تدريب Shadowing: Urinary Incontinence History | Lower Urinary Tract Symptoms | OSCE Guide | UKMLA | CPSA | PLAB 2 - تعلم التحدث بالإنجليزية عبر الفيديو
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180 جمل
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1
Hello my name is Jade, I'm one of the doctors.
2
Can I just check your name and date of birth please?
3
Yeah it's Samantha Harris and it's the 7th of April 1960.
4
Okay lovely and what brings you in today?
5
Um, yeah, it's been embarrassing.
6
Um, I've been having small accidents.
7
Okay.
8
Could you tell me a bit more about what you mean by that?
9
Um, well, it's just like, I have to wear, you know, pads everywhere I go.
10
And I really need to know, you know, where the nearest Lou is just in case.
11
Okay, yeah.
12
And these accidents, does it tend to be urine or bowels?
13
Yeah, just like going for a wee, yeah.
14
Okay, and how long has this been going on for?
15
So, I'd say two months now.
16
Okay, yeah.
17
Did it seem to come on all of a sudden or is this something that's been gradually getting worse?
18
Yeah, it has gradually been getting worse.
19
It would happen maybe once every other day, but now it's like two to three times every day.
20
Okay, yeah, seems like quite difficult to manage.
21
Very distressing, yeah.
22
Could you tell me a bit more about how it feels when you have these accidents?
23
Okay, so I'll just like have a sudden urge, you know, to go for a wee and stuff.
24
And when I get that urge, it's then when I know there's like a small amount of leakage onto the pad.
25
So the accidents tended to be kind of small amounts as well.
26
and do you have any trouble passing urine when you're trying to go to the toilet?
27
No no that's that's all fine thanks yeah
28
and does it feel like you're emptying your bladder fully when you do pass urine?
29
Yeah yeah yeah yeah and these accidents do they seem to be random or have you noticed any triggers?
30
Just sort of like it'll just come out of nowhere like
31
that sudden edge yeah yeah so sometimes people might notice their accents
32
when they're sneezing or laughing is
33
that something that's ever happened to you yeah actually now you mentioned it's sort of like occasionally you know
34
if I laugh or like yeah I have a virus
35
and a cough or something and yeah particularly
36
if my blood is full at
37
that time I will definitely have yeah okay some leakage yeah okay fine
38
and have you noticed any pain or stinging
39
when you're passing you no no okay um or any blood no no
40
or any change in the color of your urine
41
no not at all okay and then can i just ask a bit about your gynecological history as well
42
Have you ever had any previous gynae surgery?
43
No, I mean, I've given birth, but nothing complicated at all, no. Yeah, okay.
44
So how many times have you given birth?
45
So I have four children.
46
And when was the last time you were pregnant?
47
So, yeah, my youngest, so it's 32 years ago.
48
In terms of your previous deliveries, were they vaginal deliveries?
49
Yeah, no complications.
50
Did you need any instruments at all?
51
No, I was very lucky.
52
No, good and no tears or anything like that?
53
No, not at all.
54
And when was the last time you had a period?
55
Okay, so yeah, so that would have been 12 years ago.
56
Okay, yeah.
57
So went through the menopause about 12 years ago.
58
Having any menopausal symptoms since then?
59
No, I mean, I've had nothing recently and you know, I might have previously had some hot flushes, but it's all been very, very simple.
60
Okay, very lucky again.
61
Yeah, good.
62
And have you noticed any further vaginal bleeding since you went through the menopause?
63
Not at all, just 12 years ago was the last kind of bleed really.
64
Okay great and then just thinking on a day -to -day basis how much fluid would you tend to drink?
65
I've always been you know really good at drinking water
66
so I'll drink about two litres each day yeah I always have done.
67
Okay so that's not changed compared to normal.
68
No, fine.
69
And do you drink much caffeine at all?
70
Well, I did have a look on the internet and it did say that caffeine could irritate the bladder.
71
So I would have a morning coffee, but I've stopped that.
72
And I just have maybe two or three cups of tea a day, so not much at all.
73
And cutting out the coffee, has that helped your symptoms at all?
74
No, because they're just happening more regularly.
75
Okay, enough.
76
And then just to double check, how often do you open your bowels typically?
77
Just like every day, I've never had, yeah, still the same, never had a problem.
78
Yeah, and have you noticed any changes to your weight at all?
79
No. Or any bloating in your abdomen?
80
No. No?
81
Okay, any fevers or anything?
82
No. No. Okay, lovely.
83
And I guess probably one of the most important things is how has this been affecting you sort of day to day?
84
I mean it is getting me down a bit.
85
I've just found it very, very distressing.
86
It's like it's really not my confidence and self -esteem.
