تدريب Shadowing: Renal Colic History | OSCE Guide | UKMLA | CPSA | PLAB 2 - تعلم التحدث بالإنجليزية عبر الفيديو
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173 جمل
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1
Hi my name is Grace, I'm one of the medical students in A &E today.
2
Hello.
3
Hi, could I just confirm your name and date of birth?
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Yeah it's Imogen Mann, it's the 13th of August 91.
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Okay nice to meet you Imogen, how can I help you today?
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I've just been having this really severe pain in my lower back.
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It's like nothing I've ever experienced before. So yeah.
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Okay.
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Just before we begin, are you comfortable enough for me to be asking you some questions or do you need some painkillers?
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No, I've been given something.
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I'm still uncomfortable if I'm honest, but yeah, I'm happy to chat to you.
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Okay.
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If that changes Imogen's, just let me know because I want you to be comfortable.
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Okay.
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Thank you.
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Okay, Imogen.
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So you mentioned you've been having this pain.
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Do you want to tell me a bit more about your symptoms?
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Yeah, it just came on suddenly this morning in my side of my back.
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Yeah, just a really severe pain that I've never experienced before.
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Okay, and what does that feel like?
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It's like a cramping pain.
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Yeah, it's really awful.
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Okay, and I mean it sounds really uncomfortable.
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If you had to grade it on severity where 10 out of 10 was the worst pain, how would you place it on that scale?
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Definitely a 10 and I've got a pretty high pain threshold generally
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but like I say this is nothing I've ever experienced before.
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Okay and is it that all the time?
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No it sort of comes on in in waves is the best way to describe it but yeah it's awful.
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Yeah it sounds really uncomfortable.
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You mentioned that the pain is on the right hand side, where's that exactly?
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Like kind of my right lower back here.
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Is it going anywhere else?
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Yeah, it goes into the groin area.
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Okay, and have you noticed anything that makes it better or worse?
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No, I did take a couple of painkillers, but that didn't really do anything.
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And what did you take painkiller -wise?
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Cocodomol and ibuprofen.
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Okay, and what time was that?
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That was earlier this morning.
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Okay, and with this pain that you're having, have you noticed any other symptoms alongside it?
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It's so bad, it's making me feel sick when the pain comes on.
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Okay and have you been sick?
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I have yeah I've been sick twice this morning.
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Was there any blood when you were vomiting?
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I didn't know I didn't say anything like that no. Okay so it's definitely got you feeling quite unwell.
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Have you noticed any other symptoms?
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Um kind of my main worry is I think there's blood in my urine.
49
Okay can you describe that for me?
50
Um just the last two times I've been to the toilet for a week uh
51
it's been this like reddish color um which is obviously a worry okay
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so let me find out a bit more about that
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so the color of the urine you said it's reddish is it more in the pink kind of color
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or more like a deep dark red no more more pinkish
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yeah pinkish okay have there been any blood clots in the urine
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so any kind of red dots no okay and
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when you're going for a wee does that feel unusual at all no
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that that all feels fine all normal yeah okay so no burning or stinging
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No. Are you weeing more often than usual?
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No. And when you're peeing the flow of it does that feel okay?
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That's all normal yeah.
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Okay and obviously you're quite worried about the blood in your urine have you had blood in your urine before?
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No never.
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Okay so something new.
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Yeah.
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Have you noticed any other symptoms at all?
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No not that I can think of.
