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oi-*eerey, Eileen Sueeney; trad.:

Mirei I I e Mandelbrojt-sweeneyEileen Sweeney

LimbaenglezdFentru naedicigi asistente

.Edi{ia a II-a revizuti gi adiugiti

Prefaii de ]ean Bernard

Traducere de Emanuela Stoleriu

POLIROM20r4

.\.a,!.&4.

Contents/Cuprins

Prefa1d....... ..........., 13

Cuvdnt-tnainte la edilia a patra .................. 15

Cuvdnt-tnainte la edilia a treia .................. 16

Cuvdnt-tnainte la edilia tntki........... ........... 17

Introducere ...........19

General expressrbns/Expresii generale.... ...................2tMiscellaneouslGeneralittrli .....................21TimelBxpresii legate de timp.......Days of the weeklZilele sdptdmdnii .........22Months of the yearlLunile anului ,.....,.....23NumberslNtmere .......... .,,".23

QuantitylCantitate........,.. .,..................23Length and distancellungime Ei distanli ...,........:......24WeightlGreutate ............ ....;............ .....24TemperaturelTemperaturl .....................24

Pacient historylAnamneza pacientului .......... .............27MiscellaneouslGenera1it51i................ .....27General healthlStarea generaltr ..............2'lPast medical historyllstoricul personal ......................28Drug historylTratamente unnate ............28Family historyllstoricul familial ;............29HabitslObiceiuri ............ ......,.............. 30

Social historylMediul de viald ...............30The elderlylPersoanele in vdrstd .............31Review of systemsl Anamneza referitoare la sisteme............... j. ......32

PainlDurerea............... ....,.., 35

HistorylAnarrtneza........... ................:..... 35

Cardiovascular systemlSistemul cardiovascular.....,....... ..,............ 39

HistorylAnamneza .............39Chest painlDurerile toracice....... ......39Ischaemic heart diseaselCardiopatia ischemicd ....,..41DyspnoealDispneea....... .................. 42

-'i*dbbs.

Ankle oedemaiEdemul gleznelor .......PalpitarionslpalpitatriiIe.....,.............. """"""','.' 42

Heart failurellniuficienla .urOiu.e.....' """"""""' 43

peripherat vascutar svmptomstieil; tu;qi";;i;;;;;;i;;; ..:.:.,........:. .....".1:Thromboembolic diseaselBoala tromboembolicd.... .....,.,........,.,46Common cardiac conditionsl Afecgiuni cardiace frecvente.....,......... 4jclinical examination and reportiig findingsllxamenur clinic ai datele obginutela examenul clinic..,''...' ,....,'.'......',.,...i48Arterial pulseslpulsul arterial ....... ........ .

Hean soundslZgomotele cardiaceMurmursliluiurile.............. .. ..,......

' ' """""""""' 50

I nv e s t i g a t i o nsl t nve stig a l iiBliod tes*lAnaliza iAngel"i.....,,....,.. """""""""51

^. Etectrogardiosiam (ECG)tEtectro..raioer"*. ieic)nccj :::.,.:.::...,::......:.:;i

PharmacologylFarmacologie ..,.........., .,..,......,......... 54Anticaagulanls/Anticoagulante.,....,... ..,.....,....,,,..54

Symptoms/simptome

lg sp i rato ry syste m /p n e u m o I og y rSistemul respirator/pneumotogiL

..,......,... ssHistorylAnamneza,.......... ........,........... 55coughlrusea..!..!..!!;....... .,........,...... 55SputumlSputa...,....,....... ......,.......... 55H ae mop ty s i s/HernoptiziaChest painlDurerile toracice...........,..-""-""' "''"' 56

Occupational historyllstoricul profesio.;i..:.............................................. ;iSmoking historyllstoricul de fumtrtor.,..... .............57Asthmal Astmul...............copD (chronic

'ol,rrrit:"| iri*;r";;;;;"iti """""" 58

- BPOC(bronhopneumopatiaobstructivlcronicl) .............!;........59/ysrn therapyloxigenorerapia .............60Modified Medical Research Council (MMRC) Dyspnoea ScalelScala de dispnee conform Medical Research Co'un.iL iprrvr{Ci ....... 60C:yyor: respiratory conditions/Afecliuni respiratorii frecvente..........................61clinical examination and findingsrExamenur itinic gi datele obginutela examenul clinic '........ ....,.................62InspectionlExaminarea.... .................62

Palpationlpalparea .........Peicussionlpircu1ia............................ """""""':" """"""'62AuscultarlonlAuscultalia..............

