Screening

1 Read the following text and fi ll in the sentences with the correct form of the verb.
Screenings in Hungary
The general state of health of the population ……………… (be) catastrophic in Hungary. The
mortality rate ……………… (be) one of the highest in Europe. The leading causes of death
……………… (be) CHD (coronary heart disease) and different kinds of cancers. High blood
pressure also ……………………… (pose) a health risk.
The life expectancy in Hungary ……………… (be) way behind the European average.
Strokes and heart attacks ……………… (be) very common in families. This poor state of
health …………… (be) due to lack of exercise, poor diet, smoking, and excessive drinking,
and the fact that the population does not take part in voluntary screening programs.
The solution ……………… (be) prevention and regular screenings. The most common
screenings ………………………… (include) breast and cervical cancer screenings, as well as
colonoscopies. If 70% of the population ……………………… (take) part in these
examinations,
the number of deaths could be lowered by 1500-2000 in 5 -7 years.

2 Translate the following sentences.

a. People between the ages of 45-65 should get tested for coronary heart disease (CHD)
every year.
b. People at the age of 25 should get screened for diabetes once a year.
c. People between the age of 25-45 should run a test for kidney diseases every second
year.
d. People at the age of 60 should get checked for gastrointestinal cancer, and they should
repeat it every second year.
e. Men over the age of 40 should get tested for prostate cancer. They should repeat this
test every second year.
f. Men over the age of 40 are at increased risk of prostate cancer.
g. People who are sexually active should get checked for HIV on a regular basis.
h. People who like to sunbathe in summer are at increased risk of melanoma.

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3 Study the following chart and make sentences with the given expressions.

to get tested / screened / checked for sth

to screen / detect sth
a test for diagnosing / monitoring sth
a test to measure sth
to do / run a test for sth
to repeat a test
to be at (increased) risk of sth
to be sexually active

18–25 25–45 45–65 over 65

coronary heart disease (CHD): recom- every year

ECG (electrocardiography), test for mended
high blood pressure and cholesterol

diabetes: blood glucose level recom- every year

(finger-stick screening), test for mended
blood fats (lipids), urine test

kidney disease: kidney functions, every every second year if you every year
urine test, blood test second have the key risk factors –
year diabetes, high blood
pressure, heart disease,
or a family history
of kidney failure

gastrointestinal cancer every every year

(stomach cancer, colorectal second year
cancer): fecal occult test,
blood test, sigmoidoscopy,
or colonoscopy

tuberculosis compulsory once a year if you are

over the age of 30

breast cancer: mammogram, X-ray every second year

cervical cancer: cytology, HPV- every year

test

prostate cancer every second year if you are over

the age of 40

visual-perceptual deficit once every year

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 auditory processing disorder/ once every year
hearing loss

oral cancer recom- every second year

mended

Further screenings:

Chlamydia Osteoporosis
Syphilis Thyroid dysfunction
HIV Melanoma
Hepatitis B Allergy
Hepatitis C

4 Fill in the gaps.

finger-stick screening monitor risk factors blood test drawn

a poor diet blood pressure (BP) cuff compared to

What does the CHD screening involve?

A doctor or nurse will ask if you have any current lifestyle (1)……………………………
that increase your risk of developing a cardiovascular disease. These include: smoking,
obesity, (2) ……………………………, lack of physical activity, and drinking a lot of
alcohol. You will then have a (3) …………………………… to check your blood
cholesterol and glucose level. To measure your blood sugar level a quick and easy (4)
…………………………… is used. During a blood cholesterol test, blood will be (5)
…………………………… and sent to a lab for analysis. Your blood pressure will be
measured too. It involves a (6) …………………………… being placed around your upper
arm to (7) …………………………… both diastolic and systolic blood pressure. The
results are then (8) …………………………… a standardized blood pressure chart.

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5 Match the words to their definitions.

1 endoscopy a examination of the whole colon, including the part

) ) on the right side of the abdomen

2 biopsy b examination of the part of the colon nearest the rectum,

) ) including the sigmoid (bendy) colon on the left side
of the abdomen

3 sigmoidoscopy c visual examination of the interior of a canal or a hollow

) ) organ with a fiber optic camera

4 colonoscopy d) removal of a small amount of tissue for examination

) under the microscope

6 Find the words in the text.

a. These are X-ray pictures, or images, of each breast which make it possible to detect
tumors that cannot be felt.
……………………………………

b. This test detects the presence of human papillomavirus, a virus that can lead to the
development of genital warts, abnormal cervical cells or cervical cancer.

……………………………………

c. This test is used to look for cancers and precancerous changes, and may also be used to
look for viral infections in cells.
……………………………………

7 Translate the following sentences into English.

A. Egy szemvizsgálat során a szemorvos egy látásvizsgáló tábla segítségével méri fel,
mennyire jól lát messziről. A végén megállapítja, hogy az Ön látásélessége kiváló vagy
éppen távol- vagy rövidlátó.

B. A fogászati és szájüreg-daganatok leggyakoribb tünetei a duzzanatok/bőrmegvas-

tagodások, a csomók vagy göbök, a durva foltok/hegek vagy erodált területek az
ajkakon, a fogínyen, illetve a száj egyéb területein; megmagyarázhatatlan vérzés;
gyanús fehér vagy vörös elszíneződések a szájban; és fájdalmas és nehézkes rágás vagy
nyelés, beszéd, vagy az állkapocs és nyelv mozgatása.

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 C. A nemi úton terjedő fertőzések minden évben jelentős megbetegedéseket és halált
okoznak az Egyesült Államokban. 15 és 24 éves kor között a leggyakoribb szexuális
úton terjedő betegségek közé tartozik a chlamydiás fertőzések, a genitális herpesz
fertőzések, gonorrhea (tripper), a hepatitis B és C, a humán immundeficiencia vírus
(HIV), humán papillomavírus (HPV) és a szifilisz.

8 Role play. Give a presentation about the Hungarian health conditions and the way
regular screenings could improve them. Use the given expressions.

mortality rate leading causes of death obesity life expectancy exercise

inherited genetic traits asymptomatic/clinically silent period treatment recovery
opportune screening organized screening GP specialist notice
National Public Health and Medical Officer Service

1. A magyar népesség egészségi állapota katasztrofális.

2. A halálozás mértéke európai viszonylatban „dobogós” helyen van.

3. Vezető halálozási betegségek: szív- és érrendszeri, illetve daganatos megbetegedések

(tüdő-, emlő-, vastagbél- és prosztatarák).

4. Európai viszonylatban kiemelkedő probléma a magas vérnyomás, a cukorbetegség és a

túlsúly.

5. Az átlagéletkor elmarad az európai átlagtól.

6. Gyakori a családokban a szívinfarktus és a sztrók.

7. Kiváltó okok: egészségtelen életmód (dohányzás, nagymértékű alkoholfogyasztás,

egészségtelen táplálkozás, rendszertelen testmozgás), öröklött genetikai faktorok, illetve
szűrések elmulasztása.

8. Megoldás: megelőzés és rendszeres szűrővizsgálatok.

9. Cél: daganatok felismerése még a korai, tünetmentes időszakban, lehetővé téve az

előrehozott kezelést és gyógyulást.

10. Leggyakoribb szűrések: tüdőszűrés; vérnyomásmérés és labor (idősebbek); fogászati

szűrések (fiatalok); nőgyógyászati szűrések (nők).

11. Alkalomszerű szűrések: a vizsgált személy kezdeményezi a háziorvosnál vagy a szak-

orvosnál.

12. Szervezett lakossági szűrések (életkoruk alapján veszélyeztetett lakosságcsoportok)

személyes értesítés alapján: emlő-, méhnyak-, vastagbélrák-szűrések.

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 13. A szűrővizsgálaton való részvétel nem kötelező.

14. ÁNTSZ: ha a lakosság 70%-a részt venne a felkínált szűrővizsgálatokon, 5-7 éven belül
1500-2000 halálozással lenne kevesebb.

Vocabulary

to detect felismer

to measure megmér

to repeat megismétel

increased risk fokozott kockázat

coronary heart disease (CHD) szív- és érrendszeri betegség

high blood pressure magas vérnyomás

to recommend javasol, ajánl

blood glucose level magas vércukorszint

finger-stick screening ujjbegyből vett vérből történő szűrés

urine vizelet

kidney disease vesebetegség

kidney failure veseelégtelenség

stomach cancer gyomorrák

colorectal cancer vastag- és végbélrák

f(a)ecal occult test a székletben lévő okkult vér

meghatározása (FOBT)

sigmoidoscopy vég- és szigmabéltükrözés

colonoscopy vastagbéltükrözés

tuberculosis tuberkulózis (TBC)

compulsory kötelező

breast cancer mellrák

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mammogram mammográfia

cervical cancer méhnyakrák

cytology citológia, sejttan

HPV humán papillomavírus (HPV)

prostate cancer prosztatarák

visual-perceptual deficit vizuális és észlelési zavar

auditory processing disorder / auditív feldolgozási zavar

hearing loss (APD)/halláskárosodás

oral cancer szájrák

chlamydia klamídia

syphilis szifilisz

HIV humán immundeficiencia vírus (HIV)

hepatitis hepatitisz

osteoporosis csontritkulás

melanoma melanoma

allergy allergia

blood pressure (BP) cuff vérnyomásmérő mandzsetta

to compare sg to sg összehasonlít vmit vmivel

obesity elhízás

lack of sg hiány, vmi hiánya

upper arm felkar

diastolic diasztolés

systolic szisztolés

result eredmény

endoscopy endoszkópia

biopsy biopszia

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genital wart nemi szervi szemölcs

abnormal cervical cells abnormális méhnyaksejtek

mortality rate halálozási arány

leading causes of death vezető halálozási okok

life expectancy átlagéletkor, várható élettartam

inherited genetic traits öröklött genetikai faktorok

asymptomatic/clinically silent period tünetmentes időszak

opportune screening alkalomszerű szűrés

organized screening szervezett lakossági szűrés

National Public Health and Medical ÁNTSZ

Officer Service

8
 Minor ailments

Common problems your pharmacist can help with

Every year, millions of us visit our GP with minor health problems that our local pharmacist
could resolve. It is estimated that 50 million visits to the GP are made every year for minor
ailments such as coughs and colds, mild eczema and athlete’s foot. But if you visit your
pharmacy instead, you could save yourself time and trouble. To avoid booking and waiting
for a GP appointment, you can visit your local pharmacist any time – just walk in.
All pharmacists can recognise many common health complaints. They can give advice or,
where necessary, medicines that will help clear up the problem. If your problem is more
serious and needs the attention of a GP, your pharmacist will recognise this and send you to
see your GP instead.

