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Define and Shine Word Game
Background
This game is very adaptable. It can be used to cover a huge variety of topics. It is ideal as a warm up game or when you need to liven the students up.
Objectives
By the end of the game the students will:
be alert and ready to learn together
be able to explain a variety of medical conditions to lay people using simple jargon free language
be aware of (and have shown you) the gaps in their knowledge that need to be addressed
Resources required
Two or three copies of terms as below (cut up into individual terms)
Sellotape
Whiteboard/ flipchart and pens to use in explanations at the end
Facilitator
8- 15 students (more copies of words needed if more students present)
20 - 30 minutes
Outline of session
Prepare by cutting up approximately ten times more pieces of sellotape than you have students. Stick one end on to the edge of a plastic topped table to allow for easy removal.
Explain the game to the students:
Each student will have a term stuck on their back with sellotape.
The aim for each student is to find out what the term on their back is.
They must ask someone else to explain it to them. Only words that a patient would understand are allowed in the explanation, no medical jargon (and you can stipulate whether or not you will allow “sounds like”)
When they guess it correctly they take the term off their back (holding on to it for counting up at the end) and go to the tutor for another.
The winner of the game at the end is the person with most terms in their hand.
The facilitator should be listening during the game (whilst sticking words on backs) to recognise which terms students are having difficulty with. These can then be discussed at the end of the game.
PS Hartley’s Jam Sign is not real!
PPS I use Jane Austen as her heroine’s always develop an acute onset of typical pneumonia after walking across the moors in a thunder storm…
History and examination words (easy for September starters)
Aetiology / PrognosisEpidemiology / Definitive test
Differential diagnosis / Red flag
Morbidity / Mortality
Symptoms / Signs
Pathology / Conservative treatment
Presenting complaint / History of presenting complaint
Systemic enquiry / Past medical history
Drug history / Invasive tests
Non-invasive tests / Radiography
S.O.C.R.A.T.E.S. / S.O.A.P.
Social history / Family history
Referred pain / Radiation
Aggravating factors / Relieving factors
Associated symptoms / Duration
Character / Ideas
Concerns / Expectations
Severity / Risk factors
Yellow flag / Positive findings
Negative findings / Capillary refill
Allergy / Travel history
Inspection / Palpation
Percussion / Auscultation
Tachycardia / Apnoea
Tachypnoea / Arrythmia
Hypoxia / Cyanosis
Hypovolaemic / Concordance
JVP / BP
Hypo… / Hyper…
…aemia / Dyspnoea
Causes of chest pain and breathlessness
Gastro-oesophageal reflux / Broken Heart / Pneumonia / Pneumothorax / KetoacidosisBroken rib / Asthma / Dressler’s syndrome / Cardiac tamponade / Bronchiectasis
Anxiety / Pleurisy / Pericarditis / Tietze’s syndrome / Rheumatic heart disease
Pulmonary embolism / Myocardial infarction / Mesothelioma / Inhaled foreign body / Dissecting aortic aneurysm
Angina / Lung cancer / Pleural effusion / Atrial fibrillation / Severe aortic stenosis
Chronic bronchitis
(COAD) / Tuberculosis / Pericarditis / Shingles / Thyrotoxicosis
Hypochondriasis / Mitral stenosis / Emphysema / Alcoholic cardiomyopathy / Supraventricular tachycardia
Aortic incompetence / Supraventricular tachycardia / Fallot’s tetralogy / Exercise / Pneumoconiosis
Patent ductus arteriosus / Tracheitis / Hyperthyroidism / Severe anaemia / Hyperventilation
Commonly used drugs
Warfarin / ClexaneAspirin / Simvastatin
Erythromycin / Ciprofloxacin
Carbimazole /
Levothyroxine
Ramipril / Bendroflumethiazide
Furosemide / Amlodipine
Dilatiazem / Atenolol
Salmeterol / Fluticasone
Prednisolone / Terbinafine
Tiotropium / Bupropione
Varenicycline / Tetracycline
Omeprazole / Lansoprazole
Salbutamol / Beclomethasone
Diclofenac / Metronidazole
Clopidogrel / Bisoprolol
Digoxin / Amiodarone
Finasteride / Doxazosin
GTN / Isosorbide mononitrate
Vitamin K / Oxybutinin
Sildenafil / Dovonex / calcitriol
Orlistat / Metformin
Gliclazide / Thiazolidinediones / Glitazones
