쉐도잉 연습: Headache History | OSCE Guide | UKMLA | CPSA | PLAB 2 - YouTube로 영어 말하기 배우기
C1
Hello, my name's Jade, I'm one of the doctors.
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Hello, my name's Jade, I'm one of the doctors.
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Hi.
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Could I just take your name and date of birth, please?
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Yeah, it's Eve Pollack.
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It's the second or the third, 1990.
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Okay, that's great.
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Thanks, Eve.
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What's brought you in today?
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I've been suffering from really severe headaches recently.
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Okay, could you tell me a bit more about the headaches?
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Yeah, just very painful, really debilitating to be honest
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and I'm getting a bit worried about them now so I just wanted to come and have a chat about it.
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Yeah, understandable.
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So how long have these headaches been going on for?
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It's been about six months in total now.
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Okay, so quite a while.
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And whereabouts do you feel the headaches?
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It's usually just on one side of my head.
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It can be left or right but it's just on that one side.
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Okay, and what does it feel like?
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I describe it as sort of like a really kind of deep sort of throbbing,
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you know, like a pounding type of headache.
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Yeah, so when the headache comes on,
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is it all of a sudden or does it gradually build up?
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It sort of gradually comes on
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and then I'd say over a period of sort of minutes it kind of gets worse and until it,
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yeah, it's very painful and then it kind of stays like that for the rest of the time.
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How long does the headache tend to last?
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Oh, hours.
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It can be all day,
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all night to the point where I just have to try and get myself off to sleep to make it go away.
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Okay.
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And does the pain move anywhere else?
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No, it just stays on the one side.
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Okay.
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And do you ever get any other symptoms alongside the headache?
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Yeah, when I've got the headache,
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I tend to feel quite sick with it.
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Okay.
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Have you ever been sick with it?
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No, I've never been sick.
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I just feel really nauseous.
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Have you ever experienced any sort of stiffness in your neck with the headache?
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No. Okay.
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And is there any particular times you've noticed the headache coming on?
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I've noticed a couple of times it's been when I've been particularly tired from work or maybe a little bit stressed.
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And there's also been a couple of times where it's sort of happened at the start of my period.
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Okay, how frequently do you think they're happening?
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The headaches are probably once or twice a month.
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Once or twice a month, okay.
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Any particular time of day it tends to occur?
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Probably mostly afternoons, I would say,
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maybe when I finish work,
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yeah, that sort of thing.
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Okay, and has it ever woken you up in the night or in the morning?
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No. Okay, and then, so you said sometimes at the start of your period,
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how long is your cycle usually?
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28 days.
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28 days, okay.
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And are you on any contraception?
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Yes, I take the mini pill.
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The mini pill, okay.
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And anything you've noticed that makes headaches worse?
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Yeah, kind of bright lights,
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loud noises, that sort of thing that just makes it more uncomfortable.
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And in terms of other things that might make it worse,
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you haven't noticed it's affected by standing up or laying down?
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No, it tends to just not make a difference, that sort of thing.
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Okay, anything that makes it better?
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No, not really.
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I tend to just have to go and lie down in a quiet,
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dark room and just wait for it to pass.
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Have you tried any medications at all?
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Just paracetamol and ibuprofen, but I don't really seem to do much.
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How often do you tend to take them?
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When the headache comes on I'll just take,
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you know, maybe try a couple of paracetamol and then a couple of ibuprofen later but as I said,
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neither of them seem to work so I've not really taken many.
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Okay and
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if you had to put on a scale of kind of
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0 to 10 where 0 is no pain at all and 10 is the worst pain you've ever felt,
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what would you rate the headaches?
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Probably 8 out of 10.
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I mean at times I'd go so far as to say it was 10 out of 10.
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It's really awful.
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Yeah, it sounds like they're really really painful.
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How has that been impacting your life?
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It's just awful in terms of that's sometimes I'm having to wait all day
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and all night for it to go away
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and that's not what I want to be doing with my days and yeah it's not pleasant it's really debilitating.
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Yeah I can imagine.
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And then in terms of before the headache do you ever get any symptoms before the headache comes on?
