Addition

*) medication & pain & sensation >>> non countable.

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*) Although + Sentence = Despite / In spite of + v+ing or noun ‫على الرغم من‬
He was compliant with medication; however, his condition deteriorated
His condition deteriorated although he was compliant with medications
Although he was compliant with medications, his condition deteriorated
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*) within normal range / limit ... ‫طبيعي‬

*) queries ** writing ** refer ** referring .

*severe * headache

*) Be simple :
(1) Don’t expand the single sentence more than 2 lines .
(2) Don’t use more than one connector in the single sentence .
(3) Don’t use more than 2 or less than 1 cohesive device in each paragraph .
_______________________________
*) Otherwise ( cohesive device ) ‫غير ذلك‬
- He had a fever; otherwise, his vital signs were normal
- He had normal vital signs apart from fever .
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*) kindly/ please >> note / consider / be aware / be informed ,
>>> It should be noted that or It must be stressed that or
>>> It worth mentioning that = It is noteworthy : >>> to mention that
>>> mentioning that
>>> to be mentioned that
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*) No paraphrasing in the chief complaint and purpose .. e.g. adenocarcinoma in

the ascending colon .. Severe asthma triggered by upper viral respiratory infection

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________________________________

*) accompanied by = associated with …

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*) he had a 2- day history of headache >>> He had a headache of a 2-day-
duration .

- In 03/2019, Mr Smith presented with headache for 3 weeks / a 3-week history of

headache
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*) ... ‫المشبك ممنوع‬
_________________________________
*) you should write a complete sentence:
e.g. - pain in Rt arm (wrong) >>> the patient had pain in the right arm.
- For you further management (wrong) >>> Your further management would
be highly appreciated
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*) show / reveal >>> noun or verb + ing
>>> that + sentence >>> fact  present simple .
e.g. The heart is enlarged .
>>> temporal problem  past simple >>
e.g. RBCs Level was low .
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*) fortnight = 15 days .
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*) Died of …
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*) site of adverbs ( e.g. never & still & subsequently &recently…..etc. )

1-Directly Before the Verb 2- At the beginning or the end of the sentence.
e.g. the patient was in pain . (Subsequently), he was (subsequently) transferred
(subsequently)
e.g I am writing to urgently refer Mr X who has been recently diagnosed with ...
_______________________________
*) he has no fever nor headache >>>> not he has no fever and headache ..
2
_______________________________
*) Workplace assessor / Admitting Officer >>> not a medical
>>> NO - Dear Doctor
- Thank you for seeing .
- I am referring / writing to refer …
- your assessment / management … etc.
- Medical terms e.g Ibuprofen & MRI
>>> yes - Dear Sir / Madam
- I am requesting .
- I am writing regarding MR X .
- Your further cooperation.
- Simple terms e.g. Ibuprofen xx  Painkillers //// Ceftiaxone 
Antibiotic //// MRI  Imaging
Examples:
- Your further cooperation NOT assessment
- I am writing to refer (x)
- Thank you for seeing Mr X (x)
- I am writing to request work place assessment for Mr x who has been dx with ...
- I am writing regarding Mx who has a Dx of Back strain.Your assessment of his
work place would be highly appreciated
_______________________________

*) Yours sincerely ,

_______________________________

*) In accordance with ….. ‫ وفقا لـ‬/ ‫طبقا‬

e.g. In accordance with his investigations , he was diagnosed with ………

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*) Eye drops / Oral contraceptive pills >>>> singular ..

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Since + date (2016) For + time (3 y)
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Since 5 years ( wrong !!!!!!!) For 2014 ( wrong !!!!!!!)
Since 2014 ( correct ) For 5 years ( correct )
Since 5 years ago ( correct )

_____________________________________

*) STAT = immediately .
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*) with a ( height / weight /body mass index (BMI) / blood pressure (BP) /
temperature etc… ) of + Number
e.g. he is overweight with a BMI of 40 .
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*) Article ( a/ an/ the ) + noun , noun , noun and noun .
e.g. The x-ray , MRI and blood test showed ….
e.g. an MRI , x- ray and urine test were ordered .
____________________________________

*) Triggered / aggravated / relieved / + By ….

*) Exaggerated / Complicated + with

*) Accompanied by = associated with …

*) Emergency Register = Emergency doctor ‫دكتور الشيفت يعني‬

…avoid ‫** األقواس ممنوعة‬

: ‫** البد من التصاق ضمير الوصل باالسم العائد عليه‬

>>> MR X ’s condition who has a diagnosis of MI . ( WRONG !!!!)

>>> MR X’s condition which was diagnosed as MI . ( CORRECT)
>>> The condition of MR X who has a diagnosis of MI . ( CORRECT ).

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*) 1 to 12 >>> write in letters .

*) more than 12 >>> write in numbers ..

*) Negative from of >>> Has ( ‫ >>> )كفعل أساسي‬doesn’t have / has no ….

e.g. He has children . he does not have children He has no children ..

