शैडोइंग अभ्यास: Renal Colic History | OSCE Guide | UKMLA | CPSA | PLAB 2 - वीडियो के साथ अंग्रेजी बोलना सीखें
अभ्यास मोड चुनें
हर मोड पूरी स्क्रीन का अभ्यास कक्ष खोलता है।
173 वाक्य
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Hi my name is Grace, I'm one of the medical students in A &E today.
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Hello.
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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.
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Okay can you describe that for me?
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Um just the last two times I've been to the toilet for a week uh
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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
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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.
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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
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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
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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
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so thanks for your time imogen thank you today
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i spoke to imogen mann a 32 year old police officer
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who is presented to the a e department with right -sided
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lower back pain Imogen describes sudden onset day of episodic right -sided loin to groin pain
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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
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इस पाठ की शब्दावली और बोलने के सुझाव
यह स्पीकिंग पाठ वीडियो “Renal Colic History” पर आधारित है। सबसे ज़्यादा दोहराए गए शब्द ये हैं: pain, imogen, blood, urine, noticed। इस वीडियो में शैडोइंग के लिए 173 वाक्य और 1799 शब्द हैं। बोला गया हिस्सा 9:25 लंबा है। वक्ता तेज़ बोलता है, लगभग 191 शब्द प्रति मिनट, इसलिए जुड़ी हुई और कमज़ोर ध्वनियाँ ज़्यादा मिलेंगी। 84% शब्द अंग्रेज़ी के 3,000 सबसे आम शब्दों में से हैं; बाकी शब्द अभ्यास से पहले देख लेना अच्छा रहेगा। इसके 173 वाक्यों में से 31 प्रश्न हैं, इसलिए यह प्रश्नों के लहजे और छोटे जवाबों के अभ्यास के लिए अच्छा है।
इस वीडियो की मुख्य शब्दावली
वीडियो के 15 सीखने लायक शब्द, उच्चारण और अर्थ के साथ:
| शब्द | उच्चारण | अर्थ |
|---|---|---|
| urine संज्ञा | /ˈjʊɹɪn/ | पेशाब, मूत |
| symptom संज्ञा | /ˈsɪm(p)təm/ | लक्षण, अलामत |
| uncomfortable विशेषण | /ʌnˈkʌm.fɚ.tə.bl̩/ | असहज |
| kidney संज्ञा | /ˈkɪdni/ | गुर्दा |
| diagnosis संज्ञा | /daɪəɡˈnəʊsɪs/ | निदान |
| medication संज्ञा | /mɛdɪˈkeɪʃən/ | उपचार, औषधि |
| vomit क्रिया | /ˈvɑmɪt/ | उल्टी करना, वमन करना |
| fever संज्ञा | /ˈfivɚ/ | बुख़ार, ज्वर |
| bleed क्रिया | /ˈbliːd/ | रक्तस्राव |
| bowel संज्ञा | /ˈbaʊ.əl/ | बृहदान्त्र |
| assessment संज्ञा | /əˈsɛsmənt/ | निर्धारण, मूल्यांकन |
| confirm क्रिया | /kənˈfɝm/ | पुष्टि करना |
| difficulty संज्ञा | /ˈdɪfɪkəlti/ | कठिनाई, मुसीबत |
| knee संज्ञा | /ni/ | घुटना |
| pregnancy संज्ञा | /ˈpɹɛɡnənsi/ | गर्भावस्था |
वीडियो में आने वाली फ़्रेज़ल वर्ब
| शब्द | उच्चारण | अर्थ |
|---|---|---|
| wake up क्रिया | /ˌweɪk ˈʌp/ | जागना |
दोहराने लायक वाक्य
वीडियो के छोटे, पूरे वाक्य जिन्हें आप रोज़ की बातचीत में इस्तेमाल कर सकते हैं:
- 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?
