on 15-Dec-2021 (Wed)

I’ve got a sore throat and a temperature.

Ache can also be a verb to describe pain that continues for some time. By the end of the day my feet were aching. For stronger or more sudden pain, we usually use the verb hurt. My throat hurts when I speak. I hit my leg on the table and it really hurts / it’s very painful.

Disease is used to talk about more serious medical problems, often affecting certain parts of the body, e.g. heart disease. Illness is used to talk about serious and minor medical problems and those affecting the mind, e.g. mental illness. Disease is not used about a period of illness, e.g. He died after a long illness. (NOT He died after a long disease.)

By the end of the day my feet were aching.

I hit my leg on the table and it really hurts / it’s very painful.

heart disease

mental illness

He died after a long illness.

I prefer jackets with a zip; it’s easier to undo a zip [open a zip, buttons, etc.] and it’s also much quicker to do it up.

I always try on clothes before I buy them.

I like to buy designer labels, even though they’re more expensive.

I never buy clothes just because they're in fashion.

I like to dress in clothes that are casual but still look quite fashionable.

Catherine’s bag matches her coat. Catherine’s bag goes with her coat.

Oh, that’s a shame [that is disappointing; syn that’s a pity]. OK. I’ll leave it, thanks. [I have decided not to buy it; opp I’ll take it/them]

The changing rooms are down there. [the place where you can try on clothes]

Some people like modern shopping centres because everything is under one roof and it is convenient.

Everywhere is busy, and everyone seems to be in a hurry. I usually drive to work, but sometimes I get stuck in traffic jams, and when I get to work I find there's nowhere to park because the car park is already full.

Flats cost a lot, and I think you get better value for money in a smaller town or village.

I like being surrounded by nature.

I've got a bus stop round the corner and buses run every ten minutes for most of the day, and they're usually reliable.

this road bends to the right

a bend in the road

Yesterday, I got lost on my way to the airport. I decided to use side roads and go via the village of Pensford, but I took the wrong turning just before I got there, and I ended up in a supermarket car park. Fortunately I was able to ask someone the way, and a very kind woman directed me to the A38, where I could then follow signs for the airport.

A pedestrian – a young boy – stepped off the pavement and into the road just as a car was approaching.

could you swap places with Lorena?

At the end of the school year, pupils usually take/do exams before they break up [end classes for the term].

At my school, for example, pupils sometimes had to stay behind and write an essay. I used to get into trouble for wearing lipstick.

Jade has a wide vocabulary [knows a lot of words]

Jose has no problem making himself understood [saying things in a way people understand], but he needs to increase his vocabulary [make it bigger], because at the moment it's quite basic [elementary; syn simple].

Ascites is the accumulation of fluid within the peri- toneal cavity.

Patients typically note an increase in abdomi- nal girth that is often accompanied by the development of peripheral edema. The development of ascites is often insidious, and it is surpris- ing that some patients wait so long and become so distended before seeking medical attention. Patients usually have at least 1–2 L of fluid in the abdomen before they are aware that there is an increase. If ascitic fluid is massive, respiratory function can be compromised, and patients will complain of shortness of breath. Hepatic hydrothorax may also occur in this setting, contributing to respiratory symptoms. Patients with massive ascites are often malnourished and have muscle wasting and excessive fatigue and weakness.

Asthma is a syndrome characterized by airflow obstruction that varies markedly, both spontaneously and with treatment. Asthmatics harbor a special type of inflammation in the airways that makes them more responsive than nonasthmatics to a wide range of triggers, leading to excessive narrowing with consequent reduced airflow and symp- tomatic wheezing and dyspnea. Narrowing of the airways is usually reversible, but in some patients with chronic asthma there may be an element of irreversible airflow obstruction. Asthma is a heterogeneous disease with several phenotypes recognized, but thus far these do not correspond well to specific pathogenic mechanisms (endotypes) or responses to therapy. T

