В поликлинике терапевт внимательно посмотрела мою медкарту и спросила, какие симптомы появились утром.

Because в means in/at here, so it takes the prepositional case to show location.

• поликлиника = dictionary form
• в поликлинике = in/at the clinic

A useful contrast:

• в поликлинике = in the clinic (location)
• в поликлинику = to/into the clinic (motion)

Also, поликлиника usually means an outpatient clinic or local medical clinic, not a hospital.

Usually no. In a medical context, терапевт normally means a general physician, primary care doctor, or internal medicine doctor, not a psychotherapist.

So in this sentence, терапевт is the doctor at the clinic.

Also, Russian has no articles, so терапевт can mean the doctor or a doctor depending on context.

This is a very common point for learners.

Терапевт is grammatically a masculine-form noun, but it refers here to a female doctor. In modern Russian, especially in speech and everyday writing, the past-tense verb often agrees with the person’s real gender, so you get:

• терапевт посмотрела
• терапевт спросила

The feminine ending -а shows that the doctor is a woman.

So the noun keeps its usual profession form, but the verbs tell you the person is female.

Because this is the direct object of посмотрела, so it goes into the accusative case.

• моя медкарта = my medical chart (nominative)
• мою медкарту = my medical chart as the object (accusative)

Both words change:

• моя → мою
• медкарта → медкарту

Also, медкарта is a shortened, very common form of медицинская карта.

Yes, it is somewhat shortened and everyday in tone.

• медкарта = common spoken/written short form
• медицинская карта = fuller, more formal version

Both mean medical record/chart. In natural Russian, медкарта is extremely common.

This is a matter of verb aspect.

• посмотрела = perfective
• смотрела = imperfective

Here, посмотрела shows a completed action: the doctor looked over the chart and then moved on to the next action.

So the sentence presents a sequence:

1. she looked at the chart
2. she asked a question

If you used смотрела, it would sound more like the process was being emphasized: was looking at, used to look at, or simply an uncompleted/background action.

Because that part is a subordinate clause, specifically an indirect question after спросила.

Russian uses a comma before subordinate clauses much more consistently than English does.

So:

• спросила, какие симптомы появились утром
• literally: asked, what symptoms appeared in the morning

In natural English, we usually translate it without copying the punctuation exactly: asked what symptoms had appeared in the morning.

Какие симптомы is nominative plural.

That is because симптомы is the subject of появились in the subordinate clause.

• какие = which / what kind of (plural)
• симптомы = symptoms (plural nominative)

So the structure is basically:

• какие симптомы появились
• what symptoms appeared

The symptoms are the thing doing the appearing, so they stay in the nominative.

There are two main reasons:

1. Plural agreement
   The subject is симптомы (symptoms), which is plural, so the past-tense verb must also be plural:

   • симптом появился = a symptom appeared
   • симптомы появились = symptoms appeared

2. Perfective aspect
   Появились comes from появиться, a perfective verb meaning to appear / to come on / to show up. It fits well because the sentence asks about the onset of symptoms.

This is more specific than just saying the symptoms were there. It focuses on when they started to appear.

Because утром is one of the common Russian time expressions that use the instrumental form adverbially.

So:

• утро = morning
• утром = in the morning / this morning

No preposition is needed.

Similar expressions:

• днём = during the day / in the afternoon
• вечером = in the evening
• ночью = at night

The word order is very natural.

• В поликлинике sets the scene first: At the clinic
• терапевт introduces the subject
• внимательно adds manner: carefully / attentively
• посмотрела мою медкарту gives the first completed action
• и спросила... gives the next action

Russian word order is flexible, so other orders are possible, but they change emphasis. For example:

• Терапевт в поликлинике внимательно посмотрела мою медкарту...
• Мою медкарту терапевт внимательно посмотрела...

These are possible, but the original sentence is the most neutral and smooth for telling what happened.

Внимательно means carefully, closely, or attentively.

It tells you how the doctor looked at the chart. It suggests she did not just glance at it; she examined it with attention.

It most naturally modifies посмотрела:

• внимательно посмотрела = looked at carefully

In Russian, adverbs like this are often placed right before the verb, but the position can move a bit depending on emphasis.