As the mortality associated with cardiogenic shock in the setting of acute MI is high and as the
ability of therapies to improve this outcome declines with delays, the clinical evaluation (history
and physical examination, as well as early laboratory testing) should be carried out fast.

Source:UpToDate 2024

1-Cardiogenic shock definition

2-Shock diagnosis

3-Clinical manifestations

64
 READING MATERIAL
FIRST READ and STUDY Gynecology Vocabulary New England Journal of Medicine
❖ CASE REPORTS-GYNECOLOGY -Vocabulary Development
1.A 31-year-old woman was admitted to the hospital because of secondary amenorrhea and
[Link]. The patient’s menarche occurred at 13 years. Her menstrual cycles were regular at 28
[Link], with cramps, backache, bloating and breast tenderness just before each period, she
[Link] occasional right-sided pain two weeks before menses. At 20 years of age, an
[Link] device was inserted, but excessive flow and cramps prompted its removal one year
[Link]; during the next three years the patient took an oral contraceptive pill which were withdrawn
[Link] her menses returned, with molimina*. The same year her first pregnancy resulted in a still
[Link] after the first trimester and dilation and curettage was performed in the 5th month. At the age
[Link] 24, she again became pregnant and a healthy boy (birth weight of 3.8 kg) was delivered by
[Link] section. She did not breast-feed the child but noticed tenderness and engorgement of
[Link] menses became scanty and irregular with intermenstrual spotting. Her symptoms
[Link] during the next 4 years. A physician prescribed levothyroxine and progestin for 3
[Link], although no basal-body-temperature recording or thyroid tests were carried
[Link] administration failed to regulate her periods. No further flow developed, but she
[Link] with hot flashes and drenching sweats that occurred several times daily and lasted 16 minutes.

Una vez leído el caso 1, CONTESTE lo siguiente:

1-Ciclos menstruales-Características……………………………………………………………
2-¿A qué se refiere THEM en la línea 7?......................................................................................
3-¿Qué sucedió con el dispositivo intrauterino?………………………………………………………
4-Primer embarazo.
Características………………………………………………………………………………………

*molimina: premenstrual symptoms

5-VOCABULARY (Agregar palabras nuevas al GLOSARIO)

1-breast feed: 2-bloating: 3-stillbirth: 4-engorgement:

5-menses: 6-cramps: 7-backache: 5-drenching sweat:

1-A 45 year-old female was in good health until three weeks ago, when she noticed a solitary lump
in [Link] left breast. She has had no discharge or itching of her left nipple. She denies back, arm, leg
or [Link] pain, shortness of breath. There is no impairment of her sensorium and there is no family
[Link] of carcinoma. She is well nourished and in no acute distress and is well oriented to time,.
[Link] and person. The physical exam shows a firm, fixed, 2 x 2 cm painless mass in the upper
[Link] quadrant of the left breast.
1-¿Qué mostró al exámen físico?
2-¿Qué significa SHORTNESS of BREATH?
3-La masa era dolorosa-TRUE____, FALSE_____
4-La paciente tiene dolor costal-TRUE____, FALSE_____

THINK and then list some of the causes of bleeding.

65
NOTE: Rupture of the marginal sinuses, placenta previa, blood dyscrasias, placenta abruptio,
erosion of the cervix as with carcinoma, cervical polyps…………………………

Differences between Still birth and Miscarriage

*When a baby dies before delivery, many people commonly think of miscarriage. Both stillbirth
and miscarriage are types of pregnancy loss, but they differ by when the loss occurs. A miscarriage
(sometimes called a spontaneous abortion) is when a baby dies before the 20th week of pregnancy.
Stillbirth is the death of a baby after the 20th week of pregnancy but before delivery.

READING MATERIAL

IMPACT of PREGNANCY and childbirth on Pelvic Floor Disorders (PFDs):

Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP)

1-READ the text and do the exercises below

Pelvic floor disorders (PFFDs) include not only pelvic organ prolapse (POP), but also urinary and
fecal incontinence.
These disorders affect one third of adult women in the United States with an impact on their quality
of [Link] 20% of women undergo surgical treatment for PFDs and about 17% of these women
require reoperation. A casual role of pregnancy and childbirth is supported by the finding that PFDs
are more prevalent among women who have delivered at least one child. Furthermore, the rate of
PFDs increases with increasing parity. Among parous women, it has been estimated that 50% of
incontinence and 75% of prolapse can be attributed to pregnancy and childbirth.

PROGNOSIS
The prognosis for women who develop urinary incontinence during pregnancy is mainly favorable.
For most women with incontinence during pregnancy, symptoms are likely to resolve after
[Link] percent of women with onset of urinary incontinence, during pregnancy,
experience spontaneous resolution of postpartum symptoms. Specifically within 12 months
postpartum, the prevalence drops to 11 to 23%
Data Source: Effect of pregnancy and childbirth on urinary incontinence and pelvic organ
prolapse, UptoDate 2023

1-PFDs in pregnancy and childbirth

2-Prognosis
3-Find connectors

66
 READING MATERIAL
Read the following paragraph and answer the questions (Annals of Emergency
Medicine-July 2023)(Ting-Yi [Link]-Internal Medicine Service-Taiwan University)

1-What kind of article is it, an abstract? A summary? part of a review?_____________________

2-Dengue virus infection is a common triggering factor. TRUE___FALSE_____
______________
3-Why was the patient diagnosed with Dengue fever?__________________________________
4-Source of the text (fecha y lugar)__________________________Author’s origin__________
5-Write the most important features about Guillain-Barré syndrome________________________

Annals of Emergency Medicine-July 2022

67
 READING MATERIAL
READ the article Guillain Barré syndrome associated with Zika virus infection (Lancet 2022) and
underline the most important parts.
1-What type of article is it?___________________________________________________
2-Source__________________________________________________________________
3-Writing activity below the text

-Writing activity: Write an EMAIL in English asking for extra material about this Zika
virus topic.

68
 READING MATERIAL
READ this paragragh and do the exercises: MARQUE, 1-vocabulario en negrita, 2-Conteste
las preguntas A, B, C, D, E debajo del texto, 3-voz pasiva, 4-nexos

KAPOSI’s SARCOMA
Kaposi’s Sarcoma (KS) is a connective tissue cancerous tumor, and is often associated with HIV. It
is caused by infection with human herpesvirus 8 (HHV8).

SIGNS AND SYMPTOMS

Kaposi’s sarcoma can appear either as bluish-red, brown or purple spots /lesions on the skin, which
can be flat or slightly raised. The lesions may develop anywhere on the body, however are most
often found on the face (especially ears, mouth, and tip of the nose) legs and feet as well as genital
area. For those with dark-colored skin, the lesions could appear dark brown or black. Fortunately
the lesions are neither itchy nor painful.
Kaposi’s sarcoma may also appear as lesions on the palate, tongue, gums, tonsils or as
gastrointestinal (stomach or intestine). The latter gastrointestinal lesions may be silent or cause
weight loss, pain, nausea/ vomiting, diarrhea, bleeding (either vomiting blood or passing it with
bowel motions), malabsorption or intestinal obstruction. There may be involvement of the airway,
such as shortness of breath, fever, cough, hemoptysis or chest pain or as an incidental finding on
chest x-ray.

TRANSMISSION
Primary infection can occur during childhood, whereas as an adult it can be transmitted via both
sexual and non-sexual routes. HHV8 may be found in the peripheral blood mononuclear cells,
saliva, oropharyngeal mucosa, semen, cervico-vaginal secretions and, prostate glands, which may
represent the source of vertical and horizontal transmission.

