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1、询问病史12casehistoryYouneedtogetadetailedhistoryincludingthetimingandacuityofonset,exacerbatingandalleviatingfactorsandenvironmenttriggerstohelpyouconfirmadiagnosisordiscardotherdiseases/developadifferentialdiagnosis.Askyourpatientwhetherthereisahistoryoftobaccouse,orothertoxicandenviron
2、mentalexposuresandhisoccupationalhistory. General/biographical[,baiəu'ɡræfik,-kəl]data传记,marital婚姻status,nativity出生,occupation,informant提供消息的人,timeofadmissionandrecord,chiefcomplaint,historyofpresentillness,previoushealthstatus(well,ordinaryorbad),anyinfectiousdiseases,allergichistor
3、y,historyoftraumaorsurgery,smoking(abouthowmanyyears,averagehowmanypiecesperday,ceasedforhowmanyyears),alcoholintake(occasionalorfrequent),spouse’s[spaus]配偶healthstatus,menorrhea[,menə'ri:ə]月经(menarche[me'nɑ:ki:,mə-]初潮age,cyclelastingforhowmanydays,menstrualcycle,lastmenstruationperio
4、dorageofmenopause,anymenstrual['menstruəl]月经周期painorirregularcycle),childbearingorpregnancy(times,naturallabor,abortions流产,premature[,premə'tjuə,,pri:-]delivery早产,stillbirths死产,difficultlabor,familyhistory(anycongenital先天性diseases,fatherandmother:stillalive,illness,orcauseofdeath,sibl
5、ings兄弟姐妹andchildren) 常用的症状symptoms fever Cough咳嗽 Sputum(dry,purulent['pjuərjulənt]脓性的,copious['kəupiəs]greensputum大量绿色痰，tenacious[ti'neiʃəs,tə-]yellowsputum黄粘痰，frothywhitesputum白色泡沫痰，rustysputum铁锈色痰 wheezing Dyspneaduringexertion[iɡ'zə:ʃən]oratrest呼吸困难 Orthopnea[ɔ:'θɔpniə]端坐呼吸
6、 Paroxysmal[,pærək'sizməl]nocturnal[nɔk'tə:nəl]dyspnea夜间阵发性呼吸困难 Shortnessofbreath（SOB） Chesttightness胸部紧迫感 Exerciseintolerance pleuriticchestpain胸膜型胸痛 Pharyngalgia[færin'gældʒiə];pharyngodynia[,færiŋ'ɡɔdiniə]咽痛 Hemoptysis咯血 Bucking呛咳 Sneeze喷嚏 snore打鼾 malaise[mæ'leiz]不舒服 mya
7、lgia[mai'ældʒiə]肌痛 insomnia[in'sɔmniə]失眠 hoarseness声嘶 dysphonia[dis'fəuniə]发声困难 常见的体征physicalsigns clubbedfingers杵状指:increasedlongitudinal[,lɔndʒi'tju:dinəl]andtransverse横向curvature['kə:vətʃə]弯曲,lossofconcave['kɔnkeiv]凹面的nailfoldangle,bogginessofnailbedandincreasedsofttissuebulko
8、fdist
