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The Modern Concept of Endodontics

Endodontics (from the Greek endo "inside"; and odons "tooth") is one of the dental specialties which deals withthe tooth pulp and the tissues surrounding the root of a tooth. Endodontists perform a variety of procedures including rootcanal therapy, endodontic treatment, surgery, treating cracked teeth, and treating dental trauma. Root canal therapy is oneof the most common procedures. If the pulp (containing nerves, arterioles, venules, lymphatic tissue, and fibrous tissue)becomes diseased or injured, endodontic treatment is required to save the tooth. Endodontic therapy is a sequence oftreatment for the pulp of a tooth which results in the elimination of infection and protection of the decontaminated toothfrom future microbial invasion. This set of procedures is commonly referred to as a "root canal." Root canals and theirassociated pulp chamber are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vesselsand other cellular entities. Endodontic therapy involves the removal of these structures, the subsequent cleaning, shaping,and decontamination of the hollows with tiny files and irrigating solutions, and the obturation (filling) of thedecontaminated canals with an inert filling such as gutta percha.

During the last three decades, research in the field of endodontics has modified the approach to treatment. Lesionsof endodontics origin which appear radiographically as areas of radiolucency around the apices of lateral aspects of theroots of teeth are, in majority of cases, sterile. The areas are caused by toxins produced by microorganisms lying withinthe root canal system. This finding suggests that the remove of microorganisms from the root canal followed by rootfilling is the first treatment of choice and the apicectomy with a retrograde filling can only be second best. Apicectomywith a retrograde filling at the aplex is carried out in the hope of merely incarcerating microorganisms within the tooth,but does not take into account the fact that approximately 50% of teeth have at least one lateral canal. The long termsuccess rate of apicectomy must inevitable be lower than orthograde root treatment.

Research into morphology of the pulp has shown the wide variety of shapes, and the occurrence of two or eventhree canals in a single root. There is a high incidence of fins which run longitudinally within the wall of the canal and anetwork of communications between canals lying within the same root. The many nooks and crannies within the rootcanal system make it impossible for any known technique, either chemical or mechanical, to render it sterile. Strongintracanal medicaments such as paraformaldehyde will not only fail to produce sterilization but may percolate into theperiradicular tissue and damage vital healthy tissue, thus delaying healing. The current feeling is to rely on mechanicalcleaning of the canal alone, or on the use of mild medicaments which do not damage tissue.

Other areas of research have had the significant effect of changing the approach to endodidontic treatment. Thehollow tube theory postulated that tissue fluids entering the root canal stagnated and formed toxic breakdown productswhich then passed out into the periapical tissues. The theory, thet dead spaces within the body must be obturated, formedthe basis for filling root canals. However, more recently ,a variety of different studies have demonstrated that, on thecontrary, hollow tubes are tolerated by the body. As a result of this work there are currently two indications for filling aroot canal: first. To prevent micro-organisms from entering the canal system from the oral cavity or via the blood stream(anachoresis), and, secondly, to stop the ingress of tissue fluid which would provide a culture medium for any residualbacteria within the tooth.

All root canal sealers are soluble and their only function is to fill the minute spaces between the wall of the rootcanal and the root filling material. Their importance, judged by the number of products advertised in the dental press, hasbeen overemphasized. Despite much research, gutta percha remains the root filling of choice, although, it is recognizedthat a biologically inert, insoluble and injectable paste would be better suited for obturation of the root canal. Most of thenew root canal filling techniques are concerned with methods of heating gutta-percha, which makes it softer and easier toadapt to the irregular shape of the canal wall.a. Root canal tissue cannot be damaged during cleaning.b. Fluids which stagnate in the mouth may reach periapical tissues.c. Empty tubes are never tolerated by the body.d. Sealers can replace root canal filling.e. Gutta percha is no longer used for canal filling.In summary, the principles of modern endodontic treatment are:Clean: remove microorganisms and pulpal debris from the root canal systemShape: produce a gradual smooth taper in the root canal with the widest part coronal and the narrowest part Immshort ofthe apex.Fill: Obturate the canal system with an inert, insoluble filling material.