TREATMENT
KS is not curable, however it can often be treatable. In 40% or more of people with AIDS-
associated KS, the Kaposi lesions will shrink upon first starting highly active antiretroviral therapy
(HAART).
Nevertheless in a certain percentage of such people, KS could grow again after a number of years
on HAART mainly if HIV is not completely suppressed whereas few local lesions can often be
treated with local measures such as radiation therapy or cryosurgery. (UpToDate, 2023)

ANSWER THE FOLLOWING

A-Kaposi’s Sarcoma definition

B-Kaposi’s presentation
C-Kaposi’s Sarcoma in dark-skinned patients
D-Gastrointestinal lesions
E-Transmission and treatment

�IF/ WHETHER ( Si ) son nexos que indican una condición

69
70
 MEDICAL VOCABULARY

EXERCISES

● GLOSARIO: QUE INCLUIR

Objetivo: RECORDAR PALABRAS y expresiones médicas.
“IDEAS” PARA ELABORARLO ( usar cuaderno índice )
● Seleccionar palabras técnico –científico.
● Seleccionar palabras que NO sean transparentes

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72
 IRREGULAR VERBS
SIGNIFICADO INFINITIVE PAST PAST PARTICIPLE
ARISE AROSE ARISEN
AWAKE AWOKE AWOKEN
BE WAS /WERE BEEN
BEAR BORE BORN
BECOME BECAME BECOME
BEGIN BEGAN BEGUN
BEND BENT BENT
BIND BOUND BOUND
BITE BIT BITTEN
BLEED BLED BLED
BLOW BLEW BLOWN
BREAK BROKE BROKEN
BREED BRED BRED
BRING BROUGHT BROUGHT
BUILD BUILT BUILT
BURN BURNT BURNT
BURST BURST BURST
BUY BOUGHT BOUGHT
CATCH CAUGHT CAUGHT
CHOOSE CHOSE CHOSEN
COME CAME COME
CUT CUT CUT
DO DID DONE
DRAW DREW DRAWN
DRINK DRANK DRUNK
DRIVE DROVE DRIVEN
EAT ATE EATEN
FALL FELL FALLEN
FEED FED FED
FEEL FELT FELT
FIND FOUND FOUND
FLY FLEW FLOWN
FORBID FORBADE FORBIDDEN
FORGET FORGOT FORGOTTEN
FREEZE FROZE FROZEN
GET GOT GOT
GIVE GAVE GIVEN

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GO WENT GONE
GROW GREW GROWN
HANG HUNG HUNG
HAVE HAD HAD
HEAR HEARD HEARD
HIDE HID HIDDEN
HIT HIT HIT
HOLD HELD HELD
HURT HURT HURT
KEEP KEPT KEPT
KNOW KNEW KNOWN
LAY LAID LAID
LEAD LED LED
LEAN LEANT LEANT
LEARN LEARNT LEARNT
LEAVE LEFT LEFT
LEND LENT LENT
LET LET LET
LIE LAY LAIN
LIGHT LIT LIT
LOSE LOST LOST
MAKE MADE MADE
MEAN MEANT MEANT
MEET MET MET
PAY PAID PAID
PUT PUT PUT
QUIT QUIT QUIT
READ READ READ
RIDE RODE RIDDEN
RISE ROSE RISEN
RUN RAN RUN
SAY SAID SAID
SEE SAW SEEN
SEEK SOUGHT SOUGHT
SELL SOLD SOLD
SEND SENT SENT
SET SET SET
SHAKE SHOOK SHAKEN
SHOOT SHOT SHOT

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 SHOW SHOWED SHOWN
SHRINK SHRANK SHRUNK
SHUT SHUT SHUT
SINK SANK SUNK
SIT SAT SAT
SLEEP SLEPT SLEPT
SMELL SMELT SMELT
SPEAK SPOKE SPOKEN
SPEND SPENT SPENT
SPILL SPILT SPILT
SPLIT SPLIT SPLIT
SPOIL SPOILT SPOILT
SPREAD SPREAD SPREAD
STAND STOOD STOOD
STING STUNG STUNG
SWELL SWELLED SWELLED /SWOLLEN
SWIM SWAM SWUM
TAKE TOOK TAKEN
TELL TOLD TOLD
THINK THOUGHT THOUGHT
THROW THREW THROWN
UNDERSTAND UNDERSTOOD UNDERSTOOD
WAKE WOKE WOKEN
WEAR WORE WORN
WRITE WROTE WRITTEN

● REMEMBER: los nexos pueden unir ideas dentro de la oración, entre oraciones y párrafos

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 NEXOS.
1-according to-in accordance with:
2-actually-in fact-indeed:
3-although-though-albeit:
4-as long as-seeing that:
5-as regards- regarding- as for- as to:
6-as well as-also-besides-in addition to-moreover-likewise-furthermore:
7-because of:
8-both...and:
9-by means of:
10-consistent with:
11-due to-owing to:
12-either...or: neither...nor:
13-even though-though-despite:
14-hence-therefore-so-for that reason:
15-if-whether:
16-in concert with:
17-in fact:
18-in spite of-despite:
19-in turn:
20-in view of:
21-in virtue of:
22-indeed-surely-really:
23-irrespective of-regardless-disregard:
24-nevertheless-however-nonetheless:
25-not only...but also:
26-on account of:
27-on the other hand-on the contrary-conversely:
28-other than-rather than-instead of:
29-otherwise-in another way:
30-provided that-on condition:
31-rather than-instead of:
32-similarly-in the same way:
33-since:
34-so that-in order that-to the effect (that):
35-such as:
36-the former...the latter:
37-thereby-by that means:
38-therefore-as a result of-for that reason-consequently:
39-thus-therefore-in this way/manner:
40-to sum up-in conclusion-at last- in summary-finally:
41-unless:
42-unlike:
43-until/ till:
44-whereas:

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 LIST of REGULAR VERBS

La mayoría de los verbos de esta lista agregan “-d” o “-ed” al [Link] verbos duplican la
consonante final (admit-admitted) o cambian “-y” por “-ied” cuando la “y” va precedida por una
consonante (apply-applied)
Infinitive Simple Past Infinitivo Simple Past
Abate abated Gather gathered
Achieve achieved Happen happened
Add added Heat heated
Admit admitted Heal healed
Advise advised Impair impaired
Agree agreed Improve improved
Aim aimed Increase increased
Allow allowed Injure injured
Answer answered Involve involved
Apologize apologized Jeopardize jeopardized
Apply for applied Join joined
Approve approved Kill killed
Arrange arranged Knock knocked
Ask asked Last lasted
Attempt attempted Laugh laughed
Attend attended Lift lifted
Avoid avoided Link linked
Belong to belonged Like liked
Brush brushed Listen listened
Call called Live lived
Carry carried Look looked
Cease ceased Load loaded
Chew chewed Measure measured
Claim claimed Mix mixed
Clean cleaned Move moved
Close closed Miss missed
Compare compared Neglect neglected
Complain complained Obey obeyed
Cook cooked Open opened
Cry cried Perform performed
Delay delayed Pick picked
Deny denied Play played
Develop developed Press pressed
Die died Pull pulled
Disclose disclosed Push pushed
Drop dropped Raise raised
Dye dyed Reach reached
Encourage encouraged Recall recalled
Fail failed Refer referred
Fast fasted Refuse refused
Fill filled Release released
Finish finished Relieve relieved
Fit fitted Remain remained
Fold folded Remove removed

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Follow followed Resume resumed
Gauge gauged Subside subsided
Gain gained Suffer suffered
Reply replied Swallow swallowed
Report reported Stretch stretched
Rest rested Taper tapered
Resume resumed Tie tied
Retain retained Touch touched
Retrieve retrieved Try tried
Rub rubbed Turn turned
Rule out ruled Use used
Save saved Visit visited
Scatter scattered Void voided
Seem seemed Wait waited
Shout shouted Walk walked
Sign signed Want wanted
Smile smiled Wash washed
Smoke smoked Watch watched
Sound sounded Work worked
Stretch stretched Wound wounded
Stop stopped
Study studied
Replace replaced

PHRASAL VERBS
Phrasal verbs are phrases that indicate actions. They are generally used in spoken
English and informal texts. Examples: get up, wear out, write down

NOTE: Phrasal verbs consist of a verb and a preposition or an adverb:

1-BREAK OUT: to develop suddenly 11-LOOK AFTER: take care

2-CALL OFF /PUT OFF: to cancel, 12-LOOK FOR: search, seek.
postpone
3-CARRY OUT: continue, resume 13-PASS AWAY: die
4-COME DOWN WITH: become sick 14-PASS OUT: faint, lose consciousness
5-FIGHT OFF: to defend against 15-PICK STH UP: catch an illness
6-FILL IN: complete 16-PUT ON (weight): gain weight
7-GET OVER: recover, overcome a 17-PUT UP WITH: support, bear, stand.
difficulty
8-GIVE UP: stop trying, quit 18-RULE OUT: suspend, eliminate,
exclude
9-GROW UP: develop 19-SWELL UP: become bigger in size
10-LIE DOWN: rest in bed 20-THROW UP: vomit

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 MOST COMMON USED PREPOSITIONS and ADVERBS.
Above por encima de, sobre
Across a través de, por
After después (de), luego (de)
Against Contra
Along a lo largo de, junto con
Among entre (varios)
Around Alrededor
At en, a
Back detrás (de), atrás
Backward (s) hacia atrás
Before antes (de)
Behind detrás ( de)
Below (por) debajo de, debajo (de)
Beneath debajo (de)
Beside al lado de
Between entre (dos)
By por, al lado de
Down abajo, debajo
Downwards hacia abajo
During Durante
For Para
From de, desde
In en, dentro (de)
In front of en frente de, hacia adentro
Inside Adentro, dentro de
Inwards hacia adentro
Near cerca (de)
Of De
On sobre, en , encima de
On top of en la parte superior, opposite: on the bottom
Onto Hacia
Opposite frente a, opuesto a
Out fuera de
Outwards hacia fuera
Over Encima, por encima de, sobre
Since desde, ya que
Through por medio de, a través (de)
Throughout a lo largo de, durante todo

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To a, hacia
Toward (s) a, hacia
Under bajo, debajo (de)
Upon sobre (de)
Until Hasta
Up to Hasta
Upwards hacia arriba
With Con
Within dentro, en
Without Sin

READING MATERIAL

B-READ & TRANSLATE different CASE REPORTS: 1) UNDERLINE vocabulary (Use list of
verbs and vocabulary Unit 1), 2) DO the exercises below. Data Source: (NEMJ, JAMA)

1-A 24-year old man was admitted to the hospital because of the acute respiratory distress
[Link] patient had been well until several days earlier when he began to have nasal
[Link] with greenish discharge, myalgia, dry cough, mild dyspnea and a “sinus headache”. A
[Link] days before entry, the cough became productive of rust-colored sputum and was accompanied
[Link] right-sided pleuritic pain, fever, chilliness and diarrhea.

