III. Speaking

Make a dialogue between a pulmonologist and a patient. Here is vocabu­lary for you to speak about respiratory system problems.

IV. Supplement

Text1

1. Read and translate the text.

2. Write out the key sentences of the text. Be ready to speak about the

clinical manifestations of pneumonia.

PNEUMONIA

Pneumonia is an infection of one or both lungs which is usually caused by bacteria, vi­ruses, or fungi¹. Prior to the discovery of anti­biotics, one-third of all people who developed pneumonia subsequently died from the infec­tion. Currently², over 3 million people develop pneumonia each year in the United States. Over a half a million of these people are admitted to a hospital for treatment. Although most of these people recover, approximately 5 % will die from pneumonia. Pneumonia is the sixth lead­ing cause of death in the United States.

Some cases of pneumonia are contracted by breathing in small droplets³ that contain the organisms that can cause pneumonia. These droplets get into the air when a person infected with these germs coughs or sneezes. In other cases, pneumonia is caused when bacteria or viruses that are normally present in the mouth, throat, or nose inadvertently⁴ enter the lung. During sleep, it is quite common for people to aspirate secretions from the mouth, throat, or nose. Normally, the body's reflex response (coughing back up the secretions) and immune system will prevent the aspirated organisms from causing pneumonia. However, if a person is in a weakened condition from another illness, a severe pneumonia can develop. People with recent viral infections, lung disease, heart disease, and swallowing problems, as well as alcoholics, drug users, and those who have suffered a stroke or seizure are at higher risk for developing pneumo­nia than the general population.

Once organisms enter the lungs, they usually settle in the air sacs of the lung where they rapidly grow in number. This area of the lung then becomes filled with fluid and pus⁵ as the body attempts to fight off the infection.

Most people who develop pneumonia initially have symptoms of a cold which are then followed by a high fever, shaking chills, and a cough with spu­tum production. The sputum is usually discolored and sometimes bloody. Peo­ple with pneumonia may become short of breath. The only pain fibers in the lung are on the surface of the lung, in the area known as the pleura. Chest pain may develop if the outer pleural aspects of the lung are involved. This pain is usually sharp and worsens when taking a deep breath, known as pleuritic pain.

In other cases of pneumonia, there can be a slow onset of symptoms. A worsening cough, headaches, and muscle aches may be the only symptoms. In some people with pneumonia, coughing is not a major symptom because the infection is located in areas of the lung away from the larger airways.

Children and babies who develop pneumonia often do not have any specific signs of a chest infection but develop a fever, appear quite ill, and can become lethargic⁶. Elderly people may also have few symptoms with pneumonia.

Pneumonia may be suspected when the doctor examines the patient and hears coarse breathing or crackling sounds when listening to a portion of the chest with a stethoscope. There may be wheezing, or the sounds of breathing may be faint in a particular area of the chest. A chest X-ray is usually ordered to confirm the diagnosis of pneumonia. The lungs have several segments re­ferred to as lobes, usually two on the left and three on the right. When the pneumonia affects one of these lobes it is often referred to as lobar pneumonia⁷. Some pneumonias have a more patchy distribution that does not involve spe­cific lobes. In the past, when both lungs were involved in the infection, the term "double pneumonia" was used. This term is rarely used today.

Notes:

¹ fungus (pi. fungi) — грибок

² currently — нині

³ droplet — крапелька

⁴ inadvertently — випадково

⁵pus— гній

⁶ lethargic — млявий, апатичний

⁷ lobar pneumonia — крупозна пневмонія

3. Answer the following questions.

1) What is pneumonia?

2) How do people "catch" pneumonia?

3) Who is at high risk for developing pneumonia?

4) Describe the clinical course of pneumonia.

5) What are pneumonia symptoms and signs?

6) What are the symptoms of pneumonia in children and babies?

7) How is pneumonia diagnosed?
8) What is lobar pneumonia?

4. Fill in the blanks with the words given below.

1. Prior to the discovery of... one third of all people who developed pneumonia died from the....

2. Some cases of pneumonia are contracted by breathing in... that contain the organisms that can cause the disease.

3. Also pneumonia is caused when... or... that are normally present in the mouth, throat, or nose inadvertently enter the lung.

4. If a person is in a weakened condition from another illness, a severe... can develop.

5. Most people who develop pneumonia initially have symptoms of a....

6. A chest... is usually ordered to confirm the diagnosis of pneumonia.

a) pneumonia, b) cold, c) infection, d) X-ray, e) bacteria,

f) small droplets, g) antibiotics, h) viruses

Text 2

1. Read, translate and discuss the text.

ASTHMA

Asthma is a chronic (long-term) lung disease that inflames' and narrows the airways. Asthma causes recurring periods of wheezing² (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing of­ten occurs at night or early in the morning.

Asthma affects people of all ages, but it most often starts in childhood. In the United States, more than 22 million people are known to have asthma. Nearly 6 million of these people are children.

The airways are tubes that carry air into and out of your lungs. People who have asthma have inflamed airways. This makes the airways swollen and very sen­sitive. They tend to react strongly to certain substances that are breathed in.

When the airways react, the muscles around them tighten. This causes the airways to narrow, and less air flows to your lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways may make more mucus than normal. Mucus is a sticky, thick liquid that can further narrow your air­ways.

Figure A shows the location of the lungs and airways in the body. Figure В shows a cross-section of a normal airway. Figure С shows a cross-section of an airway during asthma symptoms

This chain reaction can result in asthma symptoms. Symptoms can happen each time the airways are irritated. Sometimes symptoms are mild and go away on their own or after minimal treatment with an asthma medicine. At other times, symptoms continue to get worse. When symptoms get more intense and/or ad­ditional symptoms appear, this is an asthma attack. Asthma attacks also are called flare-ups³ or exacerbations.

It's important to treat symptoms when you first notice them. This will help to prevent the symptoms from worsening and causing a severe asthma attack. Severe asthma attacks may require emergency care, and they can cause death.

Asthma can't be cured. Even when you feel fine, you still have the disease and it can flare up at any time. Current asthma treatment focuses primarily on prevent­ing or reducing the inflammation process, and relaxing the smooth muscle that tightens during bronchospasm. Healthcare professionals use asthma medications with two goals in mind:

1. To keep the airway clear so the patient can breathe normally.

2. To prevent airway remodeling, a thickening of the bronchial walls that can
result from chronic inflammation and lead to permanent damage.

There are two categories of asthma medications:

٧ Quick-relief medications. Also called "rescue" medications, these are de­signed to instantly relieve the symptoms of an asthma attack. They are usually not meant to be taken long—term.

٧ Long-term-control medications. These are designed to minimize inflamma­tion and prevent asthma flare-ups before they occur. Long-acting beta2-agonists are often used, as well as topical corticosteroids.

Patients with mild intermittent4 or mild persistent asthma may receive a quick-relief medication to aid them when their asthma flares-up. Those with moderate or severe asthma are more likely to need both quick-relief and long-term-control medications.

Asthma drugs can be delivered either in pill form or through an inhaler or nebulizer5, which allows the drug to travel directly to the bronchial tubes while minimizing the effect on the rest of the body.

Notes:

¹ to inflame — запалюватися, викликати запалення

² wheezing — важке дихання, задишка

³ flare-up — загострення

⁴ intermittent — переривчастий, який припиняється (на деякий час)

⁵ nebulizer — розпилювач