Your pharmacist may be able to help with:

 skin conditions, such as mild acne and mild eczema;
 coughs and colds, including nasal congestion and sore throat;
 minor cuts and bruises;
 constipation and haemorrhoids (piles);
 hay fever and allergies;
 aches and pains, such as headaches, earache and back pain;
 indigestion, diarrhoea and threadworms;
 period pain and thrush;
 warts and verrucas, mouth ulcers and cold sores;
 athlete’s foot;
 nappy rash and teething.

1 Read the treatments, and decide which minor ailment (from the text above) is treated
this way.

(1) …………………………… symptoms often settle down after a few days without
treatment. However, making lifestyle changes to reduce the strain on the blood vessels in
and around your anus is often recommended. These can include: gradually increasing the
amount of fibre in your diet; drinking plenty of fluid; not delaying going to the toilet;
avoiding medication that causes constipation; losing weight if you are overweight;
exercising regularly.
Most cases of (2) …………………………… are mild and can be treated at home using
self-care techniques and antifungal medication. With effective treatment usually it lasts
only for a few days or weeks. Antifungal medication clears the fungi that cause the
infection. It’s available in the form of creams, sprays, liquids, powders, tablets.
Within 7 to 10 days (3) …………………………… usually clear up by themselves
without treatment. However, antiviral creams are available over the counter from

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 pharmacies without a prescription. If used correctly, these can help ease your symptoms
and speed up the healing time. To be effective, these treatments should be applied as soon
as the first signs appear (when you feel a tingling, itching or burning sensation around
your mouth).
You can use over-the-counter painkillers such as paracetamol or ibuprofen to treat the
pain. Placing a warm flannel against the affected side may also help relieve the pain. Your
pharmacist may be able to recommend over-the-counter eardrops for your
(4) ……… ……………………, but let them know your symptoms and ask for their advice
first.
Many different treatments can be used to control symptoms and manage (5) ………
……………………………, including: self-care techniques, such as reducing scratching and
avoiding triggers; emollients (moisturising treatments) – used on a daily basis for dry
skin; topical corticosteroids – used to reduce swelling, redness and itching during flare-
ups.

Based on
http://www.nhs.uk/Livewell/Pharmacy/Pages/Commonconditions.aspx, admitted: 06.2015.

2 Find the words in the text.

a. parasite in the small intestine of mammals ……………………………

b. candidiasis characterized by creamy white plaques resembling milk curds

……………………………

c. a hard, rough lump that grows on the skin ……………………………

d. dermatitis of the buttocks and genital areas caused by diaper

……………………………

e. a strange, irritating sensation in the skin or a body part, accompanied by diminished

sensitivity to stimulation of the sensory nerves ……………………………

f. medication that can be sold without a doctor’s prescription ……………………………

g. to rub or scrape (the skin) to relieve itching ……………………………

3 Add the missing verbs to the expressions.

a. ………………… the GP b. ………………… the strain on the blood

vessels

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 c. ………………… a GP appointment d. do not ………………… going to the toilet

e. ………………… advice f. antifungal medication ………………… the

fungi

g. symptoms ………………… down h. ………………… up the healing process

4 Match the two parts of the expressions.

1) mild a) congestion
2) nasal b) sore
3) sore c) ulcers
4) hay d) fever
5) period e) throat
6) nappy f) pain
7) cold g) acne
8) burning h) rash
9) mouth i) sensation

5 Translate the following sentences into English.

A. A kisebb betegségekkel nem feltétlenül kell a háziorvoshoz fordulni, sok esetben a

gyógyszerészek is tudnak megfelelő tanácsot és kezelést nyújtani.
B. Menstruációs fájdalmak és hüvelygomba esetén sok esetben vény nélkül kapható
gyógyszerek is segíthetnek enyhíteni a tüneteket.
C. Bőrproblémák – mint pattanások, ekcéma, pelenkakiütés – kezelésére különböző tüneti
szerek, hidratáló krémek kaphatók gyógyszertárakban.
D. A megfázás, nátha vagy enyhébb allergiás reakciók tüneteinek enyhítésére különféle
tabletták, spray-k és krémek elérhetők.

6 Role play. Act out the following situation.

You are at a pharmacy. Ask for help from the pharmacist to relieve your symptoms.

COMPLAINT ADVICE
 Could you give me something to  I suggest that you take…

relieve…?  I can provide you with…

 I’ve been suffering from… for [time]…  I recommend…, which will help you

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  Is there anything that could help…? in…

minor ailment remedy

bruise on the face ice pack, herbal cream, painkiller

(swelling, haematoma, pain)

allergy (runny nose, red watery eyes, calcium, nasal spray, eye drops
sneezing)

indigestion and constipation antacid, laxative

lower back pain NSAIDs, muscle relaxant, heat pack

mouth ulcers anti-inflammatory drug (corticosteroid),

antimicrobial mouthwash

minor cut on the finger sterile dressing, adhesive tape,

antibiotic ointment

Vocabulary

minor ailment kisebb betegség

to visit the GP elmegy a háziorvoshoz

local pharmacist helyi gyógyszerész

to resolve megold

cough köhögés

cold nátha, megfázás

athlete’s foot lábgomba

to save oneself the trouble megspórolja magának a fáradságot

to book an appointment időpontot foglal

to recognise felismer

common health complaints gyakori egészségügyi panaszok

to give advice tanácsot ad

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to clear up the problem megoldja a problémát

attention figyelem

skin conditions bőrproblémák

mild acne enyhe akne

mild eczema enyhe ekcéma

nasal congestion orrdugulás

sore throat torokfájás

minor bruise kisebb zúzódás

constipation székrekedés

haemorrhoids aranyér

piles aranyér

hay fever szénanátha

aches and pains fájdalmak

indigestion gyomorrontás, emésztési zavar

diarrh(o)ea hasmenés

threadworm bélféreg

period pain menstruációs fájdalom

(vaginal) thrush hüvelygomba

wart szemölcs

verruca szemölcs

mouth ulcer szájfekély

cold sore ajakherpesz

nappy rash pelenkakiütés

teething fogzás

to settle down elmúlik

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strain terhelés

recommended javallott

fibre rost

plenty of sok

to delay halogat

overweight túlsúlyos

to exercise sportol

antifungal medication gombaölő gyógyszer

fungi (plural! – singular: fungus) gomba

infection fertőzés

antiviral cream vírusölő krém

to be available over the counter vény nélkül kapható

to ease the symptoms enyhíti a tüneteket

to speed up the healing time felgyorsítja a gyógyulási időt

to apply alkalmaz

tingling bizsergő

itching viszkető

burning sensation égető érzés

to place elhelyez

warm flannel melegítő pakolás

to relieve enyhít

eardrops fülcsepp

scratching vakargatás

trigger kiváltó faktor/ok

emollient bőrápoló krém

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moisturising treatment hidratáló kezelés

topical corticosteroids helyileg alkalmazott kortikoszteroidok

swelling duzzanat

redness vörösség

itching viszketés

flare-up betegség fellángolása

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 Nosocomial Infections

1 Reading comprehension

Read the text, then choose the best answer. Underline the part of the text which helps you
to find the right answer.

Clostridium difficile infections

A Clostridium difficile infection (CDI) is caused by the toxin-producing C. difficile bacterium.