⮚ BECAUSE OF: es un nexo que indica, A CAUSA DE, DEBIDO A, POR, PORQUE
A)Encontrar 4 FRASES SUSTANTIVAS y escribirlas en el cuadro (ejercicio 1)
1- 3-
2- 4-
Describa cómo era la secreción nasal�

B)Vocabulary Learning
1-dry cough: 2-chilliness: 3-rust-colored sputum:

⮚ IN ADDITION TO: es un nexo que significa ADEMÁS= as well as, besides, moreover,
likewise, furthermore, also.

2- A 36 year-old left-handed woman was admitted to the hospital because of progressive, bilateral
2-hand weakness and numbness, in addition to bilateral facial weakness and loss of truncal
3-sensation. She had been well 5 years ago, when she *experienced numbness in her shoulders and
4-noted a complete closure of her left eye. Both numbness and weakness developed and gradually
5-weakened in her right and left hand, she then became aware of sensory impairment of the trunk.
6-There was no history of dry mouth, abdominal pain, lower-extremity symptoms or an electric
7-sensation in the spine on neck flexion.

Escribir el significado a las Partes del cuerpo (ejercicio 2) y Marque 2 frases sustantivas

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1-shoulder: 3-right hand: 5-dry mouth:
2-left eye: 4-trunk: 6-neck:

FIND the meaning of the following L 2-5 (Encuentre el significado de lo siguiente-Línea 2- 5)

1-numbness and weakness:
2-in addition to (nexo):
3-sensory impairment:
*Experience: este verbo no siempre indica experimento también se lo traduce como: notar-
sentir-tener-presentar-padecer-sufrir-soportar.

3-A 70 year-old woman was admitted to the hospital because of dyspnea and multiple cutaneous
[Link] patient stated that she had a history of long-standing type 2 diabetes mellitus as well as
3-myocardial infarct, she also had paroxysmal atrial fibrillation and end-stage renal disease, which
4-was being treated by peritoneal dialysis. Anticoagulation with warfarin was started six months
5-before admission, the dosage of the drug had not changed recently. Blood cultures yielded no
6-organisms. A cardiac ultrasonographic study showed no evidence of infective endocarditis. The
7-patient denied permission for a skin biopsy.

Encuentre los siguientes VERBOS en el párrafo y escriba su significado:

1-denied: 2-yielded: 3-started: 4-stated:

1-¿Recuerda lo que está en negrita?____________________________________________

2-La paciente dió su permiso para una biopsia de piel.TRUE____FALSE____
3-La paciente comenzó con warfarina 6 meses después de la admisión.TRUE____FALSE____

4-A 34-year-old man reported to his physician with the chief complaint of recurrent ventricular
2-tachycardia. Radiographs of the chest disclosed ill-defined opacities in the right upper lobe. A
3-tuberculin skin test was negative, but a test with mumps antigen was positive.
4-Microscopical exam of the right and left ventricular myocardial-biopsy specimens revealed
5-myocyte hypertrophy without evidence of myocarditis. Because of recurrent bouts of ventricular
6-tachycardia, an automatic, implantable cardioverter-defibrillator was implanted. The patient was
7-discharged with atenolol (25 mg twice daily).

Answer the following questions (exercise 4), (Responder las siguientes preguntas-Ejercicio 4)
1-¿Cuál es el motivo de consulta?
2-Exámen radiográfico y microscópico

3-¿Qué sucedió después del episodio de

taquicardia ventricular?
4-¿Qué medicación tomó después del alta?
5-Escriba el significado de MUMPS y bouts
6-Escriba 2 frases sustantivas en Inglés

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5-A 59-year-old patient was admitted because of fever, confusion, thrombocytopenia, rash and renal
failure. Three days before admission, vomiting, diaphoresis and increasing fatigue developed while
he was traveling, the next day he felt feverish and took ibuprofen and over-the-counter
medications for influenza-like symptoms. Before admission his family was unable to contact him
by telephone. The emergency personnel went to the hotel and found him seated in his room, he was
nonverbal, unable to stand, but able to respond to painful stimuli. He appeared withdrawn and
confused and thought he was in his home.

a-Vocabulary work. Encuentre el significado de las palabras que están en negrita.

b-¿Cómo estaba el paciente cuando lo encontraron en el hotel?
c-¿Qué significa WITHDRAWN? Use [Link]

6-A 56-year-old woman with diabetes mellitus was admitted to this hospital because of both chest
pain and hyperglycemia. Six months before admission, vague symptoms developed, including
nausea, metallic taste, headache, throat pain, chest discomfort and “indigestion”, as well.
Ultrasonography of the abdomen revealed a moderately fatty liver, pancreatic atrophy and a cyst in
the right kidney. On the day of the admission, the patient came to the ED because of persistent
discomfort in the throat, chest and epigastrium that increased when she was in a supine position and
was associated with postprandial fullness. She reported no chest pain on exertion, and no
shortness of breath, light-headedness, melena or blood in her stool.

a-Vocabulary work. Words in bold.

b-Chief complaint.
c-Studies performed.

�NOT ONLY...BUT ALSO es un nexo que SIGNIFICA : NO SÓLO ...PERO TAMBIÉN

DENGUE FEVER CASE REPORTS

A-a 38-year-old male with no significant past medical or surgical history presented to the
emergency department (ED) with complaints of fever, headache, retro-orbital pain, and
myalgia of one-week duration. The patient reported high-grade intermittent fever for the past
seven days that was associated with rigors and chills. His other complaints included reddish-
colored urine with clots for two days along with two episodes of gum bleed. The pertinent
denials included sore throat, chest pain, shortness of breath, vomiting, abdominal pain,
diarrhea,burning micturition, dysuria, urinary frequency, and contact with animals. On
physical examination, the patient was vitally stable, oriented to person, place and time, and
had mild conjunctival pallor. On skin examination, there were multiple purpura and
petechiae on the left shoulder, trunk, and both legs, and two large ecchymotic lesions on the
patient's back. The rest of the systemic examination was unremarkable

(June 12, 2020) A Case of Dengue Fever With Hemorrhagic Manifestation.

B-A 24 years old, previously healthy female presented with a history of fever for 4 days, with
a maximum recorded temperature of 103°F. Fever was associated with chills and rigor. Along
with this, she also had a history of severe myalgia and arthralgia. For these symptoms, she
had not sought any medical care. On the third day of onset of fever, she developed severe
epigastric pain, which was nonradiating, aggravated by consumption of food and associated
with multiple episodes of non-bilious vomiting. There was no history of similar episodes in the

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 past. She was initially being managed at a local hospital for 3 days, where she was improving
with conservative treatment. She did not have any history of alcohol consumption. On
examination, her vitals were stable, and there were no signs of pallor,icterus, or dehydration.
On abdominal examination, there were no findings apart from mild tenderness in the
epigastric [Link] blood investigations revealed a blood count of 16,070/mm3(58.5%
neutrophils, 33.9% lymphocytes),hemoglobin of 9.3 g/dl, platelets count was 85,000. The
White Blood Cell (WBC) counts gradually reduced.
Dic 2023

7-A 37-year old man was seen in the oral and maxillofacial surgery clinic of this hospital because of
a lesion on the tongue. Three weeks earlier, a painful lesion had developed on the tongue,
associated with a tender nodule in the left neck; he was free of symptoms except for a development
of a dermatitis in his legs. On exam, the vital signs were normal, there was a tender, irregular,
shallow ulcerated lesion on the left ventral surface of the tongue and a mobile, smooth, tender
lymph node on the left anterior chain of lymph nodes. Scattered areas of erythema were present.
During the next 2 weeks the tongue increased slightly in size.

1-Write the synonyms of the following

shallow scattered increase 3 weeks earlier smooth

8-A 42-year old female was admitted to the hospital because of a productive cough, chills and fever.
The patient had been well 7 months ago, when a non-productive cough developed and did not
subside, despite courses of antibiotics. A chest radiograph was unremarkable. Before admission,
she began to cough up, green, foul smelling sputum and had a temperature as high as 38.5 °C
without chills or sweats.

