学术英语(医学)_Unit 1
学术英语医学Unit1-3-7-9课文翻译
学术英语unit1,unit3,unit4,unit9课文翻译 Unit 1 Text A神经过载与千头万绪的医生患者经常抱怨自己的医生不会聆听他们的诉说。
虽然可能会有那么几个医生确实充耳不闻，但是大多数医生通情达理，还是能够感同身受的人。
我就纳闷为什么即使这些医生似乎成为批评的牺牲品。
我常常想这个问题的成因是不是就是医生所受的神经过载。
有时我感觉像变戏法，大脑千头万绪，事无巨细，不能挂一漏万。
如果病人冷不丁提个要求，即使所提要求十分中肯，也会让我那内心脆弱的平衡乱作一团，就像井然有序同时演出三台节目的大马戏场突然间崩塌了一样。
有一天，我算过一次常规就诊过程中我脑子里有多少想法在翻腾，试图据此弄清楚为了完满完成一项工作，一个医生的脑海机灵转动，需要处理多少个细节。
奥索里奥夫人 56 岁，是我的病人。
她有点超重。
她的糖尿病和高血压一直控制良好，恰到好处。
她的胆固醇偏高，但并没有服用任何药物。
她锻炼不够多，最后一次 DEXA 骨密度检测显示她的骨质变得有点疏松。
尽管她一直没有爽约，按时看病，并能按时做血液化验，但是她形容自己的生活还有压力。
总的说来，她健康良好，在医疗实践中很可能被描述为一个普通患者，并非过于复杂。
以下是整个 20 分钟看病的过程中我脑海中闪过的念头。
她做了血液化验，这是好事。
血糖好点了。
胆固醇不是很好。
可能需要考虑开始服用他汀类药物。
她的肝酶正常吗？她的体重有点增加。
我需要和她谈谈每天吃五种蔬果、每天步行 30 分钟的事。
糖尿病：她早上的血糖水平和晚上的比对结果如何？她最近是否和营养师谈过？她是否看过眼科医生？足科医生呢？她的血压还好，但不是很好。
我是不是应该再加一种降血压的药？药片多了是否让她困惑？更好地控制血压的益处和她可能什么药都不吃带来的风险孰重孰轻？骨密度 DEXA 扫描显示她的骨质有点疏松。
我是否应该让她服用二磷酸盐，因为这可以预防骨质疏松症？而我现在又要给她加一种药丸，而这种药需要详细说明。
学术英语 Unit 1
Language Focuses
Colonoscopy colon（o）-
colon（结肠）
colonoscope
Neuron overload Patients‟ high expectations Mistrust and misunderstanding between the patients and physician
A case in point to exemplify how many details a doctor needsion (Pre. 2)
A 56-year-old woman Somewhat overweight Reasonably well-controlled diabetes and hypertension cholesterol on the high side without any medications for this Not as much exercise as she should Thinning of her bones on last DEXA scan Stressful but good about keeping her appointments and getting her blood tests Generally healthy
Vocabulary derived from French and Latin is not used. Colloquial terms, slangs and many phrasal verbs are common.
学术英语(一)unit 1 重点词汇-PPT精品文档
prevalent adj.
Smoking is becoming increasingly prevalent among younger women. (抽烟在年轻女性中变得越来越常见。)
Discuss the words’ meaning 5.
hand over formally submit: ____________________________________ They submitted their reports to the Chancellor yesterday but got no reply yet.
If you address a problem or task or if you address yourself to it, you try to understand it or deal with it.
e.g. You should seek to address those fears when you speak at the meeting. (在会上讲话时你应该尽量消除恐惧。) Throughout the book we have addressed ourselves to the problem of ethics. (整本书中我们都在探讨伦理观的问题。)
The next meeting will address the problem of truancy.
