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The level of this lesson is advanced. 

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And timestamps are provided in your show notes. 

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The lessons offered at docmolly.com are solely for learning Spanish.

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They are not intended to teach medicine or provide medical advice. 

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Since time is of the essence when considering thrombolytics 

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00:00:42,833 --> 00:00:46,533
for emergency stroke treatment, I thought it would be helpful to review

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questions and phrases regarding their contraindications.

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00:00:50,166 --> 00:00:53,202
To assemble this lesson, I used a
list of contraindications in the

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00:00:53,203 --> 00:00:57,834
stroke chapter of my favorite
medical education resource MKSAP 19.

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00:00:57,834 --> 00:01:01,574
There's a link in your show notes.
Now, there is a lot to cover.

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00:01:01,574 --> 00:01:06,087
Therefore, we will do it in two
lessons. In this free lesson, we

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will cover Spanish for the following
contraindications to thrombolytic

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therapy: As I say, each
contraindication. Think about how

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00:01:13,830 --> 00:01:16,530
you would say it in Spanish. 

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00:01:16,530 --> 00:01:21,533
greater than 4.5 hours since symptom onset,

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00:01:21,533 --> 00:01:24,836
recent head trauma or stroke,

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00:01:24,836 --> 00:01:28,147
evidence of bleeding,

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00:01:28,147 --> 00:01:33,813
increased risk of bleeding or
bleeding diathesis,

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00:01:33,813 --> 00:01:37,043
elevated blood pressure (>185/110)

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00:01:37,044 --> 00:01:39,663
and low blood sugar (<50) 

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00:01:39,663 --> 00:01:43,282
In the upcoming member lesson, we will complete our review of 

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00:01:43,282 --> 00:01:46,778
Spanish for discussing contraindications to thrombolytics.

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00:01:46,778 --> 00:01:51,245
We will cover intracranial lesions,

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00:01:51,245 --> 00:01:53,998
recent major surgery or trauma,

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00:01:53,998 --> 00:01:59,161
a noncompressible arterial puncture
site,

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00:01:59,162 --> 00:02:02,982
recent brain or spine surgery,

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00:02:02,982 --> 00:02:07,019
seizure at the onset of symptoms,

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00:02:07,019 --> 00:02:10,919
pregnancy and recent heart attack.

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00:02:10,919 --> 00:02:13,806
And as you may have noticed, some of

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00:02:13,806 --> 00:02:17,316
these contraindications are absolute
contraindications, others are

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00:02:17,317 --> 00:02:21,336
relative contraindications. We will
note this before we cover each

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00:02:21,336 --> 00:02:25,440
contraindication. This lesson will
also have some medical jargon

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00:02:25,441 --> 00:02:28,501
because sometimes we discover
contraindications through medical

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00:02:28,501 --> 00:02:32,791
imaging or other testing. Therefore,
some questions and phrases will be

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00:02:32,791 --> 00:02:35,991
directed at other health professionals rather than the patient.

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Since this will be a whirlwind tour of Spanish for

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00:02:39,619 --> 00:02:44,385
various medical topics, to save time,
we will not review vocabulary and

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00:02:44,385 --> 00:02:47,505
multiple variations for each
question and phrase, but I will

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00:02:47,505 --> 00:02:51,913
include variations as well as a
Quizlet set where you can review the

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00:02:51,913 --> 00:02:56,496
vocabulary in the lesson notes at
docmolly.com. And one more thing

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00:02:56,496 --> 00:03:00,455
before we begin. The purpose of this
lesson, as always, is to learn

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medical Spanish, not medicine.
Please consult your trusted medical

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00:03:04,806 --> 00:03:08,286
sources when reviewing
contraindications for thrombolytics

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00:03:08,286 --> 00:03:13,669
with your patients. Gracias. I hope
you find this lesson helpful.

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00:03:13,669 --> 00:03:17,733
¿Listos? ¡Empecemos!

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00:03:17,734 --> 00:03:21,994
Luis Almeida nos acompaña desde
Venezuela para ayudarnos con el

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00:03:21,994 --> 00:03:24,126
español de esta lección.

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00:03:24,126 --> 00:03:26,973
Contraindicación absoluta:

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00:03:26,973 --> 00:03:31,369
Los síntomas comenzaron hace más
de 4 horas y media.

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00:03:31,369 --> 00:03:45,814
Interpreta: The symptoms started
more than four and a half hours ago.

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00:03:45,814 --> 00:03:52,819
Los síntomas comenzaron hace más
de 4 horas y media.

