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1、当代医学英语微课程临床医疗问题与对策教学参考答案微课程临床医疗问题与对策教学参考答案UnitlKey to Lesson 1Activity 11.Primary care 2.options 3.illustrate plaints5.radiologist 6.motivation 7.preventative 8.reform9.attractive 10.spinalActivity 31.There is a nationwide shortage of primary care doctors.2.One of the four physician jobs are open.3.
2、It is hard to provide care to anyone in the community.4.Two major reasons:the health system and the income.5.Family doctors earn on average$190,000 annually,whileradiologists earn$424,000,and spinal surgeons,$611,000annually.6.Nationwide the number is only about 5%of the medicalstudents.7.Health ref
3、orm must change medicine so that family medicinecan be seen as an attractive option.Activity 5临床医疗中一大问题是全科医生短缺。全科医生被认为是健康的守门人,在为人口最大群体提供基本医疗服务中起着重要作用。临床医疗中一大问题是全科医生短缺.全科医生被认为是健康的守门人，在为人口最大群体提供基本医疗服务中起着重要作用。全科医生短缺，意味着医疗培训和卫生系统中应对响应机制的短缺，也意味着卫生体制和政策的危机。从政策上和报酬上吸引更多医学生从事全科医学为患者提供基本的医疗服务，是卫生体制改革的一个重点。A
4、big complaint about clinical medicine is the shortage of primary caredoctors.Primary care doctors are considered to be health concierges,who play an essential role in providing basic health care to the largestgroup of the population.A shortage of primary care doctors means ashortage of a responding
5、mechanism in medical training and healthsystems,and also a crisis in the health system and policies.It is a keypoint of health system reform to attract more medical students,by bothpolicies and remuneration,to pursue a career in primary care to providepatients with basic health care.报酬临床医疗中一大问题是全科医生
6、短缺。全科医生被认为是健康的守门人，在为人口最大群体提供基本医疗服务中起着重要作用。全科医生短缺，意味着医疗培训和卫生系统中应对响应机制的短缺，也意味着卫生体制和政策的危机。从政策上和报A big complaint about clinical medicine is the shortage of primary caredoctors.Primary care doctors are considered to be health concierges,whoplay an essential role in providing basic health care to the larg
7、est group ofthe population.A shortage of primary care doctors means a shortage of aresponding mechanism in medical training and health systems,and also acrisis in the health system and policies.It is a key point of health system酬上吸引更多医学生从事全科医学为患者提供基本的医疗服务，是卫生体制改革的一个重点。reform to attract more medical
8、students,by both policies andremuneration,to pursue a career in primary care to provide patients withbasic health care.临床医疗中一大问题是全科医生短缺。全科医生被认为是健康的守门人，在为人口最大群体提供基本医疗服务中起着重要作用。全科医生短缺，意味着医疗培训和卫生系统中应对响应机制的短缺也意味着卫生体制和政策的危机。从政策上和报酬上吸引更多医学生从事全科医学为患者提供基本的医疗服务，是卫生体制改革的一个重点。A big complaint about clinical med
9、icine is the shortage of primarycare doctors.Primary care doctors are considered to be healthconcierges,who play an essential role in providing basic health care tothe largest group of the population.A shortage of primary caredoctors means a shortage of a responding mechanism in medicaltraining and
10、health systems,and also a crisis in the health system andpolicies.It is a key point of health system reform to attract moremedical students,by both policies and remuneration,to pursue acareer in primary care to provide patients with basic health care.Key to Lesson 2Activity 11.pediatrics 2.access 3.
