Bulgarian Language Exam for Medical Specialists cheat sheet

Text purpose determines reading mode: patient leaflets and instructions are read for obligations, warnings, and dosing; discharge summaries for chronology, diagnosis, and recommendations.

Bulgarian clinical prose frequently uses reflexive impersonal forms such as 'препоръчва се', 'наблюдава се', and 'прилага се'; the omitted subject is generic, not the patient.

Definite article suffixes track referents: '-ът/-ят' masculine subject, '-а/-я' masculine non-subject, '-та', '-то', '-те'; 'болният' versus 'болната' distinguishes male and female patient.

Double negation is standard and logically single: 'Не съм получавал никакви оплаквания' means 'I have received no complaints', not a positive statement.

Bulgarian decimal comma and date order change numbers: '37,5 °C' is 37.5; '12.03.2024' is 12 March 2024; '1 500' may use a space as thousands separator.

In medication leaflets, 'трябва' marks obligation, 'може' permission or possibility, and 'не бива' prohibition; these are not interchangeable.

Sequence markers in discharge texts: 'при постъпване' on admission, 'в хода на лечение' during treatment, and 'при изписване' at discharge locate information in time.

Scan first for headings, bold warnings, and sections 'Показания', 'Противопоказания', 'Нежелани реакции', and 'Дозировка'; these carry the highest-risk information.

Open-ended interview prompts include 'Какво ви доведе?', 'Откога?', and 'Как се чувствате?'; answers typically supply onset, duration, character, and associated symptoms.

Bulgarian pain constructions place the person in an accusative clitic: 'боли ме главата' means my head hurts, and 'боли ме гърлото' means my throat hurts; the body part is the grammatical subject.

Telephone rule: confirm caller identity and callback number, then read the number back in grouped digits; Bulgarian mobile numbers are commonly 10 digits starting with 08.

Dose instructions use 'по една таблетка два пъти дневно' for one tablet twice daily, 'на всеки 8 часа' for every 8 hours, and 'преди/след храна' for before or after food.

Imperative instructions include 'Вземете', 'Приемайте', 'Не пропускайте', and 'Обадете се'; negation 'не' precedes the verb and changes compliance meaning.

Red-flag terms requiring immediate escalation include 'задушаване', 'гръдна болка', 'кръв в изпражненията', and 'внезапна загуба на съзнание'.

Hedges such as 'може би', 'някъде от', and 'понякога' mark uncertainty; a closed follow-up question narrows the report, for example 'Постоянно ли е или само при движение?'.

Passive participles agree with the patient's gender and number: 'пациентът е приет', 'пациентката е приета', and 'пациентите са приети'.

Greek and Latin roots: кардио- heart, невро- nerve, хепато- liver, нефро- kidney, пулмо- lung, гастро- stomach, дермато- skin, остео- bone.

Suffix rules: -ит inflammation as in гастрит, -оза noninflammatory or degenerative process as in артроза, -ом tumor as in лимфом, -ектомия surgical removal, -остомия artificial opening, -скопия endoscopic visualization.

Vital-sign vocabulary: 'кръвно налягане' blood pressure, 'пулс' pulse, 'температура' temperature, 'честота на дишане' respiratory rate, and 'сатурация' oxygen saturation.

Common symptom terms: 'задух' dyspnea, 'гадене' nausea, 'повръщане' vomiting, 'световъртеж' dizziness, 'втрисане' chills, and 'обрив' rash.

Hospital departments: 'Вътрешни болести', 'Хирургия', 'Кардиология', 'Неврология', 'Педиатрия', 'Акушерство и гинекология', and 'Спешно отделение'.

Dosage forms: 'таблетка', 'капсула', 'сироп', 'инжекция', 'инфузия', 'капки', 'мехлем', and 'супозитория'.

Laboratory terms: 'кръвна картина' complete blood count, 'хемоглобин', 'левкоцити', 'тромбоцити', 'креатинин', 'урея', 'глюкоза', and 'СРБ' C-reactive protein.