_ character of vocat resonance/Mooificarea re;;;;;;;;;";ii.......................... :;I nve s t i g at i onsll nve stigaliiExamination of the sp.wtumlExarnenul ,p;r;i..............................................:;Blood testslAnaliza sAngelui...........,..:... . .................65Examination of the pleuralExaminarea pleurei ................... . ..........65Intradermal tests/lntradermoreactrii......... . . ......................65

..........63lonarller !'oclr........... ............. ". 64

......,......65

. ',,. '. '... '. 65

......... 65r"............... .........65

............. 65

55

55

5"5

56

56

57

57

Pulmonary function tests (PFT)lProbe functrionale respiratorii.,..................,. 65

RadiologylExamenul radiologic.... .....66

Gaslroinfes ti n al sy ste m /g a stro e nte rol og y ISistemul digestiv/gastroenterologie,,,...,....... ........,....67

HistorylAnamneza........ .....67Abdominal painlDurerca abdominal[ .,..,..,.......,....67Appetitel Apetitul ......,.,.. ....,..........,. 69

WeightlGreutatea ......,.... .....,...,,,,...., 69

Earty satiation and postprandial fullncsslSa6ietatea precoce gi

plenitudinea postprandial[ '.... ' " '. 69

Nausea and vomiting (N&V)lGreaIa gi voma '....'..' 70

HaematemesislHematemeza,,.,...,....". ..............'... 70

Gastro-oesophageal reflux disease (COKD)lRefluxul gastroesofagian (RCE).'. 70

SwallowinglDeglutilia...,., ,........ '..... '.. '.71Bowel habitlTranzitul intestinal .,..'.'...'.72Abdominal distensionlDistensia abdominald ',.."74Rectal bleedinglSdngerlrile rectale '.......'.".."..'." 74

Jaund.icellcteru1.....,...... .......... '. '...., 75

Gastrointestinal cottditionslBoli gastrointestinale ,... ' ' '.. '.. '.. 76

Clinical examinationlExamenul clinic....,".,. '...'."'.....71InspectionlBxaminarea.... .'............'..77PalpationlPalparea .....,... . '. '. '..... ' ' '. '. 79

PercussionlPercutia ......... .. '... ' ',....... ' 80

AuscultationlAuscultalia. ........:'.'.......'..'..."......'...81Digital rectal examination (DRE)lTugeul rectal (TR) ...'.....'....'..81

Investigationsllnvestigalii ...........'...'. '.....81Alimentary tractlTubul digestiv .........'81

LiverlFicatul ..".........." 83

Gallbladde r, bile ducts and pancreaslVezic(ul)a biliar5,cdile biliare qi pancreasuI................ "...'....'.'....".83

E ndocri ne syste m/e ndocri n olog ylSistemulendocrin/endocrinologie ....'.'.....8s

Diabetes metlituslDiabetul zaharat ..'.......'..'..85HistorylAnamneza ..'..'.85

Tlryroid glandlGlanda tiroidd...... .'....'...'..87llisle,rylAnamneza ...'....87Ctinical examinationlExamenul clinic ......... ...... '... '. ' 90

Investigatiortsllnvestigalii .. '....... '.......91Other endocrine cond.itionslAlte boli endocrine...............' ........'.'.'91

Hypothalamus-pituita.ry axlslAxul hipotalamo-hipofizar..'... "'.....91Tlryroid glandlGlanda tiroidd ..."........91Parathyroid glandslGlandele paratiroide ............... ...... .. '.. ',.:....91PancreaslPancreasul ...........91Adrenal glarzdlGlanda suprarenal5 ......'................92

Investigationsllnvestigalii ..... ................ 92

G en ito-u ri n a ry syste m/ne p h rot og y/u rot og y/Sistemul genito-urinarlnefrologiJiurorogil

......,........... e5History/Anamne2a........... ....... 95Flank painlDurerea laterall/in flanc .......... ..........95Micturition clutltsel after the painlModificrri urinare oufe criza dureroasr..,. 96M_odification of urinelModificdri ale urinei......... .:., ...........,........,.,.. 92HaematurialHematuria

...................,.gjProswte p roble ms /probleme ale prostatei... ...Incontinencellncontinen1a.............. ... ......,.,........ 99common urinary ffact conditionslAfecliuni frecvente ate apuratutui urinar ..,...... gg

-- .Examination of the male genitarialdxamenul aparatului genital masculin.......l00Urinary system investigatiortslExamenul aparatului urinar..]..... "... 100Urine testl Analiza urineiBlood testslAnaliza sdngel"i....,........ """""""'.. 100

- RadiologylExamenul radiologic........ ..................................................... ,tllDialysislDiali2a............. ....................................... ..... tVzNervous system/ne u rotogylSistemul nervos/neurotogie..........

