Shadowing Practice: Pelvic & Abdominal Pain History | OSCE Guide | UKMLA | CPSA | PLAB 2 - Learn English Speaking with Video
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Hi, my name is Grace.
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I'm one of the doctors working in A &E today.
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Do you mind just confirming your name and date of birth?
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It's Amy Brooks, 14th of the 10th of 96th.
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Okay, nice to meet you, Amy.
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And how can I help you today?
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I've just been having
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this really bad stomach pain the last few days okay sorry to hear it um before
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we begin can i just check are you comfortable enough to answer some questions yeah
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i was given some codeine i feel a bit better okay fine
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if that changes just let me know
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because i want you to be comfortable okay and
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so amy do you want to start by telling me a bit more about the pain
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that you've been experiencing as it started two days ago
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and kind of went away after a little bit and then it came back and it's just been getting worse since then.
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Okay and where abouts is the pain?
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Like sort of lower abdomen like a little bit to the left as well.
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Is it going anywhere else?
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No. And what does it feel like?
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Like a really sharp like stabbing pain.
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Okay and I mean that sounds really uncomfortable and
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if you were to grade on a severity out of ten
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with ten out of ten being the worst pain how bad was it when it was at its worst?
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About a nine out of ten this morning.
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Okay and what's it like now?
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It's probably about a sixth okay um
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and the pain is it there all the time
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or is it kind of coming in waves or coming
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and going since this morning it's been there constantly
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and has anything made it better or worse uh
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so yesterday i had some paracetamol and i had like a hot water bottle
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and that helped a little bit um
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but it didn't really help at all this morning okay okay
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and other than the pain have you been feeling unwell in any other ways
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i've felt quite like dizzy since this morning as well okay tell me a bit more about
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that just if I kind of stand up from sitting I feel quite faint
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okay and how long does
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that feeling last for not very long it goes away after a few seconds
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and is that only happening when you're standing up
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or is it happening when you're sitting down as well just
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when I stand okay and have you fainted at all okay
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and have you noticed any in any other ways
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that you've been feeling unwell I've just been feeling quite sick as well okay
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and have you been sick yeah i was sick
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this morning okay okay well amy it sounds like you're feeling quite unwell um you've described to me pain
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that started the day before yesterday
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but it's gotten much worse today low down your tummy
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and stabbing um i think what i'm going to do is
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just ask you a few more questions about it generally okay
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so you mentioned feeling quite sick
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and being sick this morning can i check was there any blood in
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that vomit no and have you had anything to eat today
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and not this morning no no okay you've been kind of off your food i just since this morning okay
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and when did you last have something to eat i had some dinner last night
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and are you drinking okay
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and any change to your bowels at all no that's been fine okay
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and when did you last open your bowels uh just this morning any blood
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or mucus no okay
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and what about going for a wee any changes there no that's been normal no um burning
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or stinging you're not going more often than usual no blood
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when you're going for a wee okay have you had a fever or sweats at all no
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and you mentioned that you've been feeling quite lightheaded
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when you're standing up
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so can i check any chest pain at all no any palpitations what about your breathing is
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that all right that's all fine
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and have you been unwell with any other illnesses recently uh no okay
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and the pain is quite low down in your tummy
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so can i check i'm thinking about vaginal discharge have been any changes
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there any vaginal bleeding just a little bit of spotting this morning okay
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and tell me a bit more about
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that i mean are you someone who has regular periods what's normal for you uh they're quite irregular
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and quite light okay
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and have they always been a regular uh no i had the coil fitted about a year ago um
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so they were regular before that they were just really heavy is
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that the Mirena coil okay and when's the last time you had a bleed with
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that apart from today about seven weeks ago I think okay and is
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that sort of the normal amount of time between your bleeds with the Mirena not really
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it's longer than normal yeah okay and you mentioned
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that before you had the coil put in you had quite
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heavy periods did you have a diagnosis of anything like fibroids
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or cysts at all that you're aware of have you had any ultrasounds
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or scans before okay any previous pregnancies no have you had anything like this before this kind of
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pain with bleeding um not apart from periods okay can i check are your smears up to date yeah
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and have they all been normal yeah they've all been fine okay
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and i'm just going to check as well because it could be relevant are you sexually active at the moment
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okay and is that with a regular partner
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or casual partners uh with my boyfriend okay
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and um when's the last time that you had a partner
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that was different to your current boyfriend uh about three years ago okay
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and how long have you been with your boyfriend for my current boyfriend two years two years okay
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and have you ever had a sexual health screening before yes i have okay
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and when was the most recent time that you had