1-X Ray description

2-sputum description

9-An 87-year old female was admitted because of abdominal pain, vomiting, bloody diarrhea and
an abdominal mass. She had been in stable health until two days prior to admission, when crampy,
increasingly severe pain developed, together with nausea, vomiting and diarrhea with passage of
fresh blood. She had eaten little food since the onset of symptoms.

1-Vocabulary in BOLD, 2-Describe the pain

10-A 37-year old man was admitted to the hospital because of both blushing and hypotension. That
morning, sneezing, rhinorrhea, sore throat and subjective fever had developed. After lunch he
took an over-the-counter cold preparation. Thirty minutes later, fatigue, weakness, as well as
nausea, epigastric pain, facial blushing, red tears developed, accompanied by two bouts of
nonbloody emesis, he developed not only light-headedness but also near syncope.

1-subjective fever__________________________2-find connectors

11-A 27-year-old woman was admitted to this hospital because of nausea, vomiting, confusion and
hyponatremia. She had been healthy one week before admission, the patient had nausea and several
episodes of nonbloody, nonbilious emesis, after she had eaten seafood. The day before admission,
she had recurrent vomiting associated with eating but was able to drink large amounts of water
and participated in sightseeing activities, but in the evening she was noted to be slightly confused,

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 not able to follow directions or walk. Lab tests revealed severe hyponatremia with a high urine
osmolality and a high urine sodium level.
1-Lab tests results.
2-Vocabulary in bold.

12-A man with a 3-year history of chronic obstructive pulmonary disease presented with increasing
shortness of breath on exertion, requiring increasing flow rates of oxygen. He was a former
smoker with a 50-pack-year history. He had been diagnosed with stage I low-grade prostate cancer
several years ago. Lung exam showed no wheezing. Cardiac exam yielded a prominent pulmonary
component (P2) of the second heart sound. Non contrast computed tomography of the chest was
unremarkable. An echocardiogram revealed a dilated right atrium. Spirometry showed mild
airway obstruction. Duplex ultrasound showed a non occlusive thrombus in the left femoral and
popliteal veins.
1-What did pulmonar exam show?

13-A 41-year-old man with a weight of 159 kg and a body-mass index of 49.1 presented for
consideration of bariatric surgery. He had been morbidly obese since childhood, he had tried
several commercial weight-loss programs in addition to dieting on his own but he had had little
long-term success. The patient had a history of hyperlipidemia and had undergone
cholecystectomy. His medications included rosuvastatin. He was a current smoker and had a
remote history of excessive alcohol use and had been abstinent for 15 years. After consultation, he
decided to undergo Roux-en-Y gastric bypass.

1-Obesity onset, 2-Diets, 3-Cigarette smoking-drinking, 4-Was he operated?

14-A 34-year-old man with hearing impairment was admitted to this hospital because of
worsening renal function. The patient had been well until 11 weeks before when subjective fevers
with sweat, fatigue, decreased appetite and nausea developed. He initially attributed these
symptoms, which worsened over the next 2 months. Cough and shortness of breath on exertion also
developed during that time and the patient noted that his urine appeared foamy.
1-Chief complaint
2-Urine (what was it like)

15-A 57-year-old man was admitted to the hospital because of hypotension and tightness in the
chest. There was a 20-year history of episodic headache, flushing, lacrimation with syncope on
several occasions. On the day before admission he felt flushed, paresthesias of the fingertips,
orthostatic lightheadedness appeared. The chest discomfort subsided after 30 minutes.

1-chest tightness: 2-flushing: 3-lightheadedness:

16-There was no history of fever, chills, sweats, change in bowel habit, dyspnea, wheezing or other
indication of allergy, itching, diarrhea, heart murmur, seizures, bone pain or precipitation of
symptoms by medications.
⮚ ¿Cuál es el significado de ITCHING-SEIZURES and MURMUR?

17-A 55-year-old female was admitted because of acute respiratory distress and thrombocytopenia.
The patient had been in stable health until several weeks earlier, when an upper respiratory tract
infection developed, with vague, diffuse abdominal pain. On examination the patient was alert and

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 in severe respiratory distress, no petechiae, rash was found The carotid pulses were + + bilaterally,
without bruits. Lungs exam revealed coarse breath sounds, without crackles, rhonchi or wheezes.

Vocabulary work.
1-bruit 2-crackles 3-wheezes

⮚ Underline words: meaning

18-A 70-year-old male was admitted because of obtundation, aphasia and a right hemiparesis. He
had had a five-year history of treated hypertension. He felt well until one day before admission,
when he mentioned to his family that he had bruises around his leg veins.

What’s the meaning of the following:

1-treated hypertension
2-obtundation:
3-bruises:

19-A 15-year-old boy was referred to our institution for evaluation of abdominal pain of 4
months’duration. Previously healthy, he began to experience diffuse abdominal pain associated with
occasional episodes of nonbloody, nonbilious vomiting. At first he had constipation, which was
unrelieved by treatment with suppositories.

Write the meaning of NON and UN prefixes

1-nonbloody: 2-unrelieved:

*19-A 68-year-old woman presented to the clinic with a 40-year history of worsening
hyperkeratotic non-painful, non-pruritic papules and plaques on her hands and feet. Her mother,
son, and granddaughter had similar lesions.

1-What is the diagnosis?

20-A 25-year-old man was admitted because of hematemesis. He was well one year ago, when
[Link] gastrointestinal tract bleeding developed and the patient was informed of hepatic
[Link], no medical follow up was arranged. He was thin and appeared well and alert. No
[Link], spider angioma or palmar erythema was detected. The liver was not felt, the tip of the
[Link] was 3 cm [Link] the left costal margin.

1-¿Cuál fue el motivo de consulta? 3-Tip of the Spleen:

2-¿Qué significa “jaundice”?: 4-Spider angioma:
5-Passive Voice

21-1.A 34-year-old right-handed woman was admitted because of progressive both confusion and
[Link] loss. Two months before entry she was unable to sign checks reliably, although it was
[Link] whether the problem was related to her vision or confusion. She started to report a
[Link] right frontal headache.

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 1-Vocabulary work.
1-unable: 2-unclear:
2-¿Cúal es el NÚCLEO de la siguiente oración? Persistent right frontal headache
3-Nexos

22-A 72-year-old man was admitted because of a painful mass in the thigh. Three years earlier he
became aware of swelling in the posterior portion of the right thigh. Before entry the mass enlarged
progressively, he had local pain while sitting and after remaining seated for 30 to 60 minutes, he
experienced a sensation of “coolness” in the leg.
1-Focus on UNDERLINED words.
2-Marque el núcleo/s de PAINFUL MASS IN THE THIGH (ver Partes del Cuerpo )

23-A 22-year-old male, who was in good health prior to last night, his pain was colicky in nature,
periumbilical and rather sporadic. There were no episodes of coughing, shortness of breath or
burning in the epigastrium. The physical findings are related to the abdomen. Guarding, muscle
rigidity, rebound tenderness are all present.

⮚ Meaning of GUARDING and REBOUND TENDERNESS

24-This is a five-year-old female, who was admitted because of some nasal obstruction and sore
throat. The patient also has conjunctivitis with swelling and photophobia. She had had fever for the
last few days. There is no history of recent measles contact. The vital signs were within normal
limits. The child looked acutely ill, she was coughing and occasionally with bouts of sneezing. The
nasal mucous membranes are engorged and there is a heavy mucoid discharge coming from the
nose. Koplik’s spots are present in the mouth. The lungs are clear and there is moderate
splenomegaly.
1-¿Cúal fue el motivo de consulta?
2-¿Cómo estaban las membranas de las mucosas
nasales?
3-¿Qué tenía en la boca?
WRITE the meaning of the underlined words

25-A 61-year-old man was admitted to the hospital because of abdominal pain and a mass in the
right side of the abdomen. Six weeks earlier he developed a crampy pain in the lower portion of the
abdomen. Before entry, the episodes of abdominal pain became more severe. He experienced
anorexia, constipation and abdominal pain. He used milk of magnesia and magnesium citrate in an
attempt to relieve his symptoms.

1-Why did he use milk of magnesia?

2-What is the meaning of “crampy pain”?
3-Find verbs.

26-This is a 42-year-old male, who comes in with a chief complaint of vomiting of 3 days’duration.
2-He has vomited ten to fifteen times per day over the past 3 days. The material has been described
3-as whitish and thick without blood. The patient had been a heavy drinker over the past 10 years.
4-He experienced a boring pain, about seven to eight cm below the xiphoid. No history of chills or
5-bloating after greasy meals. Vital signs are within normal limits. His abdomen is tender to
6-palpation and there is voluntary guarding over the area previously described. Bowel sounds are
7-slightly hypoactive and the abdomen is not board-like.