Discuss the words’ meaning 4.
the quality of existing very commonly or happening prevalence:_______________________________________ frequently ________________________________________________ The prevalence of drugs in the city is alaoverty. 流行； 盛行； 普遍； （疾病等的）流行程度 e.g. They were very surprised by the prevalence of asthma in Britain and western Europe. (他们对英国和西欧哮喘的流行感到很吃惊。)
学术英语(医学)Unit 1演示PPT
• Language building-up – Signpost language – Formal English – Vocabulary test
• Suggested answers
8
Unit 1 Doctors’ Life
Text A
Critical reading and thinking
Useful expressions
• a 56-year-old woman • somewhat overweight • reasonably well-controlled diabetes and hypertension • cholesterol on the high side without any medications for
Questions for discussion
• How do you interpret the title?
– neuron overload – juggling physician
9
Unit 1
Text A
Doctors’ Life
Critical reading and thinking
Topics for presentation
1 Do you agree that it is sheer neuron overload on the doctor side that leads to the complaint that doctors don’t listen?
• neuron overload • patients’ high expectations • mistrust and misunderstanding between the
学术英语医学课文翻译医学英语课文翻译unit1-7
学术英语医学课文翻译医学英语课文翻译unit1-7导读：就爱阅读网友为您分享以下“医学英语课文翻译unit1-7”的资讯，希望对您有所帮助，感谢您对的支持!Unit1肺和肾的功能肺的血管系统肺从两个血管系统----支气管循环系统和肺循环系统获得血液供应。
它的营养血液来自于支气管循环系统，流向肺部除肺泡外的所有组织，因为支气管循环系统始于主动脉及上肋间动脉，接受大约1%的心输出量。
大约三分之一的支气管循环的静脉输出流入全身静脉，然后回到右心房。
剩余的输出流入肺静脉，并在心脏最小静脉的作用下，在正常情况下，以1%-2%的量自右向左分流。
肺动脉系统沿着气道从肺门向外周延伸，向下连接下段气道（直径大约2毫米）的动脉，它们壁薄且富有弹性。
从这儿开始，动脉成肌肉化发展，直至其达到30微米，此时肌层消失。
因为这些小肌肉动脉起着积极控制肺部血流分布的作用，所以大部分动脉压降产生在这些小肌肉动脉中。
肺小动脉将血液排空，送入广泛分布的毛细血管网，进入肺静脉。
肺静脉的壁很薄，它们最终在肺门处与动脉和支气管汇合，出肺进入左心房。
肾结构成分人类肾脏在解剖学上位于腹膜后隙，与下胸椎和上腰椎平行。
每个成年人的肾脏大约重150克，长、宽、厚分别为12厘米、6厘米以及3厘米。
肾脏的冠状部分分为/由两个明确的区域（组成）。
外周部的皮质大约1厘米厚，深部的髓质由几个肾锥体构成。
这些锥体状结构的底部位于皮髓质结合处。
锥体的顶部伸入肾门，称为肾**。
每个肾**被一个肾小盏包裹。
肾小盏与肾大盏相聚组成肾盂。
经肾**流出的尿液汇集在肾盂，通过输尿管排入膀胱。
由主动脉分支出来的肾总动脉为两肾输送血液。
肾总动脉通常分为两个主侧支，这两个侧支又进一步分为叶动脉，为肾脏上、中、下区域供应血液。
当这些血管进入肾实质，变成叶间动脉通向肾皮质时，（这些血管）又进一步细分。
细分后的更小血管在皮髓质结合处成为竖支--弓状动脉。
从弓状动脉伸出的叶间动脉进入皮质。
学术英语（医学）课后问题答案
Unit11、Some factors that may lead to the complaint:·Neuron overload·Patients* high expectations·Mistrust and misunderstanding between the patient and the doctorcondition:2、Mrs. Osorio’s·A 56-year-old woman·Somewhat overweight·Reasonably well-controlled diabetes and hypertension·Cholesterol on the high side without any medications for it·Not enough exercises she should take·Her bones a little thin on her last DEXA scan3、Good things:·Blood tests done·Glucose a little better·Her blood pressure a little better but not so great Bad things:·Cholesterol not so great·Her weight a little up·Her bones a little thin on her last DEXA scan 44、The situation:·The author was in a moderate state of panic: juggling so many thoughts aboutMrs. Osorio’s conditions and trying to resolve them all before the clock ran down.·Mrs. Osorio made a trivial request, not so important as compared to her conditions.and completely justified ·Mrs. Osorio seemed to care only about her “innocent ——request”：the form signed by her doctor.·The doctor tried to or at least pretended to pay attention to the patient whilecompleting documentation.5、Similarities:·In computer multitasking, a microprocessor actually performs only one task at a time. Like microprocessors, we human beings carft actually concentrate on two thoughts at the same exact time. Multitasking is just an illusion both in computersand human beings.Differences:·The concept of multitasking originated in computer science.·At best, human beings can juggle only a handful of thoughts in a multitasking manner, but computers can do much better.