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Okay so you've woken up today
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and as you were getting ready you developed this severe pain that's coming in waves it's got you feeling sick
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and you've been sick a couple of times
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you've also had this probably blood in your urine a bit
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pinkish urine yeah let me just check for any other symptoms
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so specifically have you noticed a fever at all no okay
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and you talked about vomiting can i just check your bowels are there any changes
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there that's all been normal okay
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when did you last open your bowels uh yesterday evening okay have you been unwell recently with anything
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i've been absolutely fine until this came on this morning okay
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and just to double check any injuries
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you've not fallen onto this side at all no okay um
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have you had anything like this before in terms of the
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pain oh no never had anything like this before okay
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and recently have you been feeling more tired than usual
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or run down no have you lost any weight no
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and you've not mentioned this
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but just to double check any difficulty breathing any pains in your chest no it's all fine any feeling lightheaded
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or dizzy no
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and have you noticed any bleeding from anywhere else from your
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back passage for example no can i ask do you have periods no i've got the marina coil
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so i don't have periods fine and have you had any unscheduled bleeding with that no so
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what are your thoughts about what's going on um my initial thoughts are
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because where the pain is um possibly something to do with my kidneys my my worry is
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that you know with the blood in my urine and my first thoughts is cancer really, but I know I'm quite young, so I don't know.
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Yeah and I can understand why you might think cancer because that is sort of a red flag isn't it?
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There's lots of different causes for blood in the urine
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so we'll be doing some tests today but I just want to reassure you
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that there's lots of other things that could be the cause.
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Okay yeah thank you.
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Is there anything else specifically that you're worried about?
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The pain really, I'd say it's such a severe pain and I'm really worried about
100
that coming back on
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and to be honest
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I really need to get back to work as quickly as I can okay what do you do for work Imogen?
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I'm a police officer right okay
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so I'm guessing you're quite busy on your feet a lot yeah okay um
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you're here in A &E we're here to help you you've had some painkillers in terms of any specific things
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that you wanted us to definitely do in A &E today did you have anything in mind
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that I should know about um I guess just get the relevant tests um
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and get this sorted so I can get back on my feet
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and back to work as soon as I can yeah I think so especially with you being so uncomfortable.
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Yeah.
111
Okay.
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So Imogen, what I'm going to do now is ask you a few more questions about your background
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because I've not met you before.
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Do you have any other medical conditions?
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Yeah, I've got hypothyroidism.
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Okay.
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Anything else?
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No. Have you had any surgeries before?
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No. And have you ever had any scans of your tummy?
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No. Okay.
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Do you take medication?
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Yes, levothyroxine.
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Do you know what dose you take?
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150, I think it is.
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Okay.
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Do you take any other medications? um nothing more prescribed i occasionally take gaviscone
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but that's it okay and are you allergic to anything no are there any medical conditions
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that run in the family no and specifically in the family are there any bladder
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or kidney problems no okay
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and you mentioned already
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you're a police officer what's your living situation uh just live
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on my own okay do you smoke at all no do
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you drink alcohol um a couple of glasses of wine in a week okay
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and do you take any recreational drugs at all no okay
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so I'm just going to summarize back to you Imogen to make sure we've not missed anything
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so you've come to A &E today because you um you wake up
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and you develop this severe pain on the right hand side going into the groin yeah um
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it's coming in waves it makes you feel quite sick
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when it comes on and you've been sick a couple of times
140
and you've also noticed some pinkishness to your urine and you're worried
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that there's some blood there that's right you're worried
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this is something to do with your kidneys
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you were a bit worried about cancer although we know there's lots of different causes for blood in the urine
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and your main concerns the pain
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and getting back to work absolutely yeah okay is there anything you feel
146
that i've missed there no i think that's everything do you have any questions for me no okay in
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that case that's all my questions
148
so thanks for your time imogen thank you today
149
i spoke to imogen mann a 32 year old police officer
150
who is presented to the a e department with right -sided
151
lower back pain Imogen describes sudden onset day of episodic right -sided loin to groin pain
152
which has a severity of up to 10 out of 10.
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This pain is cramping and has been severe enough to cause vomiting.
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Imogen has also noticed two episodes of pinkish hematuria without clots.
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She doesn't have dysuria or fever.
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Imogen has a past medical history of hypothyroidism for which she takes levothyroxine.
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She has no other medical conditions and takes no other regular medications.
