(BQ) English for pharmacy writing and oral communication has been written with the following goals in mind: to serve the English language needs of students and professionals studying and practicing pharmacy; to assist pharmacy faculty, who teach pharmacy, and pharmacy technician students, whose first or best language is not English, with their pharmacy language learning needs; to help pharmacy students, pharmacy technicians, and practicing pharmacists develop and gain communication confidence;...
Diaz_CH08_181-206.qxd 6/6/08 11:22 AM Page 181 The Musculoskeletal System PRE-ASSESSMENT True/False Questions Indicate whether each sentence below is true (T) or false (F) _ Rheumatoid arthritis results from wear and tear on the joints _ An accumulation of urate crystals causes gout, or inflammation of a joint, usually in the big toe _ Another word for degenerative joint disease is osteoporosis _ Sjögren’s syndrome is a disorder of the immune system that affects the tendons _ The adjective form of arthritis is arthritic _ A risk factor for developing lupus, a chronic inflammatory disease, is pregnancy _ Osteoporosis, which means porous bones, causes bones to be strong and brittle _ Tendonitis, which is inflammation of the tendon, affects only the wrist and elbow _ Bursitis, which is inflammation of the fluid that lubricates joints and muscle tendons, can be caused by overuse, infection, arthritis, and gout 10 _ The noun form of stiff is stiffness and stiff 11 _ Osteomyelitis refers to infection of the bone 12 _ Symptoms of Paget’s disease, which is a disease of the bone, includes bowlegs and an enlarged head size 13 _ People with Marfan syndrome have scoliosis, very loose and flexible joints, and a breastbone that protrudes outward or is concave 14 _ Scleroderma is an arthritic condition and a connective tissue disease 15 _ The adjective forms of deteriorate are deteriorated and deteriorating Multiple Choice Questions Choose the correct answer from a, b, and c _ Over time, arthritis can lead to: a deformity of the joints b weak and brittle bones c bone infection _ A risk factor for developing gout is: a malnutrition b excessive urination c excess consumption of alcohol 181 Diaz_CH08_181-206.qxd 6/6/08 11:22 AM Page 182 182 ENGLISH FOR PHARMACY WRITING AND ORAL COMMUNICATION _ The disorder of the immune system that includes symptoms of dry eyes and dry mouth is: a scleroderma b Sjögren’s syndrome c Marfan syndrome _ Lupus is a chronic autoimmune inflammatory disease that can affect the: a lungs, heart, skin, joints, kidneys, and blood cells b skin and joints only c skin only _ Digestive problems can occur in patients with: a localized scleroderma b systemic scleroderma c osteoarthritis _ Fibromyalgia is a chronic condition that affects the: a bone marrow b muscles c tendons _ A chronic form of inflammation of the spine is: a amyloidosis b ankylosing spondylitis c osteoarthritis _ The word mobility is: a a noun and a verb b a verb only c a noun only _ People with osteoporosis will experience: a sensitivity to sun b a rash on their face c fractures 10 _ The expression “I can feel it in my bones” means: a you are having bone pain b you feel something will happen, even though you are not sure it will c you are very cold How did you do? Check your answers in the Answer Key online M E D I C A L VO C A BU L A RY A good understanding of vocabulary words in pharmacy is very important for communication with professors, fellow students, patients, and coworkers Knowledge and understanding of vocabulary leads to successful communication and success as a pharmacy student, as a pharmacy technician, and as a practicing pharmacist You may already know many of the vocabulary words in this chapter, but for words that are unfamiliar, pay careful attention to them and make every effort to know their correct spelling, meaning, and pronunciation It is a good idea to keep a list of new words and to look up these new words in a bilingual dictionary or dictionary in your first language A good command of pharmacyrelated vocabulary and good pronunciation of vocabulary will help to prevent embarrassing mistakes and increase effective verbal communication skills Diaz_CH08_181-206.qxd 6/6/08 11:22 AM Page 183 The Musculoskeletal System 183 Musculoskeletal System Vocabulary aching ankylosing spondylitis arthritis autoimmune bony lumps brittle bursitis carpal tunnel syndrome cartilage collagen connective tissue debilitating deformity degenerative erythrocyte sedimentation rate fibromyalgia rheumatism scleroderma Sjögren’s syndrome spine stiffness stooped posture stress stretch subside