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Define and Shine Word Game BackgroundThis 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.

ObjectivesBy 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 requiredTwo or three copies of terms as below (cut up into individual terms)SellotapeWhiteboard/ flipchart and pens to use in explanations at the endFacilitator8- 15 students (more copies of words needed if more students present)20 - 30 minutes

Outline of sessionPrepare 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.

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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 Prognosis

Epidemiology Definitive test

Differential diagnosis Red flag

Morbidity Mortality

Symptoms Signs

Pathology Conservative treatment

Presenting complaintHistory of presenting

complaint

Systemic enquiry Past medical history

Drug history Invasive tests

Non-invasive tests Radiography

History and examination words (easy for September starters)

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

History and examination words (easy for September starters)

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

refluxBroken Heart Pneumonia Pneumothor

ax Ketoacidosis

Broken rib Asthma Dressler’s syndrome

Cardiac tamponade

Bronchiectasis

Anxiety Pleurisy Pericarditis Tietze’s syndrome

Rheumatic heart disease

Causes of chest pain and breathlessness

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 Thyrotoxicosi

s

Causes of chest pain and breathlessness

Hypochondriasis

Mitral stenosis Emphysema

Alcoholic cardiomyopa

thySupraventric

ular tachycardia

Aortic incompetenc

e

Supraventricular

tachycardiaFallot’s

tetralogy Exercise Pneumoconiosis

Patent ductus

arteriosusTracheitis Hyperthyroid

ismSevere

anaemiaHyperventila

tion

Commonly used drugs

Warfarin Clexane

Aspirin Simvastatin

Erythromycin Ciprofloxacin

Carbimazole Levothyroxine

Ramipril Bendroflumethiazide

Furosemide Amlodipine

Dilatiazem Atenolol

Salmeterol Fluticasone

Prednisolone Terbinafine

Tiotropium Bupropione

Commonly used drugs

Varenicycline Tetracycline

Omeprazole Lansoprazole

Salbutamol Beclomethasone

Diclofenac Metronidazole

Clopidogrel Bisoprolol

Digoxin Amiodarone

Finasteride Doxazosin

GTN Isosorbide mononitrate

Vitamin K Oxybutinin

Sildenafil Dovonex / calcitriol

Commonly used drugs

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 Hypochromia

Koilonychia Macrocytosis

Reticulocytes Poikilocytes

ESR Anisocytosis

Polychromasia Spherocytes

Haematology terms

Megaloblastic anaemia

White cells

Erythropoetin Blast cells

Pernicious anaemia Thalassaemia trait

Sickle Cell Disease Thalassaemia

Neutrophils Platelets

Haematology terms

Erythrocytes Normochromic

Haematopoesis Lymphocytes

Coomb’s test Paul Bunnell test

Eosinophils Haemolytic anaemia

Unconjugated bilirubin

Von Willebrand’s disease

Haematology terms

Haemophilia Thrombocytopenia

Neutropenia Aplastic Anaemia

Polycythaemia Leukaemia

Splenomegaly Splenectomy

Myeloma Bence - Jones proteins

Haematology terms

Thrombophilia Hodgkin’s lymphoma

Non-Hodgkin’s lymphoma

Pancytopenia

Heparin Warfarin

Myelofibrosis Myelosuppression

Haematology terms

Explanations of the terms in HaematologyStudents 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 = smallCyte = cellMicrocytosis = small cellsCauses include iron deficiency anaemia and thalassaemia

HypochromiaHypo = little/ lowChromia = colourHypochromia = paleCauses include iron deficiency anaemia and thalassaemia

KoilonychiaNails that are slightly concave, like a spoon.A sign of iron deficiency anaemia

MacrocytosisMacro = largeCyte = CellLarge cellsCauses include B12 deficinecy anaemia, folate deficiency anaemia, hypothyroidism, alcohol excess, liver disease and pregnancy

ReticulocytesReticule = network (in this case of RNA)Cyte = cellsYoung, large (RNA containing) red blood cells that are found in active haematopoesis (ie when you treat anaemia due to B12, folate or iron deficiency)

PoikilocytesPoikilos = varietyCytes = cellsVariably shaped cells seen in iron deficiency anaemia, thalassaemia and myelofibrosis

ESRErythrocyte sedimentation rateThe distance theat red cells will settle in anticoagulated blood over one hour. A non-specific indicator

AnisocytosisAn = notiso = samecyte = cellVariation in cell size

Haematology terms

of the presence of disease, often inflammatory, including infection, or malignant

Often seen in anaemias especially once treatment has started

PolychromasiaPoly = LotsChrome = colour

SpherocytesSphere = ball shapedcyte = cellBall 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 anaemiaMega = bigblasts= immature cellsAnaemia in which immature cells are seen in the blood stream.Causes include B12 and folate deficiency.