The surgeon

In medicine, a surgeon is a person who performs surgery. Surgery is a broad category of invasivemedical treatment that involves the cutting of a body, whether human or animal, for a specific reason suchto remove a diseased organ or to repair a tear or breakage. Surgeons may be physicians, dentists,podiatrists or veterinarians. In earlier tunes, they were also people trained solely in removing bladderstones, but at the present day specialised practitioners would have first been trained in one of theaforementioned professions.

Minimally invasive procedures such as the procedures of interventional radiology are sometimesdescribed as "minimally invasive surgery." The field traditionally described as interventionalneuroradiology, for instance, is increasingly called neurointerventional surgery.

Some medical doctors who are general practitioners or specialists in family medicine or emergencymedicine may perform limited ranges of minor, common, or emergency surgery. Anesthesia oftenaccompanies surgery, and anesthesiologists and nurse anesthetists may oversee this aspect of surgery. Firstassistants, surgical nurses, surgical technologists and operating department practitioners are trainedprofessionals who support surgeons.

Terminology1. Excision surgery names often start with a name for the organ to be excised (cut out) and end in -

ectomy.2. Procedures involving cutting into an organ or tissue end in -otomy. A surgical procedure cutting

through the abdominal wall to gain access to the abdominal cavity is a laparotomy.3. Minimally invasive procedures involving small incisions through which an endoscope is Inserted

end in -oscopy. For example, such surgery in the abdominal cavity is called laparoscopy.4. Procedures for formation of a permanent or semi-permanent opening called a stoma in the body end

in -ostomy.5. Reconstruction, plastic or cosmetic surgery of a body part starts with a name for the body part to be

reconstructed and ends in -oplasty. Rhino is used as a prefix for "nose", so rhinoplasty is basicallyreconstructive or cosmetic surgery for the nose.

6. Reparation of damaged or congenital abnormal structure ends in -rraphy. Herniorraphy is thereparation of a hernia, while perineorraphy is the reparation of perineum.

Types of surgery

• General surgery, despite its name, is a surgical specialty that focuses on abdominal organs, e.g.,intestines including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bileducts, and often the thyroid gland (depending on the availability of head and neck surgeryspecialists). They also deal with diseases involving the skin, breast, and hernias.

• Cardiothoracic surgery is the field of medicine involved in surgical treatment of diseases affectingorgans inside the thorax (the chest). Generally treatment of conditions of the heart (heart disease)and lungs (lung disease). Cardiac surgery (involving the heart and great vessels) and thoracicsurgery (involving the lungs and any other thoracic organ) are separate surgical specialties, exceptin the USA, where they are frequently grouped together, so that a surgeon training in theCardiothoracic specialty will receive a broader but less specialized experience in both fields.

• Colorectal surgery is a field in medicine, dealing with disorders of the rectum or anus. The field isalso known as proctology, but the term is outdated in the more traditional areas of medicine. Theword proctology is derived from the Greek words Proktos, meaning anus or hindparts, and Logosmeaning science or study. Physicians specializing in this field of medicine are more commonlycalled colorectal surgeons, or less commonly, proctologists. Colorectal surgeons often work closelywith urologists.

• Pediatric surgery (AE) or paediatric surgery (BE) is a subspecialty of .surgery involving thesurgery of fetuses, infants, children, adolescents, and young adults. Many pediatric surgeonspractice at children's hospitals.