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Kind of the day before
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I've noticed that I feel really tired and can get a little bit irritable
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and I feel like I just spend the day just yawning the day before I get a headache.
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Okay and how about immediately before the headache are there any sort of warning signs that's about to come on?
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Yeah I tend to see
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what I can just describe as kind of like flashing or flickering lights and then just before
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I'll get these zigzaggy kind of lines and then I know you know that's it then the headache comes on after that.
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Okay and then you mentioned that with the headache you get a bit of nausea as well.
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Yeah.
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After the headache's passed do you feel kind of back to normal or do you still feel a bit...
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No I tend to feel really washed out after the headache
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really like sort of next day sometimes yeah the next day
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or two I feel really tired yeah quite drained you know it really takes it out of us.
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Okay.
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And have you ever had any fevers?
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No. No. Any changes to your appetite?
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No. Or any changes to your weight?
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No. No. Or have you ever woken up feeling very sweaty at night?
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No. No. Okay.
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And is there anything in particular you thought might be going on?
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I don't know.
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I've never experienced anything like this before.
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So I'm just a bit baffled as to why I'm suddenly suffering from these headaches.
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Yeah.
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And is there anything about it that's really been worrying you?
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Yeah, I am a little bit concerned now because with it being going on for the last six months,
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I'm a little bit concerned that this could be something maybe a bit more sinister.
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and maybe something like a brain tumour.
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Okay, so that sounds like it's been really worrying.
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Yeah.
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Is there anything in particular you were hoping we'd be able to do for you today?
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Just try and find out what's going on really and ideally maybe get some strong painkillers,
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something that will just make the pain go away.
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Yeah, okay.
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I'm just going to run through a few more questions just about your general health.
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Have you got any other medical conditions at all?
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Yeah, I've been diagnosed in the past with depression and anxiety.
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Okay, and how has your mood been with all this going on?
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That's under control.
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I take medication, so I feel like I've been okay.
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Okay, yeah, that's good to hear.
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What medication is it that you're taking?
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Sertraline.
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Sertraline, and how long have you been taking that for?
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Oh, that's probably been a few years now,
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to be honest, yeah, but I'd say that that seems to be working the whole thing here.
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Okay, good.
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So you're on sertraline and then you mentioned the mini pill as well,
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and as well as the paracetamol and ibuprofen when you get the headache.
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Yeah.
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Is there any other medications you take?
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No, that's it.
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No?
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And any allergies at all?
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No. No. Okay, lovely.
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And any conditions that run in the family at all?
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My mum did mention to me that she's suffered from bad headaches in the past.
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Yeah, so she has, she did mention that and she's actually had breast cancer a few years back.
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She's all fine in everything now but yeah,
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that's in terms of family.
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Yeah, okay, glad to hear that she's better now.
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Thank you.
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Did she ever have any investigations for her headaches?
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I don't think so, she never mentioned,
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she just said that she used to get really bad headaches.
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Okay, and I'll just ask a bit about your lifestyle now as well now as well
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so are you working at all yes I'm a dental nurse okay
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and
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and has these headaches had any impact on your work I
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have had to kind of call in get someone to come me last minute
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which isn't again it's not ideal not something that I want to continue
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and so yeah that's a bit of a concern okay
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and are you living with anyone at the moment my boyfriend boyfriend okay
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and do you smoke no
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and do you drink any alcohol yeah i have a drink on a weekend okay
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and what is it
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that you tend to drink um i have a few glasses of wine on a friday
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and saturday night okay
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so in in a week how many glasses of wine would you have usually um say six six yeah
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and what size are the glasses um just like a small kind of standard wine glass i guess okay
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so usually about six standard glasses of wine in one week.
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And just a question we have to ask everybody,
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have you ever taken any recreational drugs?
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No. No, okay lovely, thank you.
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So what I'll do is I'm just gonna kind of summarise what you've told me
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so far and if there's anything else that you think is relevant
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or you want to add in then just let me know okay.
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So the main problem you've come in with today is these headaches
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which have been going on for the past six months or
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so and they tend to be on one side of your head
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but it can be either the left side or the right side.