susceptible synovitis temporomandibular joint tendonitis urate crystals vertebrae wear and tear flexibility fracture fusion gout immune joints knuckles ligaments lupus mobility nodes osteoarthritis osteoporosis photosensitivity range of motion relapse remission PA RTS O F S PE E C H A good understanding of parts of speech, such as verbs, nouns, adjectives, and adverbs, is important for successful communication when speaking or writing It is equally important to know the various forms of words and to use them appropriately Word Forms The table below lists the main forms of some terms that you will likely encounter in pharmacy practice Review the table and then the exercises that follow to assess your understanding Noun (n) Infinitive/Verb (v) —Past Tense Adjective (adj) Adverb (adv) ache; aching to ache; ached aching achingly arthritic arthritically brittle brittlely arthritis; arthritic brittleness to brittle; brittled collagen debilitation collagenous; collagenic to debilitate; debilitated deformity debilitating; debilitative deformed degeneration to degenerate; degenerated degenerative flexibility; flexibleness to flex; flexed flexible fracture to fracture; fractured fusion to fuse; fused gout; goutiness immunization flexibly gouty to immunize; immunized immune (continued ) Diaz_CH08_181-206.qxd 6/6/08 11:22 AM Page 184 184 ENGLISH FOR PHARMACY WRITING AND ORAL COMMUNICATION Noun (n) Infinitive/Verb (v) —Past Tense Adjective (adj) Adverb (adv) joint to join; joined jointed jointly knuckle to knuckle; knuckled ligament mobility; mobilization ligamental; ligamentary; ligamentous to mobilize; mobilized mobile osteoarthritis osteoarthritic osteoporosis osteoporotic photosensitivity photosensitive posture; posturer to posture; postured postural rheumatism rheumatoid spine spinal stiffness; a stiff to stiff; stiffed stiff; stiffish stress to stress; stressed stressful stretchability to stretch; stretched stretchable susceptibleness susceptible synovitis; synovium; synovia synovial rheumatoidally stiffly susceptibly Word Forms Exercise Read the following sentences carefully Then indicate the word form of the bolded word(s), choosing from v, n, adj, or adv Symptoms of rheumatoid arthritis include swelling and deformity in the joints of the hand and feet, loss of motion in the joints, and a loss of strength in the muscles attached to the joints rheumatoid deformity joints motion strength Gouty arthritis, also known as gout, is a form of arthritis that causes an intolerable hot, tender, and swollen sensation in the big toe gouty arthritis gout intolerable tender swollen Osteoarthritis, also known as degenerative bone disease, is a common form of arthritis that results in the breakdown of joint cartilage osteoarthritis degenerative common breakdown cartilage People with Sjögren’s syndrome, an autoimmune disorder, will experience dry eyes and dry mouth syndrome autoimmune disorder experience People with osteoporosis, which causes bones to become brittle and weak, are likely to have bone loss, fractures, and a stooped posture osteoporosis brittle fractures stooped posture Sensitivity to sunlight is a typical symptom of lupus, a chronic inflammatory disease that develops when an individual’s immune system attacks its organs and tissues sensitivity typical lupus immune attacks Diaz_CH08_181-206.qxd 6/6/08 11:22 AM Page 185 The Musculoskeletal System 185 Ankylosing spondylitis is a form of inflammatory arthritis that causes inflammation of the joints between the vertebrae of the spine and of the joints between the spine and pelvis inflammatory inflammation vertebrae spine Scleroderma, which means “hard skin,” is a connective tissue disease that leads to hardening of the skin as a result of inflammation and the overproduction of collagen, and can affect other organs in the body scleroderma hard connective hardening overproduction collagen Pain throughout the body, fatigue, interrupted sleep, headaches, facial pain, irritable bowel syndrome, and sensitivity to bright lights, noise, touch, and odors are some of the signs and symptoms of fibromyalgia interrupted facial bright touch fibromyalgia 10 It is typical for arthritic patients to experience severe fatigue during a flare-up and to have stiff and achy joints and muscles, especially after periods of rest and sleep arthritic flare-up stiff achy periods rest 11 In addition to experiencing intense joint pain and a red, swollen, and tender big toe, sufferers of gout may experience similar pain and discomfort in their hands, wrists, feet, and ankles intense tender sufferers similar discomfort 12 Fingers affected by