The pathology of asthma has been revealed through examining the lungs of patients who have died of asthma and from bronchial biopsies. The airway mucosa is infiltrated with activated eosinophils and T lymphocytes, and there is activation of mucosal mast cells. The degree of inflammation is poorly related to disease severity and may even be found in atopic patients without asthma symptoms. This inflammation is usually reduced by treatment with ICS. There are also structural changes in the airways (often termed remodeling). A characteristic finding is thickening of the basement membrane due to subepithelial collagen deposition. This feature is also found in patients with eosinophilic bronchitis presenting as cough who do not have asthma and is, therefore, likely to be a marker of eosinophilic inflam- mation in the airway as eosinophils release fibrogenic mediators. The epithelium is often shed or friable, with reduced attachments to the airway wall and increased numbers of epithelial cells in the lumen. The airway wall itself may be thickened and edematous, particularly in fatal asthma. Another common finding in fatal asthma is occlusion of the airway lumen by a mucous plug, which is comprised of mucous glycoproteins secreted from goblet cells and plasma proteins from leaky bronchial vessels (Fig. 281-1). There is also vasodilation and increased numbers of blood vessels (angiogenesis). Direct observation by bronchoscopy indicates that the airways may be narrowed, ery- thematous, and edematous. The pathology of asthma is remarkably uniform in different phenotypes of asthma, including atopic (extrinsic), non-atopic (intrinsic), occupational, aspirin-sensitive, and pediatric asthma. These pathologic changes are found in all airways, but do not extend to the lung parenchyma; peripheral airway inflammation is found particularly in patients with severe asthma. The involvement of airways may be patchy and this is consistent with bronchographic findings of uneven narrowing of the airways.

The embryology of the thyroid and parathyroid glands under- lies the anatomical position, anatomical variations and con- genital conditions of these structures and is therefore vital for surgery (Figure 50.1). The thyroglossal duct develops from the median bud of the pharynx. The foramen caecum at the junction of the anterior two-thirds and posterior one-third of the tongue is the vestigial remnant of the duct. This initially hollow structure migrates caudally and passes in close con- tinuity with, and sometimes through, the developing hyoid cartilage. The parathyroid glands develop from the third and fourth pharyngeal pouches. The thymus also develops from the third pouch. As it descends, the thymus takes the asso- ciated parathyroid gland with it, which explains why the inferior parathyroid, which arises from the third pharyngeal pouch, normally lies inferior to the superior gland. However, the inferior parathyroid may be found anywhere along this line of descent (see also Chapter 51). The developing thyroid lobes amalgamate with the structures that arise in the fourth pharyngeal pouch, i.e. the superior parathyroid gland and the ultimobranchial body. Parafollicular cells (C cells) from the neural crest reach the thyroid via the ultimobranchial body.

The normal thyroid gland weighs 20–25 g. The functioning unit is the lobule supplied by a single arteriole and consists of 24–40 follicles lined with cuboidal epithelium. The follicle contains colloid in which thyroglobulin is stored (Figure 50.2). The arterial supply is rich, and extensive anastomoses occur between the main thyroid arteries and branches of the tracheal and oesophageal arteries (Figure 50.3). There is an extensive lymphatic network within and around the gland. Although some lymph channels pass directly to the deep cervical nodes, the subcapsular plexus drains principally to the central com- partment juxtathyroid – ‘Delphian’ and paratracheal nodes

Olga is always willing to [happy and ready to] experiment with language [try something new to see what it is like]. For that reason she sometimes gets things wrong [makes mistakes], but she learns from her mistakes and she's making a lot of progress.

He picks things up [learns things without trying] very quickly, and he has a good ear for language [is good at hearing, repeating and understanding sounds and words].

Amy is a manager in a veterinary surgery. She runs [organises or controls] the day-to-day [happening every day] business of the surgery and is in charge of a small team: three receptionists, an accounts manager and a secretary.

A salary is money paid to professional people, e.g. doctors or teachers, and to office workers for the work they do, and is usually paid into a person's bank account every month. Wages are usually paid for each hour/day/week of work to people who do more physical jobs, e.g. building or cleaning.

The specific sequence of amino acids in a polypeptide chain

DNA & RNA are both polynucleotides.

Your income is the total amount of money you receive in a year. This might be money from one job; it might be money from two jobs.

They also gave me a good pay rise [more money].

After six months, I got fed up with the job – and I think I was enjoying myself too much to work very hard. Finally, the company gave me the sack [told me to leave the company; syn sacked me], and after that I was out of work [without a job; syn unemployed] for two months.