Plastic surgery is a medical specialty concerned with the correction or restoration of form andfunction. While famous for aesthetic surgery, plastic surgery also includes many types ofreconstructive surgery, hand surgery, microsurgery, and the treatment of burns. The word "plastic5'derives from the Greek "plastikos" meaning to mould or to shape.Vascular surgery is a specialty of surgery in which diseases of the vascular system, or arteries andveins, are managed by medical therapy, minimally-invasive catheter procedures, and surgicalreconstruction. The specialty evolved from general and cardiac surgery. The vascular surgeon istrained in the diagnosis and management of diseases affecting all parts of the vascular systemexcept that of the heart and brain. Cardiothoracic surgeons manage surgical disease of the heart andits vessels. Neurosurgeons manage surgical disease of the vessels in the brain (e.g. intracranialaneurysms).Transplant surgery is the division of medicine that surgically replaces an organ that is no longerfunctioning with an organ from a donor that does function. Organs are donated by living anddeceased donors in order to save the life of a recipient. Transplant surgeons may also care for thepatient prior to their transplant, and continue to care for the patient after transplant surgery. Thereare many types of transplants in medicine, however, transplant surgery is the only division ofsurgery that is concerned with organs. Other surgical specialties such as dentistry and orthopedicswill use human tissue to repair injuries and defects, but that is not considered "transplant surgery"but the use of a "tissue transplant".Trauma surgery Trauma surgeons are physicians who have completed residency training in generalsurgery and often fellowship training in trauma or surgical critical care. The trauma surgeon isresponsible for the initial resuscitation and stabilization of the patient, as well as ongoingevaluation. The attending trauma surgeon also leads the trauma team, which typically includesnurses, resident physicians, and support staff.Breast surgery is a form of surgery performed on the breast. Types include: breast reductionsurgery, augmentation mammoplasty, mastectomy, lumpectomy, breast-conserving surgery, a lessradical cancer surgery than mastectomy, mastopexy, or breast lift surgery.Surgical oncology is the branch of surgery which focuses on the surgical management of cancer.The specialty of surgical oncology has evolved in steps similar to medical oncology, which grewout of hematology, and radiation oncology, which grew out of radiology.Endocrine surgery is a surgical procedure that is performed to achieve a hormonal or anti-hormonaleffect in the body. The commonest operation is thyroidectomy. Most thyroidectomies areperformed through a 1.5-inch incision. This is called minimally invasive thyroid surgery. However,orchiectomy remains a common approach for the hormonal management of prostate cancer becauseof the simplicity of the procedure, its immediate effect, and the lack of side effects associated withthe drugs used to achieve the same hormonal suppression.Skin surgery Dermatology is the branch of medicine dealing with the skin and its diseases, a uniquespecialty with both medical and surgical aspects. A dermatologist takes care of diseases, in thewidest sense, and some cosmetic problems of the skin, scalp, hair, and nails.

Otolaryngology or ENT (ear, nose and throat) is the branch of medicine that specializes in thediagnosis and treatment of ear, nose, throat, and head and neck disorders. The full name of thespecialty is otolaryngology-head and neck surgery. Practitioners are called otolaryngologists-headand neck surgeons, or sometimes otorhinolaryngologists (ORL). Otolaryngology is one of the mostcompetitive specialties to enter for physicians.Oral and maxillofacial surgery is surgery to correct a wide spectrum of diseases, injuries anddefects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacialregion. It is a recognized international surgical specialty.Orthopaedic surgery or orthopedics (also spelled orthopaedics) is the branch of surgeryconcerned with conditions involving the musculoskeletal system. Orthopedic surgeons use bothsurgical and non-surgical means to treat musculoskeletal trauma, sports injuries, degenerativediseases, infections, tumors, and congenital disorders. Nicholas Andry coined the word"orthopaedics'-', derived from Greek words for orthos ("correct", "straight") and paideion ("child"),

when he published Orthopaedia: or the Art of Correcting and Preventing Deformities in Children in1741.

• Neurosurgery is the surgery focused on treating structural diseases and spinal column, the centralnervous system, and peripheral nervous system amenable to surgical intervention. Neurosurgeonstreat all of the same problems that orthopedic spine surgeons treat. The differences in the twospecialists with regard to spine surgery have to do with the detailed micro-surgical approachlearned in a neurosurgical training program. Neurosurgery generally has the longest training periodof all the medical specialties; in America, the neurosurgeon must complete the eight years of pre-medical and medical education, a one year-long surgical internship (where this is not a part of theresidency), and five to seven years of neurosurgery residency. Many neurosurgeons pursue anadditional one to three years of training in a subspecialty fellowship (like pediatric neurosurgery,epilepsy, tremor, or stroke ("functional") neurosurgery, microneurosurgery, endovascular or openvascular neurosurgeiy, or neuro-oncological surgery).

