Healthcare Vocabulary & Collocations

In a referral letter, 'Mrs Okafor presented with a three-day history of productive cough' means that she:

• AWas given a presentation about coughs three days ago
• BHad a dry, tickly cough that had lasted for three days without producing any sputum
• CWas referred by another clinician three days earlier for a cough that had not been assessed
• DCame to the clinician complaining of a cough that produced sputum for three days✓

Answer: 'Presented with' is the standard phrase for the complaint a patient arrives with, and 'productive' means the cough brings up sputum. A dry cough would be 'non-productive', and the phrase says nothing about a previous referral.

Which sentence uses 'commenced' correctly in clinical English?

• AHe was commenced for amlodipine 5 mg daily after the diagnosis of hypertension.
• BAmlodipine 5 mg daily commenced him after the diagnosis of hypertension.
• CHe was commenced on amlodipine 5 mg daily following the diagnosis of hypertension.✓
• DHe commenced amlodipine 5 mg daily following on the diagnosis of hypertension.

Answer: The collocation is 'to be commenced on' a medicine (or 'to commence' a medicine). 'Commenced for' and the medicine commencing the patient are wrong, and 'following on the diagnosis' is an unidiomatic preposition.

What is the difference between a patient's 'prognosis' and their 'diagnosis'?

• AThe diagnosis is what the condition is; the prognosis is the expected course and outcome✓
• BThe diagnosis is made by a nurse at triage; the prognosis is made by a doctor after the investigations
• CThe diagnosis is the treatment plan agreed with the patient; the prognosis is the list of their symptoms
• DThey mean the same thing and are used interchangeably

Answer: A diagnosis identifies the condition; a prognosis is the forecast of how it is likely to progress and what the outcome will be. Neither term refers to the treatment plan, and they are not interchangeable.

A discharge summary says the patient 'self-discharged against medical advice'. What happened?

• AThe patient chose to leave hospital although the clinical team advised them to stay✓
• BThe patient was sent home early on the advice of the doctors
• CThe medical team discharged the patient without giving any advice
• DThe patient was discharged because they no longer needed medical advice

Answer: 'Self-discharged against medical advice' means the patient left of their own accord despite being advised not to. It is the patient's decision, not the team's, and the team's advice was to remain.

Which word best completes the sentence: 'The wound is ____ well, with no signs of infection.'

• Atreating
• Brecovering
• Chealing✓
• Dcuring

Answer: Wounds 'heal'; patients 'recover'; conditions are 'cured' or 'treated'. 'The wound is healing well' is the natural collocation in clinical notes.

What does 'adherence' mean in 'poor adherence to the medication regimen', and why is it now preferred to 'compliance'?

• AThe patient's ability to afford the medicines prescribed; it is preferred because it avoids the awkward subject of cost
• BThe extent to which the patient takes medicines as agreed; it implies partnership rather than obedience✓
• CThe number of medicines prescribed to a patient at once; it is preferred because it sounds more scientific
• DThe doctor's willingness to prescribe what the patient asks for; it is preferred because it is the more formal term

Answer: Adherence describes how closely a patient follows an agreed treatment plan. It has replaced 'compliance' in guidance because compliance suggests passively obeying instructions, whereas adherence reflects a shared decision.

In clinical writing, what is the difference between 'acute' and 'chronic'?

• AAcute means that a condition is severe or dangerous; chronic means that it is mild and can be safely ignored
• BAcute means of sudden onset or short duration; chronic means long-standing or persistent✓
• CAcute means that a condition is life-threatening; chronic means that it is not serious enough to need treatment
• DAcute describes conditions that affect younger adults; chronic describes conditions that affect older people

Answer: The terms describe time course, not severity: an acute condition begins suddenly or lasts a short time, while a chronic one persists over a long period. A chronic condition can be severe and an acute one mild.

Which phrase correctly describes sending a patient to a specialist?

• AThe patient was referred at a cardiologist for a further assessment.
• BThe patient referred to a cardiologist by further assessment.
• CThe patient was referred for a cardiologist to further assessment.
• DThe patient was referred to a cardiologist for further assessment.✓

Answer: The collocation is 'referred to' a specialist 'for' a purpose. The other versions misuse the prepositions or make the patient the one doing the referring.

A letter says the patient was admitted with 'an acute exacerbation of COPD'. What does 'exacerbation' mean here?

• AThe complete resolution of a condition after treatment
• BA side effect caused by the treatment of a condition
• CThe first appearance of a condition in a patient
• DA worsening of a condition the patient already has✓

Answer: An exacerbation is a flare-up or worsening of an existing, usually chronic, condition; 'acute' says that it came on quickly. The first appearance would be the 'onset' or 'presentation', and side effects and resolution are unrelated.

A handover note says a patient is 'nil by mouth'. What does this mean?

• AThe patient is unable to speak because of a stroke
• BThe patient is on a soft diet only until reviewed
• CThe patient must not eat or drink anything✓
• DThe patient is refusing all food and drink offered

Answer: 'Nil by mouth' (NBM) is an instruction that the patient must take nothing orally, usually before surgery or because swallowing is unsafe. It describes an order, not the patient's speech, preference or diet texture.

Which verb best completes the sentence: 'The MRI scan ____ the diagnosis of a stroke'?

• Aapproved
• Bagreed
• Cconfirmed✓
• Dcertified

Answer: 'Confirm a diagnosis' is the standard collocation: an investigation confirms (or excludes, or supports) a diagnosis. 'Agree', 'approve' and 'certify' are used of people and documents, not of scans and diagnoses.

Which verb best completes the sentence: 'Overnight the patient's condition ____ and she was transferred to the intensive care unit'?

• Apresented
• Bstabilised
• Cimproved
• Ddeteriorated✓

Answer: A transfer to intensive care follows a worsening, and 'deteriorate' is the clinical verb for a condition getting worse. 'Stabilised' and 'improved' would not lead to transfer, and 'presented' describes arriving with symptoms, not a change in condition.

A handover says that a patient 'is now for palliative care only'. What does this mean?

• AThe patient needs physiotherapy to regain independence before going home, with no further medical treatment
• BThe patient is waiting for surgery that will relieve the symptoms and is being kept comfortable meanwhile
• CThe patient is ready for discharge to a nursing home within a few days once a place has been found
• DThe aim of care has changed to comfort and symptom control rather than cure✓

Answer: Palliative care focuses on relieving symptoms and maintaining quality of life when a condition cannot be cured; 'for palliative care only' signals that active treatment aimed at cure has stopped. It does not by itself say where the patient will be cared for.