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 ⮚ What´s the material like (line 2)?-------------------------------------------------------------------------
⮚ What's BORING pain?-----------------------------------------------------------------------------------
⮚ What´s BLOATING----------------------------------------------------------------------------------------

27-A 39-year-old man was admitted to the hospital because of acute leukemia. Epistaxis occurred
and required cauterization. Two weeks before entry, the fever resolved but the lymphadenopathy
increased, his gums became painful and bled intermittently. An ophthalmic exam yielded retinal
detachment involving the macula in the right eye. On the ninth day, the temperature rose to 39.5 ºC
with shaking chills, headache and slightly loose stools. Radiographs of the abdomen gave a
nonspecific pattern of bowel gas.

1-Ophthalmic exam
2-Abdomen X Ray
3-What were the stools like?

⮚ Meaning of SLIGHTLY LOOSE STOOLS_________________________________

28-An 11-year-old girl was evaluated at our institution because of visual loss in the right eye. One
2-month earlier, she had noticed decreased vision in the right eye, without pain, photophobia,
3-excessive lacrimation or discharge. Four weeks later on a routine school eye exam, leukokoria
4-was noted in the right eye, and a posterior fibrovascular lesion was seen. At that time visual
5-acuity was limited to light perception in the right eye, neovascularization of the right iris was
6-seen with a total exudative retinal detachment, the detached retina was displaced forward to the
7-posterior lens capsule and telangiectatic vessels were visible on the retinal surface.
8-The patient was born at full term and had met physical and developmental milestones. She had
9-no history of eye problem, a younger brother had strabismus which was treated with glasses and a
[Link] eye movements were full, with right hypertropia and exotropia present in the primary
11-glaze. On slit-lamp exam, the retina was totally detached and was in contact with the posterior
12-capsule of the lens.

1-¿Qué incluiría en el diagnóstico diferencial y

porqué?
2-Diagnóstico: Retinoblastoma- que sabe sobre este
tema? enumere lo + importante.
3-Subraye vocabulario específico de oftalmología.
4-¿Qué significa lo siguiente?
Línea 8-developmental milestones:
Línea 11- on slit lamp exam:

Difference between DETACH y DISPLACE ______________________________________

29-A 30-year-old man came to the Orbital Center, Amsterdam, Netherlands, with a painful swelling
2-of the left lacrimal gland. The swelling had begun 3 months earlier, accompanied by
inflammation 3-and ptosis of the upper eyelid. He was treated with amoxicillin for bacterial
dacryoadenitis

87
 4-years earlier, he recalled an episode of similar swelling of both upper eyelids with blurring of his
5-sight. On examination, a well-demarcated lump in the left temporal upper eyelid was noted.
6-Orbital CT disclosed a mass confined to the left lacrimal gland without bone destruction. Fine-
7-needle aspiration biopsy of the mass showed reactive inflammatory cells.

1-¿Cúal es el motivo de consulta?

2-¿Qué mostró la CT ?
3-¿Qué medicación fue indicada 12 años antes?
4-¿Qué recordó en la línea 4?
5-Significado de “a well-demarcated lump”L 5

30-A 69-year-old man was admitted to the hospital because of severe abdominal pain. The patient
had become anorectic two days before admission. He had diffuse, dull abdominal pain with nausea
and “dry heaves”. That evening he passed a formed brown stool followed by flatus. The patient
had a complex medical history of repeated bouts of deep venous thrombosis, hypertension and a
stroke that had occurred many years earlier, followed by chronic congestive heart failure as well
as a cerebral transient attack. On examination he was an overweight man who appeared mildly ill. A
surgical scar was present over the left carotid artery, without bruit. Breath sounds were diminished
over both lungs, with dry crackles. Multiple gallstones were seen within the gallbladder. There
were multiple loops of fluid-filled small bowel. Haziness of the small-bowel mesentery in the right
lower quadrant suggested the presence of an inflammatory process or edema.
● Vocabulary: DICTIONARY WORK
1-dull pain: 4-dry heaves:
2-multiple gallstones: 5-dry crackles:
3-haziness: 6-loops of fluid-filled small bowel:

31-A 64-year-old man was admitted to the hospital because of hyperadrenocorticism. The patient
had a history of angina pectoris and had undergone five-vessel coronary-artery bypass surgery nine
years before admission. He had long-standing heartburn and had intermittent upper abdominal
pain that responded to ranitidine. Before admission he began to bruise easily, weakness, emotional
lability and peripheral edema developed. Tremor developed in his hands. Bouts of tachycardia and
bradycardia occurred and a dual-chamber electronic pacemaker was implanted. Three months
later he began to have dark stools with the subsequent development of fatigue, orthostatic
lightheadedness and hematochezia. Three days after discharge he was pale and had purpuric rash
over the lower abdomen and upper thighs. Passage of a nasogastric tube yielded no gross blood.

● Dictionary work, words in bold

32-A 4-year-old boy was transferred to this hospital because of hypoxemia of unknown origin. The
child’s fever subsided within 24 hours. Auscultation of the chest revealed wheezing in the left lung
and there was a grade 2/6 systolic ejection murmur at the left sternal border. An attempt was made
to obtain a high-resolution CT of the chest, but the patient became agitated and began crying. The
patient had been delivered at 38 weeks of gestation by cesarean section; his birth weight was 5.27
kg. His mother had had gestational diabetes. The infant’s parents were told that he had a heart
problem, which was not further explained. The boy often had shortness of breath with bottle-
feeding and increased respiratory effort with exertion. On physical exam, the boy was tall and

88
 gaunt. Examinations of the ears and throat showed no abnormalities. There was mild clubbing of
the fingers and toes. The heart was normal in size and the aorta and its branches were normal. There
was patchy atelectasis at the base of the right lung.
● The child´s fever resumed within 24 hours. True__False__
● A CT of the chest was performed.True__False__
● The doctors explained well the infant´s parents about a heart problem.True__False__

33-An 11-year-old boy was admitted because of recurrent abdominal pain. The child was born of a
2-full-term normal pregnancy and delivery, weighing 3.5 kg. His early growth and development
3-were normal. One month before entry, he experienced the onset of periumbilical, nonradiating
4-“squeezing” pain. The pain began without relation to food intake, sometimes awakened him
5-during night and was relieved by nothing but improved temporarily by defecation. He started to
6-pass one soft stool every day without blood. Physical exam revealed mild lower abdominal
7-tenderness. An abdominal ultrasonographic study disclosed no stones within the gall-bladder.
8-Ferrous sulfate and a low-fat diet were prescribed, but brief bouts of mild abdominal pain
9-resumed. The oral intake was withheld. After a week after discharge abdominal pain recurred
10-with 6 to 10 bouts daily and were unrelated to meals. During the ensuing six weeks brief
11-fits of colicky abdominal pain resumed and increased in frequency.

Answer the information related to paragraph 33

1-Tipo de parto al nacer
2-¿Qué clase de dolor experimentó antes de ser admitido?
3-¿Qué reveló el exámen físico?
4-¿Qué estudios adicionales se le realizaron?
5-¿Qué sucedió con la ingesta oral?

Verbs (dictionary work)

1-awakened (Línea 4) 2-relieved (L5) 3-withheld (L9)
4-ensuing (L10) 5-resumed (L 11) 6-to pass soft stool (L6):

⮚ What kind of pain is “squeezing pain”?__________________

34-1-A boy six years and a half was admitted because of sexual precocity, polyostotic fibrous
2-dysplasia and café-au-lait spots. He was born after a 37-week, uncomplicated pregnancy to a 23
3-year-old primigravida, he was delivered by cesarean section because of failure to progress and
4-a decrease in the heart rate noted on the fetal monitor, the birth weight was 2.66 kg and reached
his
5-his milestones at appropriate ages, he walked at 11 months and toilet-trained at 2 and a half years.
6-He reported pain in the leg and limped when he was tired.
7-The extremities were normal except for striking bowing of the proximal femur. Ankle jerks were
8-++, the gait was normal despite the discrepancy in the leg length. A skeletal survey disclosed a
9-lesion of the proximal femur, 4 cm in length, that had a ground-glass appearance with well
10-defined, slightly osteosclerotic margins.

