《医学英语》课件：listen.pptVIP

Listening Dan Zhang SRRSH Neurology department A case from NEJM（1247） A 55-year-old woman with autoimmune hepatitis, cirrhosis, anorexia, and abdominal pain Katheleen E. Corey and colleagues Massachusetts General Hospital A case from NEJM-1 A 55-year-old woman with a history of autoimmune hepatitis was admitted to the hospital because of increasing lethargy, anorexia, and abdominal pain. 7 years earlier, this patient received a diagnosis of autoimmune hepatitis, and she began taking prednisone. A case from NEJM-2 During the next 6 years, splenomegaly, leukopenia, thromocytopenia, jaundice and lethargy occurred, as did recurrent episodes of ascites, spontaneous bacterial peritonitis, and encephalopathy. Three and half months before this admission, this patient was seen in a emergency department because of intermittent headaches, weakness, dizziness, fatigue, and increasing abdominal and ankle swelling. A case from NEJM-3 The patient was advised to continue her medication at home. 9 days later, the patient was found unresponsive on the floor at home. A glucose infusion was administered and her condition improved. During the next several weeks, she has increasing fatigue, confusion, non-radiating middle abdominal pain, and vomitting. A case from NEJM-4 The patient was admitted to this hospital. On the second day, melena and hypotension developed. When this patient was first evaluated, the physician thought that indentification of the source of melena would lead them to the diagnosis. However, in additon, the prolonged used of high dose of glucocorticosteroid increased the patient’s risk of acquiring opportunistic infection. Annals of internal medicine JAMA JAMA The Lancet Neurology BMJ