• Ophthalmology is a branch of medicine which deals with the diseases and surgery of the visualpathways, including the eye, hairs, and areas surrounding the eye, such as the lacrimal system andeyelids. The term ophthalmologist is an eye specialist for medical and surgical problems. Sinceophthalmologists perform operations on eyes, they are considered to be both a surgical and medicalspecialty. The word ophthalmology comes from the Greek roots "ophthalmos" meaning eye and"logos" meaning word, thought or discourse; ophthalmology literally means "the science of eyes".

• Podiatric surgery is a branch of medicine devoted to the study, diagnosis and treatment ofdisorders of the foot, ankle and lower leg. Within the field of podiatry, practitioners can focus onmany different specialty areas, including surgery, sports medicine, biomechanics, geriatrics,pediatrics, orthopedics or primary care. In many English-speaking countries, the older title of"chiropodist" may still be used by some clinicians but is gradually falling out of use. In many non-English-speaking countries of Europe, the title used instead of podiatrist may be "podologist" or"podolog". The level and scope of practice may vary in these countries as compared in the US.

• Urology (from Greek ouron, "urine" and -logia "study of) is the surgical specialty that focuses onthe urinary tracts of males and females, and on the reproductive system of males. Medicalprofessionals specializing in the field of urology are called urologists and are trained to diagnose,treat and manage patients with urological disorders. Both Urologists and General Surgeons operateon the adrenal glands. Urology combines management of medical (i.e. non-surgical) problems suchas urinary tract infections and benign prostatic hyperplasia, as well as surgical problems such as thesurgical management of cancers, the correction of congenital abnormalities, and correcting stressincontinence. Urology is closely related to, and in some cases overlaps with, the medical fields ofoncology, nephrology, gynecology, andrology, pediatric surgery, gastroenterology, andendocrinology.

Description of surgical procedureAt a hospital, modern surgery is often done in an operating theater using surgical instruments, an

operating table for the patient, and other equipment. The environment and procedures used in surgery aregoverned by the principles of aseptic technique: the strict separation of "sterile" (free of microorganisms)things from "unsterile" or "contaminated" things. All surgical instruments must be sterilized, and an-instrument must be replaced or re-sterilized if it becomes contaminated (i.e. handled in an unsterilemanner, or allowed to touch an unsterile surface). Operating room staff must wear sterile attire (scrubs, ascrub cap, a sterile surgical gown, sterile latex or non-latex polymer gloves and a surgical mask), and theymust scrub hands and arms with an approved disinfectant agent before each procedure.

Prior to surgery, the patient is given a medical examination and certain pre-operative tests. If theseresults are satisfactory, the patient signs a consent form and is given a surgical clearance. If the procedureis expected to result in significant blood loss, an autologous blood donation may be made some weeksprior to surgery. If the surgery involves the digestive system, the patient may be instructed to perform abowel prep by drinking a solution of polyethylene glycol the night before the procedure. Patients are alsoinstructed to abstain from food or drink.

In the pre-operative holding area, the patient changes out of his or her street clothes and is asked toconfirm the details of his or her surgery. A set of vital signs are recorded, a peripheral IV line is placed,and pre-operative medications (antibiotics, sedatives, etc) are given. When the patient enters the operating

room, the skin surface to be operated on is cleaned and prepared by applying an antiseptic such as' - chlorhexidine gluconate or povidone-iodine to reduce the possibility of infection. If hair is present at the

surgical site, it is clipped off prior to prep application. Sterile drapes are used to cover all of the patient'sbody except for the surgical site and the patient's head; the drapes are clipped to a pair of poles near thehead of the bed to form an "ether screen", which separates the anesthetist/anesthesiologist's working area(unsterile) from the surgical site (sterile).