It causes one of the most severe forms of antibiotic-associated diarrhea. The disease ranges
from mild diarrhea to severe colon inflammation that can even be fatal. CDI usually occurs
when people have taken antibiotics that change the normal colon bacteria, allowing the C.
difficile bacteria to grow and produce its toxins. Since 2000, there has been a dramatic increase
in the number and severity of cases of C. difficile infection (CDI) in the US, Canada, and other
countries. C. difficile is a gram positive bacterium. It is everywhere in the environment and
produces spores that are heat and acid resistant. It produces two main toxins – toxins A and
B – that cause inflammation in the colon.
The major risk factor for CDI is taking antibiotics in the previous several weeks, but
sometimes it occurs even without prior antibiotic use. High-risk antibiotics are clindamycin,
cephalosporins, and quinolones (i.e. ciprofloxaxin, levofloxacin). Major risk factors are older
age, weakened immune system, having other illnesses, and being in a hospital or a long-term
care facility. However, even healthy individuals who have not had antibiotics can develop
CDI. Patients with inflammatory bowel disease (Crohn’s disease or ulcerative colitis) are
more susceptible to CDI, and may be sicker than patients with IBD alone or CDI alone. Many
studies have also suggested that use of acid suppressive medications (proton pump
inhibitors) may increase the risk of CDI. Individuals can pick up C. difficile by ingesting
spores that are all around in the environment, especially in hospitals. Infected individuals
excrete spores, and transmission among patients in hospitals has been well documented.
Symptoms of CDI can vary. Diarrhea is the most common symptom; it is usually watery
and, rarely, bloody, and may be associated with crampy abdominal pain. Associated
symptoms are feeling poorly, fever, nausea and vomiting. Signs of severe disease include
fever and abdominal distension and/or tenderness.
A diagnosis of C. difficile infection requires documenting the presence of C. difficile, its
toxin, or its DNA in the stool, usually by testing for the gene that produces toxin B, using a
method called PCR. It is very sensitive, so it should not be used to test solid stools, since
some people are carriers of C. difficile without having an active infection. An older test is an
enzyme immunoassay test for toxin A and B, but it is less sensitive.
Once C. difficile infection is diagnosed, it would be ideal to stop the antibiotic that led to
the infection in the first place. This may not always be possible, however, as some infections,
like severe bone or heart infections, need long-term antibiotics. If the patient does not get
better after several days on metronidazole, a switch to vancomycin is recommended.

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Fidaxomicin is a new antibiotic that appears equivalent to vancomycin, but is much more
expensive. Antidiarrheal drugs should never be used for CDI, as slowing down an inflamed
colon may result in a severe complication called toxic megacolon.
Patients with a severe infection may not have diarrhea if their colon is very inflamed.
They are usually very sick, with fever, severe abdominal pain and tenderness. In such cases,
oral vancomycin is the best choice. Sometimes intravenous metronidazole is added as well.
In some patients, CDI is so severe that antibiotics do not work. When this happens, surgery
to remove the colon may be needed to save the person’s life.
While antibiotics are effective in treating most cases of CDI, the symptoms recur after the
end of treatment in 10-20% of cases, with the rate increasing to 35-65% after the first
recurrence. Wise antibiotic policies, especially using narrow-spectrum agents when directed
and avoiding unnecessary use of broad-spectrum antibiotics, are key in the prevention of
CDI. Environmental cleaning is also important – especially hand washing with soap and
water, since alcohol gels do not inactivate spores. In hospitals, everyone entering the room of
a patient with CDI should wear a gown and gloves, and use disposable equipment.

Source: http://patients.gi.org/topics/c-difficile-infection

2 Read through each possible answer, then choose the one you think is correct.

1.1.1 CDI is a gram positive bacterium that causes inflammation of the large intestine.
1.1.2 Older patients taking antibiotics for a prolonged period of time have a higher
chance of developing CDI.
1.1.3 CDI is only related to long-term hospital care.
1.1.4 Taking proton-pump inhibitors decreases the risk of developing CDI.

1.2. CDI can cause these symptoms except for

1.2.1 diarrhea
1.2.2 fever
1.2.3 abdominal cramps
1.2.4 hearing loss

1.3. CDI is treated with

1.3.1 antidiarrheal medication
1.3.2 surgical solutions
1.3.3 a combination of antibiotics after the original one has been stopped
1.3.4 with various narrow-spectrum antibiotics, depending on how the patient
responds to the medication

1.4. Which is true ?

1.4.1 With each recurrence of C. difficile infection, it is believed that the chance of

17
 another recurrence goes up.
1.4.2 Visitors and healthcare professionals need to use alcohol based disinfectant
before entering the isolated patient’s room.
1.4.3 Wearing protective gear reduces the likelihood of CDI recurrence.
1.4.4 Broad-spectrum antibiotics and environmental cleaning help prevent the
development of CDI.

3 Based on the text complete the gaps with one word in each gap.

The majority of C. difficile infections occur in health care settings, where germs spread easily,
and (1) …………………… use is common. The bacteria produce (2) ……………………
so alcohol-based disinfectants cannot prevent the infection. Patients with serious illness such
as inflammatory bowel disease, or a weakened immune system are more (3) ……………
…………… to a C. difficile infection. After having a previous C. difficile infection, the risk of (4)
…………………………… infection goes up to 20 percent.
Confirmation of infection is by the detection of C. difficile toxins A and B in (5)
……………… stool samples from a symptomatic patient.
People who are hospitalized with a C. difficile infection are isolated or share a room with
someone who has the same illness. While in the hospital room, staff and visitors wear
(6) …………………… and isolation gowns.

4 Inform a patient’s relative about C. difficile and the preventive procedures using the
cues. Talk about the causes, symptoms, and ways of prevention of it from spreading.

Helyszín: Kórház
Résztvevők: Egészségügyi szakember (vizsgázó)
Egy idős clostridiumos beteg hozzátartozója (vizsgáztató)

Száz egészséges felnőtt ember közül akár 5 is hordozhatja a Clostridium difficile

baktériumot anélkül, hogy tudna róla.
A tünetek az enyhe hasmenéstől a súlyos, szövődményekkel járó bélgyulladásig ter-
jedhetnek.
A betegnél láz és hasmenés jelentkezett, szerencsére enyhe lefolyású, de a székletminta
megerősítette a fertőzés meglétét ezért kellett a beteget egy másik kórterembe
áthelyezni.
A spórák terjedésének megakadályozása érdekében nagyon fontos a kézhigiéné. Az
alkoholos fertőtlenítők nem rendelkeznek sporocid hatással, ezért szappanos
kézmosás szükséges, illetve a környezet sporocid hatású fertőtlenítővel való
fertőtlenítése.
A látogatóknak mindig kötelező az eldobható maszk és köpeny felvétele mielőtt a
kórterembe lépnek.

18
5 Mediation in writing
Read the text and write a summary in English, in at least 150 words, based on the points
given.

MRSA-fertőzés

Az MRSA súlyos kórházi fertőzés, amelyet ún.methicillin-rezisztens Staphylococcus

aureus (MRSA) baktérium okoz. Leggyakrabban egészségügyi intézményekben fekvő
betegeknél fordul elő (kórházak, ápolási otthonok, dialízis-centrumok). Ezt HA-MRSA-nak
nevezik, ami arra utal, hogy a beteg a kórházi, egészségügyi ellátás során fertőződött.
Tipikusan invazív beavatkozás után jelentkezik, orvosi eszközök használata kapcsán mint
pl. műtéti beavatkozás, intravénás kanül,ízületek pótlása.
Európában minden 18. ápolt beteget nem saját betegsége, hanem valamilyen bakteriális
fertőzés miatt kezelnek kórházban. Ennek köszönhetően a prognózisok szerint 2020-ra a
bakteriális fertőzésekben elhunytak száma meghaladja majd a daganatos megbetegedések
halálozási arányát.
Létezik egy másik típusú, a közösségben, populációban szerzett MRSA-fertőzés. Ez a CA-
MRSA, ami egy fájdalmas bőrjelenséggel kezdődik. Leggyakoribb a test-test kontaktussal
való terjedése. Gyakori lehet gyermekápolási intézményekben, nagy tömegben, vagy
sportolók között.
A staphylococcus okozta bőrfertőzés, így az MRSA is általában kisméretű vöröses,
pattanásra, égésre vagy pókcsípésre emlékeztető bőrjelenséggel kezdődik. Ez gyorsan
terjedhet a bőr mélyebb rétegeibe, fájdalmas tályogok alakulnak ki, amelyek sebészeti
megnyitást igényelnek. Egyes esetekben a baktérium nem terjed tovább, a bőrben marad. A
fertőzés a bőrön kívül a kötőszövet, illetve ízületek, csontok irányába is terjedhet, a
véráramba jutás következtében vérmérgezés is kialakulhat.
Az MRSA-fertőzés számos antibiotikumnak ellenáll, ezért kezelése meglehetősen
nehézkes. Így kialakulhat súlyos, akár az életet is veszélyeztető állapot.
Az MRSA diagnosztika alapja szövetminta, orrváladék stb mikrobiológiai laboratóriumi
vizsgálata. Mivel a tenyésztés legalább 48 órát igényel, újabban elterjedtek a staphyloccus-
DNS alapú tesztek, amelyekkel pár óra alatt meg lehet határozni az MRSA jelenlétét.
A kétféle típus esetén más-más kockázattal kell szembenéznünk. A HA-MRSA a leg-
érzékenyebb betegeket támadja meg, tehát az időskorúakat és a legyengült
immunrendszerrel rendelkező személyeket. A vénás kanül, a húgyúti katéter, mind
lehetséges bejutási út az MRSA számára. a A hosszú távú tartózkodás ápolási
intézményekben jockázati tényezőt jelent, de terjeszthetik azok a hordozók is akik még
nem betegedtek meg.
A CA-MRSA jellemzően a direkt testi kontaktussal járó sportágakban terjedhet. A
higiénés szabályok be nem tartása is vezethet MRSA fertőzéshez
gyermekintézményekben, börtönökben vagy katonai táborokban.
Mindkét típusnál antibiotikum-kezelés alkalmazható. Ezek azonban általában a
speciális, csak egyes kórokozókra fenntartott (ún. páncélszekrény-) antibiotikumok. Kezelni
kell a bőrfelületi tályogokat is gyógyszeres úton.