:................,..........103HistorylAnamneza"""'.'.. ................... 103HeadachelDureri de cap/cefalee..

.....103Motor disturbanceslTulburlri motorii .................106Balance disturbance lTulbur5ri de echilibruNeurological conditionsl Afecliuni neurologice. . . . . .. ltOClinical examinationlExamenul clinic......... ............. ll2Mental statelstarea mentald....... ...... ilzCranial ne rve s /N ervii cranieni

lotor nene functionlFunclia n".uurui *oi;;.....,........................,......,..... li3Tone ofmuscleslTonusul rnuscular..,.. ..!.....!..;....................... lt6Tendon reflexeslReflexele osteotendinoase..... .,..... 116Neck stffiesslRedoarea cefei ........... 116Sensation/sensibilitatea... ................. lt6Neurological examinationlExamenul neurologic... .,................. ll7Investigationsllnvestigalii

...............,...,. ll9Obsfefrlcs and gynaecologylObstetrici gi ginecologie .................121HistorylAnamneza

............ r2rMenstruationlMenstrualia ............... l2lAbnormal vaginat bleedinglSAngerarea vaginall anormall...,. ....122

lySi1at dischargelscurgerile vaglnate ............,....122Vaginal prurituslprurirul vaginai ......t23Preconceptionlinaintea conceptriei... ....................123. PregnancylSarcina .......123Past pregnancieslSarcini precedente... ...........,.....t24

Prolapse lprolapsul .........Birth controlliontraceptria """""""'125

................... 126

,........95

..'. '.. ' '.. 103

Infertilityllnfertilitatea .....;.....,......,.;127MenopauselMenopau2a................ ..r..............,.,.128

Clinicat exqminationlExamenul clinic......... .............128Investigationsllnvestigalii ..........,.......... 129

HistorylAnamneza........... ..... 131

Breast lumpllJmfldturi la nivelul sAnilor...,.. ...............:..........131Mastalgia (breast pain)lMastalgia (durerea de sdn) ................. 132

Breast examinationlExaminarea sinilor ....132Common breast conditionsl Afecliuni frecvente ale sdnilor... .. . .. ".. . . .132Breast surgery l Chirurgia sAnilor

PaediatricsiPediatrie .... ,......................... 135

HistorylAnamneza........ .....135MiscellaneouslGeneraIittr1i.,.............. ................135Pregnancy historyllstoricul sarcinii..:..........,..... ............,.......135Neonatal periodlPerioada neonatald............... ..............136Feeding lrisrorylModul de alimenta1ie............... ........'...'........137ImmunisationslVaccindri ."'....'....'.".137Developmental milestones lDezvoltarea psihomotorie

Social historylMediul de vialX ..............'.'..'......'139Chitdhood dls e as e s lBolile copiltrriei

PsychiatrylPsihiatrie...... ......' l4l

History l Anamneza........Mood disurbancelTulburflri de dispozitie...........'.' ..'..."........ t4lThought contentlcanlinutul gdndurilor........... .....143

Common psychiatric conditionslBoli psihiatrice frecvente .................;....'........143InteltectuatfunctionslFuncliile intelectuale............. ...,.'....".'......144

TreatmentlTratament .'....'.'..."'... ....144

Toxicomania and addiaion (alcohol)lToxicomania Ei dependenla (alcool) .....".'.1'15

I nfe ctiou s dlseasesiBoli i nfectioase

History l Anamneza ...........The febrile patientlBolnavul febril .'-.147

List of infectious diseasesllista bolilor infectioase "'..149Clinicat examinationlExamenul clinic .....,... ........ '. ' '. 150

Investigationsllnvestigalii . ". 150

Sexually transmitted infectioru (SI/)/Boli cu transmitere sexual[ (BTS)........"'.' l5lMalarialMalarialPaludismul.............. ..'.....'.."..'.....152Tuberculosis (I8)/Tuberculoza (TBC).. ......'...'.......'.153