White cellsBlood cells that fight infection.

ErythropoetinA growth factor that stimulates the bone marrow to produce more blood cells

Blast cellsImmature cells that are not normally found in the blood stream but that may appear in disease

Pernicious anaemiaLow red blood count due to the body not being able to absorb sufficient amounts of vitamin B12.

Thalassaemia traitAn 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.

Haematology terms

Sickle Cell DiseaseAn 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.

Thalassaemia

NeutrophilsThe white cells in the blood that fight bacterial infection

PlateletsLittle fragments of cells in the blood that help clotting so that we do not bleed to death if we cut ourselves

ErythrocytesRed cells in the blood – they carry oxygen

NormochromicNormal colourNormochromic normocytic anaemia is often due to chronic disease

HaematopoesisProduction of blood cells

LymphocytesOne type of cells that fight infections, particulary viral infectins

Coomb’s testA test for autoimmune haemolytic anaemia

Paul Bunnell testA test for glandular fever

EosinophilsEosin = a type of chemical stain used in preparing the blood slidePhil = likesi.e. cells that stain with eosin

Haemolytic anaemiaThe bone marrow is producing enough red cells but the cells are being broken down in the body

Haematology terms

The cells in the blood that respond to allergy and to parasite (worm) infections

Unconjugated bilirubinBilirubin 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 diseaseAn inherited deficiency of one of the clotting factors. This means that the affected person will bleed profusely if they cut themselves.

HaemophiliaAn 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

ThrombocytopeniaThrombo = clottingcyte = cellpenia = lack of Lack of clotting cells, i.e. to few platelets.

NeutropeniaNeutrophils are the cells that help the body fight bacterial infectionspenia = lack ofToo few neutrophils

Aplastic AnaemiaAnaemia due to bone marrow failure

PolycythaemiaPoly = lotsCyte = cellAemia = blood

Lots of red cells in the blood (too many)

LeukaemiaLeuk = whiteAemia = blood

Too many white cells in the bloodA kind of cancer of the blood cells

SplenomegalyBig spleen

SplenectomySurgical removal of the spleen.This may be necessary to reduce

Haematology terms

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

haemolysis if the patient has abnormally fragile red cells, such as in spherocytosis.

MyelomaA 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 proteinsThese proteins can be found by electrophoresis of the urine in patients with myeloma. They cannot be detected by urine dipstick.

ThrombophiliaThrombo = clottingPhilia = likes

A tendency to clot too much

Hodgkin’s lymphomaA 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 lymphomaA kind of cancer of lymphocytes, one of the cell lines in the lymph glands.

Non- Hodgkin’s lymphoma is distinguished from Hodgkins

PancytopeniaPan = AllCyte = cellpenia = lack of

Lack of all types of blood cells usually due to bone marrow failure.

Haematology terms

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

HeparinAn anticoagulant that is used to prevent blood clots in the legs or the lungs.

WarfarinA medicine that prevents unwanted blood clots. It is taken by mouth.

MyelofibrosisMyelo= marrowfibrosis = infiltration with fibrous tissue

The bone marrow is no longer producing blood cells as it has been replaced by fibrous tissue.

MyelosuppressionMarrow 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 Angioplasty

Bone 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

Procedures - HLB

Sputum culture Serology

Cold agglutinins Pleurodesis

Thoracotomy Mediastinotomy

Lymph node biopsy MRI scan

CT scan Thallium scan

Troponin CT angiography

D dimer test Echocardiography

Procedures - HLB

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

Procedures - HLB

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-resonant

Dull Stony Dull

Lub dup Vesicular

Bronchial Crackles

Wheezes Bases

Apical Mid-zones

Systolic Diastolic

JVP Oedema

Malar Flush Clubbing

Splinter haemorrhages

Murmur

Examination terms – HL/ NME

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

Examination terms – HL/ NME

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

Examination terms – HL/ NME

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

Examination terms – HL/ NME

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

Examination terms – HL/ NME

O/E Cachectic

Pneumonias – difficult for students, needs lots of explanation of different causes of penumonia

Chlamydia psittica Coxiella burnetti

Mycoplasma 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

Pneumonias – difficult for students, needs lots of explanation of different causes of penumonia

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

Pneumonias – difficult for students, needs lots of explanation of different causes of penumonia

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

Pneumonias – difficult for students, needs lots of explanation of different causes of penumonia

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