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 Kórházi fertőzés esetén a beteget elkülönítik, így megelőzhető, hogy a fertőzés másokra
is átterjedjen. A kórházi személyzet és a látogatók ilyen esetekben csak köpeny és
védőfelszerelés viselésével léphetnek be a beteghez, szigorú kézhigiénés előírások mellett.
A szennyezett felületeket, ágyneműt, ruházatot megfelelő módon fertőtleníteni kell.
A bőrfelületen lévő sebeket, sérüléseket steril száraz kötszerrel fedik le a
gyógyulásáig. Gennyező seb is MRSA-forrás lehet, sebfedéssel, és a kötszer gyakori
cseréjével ez megelőzhető.

Forrás: https://mok.hu/hirek/mokhirek/korhazi-fertozesek-tevhitek-es-dilemmak

MSD Orvosi Kézikönyv

1 definíció

2 fertőzés előfordulása

3 HA-MRSA

4 CA-MRSA

5 fertőzés terjedése

6 szövődmények

7 diagnózis

8 kezelés megválasztásának tényezői

9 infekció kontrol

10 sebkezelés

6 Letter writing

1. Read the main body of a letter of complaint and put the verbs in the correct tense and
voice.

I ……………………… (write) to complain about the medical supplies. I ……………………

(order) from your company on 25th of November.
It ……………… (be) now three weeks since I ………………………… (receive) the
confirmation of my order but the required 50 boxes of disposable gloves, 500 medical shoe
cover booties, and 100 isolation gowns have not arrived.
I …………………… (make) numerous phone calls to your company headquarters and
…………………… (send) e-mails, but so far I ………………………… ( receive) no reply.
We are a clinical infection ward, and we care for patients with clinical-infection
conditions.

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 The protective gears are crucial for our work, and we placed the order in due time. I
…………… (be) grateful if you ……………… (can) look into the matter urgently.
Unless this matter ……………………… (resolve) soon, I will be forced to take legal action.

Common Respiratory Diseases

1 Discussion
Work in pairs or small groups and answer the following questions.

Make a list of recent ideas/discoveries and new methods/approaches in healthcare and

specifically in your profession.
Discuss them – in what ways are they useful?
How is your profession different now from the way it was ten years ago?
How can healthcare professionals keep up new ideas and the results of current research in
their area of expertise?
What are the benefits of keeping your professional knowledge up-to-date?
How do your studies at university help you in this respect?
What kind of scientific journals do you read or know about?
How do you gain access to them?
What is the role of the internet?
How important are conferences as a way of exchanging new ideas?

2 Reading comprehension

2.1. Croup

2.1.1. Pre-reading task

Discuss the following questions.

1. In what ways is treating children different from treating adults? Have you ever worked
with children / do you think you will work with children in future? Discuss your
experience/expectations.
2. Make a list of respiratory diseases you know about. What are the symptoms?
3. How are various respiratory diseases usually treated? Have you heard about any
alternative treatments / traditional or home remedies used to cure patients suffering
from these diseases?

(You may consider, for example: herbal teas, natural and herbal remedies, such as honey,
ginger, garlic, horseradish, etc., increased intake of vitamins and minerals, halotherapy (salt

21
therapy), homeopathy, acupuncture, and essential oils.) What do you think about them?

22
2.1.2. Read the text about croup and do the exam tasks.

Croup

1. Croup refers to an infection of the upper airway, which obstructs breathing and causes a
characteristic barking cough.
The cough is the result of swelling around the voice box (larynx), windpipe (trachea), and
bronchial tubes (bronchi). When a cough forces air through this narrowed passageway, the
swollen vocal cords produce a noise similar to a seal barking. Likewise, taking a breath often
produces a high-pitched whistling sound (stridor).
Croup often begins as a typical cold. If there’s enough inflammation and coughing, a child
will develop:
 A loud barking cough that’s further aggravated by crying, anxiety, and agitation
 Fever
 A hoarse voice
 Breathing that may be noisy or labored
Seek immediate medical attention if your child:
 Makes noisy, high-pitched breathing sounds both when inhaling and exhaling
 Makes high-pitched breathing sounds when not crying or agitated
 Begins drooling or has difficulty swallowing
 Seems anxious and agitated or fatigued and listless
 Breathes at a faster rate than usual
 Struggles to breathe
 Develops blue or grayish skin around the nose, mouth, or fingernails (cyanosis)

2. Croup is usually caused by a viral infection, most often a parainfluenza virus.

Your child may contract a virus by breathing infected respiratory droplets coughed or
sneezed into the air. Virus particles in these droplets may also survive on toys and other
surfaces. If your child touches a contaminated surface and then touches his or her eyes, nose
or mouth, an infection may follow.
Most at risk of getting croup are children between 6 months and 3 years of age. Because
children have small airways, they are most susceptible to having more symptoms with
croup.

3. Croup often runs its course within three to five days. In the meantime, keep your child
comfortable with a few simple measures:
 Stay calm. Comfort or distract your child-cuddle, read a book or play a quiet game.
Crying makes breathing more difficult.
 Provide humidified or cool air. Although there’s no evidence of benefit from these
practices, many parents believe that humid air or cool air helps a child’s breathing. For
moist air, you can use a humidifier or sit with the child in a bathroom filled with steam
generated by running hot water from the shower. If it’s cool outside, you can open a
window for your child to breathe the cool air.

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  Hold your child in a comfortable upright position.  Sitting upright may make
breathing easier.
 Offer fluids. 
 Encourage rest. Sleep can help your child fight the infection.
 Try a fever reducer. If your child has a fever, over-the-counter medicines, such as
acetaminophen (Tylenol, others), may help.

4. If your child’s symptoms persist beyond three to five days or worsen, your child’s doctor
may prescribe these medications:
 A type of steroid (glucocorticoid) may be given to reduce inflammation in the
airway. Benefits will typically be felt within a few hours. A single dose of
dexamethasone is usually recommended because of its long-lasting effects.
 Epinephrine also is effective in reducing airway inflammation and may be given in
an inhaled form using a nebulizer for more-severe symptoms. It’s fast acting, but its
effects wear off quickly. Your child likely will need to be observed in the emergency
room for several hours before going home to determine if a second dose is needed.
For severe croup, your child may need to spend time in a hospital to be monitored and
receive additional treatments.
Source: Mayo Clinic,
https://www.mayoclinic.org/diseases-conditions/croup/symptoms-causes/syc-20350348

1) Match the headings (A–G) with a paragraph. Two headings are unnecessary.

A how croup spreads

B diagnosis

C medical treatment

D signs and symptoms of croup

E when hospitalization is indicated

F home remedies

2) Fill in the gaps based on the text above. Use only one word in each gap.

Croup

air goes through a (1) …………………………… passageway due

barking cough
to swelling around the larynx, trachea and bronchi
a high-pitched whistling sound when taking a (2)
stridor
………………………

24
 cyanosis indicated by (3) ……………………………………………… skin

pathogen usually a (4) ………………………………………………… virus

use a humidifier or (5) ……………………………………………

humidification
from hot running water

prescription drugs glucocorticoid or epinephrine may resolve (6) ……………………

2 COPD

2.2.1. Pre-reading task

Discuss the following questions:

How does smoking affect the respiratory system?

What kind of diseases can it cause?
How dangerous is secondhand smoking?

2.2.2. Read the text about COPD and do the exam tasks.

Chronic obstructive pulmonary disease (COPD)

Overview
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that
causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough,
mucus (sputum) production, and wheezing. It’s caused by long-term exposure to irritating
gases or particulate matter, most often from cigarette smoke. People with COPD are at
increased risk of developing heart disease, lung cancer, and a variety of other conditions.

Symptoms
COPD symptoms often don’t appear until significant lung damage has occurred, and they
usually worsen over time, particularly if smoking exposure continues. For chronic bronchitis,
the main symptom is a daily cough and mucus (sputum) production at least three months
a year for two consecutive years.
Other signs and symptoms of  COPD  may include:
 Shortness of breath, especially during physical activities
 Wheezing
 Chest tightness
 Having to clear your throat first thing in the morning, due to excess mucus in your
lungs
 A chronic cough that may produce mucus (sputum) that may be clear, white,
yellow, or greenish
 Blueness of the lips or fingernail beds (cyanosis)

25
  Frequent respiratory infections
 Lack of energy
 Unintended weight loss (in later stages)
 Swelling in ankles, feet or legs
Causes
Air travels down your windpipe (trachea) and into your lungs through two large tubes
(bronchi). Inside your lungs, these tubes divide many times – like the branches of a tree –
into many smaller tubes (bronchioles) that end in clusters of tiny air sacs (alveoli).
The air sacs have very thin walls full of tiny blood vessels (capillaries). The oxygen in the
air you inhale passes into these blood vessels and enters your bloodstream. At the same time,
carbon dioxide – a gas that is a waste product of metabolism – is exhaled.
Your lungs rely on the natural elasticity of the bronchial tubes and air sacs to force air out
of your body. COPD causes them to lose their elasticity and overexpand, which leaves some
air trapped in your lungs when you exhale.