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00:03:52,819 --> 00:04:02,223
Utilizando EMPEZAR, When did the
symptoms begin?

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00:04:02,223 --> 00:04:06,943
¿Cuándo empezaron los síntomas?

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00:04:06,943 --> 00:04:14,772
What time did the symptoms begin?

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00:04:14,772 --> 00:04:20,421
¿A qué hora empezaron los
síntomas?

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00:04:20,421 --> 00:04:24,326
Ahora, preguntando al acompañante
del paciente, 

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00:04:24,326 --> 00:04:35,531
When was the last time
she seemed normal to you?

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00:04:35,532 --> 00:04:42,314
¿Cuándo fue la última vez que le
pareció normal?

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00:04:42,314 --> 00:04:46,114
Referring to a male patient and
using VER, 

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00:04:46,114 --> 00:04:57,322
When was the last time
you saw him normal?

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00:04:57,322 --> 00:05:06,880
¿Cuándo fue la última vez que lo
vio normal?

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00:05:06,880 --> 00:05:09,716
Contraindicación absoluta:

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00:05:09,717 --> 00:05:15,688
Traumatismo craneal o infarto cerebral
durante los últimos tres meses

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00:05:15,688 --> 00:05:32,411
Interpreta: Head trauma or stroke
during the last three months

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00:05:32,411 --> 00:05:41,039
Traumatismo craneal o infarto
cerebral durante los últimos tres meses

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00:05:41,040 --> 00:05:55,455
In the last three months, have you
suffered any head trauma?

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00:05:55,455 --> 00:06:04,431
En los últimos tres meses, ¿ha
sufrido algún traumatismo craneal?

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00:06:04,431 --> 00:06:17,938
In the last three months, have you
suffered any blows to the head?

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00:06:17,938 --> 00:06:25,295
En los últimos tres meses, ¿ha
sufrido algún golpe en la cabeza?

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00:06:25,295 --> 00:06:30,785
And here, you may want to use GOLPE
FUERTE to indicate a severe blow to

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the head, not just a bump on the
head.

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00:06:33,207 --> 00:06:42,345
¿Ha sufrido algún golpe fuerte en la cabeza?

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00:06:42,345 --> 00:06:53,893
In the last three months, have you
suffered a stroke?

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00:06:53,893 --> 00:07:03,813
En los últimos tres meses. ¿Ha
sufrido un infarto cerebral?

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00:07:03,813 --> 00:07:06,764
Contraindicación absoluta:

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00:07:06,764 --> 00:07:09,677
Sangrado interno activo

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00:07:09,677 --> 00:07:19,740
Interpreta: Active internal bleeding

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00:07:19,740 --> 00:07:24,159
Sangrado interno activo

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00:07:24,159 --> 00:07:36,667
Utilizando HEMORRAGIA interpreta:
Have you had any bleeding?

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00:07:36,667 --> 00:07:41,485
¿Ha tenido alguna hemorragia?

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00:07:41,485 --> 00:07:49,762
Has he suffered any internal
bleeding?

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00:07:49,762 --> 00:07:55,341
¿Ha sufrido alguna hemorragia
interna?

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00:07:55,341 --> 00:07:57,741
Or using SANGRADO,

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00:07:57,741 --> 00:08:03,072
¿Ha sufrido algún sangrado interno?

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00:08:03,072 --> 00:08:09,852
Note that although both SANGRADO y
HEMORRAGIA can be translated as

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bleeding, just like "hemorrhage" in
English, HEMORRAGIA implies that the

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00:08:16,369 --> 00:08:22,176
bleeding is more serious.

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00:08:22,176 --> 00:08:25,023
Contraindicación relativa:

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00:08:25,023 --> 00:08:31,344
Hemorragia gastrointestinal o genito-
urinaria durante los últimos 21 días.

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00:08:31,344 --> 00:08:52,700
Interpreta: Gastrointestinal or genito-urinary bleeding within the last 21 days

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00:08:52,700 --> 00:09:02,177
Hemorragia gastrointestinal o genito-
urinaria durante los últimos 21 días

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00:09:02,177 --> 00:09:09,968
Do you have bleeding ulcers?

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00:09:09,968 --> 00:09:15,181
¿Tiene úlceras sangrantes?

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00:09:15,181 --> 00:09:21,802
¿Tiene úlceras hemorrágicas?

