¶ Intro / Opening
The level of this lesson is advanced. And timestamps are provided in your show notes. The lessons offered at docmolly.com are solely for learning Spanish. They are not intended to teach medicine or provide medical advice. Since time is of the essence when considering thrombolytics for emergency stroke treatment, I thought it would be helpful to review questions and phrases regarding their contraindications.
To assemble this lesson, I used a list of contraindications in the stroke chapter of my favorite medical education resource MKSAP 19. There's a link in your show notes. Now, there is a lot to cover. Therefore, we will do it in two lessons. In this free lesson, we will cover Spanish for the following contraindications to thrombolytic
As I say, each contraindication. Think about how you would say it in Spanish. greater than 4.5 hours since symptom onset, recent head trauma or stroke, evidence of bleeding, increased risk of bleeding or bleeding diathesis, elevated blood pressure (>185/110) and low blood sugar (<50) In the upcoming member lesson, we will complete our review of Spanish for discussing contraindications to thrombolytics.
We will cover intracranial lesions, recent major surgery or trauma, a noncompressible arterial puncture site, recent brain or spine surgery, seizure at the onset of symptoms, pregnancy and recent heart attack. And as you may have noticed, some of these contraindications are absolute contraindications, others are relative contraindications. We will note this before we cover each
contraindication. This lesson will also have some medical jargon because sometimes we discover contraindications through medical imaging or other testing. Therefore, some questions and phrases will be directed at other health professionals rather than the patient.
Since this will be a whirlwind tour of Spanish for various medical topics, to save time, we will not review vocabulary and multiple variations for each question and phrase, but I will include variations as well as a Quizlet set where you can review the vocabulary in the lesson notes at docmolly.com. And one more thing before we begin. The purpose of this lesson, as always, is to learn
medical Spanish, not medicine. Please consult your trusted medical sources when reviewing contraindications for thrombolytics with your patients. Gracias. I hope you find this lesson helpful. ¿Listos? ¡Empecemos! Luis Almeida nos acompaña desde Venezuela para ayudarnos con el español de esta lección.
¶ Greater than 4.5 hours since symptom onset
Contraindicación absoluta: Los síntomas comenzaron hace más de 4 horas y media.
The symptoms started more than four and a half hours ago. Los síntomas comenzaron hace más de 4 horas y media. Utilizando EMPEZAR, When did the symptoms begin? ¿Cuándo empezaron los síntomas? What time did the symptoms begin? ¿A qué hora empezaron los síntomas? Ahora, preguntando al acompañante del paciente, When was the last time she seemed normal to you? ¿Cuándo fue la última vez que le pareció normal? Referring to a male patient and using VER, When was the last time you saw him normal?
¿Cuándo fue la última vez que lo vio normal?
¶ Recent head trauma or stroke,
Contraindicación absoluta: Traumatismo craneal o infarto cerebral durante los últimos tres meses Head trauma or stroke during the last three months Traumatismo craneal o infarto cerebral durante los últimos tres meses In the last three months, have you suffered any head trauma? En los últimos tres meses, ¿ha sufrido algún traumatismo craneal? In the last three months, have you suffered any blows to the head? En los últimos tres meses, ¿ha sufrido algún golpe en la cabeza?
And here, you may want to use GOLPE FUERTE to indicate a severe blow to the head, not just a bump on the head. ¿Ha sufrido algún golpe fuerte en la cabeza? In the last three months, have you suffered a stroke? En los últimos tres meses. ¿Ha sufrido un infarto cerebral?
¶ Active internal bleeding,
Contraindicación absoluta: Sangrado interno activo Active internal bleeding Sangrado interno activo Utilizando HEMORRAGIA interpreta: Have you had any bleeding? ¿Ha tenido alguna hemorragia? Has he suffered any internal bleeding? ¿Ha sufrido alguna hemorragia interna? Or using SANGRADO, ¿Ha sufrido algún sangrado interno? Note that although both SANGRADO y HEMORRAGIA can be translated as bleeding, just like "hemorrhage" in English, HEMORRAGIA implies that the bleeding is more serious.