11、chronic 4.coordinate5.screening 6.unavailable 7.insurance 8.consistent9.practitioner 10.follow-upActivity 31.Access to primary doctors is often unavailable to manyAmericans.2.Many patients go unnecessarily and expensively to emergencyrooms.3.Regular follow-ups and good preventive medicine.4.Primary
12、care was offered in an old-fashioned way:Mondaythrough Friday,9 to 5.5.Physician assistance and nurse practitioners started to seepatients nights and weekends,and provide 24-hour-phoneservice.6.They have improved care for patients and decreasedhealthcare cost.7.It increases from 5 to almost 8 percen
13、t each year.1.许多美国人常常无法获得初级医生的诊治。2.许多病人不必要而昂贵地去了急诊室。3.定期随访和良好的预防医学。4.初级保健是以传统的方式提供的:周一到周五，朝九晚五。5.医生助理和护士从业人员开始在晚上和周末看望病人，并提供24小时电话服务。6.他们改善了对病人的护理，降低了医疗成本。7.每年从5%增长到8%。Activity 5除了全科医生严重不足，临床医疗还面临着包括看病难和成本高的问题。著名的梅奥诊所也存在这些问题，不过通过一系列的医疗改革措施，不仅患者得到了周到的服务，而且医疗费用也下降了。看病难和成本高也是中国卫生服务中常常被抱怨的问题。美国梅奥诊所的那些应对
14、措施能为中国的医疗改革提供哪些借 鉴？Apart from the serious shortage of primary care physicians,the problemsexisting in clinical medicine also include difficult access to health care andhigh medical cost.This is also the case with the famous Mayo Clinic,butthrough a series of health care reform measures,the Mayo Clin
15、ic has notonly provided patients with thoughtful health service,but also decreasedmedical expenses.Difficult access to health care and high medical cost arealso common complaints about the health care in China.What lessons canbe drawn from the measures taken by the Mayo Clinic in the U.S.for theheal
16、th care reform in China?当代医学英语微课程临床医疗问题与对策教学参考答案Unit 2Key to Lesson 4Activity 11.triage 2.admission 3.agonizing 4.round-the-clock5.stuck 6.understaffed 7.streamline 8.instantaneously9.moan 10.suiteActivity 31.The wait.2.Four hours.3.By hiring more doctors and nurses,and streamlining labtechniques.4.
17、Patients will be seen within 30 minutes of their arrival.5.Its emergency department has now a“Fast-track“program,24-hours a day.6.By new clinical information software.7.It is not only good medicine,but also good business.Activity 5提升医疗服务的效瘠口质量历来是临床医疗始终关注的问题。急诊室等候时间过长可能是患者就医最痛苦的经历。一般患者在急诊室要等上4-5小时，原因
18、可能是患者人数过多或急诊室人员配备不足。减少急诊室等候时间是优质医疗服务的一部分。一些医院已在采取各种措施，如30分钟急症室保障项目 来提升快速的急诊室医疗服务。Improving the efficiency and quality of medical services has always beena concern in clinical medicine.Waiting for a long time in emergencyroom may be the most agonizing experience for patients seekingmedical treatment.
19、The average patient has to wait in the emergencyroom for 4-5 hours,perhaps because emergency rooms areovercrowded and understaffed.Reducing ER wait times is a part of goodmedicine.Some hospitals have taken various measures,such as/r30-minute Emergency Room Guarantee”,to improve the rapid ERservice.K
20、ey to Lesson 5Activity 11.overhaul 2.brush up on 3.disgruntled 4.bland5.renowned 6.a slew of 7.implemented 8.lousy9.courtesy 10.gripeActivity 31.Doctors and nurses are brushing up on techniques.2.Bland food,long waits and often lousy bedside manner.3.Because hospitals that discharge disgruntled pati
21、ents stand tolose big money.4.“How often were you treated with courtesy and respect?5.Cutting wait time.6.To teach techniques to improve patient care.7.To improve the quality of healthcare for everyone.Activity 5医院的形象与医疗服务质量密切相关。现在很多医院正在努力改进食物淡而无味、候诊时间长以及诊疗态度差劲的形象.医生和护士在温习技术，管理者也在增设大量特色项目，尽可能让患者在住院期
22、间感到舒适.很多医院也在努力减少候诊时间，防止院内的致命感染?口医疗事故.这些变化最终有助于提升医疗质量以及医院的形象.The image of a hospital is closely related to its quality of medical service.Now many hospitals are trying to polish the image of bland food,longwaits and often lousy bedside manner.Doctors and nurses are brushingup on techniques,and admini
23、strators are adding a slew of new featuresto keep patients as comfortable as possible in hospitalization.Manyhospitals are also trying to cut wait time and prevent deadly hospitalinfections and mistakes.These changes will ultimately help to improvethe quality of medical care and the image of hospita