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00:09:21,802 --> 00:09:25,408
Utilizando SUFRIR y SANGRADO,

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00:09:25,408 --> 00:09:29,286
During the last three weeks, has she
had any bleeding from the

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00:09:29,286 --> 00:09:50,336
gastrointestinal tract or the
urinary tract?

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00:09:50,337 --> 00:09:54,567
¿Durante las últimas tres semanas,
ha sufrido algún sangrado del

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00:09:54,567 --> 00:10:01,788
tracto gastrointestinal o del tracto
urinario?

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00:10:01,788 --> 00:10:13,017
Utilizando POPÓ, Have you noticed
blood in your stool?

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00:10:13,017 --> 00:10:18,018
¿Ha notado sangre en el popó?

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00:10:18,018 --> 00:10:24,123
And the noun POPÓ can be either
masculine or feminine.

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00:10:24,123 --> 00:10:29,504
¿Ha notado sangre en la popó?

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00:10:29,504 --> 00:10:38,240
Have you noticed blood in your urine?

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00:10:38,240 --> 00:10:43,289
¿Ha notado sangre en la orina?

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00:10:43,289 --> 00:10:53,149
Does your poop look dark and sticky?

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00:10:53,149 --> 00:10:56,588
¿Su popó parece oscura y pegajosa?

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00:10:56,588 --> 00:10:59,524
Or using the masculine noun POPÓ,

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00:10:59,524 --> 00:11:05,125
¿Su popó parece oscuro y pegajoso?

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00:11:05,125 --> 00:11:16,761
Utilizando SANGRADO, Have you had
any bleeding from the uterus?

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00:11:16,761 --> 00:11:25,933
¿Ha tenido algún sangrado del
útero?

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00:11:25,933 --> 00:11:28,792
Contraindicación absoluta:

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00:11:28,792 --> 00:11:31,621
Diátesis hemorrágica activa

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00:11:31,621 --> 00:11:42,172
Interpreta: Active bleeding diathesis

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00:11:42,172 --> 00:11:47,431
Diátesis hemorrágica activa

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00:11:47,431 --> 00:11:51,138
Utilizando HEMORRAGIAS, interpreta:

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00:11:51,138 --> 00:12:03,742
Have you been diagnosed with any
bleeding problems?

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00:12:03,742 --> 00:12:08,703
¿Le han diagnosticado algún
problema de hemorragias?

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00:12:08,703 --> 00:12:14,943
Notice how Luis used an unspecified
subject of "they" to express the

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00:12:14,943 --> 00:12:17,892
passive action of being diagnosed.

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00:12:17,892 --> 00:12:22,850
Literally, "Have they diagnosed you
any bleeding problems?

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00:12:22,850 --> 00:12:26,816
¿Le han diagnosticado algún
problema de hemorragias?

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00:12:26,816 --> 00:12:28,950
Interprétalo otra vez.

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00:12:28,950 --> 00:12:41,591
Have you been diagnosed with any bleeding problems?

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00:12:41,592 --> 00:12:47,291
¿Le han diagnosticado algún
problema de hemorragias?

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00:12:47,291 --> 00:12:55,727
Do you take anticoagulants?

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00:12:55,727 --> 00:13:00,910
¿Toma anticoagulantes?

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00:13:00,910 --> 00:13:10,607
Do you take medications to thin the
blood?

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00:13:10,607 --> 00:13:17,552
¿Toma medicamentos para adelgazar
la sangre?

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00:13:17,552 --> 00:13:22,920
¿Toma medicamentos para diluir la
sangre?

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00:13:22,920 --> 00:13:31,296
So you'll hear both ADELGAZAR y
DILUIR to say to "thin the blood."

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00:13:31,296 --> 00:13:47,673
Utilizando ADMINISTRAR, Has she been
given heparin in the last 24 hours?

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00:13:47,673 --> 00:13:56,111
¿Le han administrado heparina en
las últimas 24 horas?

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00:13:56,111 --> 00:14:06,703
Does he have a platelet count less
than 100?

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00:14:06,703 --> 00:14:16,238
¿Tiene un conteo de plaquetas
inferior a 100?

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00:14:16,238 --> 00:14:19,196
Contraindicación absoluta:

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00:14:19,196 --> 00:14:24,502
Presión arterial superior a 185
sobre 110.