Glucagon / Cimetadine
Co -codamol / Tramadol
Ipratropium bromide /
Atrovent / Loratadine
Trimethorpim / Desmopressin
Metaclopramide / Lactulose
Cyproterone acetate / Zoladex /
goseralin
Betnovate cream / Aciclovir
Co-trimoxazole / Spironolactone
Haematology terms
Microcytosis / HypochromiaKoilonychia / Macrocytosis
Reticulocytes / Poikilocytes
ESR / Anisocytosis
Polychromasia / Spherocytes
Megaloblastic anaemia / White cells
Erythropoetin / Blast cells
Pernicious anaemia / Thalassaemia trait
Sickle Cell Disease / Thalassaemia
Neutrophils / Platelets
Erythrocytes / Normochromic
Haematopoesis / Lymphocytes
Coomb’s test / Paul Bunnell test
Eosinophils / Haemolytic anaemia
Unconjugated bilirubin / Von Willebrand’s disease
Haemophilia / Thrombocytopenia
Neutropenia / Aplastic Anaemia
Polycythaemia / Leukaemia
Splenomegaly / Splenectomy
Myeloma / Bence - Jones proteins
Thrombophilia / Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma / Pancytopenia
Heparin / Warfarin
Myelofibrosis / Myelosuppression
Explanations of the terms in Haematology
Students find haematology terms very difficult at first. One way of making them easier is to help the students to break the word down into its original parts. They can do this even without having ever learned Latin or Greek, simply by comparing words to others that they are familiar with. Usually spend some time doing this on the board after the word on the back game.
This also works well for dermatology terms.
You may wish to give out definitions as a handout or simply to use the following as a crib sheet.
MicrocytosisMicro = small
Cyte = cell
Microcytosis = small cells
Causes include iron deficiency anaemia and thalassaemia / Hypochromia
Hypo = little/ low
Chromia = colour
Hypochromia = pale
Causes include iron deficiency anaemia and thalassaemia
Koilonychia
Nails that are slightly concave, like a spoon.
A sign of iron deficiency anaemia / Macrocytosis
Macro = large
Cyte = Cell
Large cells
Causes include B12 deficinecy anaemia, folate deficiency anaemia, hypothyroidism, alcohol excess, liver disease and pregnancy
Reticulocytes
Reticule = network (in this case of RNA)
Cyte = cells
Young, large (RNA containing) red blood cells that are found in active haematopoesis
(ie when you treat anaemia due to B12, folate or iron deficiency) / Poikilocytes
Poikilos = variety
Cytes = cells
Variably shaped cells seen in iron deficiency anaemia, thalassaemia and myelofibrosis
ESR
Erythrocyte sedimentation rate
The distance theat red cells will settle in anticoagulated blood over one hour. A non-specific indicator of the presence of disease, often inflammatory, including infection, or malignant / Anisocytosis
An = not
iso = same
cyte = cell
Variation in cell size
Often seen in anaemias especially once treatment has started
Polychromasia
Poly = Lots
Chrome = colour / Spherocytes
Sphere = ball shaped
cyte = cell
Ball shaped cells – which are more fragile than normal red blood cells and therefore break down faster causing anaemia in those with this inherited disease
Megaloblastic anaemia
Mega = big
blasts= immature cells
Anaemia in which immature cells are seen in the blood stream.
Causes include B12 and folate deficiency. / White cells
Blood cells that fight infection.
Erythropoetin
A growth factor that stimulates the bone marrow to produce more blood cells / Blast cells
Immature cells that are not normally found in the blood stream but that may appear in disease
Pernicious anaemia
Low red blood count due to the body not being able to absorb sufficient amounts of vitamin B12. / Thalassaemia trait
An inherited condition in which some of the red blood cells are smaller than normal (due to differences in the haemoglobin that fills the cells). This may cause mild anaemia but otherwise does not normally cause problems to the individual.
Problems arise if two people with thalassaemia trait have children as if the child has no normal red cells they may be very anaemic.
Sickle Cell Disease
An inherited condition found most often in people of African descent. the haemoglobin which fills the red cells and carries the oxygen is abnormal.
The person with sickle cell disease may suffer:
- life threatening anaemia
- the small blood vessels in the bones may be blocked by sickle shaped cells causing sever pain.
