Принимают желтоватую окраску, сильный зуд, в запущенных случаях, обычное осложнение.

Text Е. Jaundice

Jaundice is a symptom common to many disturbances and diseases of the liver, such as obstruction of the bile ducts, cancer, etc. In jaundice the skin and the sclerae take on a yellowish colour which may vary in its intensity. Even the serum of the blood is bile coloured. Jaundice is frequently accompanied by severe itching. The pulse is usually slow, and there is a tendency to haemorrhage. In advanced cases nervous symptoms may develop. Jaundice being caused by obstruction, the bile cannot pass to the intestines and the stools are of a white colour. The urine is deeply coloured. In toxic jaundice the stools may be of normal colour or deeply bile coloured.

Infectious jaundice in adults has been found to be due to a virus. It is characterized by fever, vomiting, jaundice and haemorrhage from the nose, intestines, etc. Jaundice is not a rare complication in case of severe intoxication.

VI. Приготовьте сообщение на тему «Infectious Hepatitis» на основании текстов А, В, Е.

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VII. Translate the words with the same root:

Strong, strength, strengthen, strongly; continue, continuous, discontinue, discontinuous, discontinuation; digest, digestive, digestion, indigestion; sense, sensitive, sensitivity, senseless, hypersensitivity; thick, thickly, thickness, thicken, thickened; local, locate, localize, localized, localization, location, locality; wide, widely, width, widen, widened.

VIII. Memorize the reading and meaning of the medical terms: diabetes [,daiə'bi:tis] n диабет, сахарнаяболезнь biopsy ['baiəpsi] n биопсия (диагностическое исследование ткани, взятой из живого организма) pigmentation [,pigmən'teiʃn] n окрашивание stasis ['steisis] n застой,стаз rash [rfʃ] n сыпь

IX. Finish the following definitions and answer the questions:

The disease of the endocrine system caused by a large amount of sugar in the blood is- 2. The colouring of the skin caused by some disturbances in the body is- 3. The diagnostic examination of the tissue taken from a living body is- 4. An unusual eruption (высыпание) on the skin mostly caused by some infectious disease is- 5. The disturbance of blood circulation that causes blood to stop at a certain portion of a vessel is-

What is: a) pigmentation; b) rash; c) diabetes; d) stasis; e) biopsy?

X. 1. Read Text F. 2. Translate the second paragraph. 3. Name the findings of the physical examination. 4. State the abnormalities revealed by laboratory analyses. 5. Summarize the essence of each paragraph in a sentence so as to make the plan of the case history.

Text F. Hepatic Damage due to Chemotherapy

A 50-year-old woman had been known to have diabetes for 20 years. Her condition had been controlled by diet and administration of 100 units of

2. insulin preparation daily. In an effort to improve the intensity of her control she had been given in addition 1 g of chlorpropamide¹ per day.

About three weeks later she noted general malaise, weakness and loss of appetite, followed in a few days by the discovery of dark urine, light stools and rash on her trunk. With the passage of an additional week by which time she had taken a total of 27 g of chlorpropamide, she noted jaundice. There was no pain, fever, nausea, or vomiting. Her past history did not reveal liver or bile duct diseases. She was hospitalized on October 10th for further studies.

The findings of the physical examination showed the presence of jaundice and diffuse rash on the chest and abdomen. The liver was enlarged and there was tenderness on palpation.

The blood analysis revealed serum bilirubin to be at the level of

8.9 mg%, the hemoglobin level was 11.6 g% and the white blood cell count 7,600 per cubic millimetre. Platelets averaged to 490,000 per cubic millimetre. Urinalysis revealed the presence of bile.

1. The biopsy of the liver performed on October 16th showed normal liver structure. There was mild pigmentation of Kupffer cells² and slight capillary bile stasis. Some inflammatory reaction in the portal tracts was noted, but no inflammatory or degenerative changes were observed in the hepatic cells.

The patient was discontinued chemotherapy with chlorpropamide and her diabetes was controlled by a diet containing 150 g of carbohydrates, 75 g of proteins and 80 g of fats and the administration of 80 units of insulin preparation daily.

Her symptoms having been relieved after a month’s treatment, the patient was discharged on November 14th. She complained of neither jaundice nor any other symptoms when she was seen for a follow-up examination three months later.

Notes

¹ chlorpropamide - хлорпропамид (название препарата) ² Kupffer ['kυpfə] cells - купферовскиеклетки в печени

LESSON 47

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