138
00:14:24,502 --> 00:14:40,146
Interpreta: Blood pressure greater
than 185 over 110

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00:14:40,146 --> 00:14:47,084
Presión arterial superior a 185
sobre 110

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00:14:47,084 --> 00:14:51,945
And we should have added here, A
PESAR DE TRATAMIENTO, despite

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00:14:51,945 --> 00:14:55,455
treatment. So, if someone's blood
pressure is really high when they

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00:14:55,455 --> 00:14:59,805
come in the E.R., we can treat that,
get it down with nicardipine and

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00:14:59,805 --> 00:15:04,135
then give them the thrombolytics.
Okay, now back to the medical Spanish.

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00:15:04,135 --> 00:15:16,390
Empezando con USTED, Do you
have uncontrolled blood pressure?

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00:15:16,390 --> 00:15:22,679
¿Usted tiene la presión arterial
descontrolada?

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00:15:22,679 --> 00:15:39,563
Her blood pressure is 192 over 80.

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00:15:39,563 --> 00:15:46,920
Su presión es de 192 sobre 80.

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00:15:46,920 --> 00:15:52,710
Fíjate en cómo se puede utilizar
simplemente LA PRESIÓN para

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00:15:52,710 --> 00:15:56,188
referirse a LA PRESIÓN ARTERIAL.

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00:15:56,188 --> 00:16:00,771
Su presión es de 192 sobre 80.

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00:16:00,771 --> 00:16:06,999
En los siguientes ejemplos Vamos a
utilizar LA PRESIÓN ARTERIAL. 

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00:16:06,999 --> 00:16:23,307
His systolic blood pressure is over 185.

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00:16:23,307 --> 00:16:31,696
Su presión arterial sistólica es
superior a 185.

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00:16:31,696 --> 00:16:47,212
His diastolic blood pressure is over
110.

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00:16:47,212 --> 00:16:54,170
Su presión arterial diastólica es
superior a 110.

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00:16:54,170 --> 00:16:57,260
And if you would like to practice
more with numbers and reporting

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00:16:57,260 --> 00:17:05,113
blood pressures, there's a link in
your lesson notes.

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00:17:05,113 --> 00:17:08,113
Contraindicación absoluta:

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00:17:08,113 --> 00:17:12,426
Nivel de glucosa en la sangre
inferior a 50

160
00:17:12,426 --> 00:17:24,362
Interpreta: Blood glucose level
under 50

161
00:17:24,363 --> 00:17:30,647
Nivel de glucosa en la sangre
inferior a 50

162
00:17:30,647 --> 00:17:36,523
Do you suffer from diabetes?

163
00:17:36,523 --> 00:17:40,429
¿Sufre de diabetes?

164
00:17:40,430 --> 00:17:47,124
Do you take medications for diabetes?

165
00:17:47,124 --> 00:17:54,645
¿Toma medicamentos para la diabetes?

166
00:17:54,645 --> 00:18:00,989
Do you take insulin?

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00:18:00,989 --> 00:18:05,787
¿Se pone insulina? 

168
00:18:05,787 --> 00:18:10,077
¿Se inyecta insulina?

169
00:18:10,077 --> 00:18:14,070
So when speaking of injectable
medications, you can use PONERSE,

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00:18:14,070 --> 00:18:19,463
INYECTARSE, or APLICARSE.

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00:18:19,463 --> 00:18:24,383
Contraindicación absoluta: Un
infarto cerebral grande observado en

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00:18:24,383 --> 00:18:26,943
la tomografía. Interpreta:

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00:18:26,943 --> 00:18:30,843
In the upcoming member lesson, we
will complete our review of Spanish

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00:18:30,843 --> 00:18:35,132
for discussing contraindications to
thrombolytics. We'll learn how to

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00:18:35,132 --> 00:18:39,842
ask about intracranial lesions,
recent major surgery or trauma, a

176
00:18:39,842 --> 00:18:44,977
noncompressible arterial puncture
site, recent brain or spine surgery,

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00:18:44,977 --> 00:18:49,935
seizure at the onset of symptoms,
pregnancy, and recent heart attack.

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00:18:49,935 --> 00:18:53,715
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00:18:53,715 --> 00:18:57,315
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00:18:57,315 --> 00:19:01,993
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00:19:01,993 --> 00:19:07,032
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00:19:07,032 --> 00:19:11,170
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00:19:11,171 --> 00:19:14,791
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184
00:19:14,791 --> 00:19:18,211
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00:19:18,211 --> 00:19:23,436
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00:19:23,436 --> 00:19:28,066
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00:19:28,067 --> 00:19:32,772
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00:19:32,772 --> 00:19:38,199
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00:19:38,199 --> 00:19:41,681
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