１本目：【英語で医療面接】頭痛 Headache

台本

Doctor: Hello, my name is Dr. Suzuki, part of the healthcare team that’s taking care of you. Before we begin, can I get your full name and date of birth please?
Patient: Hi, my name is Hanako Tanaka, date of birth is Aug 15, 1992.
Doctor: How would you like me to address you?
Patient: Just Hanako is fine.
Doctor: How can I help you today?
Patient: Yeah doctor, I’ve been having this headache...
Doctor: Oh, for how long already?
Patient: For about 3 days now.
Doctor: Where exactly is the pain?
Patient: On my forehead.
Doctor: Oh, on one side or both sides?
Patient: On both sides actually.
Doctor: Oh I see. How would you describe the pain? Is it sharp? Dull? Pulsating?
Patient: I would describe it as dull.
Doctor: I see. Does the pain move or spread anywhere?
Patient: Nope it doesn’t. It’s just at my forehead area\
Doctor: Does anything make the pain better?
Patient: Hmm not really. Maybe paracetamol?
Doctor: I see. Does anything make the pain worse?
Patient: Hmm not really, but at the same time I’ve been having a lot of discharge from my nose.
Doctor: Oh is it? When did it start?
Patient: Around the same time as my headache.
Doctor: What color is the discharge? Is it just like a usual runny nose?
Patient: No, the discharge is yellow and is quite thick actually.
Doctor: Ah ok. Any cough or fever?
Patient: Actually, I just recovered from a cold about a week ago.
Doctor: Oh I see. Did you see a doctor for that?
Patient: Nope, I just took some paracetamol.
Doctor: Ok, going back to your headache, on a scale of zero to ten; zero being no pain at all and ten being the worst pain you can imagine, how would you rate the pain?
Patient: It’s not too bad actually, I would say about a 3.
Doctor: Is the pain always there or does it come and go?
Patient: It’s always there.
Doctor: Ok. Since the headache started, do you feel like you’re more sensitive to light and sound and want to go to a dark / quiet place?
Patient: Nope.
Doctor: Do you feel like your neck is stiff?
Patient: Nope.
Doctor: Is your headache worse when lying down?
Patient: Nope, but actually my nose discharges are worse in the morning when I just wake up.
Doctor: Ah I see. Has your headache ever woke you up from your sleep?
Patient: Nope.
Doctor: Any nausea / vomiting?
Patient: Nope.
Doctor: Would you describe this headache as the worst headache of your life?
Patient: Nope, far from it.
Doctor: I see. Any loss of appetite or loss of weight recently?
Patient: Nope doctor.
Doctor: Alright. Any weakness or numbness of your face / limbs?
Patient: Nope.
Doctor: Great. Moving on, do you have any ongoing medical conditions?
Patient: Nope.
Doctor: Do you take any long term medications?
Patient: Nope.
Doctor: Do you have any family members with chronic headaches or any cancers of the brain?
Doctor: Alright. Based on what you told me, I think you might have a condition called sinusitis, where the hollow spaces in your forehead area that connects to your nose is inflamed, and there is fluid built up in the area. It may be due to your recent cold. I’ll prescribe you some paracetamol and nose spray, but your symptoms should go away in few days time. Please come back if your headache or nose discharge worsens, or if your symptoms are still persistent - say, in about a week’s time. Is that alright?
Patient: Alright, thank you doctor!

２本目：【解説動画】頭痛 - 英語で医療面接

解説ポイント

>> 痛みの箇所
前頭部 : frontal headache / on the forehead
後頭部 : occipital headache / back of the head
片側 : right sided / left sided
片側を強調したい場合 : unilateral headache on the right / left
頭頂部 : vertex / pain at the vertex
全体の痛み : generalized

>> 群発頭痛の症状の聞き方
Do you get teary when you get the headaches?
Do you tear?
Do you have pain behind your eyes?

>> 緊張性頭痛の症状の聞き方
Any band-like sensation over your head?
Do you feel stressed lately?
Any increase in stress lately?
Any stress at work lately?

>> SAHの痛みの表し方（USMLE頻出）
thunder-clap headache

>> 偏頭痛
Do you have any aura before the headache?
Do you see funny things / zigzags / lines before the headache?
偏頭痛のauraの名前：fortification spectrum

>> Return advice / 有事再診
Return advice given: if worsening headache, nausea / vomiting, to return to ER　というふうに書かれる

３本目：【口頭発表・プレゼン例】頭痛 - 英語で医療面接

プレゼン例1

  A 29-year-old healthy female presented complaining of a 3-day-history of dull frontal headache associated with nasal discharge and upper respiratory tract infection.
  The pain is described as dull, constant, 3/10 in intensity, localized to bilateral forehead with no radiation and it alleviates with the use of paracetamol, associated with a thick, yellow nasal discharge that exacerbates in the morning. She had an upper respiratory infection, which resolved with over-the-counter paracetamol a week ago. Otherwise, there are no neurological symptoms such as photophobia, nuchal rigidity, hypnic headache, or limb weakness, and also she denies recent constitutional symptoms such as nausea/ vomiting, unintentional weight loss. Her past medical history, family history and medications are non-contributory.

プレゼン例2

Patient is a 29 year old previously healthy female with recent URTI symptoms presenting with 3 days history of bifrontal headache associated with nasal discharge. The pain is constant and dull with no radiation, pain score 3/10. Patient recently recovered from URTI and also reports some thick and yellow nasal discharge since around the same time her headache started. Otherwise she has no red flag symptoms such as nausea or vomiting, photophobia or phonophobia, neck stiffness, recent weight loss, other neurological symptoms such as weakness or numbness, or morning headaches. The headache does not wake her up from sleep nor does she describe it as the worst headache of her life.

解説ポイント

Non-contributory: ～に寄与しない
Unremarkable: 特記事項なし

Patient is a 29 year old previously healthy female with recent URTI symptoms
Patient is a 29 year old previously healthy female who recently had URTI
Patient is a 29 year old previously healthy female who recently recovered from URTI

The pain is described as dull, constant, 3/10 in intensity, localized to bilateral forehead with no radiation and it alleviates with the use of paracetamol

The pain is described as dull, constant, 3/10 in intensity, localized to bilateral forehead with no radiation, alleviated with the use of paracetamol

>> 痛みの強さの表し方
3/10 in intensity (three out of ten in intensity)
pain score 3/10 (pain score three out of ten)