87
So I just find it so embarrassing
88
so I mean I'm going out far less I mean I will go to work but
89
yeah and I find it work very stressful you know just really scared I'll have like a major accident
90
so yeah it's really affecting yeah
91
it seems like it's sort of dictating what you do with your day it is yeah yeah yeah and
92
so you mentioned you've sort of had a read on the internet is there anything in particular
93
you thought might be going on?
94
I mean I have no idea
95
if I'm absolutely honest what's causing it I was just guessing it might have something to do with having had children.
96
Yeah and is there anything about it that's been really worrying you?
97
I'm really worried um you know the accidents are becoming more regular
98
and more I'm worried
99
that it's going to continue to get worse I mean
100
it's a struggle at the moment to leave the house you just think people can smell you
101
so goodness if it just gets worse I dread to think I'll not go out
102
and is there anything in particular you were hoping
103
that we'd be able to do to help you today yeah just hoping
104
you could help reduce the number of accidents I don't a tablet or something.
105
Okay next I'll be asking a little bit more about your background history
106
but just before we move on I'll just kind of summarise back to you what we've talked about
107
so far so that you can correct me or add anything in if it's okay.
108
So you've come in today
109
because over the past couple of months you've been having some accidents where you're incontinent of urine
110
and these have been gradually getting worse
111
so now you're needing to wear pads all the time
112
and are experiencing these accidents two to three times a day
113
which is obviously very distressing for you and
114
when it happens you tend to feel a sudden urge to need to pass urine
115
and that's when the accidents occur they've also been occasionally triggered by things like coughing
116
if you've got a bit of a bug or
117
when you're laughing as well
118
but you've not had any problems in passing urine emptying your bladder you've not noticed any pain
119
or stinging in blood in the urine either
120
and you've had four children previously all by vaginal delivery
121
and there weren't any complications and you've not had any significant gynecological problems in the past
122
You've been drinking the same amount of fluid as you've usually done, but you have cut back on caffeine to see if that would help.
123
But it's not made much difference so far.
124
Does that all sound about right?
125
That's perfectly right, thank you.
126
Do you have any other medical problems at all?
127
Yeah, I've got high blood pressure and high cholesterol.
128
OK.
129
And ever been admitted to hospital before?
130
No. Or any surgeries?
131
No. Lovely.
132
And so do you take regular medications?
133
Yeah, for a long time now.
134
So like Simvastatin, Ramipril and Lodipine.
135
Yes, I'm on those.
136
Okay, those are the main things.
137
And anything over the counter?
138
No, no. Lovely.
139
And are you allergic to any medications?
140
No, not at all.
141
No. Great.
142
And is there anything that runs in the family? or?
143
Yeah so my mum, she died of breast cancer, I mean she was 82.
144
Actually my dad, he died of prostate cancer.
145
Yeah, but I mean he was 90 so.
146
I'm sorry.
147
Thank you.
148
And just a bit about your lifestyle as well.
149
So do you live with anyone at home?
150
I live with my partner.
151
And you mentioned you're working.
152
Yeah, so I'm a receptionist at the local primary school.
153
Okay, lovely.
154
And then just a few questions we ask everyone.
155
So do you smoke at all?
156
Never, never smoked, no. Any alcohol?
157
Rarely, I mean maybe a special occasion I'll have a glass of wine but very very.
158
So on a weekly basis?
159
No, no, no. Okay and then have you ever tried any recreational drugs?
160
No, never.
161
Okay I think that's all the questions I've got to ask.
162
Thank you very much for speaking to me today, Saman.
163
Thank you.
164
Today I spoke with Samantha Harris, a 64 year old lady presenting with urinary incontinence.
165
Samantha describes progressively worsening urinary incontinence over the past two months.
166
She experiences a sudden urge to go to the toilet two to three times a day
167
which often results in a small amount of leakage before she's able to reach the toilet.
168
She also occasionally experiences leakage when coughing or laughing.
169
This has been very distressing for Samantha and has significantly affected her confidence.
170
Samantha has a past medical history of hypertension and high cholesterol for which she takes simvastatin, ramipril and amlodipine.
171
She has four children all born via vaginal deliveries with no complications.
172
She has no known allergies.
173
Samantha works as a receptionist at the local primary school.
174
She does not smoke and rarely drinks alcohol.
175
Samantha is concerned that her symptoms will continue to worsen and this will affect her quality of life further.
176
The most likely diagnosis is mixed urinary incontinence with predominant urge incontinence and occasional stress incontinence.
177
To complete my assessment I would perform an abdominal and pelvic examination in addition to urinalysis.
178
I would refer Samantha to the continence service for further evaluation and bladder training.