¶ Recent gastrointestinal or genitourinary bleeding,
Contraindicación relativa: Hemorragia gastrointestinal o genito- urinaria durante los últimos 21 días. Gastrointestinal or genito-urinary bleeding within the last 21 days Hemorragia gastrointestinal o genito- urinaria durante los últimos 21 días Do you have bleeding ulcers? ¿Tiene úlceras sangrantes? ¿Tiene úlceras hemorrágicas? Utilizando SUFRIR y SANGRADO, During the last three weeks, has she had any bleeding from the gastrointestinal tract or the urinary tract?
¿Durante las últimas tres semanas, ha sufrido algún sangrado del tracto gastrointestinal o del tracto urinario? Utilizando POPÓ, Have you noticed blood in your stool? ¿Ha notado sangre en el popó? And the noun POPÓ can be either masculine or feminine. ¿Ha notado sangre en la popó? Have you noticed blood in your urine? ¿Ha notado sangre en la orina? Does your poop look dark and sticky? ¿Su popó parece oscura y pegajosa? Or using the masculine noun POPÓ, ¿Su popó parece oscuro y pegajoso?
Utilizando SANGRADO, Have you had any bleeding from the uterus? ¿Ha tenido algún sangrado del útero? Contraindicación absoluta: Diátesis hemorrágica activa Active bleeding diathesis Diátesis hemorrágica activa Utilizando HEMORRAGIAS, interpreta: Have you been diagnosed with any bleeding problems? ¿Le han diagnosticado algún problema de hemorragias? Notice how Luis used an unspecified subject of "they" to express the passive action of being diagnosed.
Literally, "Have they diagnosed you any bleeding problems? ¿Le han diagnosticado algún problema de hemorragias? Interprétalo otra vez. Have you been diagnosed with any bleeding problems? ¿Le han diagnosticado algún problema de hemorragias? Do you take anticoagulants? ¿Toma anticoagulantes? Do you take medications to thin the blood? ¿Toma medicamentos para adelgazar la sangre? ¿Toma medicamentos para diluir la sangre? So you'll hear both ADELGAZAR y DILUIR to say to "thin the blood."
Utilizando ADMINISTRAR, Has she been given heparin in the last 24 hours? ¿Le han administrado heparina en las últimas 24 horas? Does he have a platelet count less than 100? ¿Tiene un conteo de plaquetas inferior a 100?
¶ Elevated BP (> 185/110) despite treatment
Contraindicación absoluta: Presión arterial superior a 185 sobre 110. Blood pressure greater than 185 over 110 Presión arterial superior a 185 sobre 110 And we should have added here, A PESAR DE TRATAMIENTO, despite treatment. So, if someone's blood pressure is really high when they come in the E.R., we can treat that, get it down with nicardipine and then give them the thrombolytics. Okay, now back to the medical Spanish. Empezando con USTED, Do you have uncontrolled blood pressure?
¿Usted tiene la presión arterial descontrolada? Her blood pressure is 192 over 80. Su presión es de 192 sobre 80. Fíjate en cómo se puede utilizar simplemente LA PRESIÓN para referirse a LA PRESIÓN ARTERIAL. Su presión es de 192 sobre 80. En los siguientes ejemplos Vamos a utilizar LA PRESIÓN ARTERIAL. His systolic blood pressure is over 185. Su presión arterial sistólica es superior a 185. His diastolic blood pressure is over 110. Su presión arterial diastólica es superior a 110.
And if you would like to practice more with numbers and reporting blood pressures, there's a link in your lesson notes. Contraindicación absoluta: Nivel de glucosa en la sangre inferior a 50 Blood glucose level under 50 Nivel de glucosa en la sangre inferior a 50 Do you suffer from diabetes? ¿Sufre de diabetes? Do you take medications for diabetes? ¿Toma medicamentos para la diabetes? Do you take insulin? ¿Se pone insulina? ¿Se inyecta insulina?
So when speaking of injectable medications, you can use PONERSE, INYECTARSE, or APLICARSE. Contraindicación absoluta: Un infarto cerebral grande observado en la tomografía. Interpreta: In the upcoming member lesson, we will complete our review of Spanish
for discussing contraindications to thrombolytics. We'll learn how to ask about intracranial lesions, recent major surgery or trauma, a noncompressible arterial puncture site, recent brain or spine surgery, seizure at the onset of symptoms, pregnancy, and recent heart attack. To learn more with us and support the podcast, click the link in your show notes to become a member and access all our lessons and courses
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