Shadowing Practice: Renal Colic History | OSCE Guide | UKMLA | CPSA | PLAB 2 - Learn English Speaking with Video
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173 cümleler
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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
Check out the GeekyMedics collection of over 1 ,000 OSCE stations.
173
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Bu dersin kelimeleri ve konuşma notları
Bu konuşma dersi “Renal Colic History” videosuna dayanıyor. En çok tekrarlanan kelimeler: pain, imogen, blood, urine, noticed. Bu videoda gölgeleme çalışması için 173 cümle ve 1799 kelime var. Konuşma bölümü 9:25 sürüyor. Konuşmacı hızlı konuşuyor, dakikada yaklaşık 191 kelime; bu yüzden birbirine bağlanan ve zayıflayan sesler duyacaksınız. Kelimelerin %84’i İngilizcede en sık kullanılan 3.000 kelime arasında; geri kalanına başlamadan önce bakmakta fayda var. 173 cümlenin 31 tanesi soru; soru tonlaması ve kısa cevaplar için iyi bir alıştırma.
Bu videodaki önemli kelimeler
Videodan öğrenmeye değer 15 kelime, telaffuzu ve anlamıyla:
| Kelime | Telaffuz | Anlam |
|---|---|---|
| urine isim | /ˈjʊɹɪn/ | çiş, idrar |
| symptom isim | /ˈsɪm(p)təm/ | semptom, belgi |
| uncomfortable sıfat | /ʌnˈkʌm.fɚ.tə.bl̩/ | rahatsız |
| kidney isim | /ˈkɪdni/ | böbrek |
| diagnosis isim | /daɪəɡˈnəʊsɪs/ | tanı, teşhis |
| vomit fiil | /ˈvɑmɪt/ | kusmak, istifra etmek |
| awful sıfat | /ˈɔːfʊl/ | berbat |
| fever isim | /ˈfivɚ/ | ateş, humma |
| bleed fiil | /ˈbliːd/ | kanamak [-ar] |
| severity isim | /səˈvɛɹ.ə.ti/ | vehamet, şiddet |
| bowel isim | /ˈbaʊ.əl/ | bağırsak, kalın bağırsak |
| unusual sıfat | /ʌnˈjuːʒ(u)əl/ | alışılmadık, olağandışı |
| confirm fiil | /kənˈfɝm/ | onaylamak, tasdik etmek |
| sudden sıfat | /ˈsʌd.ən/ | ani |
| occasionally zarf | /əˈkeɪʒənəli/ | ara sıra |
Duyacağınız deyimsel fiiller
| Kelime | Telaffuz | Anlam |
|---|---|---|
| wake up fiil | /ˌweɪk ˈʌp/ | uyanmak |
| check out fiil | gözden geçirmek | |
| find out fiil | anlamak, ortaya çıkarmak |
Tekrar etmeye değer cümleler
Videodan, günlük konuşmada yeniden kullanabileceğiniz kısa ve tam cümleler:
- 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?
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 having |
| Present perfect have/has + fiilin üçüncü hâli — geçmişte olan ama şimdi de önemli olan bir eylem | I've ever experienced · I've been given · I've never experienced |
| Edilgen yapı be + fiilin üçüncü hâli — kimin yaptığı değil, ne olduğu önemli | I've been given · is presented |
Dikkat edilecek telaffuzlar
Konuşmacı I've, I'm, you're gibi kısaltılmış biçimleri 56 kez kullanıyor. Bunları duyduğunuz gibi kısa söyleyin.
- “th” sesleri: breathe /bɹiːð/, gather /ˈɡæðɚ/, threshold /ˈθɹɛʃ(h)oʊld/, hypothyroidism /ˌhaɪpəˈθaɪɹɔɪˌdɪzəm/, levothyroxine /ˌli.voʊ.θaɪˈɹɑkˌsin/
- “sh” ve “zh” sesleri: medication /mɛdɪˈkeɪʃən/, unusual /ʌnˈjuːʒ(u)əl/, occasionally /əˈkeɪʒənəli/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, threshold /ˈθɹɛʃ(h)oʊld/
- Uzun kelimeler — vurguyu doğru yere koyun: uncomfortable /ʌnˈkʌm.fɚ.tə.bl̩/, medication /mɛdɪˈkeɪʃən/, severity /səˈvɛɹ.ə.ti/, unusual /ʌnˈjuːʒ(u)əl/, occasionally /əˈkeɪʒənəli/
Türkçe konuşanların zorlandığı sesler:
- /w/ — dudaklar yuvarlak, /v/ değil: wee /wiː/, unwell /ʌnˈwɛl/
- Kelime başındaki ünsüz kümesi — araya ünlü eklemeyin: bleed /ˈbliːd/, pregnancy /ˈpɹɛɡnənsi/, breathe /bɹiːð/, scan /skæn/, threshold /ˈθɹɛʃ(h)oʊld/
- /æ/ — “e”den daha açık: passage /ˈpæsɪd͡ʒ/, examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, gather /ˈɡæðɚ/, scan /skæn/, bladder /ˈblædɚ/
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; urine, symptom, uncomfortable 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.