Causes of airway obstruction include:

Emphysema. This lung disease causes destruction of the fragile walls and elastic fibers of the
alveoli. Small airways collapse when you exhale, impairing airflow out of your lungs.
Chronic bronchitis. In this condition, your bronchial tubes become inflamed and
narrowed and your lungs produce more mucus, which can further block the narrowed tubes.
You develop a chronic cough trying to clear your airways.

Risk factors for  COPD  include:

 Exposure to tobacco smoke. The most significant risk factor for COPD is long-term
cigarette smoking. The more years you smoke and the more packs you smoke, the
greater your risk. Pipe smokers, cigar smokers, and marijuana smokers also may be at
risk, as well as people exposed to large amounts of secondhand smoke.
 People with asthma who smoke. The combination of asthma, a chronic
inflammatory airway disease and smoking increases the risk of COPD even more.
 Occupational exposure to dusts and chemicals. Long-term exposure to chemical
fumes, vapors, and dust in the workplace can irritate and inflame your lungs.
 Exposure to fumes from burning fuel. In the developing world, people exposed to
fumes from burning fuel for cooking and heating in poorly ventilated homes are at
higher risk of developing COPD.
 Age. COPD develops slowly over years, so most people are at least 40 years old
when symptoms begin.
 Genetics. The uncommon genetic disorder alpha-1-antitrypsin deficiency is the
cause of some cases of COPD. Other genetic factors likely make certain smokers more
susceptible to the disease.

Complications
COPD can cause many complications, including:
 Respiratory infections
 Heart problems
 Lung cancer 

26
  High blood pressure in lung arteries (pulmonary hypertension)
 Depression.

1) Circle the only possible answer based on the text about COPD.

1.1.1 Smokers who develop COPD usually experience severe symptoms at an early stage
of the disease, and the symptoms worsen over time.
1.1.2 When lung damage has already occurred, the worsening of the symptoms is not
affected by continued exposure to cigarette smoke any longer.
1.1.3 Patients, particularly smokers, never experience the symptoms of COPD until
significant lung damage has occurred.
1.1.4 Even if COPD is initially asymptomatic, the lungs may become severely damaged,
which will eventually lead to the appearance of symptoms.

1.2.1 Symptoms of COPD include difficulty breathing, a chronic cough, and swelling in
the upper extremities.
1.2.2 Signs and symptoms of COPD may include a feeling of tightness in the chest,
intensive mucus production, and swollen feet.
1.2.3 Potential signs and symptoms of COPD affect only the respiratory system.
1.2.4 The main symptom of chronic bronchitis is a daily cough with mucus production
lasting for at least two years and three months.

1.3.1 In COPD, the bronchioles lose their elasticity, which means that carbon dioxide is
exhaled.
1.3.2 The bronchioles are tiny air sacs at the end of the alveoli.
1.3.3 In COPD, part of the air remains in the lungs when the patient exhales, due to a lack
of elasticity and overexpansion of the bronchioles and the alveoli.
1.3.4 In chronic bronchitis, a chronic cough leads to the narrowing and blocking of the
bronchial tubes.

1.4.1 Long-term cigarette smoke increases your chance of developing COPD, but smoking
a pipe is considered safe.
1.4.2 A fifty-year-old man who has been a chain-smoker for over 20 years is at risk of
developing COPD, but his family members are not.
1.4.3 Certain working conditions increase the risk of COPD in workers.
1.4.4 The genetic disorder called alpha-1-antitrypsin deficiency is another frequent cause
of COPD.

2) Fill in the gaps of the text below with one suitable word.

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions
that cause breathing difficulties. It includes emphysema, which is damage to the air sacs in
the lungs, and chronic (1) ……………… (long-term inflammation of the airways). The
breathing problems tend to get gradually (2) ……………… over time. COPD is a common

27
condition that mainly (3) …………… middle-aged or older adults who smoke, but long-term
(4) ………………… to dust, chemicals, and fumes from burning (5)
………………………………………, as well as certain (6) ………………… factors, also increase
the risk.

3 Mediation in writing
Read the text and write a summary in English, in at least 150 words, based on the points
given.

Szamárköhögés

A szamárköhögés tágabban értelmezve – különböző kórokozók által okozott –

tünetegyüttes (szindróma), amelyet rohamokban jelentkező jellegzetes köhögés, hetekig
elhúzódó kórlefolyás jellemez. 
A pertussis létrehozásában a Bordetella nevű baktériumcsoportba tartozó alfajok:
a Bordetella pertussis, parapertussis, bronchiseptica  és  holmesii játszanak szerepet. A kórkép
világszerte előfordul, minden életkorban kialakulhat, legsúlyosabb a védettséggel nem
rendelkező csecsemők Bordetella pertussis okozta betegsége.
A tipikus köhögési rohamok esetében az orvosnak nem nehéz megállapítania a szamár-
köhögést. Az éjszakai, a nyelv kidugásával járó rohamok különösen jellegzetesek. A
köhögéseket a nyelv hátsó, gyöki részének vizsgáló spatulával való megnyomásával is
könnyen ki lehet váltani, ami betegség esetén a gyanút erősíti.

A kórokozó baktériumot a betegség kezdeti stádiumában a torokból vett kenetből speciális

festéssel lehet kimutatni.
A szamárköhögés típusos esetben jellegzetesen három szakaszban lezajló betegség.
Az első szakasz 1-2 hétig tart, légúti hurutos tünetek jellemzik („hurutos szakasz”) főként
éjszakai köhögéssel. Ezt követően a tünetek egyre súlyosabbá válásával alakul ki a második
szakasz, az ún. „paroxizmális köhögés szakasza”. Erre jellemző a 4-6 héten át fennálló,
rohamokban jelentkező, kínzó köhögés, a hangos, húzó belégzés („szamár-ordítás”) és a
rohamot befejező hányás. Fiatal, oltatlan, vagy csak részben immunizált csecsemőkben a
köhögési rohamok során légzésszünet (apnoe), illetve légzésleállás is beállhat. A tünetek
enyhülésével, majd fokozatos megszűnésével következik a harmadik szakasz, a 2-3 hét
alatt lezajló felépülési időszak. A légúti ingerek vagy izgalom kiváltotta köhögés azonban
még hónapokig pertussisra emlékeztető lehet. A szövődmények különösen csecsemő- és
fiatal kisdedkorban gyakoriak; a középfülgyulladás (otitis media) és
tüdőgyulladás (pneumonia) mellett ritkábban ideg- rendszeri komplikációk, görcsös
állapot (eclampsia) is felléphetnek. Minden nyolcadik fertőzöttnél tüdőgyulladás, minden
huszadiknál agyi károsodás léphet fel. 200 beteg közül egy meghal.

A felnőttkori betegség tüneteit, súlyosságát az aktuális védettség mértéke határozza meg

leginkább. Ennek függvényében sokféle lefolyás fordulhat elő. Leggyakoribb tünet az
elhúzódó, 2 héten túl fennálló, izgatott köhögés, esetleg befejező hányással. A hangos,
húzó belégzés ebben az életkorban ritka. A gyermekkori formára jellemző laboratóriumi

28
jelek a feltűnően alacsony vörösvértest-süllyedés (1-2 mm/óra) mellett a vérképben magas
fehérvérsejt-szám limfocita-túlsúllyal. A felnőttek betegségében ezek nem jellemzőek.

Újabb, széleskörű felmérések azt mutatják, hogy az enyhe, ún. atípusos kórformák

gyakoribbak, mint azt korábban vélték. Különösen érvényes ez a korábban már oltottak, a
serdülők és a fiatal felnőttek vonatkozásában. Utóbbiak fertőzőforrásként szerepelnek, a
nem oltott csecsemők és fiatal gyermekek megbetegedései többnyire ezekből a fel nem ismert
esetekből származnak.

Forrás: https://www.hazipatika.com/betegsegek_a_z/szamarkohoges/156?autorefreshed=1

Az összefoglalás szempontjai

1 A szamárköhögés definíciója

2 A kórokozó

3 A szamárköhögés diagnosztizálása

4 A betegség első szakasza

5 A betegség második szakasza

6 A betegség harmadik szakasza

7 A szamárköhögés szövődményei

8 Halálozási ráta

9 A betegség lefolyása felnőttek esetében

10 Atípusos kórformák

29
 Cancer

Task 1 Discuss the following questions in small groups.

1. What are the most common cancers in Hungary?

2. What screening programmes are provided in your country to diagnose cancer early?
3. What do these terms mean: biopsy, tumour markers, benign, malignant,
in-situ / localised, invasive, metastases
4. What major types of treatment are available for the different cancers?

Task 2 Discuss with your partner (s) whether you agree with these statements. Collect
arguments to support your view.

1. Governments should ban products that harm our bodies, such as cigarettes or
chocolate.
2. Citizens should be fined if they don’t attend the regular screening programmes.
3. People who don’t exercise, who smoke, or who make themselves obese should pay
higher taxes.
4. Cancer should be at the top of the list of medical problems that need to be researched.

Task 3 Read the text on pancreatic cancer and match headings (A–F) to sections (1–4).
There are two extra headings that you do not need.