Neutrophils
The white cells in the blood that fight bacterial infection / Platelets
Little fragments of cells in the blood that help clotting so that we do not bleed to death if we cut ourselves
Erythrocytes
Red cells in the blood – they carry oxygen / Normochromic
Normal colour
Normochromic normocytic anaemia is often due to chronic disease
Haematopoesis
Production of blood cells / Lymphocytes
One type of cells that fight infections, particulary viral infectins
Coomb’s test
A test for autoimmune haemolytic anaemia / Paul Bunnell test
A test for glandular fever
Eosinophils
Eosin = a type of chemical stain used in preparing the blood slide
Phil = likes
i.e. cells that stain with eosin
The cells in the blood that respond to allergy and to parasite (worm) infections / Haemolytic anaemia
The bone marrow is producing enough red cells but the cells are being broken down in the body
Unconjugated bilirubin
Bilirubin is a pigment or dye that is produced as a by product of the normal breakdown of red cells in the body. It is normally excreted in the bile. If too many cells are broken down the body excretion system cannot keep up with production and the extra bilirubin in the circulation may make the patient look pale yellow. / Von Willebrand’s disease
An inherited deficiency of one of the clotting factors. This means that the affected person will bleed profusely if they cut themselves.
Haemophilia
An inherited disease in which the sufferer is lacking one of the factors (factor VIII) that helps the blood clotting. Sufferers bleed into joints after minor injury. They need to be treated with manufactured factor 8 / Thrombocytopenia
Thrombo = clotting
cyte = cell
penia = lack of
Lack of clotting cells, i.e. to few platelets.
Neutropenia
Neutrophils are the cells that help the body fight bacterial infections
penia = lack of
Too few neutrophils / Aplastic Anaemia
Anaemia due to bone marrow failure
Polycythaemia
Poly = lots
Cyte = cell
Aemia = blood
Lots of red cells in the blood (too many) / Leukaemia
Leuk = white
Aemia = blood
Too many white cells in the blood
A kind of cancer of the blood cells
Splenomegaly
Big spleen
The spleen is the organ that breaks down old damaged red cells. It becomes enlarged if there are lots of abnormal red cells, as in malaria infections, or in certain leukaemias when it may be a site of cell production / Splenectomy
Surgical removal of the spleen.
This may be necessary to reduce haemolysis if the patient has abnormally fragile red cells, such as in spherocytosis.
Myeloma
A kind of cancer of one of the blood cells. One of the cell lines (the plasma cells) that produces antibodies (which normally fight infection) proliferates out of control and causes small deposits that weaken bone.
The antibodies produced by myeloma cells are no help in fighting infection / Bence - Jones proteins
These proteins can be found by electrophoresis of the urine in patients with myeloma. They cannot be detected by urine dipstick.
Thrombophilia
Thrombo = clotting
Philia = likes
A tendency to clot too much / Hodgkin’s lymphoma
A kind of cancer of lymphocytes, one of the cell lines in the lymph glands.
Hodgkin’s lymphoma is distinguished from non-Hodgkins lymphoma by the presence of certain cells that can be seen dwon the microscope – the Reed Sternberg cells. This is important as it helps us predict how the disease will respond to treatment
Non-Hodgkin’s lymphoma
A kind of cancer of lymphocytes, one of the cell lines in the lymph glands.
Non- Hodgkin’s lymphoma is distinguished from Hodgkins lymphoma by the absence of certain cells that can be seen down the microscope – the Reed Sternberg cells. This is important as it helps us predict how the disease will respond to treatment / Pancytopenia
Pan = All
Cyte = cell
penia = lack of
Lack of all types of blood cells usually due to bone marrow failure.
Heparin
An anticoagulant that is used to prevent blood clots in the legs or the lungs. / Warfarin
A medicine that prevents unwanted blood clots. It is taken by mouth.
Myelofibrosis
Myelo= marrow
fibrosis = infiltration with fibrous tissue
The bone marrow is no longer producing blood cells as it has been replaced by fibrous tissue. / Myelosuppression
Marrow suppression – the bone marrow is no longer producing blood cells because something (usually a drug or sever infection) has caused it to switch off.
