Pratique du Shadowing: How to Present a Patient: Inpatient Bedside Teaching Rounds (Group 12) - Apprendre l'anglais à l'oral avec la vidéo
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61 phrases
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Jonathan, this is Dr. Jones and our internal medicine service team.
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Hi.
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Hi Jonathan.
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We're going to be, I'm going to be presenting your case to them.
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Is that alright if I do that in the presence of your girlfriend and co-worker here?
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Yes, this way.
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Thanks Jonathan.
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So this is the first UMC visit for Jonathan, who is a 24-year-old African-American
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with a history of sickle cell disease who presented to the emergency department with a two-day history of bilateral knee pain.
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He's ectomorphic and is in moderate distress.
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The pain began Tuesday at approximately 4 a.m while he was working a night shift at Walmart.
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He had difficulty sleeping because of the pain that night, that night and the pain gradually continued to increase due to a severity of 8 out of 10 today.
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The pain was exacerbated with walking and standing and was not significantly relieved with Percocet,
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which he received from another physician that we aren't sure who it was.
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Jonathan has never experienced knee pain to this extent before, but he did say that he's had a few episodes in the distant past of knee pain.
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He reports some chills and a mild shortness of breath, but he denied fever, nausea,
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vomiting, cough, chest pain, abdominal pain, or recent trauma to the knees.
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He has no other known medical illness and isn't on any chronic medication for sickle cell disease either.
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In the ED, he was given an IV bolus and received two doses of morphine at 6 mg and 8 mg doses.
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For past medical history, he was diagnosed with sickle cell disease at age six
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and has had six to eight previous hospitalizations for that.
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He has a history of lower extremity ulcers as well, but he has never had a pneumococcal vaccine which is interesting.
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His social history includes, he lives with his mother and four siblings.
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He works at Walmart as a stalker but denies any IV drug use or tobacco use.
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He does consume alcohol occasionally, and last time was this last weekend.
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He has two siblings that also have sickle cell disease.
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In the review of systems, it was negative except for lower extremity ulcers and intermittent left hand pain.
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In his vitals, he had a temperature of 36.3 degrees Celsius, heart rate of 96, a respiratory rate of 16,
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blood pressure of 108 over 70, and his O2 saturation was 89% on room air.
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For Hent, he's normocephalic, atraumatic, perle, and extraocular movements are intact.
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With lungs, they're clear to auscultation and percussion with no wheezes, rails, or bronchi.
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CV, his S1, S2 were normal.
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He is tachycardic with a soft flow murmur heard at the base.
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There was no S4, but he does have decreased pedal pulses.
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For abdominal exam, bowel sounds are normal the spleen tip was not palpable.
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GU, he didn't have any urethral discharge either.
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For skin, he had a silver scaly rash on the flexor surface of the right elbow,
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and there are non-healing bilateral ulcers of one centimeter diameter on both medial malleoli.
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For musculoskeletal, he has mild swelling of the right knee and small effusion.
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There's no erythema, and it's not tender to palpation, but there was pain on full extension his left knee didn't have any significant swelling or tenderness.
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He did have full range of motion bilaterally with his knees.
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Now in the lab work we have a CBC, BMP and liver function test pending.
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And so in conclusion or in summary, Jonathan, he's a 24-year-old African-American man with a history of sickle cell disease and hypoxia.
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He presented the emergency department with bilateral knee pain and minor right knee effusion.
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On the differential diagnosis, we have vaso-occlusive disease, periarticular infarct, septic arthritis, and gout.
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Vaso-occlusive disease is most likely due to the afebrile presentation of the patient.
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And the pending CBC results will likely rule out septic arthritis due to a gram-negative Neisseria, Staph, or Salmonella.
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Potential plans of treatment include knee pain.
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Well, for knee pain, we would consider NSAID treatment with morphine for breakthrough pain.
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For sickle cell disease, we should monitor closely for acute chest syndrome, splenic sequestration, and aplastic crisis,
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and consult a hemonch for a sickle cell referral after he is released from the hospital.
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And then we should also obtain a chest X-ray to rule out new infiltrates and consider oxygen therapy
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if he becomes symptomatic in his lungs again.
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All right, any questions?
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Would I also recommend adding two liters of oxygen via nasal cannula?
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I think that'd be a great idea.
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And great job, Bryce, you really were very thorough.
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Thank you for letting us present in front of you.
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That was really great.
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Thank you.
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Thank you.
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Vocabulaire et conseils d’expression pour cette leçon
Cette vidéo contient 61 phrases et 789 mots à répéter en shadowing. La partie parlée dure 5:50. Le locuteur parle à un rythme régulier d’environ 135 mots par minute, confortable pour le shadowing. Seuls 71 % des mots font partie des 3 000 mots les plus courants en anglais, le vocabulaire est donc exigeant.