osteoarthritis can develop nodes, or bony knobs, and the bones along the spine affected by osteoarthritis can deteriorate, leading to neck pain and stiffness nodes bony bones deteriorate lead stiffness 13 In addition to dry eyes and dry mouth, symptoms of Sjögren’s syndrome include, but are not limited to, a dry cough without sputum, difficulty chewing and swallowing, fatigue, dental cavities, and swollen and stiff joints cough difficulty dental cavities stiff 14 Inflammation in the joints in an arthritic person occurs when red blood cells attack the synovial membrane that lines the movable joints, which becomes inflamed arthritic synovial lines movable inflamed 15 Medications and lifestyle changes such as weight reduction, limiting alcohol intake, which can prevent the excretion of uric acid, and drinking plenty of water to dilute uric acid in the body can help reduce attacks of gout lifestyle reduction excretion dilute attacks How did you do? Check your answers against the Answer Key online Typical Medical Conditions and Patient Complaints The sentences below contain vocabulary that describes and explains typical medical conditions, diseases, symptoms, and patient complaints that a pharmacist encounters Read the sentences carefully Then indicate the word form of the bolded word(s), choosing from v, n, adj, or adv Look up words you not know in your bilingual or first-language dictionary Before she was diagnosed with lupus, the patient had complained of a rash that developed across the cheeks and bridge of her nose, of pain and stiffness in her wrists, hips, and knees, of swelling in her fingers, and that she could not tolerate the sun diagnosed complained stiffness swelling tolerate Sufferers of ankylosing spondylitis, which can affect other parts of the body such as the joints between the ribs and the spine, the joints in the feet, knees, shoulders, and hips, and the Diaz_CH08_181-206.qxd 6/6/08 11:22 AM Page 186 186 ENGLISH FOR PHARMACY WRITING AND ORAL COMMUNICATION tendons and ligaments, may also develop chronic stooping, a stiff, inflexible spine, and bowel inflammation sufferers spine ligaments chronic stooping inflexible Scleroderma, which is caused when the body attacks itself and produces too much collagen, is classified into localized scleroderma, a disease that affects only the skin, and systemic scleroderma, which affects the skin, blood vessels, and major organs attacks produces localized affects systemic major People who suffer from fibromyalgia need to reduce stress and avoid overexertion, get enough sleep to help reduce the fatigue typical of fibromyalgia, exercise, learn relaxation techniques, and eat healthy foods suffer stress avoid overexertion typical exercise Arthritis, which comes in many forms, is a joint disorder accompanied by inflammation and ranges from rheumatoid arthritis, which is inflammation from an overactive immune system, to osteoarthritis, which is the wear and tear of cartilage forms disorder rheumatoid overactive wear and tear Aging, heredity, and injury can cause osteoarthritis, also known as degenerative arthritis, which is the loss and degeneration of cartilage caused by inflammation aging osteoarthritis degenerative degeneration caused Patients with Sjögren’s syndrome, an autoimmune disease that affects the glands that produce tears and saliva and causes dry eye and dry mouth, can be treated with artificial tears and eye lubricant ointments, plenty of fluids, and humidifying air autoimmune tears artificial lubricant humidifying Quitting smoking, reducing alcohol consumption, exercising, and eating foods with calcium and vitamin D can help treat the loss of bone and loss of bone strength caused by osteoporosis, which results in bone fractures reducing consumption loss strength fractures Kidney stones and decreased kidney function can result from gout, a form of arthritis that is caused by very high levels of uric acid in the blood decreased function high uric acid 10 Ankylosing spondylitis, which is chronic inflammation of the spine and the sacroiliac joints that causes stiffness, pain, and the loss of mobility of the spine, can also affect other tissue and organs in the body chronic spine sacroiliac stiffness mobility affect 11 People suffering from fibromyalgia, a chronic condition that is aggravated by weather change, emotional stress, and noise, are sensitive to various stimuli, feel pain, stiffness, and tenderness throughout their body and may experience sleep disturbances, anxiety, depression, fatigue, and irritable bowel syndrome change emotional sensitive tenderness disturbances 12 Some people with