>>> Have  don’t have / have no ….

e.g.They have children . they do not have children . they have no children.

>>> Had  didn’t have / had no …

e.g. He had children . he did not have children . he had no children.

*) subject + Be + a or an + adj + noun / adj .

e.g. He is an overweight male (correct ) .
e.g. He is an overweight ……….( wrong !!!!!) .
e.g. He is overweight …………... ( correct ) .

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*) Timing in reported speech:

،،‫ و هي حكيتلي الموضوع ده لما قابلتها من سنة‬،،‫ و قالتلي ان ابنها سخن امبارح‬،‫لو افترضنا ان فيه أم‬
‫ و عاوز اقول انها أخبرتني ان ابنها سخن امبارح (خطأ) النها اخبرتني امبارح بس‬،،‫بعد سنة انا قابلتها تاني‬
،،‫قبل سنة من الوقتي‬
،،‫لذلك بنقول انها اخبرتني ان ابنها سخن قبل يوم‬
.....
: ‫كذلك باالنجلش‬
-His mother reported that her child had had a fever yesterday (false)
-His mother reported that her child had had a fever the day before (true)

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today that day

"I saw him today", she said. She said that she had seen him that day.

yesterday the day before

"I saw him yesterday", she said. She said that she had seen him the day before.

The day before yesterday two days before

"I met her the day before He said that he had met her two days before.
yesterday", he said.

Tomorrow the next/following day

"I'll see you tomorrow", he said He said that he would see me the next day.

Next week/month/year the following week/month/year

"I have an appointment next week", She said that she had an appointment the following
she said. week.

Last week/month/year the previous/week/month/year

"I was on holiday last week", he told He told us that he had been on holiday the previous
us. week.

ago before

"I saw her a week ago," he said. He said he had seen her a week before.

this (for time) that

"I'm getting a new car this week", She said she was getting a new car that week.
she said.

here there

He said, "I live here". He told me he lived there.

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Q: On 3/4/2021, Mr X (present) with fever for 3 weeks  Past simple or Present
Perfect ??
Answer: Past Simple because 3 weeks is an adjective for “fever” not for the verb
“present”
However, we can avoid this situation by changing the time range into a compound
adjective (for 3 weeks - a 3-week- history/complaint of)
 On 3/4/2021, Mr X (present) with a 3 –week- history/complaint of fever.

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- Present perfect  preferred in confirmed information
e.g. The dx has been confirmed by a biopsy

 Prescribed & Commenced if the patient was still on the ttt;

otherwise, use past simple
e.g. The Pt has been commenced on Aspirin (Still taking Aspirin)
The Pt was commenced on Aspirin (Stopped)
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- Continuous Tenses (Past & Present)  Deterioration & Responding &
Recovering
e.g. He was responding well to the treatment
He is recovering/deteriorating
______________________________________________
- She requested a referral to an endocrinologist (Wrong)
- She requested a referral to you (True)
_______________________________________________
- An x-ray was ordered. Please note, She did an x-ray 3 years ago for a car
accident
- An x ray was ordered. The x ray showed a fractured bone

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 paraphrasing
: ‫ طرق وهم‬3 ‫فيه‬.... ‫** عاوز أقول إن المريض يعاني من حرارة و إرهاق‬
(1) Noun >>> He had fever and fatigue ..
(2) Adjective >>> He was feverish and fatigued .
(3) Verb >>> He experienced fever and fatigue .

.Case note ‫ للجمل الموجودة في ال‬paraphrasing ‫** وهكذا بنفس الطريقة نقدر نعمل‬

Exercise
(1) Make a complex sentence from the following :
(a) The patient was complaint . He recovered well .
(b) The patient was complaint . His condition deteriorated .
(c) The patient took medication . He had physiotherapy too .

(2) Put the correct punctuation :

(a) Initially ……. he presented with vomiting .
(b) On examination ……. he had an abdominal mass .
(c) I am writing to refer MR X …..… a 30 year – old man …….. who is
presenting with …….
(d) If you have any queries … contact me .
(e) The patient was commenced on paracetamol …...500 mg
……..warfarin….. 150 mg …. Aspirin ….. 300mg and penicillin
…..1000 mg .

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(3) Use a connector instead of “and” in the following
(a) The patient complained of vomiting and headache .
(b) Tenderness and rashes were noted .
(c) The patient was prescribed warfarin and physiotherapy was arranged..

(4) Put the appropriate preposition :

(a) …..8/2020 or ….. 5/8/2020 , the patient presented with vomiting .
(b) The patient has a wound ……. his arm .
(c) I am writing to update you ….. MR X ’s condition .
(d) The patient ’s father died ……cancer .
(e) The patient was treated …….aspirin / …….HTN .
(f) The patient was prescribed paracetamol ……his pain .
(g) The patient is allergic …… penicillin .

(5) Capital or lower case ?

(a) Voltaren
(b) Diabetes mellitus .
(c) Cancer.
(d) Down syndrome .
(e) Emergency Department.
(f) Streptococcal meningitides.