Anesthesia is administered to prevent pain from incision, tissue manipulation and suturing. Basedon the procedure, anesthesia may be provided locally or as general anesthesia. Spinal anesthesia may beused when the surgical site is too large or deep for a local block, but general anesthesia may not bedesirable. With local and spinal anesthesia, the surgical site is anesthetized, but the patient can remainconscious or minimally sedated. In contrast, general anesthesia renders the patient unconscious andparalyzed during surgery. The patient is intubated and is placed on a mechanical ventilator, and anesthesiais produced by a combination of injected and inhaled agents.

An incision is made to access the surgical site. Blood vessels may be clamped to prevent bleeding,and retractors may be used to expose the site or keep the incision open. The approach to the surgical sitemay involve several layers of incision and dissection, as in abdominal surgery, where the incision musttraverse skin, subcutaneous tissue, three layers of muscle and then peritoneum. In certain cases, bone maybe cut to further access the interior of the body; for example, cutting the skull for brain surgery or cuttingthe sternum for thoracic (chest) surgery to open up the rib cage.Work to correct the problem in body then proceeds. This work may involve:excision - cutting out an organ, tumor, or other tissue.resection - partial removal of an organ or other bodily structure.reconnection of organs, tissues, particularly if severed. Resection of organs such as intestines involvesreconnection. Internal suturing or stapling may be used. Surgical connection between blood vessels orother tubular or hollow structures such as loops of intestine is called anastomosis.ligation - tying off blood vessels, ducts, or "tubes".grafts - may be severed pieces of tissue cut from the same (or different) body or flaps of tissue still partlyconnected to the body but resewn for rearranging or restructuring of the area of the body in question.Although grafting is often used in cosmetic surgery, it is also used in other surgery.insertion of prosthetic parts when needed. Pins or screws to set and hold bones may be used. Sections ofbone may be replaced with prosthetic rods or other parts. Sometime a plate is inserted to replace adamaged area of skull. Artificial hip replacement has become more common. Heart pacemakers or valvesmay be inserted. Many other types of prostheses are used,creation of a stoma, a permanent or semi-permanent opening in the bodyarthrodesis - surgical connection of adjacent bones so the bones can grow together into one. Spinal fusionis an example of adjacent vertebrae connected allowing them to grow together into one piece,repair of a fistula, hernia, or prolapse- other procedures, including:

• clearing clogged ducts, blood or other vessels• removal of calculi (stones)• draining of accumulated fluids• debridement- removal of dead, damaged, or diseased tissueBlood or blood expanders may be administered to compensate for blood lost during surgery. Once the

procedure is complete, sutures or staples are used to close the incision. Once the incision is closed, theanesthetic agents are stopped and/or reversed, and the patient is taken off ventilation and extubated (ifgeneral anesthesia was administered).

After completion of surgery, the patient is transferred to the post anesthesia care unit and closelymonitored. When the patient is judged to have recovered from the anesthesia, he/she is either transferred toa surgical ward elsewhere in the hospital or discharged home. During the post-operative period, thepatient's general function is assessed, the outcome of the procedure is assessed, and the surgical site ischecked for signs of infection. Post-operative therapy may include adjuvant treatment such as

r chemotherapy, radiation therapy, or administration of medication such as anti-rejection medication fortransplants. Other follow-up studies or rehabilitation may be prescribed during and after the recoveryperiod

Medical Vocabulary - HOSPITAL

E PEOPLE IN THE HOSPITALMatch the correct definition with the person: radiology technicians, pharmacists, "social workers,porters, consultants, pediatricians, speech therapists, physioterapists. general practitioners, occupationaltherapists, chiropodists, dieticians, plastic surgeons, laundry staff, pesjV\-e.vvvt*, ordL-efUts.