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She has no known drug allergies.
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Imogen lives alone.
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She drinks up to 10 units of alcohol per week.
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She doesn't smoke or take recreational drugs.
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Imogen suspected that this could be a kidney problem.
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She did have concerns that there could be a cancer given the blood in her urine.
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Her other concerns are the level of pain and that she wants to get back to work.
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Her expectations are analgesia and investigations in A &E.
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Based on the information gathered so far the most likely differential diagnosis here is renal colic due to a ureteric stone.
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Other possible diagnoses would be a palonephritis.
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To complete my assessment today I would perform an abdominal examination and check vital signs.
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I'd perform bedside tests including urinalysis and and urinary pregnancy test.
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I will check bloods, including full blood count, user knees and CRP.
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Based on the likely diagnosis, it would be appropriate to consider further imaging, such as a CTKUB.
172
Check out the GeekyMedics collection of over 1 ,000 OSCE stations.
173
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تنزيل التطبيق
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المفرداتابنِ رصيدك من الكلمات
لعبة المفرداتتعلّم أثناء اللعب
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المفردات وملاحظات التحدث لهذا الدرس
هذا الدرس في المحادثة مبني على الفيديو “Renal Colic History”. أكثر الكلمات تكرارًا في الفيديو: pain, imogen, blood, urine, noticed. يحتوي هذا الفيديو على 173 جملة و1799 كلمة للتدرب على الترديد. مدة الكلام 9:25. يتكلم المتحدث بسرعة، نحو 191 كلمة في الدقيقة، لذا ستسمع كثيرًا من وصل الكلمات واختزال الأصوات. 84% من الكلمات ضمن أكثر 3,000 كلمة شيوعًا في الإنجليزية، ويُستحسن مراجعة الباقي قبل البدء. 31 من أصل 173 جملة هي أسئلة، لذلك يناسب التدرب على نبرة السؤال والإجابات القصيرة.
أهم المفردات في هذا الفيديو
15 كلمة من الفيديو تستحق التعلّم، مع النطق والمعنى:
| الكلمة | النطق | المعنى |
|---|---|---|
| urine اسم | /ˈjʊɹɪn/ | بَوْل |
| symptom اسم | /ˈsɪm(p)təm/ | عَرَض, عَلَامَة |
| uncomfortable صفة | /ʌnˈkʌm.fɚ.tə.bl̩/ | غَيْر مُرِيح |
| kidney اسم | /ˈkɪdni/ | كُلْيَة |
| diagnosis اسم | /daɪəɡˈnəʊsɪs/ | تَشْخِيص |
| medication اسم | /mɛdɪˈkeɪʃən/ | دَوَاء |
| vomit فعل | /ˈvɑmɪt/ | تَقَيَّأَ, قَاءَ |
| awful صفة | /ˈɔːfʊl/ | فَظِيع, أَرْبَد |
| fever اسم | /ˈfivɚ/ | حُمَّة, حُمَّى |
| bleed فعل | /ˈbliːd/ | نَزَفَ |
| severity اسم | /səˈvɛɹ.ə.ti/ | صَرَامَة |
| bowel اسم | /ˈbaʊ.əl/ | أَمْعَاء غَلِيظَة |
| assessment اسم | /əˈsɛsmənt/ | تَقْيِيم |
| alongside | /əˌlɔŋˈsaɪd/ | تَزَامُنًا |
| confirm فعل | /kənˈfɝm/ | أَكَّدَ, أَثْبَتَ |
الأفعال المركبة التي ستسمعها
| الكلمة | النطق | المعنى |
|---|---|---|
| wake up فعل | /ˌweɪk ˈʌp/ | صَحَا, اِسْتَيْقَظَ |
جمل تستحق التكرار
جمل قصيرة وكاملة من الفيديو يمكنك استخدامها في الحديث اليومي:
- Was there any blood when you were vomiting?