TB presentationslForme de tuberculozd.............. .'.....'.'.....'.;'153Investigations ofTBllnvestigalii pentru depistarea tuberculozei'....'..'.'......."153

H o sp ital a c qui re d / no s o c omia I infe c tions IInfeclii contractate in spital/nosocomiale....... ........"'154

Infection control in health carelControlul infecliilor in serviciile de sdndtate ...15+

l3l

HaematologylHematologie ........,.........,..155HistorylAnamneza........,.. ...................155MiscellaneouslGeneralitdti ................ ................ 155

-- Transfusions of blood protructsrTransfuzie de componente sangvine ............. i;;Haematological conditionrlBoli hematologice ..,...,.........., ...,....... 157I nve s ti g ationsllnvestigagii

Futl btood count (FBC)/Numdrarea f";;i;;';;;g"i". iNei):,.......:............ ffiCoagulationl Coagularea.. .............:,................... ................ i5;Other testsl Alte teste.......

Haematotogy and oncotogy terminotogytr;;i;;i";t; firi;;il;" ;.;;;;i;;i; ' t"gi oncologie, ..,.................159

Vascular accessl Acces vascular..........

-r'';f,;,nffi,:t;ffiil;1;1;;;'"1 ,,, i. ., ... l;1

TraumatologylTraumatologie .............Rheumatotogic1t conauiorslBoli .rurnuti""......:...:.....:.....:...:...:'.....:...:...:..:... l:;Clinical examinationlExamenul clinic......... .............167

Inspe cti on lExaminarea... .

paipationtparparea ......... :...::...,:..:..:.:.....:.:.................:...:.:. i:;M ove me nt s / Mo bi l itateaspine or vertebral corumn exarninationlExamenul coloanei vertebrale ............... 16gInvestigationsllnvestigalii ..................... i;;Blood testslAnalize de sdnge.......... ....................168J_oint aspiration/puncgia articulard ... ......................:.,:......i;;Rad.iologylExamenul radiologic ........169Other investigationslAlte investigatrii... ................169PharmacologylFarmacologir.............,. .."............ 169Non.pharmacological treatmentslTratamente nefarmacologice ....... "............. 170

DermatologylDermatologie .............. ....... r73HistorylAnam\e2a........... ...................173, RashlErup1ia.......... .....,.............. izi

common deimatotogicat disordersteori oermar;i;;;;; ;;;;;;;.................,.... 176Past medical historyllstoricul medical. .. ... ............ izoCorymon dennatological disorders/Bolidermatologice frecvente ....1:16

Malignant melanoma/Melanomul malign .......,.....177Clinical examinationlExamenul clinic.......... ....,.,.....177Clinical findings (of the lesion)llnformaliile oblinutela examenul clinic (al leziunii)...... ........177I nv e s ti g at i onslInvestigaliiMedications/Medicamente................ .....t79

Medical recordslFiga de observafie..............M is c e llane ouslFiga administrativ[Medical recordstObservalii medical.........:...............::................^................

181

l8l181

r83False friendslFalgi

,''..'.'....,,.'...,. 177

...,:,179

181

l8r181

List of symptoms, syndromes and diseases/Lista simptomelor, iindroamelor gi bolilor... ................ r85

List of abbrevi ations/Lista abrevierilor.

Health care personnel and establishmentslPersonalul medico-sanitar gi unititile de ingrijire.............. ...........22t

Health care stafflPersonalul medico-sanitar.............. ..................221Specialists (consuhants)/Medici specialigti.... ............221Alternative therapistslSpecialigti in medicind alternativd... ........223Couns ellors lConsilieri ..,....'...........Nursing stafflCadre medicale medii.........!........!...r... j ...........223Paramedical stafflPersonalul paramedical ............ ..................,224Multidisciplinary team (MDT)lEchipa multidisciplinar[.......... ....................224WelfarestafflPersonaluldincadrulserviciilorsociale......'.Administation s/a,;f/Personalul administrativ ............. ............,.224

Health care facilitieslUnit[1i de ingrijire ...................225In general practicelLaclinicl .......,..225At the surgery, at the health centelLa clinica de chirurgie,la centrul de ingrijire a strn[t[tii.... ........;............225At the chemisrlpharmacy/La farmacie. .................226At the communiry health service centerlLa dispensar ...............226