इस वीडियो का व्याकरण
वक्ता जिन संरचनाओं का सबसे अधिक प्रयोग करता है, वीडियो के असली शब्दों के साथ:
| संरचना | वीडियो में |
|---|---|
| Present perfect continuous have/has been + -ing — पहले शुरू हुआ काम जो अब भी जारी है | I've just been having · you've been having |
| Present perfect have/has + past participle — बीता हुआ काम जिसका असर अभी भी है | I've ever experienced · I've been given · I've never experienced |
| Passive voice be + past participle — ज़ोर इस पर कि क्या होता है, न कि कौन करता है | I've been given · is presented |
ध्यान देने योग्य उच्चारण
वक्ता 56 बार संक्षिप्त रूपों का प्रयोग करता है, जैसे I've, I'm, you're। इन्हें वैसे ही छोटा बोलें जैसा आप सुनते हैं।
- “th” की ध्वनियाँ: breathe /bɹiːð/, gather /ˈɡæðɚ/, threshold /ˈθɹɛʃ(h)oʊld/, hypothyroidism /ˌhaɪpəˈθaɪɹɔɪˌdɪzəm/, levothyroxine /ˌli.voʊ.θaɪˈɹɑkˌsin/
- “sh” और “zh” की ध्वनियाँ: medication /mɛdɪˈkeɪʃən/, unusual /ʌnˈjuːʒ(u)əl/, occasionally /əˈkeɪʒənəli/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, threshold /ˈθɹɛʃ(h)oʊld/
- लंबे शब्द — बलाघात सही रखें: uncomfortable /ʌnˈkʌm.fɚ.tə.bl̩/, medication /mɛdɪˈkeɪʃən/, severity /səˈvɛɹ.ə.ti/, unusual /ʌnˈjuːʒ(u)əl/, occasionally /əˈkeɪʒənəli/
हिंदी भाषियों के लिए मुश्किल ध्वनियाँ:
- /v/ और /w/ का फ़र्क़ — /v/ में ऊपर के दाँत निचले होंठ को छूते हैं, /w/ में होंठ गोल होते हैं: vomit /ˈvɑmɪt/, fever /ˈfivɚ/, severity /səˈvɛɹ.ə.ti/, vital /ˈvaɪtəl/, virtual /ˈvɜɹt͡ʃuəl/
- /z/ — इसे “ज” (/dʒ/) न बनाएँ: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, hypothyroidism /ˌhaɪpəˈθaɪɹɔɪˌdɪzəm/, dizzy /ˈdɪzi/, summarize /ˈsʌməˌɹaɪz/
- शब्द की शुरुआत में s + व्यंजन — पहले “इ” न जोड़ें: scan /skæn/, sting /ˈstɪŋ/
इस वीडियो से अभ्यास कैसे करें
- पहले बिना बोले पूरा वीडियो एक बार सुनें और जो शब्द नहीं आते उन्हें लिख लें।
- 0.75× गति से शुरू करें, एक-एक वाक्य की शैडोइंग करें, और सहज लगने पर सामान्य गति पर लौटें।
- अपनी आवाज़ रिकॉर्ड करें और मूल से तुलना करें, ख़ासकर urine, symptom, uncomfortable जैसे शब्दों पर ध्यान दें।
शैडोइंग तकनीक क्या है?
शैडोइंग (Shadowing) एक विज्ञान-समर्थित भाषा सीखने की तकनीक है जो मूल रूप से पेशेवर दुभाषिया प्रशिक्षण के लिए विकसित की गई थी। विधि सरल लेकिन शक्तिशाली है: आप मूल अंग्रेज़ी ऑडियो सुनते हैं और तुरंत इसे ज़ोर से दोहराते हैं — जैसे वक्ता की छाया 1-2 सेकंड की देरी से। शोध से पता चलता है कि यह उच्चारण सटीकता, स्वर, लय, जुड़ी हुई ध्वनियाँ, सुनने की समझ और बोलने की प्रवाहशीलता में काफ़ी सुधार करता है।