·The more thoughts human beings juggle, the less human beings are able to attune fully to any given thought, but computers can do much better.6、·7 medical issues to consider·5 separate thoughts, at least, for each issue·7 x 5 = 35 thoughts·10 patients that afternoon·35 x 10 = 350 thoughts·5 residents under the authors supervision·4 patients seen by each resident·10 thoughts, at least, generated from each patient·5 x 4 x 10 = anther 200 thoughts·350 + 200 = 550 thoughts to be handled in total·If the doctor does a good job juggling 98% of the time, that still leaves about 10 thoughts that might get lost in the process.7、Possible solutions:·Computer-generated reminders·Case managers·Ancillary services·The simplest solution: timeUnit21、The author implies:Peoples inadequate consciousness about the consequence of neglecting the re- emerging infectious diseases·Unjustifiability of peoples complacency about the prevention and control of theinfectious diseases·Unfinished war against infectious diseases2、Victory declarations:·Surgeon General William Stewart's hyperbolic statement of closing “the book on infectious disease”.·A string of impressive victories incurred by antibiotics and vaccines·The thought that the war against infectious diseases was almost overWhat followed ever since:·Appearance of new diseases such as AIDS and Ebola·Comeback of the old afflictions:Diphtheria in the former Soviet UnionTB in urban centers like New York CityRising Group A streptococcal conditions like scarlet fever·The fear of a powerful new flu strain sweeping the world3、Elaborate on the joined battle:·WHO established a new division devoted to worldwide surveillance and controlof emerging disease in October 1995.·CDC launched a prevention strategy in 1994.·Congress raised fund from $6.7 million in 1995 to $26 million in 1997.4、The borders are meaningless to pathogenic microbes, which can travel fromone country to another remote country in a very short time.5、TB:·Prisons and homeless shelters as ideal places for TB spread·Emerging of drug-resistant strain or even multi-drug-resistant strain·A ride on the HIV w^on by attacking the immunocompromisedGroup A strep:·A change in virulence·Mutation in the exterior of the bacteriumFlu:Constant changes in its coat (surface antigens) and resultant changes in its levelof virulence6、Examples:·Experiment in England is seeing the waning immunity because of no vaccination. ·Du e to poor vaccination efforts, the diphtheria situation in the former Soviet Union is serious. 'The vaccination rates are dropping in some American cities, and it will lead to more diphtheria and whooping cough.7、The four areas of focus:·The need for surveillance·Updated science capable of dealing with discoveries in the field·Appropriate prevention and control·Strong public health infrastructure8、The infectious diseases such as TB, flu, diphtheria and scarlet fever will never really go away, and the war against them will never end.Unit31、Terry's life before·She loved practicing Tae Kwon Do·She loved the surge of adrenaline that came with the controlled combat of tournaments.·She competed nationally, even won bronze medal in the trials for the Pan American Games.·She attended medical school, practiced as an internal medicine resident, and became an academic general internist.·She got married and got a son and a daughter.2、The symptoms of MS and autoimmune disease:·Loss of stamina and strength·Problems with balance·Bouts of horrific facial pain·Dips in visual acuity3、Terry did the following before she self-experimented:·She started injections.·She adopted many pharmacotherapies.