179
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180
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تنزيل التطبيق
كل ما تحتاجه للتحدث بطلاقة
تقييم النطق بالذكاء الاصطناعيتقييم كل جملة
تدريب IPAأتقن كل صوت
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المفردات وملاحظات التحدث لهذا الدرس
هذا الدرس في المحادثة مبني على الفيديو “Urinary Incontinence History”. أكثر الكلمات تكرارًا في الفيديو: accident, Samantha, urine. يحتوي هذا الفيديو على 180 جملة و1804 كلمة للتدرب على الترديد. مدة الكلام 12:23. يتكلم المتحدث بسرعة ثابتة، نحو 146 كلمة في الدقيقة، وهي سرعة مريحة للترديد. 83% من الكلمات ضمن أكثر 3,000 كلمة شيوعًا في الإنجليزية، ويُستحسن مراجعة الباقي قبل البدء. 44 من أصل 180 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 |
| sudden صفة | /ˈsʌd.ən/ | مُبَاغِت, مُفَاجِئ |
| urge فعل | /ɜːd͡ʒ/ | حَثَّ |
| distress اسم | /dɪˈstɹɛs/ | مِحْنَة |
| bladder اسم | /ˈblædɚ/ | حُوَيْصِلَة |
| occasionally ظرف | /əˈkeɪʒənəli/ | أَحْيَانًا |
| gradually ظرف | /ˈɡɹæd͡ʒuəli/ | شَيْئاً فَشَيْئاً, خُطْوةً فَخُطْوةً |
| cough فعل | /kɔf/ | كَحَّ, سَعَلَ |
| caffeine اسم | /ˈkæfiːn/ | كَافِيِين |
| symptom اسم | /ˈsɪm(p)təm/ | عَرَض, عَلَامَة |
| rarely ظرف | /ˈɹɛəɹli/ | قَلِيلًا, قَلِيلًا مَا |
| trigger اسم | /ˈtɹɪɡɚ/ | زِنَاد |
| fluid اسم | /ˈflu.ɪd/ | سَائِل, مَائِع |
| medication اسم | /mɛdɪˈkeɪʃən/ | دَوَاء |
| sting فعل | /ˈstɪŋ/ | طَعَنَ |
الأفعال المركبة التي ستسمعها
| الكلمة | المعنى |
|---|---|
| go out فعل | خَرَجَ |
جمل تستحق التكرار
جمل قصيرة وكاملة من الفيديو يمكنك استخدامها في الحديث اليومي:
- Can I just check your name and date of birth please?
- Have you ever had any previous gynae surgery?
- In terms of your previous deliveries, were they vaginal deliveries?
- Did you need any instruments at all?
- Do you have any other medical problems at all?
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 been having · you've been having · You've been drinking |
| المضارع التام have/has + اسم المفعول — حدث ماضٍ ما زال له أثر الآن | that's been · have you noticed · Have you ever had |
نطق يحتاج إلى انتباه
يستخدم المتحدث 50 من الصيغ المختصرة، مثل you've, I've, I'm. انطقها بصيغتها القصيرة كما تسمعها.
- أصوات “sh” و“zh”: occasionally /əˈkeɪʒənəli/, medication /mɛdɪˈkeɪʃən/, occasion /əˈkeɪ̯ʒən/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, evaluation /ɪˌvæljuˈeɪʃn̩/
- الكلمات الطويلة — انتبه لموضع النبر: occasionally /əˈkeɪʒənəli/, medication /mɛdɪˈkeɪʃən/, cholesterol /kəˈlɛstəɹɒl/, complicated /ˈkɑm.plɪˌkeɪ.tɪd/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/
أصوات يجدها متحدثو العربية صعبة:
- /p/ — ليس /b/: انطقه مع نفخة هواء: symptom /ˈsɪm(p)təm/, pad /pæd/, complicated /ˈkɑm.plɪˌkeɪ.tɪd/, compare /kəmˈpɛɚ/, prostate /ˈpɹɑs.teɪt/
- /v/ — ليس /f/: مع اهتزاز الأوتار الصوتية: virus /ˈvaɪ.ɹəs/, virtual /ˈvɜɹt͡ʃuəl/, fever /ˈfivɚ/, evaluation /ɪˌvæljuˈeɪʃn̩/, vaginal /ˈvæd͡ʒ.ən.əl/
- تتابع الصوامت — لا تضف حركة بينها: distress /dɪˈstɹɛs/, bladder /ˈblædɚ/, gradually /ˈɡɹæd͡ʒuəli/, symptom /ˈsɪm(p)təm/, trigger /ˈtɹɪɡɚ/
كيف تتدرب بهذا الفيديو
- استمع إلى الفيديو كاملًا مرة واحدة دون أن تتكلم، ودوّن الكلمات التي لا تعرفها.
- ردّد جملة جملة بالسرعة العادية، وكرّر كل جملة حتى يتطابق إيقاعك مع المتحدث.
- سجّل صوتك وقارنه بالأصل، مع الانتباه إلى كلمات مثل urine, sudden, urge.
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.