- Have you noticed any other symptoms?
- Are you weeing more often than usual?
- Have you noticed any other symptoms at all?
- Is there anything else specifically that you're worried about?
القواعد في هذا الفيديو
أكثر التراكيب التي يستخدمها المتحدث، مع العبارات نفسها من الفيديو:
| التركيب | في الفيديو |
|---|---|
| المضارع التام المستمر have/has been + -ing — حدث بدأ سابقًا وما زال مستمرًا | I've just been having · you've been having |
| المضارع التام have/has + اسم المفعول — حدث ماضٍ ما زال له أثر الآن | I've ever experienced · I've been given · I've never experienced |
| المبني للمجهول be + اسم المفعول — التركيز على ما يحدث لا على من يفعله | I've been given · is presented |
نطق يحتاج إلى انتباه
يستخدم المتحدث 56 من الصيغ المختصرة، مثل I've, I'm, you're. انطقها بصيغتها القصيرة كما تسمعها.
- أصوات “th”: breathe /bɹiːð/, gather /ˈɡæðɚ/, threshold /ˈθɹɛʃ(h)oʊld/, hypothyroidism /ˌhaɪpəˈθaɪɹɔɪˌdɪzəm/, levothyroxine /ˌli.voʊ.θaɪˈɹɑkˌsin/
- أصوات “sh” و“zh”: medication /mɛdɪˈkeɪʃən/, unusual /ʌnˈjuːʒ(u)əl/, occasionally /əˈkeɪʒənəli/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, threshold /ˈθɹɛʃ(h)oʊld/
- الكلمات الطويلة — انتبه لموضع النبر: uncomfortable /ʌnˈkʌm.fɚ.tə.bl̩/, medication /mɛdɪˈkeɪʃən/, severity /səˈvɛɹ.ə.ti/, unusual /ʌnˈjuːʒ(u)əl/, occasionally /əˈkeɪʒənəli/
أصوات يجدها متحدثو العربية صعبة:
- /p/ — ليس /b/: انطقه مع نفخة هواء: symptom /ˈsɪm(p)təm/, pregnancy /ˈpɹɛɡnənsi/, passage /ˈpæsɪd͡ʒ/, expectation /ˌɛk.spɛkˈteɪ.ʃən/, pee /ˈpiː/
- /v/ — ليس /f/: مع اهتزاز الأوتار الصوتية: vomit /ˈvɑmɪt/, fever /ˈfivɚ/, severity /səˈvɛɹ.ə.ti/, vital /ˈvaɪtəl/, virtual /ˈvɜɹt͡ʃuəl/
- تتابع الصوامت — لا تضف حركة بينها: symptom /ˈsɪm(p)təm/, bleed /ˈbliːd/, assessment /əˈsɛsmənt/, pregnancy /ˈpɹɛɡnənsi/, breathe /bɹiːð/
كيف تتدرب بهذا الفيديو
- استمع إلى الفيديو كاملًا مرة واحدة دون أن تتكلم، ودوّن الكلمات التي لا تعرفها.
- ابدأ بسرعة 0.75×، وردّد جملة جملة، ثم عُد إلى السرعة العادية عندما يصبح الأمر سهلًا.
- سجّل صوتك وقارنه بالأصل، مع الانتباه إلى كلمات مثل urine, symptom, uncomfortable.
ما هي تقنية التظليل الصوتي؟
التظليل الصوتي (Shadowing) تقنية تعلم لغة مدعومة علمياً، طُورت أصلاً لتدريب المترجمين الفوريين المحترفين. الطريقة بسيطة لكنها قوية: تستمع لصوت إنجليزي أصلي وتكرره فوراً بصوت عالٍ — كظل يتبع المتحدث بتأخير 1-2 ثانية. تُظهر الأبحاث تحسناً كبيراً في دقة النطق والتنغيم والإيقاع وربط الأصوات والاستماع والطلاقة.