rheumatoid arthritis, which is an autoimmune disease that causes the joints to inflame, will experience remission for weeks, months, or years during which symptoms such as joint pain, fatigue, swelling, stiffness, and muscle and joint aches disappear causes inflame remission aches disappear 13 Scleroderma can be classified into diffused scleroderma, which causes thickening of the skin on the face, extremities, and in major organs such as the esophagus, lungs, kidneys, bowels, and heart, and limited scleroderma, which affects the skin and fingers diffused thickening extremities major limited Diaz_CH08_181-206.qxd 6/6/08 11:22 AM Page 187 The Musculoskeletal System 187 14 People with discoid lupus will have a painless and itchless skin rash on their face and scalp, whereas people with systemic lupus, which seriously affects other organs such as the brain, kidney, lungs, and heart, will complain of fatigue, a butterfly rash on their face, joint pain, muscle aches, loss of appetite, and photosensitivity painless itchless complain loss photosensitivity 15 Because the elderly have porous bones, they are at a greater risk for developing osteoporosis and having hip and spine fractures, severe back pain, and loss of height or a stooped, hunchedback appearance elderly porous severe height stooped hunched-back 16 Osteoarthritis that is caused by factors other than aging and heredity, such as obesity, trauma, diabetes, and gout, is referred to as secondary osteoarthritis, whereas osteoarthritis that is caused by aging, heredity, and repetitive use of the joints over time is referred to as primary osteoarthritis factors secondary repetitive use primary 17 A good way to manage rheumatoid arthritis is to exercise regularly, to control weight, and to apply heat to painful joints and muscles manage regularly control weight apply 18 It is important for people who smoke and who have ankylosing spondylitis to quit because smoking can affect the mobility of the rib cage and can complicate the ability to breathe quit smoking mobility complicate ability breathe 19 It is important for patients with scleroderma to keep their body flexible to improve circulation and relieve stiffness, to quit smoking, to protect themselves from cold temperatures, and to avoid foods that cause heartburn or gas flexible circulation relieve protect cold avoid 20 To manage fibromyalgia, patients need to get enough sleep to reduce fatigue, avoid overexertion, learn to meditate, exercise regularly, and maintain a healthy lifestyle need enough overexertion meditate maintain How did you do? Check your answers against the Answer Key online Medical Vocabulary Comprehension Now that you have read sentences through 20 describing language regarding the musculoskeletal system, assess your understanding by doing the exercises below Multiple Choice Questions Choose the answer that correctly completes each sentence below _ Osteoarthritis is also called: a osteoporosis b rheumatoid arthritis c degenerative bone disease _ Scleroderma is the result of: a inflammation and bony knobs b overproduction of collagen and inflammation c stooping Diaz_CH08_181-206.qxd 6/6/08 11:22 AM Page 188 188 ENGLISH FOR PHARMACY WRITING AND ORAL COMMUNICATION _ Decreased kidney function can result from: a fibromyalgia b ankylosing spondylitis c gout _ Osteoporosis can cause: a fractures, severe back pain, loss of height, and a stooped appearance b an increase in mobility c chronic inflammation of the spine _ Another term for scleroderma is: a autoimmune disorder b hard skin c collagen _ A person experiencing dry eyes and a dry mouth should be tested for: a gout b lupus c Sjögren’s syndrome _ Inflammation from an overactive immune system describes: a fibromyalgia b rheumatoid arthritis c osteoarthritis _ If a person is sensitive to sunlight, has joint pain, and a butterfly rash on the face, he or she may have: a gout b lupus c rheumatoid arthritis _ It is important that patients with ankylosing spondylitis not smoke because smoking: a will cause fatigue b will put stress on the spine c can affect the mobility of the rib cage and complicate the ability to breathe 10 _ Symptoms of rheumatoid arthritis include: a swelling, deformity in the joints of the hands and feet, and loss of motion in the joints b a hot and swollen sensation in the hands c inflammation between the spine and pelvis 11 _ Gout is: a a common form of arthritis that results in the breakdown of joint cartilage b a form of arthritis that causes an intolerable hot, tender, and swollen sensation in the big toe c a form of secondary osteoarthritis 12 _ A person who is