89
 ANSWER THE FOLLOWING related to text N°34
1-Motivo de consulta
2-¿Porqué nació por cesárea?
3-¿A qué edad controló esfínteres?
4-¿Cómo se traduce? He was delivered by cesarean section (L3)

VOCABULARY development-USE THE GLOSSARY

1-reached his milestones (Line 5)
2-café-au-lait spots (Line 2)
3-pain in his leg and limped (Line 6)
4-striking bowing (Line 7)
5-skeletal survey (Line 8)
6-ground glass appearance (Line 9)

35-A 21-year-old woman presented to the emergency department with an 8-month history of
swelling and pain in the right thigh. MRI of the right leg revealed a large periosteal femoral mass
and thrombus in the right femoral vein, for which she received anticoagulation therapy. The patient
subsequently experienced shortness of breath and pleuritic chest pain, and a chest x-ray was done.
1-What is the likely diagnosis?
1-Pulmonary embolism
2-Pulmonary sarcoidosis
3-Eosinophilic granulomatosis with polyangiitis
4-Chondroblastic osteosarcoma
5-Miliary tuberculosis

36-A 19-year old woman was transferred to this hospital because of nausea, jaundice and itching.
She had been well about 2 weeks earlier, when malaise, vomiting and upper respiratory symptoms
developed, which resolved after 3 days. She realized darkening of her skin and itching and dark
urine as well. She reported she took pseudoephedrine and tablets containing acetaminophen, aspirin
and caffeine. When her mother brought her to the Emergency Department, she had generalized
malaise, decreased appetite and weight loss. On the exam, the vital signs were normal, the
conjunctivae and skin were icteric, the remainder of the exam was normal.
1- Was she aware about her skin?

37-A 47 year-old woman was seen in the Rheumatology Clinic because of numbness and pain in
both legs and a rash. She said she had seen a Rheumatologist and reported dry eyes (for which she
used cyclosporine eye drops) and numbness, tingling, and color changes in her fingers in
conditions of extreme cold without digital pallor. She had had chicken-pox in childhood, mild
hypertension for 10 years and ruptured appendix with peritonitis 15 years earlier. Her mother and a
maternal relative had Sjögren’s syndrome and had died of interstitial lung disease, her father had a
neuropathy when he was elderly. An older sister had been reported to have “vasculitis”.
1-Vocabulary work

90
38-A 30-year-old man presented to the ED with a two day history of fever, sore throat and
progressive difficulty swallowing. His medical history included recurrent tonsillitis, which had
been treated with antibiotics; he smoked 15 cigarettes a day. On initial examination he had
tachycardia and fever. The remainder of his respiratory and cardiovascular examination was normal.
Oropharyngeal exam disclosed a swollen uvula and enlarged red tonsils without pus. There was no
lip or tongue swelling and no obvious rash. Ten minutes later he developed progressive worsening
stridor. He was unable to complete the sentences and was drooling. A wheeze was present
throughout his chest.
1-Let´s remember: swallow-choke-chew
2-Vocabulary in bold.

39-A 73-year-old man with multiple chronic mental illnesses was admitted to this hospital because
of confusion and irritability. Two days prior to admission, increasing weakness, lethargy, chills and
diarrhea developed. The patient became not only less responsive to his family but also irritable and
confused. He stopped taking medications. On the day he was admitted his oral intake was 500 ml
of liquid. His family reported that he was in a “almost catatonic” state, he was unable to arise from
bed, had recurrent epistaxis and reported pain in both his chest and left arm. The patient had been in
poor health, with a recent diagnosis of atypical pneumonia, which was treated with levofloxacin, he
also had Diabetes Mellitus, atrial fibrillation, coronary artery disease, diastolic heart failure and
pulmonary hypertension.
1-vocabulary work
2-find connectors

40-A 67-year-old woman presented to the ED with increasing dyspnea and chest wall tenderness.
Two hours before the presentation, she choked on her food while at dinner and received repeated
attempts at the Heimlich maneuver with successful dislodgement of a piece of ham. The choking
episode lasted 10 seconds, during which the patient was unable to speak. She has a history of
hypertension and gastroesophageal reflux disease as well. On arrival she was dyspneic and in
respiratory distress. A 12-lead electrocardiogram yielded normal sinus rhythm without acute ST or
T-wave changes. The patient received a chest X ray and a computed tomographic scan of the chest.
1-Chest X Ray, CT scan results and others.
2-Describe the choking episode.

Updated COVID case reports (A, B, C and D)

A-Three adult patients presented with severe pneumonia and were admitted to a hospital in Wuhan
on December 27, 2019. Patient 1 was a 49-year-old woman, Patient 2 was a 61-year-old man, and
Patient 3 was a 32-year-old man. Clinical profiles were available for Patients 1 and 2. Patient 1
reported having no underlying chronic medical conditions but reported fever (temperature, 37°C to
38°C) and cough with chest discomfort on December 23, 2019. Four days after the onset of illness,
her cough and chest discomfort worsened, but the fever was reduced; a diagnosis of pneumonia was
based on a computed tomographic (CT) scan. Her occupation was a retailer in the seafood
wholesale market. Patient 2 initially reported fever and cough on December 20, 2019; respiratory
distress developed 7 days after the onset of illness and worsened over the next 2 days, at which
time mechanical ventilation was started. He had been a frequent visitor to the seafood wholesale
market. Patients 1 and 3 recovered and were discharged from the hospital on January 16, 2020.
Patient 2 died on January 9, 2020. No biopsy specimens were obtained.

91
 Clinical profiles + vocabulary (in bold)
Patient 1 Patient 2 Patient 3

B-A 69-year-old man with a history of hypertension, diabetes, and stroke presented with fever,
cough, shortness of breath, diarrhea, and headache. Covid-19 was diagnosed in the patient on
January 25, 2020, on the basis of RT-PCR testing that detected SARS-CoV-2. The initial treatment
was supportive; however, the illness subsequently progressed to hypoxemic respiratory failure
warranting the onset of invasive mechanical ventilation. The patient had evidence of ischemia in
the lower limbs bilaterally as well as in digits two and three of the left hand. Computed tomographic
imaging of the brain showed bilateral cerebral infarcts in multiple vascular territories.
1-How was Covid diagnosed?
2-Did the patient start with mechanical ventilation?
3-Studies and connectors

C-Four patients with COVID-19 who met criteria either for hospital discharge or discontinuation
of quarantine in China (lack of clinical symptoms and radiological abnormalities and 2 negative
RT-PCR test results) had positive RT-PCR test results 5 to 13 days later. These findings suggest
that at least a proportion of recovered patients still may be virus carriers. Although no family
members were infected, all reported patients were medical professionals and took special care
during home quarantine. Current criteria for hospital discharge or discontinuation of quarantine and
continued patient management may also need to be reevaluated.

1-Find connectors and underline them, 2-find the meaning of the words in bold.

D-On February 20, 2020, a patient in his 30s admitted to the intensive care unit (ICU) in Codogno
Hospital (Lodi, Lombardy, Italy) tested positive for a new coronavirus, severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2). He had a history of atypical pneumonia that was not
responding to treatment, but he was not considered at risk for COVID-19 infection. The positive
result was immediately reported to the Lombardy health care systems. In the next 24 hours, the
number of reported positive cases increased to 36. This situation was considered a serious
development for several reasons: the patient (“patient 1”) was healthy and young; in less than 24
hours, 36 additional cases were identified, without links to patient 1 or previously identified positive
cases already in the country; it was not possible to identify with certainty the source of
transmission to patient 1 at the time; and, because patient 1 was in the ICU and there were already
36 cases by day 2, chances were that a cluster of unknown magnitude was present and additional
spread was likely.

1-Describe patient 1, 2-The situation after 24 hours, 3-Was it possible to find the source of
transmission, 4-Why was the situation considered a serious development?

E-A previously healthy 39-year-old woman who was vaccinated with ChAdOx1 nCoV-19,
presented to the emergency department with abdominal pain and headaches 8 days after
vaccination. A mild thrombocytopenia was revealed. An abdominal ultrasound examination was
normal, and she was discharged. The headaches increased in intensity, and she returned to the ED 2
92
days later. Cerebral CT with venography yielded massive thrombosis in the deep and superficial
cerebral veins and right cerebellar hemorrhagic infarction. The platelet count was 70,000 per cubic
millimeter. She was afebrile and had neither signs of infection nor neurologic deficits. Treatment
with dalteparin (200 IU per kilogram per day), prednisolone (1 mg per kilogram per day), and
intravenous immune globulin (1 g per kilogram per day for 2 days) was started. The platelet count
was normalized within 2 days . Follow-up CT venography showed recanalization in the affected
cerebral venous sinuses. When she was discharged after 10 days, the symptoms had resolved. Her
anticoagulation treatment was changed from dalteparin to warfarin, and treatment with
prednisolone was resumed in tapering doses.

1-Motivo de consulta
2-Enumere los estudios realizados

3-¿Qué medicación tomó?

4-Seguimiento
5-¿Qué sucedió cuando recibió el alta?

93
 READING MATERIAL
classified advertising /ads

1-LEA atentamente lo siguiente y luego realice los ejercicios.