24、ls as well.当代医学英语微课程临床医疗问题与对策教学参考答案Unit 3Key to Lesson 7Activity 11.diagnostic 2.stature 3.staggering 4.ails5.outpatients 6.elevate 7.grave 8.ulcer9.misdiagnosis 10.A wake-up callActivity 31.Misdiagnosis.2.Very grave consequences.3.Misdiagnoses contribute to 1 out of 10 patient deaths.4.1 in 20.5.Ch
25、anging the pay structure for doctors,elevating the statureof nurses,and improving communications throughout theprocess.6.Her kidney cancer was misdiagnosed as a stomach ulcer.7.They need to know what their symptoms were and whethertheir doctor fully listened to them as he gave diagnosis.Activity 5误诊
26、意味着在当时那个时点错过了做出及时正确的医学判断机会。误诊是临床医疗中常见的问题，也是门诊医疗差错的主要原因。据估计，每年去门诊就医的美国人中有1/20被 误 诊，误诊还导致1/10的患者死亡。由此可见，误诊的后果十分严重，足以向医患双方敲响警钟，需更多关注医疗体制中这一危险的盲Misdiagnosis means that there was a missed opportunity to make a timelyand correct medical diagnosis at that point of time.Misdiagnosis is acommon problem in cl
27、inical medicine and also the leading cause ofmedical error in outpatient facilities.It is estimated that 1 in 20 Americansseeking outpatient care is misdiagnosed ever year and that misdiagnosescontribute to 1 out of 10 patient deaths.This shows that the consequencesof misdiagnosis are grave enough t
28、o be a wake-up call for both doctorsand patients,demanding more attention to this dangerous blind spot inthe healthcare system.Key to Lesson 8Activity 11.pathology 2.undergo 3.Gallup poll 4.recovery5.biopsy 6.match up 7.mastectomy 8.monitor9.appropriate 10.gutActivity 31.She was diagnosed with breas
29、t cancer.2.She expects to make a full recovery after her doublemastectomy.3.Because she caught breast cancer early and got a secondopinion.4.She was urged to get a second opinion on the pathology.5.They had their treatment plans changed.6.They have time to seek a second opinion and to plan the mosta
30、ppropriate course of therapy.7.Although confident in their doctor7 s advice,most patientsneed to get a second opinion or do their own research.Activity 5演员及歌手丽塔威尔逊因患乳腺癌而作了双乳切除手术。她的经历表明求医治病中听取第二方意见有多么重要。癌症专家也认为，一旦诊断有乳腺癌，患者有时间去咨询第二方意见，规划最合适的疗程，不必立即治疗。医疗中误诊并不少见，但多达70%的美国人很相信医生，不觉得有必要获得第二方意见或自己研究一下，而威尔逊
31、的案例给患者带来了警示。Rita Wilson,an American actress and singer,underwent a doublemastectomy for her breast cancer.Her experience shows how important itis to seek a second opinion in the treatment.According to cancerspecialists,when the diagnosis of breast cancer is made,the patient hastime to seek a second
32、opinion and to plan the most appropriate course oftherapy.There is no immediate need to have treatment.A misdiagnosis isnot uncommon in medicine,but as many as 70%of Americans are soconfident in their doctor,s advice.They didn t feel they need to get asecond opinion or do their own research.Neverthe
33、less,the Wilson/s case isa wake-up call for patients.当代医学英语微课程临床医疗问题与对策教学参考答案Unit 7Key to Lesson 19Activity 11.nausea 2.heartburn 3.sweat 4.tightness in the chest5.highlights 6.atypical 7.empowered 8.shortness of breath9.hefty 10.overwhelmingActivity 31.Heart disease kills more women than all cancer
34、s combined.2.It is highlighting why so many women are dying of heartattacks.3.She was just 41 years old.4.They don t have classic symptoms of heart attacks.5.Shortness of breath,light headedness,pain in the jaw,neck orarms,nausea,cold sweats and extreme fatigue.6.Being overtired and terribly stresse
35、d,tightness in her chest,pain in her jaw.7.Knowing gender differences in a heart attack and acting onthem can save your life.Activity 5在 美 国，心脏病这一头号杀手造成的女性死亡人数超过女性死于所有癌症之合，因此成为临床医疗中的重大问题之一。临床上，心脏病发作有着性别差异。女性更可能有的非典型症状包括冷汗、恶心、呼吸浅短、头晕、胸闷、下颈及颈部疼痛、极度乏力等。很多心脏病发作的案列表明，了解这些差异并根据这些差异采取行动，能挽救很多女性的生命。Heart di
36、sease,the number one killer in the U.S.,kills more womenthan all cancers combined.Therefore,it is one of the major problemsin clinical medicine.Clinically,there are gender differences in heartattacks.Women are more likely to have atypical symptoms:coldsweats,nausea,shortness of breath,light headedne
37、ss,tightness inthe chest,pain in the jaw or neck,and extreme fatigue.Numerouscases of heart attacks show that knowing those differences andacting on them can save many women*s lives.Key to Lesson 20Activity 11.coronary 2.implant 3.inflammation 4.intra-aortic5.intervention 6.pump 7.prognosis 8.myocar