Procedures - HLB
Angiography / AngioplastyBone marrow aspiration / Bronchoscopy
Pleural aspiration / Pleural biopsy
Thrombolysis / Exercise ECG
24 hour tape / Ambulatory blood pressure monitoring
Cardioversion / Pulse oximetry
Arterial blood gases / Cardiac enzymes
AAFB / Bronchial washings
Sputum culture / Serology
Cold agglutinins / Pleurodesis
Thoracotomy / Mediastinotomy
Lymph node biopsy / MRI scan
CT scan / Thallium scan
Troponin / CT angiography
D dimer test / Echocardiography
Transoesophageal echo / Radio-ablation
Bone marrow transplant / Anticoagulation
Blood pressure / Pleurodectomy
Lobectomy / CABG
Heart transplant / ECMO
Aortic grafting / CPR
Peak flow / Spirometry
Reversibility testing / CXR
Post mortem / ASO titre
Cholesterol / HDL
LDL / INR
Warfarinisation / Chemotherapy
Central line insertion / IV infusion
Cannulation / Auscultate
Percuss / Palpate
Examination terms – HL/ NME
Resonant / Hyper-resonantDull / Stony Dull
Lub dup / Vesicular
Bronchial / Crackles
Wheezes / Bases
Apical / Mid-zones
Systolic /
Diastolic
JVP / Oedema
Malar Flush / Clubbing
Splinter haemorrhages / Murmur
Goitre / Icteric sclera
Conjunctival Pallor / Palmar erythema
Dupyutren’s contracture / Cyanosis
Shifting dullness / Rebound tenderness
Stridor / Vocal fremitus
Apex beat / Heave
Thrill / Spider naevi
Guarding / Lymphadenopathy
Tremor / Bronchial breathing
Absent breath sounds / Tracheal deviation
Splenomegaly / Range of movement
Hepatomegaly / Spider naevi
Reflexes / Ballot
Craggy / Fluctuant
Trans-illuminable / Echymosis
Chest clear / NAD
F.R.O.M / Ejection systolic
Mid-diastolic / Machinery
Slow rising pulse / Pulse pressure
JVP / Nicotine stains
Beau’s lines / Arcus senilus
Xanthomata / Sweating
Redness / Warm
Tender / Capillary refill time
Blanching / Borborygma
Active movements / Passive movements
Objective / General appearance
Blood pressure / Pulse rate
Pulse character / Respiratory rate
Use of accessory muscles / Barrel chest
Lip pursing / Supine
45 degrees / Exposed as fully as possible
Comfortable / Privacy and dignity
Chaperone / Hartley’s jam sign
Intercostal indrawing / Scars
Peak flow meter / Spirometry
FEV1 / FVC
Bovine cough / Pyrexia
Vocal resonance / Flail chest
O/E / Cachectic
Pneumonias – difficult for students, needs lots of explanation of different causes of penumonia
Chlamydia psittica / Coxiella burnettiMycoplasma pneumonia / Tuberculosis
Legionella / Staphylococcus aureus
Influenza / H1N1
Streptococcus pneumonia / Pneumocystis carinii
Haemophilus influenza / Varicella Zoster
Asbestosis / Pneumothorax
lung cancer / Empyema
Pleural effusion / Fibrosis
Psitticosis / Silicosis
Bird fancier’s lung / Extrinisic allergice alveolitis
HIV / Cotrimoxazole
Benzyl penicillin / Marcolides
Tetracyclines / Quinolones
Amoxicillin / Erythromycin
COPD / Asthma
Restrictive lung disease / FEV1
FVC / Spirometry
Peak flow / Tracheal deviation
Whispering pectoriloquy / Aegophony
Cold agglutinins / IgM
Serology / AAFBs
Klebsiella pneumonia / Aspergillosis
Hyponatraemia / Pseudomonas aeruginosa
Steven’s Johnson syndrome / Herpes labialis
Jane Austen / Aspiration pneumonia
pCO2 / pO2
Steroids / Atrial fibrillation
Patchy shadowing / Lobar pneumonia
Kerley B lines / Upper lobe diversion
Fine bibasal end inspiratory crackles / Coarse crepitations
Pleural rub / Hyper-resonance
Stony dullness / Bronchial breathing
Clubbing / Bronchiectasis
Cystic fibrosis / Cyanosis
Accessory muscles / Barrel shaped chest
Silent chest / Intercostal indrawing
Respiratory rate / Tachypnoea
Tachycardia / Low pitched monophonic rhonchi
High pitched polyphonic wheeze / Stridor
Pneumonias – difficult for students, needs lots of explanation of different causes of penumonia