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that about two years ago when we got together lovely
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and was that normal yeah that was fine fine
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and have you ever had a sexually transmitted infection before yeah about three years ago
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and which infection was that I had chlamydia
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and did you get antibiotics in that I did okay perfect
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and and can I just check just to make sure
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when was the last time
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that you had sex with your partner about three days ago now okay
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and I know you have the my arena room
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which would protect you against pregnancy can I to use condoms as well
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or just some irena no just coil okay okay thanks for answering those questions
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so i think what i'm going to do is just summarize back to you to make sure
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that we've not missed anything here so you've described a pain
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that started a couple of days ago kind of low down in your tummy
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and on the left hand side it went away
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but then it's come back today
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and it's stabbing it's been up to a nine out of ten severity it's very uncomfortable you vomited with it
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and you felt quite lightheaded when you're standing up
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and you've also noticed some sort of vaginal spotting as well
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which is a bit out of sync with what's normal for you um
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and you have a regular partner
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that you've been with for a couple of years is
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that right yeah okay
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and can i just check amy you said you've not had something particularly like this before
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but did you have any thoughts of what this could be um at first
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i thought maybe just a period pain um i'm not sure
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if it's maybe something worse like a cyst or something like
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that okay yeah i mean that's a reasonable thought with the pain being done there
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and on one side and sometimes people have something they're particularly worried about
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when they come in is there anything that you want to tell me
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or ask me about any worries you might have I've just had two days off work already
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and I can't really afford to take any more time off
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so I just really want to kind of get to the bottom of it
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and find out what's what's wrong yeah of course
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and obviously coming into A &E we're here to help you to figure out what's going on
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and to make sure you're comfortable was there anything else you had in mind
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that you wanted us to help you with today uh just to find out what it is okay
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fine so amy i've not met you before
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so you've given me a really good idea about what's been happening in the last few days um
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but i just want to check things before that
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and a bit about your background
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so can i ask do you have any other medical conditions
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at all no do you take any regular medications no
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i don't are you allergic to anything are there any conditions
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that run in your family at all i don't think so no and specifically any kind of gynecological conditions
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uh no okay and your living situation
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so who do you live with at the moment i just live with my boyfriend okay
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and you mentioned you're a bit worried about having time off work what is it
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that you do for work i'm an accountant okay
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and can i ask um do you smoke at all uh yeah
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i do yeah how many a day probably about 10 a day okay
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and how old were you when you started smoking uh 19.
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okay
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and do you take any drugs at all any recreational drugs
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do you drink alcohol a little bit not a lot usually just
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if i go out with friends or something like that okay
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and how much would you have if you went out with friends maybe like two
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or three drinks like vodka tonics or something like that okay
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so perfect do you give me a good idea there about what's going on amy
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so what i'm going to do i'm just going to summarize back to you to make sure
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that we've not missed anything
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so you've described quite severe lower abdominal pain on the left -hand side
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that started a couple of days ago
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and got worse today you vomited you're feeling lightheaded
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and you've also had some spotting bleeding otherwise you're generally in good health you don't take any regular medications is
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that right yes is there anything else
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that you'd like to add I don't think so okay
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and do you have any questions for me no okay and that case
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Amy that's all for today okay thank you your time thank you today
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i spoke with amy brooks a 27 year old woman who's presented to the accident
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and emergency department with a two -day history of progressive left lower quadrant pain this pain is sharp severe
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and stabbing she's also been feeling nauseous and has vomited
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and has been feeling lightheaded understanding amy has also experienced some vaginal bleeding for the last couple of days
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which she describes as light spotting.
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She has a Mirena IUD in situ and hasn't had a bleed for the last seven weeks which is unusual for her.
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She has a regular male partner and last had a sexual health screen two years ago which was negative.
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Amy has no other medical conditions and takes no regular medications.
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She lives with her partner.
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Her main concern is getting back to work and she worries that this could be something like an ovarian cyst.
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The most important differentials to consider today would be an ectopic pregnancy
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or ovarian pathology such as ovarian cyst rupture or ovarian torsion.
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In order to complete my assessment today, I would perform an abdominal examination, check vital signs and perform a urinary pregnancy test.
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For this patient I would consider referring them urgently to the gynaecology team for their assessment
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and management and their consideration of further imaging.
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Bu dersin kelimeleri ve konuşma notları
Bu konuşma dersi “Pelvic & Abdominal Pain History” videosuna dayanıyor. En çok tekrarlanan kelimeler: pain, amy, feeling, regular. Bu videoda gölgeleme çalışması için 178 cümle ve 2087 kelime var. Konuşma bölümü 10:25 sürüyor. Konuşmacı hızlı konuşuyor, dakikada yaklaşık 200 kelime; bu yüzden birbirine bağlanan ve zayıflayan sesler duyacaksınız. Kelimelerin %85’i İngilizcede en sık kullanılan 3.000 kelime arasında; geri kalanına başlamadan önce bakmakta fayda var.