38、ditis9.lymphocytic 10.in conjunction withActivity 31.Nearly half a million.2.Coronary artery disease or years of high blood pressure.3.A rare form of heart failure called lymphocytic myocarditis.4.A common virus.5.By implanting an intra-aortic balloon pump and medication.6.Shortness of breath,fatigu
39、e and a general feeling of beingunwell.7.The faster you get treatment for it,the healthier you will be.Activity 5当心脏无法有效泵送血液以满足身体的需要 时，就发生心力衰竭。每年将近50万美国人诊断有心力衰竭，足以表明它是临床医疗中的重大问题。心力衰竭的常见原因有冠状动脉疾病（包括以前的心脏病发作 人 高 血 压、感染、过量饮酒、心肌炎等.治疗取决于此病的原因和严重程度.典型的心力衰竭康复比较慢。不 过，治疗Heart failure occurs when the heart is
40、 unable to pump blood efficientlyto meet the body,s needs.Every year nearly half a million Americans arediagnosed with heart failure,and this shows that it is a major problem inclinical medicine.Common causes of heart failure include coronary arterydisease(including a previous heart attack),high blo
41、od pressure,excessalcohol use,infection,and myocarditis.Treatment depends on the causeand severity of the disease.Typical heart failure comes on slowly.However,the prognosis of heart failure gets better the earlier you start开始得越早，心力衰竭的预后会越好。treatment.当代医学英语微课程临床医疗问题与对策教学参考答案Unit 11Key to Lesson 31Ac
42、tivity 11.allergen 2.Spasm 3.allergies 4.pollen5.drastically 6.reactive 7.inhaler 8.kick up9.allergist 10.triggersActivity 31.More than 17 million Americans.2.They will wheeze,cough and get shortness of breath.3.He thinks pollution is probably the most important reason.4.Infections.5.By recognizing
43、triggers,avoiding the triggers and knowingwhat medications to use.6.Any effective care could be compromised,which could lead tomore troublesome symptoms.7.The theory goes that being exposed to a whole host ofallergens on the farm can do that.Activity 5哮喘是呼吸道常见疾病之一。据估计2011年全球有235百万-330百万人患哮喘，每年25万-34
44、万人死于此病.哮喘由复杂的、未完全明了的环境和遗传因素相互作用引起。与哮喘发生有关的众多环境因素包括过敏原、空气污褐口其他环境Asthma is one of the common respiratory diseases with estimates that as of2011,235-330 million people worldwide are affected by asthma andapproximately 250,000-345,000 people die per year from the disease.Asthma is caused by a combinatio
45、n of complex and incompletely understoodenvironmental and genetic interactions.Many environmental factorsassociated with asthma*s development include allergens,air pollution,and化学物。据一项全国调查发现，80%以上的患者未能有效控制疾病。这就意味着他们将面临哮喘严重发作及 部长期损伤的风险。other environmental chemicals.According to a nationwide survey,mo
46、re than80%of patients with asthma failed to effectively control the disease.Thismeans they will face the risk of severe asthma attacks and long-term lungdamage.Key to Lesson 32Activity 11.lightning 2.declaration 3.hospitalization 4.toll5.pandemic 6.swine flu 7.intent 8.mortality9.category 10.predisp
47、ositionActivity 31.The swine flu was declared a global pandemic.2.Because the virus is spreading from person to person in atleast 37 countries.3.Because the US government has been in face of the pandemicfor some time.4.More than 30 deaths.5.Men and women with asthma and other lung problems,heartdise
48、ase,diabetes and obesity.6.The one in 1918 killed 50 million people worldwide.In 1957,2million people died.And in 1968 the toll was I million.7.The virus could change as it moves from place to place.Activity 5呼吸道疾病是全球疾病和死亡的一个常见和重大的原因。呼吸道疾病中的病毒性肺炎及哮喘的恶化，可能是流感导致的并发症。2009年至少37个国家暴发了猪流感，被世界卫生组织宣布为全球大流行病
49、。在现代历史上曾发生三次流感大流行，每次死亡人数在100万以上。为什么在医学取得很大进步的今天还会暴发全球流感大流行？这个问题确实值得研究。Respiratory disease is a common and significant cause of illness anddeath around the world.Among respiratory diseases,viral pneumoniaand worsening of asthma can be complications due to influenza.Theoutbreak of the swine flu in 200
50、9 in at least 37 countries around theworld was officially declared a global pandemic by the World HealthOrganization.There have been three global influenza pandemics inmodern history,each resulting in more than a million deaths.Why doesa global flu pandemic still outbreak in a day when medicine has