1.
95% of pancreatic tissue is non-endocrine, i.e., exocrine. More than 75% of non-endocrine
pancreatic cancers are adenocarcinomas of the pancreas. Other rare non-endocrine cancers
include adenosquamous, acinar, giant cell, and pancreaticoblastomas. There is also a group
of cystic non-endocrine tumours of the pancreas, including serocytic, mucinous, intraduct
papillary mucinous, and acinar cell cystadenocarcinoma tumours. Of these, the mucinous
type has a strong malignant potential. Endocrine tumours of the pancreas (PET) are
uncommon. At least 50% of them do not affect hormone production and are most often
benign. These tumors are also called islet cell tumors or neurendocrine tumors.

2.
Symptoms are not usually sufficiently specific to make a confident diagnosis of pancreatic
cancer without supporting laboratory, radiological, and pathological examinations. The most
frequent site of pancreatic tumours is the head of the pancreas. Tumours of the head of the
pancreas often present with jaundice, often painless. This develops as the tumour encroaches
on the common bile duct. The presence of jaundice necessitates urgent investigation.
Abdominal pain is present in two thirds of patients with pancreatic cancer. Initially it may be

30
subtle for one or 2 months, but becomes epigastric and constant, with increasing severity,
and eventually may be unremitting. It may radiate to the back and is thought to be due to the
invasion of the coeliac plexus of nerves. As many as 80-90% of patients have chronic
abdominal pain and weight loss, which is often associated with chronic abdominal pain
causing anorexia.

3.
The most prominent and constant risk factor in pancreatic cancer is cigarette smoking, the
relative risk of smokers being at least 1.5. The risk increases as the level of cigarette smoking
increases. The highest risk ratio, tenfold, has been seen in males who consume over 40
cigarettes daily. A second important risk factor for pancreatic cancer is probably diet.
Increased risks have been associated with a diet high in animal protein and fat consumption
and decreased risks with high intake of vegetables and fruit. The relationship between body
mass index and calorie intake suggests that energy balance is important in pancreatic
carcinogenesis. Excessively high rates of pancreatic cancer have been reported in some
occupational groups; including chemists, coal and gas exploration workers, and those in
metal industries.

4.
About 6,900 patients are diagnosed with cancer of the pancreas each year in the United
Kingdom. This is 3% of all cancers and makes it the 11th commonest cancer in the United
Kingdom in women and the 9th commonest cancer in men.
Two thirds of the patients (63%) diagnosed are over 70 years of age.
Outcomes for this disease are poor and resection (proximal pancreatic duodenectomy) is
the only curative treatment. Results of surgery in terms of complications and death have
improved considerably over the last 20-30 years.
Of all the patients diagnosed with pancreatic cancer, less than 13% are alive at one year
and less than 2-3% at 5 years.Even after successful resection, less than 1% are alive at 10
years.
Most patients with unresectable cancer of the pancreas receive chemotherapy. It may also
be used as an adjuvant to resection. Rates of the condition increase with age and are higher
in males than females. Epidemiological studies showed increased incidences of this
condition in earlier decades of this century, and rates have now levelled off. Thus, both
genetic factors and environmental exposure to carcinogens may increase the risks of
pancreatic cancer.

Source: https://assets.publishing.service.gov.uk/government/uploads/
system/uploads/attachment_data/file/384472/cancer_pancreas.pdf

A Incidence and treatment options

B Risk factors of pancreatic cancer

C Stages of the cancer

31
 D Types of pancreatic cancer

E Clinical features of pancreatic cancer

F Prevalence

3.1. Read the text again and complete the table. Write one word in each gap.

Causes Symptoms Treatment

Doctors have identified As pancreatic cancer The first goal of pancreatic

factors, such as smoking, progresses, it can cancer treatment is to
that (1) …………… the risk (3) cause ……………… (5) ……………… the
of developing the cancer such as jaundice. cancer,
when possible.
More than three A tumour may (4) …………
(2) ………… of the patients on nerves in the abdomen, Most patients receive
have pancreatic causing pain that can (6) ……………… when
adenocarcinoma. become severe. the tumour cannot be
removed surgically.

3.2. In the text find the words which express these ideas. The number refers to the number
of the section.

1. non-endocrine (1) ………………………………

2. rare (1)

3. originating in or being caused by (1) ………………………………

4. advance gradually beyond usual or acceptable limits (2) ………………………………

5. so delicate that it is difficult to analyse or describe (2) ………………………………

32
 6. important (3) ………………………………

7. ten times (3) ………………………………

8. to be connected with something in some way (3) ………………………………

9. consequences (4) ………………………………

10. cannot be surgically removed (4) ………………………………

11. therapy applied after initial treatment (4) ………………………………

3.3. Complete the table.

Verb Noun Adjective Hungarian

mucin

necessity

present

invade
foglalkozással
összefüggő
resect

Task 4 Reading comprehension

Read the text and then choose the best answer.

Stomach Cancer

Ninety-five percent of malignant stomach cancers develop from epithelial cells lining the
stomach. These tumours arc called adenocarcinomas. Other stomach cancers can develop
from the surrounding immune cells, hormone-producing cells, or connective tissue. Multiple
risk factors that increase a person’s probability of developing this cancer have been
identified. These include a diet high in salted, smoked, or pickled foods, infection by the
bacterium Helicobacter pylori, tobacco and alcohol use, or a family history of stomach
cancer. Other factors that may increase the risk of stomach cancer to varying degrees are
previous stomach surgery, blood type A, advanced age (60-70 years), or chronic stomach
inflammation. Males develop stomach cancer at approximately twice the rate of females.
Rare disorders such as pemicious anemia or Menetrier disease and congenital disorders that
lead to increased risk for colorectal cancer may also increase stomach cancer risk.
The symptoms of stomach cancer are prevalent in many other illnesses and may include
abdominal pain or discomfort, unexplained weight loss, vomiting, poor digestion, or visible
swelling in the abdomen.

33
 No specific laboratory test for stomach cancer exists, and the disease is therefore usually
diagnosed through a combination of imaging means. A physician can inspect the lining of
the stomach with a flexible, lens-containing tube called an endoscope. The endoscope can
also be used to take samples from potentially cancerous tissues for biopsy. These samples are
examined under a microscope for signs of cancer. An endoscope may also be modified with a
special probe that emits sound waves in the stomach, which allows the physician to create an
image of the stomach wall. X rays are also employed, usually after the patient has swallowed
a barium compound that coats the stomach and provides better image contrast. Other
imaging techniques such as computed tomography scans and magnetic resonance imaging
are also used, especially when the cancer is believed to have spread.
Once stomach cancer has been diagnosed, its stage is determined. The stage is an indicator
of how far the cancer has progressed. Staging for stomach cancer is complicated and is based
on a combination of how far the cancer has grown through the stomach wall and on the
number of lymph nodes affected, if any. Stage O stomach cancer is also called carcinoma in
situ and is confined to the epithelial cells that line the stomach. Stage I and stage II cancers
have spread into the connective tissue or muscle layers that underlie the epithelial cells, but
they have reached fewer than six nearby lymph nodes. Stage III and IV cancers are more
advanced and may have metastasized to distant tissues.
A very high percentage of individuals survive stomach cancer for at least five years if the
cancer is diagnosed very early, and many of them go on to live long, healthy lives.
Unfortunately, only a small percentage of stomach cancers are identified and treated at such
an early stage. At the time when most lower-stomach cancers are diagnosed, roughly half the
patients survive for at least five years. Patients with cancers of the upper- stomach have a
lower survival rate, and if the cancer has spread to distant tissues in the body, the survival
rate is extremely low.
Source: http://www.britannica.comleb/article?eu=138406&tocid=214154

4.1. Read through each possible answer, then choose the one you think is correct.

1.1 The risk of stomach cancer is likely to be increased by various dietary factors.
1.2 The risk of stomach cancer is unlikely to be increased by bacterial infection.
1.3 The risk of stomach cancer is likely to be reduced by stomach surgery.
1.4 The risk of stomach cancer is likely to be decreased with age.

2.1 The ratio of stomach cancer is presumably the same in both sexes.
2.2 The ratio of stomach cancer is very much alike in both sexes.
2.3 The ratio of stomach cancer is three times as high in women as in men.
2.4 The ratio of stomach cancer is two times as high in men as in women.

3.1 Only laboratory tests are used to identify stomach cancer.

3.2 No laboratory test are available to detect the cancer.
3.4 Both laboratory tests and imaging technics are used to identify stomach cancer.
3.5 Either endoscopic or laboratory tests are used to identify stomach cancer.

34
4.2. Fill in the gaps based on the text above. Use only one word in each gap.

The (1) ………………………………… of the stomach is inspected by an endoscope, and

(2) ……………………………… is performed to determine the presence cancerous cells. After
the (3) ……………………………… of the cancer is made, the (4) …………………………………
is also defined. It depends on how far the cancer has (5) ……………………………… and how
many lymph nodes are (6) …………………………… .
(7) …………………………… greatly depends on how far and deep the cancer is present in
the body.
Task 5 Write a letter of inquiry to a students’ conference organisers. Write no more than
150-180 words.

Ön Kiss István/Andrea, a Semmelweis ETK hallgatója (címe: 1088 Vas utca 17). Az interneten
olvasott a Rigában megrendezésre kerülő Health and Social Sciences elnevezésű
konferenciáról, amelyen egyetemi hallgatók tartanak előadásokat. Írjon levelet a konferenciát
szervező központnak (Rīga Stradiņš University 16 Dzirciema iela, Rīga, LV-1007), mivel a
konferencián Ön is részt szeretne venni.