Prefix rules: 'хипер-' high, 'хипо-' low, 'тахи-' fast, 'бради-' slow, 'дис-' disordered, and 'а-' without.

The Bulgarian definite article is postposed: masculine subject singular '-ът/-ят' as in лекарят, masculine non-subject '-а/-я' as in лекаря, feminine '-та', neuter '-то', and plural '-те'.

Present tense of 'съм': съм, си, е, сме, сте, са; clitics follow the first focused element as in 'Аз съм лекар', 'Той не е тук', and 'Вие лекар ли сте?'.

Imperfect versus aorist: 'болеше ме' describes an ongoing past state; 'заболя ме' marks onset; perfect 'приет е' presents a completed result relevant now.

Modal rule: 'трябва да + present', 'може да + present', and 'не бива да + present'; Bulgarian uses da-constructions rather than an infinitive.

Imperative forms: informal 'Вземи', polite or plural 'Вземете'; negative imperative commonly 'не вземайте', not 'не вземете'.

Reflexive clitic 'се' precedes the verb: 'чувствам се' and 'запознавам се'; in third person it can mark passive or impersonal meaning as in 'прилага се'.

Number agreement: 'един пациент', 'една пациентка', 'две таблетки'; masculine persons use 'двама лекари', and feminine persons use 'две сестри'.

Prepositions: 'от' from or since, 'до' until or to, 'след' after, 'преди' before, 'в' in, 'на' on or to; 'от три дни' means for three days.

Question rule: enclitic 'ли' follows the focused word, as in 'Имате ли болка?' and 'Кога започна болката?'.

Discharge summary order: patient identifiers, admission and discharge dates, main and accompanying diagnoses with ICD-10 codes, anamnesis, status, investigations, treatment, course, and recommendations.

Formal register uses impersonal or passive constructions such as 'Пациентът е приет', 'Изписва се', and 'Препоръчва се'; colloquial verbs and first-person narration are avoided.

Referral letter content rule: state the reason for referral, urgency, relevant findings, current treatment, and the specific question for the specialist.

Diagnosis labels: 'Основна диагноза' main diagnosis and 'Съпътстваща диагноза' comorbidity; ICD-10 codes are written after the diagnosis.

Medication order formula: drug name plus dose, frequency, route, duration, and food relation, for example 'по 1 табл. 2 пъти дневно след храна'.

Date and time format: dd.mm.yyyy and 24-hour clock; '12.03.2024, 14:30' is unambiguous in Bulgarian clinical records.

Objective and subjective separation: patient-reported information is marked 'по думите на пациента', while examination findings are marked 'обективно'.

Abbreviations are defined at first use: 'АД' blood pressure, 'ЧД' respiratory rate, 'Т' temperature, and 'П' pulse; ambiguous abbreviations are avoided.

Signature block: 'Изготвил: д-р ...', specialty, signature, and stamp; the author and institution must be identifiable.

Polite address uses title plus surname: 'Господине Петров' and 'Госпожо Иванова'; the pronoun 'Вие' is capitalized in formal correspondence but not obligatory in speech.

Plain-language explanation rule: replace jargon with a Bulgarian equivalent, then check understanding with 'Разбрахте ли?' and 'Имате ли въпроси?'.

Informed consent phrases: 'Ще ви обясня', 'Може да откажете', and 'Имате право да зададете въпроси'; consent is documented before the procedure.

Empathy statements: 'Разбирам', 'Съжалявам', and 'Това трябва да е трудно'; they acknowledge emotion without replacing information.

Pain interview sequence: 'Къде боли?', 'Какво е усещането?', 'Откога?', and 'Какво го облекчава или влошава?'.

Safety-net closing rule: summarize the plan and name specific return triggers, for example 'Ако се появи задух или кръв, потърсете спешна помощ'.

Telephone communication: speak slowly, confirm the patient's name and number, repeat instructions, and ask the patient to repeat them back.

Interpreter rule: use a professional interpreter for consent and sensitive information; address the patient directly, not the interpreter.