·She began her own study of literature:She read articles on websites such as PubMed.She searched for articles testing new MS drugs in animal models.She turned to articles concerning neurodegeneration of all types — dementia，Parkinson's disease, Huntington's disease, and Lou Gehrig's disease.She relearned basic sciences such as cellular physiology, biochemistry, andneurophysiology.4、Approaches Terry mainly used:·Self-experimentation with various nutrients to slow neurodegeneration based on literature reports on animal models·Self-experimentation with neuromuscular electrical stimulation which is not an approved treatment for MS·Online search to identify the sources of micronutrients and having a new diet ·Reduction of food allergies and toxic load5、Cases mentioned in the text:·Increased mercury stores in the brains of people with dental fillings·High levels of the herbicide atrazine in private wells in Iowa·The strong association between pesticide exposure and neurodegeneration·The association of single nucleotide polymorphisms involving metabolism of sulfur and/or B vitamins·Inefficient clearing of toxins6、With 70% to 90% of the risk for diabetes, heart disease, cancer, andautoimmunity being due to environmental factors other than the genes, we cantake many health problems and the health care crisis under our control, for example, optimizing our nutrition and reducing our toxic load.Unit41、Two concepts:·Complementary medicine refers to the use of conventional therapies together with alternative treatments such as using acupuncture in addition to usual care to help lessen pain. Complementary and alternative medicine is shortened as CAM.·Alternative medicine refers to healing treatments that are not part of conventional therapies —like acupuncture, massage therapy, or herbal medicine. They are called so because people used to consider practices like these outside the mainstream.2·TCM does not require advanced, complicated, and in most cases, expensivefacilities.·TCM employs needles, cups, coins, to mention but a few.·Most procedures and operations of TCM are noninvasive.·The substances used as medicine are raw herbs or abstracts from them, andthey are indeed all natural, from nature.·TCM has been practiced as long as the Chinese history, so the efficiency i s proven and ensured.·Ongoing research around the world on acupuncture, herbs, massage and Tai Chi have shed light on some of the theories and practices of TCM3、It may be used as an adjunct treatment, an alternative, or part of a comprehensive management program for a number of conditions: post-operativeand chemotherapy induced nausea and vomiting, post-operative dental pain, addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma.4、A well-justified NO:·More intense research to uncover additional areas for the use of acupuncture ·Higher adoption of acupuncture as a common therapeutic modality not only in treatment but also in prevention of disease and promotion of wellness·Exploration and perfection of innovative methods of acupuncture point stimulation with technological advancement·Improved understanding of neuroscience and other aspects of human physiology and function by basic research on acupuncture·Greater interest by stakeholders·An increasing number of physician acupuncturists5、·Appropriate uses of herbs depend on proper guidance:Proper TCM diagnosis of the zheng of the patientCorrect selection of the corresponding therapeutic strategies and principles that guide the choice of herbs and herbal formulas·Digression from either of the above guidence will lead to misuses of herbs, andwill result