询问病史12casehistoryYouneedtogetadetailedhistoryincludingthetimingandacuityofonset,exacerbatingandalleviatingfactorsandenvironmenttriggerstohelpyouconfirmadiagnosisordiscardotherdiseases/developadifferentialdiagnosis.Askyourpatientwhetherthereisahistoryoftobaccouse,orothertoxicandenvironmentalexposuresandhisoccupationalhistory.General/biographical[,baiəu'ræfik,-kəl]ɡdata传记,marital婚姻status,nativity出生,occupation,informant提供消息的人,timeofadmissionandrecord,chiefcomplaint,historyofpresentillness,previoushealthstatus(well,ordinaryorbad),anyinfectiousdiseases,allergichistory,historyoftraumaorsurgery,smoking(abouthowmanyyears,averagehowmanypiecesperday,ceasedforhowmanyyears),alcoholintake(occasionalorfrequent),spouse’s[spaus]配偶healthstatus,menorrhea[,menə'ri:ə]月经(menarche[me'n:ki:,mə-]ɑ初潮age,cyclelastingforhowmanydays,menstrualcycle,lastmenstruationperiodorageofmenopause,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,siblings兄弟姐妹andchildren)常用的症状symptomsfeverCough咳嗽Sputum(dry,purulent['pjuərjulənt]脓性的,copious['kəupiəs]greensputum大量绿色痰，tenacious[ti'neiəs,tə-]ʃyellowsputum黄粘痰，frothywhitesputum白色泡沫痰，rustysputum铁锈色痰wheezingDyspneaduringexertion[i'zə:ən]ɡʃoratrest呼吸困难Orthopnea[:'θpniə]ɔɔ端坐呼吸Paroxysmal[,pærək'sizməl]nocturnal[nk'tə:nəl]ɔdyspnea夜间阵发性呼吸困难Shortnessofbreath（SOB）Chesttightness胸部紧迫感Exerciseintolerancepleuriticchestpain胸膜型胸痛Pharyngalgia[færin'gældiə]ʒ;pharyngodynia[,færiŋ'diniə]ɡɔ咽痛Hemoptysis咯血Bucking呛咳Sneeze喷嚏snore打鼾malaise[mæ'leiz]不舒服myalgia[mai'ældiə]ʒ肌痛insomnia[in'smniə]ɔ失眠hoarseness声嘶dysphonia[dis'fəuniə]发声困难常见的体征physicalsignsclubbedfingers杵状指:increasedlongitudinal[,lndi'tju:dinəl]ɔʒandtransverse横向curvature['kə:vətə]ʃ弯曲,lossofconcave['knkeiv]ɔ凹面的nailfoldangle,bogginessofnailbedandincreasedsofttissuebulkofdistalphalanx['fælæŋks,'fei-]趾骨,指骨,drumstick-likenicotinestainingcyanosis[,saiə'nəusis]发绀:bluediscolourationofmucosalmembranesandskin,causedwhenmeancapillaryconcentrationofdeoxyhemoglobin[di:,ksi'heməu,ləubin]ɔɡ去氧血红蛋白morethan5g/dl,O2saturationlessthan85%,PaO2lessthan8KPaperipheral[pə'rifərəl]外围的,次要的cyanosis:coldblueperipheries,e.g.nailbedsduetocoldexposurescentralcyanosis:warmperipheries,bluetongueorlipshandflap:duetoCO2retention潴留asterixis扑翼样震颤papilloedema视乳头水肿chemosis球结膜水肿enlargedsupraclavicula锁骨上的r[klæ'vikjulə]andaxillary[æk'siləri]腋窝lymphnodesincreasedrespiratoryratetachycardia心动过速pulsusparadoxus:>10mmHg↓oninspiration(seeninsevereasthma)barrelchesthyperexpanded,decreasedexpansionkyphosis[kai'fəusis]驼背，脊柱后凸Inspection:tachypnea[,tækip'ni:ə]呼吸急促accessorymusclesofrespiration[,respə'reiən]ʃ:sternocleidomastoid['stə:nəu,klaidə'mæstid]ɔ胸锁乳突肌muscle,armsupport,alaeflaringwideornarrowintercostal[,intə'kstəl]ɔ肋间的spacetactile触觉的vocal声音的fremitus震颤触觉语颤subcutaneouscrepitus皮下捻发感Percussion:resonance清音dullness浊音flatness实音hyperresonance过清音tympany/timp2ni/鼓音lowerbord...