Bu videodaki önemli kelimeler
Videodan öğrenmeye değer 15 kelime, telaffuzu ve anlamıyla:
| Kelime | Telaffuz | Anlam |
|---|---|---|
| bleed fiil | /ˈbliːd/ | kanamak [-ar] |
| pregnancy isim | /ˈpɹɛɡnənsi/ | hamilelik |
| stab fiil | /stæb/ | bıçaklamak, şişlemek |
| coil isim | /kɔɪl/ | makara |
| vomit fiil | /ˈvɑmɪt/ | kusmak, istifra etmek |
| sharp sıfat | /ʃɑɹp/ | keskin, sivri |
| infection isim | /ɪnˈfɛkʃən/ | enfeksiyon |
| uncomfortable sıfat | /ʌnˈkʌm.fɚ.tə.bl̩/ | rahatsız |
| severity isim | /səˈvɛɹ.ə.ti/ | vehamet, şiddet |
| abdominal sıfat | /æbˈdɑm.ə.nl̩/ | karın ile ilgili |
| bowel isim | /ˈbaʊ.əl/ | bağırsak, kalın bağırsak |
| refer fiil | /ɹɪˈfɜː/ | zikretmek |
| unusual sıfat | /ʌnˈjuːʒ(u)əl/ | alışılmadık, olağandışı |
| stomach isim | /ˈstʌmək/ | mide, karın |
| illness isim | /ˈɪl.nəs/ | hastalık, maraz |
Duyacağınız deyimsel fiiller
| Kelime | Anlam |
|---|---|
| stand up fiil | satmak |
| find out fiil | anlamak, ortaya çıkarmak |
| check out fiil | gözden geçirmek |
| figure out fiil | açığa çıkarmak |
| get together fiil | toplanmak, buluşmak |
| sit down fiil | oturmak |
Bu videodaki dil bilgisi
Konuşmacının en çok kullandığı yapılar, videodaki sözcüklerin aynısıyla:
| Yapı | Videoda |
|---|---|
| Present perfect continuous have/has been + -ing — önceden başlayıp hâlâ süren bir eylem | I've just been having · you've been experiencing · it's just been getting |
| Present perfect have/has + fiilin üçüncü hâli — geçmişte olan ama şimdi de önemli olan bir eylem | it's been · i've felt · have you fainted |
| İlgi cümlecikleri who / which + cümle — bir kişi ya da şey hakkında ek bilgi | someone who has · weeks which is · ago which was |
| Edilgen yapı be + fiilin üçüncü hâli — kimin yaptığı değil, ne olduğu önemli | was given · being done |
Dikkat edilecek telaffuzlar
Konuşmacı you're, you've, I'm gibi kısaltılmış biçimleri 52 kez kullanıyor. Bunları duyduğunuz gibi kısa söyleyin.
- “th” sesleri: sixth /sɪksθ/, breathe /bɹiːð/, pathology /pəˈθɒləd͡ʒi/
- “sh” ve “zh” sesleri: medication /mɛdɪˈkeɪʃən/, sharp /ʃɑɹp/, infection /ɪnˈfɛkʃən/, unusual /ʌnˈjuːʒ(u)əl/, consideration /kənˌsɪd.əˈɹeɪ.ʃən/
- Uzun kelimeler — vurguyu doğru yere koyun: medication /mɛdɪˈkeɪʃən/, uncomfortable /ʌnˈkʌm.fɚ.tə.bl̩/, severity /səˈvɛɹ.ə.ti/, unusual /ʌnˈjuːʒ(u)əl/, consideration /kənˌsɪd.əˈɹeɪ.ʃən/
Türkçe konuşanların zorlandığı sesler:
- /w/ — dudaklar yuvarlak, /v/ değil: sweat /swɛt/, unwell /ʌnˈwɛl/, quadrant /ˈkwɑ.dɹənt/
- Kelime başındaki ünsüz kümesi — araya ünlü eklemeyin: bleed /ˈbliːd/, pregnancy /ˈpɹɛɡnənsi/, stab /stæb/, stomach /ˈstʌmək/, progressive /pɹəˈɡɹɛsɪv/
- /æ/ — “e”den daha açık: stab /stæb/, abdominal /æbˈdɑm.ə.nl̩/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, casual /ˈkæʒ(u)əl/, scan /skæn/
Bu videoyla nasıl çalışılır
- Videonun tamamını konuşmadan bir kez dinleyin ve bilmediğiniz kelimeleri not edin.
- 0,75× hızla başlayın, cümle cümle tekrar edin ve kolaylaşınca normal hıza dönün.
- Kendinizi kaydedin ve orijinaliyle karşılaştırın; bleed, pregnancy, stab gibi kelimelere özellikle dikkat edin.
Gölgeleme Tekniği Nedir?
Gölgeleme, başlangıçta profesyonel tercüman eğitimi için geliştirilen ve çok dilli Dr. Alexander Arguelles tarafından popüler hale getirilen, bilim destekli bir dil öğrenme tekniğidir. Yöntem basit ama güçlüdür: ana dili İngilizce olan bir sesi dinler ve hemen yüksek sesle tekrar edersiniz — konuşmacıyı 1-2 saniye gecikmeyle takip eden bir gölge gibi. Pasif dinleme veya dilbilgisi alıştırmalarının aksine, gölgeleme beyninizi ve ağız kaslarınızı gerçek konuşma kalıplarını eşzamanlı olarak işlemeye ve yeniden üretmeye zorlar. Araştırmalar, telaffuz doğruluğu, tonlama, ritim, bağlı konuşma, dinleme anlama ve konuşma akıcılığını önemli ölçüde geliştirdiğini göstermektedir — bu da onu IELTS Konuşma hazırlığı ve gerçek dünya İngilizce iletişimi için en etkili yöntemlerden biri yapar.