in complications in patient6、·Randomized controlled trialsAdvantages:Elimination of the potential bias in the allocation of participants to the intervention group or control groupTendency to produce comparable groupsGuaranteed validity of statistical tests of significanceLimitations:Difficulty in generalizing the results obtained from the selected sampling to the population as a wholeA poor choice for research where temporal factors are anissueExtremely heavy resources, requiring very large samplegroupsQuasi-experimentsAdvantages:Control group comparisons possibleReduced threats to external validity as natural environments do notsuffer the same problems of artificiality as compared to a well-controlledlaboratory setting.Generalizations of the findings to be made about population since quasiexperiments are natural experimentsLimitations：Potential for non-equivalent groups as quasi-experimental designs donot use random sampling in constructing experimental and controlgroups.Potential for low internal validity as a result of not using random sampling methods to construct the experimental and control groupsCohort studiesAdvantages:Clear indication of the temporal sequence between exposure and outcomeParticular use for evaluating the effects of rare or unusual exposureAbility to examine multiple outcomes of a single risk factorLimitations:Larger, longer, and more expensiveProne to certain types of biasNot practical for rare outcomesCase-control studiesAdvantages:The only feasible method in the case of rare diseases and those with longperiods between exposure and outcomeTime and cost effective with relatively fewer subjects as compared to other observational methodsLimitations：Unable to provide the same level of evidence as randomized controlled trialsas it is observational in natureDifficult to establish the timeline of exposure to disease outcomeN=1” trials“AdvantagesEasy to manageInexpensiveLimitations：Findings difficult to be generalized to the whole populationWeakest evidence due to the number of the subject7、Synthesis of evidence is completely dependent on:The completeness of the literature search (unavailable for foreign studies)The accuracy of evaluation·There are situations in which no answer can be found for the questions of interest in RCTs and database analyses.·There's the requirement of using less stringent information rather than “hard data”8、·Assessment of the intrinsic value of traditional medicine in society·Research and education·Political, economic, and social factorsUnit51、·Dis-ease refers to the imbalance arising from：Continuous stressPainHardships·Disease is a health crisis ascribable to various dis-eases.·Prompting elimination of dis-eases can alleviate some diseases.2、·Wellness is a state involving every aspect of our being: body, mind and spirit.·Manifestations of a healthy person:Energy and vitalityA certain zip in gaitA warm feeling of peace of heart seen through behavior3、·Constant messages, positive and negative，are sent to our mind about the health of our body.·Physical symptoms are suppressed by people who go through life on automatic pilot.·Being well equals to being disease- or illness-free in the minds of them.·They confused wellness with an absence of symptoms.4、·People's minds are infected by spin:Half-truthFearful fictionsBlatant deceit: some as a form of self-deceit·Spin is a result of unconscious living.·The kind of falseness is pandemic.5·Our body intelligence is suppressed or dormant from a lack of use.·There are tremendous amount of stress on a daily basis.