Ministry of health protection of the republic of uzbekistan

Text A. Jaundice

Perhaps the most obvious symptom that may result from disease of the liver or biliary passages is jaundice, and the estimation of the level of bilirubin in the serum is to be therefore frequently carried out in the investigation of a case of liver disease.

The fact that sera from different cases of jaundice can give different types of reaction has been used as a basis for differentiating between different types of jaundice. Jaundice should be divided into three main types, viz.: obstructive jaundice, hepatocellular or “toxic” jaundice (with or without some degree of accompanying obstruction) and haemolytic jaundice. In uncomlicated obstructive jaundice, liver function is largely or wholly normal, so that the bile pigments are excreted normally into the bile passages; but owing to the presence of some obstruction (either a stone impacted in the common bile duct, or obliteration of the duct by a carcinoma of the head of the pancreas) the bile is unable to enter the duodenum and has instead to be re-absorbed into the circulation. In hepatocellular jaundice the function of the liver cells is changed so that they can not excrete the normal amount of bile pigment reaching them in the blood stream. In this case bilirubin level gradually rises. In haemolytic jaundice the excessive amounts of bile pigment (which are formed as a result of the excessive red cell destruction) are incompletely excreted by the liver cells and have been re-absorbed from the obstruc­tive bile passages. In hepatocellular or obstructive jaundice the excess of circulating pigment has not passed through the liver cells.


Exercise 6. Look through text A and find sentences in which symptoms of all types of jaundice are described.


Exercise 7. Find in the text answers to the following questions and read them.
1. What procedure has to be performed to diagnose a liver disease? 2. How can a doctor differentiate between the types of jaundice? 3. How many types of jaundice are there? 4. How does the function of the liver change in the cases of hepatocellular jaundice?


Exercise 8. Fill in the blanks with modal verbs can; could; may, might; must; should.
1. If you are ill you ... consult a physician and ... do what he says. 2. Since one pack of 20 cigarettes contains 30 mg of cadmium, it is possible that chronic inhalation of cigarette smoke ... lead to an en­hanced cadmium intake. 3. The patient who receives the blood of the diseased donor ... develop a positive test for the hepatitis antigen shortly after transfusion. 4. This patient had received 1 unit of blood at opera­tion and ... have viral hepatitis. 5. The patients with jaundice ... be immediately transferred to an infectious hospital. 6. Sera from appar­ently healthy blood donors ... be always tested for the presence of hepatitits antigen.


Exercise 9. Translate the following sentences with modal verbs and their equivalents.
1. Infectious hepatitis with a short incubation period can also be transmitted during blood transfusion. 2. There is experimental evidence that the passive administration of Ig.G antibody interferes with the syn­thesis of Ig.M antibody and in this way is able to alter the immune response. 3. Some researchers suggest that the differences between se­rum hepatitis and infective hepatitis might depend on whether a com­mon causative agent is or not bound by antibody. 4. The strong associ­ation of the hepatitis antigen with acute viral hepatitis increases the suspicion that donor blood containing the antigen may be infectious. 5. You should take the drug three times a day before meals. 6. We had to examine samples from normal subjects who had been exposed to hepatitis. 7. Convalescent sera from patients with hepatitis may contain trace amounts of antibody and require further study. 8.10 patients were to be studied with a clinical picture quite compatible with acute hepati­tis. 9. We were allowed to follow up sera in 27 of 49 experimental patients with positive reactions for hepatitis.


LESSON 16


Exercise 1. Learn the following words and word combinations:
ulcer [ ls ] n язва, yara
condition [k n'di n] n состояние, ус­ловие; зд. заболевание, xolat, kasallik
ascribe [ 'skraib] v приписывать, qo’shib yozmoq
recognize ['rek gnaiz] v распознавать, tan olmoq
complain [k m'plein] v (of) жаловать­ся (на), shikoyat qilmoq
heartburn ['ha:tb :n] n изжога, zarda
suppress [s 'pres] v подавлять, pasaytirmoq


Exercise 2. Look through text B in 10 minutes. 1) Divide it into some parts according to the meaning. 2) Find and translate sentences with modal verbs and their equivalents.