Prática de Shadowing: Renal Colic History | OSCE Guide | UKMLA | CPSA | PLAB 2 - Aprenda a falar inglês com vídeo
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173 frases
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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.
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Vocabulário e dicas de fala para esta lição
Esta aula de conversação usa o vídeo “Renal Colic History”. As palavras que mais se repetem: pain, imogen, blood, urine, noticed. Este vídeo tem 173 frases e 1799 palavras para praticar shadowing. A fala dura 9:25. O falante fala rápido, cerca de 191 palavras por minuto, então espere sons ligados e reduzidos. 84% das palavras estão entre as 3.000 mais comuns do inglês; vale a pena estudar o restante antes de começar. 31 das 173 frases são perguntas, por isso é um bom treino para a entonação de perguntas e respostas curtas.
Vocabulário principal deste vídeo
15 palavras do vídeo que vale a pena aprender, com pronúncia e significado:
| Palavra | Pronúncia | Significado |
|---|---|---|
| urine substantivo | /ˈjʊɹɪn/ | urina |
| symptom substantivo | /ˈsɪm(p)təm/ | sintoma |
| uncomfortable adjetivo | /ʌnˈkʌm.fɚ.tə.bl̩/ | desconfortável, incómodo |
| kidney substantivo | /ˈkɪdni/ | rim |
| diagnosis substantivo | /daɪəɡˈnəʊsɪs/ | diagnóstico |
| medication substantivo | /mɛdɪˈkeɪʃən/ | medicamento, medicação |
| vomit verbo | /ˈvɑmɪt/ | vomitar, regurgitar |
| awful adjetivo | /ˈɔːfʊl/ | horrível, terrível |
| fever substantivo | /ˈfivɚ/ | febre |
| bleed verbo | /ˈbliːd/ | sangrar |
| severity substantivo | /səˈvɛɹ.ə.ti/ | gravidade, severidade |
| bowel substantivo | /ˈbaʊ.əl/ | intestino grosso |
| assessment substantivo | /əˈsɛsmənt/ | contabilização |
| alongside | /əˌlɔŋˈsaɪd/ | junto a, juntamente com |
| unusual adjetivo | /ʌnˈjuːʒ(u)əl/ | inesperado, inusual |
Phrasal verbs que você vai ouvir
| Palavra | Pronúncia | Significado |
|---|---|---|
| wake up verbo | /ˌweɪk ˈʌp/ | acordar, despertar |
| check out verbo | verificar, sacar só | |
| find out verbo | descobrir | |
| run down verbo | atropelar |
Frases que vale a pena repetir
Frases curtas e completas do vídeo que você pode usar na conversa do dia a dia:
- 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?
Gramática neste vídeo
As estruturas que o falante mais usa, com as palavras exatas do vídeo:
| Estrutura | No vídeo |
|---|---|
| Present perfect continuous have/has been + -ing — uma ação que começou antes e continua | I've just been having · you've been having |
| Present perfect have/has + particípio passado — uma ação passada que ainda importa agora | I've ever experienced · I've been given · I've never experienced |
| Voz passiva be + particípio passado — o foco está no que acontece, não em quem faz | I've been given · is presented |
Pronúncia para ficar de olho
O falante usa 56 contrações e formas reduzidas, como I've, I'm, you're. Diga-as na forma curta, do jeito que você ouve.
- Os sons de “th”: breathe /bɹiːð/, gather /ˈɡæðɚ/, threshold /ˈθɹɛʃ(h)oʊld/, hypothyroidism /ˌhaɪpəˈθaɪɹɔɪˌdɪzəm/, levothyroxine /ˌli.voʊ.θaɪˈɹɑkˌsin/
- Os sons de “sh” e “zh”: medication /mɛdɪˈkeɪʃən/, unusual /ʌnˈjuːʒ(u)əl/, occasionally /əˈkeɪʒənəli/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, threshold /ˈθɹɛʃ(h)oʊld/
- Palavras longas — acerte a sílaba tônica: uncomfortable /ʌnˈkʌm.fɚ.tə.bl̩/, medication /mɛdɪˈkeɪʃən/, severity /səˈvɛɹ.ə.ti/, unusual /ʌnˈjuːʒ(u)əl/, occasionally /əˈkeɪʒənəli/
Sons difíceis para falantes de português:
- Consoante final — sem acrescentar um “i” depois: vomit /ˈvɑmɪt/, bleed /ˈbliːd/, assessment /əˈsɛsmənt/, alongside /əˌlɔŋˈsaɪd/, toilet /ˈtɔɪ.lət/
- /l/ final — a língua toca o céu da boca, não vira “u”: awful /ˈɔːfʊl/, bowel /ˈbaʊ.əl/, unusual /ʌnˈjuːʒ(u)əl/, vital /ˈvaɪtəl/, virtual /ˈvɜɹt͡ʃuəl/
- /h/ — um sopro suave, diferente do “r”: threshold /ˈθɹɛʃ(h)oʊld/, hypothyroidism /ˌhaɪpəˈθaɪɹɔɪˌdɪzəm/
Como praticar com este vídeo
- Ouça o vídeo inteiro uma vez sem falar e anote as palavras que você não conhece.
- Comece na velocidade 0,75×, faça shadowing frase por frase e volte à velocidade normal quando ficar fácil.
- Grave a sua voz e compare com o original, prestando atenção a palavras como urine, symptom, uncomfortable.
O que é a Técnica de Shadowing?
Shadowing é uma técnica de aprendizado de idiomas com base científica, originalmente desenvolvida para o treinamento de intérpretes profissionais. O método é simples, mas poderoso: você ouve áudio em inglês nativo e repete imediatamente em voz alta — como uma sombra seguindo o falante com 1-2 segundos de atraso. Pesquisas mostram melhora significativa na precisão da pronúncia, entonação, ritmo, sons conectados, compreensão auditiva e fluência na fala.