16.

  1. A duodenal ulcer.
  2. Stomach ulcer.
  3. A mouth ulcer.
  4. A skin ulcer.

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17.

  1. Have an operation.
  2. Try medical means.
  3. See a psychiatrist.
  4. Be off work for a while.

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18.

  1. Overweight.
  2. Smoking.
  3. Heredity.
  4. Stress.

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19.

  1. He is a light smoker.
  2. He is a casual smoker.
  3. He is a heavy smoker.
  4. He is a moderate smoker.

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20.

  1. Stop smoking.
  2. Have a surgery.
  3. Eat regularly and exercise more.
  4. Make an appointment with Dr. Oakes.

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W:How are you now?
M:Not too good.
W:Are you still getting the pain?
M:Yes.
W:Well. The X-ray doctor found irritability and distortion of the duodenum although there was no actual ulcer visible on the X-ray. This does not necessarily mean that you have no duodenal ulcer. We have to decide the best way of treating it. There are two ways: medical and surgical. In young people, we try to avoid operations and we hope that medical means will help. Now, you did have a spell in hospital and it disappeared but now it started again. Has anyone in your family had an ulcer?
M:Yes, my father had one but it cleared up.
W:Well, this could be relevant as ulcers may run in the family. The other factors of course are smoking, worry and anxiety, irregular meals or over-tiredness, overwork and stress. These all will affect an ulcer. Unfortunately, you have a lot of stress and worry at home, so I feel despite your being so young, putting you to bed for a few weeks isn't enough. I'd like you to see Mr. Oakes, he has a great deal of experience with ulcers. And if he feels an operation is the answer, I think we should take his advice. Now, have you managed to do anything about your smoking?
M:I smoke about 50 a day.
W:How often do you get the pain now?
M:Every day.
W:Have you lost time form work because of it?
M:Yes. Nowadays here and there.
W:Well, make an appointment to see Mr. Oakes, and I'll write to him and to your doctor.
M:Thank you, doctor.