Vocabulaire clé de cette vidéo
15 mots moins courants de la vidéo, avec leur prononciation et leur sens :
- knee /ni/ (nom) — genou. In humans, the joint or the region of the joint in the middle part of the leg between the thigh and the shank.
- bilateral /baɪˈlætəɹəl/ (adjectif) — bilatéral. Having two sides.
- deny /dəˈnaɪ/ (verbe) — nier, démentir. To disallow or reject.
- oxygen /ˈɑksɪd͡ʒən/ (nom) — oxygène. The chemical element (symbol O) with an atomic number of 8 and relative atomic mass of 15.9994. It is a colorless and odorless gas. Sometimes called elemental…
- dose /ˈdəʊ̯s/ (nom) — dose. A measured portion of medicine taken at any one time.
- mild /ˈmaɪld/ (adjectif) — doux, douce. Gentle and not easily angered
- lung /ˈlʌŋ/ (nom) — poumon. A biological organ of vertebrates that controls breathing and oxygenates the blood.
- pending /ˈpɛndɪŋ/ (adjectif) — en suspens. Awaiting a conclusion or a confirmation.
- swell /swɛl/ (verbe) — gonfler, enfler. To become larger, fuller, or rounder, or expand in size or shape, usually as a result of pressure from within.
- arthritis /ɑːˈθɹ(a)ɪtɪs/ (nom) — arthrite. Inflammation of a joint or joints causing pain and/or disability, swelling and stiffness, and due to various causes such as infection, trauma, degenerative…
- sibling /ˈsɪb.lɪŋ/ (nom) — frère et sœur, adelphe. A person who shares a parent; one's brother or sister who one shares a parent with.
- abdominal /æbˈdɑm.ə.nl̩/ (adjectif) — abdominal. Of or pertaining to the abdomen; ventral.
- extent /ɪkˈstɛnt/ (nom) — mesure. A range of values or locations.
- extension /ɪkˈstɛnʃən/ (nom) — extension. The act of extending; a stretching out; enlargement in length, breadth, or time; an increase.
- worker /ˈwɝ.kɚ/ (nom) — travailleur, travailleuse. One who works: a person who performs labor for a living; traditionally, especially, manual labor.
Les verbes à particule que vous entendrez
- rule out (verbe) — barrer, biffer. To cross an item out by drawing a straight line through it, as with a ruler.
Prononciation à surveiller
Le locuteur utilise 8 contractions et formes réduites, comme didn't, aren't, I'm. Prononcez-les sous leur forme courte, telles que vous les entendez.
- Les sons « th »: arthritis /ɑːˈθɹ(a)ɪtɪs/, breathe /bɹiːð/, thorough /ˈθʌɹoʊ/, breakthrough /ˈbɹeɪk.θɹuː/, erythema /ˌɛɹɪˈθiːmə/
- Les sons « sh » et « zh »: extension /ɪkˈstɛnʃən/, conclusion /kənˈkluːʒən/, occasionally /əˈkeɪʒənəli/, presentation /ˌpɹɛzn̩ˈteɪʃn̩/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/
- Mots longs — placez bien l’accent: bilateral /baɪˈlætəɹəl/, arthritis /ɑːˈθɹ(a)ɪtɪs/, occasionally /əˈkeɪʒənəli/, difficulty /ˈdɪfɪkəlti/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/
Comment s’entraîner avec cette vidéo
- Écoutez la vidéo en entier une fois sans parler et notez les mots que vous ne connaissez pas.
- Répétez phrase par phrase à vitesse normale, en reprenant chacune jusqu’à ce que votre rythme corresponde à celui du locuteur.
- Enregistrez-vous et comparez avec l’original, en faisant attention à des mots comme knee, bilateral, deny.
La grammaire de cette vidéo
Les structures que le locuteur utilise le plus, avec les mots exacts de la vidéo :
| Structure | Dans la vidéo |
|---|---|
| Present perfect have/has + participe passé — une action passée qui compte encore maintenant | has never experienced · has had · has never had |
| Voix passive be + participe passé — l’accent est mis sur ce qui arrive, pas sur qui le fait | was exacerbated · was given · was diagnosed |
Qu'est-ce que la technique du Shadowing ?
Le Shadowing est une technique d'apprentissage des langues fondée sur la science, développée à l'origine pour la formation des interprètes professionnels. Le principe est simple mais puissant : vous écoutez de l'anglais natif et le répétez immédiatement à voix haute — comme une ombre suivant le locuteur avec un décalage de 1 à 2 secondes. Les recherches montrent une amélioration significative de la précision de la prononciation, de l'intonation, du rythme, des liaisons, de la compréhension orale et de la fluidité.