At the hospital/La spitalFacilitieslUnitdti..........., ................226.Hospital wardslSecliile spitalului.. ....227

Working abroadlProfesarea in striinitate:. ...............229

GP training in Great Brttain and lrelandlFormarea medicului specialistin medicinl intern5 in Marea Britanie gi Irlanda.... ...............;......229Specialist training in Great Britain and lrelandlPractica medicului specialistin Marea Britanie gi IrlandaAddress booklCarnet de adrese ........,,....230

CollegeslColegii............ ..............,.,230M edical D efens e Organis ationslOrganizalii de asigurarede rlspundere medicali ...................231PublicationslPublica1ii... ..........,.....:.232OtherlAltele ............ .........:........ ..........,..........232Curriculum vitaelCurriculum vitae .....................232

PharmacologylFarmacologie.......... ........235

HistorylAnamneza........ ....235Allergiesl{lergii............. ....................235FormlFormd ....................236PresuiptionlRegeta ....".., ....236Side ffictslEfecte secund&r€..........:.. ...,.................237

Index - limba eng1e2d............... ...............243Irulex - limba romhnd............... ...............249

General expressions Expresii generale

Miscellaneous Generaliti'ti

Hello, what is your name? Buntr ziua, cum vtr numili? :

- Surname - Nume de familie

- First name - Prenume

How old are you ? Ce vArsti aveli ?

Where do you feel the pain ? (show me Unde vI doare ? (ardtatri-mi cu mdna)with your hand)

Point out in the table of contents the chap- Indicatri in cuprins capitolul referitor later related to your complaint. problema dumneavoastr5.

Time Expresii legate de timpSeconds (sec) Secunde (sec.)

Minutes (min) Minute (min.)

Hours (h/hr) Ore (h)

Days ZileWeeks Strpttrmini

Months Luni

Years AniFor abbreviations for days, weeks and Pentru abrevierile referitoare la numtrrulmonths as they are used in English med- dezile, slpttrmdni, luni in fi$ele de obser-ical records, see table 1. vade englezeqti, vezi tabelul l.

Table l/Tabelul IExpressions of days, weeks, months in the medical recorcl/

Exprimarea zilelor sdptdmdnilor 1i lunilor in fiSa de observa[ie

#t7 3t7 #t52 2ts2 #t12 6t12Number ofdavs

Three days Number ofweeks

Two weeks Number ofmonths

Six months

Numfru] dezile

Trei zile NumXrul des[ottrmAni

Dou[slntlmAni

Numirul deluni

$ase luni

22 General expressions

Next

Last

Before

AfterToday

Tomorrow

Yesterday

Day before yesterday

Morning

Afternoon

Midday

Night

Occasionally

Rarely

Often

During

Always

For

I have a pain for three months.

Since (a date)

Since when do you have this pain ?

I have a pain since yesterday.

Days of the week

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Urmitor (urmdtoare)

Ultimul (ultima)

inainte

Dupd

AziMdine

IeriAlaltdieri

Dimineatra

Dup5-amiaza

I-a prdnz

Noaptea

Din cdnd in cdnd

Rar'Adesea

in timpulintotdeauna

De...

Am o durere de trei luni.De... (incepdnd de Ia o anumit[ dat[)De cAnd avetri aceastd durere ?

Arn o durere de ieri.

Zilele siptimAniiLuni

Ma4iMiercuri

Joi

Vineri

SAmb[ttr

Duminictr

{tor (urmtrtoare)

nut (ultima)

me

l

rEturi

imgaf-amiaza

rinzpacfod in cdnd

Elryuldeauna

o durere de trei luni.

- (ircepand de la o anumit[ datl):fod avegi aceaste durere ? :

o &uere de ieri.