sensitive to bright lights, noise, touch, and odor and has pain throughout the body may have: a lupus b fibromyalgia c Sjögren’s syndrome 13 _ Difficulty swallowing and chewing, fatigue, dental cavities, and swollen and stiff joints are symptoms of: Diaz_CH08_181-206.qxd 6/6/08 11:22 AM Page 189 The Musculoskeletal System 189 a Sjögren’s syndrome b primary osteoarthritis c osteoporosis 14 _ Patients with osteoporosis have: a brittle and strong bones b brittle and weak bones and may develop a stooped posture c poor cartilage 15 _ Systemic lupus affects: a the skin only b major organs only c the skin, blood vessels, and major organs True/False Questions Indicate whether each sentence below is true (T) or false (F) _ Hardening of the skin as a result of overproduction of collagen is called Sjögren’s syndrome _ A person who has ankylosing spondylitis suffers from degenerative bone loss _ People who suffer from fibromyalgia should reduce stress, avoid overexertion, and learn relaxation techniques _ Rheumatoid arthritis is inflammation from an overactive immune system, and osteoarthritis results from wear and tear of cartilage _ People with Sjögren’s syndrome should not be treated with artificial tears and eye lubricant ointments _ The word “stressed” is both an adjective and a verb _ Only reducing alcohol consumption and quitting smoking can help treat osteoporosis _ The word “arthritic” is an adjective only _ Patients with scleroderma need to keep their body flexible to improve circulation and relieve stiffness 10 _ If a patient with rheumatoid arthritis is in remission, the joint pain, swelling, and stiffness have returned How did you do? Check your answers against the Answer Key online Writing Exercise An important part of communication is the ability to write about what you read, to write correctly, and to spell correctly In the exercises below, write your understanding of the meaning of the bolded words Describe in writing what rheumatoid arthritis is Describe in writing what osteoporosis and osteoarthritis are Diaz_CH08_181-206.qxd 6/6/08 11:22 AM Page 190 190 ENGLISH FOR PHARMACY WRITING AND ORAL COMMUNICATION Describe in writing what scleroderma and lupus are Describe in writing what ankylosing spondylitis is Describe in writing what gout, fibromyalgia, and Sjögren’s syndrome are Check what you have written with acceptable answers that appear in the Answer Key online L I S T E N I N G A N D P RO N U N C I AT I O N The ability to listen and understand what is being said and heard, and the ability to pronounce words clearly, is extremely important A word misheard and a word mispronounced will lead to poor communication and can seriously put both the pharmacist and patient in danger Therefore, it is very important that one hear clearly what another person has said, and that one speak clearly with correct pronunciation Listen carefully to the pharmacy-related words presented in the audio files found in Chapter on thePoint (thePoint.lww.com/diaz-gilbert), and then pronounce them as accurately as you can Listen and then repeat You will listen to each word once and then you will repeat it You will this twice for each word Listening and pronunciation practice will increase your listening and speaking confidence Many languages not produce or emphasize certain sounds produced and emphasized in English, so pay careful attention to the pronunciation of each word Pronunciation Exercise Listen to the audio files found in Chapter on thePoint (thePoint.lww.com/diaz-gilbert) Listen and repeat the words Then say the words aloud for additional practice a Јk ng àngk lozing sponЈdl- Јt s är-thr Јt s ôЈt o - -my oonЈ b o Јn e l u mp br tЈl b r-s Јt s kärЈp l t u nЈ l s nЈdr omЈ kärЈtl- j k o lЈ -j n k -nekЈt v t shЈ oo e e e e e e e aching ankylosing spondylitis arthritis autoimmune bony lump brittle bursitis carpal tunnel syndrome cartilage 10 collagen 11 connective tissue Diaz_App_B_393-400.qxd 6/3/08 3:24 PM Page 400 400 ENGLISH FOR PHARMACY WRITING AND ORAL COMMUNICATION PARAMETERS COMMONLY USED TO EVALUATE EFFECTIVENESS AND/OR SAFETY OF DRUG THERAPY PARAMETER Blood pressure Total Cholesterol LDL Low-density lipoprotein HDL High-density lipoprotein Triglycerides Glucose HbA1c Hemoglobin A1c TSH Thyroid Stimulating Hormone INR International Normalized Ratio K + Serum Potassium Creatinine serum creatinine (SCr) creatinine clearance (CrCl) ALT Alanine aminotransferase AST Aspartate aminotrasnferase GOALS OF THERAPY (NORMAL VALUES) Goals of therapy include: systolic blood pressure of 110–140 mmHg diastolic blood pressure of 75–85 mmHg 55 • without other risk factors