·Our bodies are easily ignored for years because of a lack of recreation time. ·Limiting, self-defeating and even self-destructive behaviors undermine our wellbeing and keep them from achieving our full potential.6·We grow more reluctant to take risks.·We lose the ability to feel and acknowledge our deepest feelings and the courage to speak our truth.·We continue to deny and repress our feelings to protect ourselves.·Fear, denial and disconnection from our bodies and feelings become an unconscious, self-protective habit, a kind of default response to life.7·A multi-faceted process:Looking for roots of and resolutions for the issues in different dimensionsBuilding our wellness toolbox slowlyPicturing our whole state of being·Attention to the little stuff:Examining our lives honestly and setting clear intentions to changeStriving to maintain a balance of our mind, body and spiritTaking small steps in the way to perceive and resolve conflict8·Try to awaken and evolve in order to live more consciously.·Get in touch with our genuine feelings and emotions.·Come to terms with the toxic emotionsUnit61、In the past, most people died at home. But now, more and more people are caredin hospitals and nursing homes at their end of life, which of course brings a newset of questions to consider.2、·Sixty-four years old with a history of congestive heart failure·Deciding to do everything medically possible to extend his life·Availability of around-the-clock medical services and a full range of treatmentchoices, tests, and other medical care·Relaxed visiting hours, and personal items from home3、Availability of around-the-clock medical resources, including doctors, nurses, andfacility.4、·Taking on a job which is big physically, emotionally, and financially·Hiring a home nurse for additional help·Arranging for services (such as visiting nurses) and special equipment (like ahospital bed or bedside commode)5、·Health insurance·Planning by a professional, such as a hospital discharge plaimer or a social worker·Help from local governmental agencies·Doctor's supervision at home6、·Traditionally, it is only about symptom care.·Recently, it is a comprehensive approach to improving the quality of life for people who are living with potentially fatal diseases.7、·Stopping treatment specifically aimed at curing an illness equals discontinuing all treatment.·Choosing a hospice is a permanent decision.Unit71、·A dying patient·Decision whether to withdraw life-support machines and medication and startcomfort measures·The family's refusal to make any decision or withdraw any treatments2、·The doctor as exclusive decision-maker·The patient as participant with little say in the final choice3、·Respect for the patient, especially the patient s autonomy·Patient-centered care·The patient as decision-maker based on the information provided by the doctor4、·Patients are forced to make decisions they never want to.·Patients, at least a large majority of them, prefer their doctors to make final decisions.·Shifting responsibility of decision-making to patients will bring about more stress to patients and their families, especially when the best option for the patient is uncertain.5、Doctors are very much cautious about committing some kind of ethicaltransgression.6、·Shouldering responsibility together with the patient may be better than havingthe patient make decisions on their own.