Zilele slptimAnii

rcuri

rirurfficl

Months of the year

January

RbruaryMarch

AprilMay

June

July

August

September

October

November

December

Numbers

One

Two

Three

Four

Five

Six

Seven

Eight

Nine

len

QuantityTea spoon

Table spoon

Cup tullMillilitres (ml)

Litres (l)

Pint (- 474 ml)

Expresii generale

Lunile anului

Ianuarie

Februarie

Martie

AprilieMai

Iunie

IulieAugust

Septembrie

Octombrie

Noiembrie

Decembrie

Numere

Unu

Doi

Trei

Patru

Cinci

$ase

$apte

optNoutr

Tnce

LingurildLingurd

Cantr

Mililitri (ml)

Litri (l)Pintd

Cantitate

24 General expressions

Noral amount

Small amount

None at allA lotReduced quantiry (a few drops)I unit of alcohol(alclvol X volume consumed) : 1000 :X units

Length and distance

Millimetre (mm)

Centimetre (cm)

Metre (m)

Units of measurements sometimes stillused in English-speaking countries :

* Inch (= 2.54 cm)

- Foot (= 0.3048 m)

- Yard (= 0.9144 m)

Weight

Gram (g)

Kilogram (kg) (l kg = 2.2 tb)Units of measurements sometimes stillused in English-speaking countries :

Pounds (l lb : 0.45 kg)Stone (14 lbs)

Temperature

Celsius ('C)Now used in most countries except inthe USA and in the English-speakingelderly population !

Fahrenheit ("F)

Cantitate normallCantitate mictr/Putrin

Deloc

Mult, dbundent

Cantitate foarte micd (cdteva picdtqri)o unitate de alcool(alc/vol x volum consumat) : 1000X unitdli

Lungime gi distan{a

Milimetru (mm)

Centimetru (cm)

Metru (m)

Unitdti de m5surX incd utilizatetrdrile anglofone:

- Inch

- Picior

- Yard

Greutate

Gram (g)

Kilogram (kg)

Unidti de mtrsurI incl urilizate in15rile anglofone:

- Livre

- cca6kg

Temperaturi

Grad Celsius ('C)in prezent folosit in majoritatea gri-lor, cu exceptia Statelor Unite Si apersoanelor anglofone in vArstd !

grad Fahrenheit ('F)

ln

frrrc normal[ftete micilPulinrc

t, ibundent

flrte foarte mici (citeva pic[turi)lm de alcool

hnl x volum consumat) : 1000 :r$

llngime gi distan{i l

imr (mm)

tirtru (cm,l

n (m)

ffiti de mtrsur[ incl utilizate inlile atglofone;-hh- Pbior-bd

Greutate

r (g)

cEn (kg)

ffiti de mtrsurl inc[ utilizate inftfl3r anglofone:

- Livre- u6kg

Temperaturi

bd Celsius ("C)

tr pczent folosit in majoritatea 1trri-q cu erceptia Statelor Unite Ei a:nrmelor anglofone in vdrstd !

nd fahrenheit ("F)

Celsius to Fahrenheit:"F=(oCx9lS)+32

- Iluman body temperature

36.1 - 37.5 .C (96.9 - 99.5

Expresii generale 25

Transformarea grade Fahrenheit -grade Celsius : oC : ("F - 32) x 5/9

- Temperatura corpului uman

'F) 36,1-37,5 oC

Table 2/Tabelul 2

Celsius ("C) Fahrenheit ('F)38,5 l0r.339 t42,239,5 103,I40 104

40,5 r04,94t 105,842 t47,6

Temperature equivalence in degrees Celsius and degrees Fahrenhe.it/Echivalenla temperaturii in grade Celsius Si grde Falvenheit

Cdsius (oC) Fahrenheit (oF)

t5 95

15,5 95.95 96,816.5 97.7n 98.6t7.5 99.5s 100,4

Pacient history Anamneza pacientului .

Miscellaneous Generalitefi

Hello, what is your name? Bund ziua, cum vtr numili?

- Surname Nume

- First name (Christian name) - Prenume

How old are you ? Ce vdrsttr aveli ?

What brings you here today ? De ce ati venit azi la consultalie ?

Where do you feel the pain ? (show me Unde vd doare ? (ardtatri-mi cu mina)with your hand)

Foint out in the table of contents the chap- Indicali in cuprins capitolul referitor la

ter related to your complaint. problema dumneavoastr[.

General health, Starea generale

How much do you weigh ? Ce greutate ave[i ?

I kg : 2.21lb I livrl = 0,45 kg

Your weight: Greutatea dumneavoastr[ :

- is it stable? - este stabiltr?

- has it increased ? - a crescut ?

- has it decreased: - a scdzut:

- by how many kilogrammes ? (See - cu cite kilograme ? (Vezi pagina 24)page 24)

- in how much time? (See page 2l) - in cdt timp? (Vezi pagina 2l)Do you feel a lack of energy ? Vd simtiti lipsit de energie ?