1-¿Qué significa CLASSIFIED ADVERTISING?___________________________________
2-Que ofrece el Northwell Health? en que ciudad de los Estados Unidos está?_______________
3-Importancia del lugar _______________________________________________________
________________________________________________________________________
4-Requisitos_______________________________________________________________

General Urology at Northwell Health

Our urological health services at Northwell Health are seeking a General Urologist for two
years.

Location: Westchester, New York. The Department of Urology

Our physicians have vast experience in minimally invasive procedures to treat all urologic diseases
including those affecting the bladder, kidneys, male genitalia, and prostate.

Qualifications:
*MD Degree or equivalent from an accredited College of Medicine.
*Completion of Residency with Board Certification or eligibility.
*Outstanding communication and management skills and an ability to work
collaboratively with medical staff and hospital management.
*Must possess recent experience in generally accepted and currently used
methods and techniques regarding Urologic diseases

All candidates will receive competitive salaries, a comprehensive benefits package

:housing and vacation.

*Send the Curriculum vitae to Office of Physician Recruitment, Northwell Health:

OPR@[Link]

2-FIND and explain the difference between a CV and a COVER LETTER,

[Link], word [Link]
4-SEND an EMAIL (written in English), asking for information (salary, housing and vacation)

94
 WRITING and ANSWERING EMAILS
⮚ TIPS for WRITING and ANSWERING/ REPLYING /FORWARDING emails

ESTRUCTURA DE UN EMAIL FORMAL EN INGLÉS

1) Greeting(SALUDO), 2) Cuerpo, 3) Cierre, 4) Despedida y EDICION: revisar antes de

enviarlo, check: spelling and grammar

Se usa letra 12, tipo de letra más usado: TIMES NEW ROMAN, CALIBRI. CAMBRIA,
ARIAL Y VERDANA

1-SALUDOS EN UN EMAIL FORMAL

Si conocemos a la persona a la que nos dirigimos, empezamos con estos saludos:

– Dear Mr. Woods,

– Dear Ms. Green, (hoy no se usa el estado civil del destinatario)

Si no le conocemos, nos tenemos que dirigir con saludos menos personales. Estos saludos se
utilizan sobre todo en cartas de reclamos o cuando tenemos que pedir información.

Dear Sir/Madam,

To whom it may concern,

2-CUERPO DEL EMAIL FORMAL

Avanzamos con el desarrollo del cuerpo del email, teniendo en cuenta el propósito de la carta.

La forma más corriente de empezar es con un “I am writing to…” seguido por nuestra finalidad,
que podría ser:

1-Agradecimiento – I am writing to thank you for…

2-Pedir Información – I am writing to ask/inquire about…

3-Dar Información – I am writing to inform you that…

4-Seguimiento – I am writing to follow up on…

5-Respuesta – I am writing in response to…

6- dar agradecimiento desde el principio:Thank you for…I (we) would like to thank you for…

95
7-Y si queremos pedir ayuda: I would be grateful if you could…Would you mind…?

8-Y para ofrecer ayuda: I (we) would be happy to…I (we) would be pleased to…

9-Pedir disculpas: Sorry, I could no send the summary on time, is it posible to send it …

I’m afraid I won´t be able to attend/ write back/ meet…

3-CIERRE DE UN EMAIL FORMAL EN INGLÉS

Agradecimiento
· Thank you once more for…
· I (we) would like to thank you again for…

Reunión en el Futuro Próximo

· I (we) look forward to meeting / seeing you…

Ofrecer Ayuda
· Please do not hesitate to contact me if you have any questions regarding this matter.
· If you need any further assistance, please contact me.

4-DESPEDIDAS EN UN EMAIL FORMAL

* Si no conocemos al destinatario, utilizamos: Yours sincerely, Yours faithfully,

*Si conocemos al destinatario, utilizamos: Best regards, Best wishes, Sincerely, Cordially,

*Emails in English are EASY TO READ, SPECIFIC and TO THE POINT

1-Dear Dr/ Mr/ Mrs……..,

We have read your article on “Risk factors for early recurrence after Ischemic Stroke”, published in
………Journal, August [Link] are just working on that topic. The article was excellent and it was
most helpful. Is there any possibility you could send me/ us more references about this topic/ issue?
Thanks in advance,
Cordially,

2-Dear Mr/ Mrs/ Dr……,

I am so (deeply) interested in your article on “TAMOXIFEN’S RISKS” published in Obstetrics and
Gynecology”, Jan 2023. I would very much appreciate if you could send us more information
related to this topic.
Looking forward to a favorable reply,
Respectfully,
Dr…………………………………………………………

96
 ANSWERING emails
1-Dear Dr……..,
Thank you for getting in touch with me and sending the review on “Breast Cancer” I was interested
in, it was most helpful.
Sincerely,
DR……………………………………………………….

2-Dear Sir, I would like to know about “SURGISIS” (A Surgical mesh for tissue reinforcement).
Please let me know about cost and shipping,
Thanks in advance, let’s keep in touch.
Cordially,

3-Dear Dr Evans, Sorry I won’t be able to send you the Abstract related to “End-stage Renal
Disease” I have promised for Monday morning. Could it be possible to send it to you in one week?
Thanks a lot and sorry for all the inconveniences,
Sincerely,

EXAMPLE:

Subject: Inquiry about article on [topic of article]

Dear Dr. [Doctor's last name],
I am writing to you today to inquire about an article you recently authored on [topic of article]. I
found the article to be very informative and I am particularly interested in learning more about
[specific aspect of the article].
I would be grateful if you could provide me with some additional information on [specific aspect of
the article]. Perhaps you could share some resources or references that you found helpful during
your research.
Thank you for your time and consideration.
Sincerely,
[Your name]

READING MATERIAL
ACUTE PULMONARY EMBOLISM (PE)

READ the paragraph and ANSWER the questions

Definition: PE can be classified as acute or chronic. Patients with acute PE typically develop
symptoms and signs immediately after obstruction of pulmonary vessels. In contrast, patients with
chronic PE tend to develop slowly progressive dyspnea over a period of years due to pulmonary
hypertension.
Clinical Manifestations: Leg pain, warmth or swelling may serve as a clue that a patient has deep
venous thrombosis. Patients with PE often have dyspnea or chest pain, either sudden in onset or
evolving over a period of days to weeks. Pleuritic chest pain and hemoptysis occur more often in
patients with pulmonary infarction, which is characterized by smaller, more peripheral emboli and
in such patients, a pleural rub may be evident. Symptoms of cough, palpitations and light-
headedness and signs including fever, wheezing and rales may result from pulmonary embolism or
from concomitant illnesses. Tachycardia and tachypnea are common.
Treatment: anticoagulation is the mainstay of therapy for acute PE. If PE is confirmed,
thrombolytic therapy should be considered. Long-term anticoagulation is indicated for patients with
confirmed [Link] who have contraindications or develop complications to anticoagulation (e.g.

97
 severe bleeding) should have an inferior vena cava filter placed instead. (N Engl J Med, Lancet
2023)

1-¿Qué significa PE?_________________________________________________________

2-Un paciente con PE________________________________________________________
3-Síntomas________________________________________________________________
4-Tratamiento y terapia efectiva__________________________________________________

CHECK YOUR VOCABULARY

A-WORDS RELATED TO BLOOD
Blood vessel: Blood clotting:
Blood cell: Draw /Withdraw blood:
Blood casts: Blood loss:
Blood culture: Blood sugar level:
Blood platelet/plasma: Blood type:
Blood transfusion: Bloodstream:
Blood count: Bloodshot:
Blood sample: Blood pressure:
Packed red cells: Blood smear:

B-DIFFERENT TYPES OF BLOOD

Fresh blood: *Exchange blood: p transfusión se usa poco
Frozen blood: *Reused blood
Clotted blood sangre coagulada *Thick blood: exámen por gota gruesa
Altered blood: Anticoagulated blood
*Se usan poco Hemolyzed blood:

C-DIFFERENT ILLNESSES
Measles: Small-pox:
Chicken-pox Jaundice:
Influenza-flu/a cold: Mumps:
Whooping cough: Goitre / goiter:
Scarlet fever: Gout:
Note: gait : marcha-waddling gait: de pato

98
 QUARANTINABLE DISEASES

1-CHOLERA 5-YELLOW FEVER

2-DIPHTHERIA 6-VIRAL HEMORRHAGIC FEVERS
3-INFLUENZA that can cause a Pandemic 7-SEVERE ACUTE RESPIRATORY
SYNDROMES
4-INFECTIOUS TUBERCULOSIS 8-SMALLPOX

* source: Centers for Disease Control and Prevention. Legal authorities for isolation and quarantine.