Levelében térjen ki a következőkre:

bemutatkozás: (pl. III. éves hallgató);

előzmények ismertetése: konferencia meghirdetésének olvasása;

érdeklődési kör: tudományos érdeklődési köre: onko-rehabilitáció, TDK kutatási területe

(gyermekkori leukémia és a gyógytorna a fizikális és mentális egészség

helyreállításának szolgálatában);
érdem: sikeres játékos gyakorlatok kidolgozása már intenzív kezelés szakaszában, első

helyezés a budapesti TDK konferencián 2019-ben;

célkitűzés: a kutatások folytatása az egyetem elvégzése után;

információ adása: mellékeli önéletrajzát, publikációs listáját és egy ajánlólevelet

mentorától, Dr. Popper Máriától;

kérés: lehetséges-e részletes ismertető küldése a konferenciáról, illetve az absztrakt

formai követelményeiről.

Task 6 Mediation in writing

Read the text and write a summary in English, in at least 150 words, based on the points
given.

Bizonyos rákok kialakulásának a kockázata táplálkozási vagy életmódi változtatásokkal

csökkenthető. A dohányzás mellőzése, illetve a dohányfüst kerülése például jelentősen
csökkenti a tüdő-, a vese-, a húgyhólyag-, a fej-nyaki rákok kialakulásának kockázatát.
A napfény kerülése csökkenti a bőrrák kialakulásának kockázatát. A napfénynek kitett
bőr- területek fedése, vagy magas napvédő faktorú naptejek használata az UV-sugárzás ellen
szintén ezt a célt szolgálja.
A különböző rákok kialakulásának kockázatát egyéb életmódi változtatások is mérséklik.

35
A zsírszegény táplálkozás csökkenti az emlő- és vastagbélrák esélyét.Az aszpirin és az
egyéb nem-szteroid gyulladásgátló szerek is csökkentik a vastagbélrák előfordulását.
A rákos betegségek gyógyítása az orvostudomány egyik legösszetettebb feladata. Olyan
csapatmunkára van szükség, ahol számos szakterület képviselője, háziorvosok,
nőgyógyászok, onkológusok, sebészek, radioterapeuták és kórszövettanászok illetve
egészségügyi személyzet (például nővérek,és fizikoterapeuták) dolgozik együtt.A kezelés
megválasztásánál sokféle tényezőt kell figyelembe venni, így a gyógyulás esélyét, a túlélés
meghosszabbítását gyó- gyíthatatlan betegségben, a tünetek csillapítását, a kezelés
mellékhatásait és a beteg kívánságait a fentiekkel kapcsolatban. A daganatos betegségen
átesettek a lehető legjobb kimenetelben,
a lehető leghosszabb túlélésben és legjobb életminőségben bíznak. A sugár- illetve
daganatgátló kezelésre kerülő betegeknek ugyanakkor tisztában kell lenniük a kezelés
kockázataival.
A gyógyíthatatlan rákbetegeknek a kezelésben résztvevő orvosi személyzet valamennyi
tagjával meg kell beszélni kéréseiket, beleértve a kezelés intenzitását is.
A diagnózis felállításakor a kezelés elsődleges célja a rák lehetőség szerinti eltávolítása
(műtéttel, sugárkezeléssel és kemoterápiával, vagy ezek kombinációjával) az áttétképzés
esélyének csökkentésére.Az eredeti (elsődleges) helyükről továbbterjedő daganatok keze-
lésére rendszerint az egyetlen lehetőség a kemoterápia. A különböző kemoterápiás szerek
kombinációja segít elpusztítani az eredeti daganatot, és kiirtani a szervezet bármely
részén elhelyezkedő daganatsejteket.
Ha a rák gyógyíthatatlannak is bizonyul, a daganat által okozott tüneteket gyakran
lehet enyhíteni, növelve ezzel a túlélés idejét, és javítva az életminőséget (palliatív
terápia). Ha egy daganat például nem távolítható el sebészileg, a sugárkezelés csökkentheti a
daganat méretét, ami által a daganat eredeti helyén csökken a fájdalom és az egyéb tünetek.
Ahogyan a kezelés egyre összetettebbé vált, különböző terápiás protokollokat alakítottak
ki az egyes daganatféleségekre, amelyek biztosítják a betegek számára a leghatékonyabb
kezelést, a lehető legkevesebb mellékhatással. Ezek a terápiás protokollok biztosítják, hogy
azonos daganat azonos stádiumában szenvedő betegek e standardoknak megfelelően azonos
sorrendben azonos dózisú kezelést kapjanak.
Ha a kezelés után tetszőleges idővel a daganat eltűnik, komplett válaszról, remisszióról
beszélünk. Parciális remisszió során egy vagy több daganat mérete kisebb, mint felére
csökken; ez a válasz csökkentheti a tüneteket és meghosszabbíthatja az élettartamot, de a
daganat újra növekedni fog.
A legsikeresebb kezelés eredménye a gyógyulás. A gyógyulás aztjelenti, hogy a rák
minden tünete eltűnik, és soha többé nem jelentkezik. Az orvosok a gyógyulást 5-10 éves
betegségmentes túlélésben jelölik meg, amely alatt a daganat teljesen eltűnik, és nem is tér
vissza.
Forrás: https://drinfo.aeek.hu/betegseg-informaciok

Az összefoglalás szempontjai

1 Kockázati tényezők a különböző rákokban

36
2 Életmódbeli változtatások szerepe

3 Gyógyszerek szerepe

4 Kooperáció az egészségügyben

5 Kezelés megválasztásának tényezői

6 Prioritás a diagnózis felállításakor

7 Palliatív terápia

8 Kezelési sémák szerepe

9 Parciális remisszió

10 Teljes gyógyulás

37
 Epidemic Diseases

Task 1 Discussion
Work in pairs or small groups and answer the following questions.

Where do you think you will work after finishing your studies?
What will be your daily responsibilities?
In your opinion, what is the greatest challenge of your profession today?
What difficulties do you think you will have to overcome on a regular basis? (Discuss
potential problems related to patients, working conditions, professional challenges,
health risks, etc.)
What kind of challenges do professionals face nowadays in Hungary and worldwide?
How can healthcare professionals overcome difficulties caused by work-related stress,
irregular working hours, the emotional impact of dealing with terminally ill or severely
injured patients, the exhaustion resulting from doing overtime, the demands of the job
etc.?
What do you know about burnout?
What are the causes, the risk factors, and the symptoms?
What can people do to fight it off?
What specific challenges do young professionals face at the beginning of their careers?
How can young professionals benefit from mentoring?
What profession-related difficulties do you think healthcare professionals may have to
overcome as they are getting older?

Task 2 Reading Comprehension

Task 2.1. Cholera

Task 2.1.1. Pre-reading task

Discuss the following questions.

1. What can you do to avoid various infections while travelling? What advice would you
give to someone going on holiday to a tropical country?
2. How can various healthcare professionals be exposed to bacterial infections while
working? What can you do to prevent contracting an infectious disease in these
situations?
Task 2.1.2. Pre-reading task

38
Try to guess the answers to these questions, then read the article and check your answers.

1. What kind of disease is cholera: viral or bacterial?

2. Which of the following is not a symptom of cholera: diarrhea, dehydration, an itchy
skin rash, muscle cramps?
3. Which fruit would be safer to eat in an area affected by cholera, a banana or a
strawberry? Why?

Task 2.1.3. Read the article about cholera and do the exam tasks.

Cholera

1. Cholera is a bacterial disease usually spread through contaminated water. Most people
exposed to the cholera bacterium don’t become ill and never know they’ve been infected. Yet
because they shed cholera bacteria in their stool for 7 to 14 days, they can still infect others
through contaminated water. Most symptomatic cases of cholera cause mild or moderate
diarrhea. Only about 1 in 10 infected people develops more serious signs and symptoms of
cholera, usually within a few days of infection. Symptoms may include:
Diarrhea. Cholera-related diarrhea comes on suddenly and may quickly cause

dangerous fluid loss.

Nausea and vomiting. Occurring especially in the early stages of cholera, vomiting

may persist for hours at a time.

Dehydration can range from mild to severe. A loss of 10 percent or more of total body

weight indicates severe dehydration. Signs and symptoms of cholera dehydration

include irritability, lethargy, sunken eyes, a dry mouth, extreme thirst, dry and
shriveled skin, little or no urine output, low blood pressure, and an irregular heartbeat.
Dehydration may lead to a rapid loss of minerals in your blood (electrolytes) that
maintain the balance of fluids in your body. This is called an electrolyte imbalance. It can
lead to:
Muscle cramps. These result from the rapid loss of salts such as sodium, chloride, and

potassium.
Shock. It occurs when low blood volume causes a drop in blood pressure and a drop in

the amount of oxygen in your body.

Children are particularly susceptible to hypoglycemia due to fluid loss.

2. A bacterium called Vibrio cholerae causes cholera infections. The deadly effects of the
disease are the result of the cholera toxin (CTX) the bacteria produce in the small intestine.
The most common sources of cholera infections are the following:
Surface or well water. Cholera bacteria can lie dormant in water for long periods, and

contaminated public wells are frequent sources of large-scale cholera outbreaks.