Do you have any fever? Avetri febrd?

Since when ? De cdnd ?

3: iil #: il:il;tacks or shivering, ffiliH::;.,How long have you been fasting ? De cit timp nu mdncatri ?

General deterioration Alterarea stdrii generale

28 Pacient history

Past medical history

Have you ever been hospitalised ?

- Where ? (address)

- When?

Have you had all the childhood diseases ?

Have you had any surgery ?

- When (time) ?

- Which ones ?

- appendix

- tonsils

- hernia

- tumour

- other (show me your scar)Did you ever/do you have:

- high blood pressure (hypertension) ?

- diabetes ?

- asthma ?

_ COPD?

- sexually transmitted diseases ?

If you have this complaint for a fewmonths now, why did you present today ?Has something changed ?

Istoricul personal

A1i mai fost spitalizat ?

- Unde ? (adresa)

- Cdnd ?

Atri avut toate bolile copiltrriei ? ,

Atri suferit vreo operafie ?

- Cdnd ? (scrieli data)

- Ce fel?

- apendiciti

- amigdale

- hernie

- fumord

- altele (ardtagi-mi cicatricea)Atri avut vreodat5/ave1i :

- hipertensiune arteriali ?

- diabet ?

- astm?_ BPOC?

- boli cu transmitere sexual[ ?

Daci avetri aceste probleme de mai multeluni, de ce v-ati prezentat astdzi?

S-a schimbat ceva ?

Drug history

Do you take arry:

- prescribed medication ?

- over the counrer medication (OTC) ?

Do you kuow their names ?

What dose are you taking ?

How many times a day ?

Do you have them with you ?

Show me the medicine containers.

Tratamente urmate

Luatri:

- medicamente pe retetl ?

- medicamente eliberate ftrrd retretd'l

$titri cum se numesc ?

Ce dozl luali ?De cdte ori pe zi?Le aveli la dumneavoastri ?

Aritali-mi curiile de medicamente.Can you show me a list or your last pre- imi putetri ardta o listtr a medicamentelorscription ? 6urruleavoastrtr sau ultima reteti ?

Istoricul personal

ri fr6t spitalizar ?

? (dresa)

U?it Etre bolile copiltrriei?

*rl vreo operalie?

I? (scriegi data)

b tr?- acndicitil- rlgdate' htrb-ffi- #e (artrtati-mi cicatricea)

,

ll vrcodatitr/ave1i :

irrmiune arterialtr ?

E"l--Foc?fr cu transmitere sexuald ?

tqimte probleme de mai multe, - oe v-a1i prezentat ast5;zi?

frbet ceta'

Tratamente urmate

[:fuente pe regetd'l

nfumte eliberate fdr[ retretd?

Gn s numesc?

H hrti?*ai pea?Efi h drmneavoastrd ?

li-ri Giiih de medicamente.

-fi rllr o listtr a medicamenrelor

ffi sau ultima reletd'l

Anarnneqa pacientului 29

Are you allergic to anything that you Din cite gti1i, suntetri alergic la ceva ?tnow of?

- aspirin

- penicillin

- gther antibiotics

- other medicine (write the name down) - alt medicament (scrieli denumirea) I

What happens when you take them ? Ce se intimpl[ c6nd le luali ?

- anaphylaxis

- rash

- mouth swelling

difficulry breathing* choking sensation

- abdominal discomfort

Family history

Are your parents alive ?

- accident

- heart problem

- cancer

- infectious disease

- other

Do you have any:

- children?

- How many?

- Age?

Are they in good health ?

- brothers and sisters (siblings) ? - foati Si surori?

- aspirintr

- penlcllna

- alte antibiotice

- $oe anafiIactic

- erup1ie cutanati

- umflarea gurii

- dificult{i de respiralie

- senzatie de sufocare

- durere abdominal5

Istoricul familial

Ptrrinlii dumneavoastrd sunt in viald ?

- accident

- probleme cardiace* cancer

- boald infectrioasd

- altele

Aveli:

- copii ?

- Ceti?

- Ce vdrsttr au ?

Sunt slnltoEi?

No known drug allergies (NKDA) Nicio alergie cunoscurtr

If not, at what age did they die? Dactr nu, la ce vdrsttr au decedat?

What was the cause of their death? Din ce cauzl au decedat?

- hereditary disease - which one ? boaltr ereditartr : care ?