D-WORDS ENDING IN "NESS"

1-Blindness: 13-Lightheadedness:
2-Breathlessness: 14-Listless:
3-Clumsiness: 15-Numbness:
4-Coolness: 16-Rebound tenderness:
5-Deafness: 17-Redness:
6-Dizziness: 18-Restlessness:
7-Drowsiness: 19-Shortsightedness:
8-Dullness: 20-Clamminess:
9-Fullness: 21-Stiffness:
10-Giddiness: 22-Tenderness:
11-Haziness: 23-Tightness:
12-Hoarseness: 24-Weakness:

E-ORGANS
Skin: Brain:
Kidney: Bladder:
Lungs: Liver:
Large /small intestine/ Gut/ Bowel: Gallbladder:
Spleen: Heart:

F-Find out the meaning of the words below related to different types of PAIN?

1-Acute: 10-Crampy:
2-Colicky: 11-Throbbing (headache)
3-Knife-like: 12-Fleeting:
4-Rib: 13-Labor pain:
5-Stabbing: 14-Pressing:
6-Boring: 15-Referred:

99
7-Piercing (acute): 16-Localized:
8-Squeezing: 17-Burning:
9-Radiating-Spreading: 18-Dull-nagging:

Questions related to PAIN!!!!!!

● Site: Where exactly is the pain?

● Onset: When did it start, was it constant/intermittent, gradual/ sudden?

● Character: What is the pain like? What kind of pain is it? Is it continuous? sharp,
burning?

● Radiation: Does it radiate/move anywhere?

● Associations: Is there anything else associated with the pain, e.g. sweating, vomiting.

● Time course: Does it follow any time pattern, how long did it last?

● Medication: Have you taken anything for it?

● Exacerbating / relieving factors: Does anything make it better or worse?

● Severity: How severe is the pain, consider using the 1-10 scale?

G-DIFFERENT TYPES OF FEVER

Hay fever: Tick fever (bites from ticks):
Yellow fever: Hectic fever (Tuberculosis):
Trench fever (rickettsia): Typhoid (caused by salmonella):
Pel -Ebstein fever (brucelosis):

I -MEDICAL PRESENTATION
Tablets: Syrup: Pellet:
Pills: Ampul: Pastille:
Powder: Blister: Cream:
Ointment: Lozenge: Gel:

100
 PARTS OF THE HUMAN BODY
⮚ FROM THE NECK UP.
Hair: hair line: Skull: Crown of the head:
Face: Forehead: Temples:
Eye: Eyebrow: Eyelashes:
Eyelid: Eyeball: Lens:
Blind spot: Pupil: Iris:
Cornea: Cheeks: Cheekbone:
Nose: Nostrils: Bridge of the nose:
Mouth: Tongue: Upper-lower lip:
Gums: Jaw: Tooth (plural: teeth):
Chin: Throat: Palatine tonsils:
Nape: Neck: Hollow of the throat:
Ears: Ear lobes: Complexion:

⮚ FROM SHOULDER TO FINGERTIPS.

Shoulder: Shoulder blade: Arm:
Upper arm: Armpit: Forearm/ underarm:
Elbow: Chest: Breast:
Nipple: Areola: Breastbone:
Hip: Navel: Stomach:
Waist: Loin: Back:
Hand: Finger: Palm:
Thumb: Index finger: Middle finger:
Ring finger: Little finger: Finger pad:
Finger tip: Fingernails: Knuckle:
Wrist: Fist:

⮚ FROM THE BOTTOM DOWN.

Knee: Kneecap: Shin/shinbone:
Thigh: Ankle: Heel:
Foot-feet: Instep: Sole of the foot:
First/big toe: Second/long toe: Third toe:
Fourth toe: Little toe: Toenails:
Groin: Buttock: Calf (plural:calves):

101
�UNLESS: se traduce A MENOS QUE, UNLIKE: se traduce A DIFERENCIA DE

1- Label the human body diagram using this word list below.
(Adapted from [Link]-Human Body images)

Ankle Ear Hand Leg shoulder

arm elbow head lips blade
breastbone eye heel loin thigh
calf fingers hip mouth tongue
chest foot instep navel toes
chin forehead kneecap nose waist
cheekbone neck wrist
shin

102
 Building Covid-19 vocabulary, MARQUE el núcleo / s

1-Coronavirus (Covid-19) outbreak 9-Social, preventive and compulsory isolation

2-Proper Hand hygiene and face 10-ICU beds and ventilators

masks
3-Case fatality rate 11-First pneumonia cases of unknown origin

4-Seasonal pattern 12-Key workers

5-Angina-related symptoms 13-Specimen with nasopharyngeal swabs

6-Herd Immunity 14-Critically ill coronavirus patients

7-Flatten the curve 15-Coexisting lower respiratory bacterial

infections

8-Intravenous antibiotic therapy 16-The average infected person

GUÍA RÁPIDA PARA LEER UN ARTÍCULO

READ the following:
1-TITLE and copyright page.
2-AUTHOR/ S- AUTHOR’S e-mail.
3-DATE OF PUBLICATION (ayuda a determinar si el contenido es actualizado )
4-CHECK if the text contains:
*FORMATO TIPICO: (Abstract) v, Introduction, Background, Methods, Results, Discussion
and Conclusión .Cómo escribir una conclusión para un trabajo científico
*TIPOGRAFIA el uso de negrita o cursiva, MAYÚSCULA, subrayado, etc
El texto tiene:
*TABLE OF CONTENTS (tabla de contenidos) al comienzo o al final?
*REFERENCES?
*a GLOSSARY?
*BIBLIOGRAPHY?
*CHARTS and GRAPHICS ?
*End of CHAPTER QUESTIONS?
*SUMMARY(resúmen) ayuda a la profundidad con que ha sido tratado el tema.

103
 WORD FORMATION Adapted from Abbreviations Booklet- Medical Dictionary-Peter Collins
A (an) Without
Ab Away from
Ad Toward
Al Pertaining to: relacionado a
Algia Pain
Angi/o Blood vessel
Antero Latin pref: anterior, front.
Arthr/o Joint
Bradi Slow
Blephar/o Eyelid
Caud/o Tail or down.
Centesis Puncture and aspiration of
Cephal/cephalon Head
Cheil/o Lip
Cho/o, chol/e Bile, gall
Chondr-chondro Cartilage
Colp/o Vagina
Cost/o Rib
Cyan/o Blue, lack of oxigen
Cyst/o Bladder
Cyt/o Cell
Denti-dent-odont-odonto Teeth
Derm/o Skin
Diplo Two
Dys Bad or painful
Ectomy Surgical removal, excision.
Emesis Vomit
Emia Condition of the blood
End/o Inside
Enter/o Intestines
Erythr/o Red
Gloss/o Tongue
Graphy Process of recording
Hem/o Blood (vessel).
Hemat/o Blood (tissue).
Hepat/o Liver
Hidro Water
Hist/o Tissue.

104
Hyper Above normal
Hypo Below normal
Hyster/o Uterus
Ic Pertaining to
Ile/o Ileum
Inter Between
Intra Within
Irid/o Iris
It is Inflammation
Kerat/o Cornea
Larar/o Abdomen
Leuk/o White
Lith/o Stone, calculus.
Mast/o Breast
Megaly Enlargement
Men/o Menstruation
Metr/o Uterus
Myel/o Spinal cord, bone marrow
My/o Muscle
Nephr/o Kidney
Neur/o Nerve
Oid Resembling
Ologist Specialist
Ology Study of
Oma Tumor
Oophor/o Ovary
Ophthalm/o Eye
Orchi/o Testicle, testis
Orrhagia Rapid discharge
Orrhaphy To suture
Orrhea Discharge
Osis Abnormal condition
Oste/o Bone
Ostomy Creation of an artificial opening
Ot/o Ear
Otomy Surgical incision.
Patell/o Patella
Path/o Disease

105
Peri Around
Phleb/o Vein
Plasty Surgical repair
Plegia Paralysis, stroke.
Pnea Respiration, breathing.
Proct/o Rectum
Pyel/o Renal pelvis
Ren/o Kidney
Rachi/ rachio Spine
Retin/o Retina
Retro Behind, at the back
Rhin/o Nose
Rhiz/ rhizo Root
Sacchar Sugar
Salping/o Fallopian or uterine tube
Sarc/ sarco 1-flesh, 2-muscle
Scat/ o Feces, stools
Sclerosis Hardening
Scopy Visual examination
Scoto Dark
Ser/ o 1-blood serum, 2-serous membrane
Sidero Iron
Sigmoid/o Sigmoid flexure
Splen/o Spleen
Steno 1-Narrowing, 2-constricted
Stern/o Sternum
Steth/o Chest
Stomat/o Mouth
Sub Under or below.
Supra Above
Tachy Fast
Talo Ankle bone
Thorac/o Chest
Tonsill/o Tonsil
Thromb/o Clot
Trich/o Hair
Toxico Poison
Trophy Development
Urin/o Urine

106
Ven/o (Phleb/o) Vein
Viscer/o Internal organs
Xanth Yellow
Xero Dry

107
108
GLOSSARY

109
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