Seafood. Eating raw or undercooked seafood, especially shellfish, that originates from

certain locations can expose you to cholera bacteria.

Raw fruits and vegetables. Raw, unpeeled fruits and vegetables are a frequent source

of cholera infection in areas where cholera is endemic.

39
 Grains. In regions where cholera is widespread, grains such as rice and millet that are
contaminated after cooking and allowed to remain at room temperature for several
hours become a medium for the growth of cholera bacteria.
Risk factors for cholera include:
Poor sanitary conditions. Such conditions are common to refugee camps, impoverished

countries, and areas devastated by famine, war, or natural disasters.

Reduced or nonexistent stomach acid (hypochlorhydria or achlorhydria). Cholera

bacteria can’t survive in an acidic environment, and ordinary stomach acid often serves
as a first line defense against infection. But people with low levels of stomach acid –
such as children, older adults, and people who take antacids, H-2 blockers or proton
pump inhibitors – lack this protection, so they’re at greater risk of cholera.
Household exposure. You’re at significantly increased risk of cholera if you live with

someone who has the disease.

Type O blood. People with type O blood are twice as likely to develop cholera

compared with people with other blood types.

Raw or undercooked shellfish. Eating shellfish from waters known to harbor the

bacteria greatly increases your risk.

3. Cholera can quickly become fatal. In the most severe cases, the rapid loss of large amounts
of fluids and electrolytes can lead to death within two to three hours. Although shock and
severe dehydration are the most devastating complications of cholera, other problems can
occur, such as:
Low blood sugar (hypoglycemia). 

Low potassium levels (hypokalemia).  Very low potassium levels interfere with heart

and nerve function and are life-threatening.

Kidney failure. 

4. If you’re traveling to cholera-endemic areas:

Wash your hands with soap and water frequently, especially after using the toilet and

before handling food. If soap and water aren’t available, use an alcohol-based hand
sanitizer.
Drink only safe water, including bottled water or water you’ve boiled or disinfected

yourself. Use bottled water even to brush your teeth. Avoid adding ice to your
beverages unless you made it yourself using safe water.
Eat food that’s completely cooked and hot and avoid street vendor food.

Avoid sushi, as well as raw or improperly cooked fish and seafood of any kind.

Stick to fruits and vegetables that you can peel yourself, such as bananas, oranges and

avocados
Be wary of dairy foods, including ice cream, which is often contaminated, and

unpasteurized milk.
Vaccine: For adults traveling to areas affected by cholera, a vaccine is now available. It

is a liquid dose taken by mouth at least 10 days before travel.

Source: https://www.mayoclinic.org/diseases-conditions/cholera/symptoms-causes/syc-20355287
1. Match the headings (A-G) with a paragraph. Two headings are unnecessary.

40
 A how cholera spreads

B incidence of cholera

C how the infection affects patients

D complications that may result from cholera

E morbidity and mortality rates

F how you can avoid getting infected

2. Fill in the gaps based on the text above. Use only one word in each gap.

Cholera

infected people who show no symptoms can spread the

asymptomatic cases
infection for up to two (1) ………………………

electrolyte imbalance is a result of (2) ………………………

electrolyte imbalance
when the body rapidly loses important minerals

cholera may lead to low blood sugar levels, especially in

blood sugar
(3) …………………

a (4) ………………… in the small intestine produced by

cause
Vibrio cholerae

water (5) ………………………………………… by cholera

source of infection
bacteria

wash your hands, drink only bottled water and make sure
preventive measures
your food is properly (6) …………………………………

Task 2.1.4. Post-reading task

Read the definitions and find these words in the article.

a. a drop below the normal levels of water in the body ………………………………

b. a sudden, painful tightening in a muscle ………………………………

41
 c. be inactive ………………………………

d. regularly found / common in a particular area ………………………………

e. not cooked (food) ………………………………

f. a period when there isn’t enough food ………………………………

Task 2.2. Ebola

2.2.1. Pre-reading task

Discuss the following questions.

Make a list of epidemic diseases. How dangerous are they? How do they spread? What do
you know about treatment options?
What is an epidemic? Have you heard about any significant epidemics in human history?
What do you know about them?
How can the spread of infectious diseases be prevented? What advice would you give to
lay people? What can healthcare professionals do? How are nurses / midwives /
dieticians / public health inspectors and other professionals involved in infection
prevention?

Task 2.2.2. Pre-reading task

Explain (check) what the following words mean:

outbreak, quarantine, fatal, body fluid, precaution

Task 2.2.3. Read the article about Ebola virus and do the exam tasks.

Ebola virus disease

Ebola virus disease is a serious illness that originated in Africa, where a large outbreak
occurred in 2014-15.  It mainly affected three countries in West Africa: Guinea, Liberia, and
Sierra Leone. Some cases also occurred in parts of Central Africa. Around 28,000 cases and
more than 11,000 deaths were reported by the World Health Organization. This was the
largest known outbreak of Ebola. In June 2016, the outbreak was officially declared over.

Symptoms of Ebola
A person infected with Ebola virus will typically develop a high temperature (fever),
a headache, joint and muscle pain, a sore throat, and severe muscle weakness. These
symptoms start suddenly between 2 and 21 days after a person becomes infected.

42
Diarrhoea, vomiting, a rash, stomach pain, and reduced kidney and liver function can
follow. The person may then bleed internally, and may also bleed from the ears, eyes, nose,
or mouth.

How Ebola virus is spread

The Ebola virus is spread in the blood, body fluids, or organs of a person or animal with the
infection. For example, it can be spread by
directly touching the body of someone with the infection who has symptoms

or recently died – the virus can survive for several days outside the body
cleaning up body fluids (blood, stools, urine, or vomit) or touching the soiled clothing

of an infected person
handling unsterilized needles or medical equipment used in the care of the infected

person
having sex with an infected person without using a condom – studies show traces of

Ebola may remain in a man’s semen many months after he has recovered
handling or eating raw or undercooked "bushmeat"

Ebola can’t be caught through routine social contact, such as shaking hands with people
who don’t have symptoms.

Treatment for Ebola
There’s currently no licensed treatment or vaccine for Ebola, although potential new vaccines
and drug therapies are being developed and tested. Any area affected by an outbreak should
be immediately quarantined, and people confirmed to have the infection should be treated in
isolation in intensive care.
Dehydration is common, so fluids may be given directly into a vein. Blood oxygen levels
and blood pressure also need to be maintained at the right level, and body organs need to be
supported while the person’s body fights the infection.
Healthcare workers need to avoid contact with the bodily fluids of their infected patients
by taking strict precautions, such as wearing protective equipment.
Ebola virus disease is sometimes fatal. The sooner people are given care, the better the
chance they’ll survive.

Preventing Ebola
The Ebola outbreak in West Africa is now over. The risk of catching the infection while
travelling to previously affected countries is very small. But if you’re visiting one of these
areas, it’s still a good idea to follow these simple precautions to minimise your risk of
picking up potentially serious infections:
wash your hands frequently using soap and water – use alcohol hand rubs when soap

isn’t available
make sure fruit and vegetables are properly washed and peeled before you eat them

avoid physical contact with anyone who has possible symptoms of an infection

don’t handle dead animals or their raw meat

don’t eat "bushmeat"

Source: NHS https://www.nhs.uk/conditions/ebola/

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1. Circle the only possible answer based on the text about Ebola.

1.1.1 Around 28,000 people caught Ebola in Central Africa during the 2014-15 outbreak.
1.1.2 Almost 11,000 patients died of Ebola during the recent outbreak.
1.1.3 The Ebola outbreak affected three countries only.
1.1.4 The number of deaths due to the Ebola outbreak in Africa was over 10,000.

1.2.1 The only body fluids that can contain Ebola virus are blood, stools, urine, and
vomit.
1.2.2 The virus does not stay alive in a dead person’s body longer than a day.
1.2.3 The spread of the disease may also be linked to the consumption of a certain type of
food.
1.2.4 A mere handshake even with someone who doesn’t have symptoms can be very
dangerous during an Ebola outbreak.

1.3.1 Currently, there are new vaccines and drug therapies to treat Ebola.
1.3.2 Patients infected with Ebola virus must be kept away from other patients.
1.3.3 The single most important precaution for healthcare workers is washing their hands
after being in contact with the body fluids of their infected patients.
1.3.4 The outcome of the disease does not depend on how soon the patient is given care.

1.4.1 There is always a significant risk of catching the Ebola infection if you travel to West
Africa.
1.4.2 Proper hand hygiene is essential if you want to avoid being infected.
1.4.3 Make sure you avoid eating fruit and vegetables while travelling.
1.4.4 Do not touch meat unless it is raw.

2. Fill in the gaps of the text below with one suitable word.

Ebola is a serious viral disease originating in Africa. The outbreak of 2014-15 resulted in high
(1) …………………………, especially in the western part of the continent. Initial symptoms of
the disease include fever, headache, a sore throat, and a lack of muscle (2) ……………… .
Later, the patient may develop further symptoms, such as diarrhoea, vomiting, a
rash, stomach pain, and even internal (3) ………………………………… . In the absence of
licensed treatment or vaccines, affected geographical areas have to be (4)
………………………………………… in order to control the epidemic. Intravenously giving
the patients fluids can help them stay (5) …………………………… . Even if there is no
epidemic currently, it is advisable to follow certain (6) ………………………………… if you
are travelling to potentially affected areas.

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