·Balancing between paternalism and respect for patients autonomy constitutes alarge part of medical practice.Unit81、·Research:An activity to test hypothesis, to permit conclusions to be drawn, and thereby to develop or contribute to generalizable knowledge·Practice:Interventions solely to enhance the well-being of an individual patient or client and that have a reasonable expectation of success·Blurred distinction:Cooccurrence of research and practice like in research designed to evaluate a therapyNotable departure s from standard practice being called “experimental” withl”and “research” carelessly definedthe terms “experimenta2、·Autonomy：Individuals treated as autonomous agents .·Protection:Persons with diminished autonomy entitled to protection·A case in point:Prisoners involved in research3·“Do no harm” as the primary principle·Maximization of possible benefits and minimization of possible harms .·Balance between benefits and potential risks involved in every step of seedingthe benefits4、·“Do no harm” as a fundamental principle of medical ethics·Extension of it to the realm of research by Claude Bernard·Benefits and risks as a set “duet” in both medical practice and research 5、·Unreasonable denial of entitled benefit and unduly imposed burden：Enrolment of patients in new drug trial: Who should be enrolled and who should not?·Equal treatment of equals:Determining factors of equality: age, sex, severity of the condition, financial status, social status6、·Definition:The opportunity to choose what shall or shall not happen to them·Application:A process rather than signing a written formAdequate information as the premiseA well-informed decision as the expected result7、·Requirements for consent as entailed by the principle of respect for persons ·Risk/benefit assessment as entailed by the principle of beneficence ·More requirements of fairness as entailed by the principle of justice: At the individual level: fairnessAt the social level: distinction between classes。
学术英语医学Unit1-3-7-9课文翻译
学术英语unit1,unit3,unit4,unit9课文翻译 Unit 1 Text A神经过载与千头万绪的医生患者经常抱怨自己的医生不会聆听他们的诉说。
虽然可能会有那么几个医生确实充耳不闻，但是大多数医生通情达理，还是能够感同身受的人。
我就纳闷为什么即使这些医生似乎成为批评的牺牲品。
我常常想这个问题的成因是不是就是医生所受的神经过载。
有时我感觉像变戏法，大脑千头万绪，事无巨细，不能挂一漏万。
如果病人冷不丁提个要求，即使所提要求十分中肯，也会让我那内心脆弱的平衡乱作一团，就像井然有序同时演出三台节目的大马戏场突然间崩塌了一样。
有一天，我算过一次常规就诊过程中我脑子里有多少想法在翻腾，试图据此弄清楚为了完满完成一项工作，一个医生的脑海机灵转动，需要处理多少个细节。
奥索里奥夫人 56 岁，是我的病人。
她有点超重。
她的糖尿病和高血压一直控制良好，恰到好处。
她的胆固醇偏高，但并没有服用任何药物。
她锻炼不够多，最后一次 DEXA 骨密度检测显示她的骨质变得有点疏松。
尽管她一直没有爽约，按时看病，并能按时做血液化验，但是她形容自己的生活还有压力。
总的说来，她健康良好，在医疗实践中很可能被描述为一个普通患者，并非过于复杂。
以下是整个 20 分钟看病的过程中我脑海中闪过的念头。
她做了血液化验，这是好事。
血糖好点了。
胆固醇不是很好。
可能需要考虑开始服用他汀类药物。
她的肝酶正常吗？她的体重有点增加。
我需要和她谈谈每天吃五种蔬果、每天步行 30 分钟的事。
糖尿病：她早上的血糖水平和晚上的比对结果如何？她最近是否和营养师谈过？她是否看过眼科医生？足科医生呢？她的血压还好，但不是很好。
我是不是应该再加一种降血压的药？药片多了是否让她困惑？更好地控制血压的益处和她可能什么药都不吃带来的风险孰重孰轻？骨密度 DEXA 扫描显示她的骨质有点疏松。
我是否应该让她服用二磷酸盐，因为这可以预防骨质疏松症？而我现在又要给她加一种药丸，而这种药需要详细说明。
学术英语Unit1~4课文翻译
Unit 1 Text A神经过载与千头万绪的医生患者经常抱怨自己的医生不会聆听他们的诉说。
虽然可能会有那么几个医生确实充耳不闻，但是大多数医生通情达理，还是能够感同身受的人。
我就纳闷为什么即使这些医生似乎成为批评的牺牲品。
我常常想这个问题的成因是不是就是医生所受的神经过载。
有时我感觉像变戏法，大脑千头万绪，事无巨细，不能挂一漏万。
如果病人冷不丁提个要求，即使所提要求十分中肯，也会让我那内心脆弱的平衡乱作一团，就像井然有序同时演出三台节目的大马戏场突然间崩塌了一样。
有一天，我算过一次常规就诊过程中我脑子里有多少想法在翻腾，试图据此弄清楚为了完满完成一项工作，一个医生的脑海机灵转动，需要处理多少个细节。
奥索里奥夫人 56 岁，是我的病人。
她有点超重。
她的糖尿病和高血压一直控制良好，恰到好处。
她的胆固醇偏高，但并没有服用任何药物。
她锻炼不够多，最后一次 DEXA 骨密度检测显示她的骨质变得有点疏松。
尽管她一直没有爽约，按时看病，并能按时做血液化验，但是她形容自己的生活还有压力。
总的说来，她健康良好，在医疗实践中很可能被描述为一个普通患者，并非过于复杂。
以下是整个 20 分钟看病的过程中我脑海中闪过的念头。
她做了血液化验，这是好事。
血糖好点了。
胆固醇不是很好。
可能需要考虑开始服用他汀类药物。
她的肝酶正常吗？她的体重有点增加。
我需要和她谈谈每天吃五种蔬果、每天步行 30 分钟的事。
糖尿病：她早上的血糖水平和晚上的比对结果如何？她最近是否和营养师谈过？她是否看过眼科医生？足科医生呢？她的血压还好，但不是很好。
我是不是应该再加一种降血压的药？药片多了是否让她困惑？更好地控制血压的益处和她可能什么药都不吃带来的风险孰重孰轻？骨密度 DEXA 扫描显示她的骨质有点疏松。
我是否应该让她服用二磷酸盐，因为这可以预防骨质疏松症？而我现在又要给她加一种药丸，而这种药需要详细说明。
也许留到下一次再说吧？她家里的情况怎么样呢？她现在是否有常见的生活压力？亦或她有可能有抑郁症或焦虑症？有没有时间让她做个抑郁问卷调查呢？健康保养：她最后一次乳房 X 光检查是什么时候做的？子宫颈抹片呢？ 50 岁之后是否做过结肠镜检查？过去 10 年间她是否注射过破伤风加强疫苗？她是否符合接种肺炎疫苗的条件？奥索里奥夫人打断了我的思路，告诉我过去的几个月里她一直背痛。