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Texts for listening comprehension

Listen to the texts twice and give the answers to the following questions:

  1. What can weight loss signify?

  2. What pathologic conditions are associated with weight loss?

  3. The weight loss is relatively slow in ….

  4. The patients with … often gain weight.

  5. Weight loss is more severe in ….

  6. The most extreme degree of weight loss occurs in ….

Weight Loss

Significant loss of weight occurs in many gastrointestinal disorders. When pain is the principal complaint, weight loss of much magnitude is associated with relatively few disorders. Weight loss can signify a reduction in caloric intake, an increase in caloric loss, or malignancy.

Any intra-abdominal disease in which the pain is exacerbated by eating leads to weight loss. Most patients attempt to get around the problem by eating frequent small meals, by avoiding offending foods and beverages, and by eating soothing foods like milk products which are calorically dense. These maneuvers work quite well when the source of pain is gastritis or gastric ulcer so that weight loss is relatively slow and small in those disorders. A patient with duodenal ulcer often gains weight because such foods generally relieve the pain quite well.

When the source of pain is the pancreas or biliary tree these maneuvers do not work, so that weight loss is more severe. The most extreme degree of weight loss associated with abdominal pain which occurs in carcinoma of the pancreas; this reflects the combined effects of a reduced caloric intake and of the malignancy. An equally extreme degree of weight loss occurs in intestinal ischemia because eating anything inevitably causes pain.

Give the answers to the following questions:

1. What is the medullary nausea center activated by?

2. What diseases of gastrointestinal tract is nausea associated with?

3. It is more common in … .

4. It is rare in … .

5. It is uncommon in … .

Nausea and Vomiting

The medullary nausea center is activated by both somatic and autonomic inputs so you must establish that the nausea is indeed related to the abdominal pain by asking about a temporal relationship.

Nausea accompanies many causes of abdominal pain. It occurs with both malignant and inflammatory disease of intra-abdominal organs but it is more common with disease of the upper gastrointestinal tract than the lower. It is rare in esophageal disease, very common in gastric and small intestinal disease, and uncommon in colonic disease. Nausea also accompanies disease of the solid organs and peritoneum.

Nausea seems to be particularly associated with distension of the gut. Thus the development of nausea during the course of well-established abdominal pain suggests that an initially nonobstructive lesion has extended to produce obstruction.

Give the answers to the following questions:

What common symptoms are presented by the patients with carcinoma of the stomach?

What may physical examination reveal?

What is the age and complaints of the patients with the suspected carcinoma?