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It's kind of a deep throbbing pain but it doesn't move anywhere
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and you often get a bit of nausea with it as well but you haven't been sick.
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They tend to occur a couple of times a month
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and you've noticed it may be related to when you've not slept properly,
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when you've got a lot of stress or potentially at the beginning of your menstrual cycle as well.
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In terms of things that make it better you've tried kind of paracetamol ibuprofen
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but they don't tend to help you just have to go lie down in a room in the dark
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and things that make it worse,
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so bright lights and loud noises as well.
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And it's been kind of usually an 8 out of 10,
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but at its worst, a 10 out of 10,
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which has meant it's had quite a significant impact on your life.
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It is debilitating and impacted you at work as well.
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And then your main worry was about whether this could be something more sinister.
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So you're just hoping to find out what the headaches could be caused by
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if there's any extra medications we could give you.
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Is that right?
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Yeah, that's right.
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Is there anything else you'd like to add?
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No. No, and is there any other questions that you've got for me today?
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No, I don't think so.
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Okay, well thank you very much for speaking to me.
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Thank you.
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Today I spoke to Eve,
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a 34 year old lady presenting with headaches.
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Eve described a unilateral headache with gradual onset building up over a few minutes that can last hours or even days.
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Eve described the day before the headache feeling tired and irritable with excessive yawning.
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Immediately prior to the headache she described some visual disturbances.
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The headache itself could last hours and is associated with some nausea but no vomiting.
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These headaches typically occur one to two times a month.
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The timing of the day can vary but are typically in the afternoon or evening.
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Eve has also noticed that the headaches can be associated with the beginning of her menstrual cycle.
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The headaches can also be made worse by bright lights and loud noises.
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She has tried using medications such as paracetamol and ibuprofen,
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but has not found any benefit from this.
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Eve described the pain as debilitating,
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often an 8 out of 10,
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but sometimes 10 out of 10.
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This has had a significant impact on her life and she has occasionally had to miss work as a result.
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Eve has a past medical history of depression,
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which is well controlled using sertraline.
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Her only other regular medication is the progesterone only pill and she takes over-the-counter paracetamol and ibuprofen occasionally.
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Eve does not smoke.
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She drinks six small glasses of wine a week.
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She does not take any recreational drugs.
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Eve currently works as a dental nurse and lives with her boyfriend.
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Eve is unclear why she has been getting these headaches as she has never suffered from them before
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and she is worried that there may be something sinister underlying it such as a brain tumour.
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She would like to find out what the cause of the headaches are
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and see if there are any additional painkillers that may be beneficial.
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To complete my assessment I would perform a full neurological and cardiovascular examination and consider further investigations including a headache diary.
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핵심 어휘 및 구문
- 이름 (name) - 본인 혹은 다른 사람의 이름을 말할 때 사용
- 두통 (headache) - 증상 설명 중 가장 많이 사용되는 단어
- 심한 (severe) - 강도를 표현할 때 유용한 형용사
- 완화하다 (relieve) - 통증이나 증상을 줄이는 것을 의미
- 메스꺼움 (nausea) - 두통과 함께 느끼는 증상 중 하나
- 스트레스 (stress) - 두통의 유발원으로 언급
- 발작 (attack) - 두통이 오는 상황을 설명할 때 사용
- 주기 (frequency) - 두통이 얼마나 자주 발생하는지 설명할 때 중요
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이번 유튜브 영어 공부 영상에서는 의사와의 대화가 자연스럽고 차분한 속도로 진행됩니다. 영어 쉐도잉을 통해 shadow speech 기법을 연습할 수 있습니다. 대화의 내용을 따라 읽으며 발음과 억양을 주의 깊게 살펴보세요. 특히 문장이 시작될 때의 감정 표현과 강세에 신경 쓰는 것이 중요합니다. 어려운 부분이 나타난다면 여러 번 반복하며 습득할 수 있도록 하세요. 주의 깊게 따라 하는 것만으로도 shadowspeak 기술을 향상시킬 수 있습니다.
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