I.They assist patients who have difficulties speaking. 2. They move patients on beds, trolleys andwheelchairs. 3. They look after people's feet. 4. They work out special meals and give advice on themost appropriate food. 5. They are responsible for. prepare and dispense medicine. 6. These doctors5

speciality is children. 7. Senior medical people who give expert advice and are responsible for finaldecision making. 8. They give massage and exercise to restore specific bodily functions. 9. Theyoperate on patients to repair skin damage or improve a patient's appearance. 10. Their work isrehabilitation and assistance of people recovering from or suffering from illness. 11. They operateequipment in the X-ray department. 12. They work together with medical personnel in hospital and try-to deal with a patient's problems at home. 13. They clean and organize bed linen. 14. These doctorsmay refer their patients to hospital to see a specialist or to receive specialist care.

• THINGS ON THE WARDMatch each of the following descriptions with the correct word: sheets, mattress, crutch, trolley,curtain, drip stand, bedpan, tray, bedspread, observations chart, oxygen point, urine bottle, hoist,wheelchair, pillow, call button, blanket, basin, name band, monkey pole,

1. This covers the bed to keep off the dust. 2. Something to rest one's head on. 3. A patient confinedto bed will have to use this to urinate and defecate. 4. Patients use this when they need to call a nurse.5. For identification, this is worn by patients around their wrist. 6. A narrow bed used for transportingpatients. 7. Wash your hands here. 8. A mechanical device for lifting and moving patients. 9. Drawnaround a patient's bed to provide some privacy. 10. Two of these on the bed are straightened regularlyand washed every few days. 1 i. Meals are brought to the bed on this. 12. These keep the patient warm.13, Male patients confined to bed use this to urinate. 14. Suspended above the bed, this can be usedby the patient to pull himself/herself up. 15. Patients lie on this, it's sometimes hard and sometimessoft! 16. Intravenous fluid bags are suspended on this. 17. Patients who can sit up comfortably can betransported in one of these. 18. A patient with a broken leg will need 2 of these to get around. 19. Amask and tube from this will supply oxygen to the patient. 20. The patient's condition is recorded here.

BPROCEDURESThe following phrases are spoken by a nurse carrying out nasogastric intubation. They are all mixedup. Put them in the correct order.

1. Now I'll just check that we've got it in the right place, so I'm going to pass just a little bit of air intothe tube and listen to it. Can you let me listen to your stomach, please ?2. OK., can you sit forward on your chair, please ? That's it! Now can you just lift your head a little ?That's fine ! Now I'm just going to mark the lenghl of Lube we need with this tape. That's it.3. Yes. that seems fine. Well done ! Now I'll just put a little bit of tape over the tube to hold it in place.That's it I All over. You can relax now.4. Now just a little spray in your left nostril. That's fine ! Now if you want me to stop at any time justraise yonr hand. OK ? Right, now here comes the first bit. You're doing very well.5. Hello Mrs. Turner. I'm Amy Nathan.6. Now. can you just bend your head forward a little and I'd like you to take a sip of water through thisstraw. Fine !

7. Now. you're going to have an operation tomorrow and we need to make sure that your stomach isempty. What I'd like to do is slide" a'̂ lmT-plas^ie-^iifee-^.ifeiisii-yGUTnose and down into your stomach,.8. You're doing very well. Now, take another sip. That's it. And now another. Good. We're almostthere. Weil done !9. Don't worry, it won't cause you any pain, but it will feel a bit unconfortable. It's not the most pleasantof things but we'll take it carefully. Are you OK about this ?

• LETTER OF REFERRAL

There are two letters below. One is a letter from a general practitioner to a consultant and the otherone the consultant's reply. Fill in the missing words. Choose from the folio-wing: discomfort, drip,examination, findings, grateful, instance, nasal, obstruction, opinion, persist, persistently, respond,responds, response

Consultant: Dr Holger BauerPatient name: John GardnerDOB: 14/07/8007/05/02

Dear Mr BauerI would be (1) grateful if you could see this young man who has had a (2)... blocked nose over the lastfew months. On two occasions I have noted polyps. They (3)... to a small degree to beclamethasone(4) ... spray, but continue to (5).... I would be grateful for your (6)....

Yours sincerely,.Andrew Connor

Department of OtolaryngologyNew patient consultation: John Gardner, DOB 14/07/8025/06/02 ( Clinic 19/06/02)

Dear Dr ConnorThank you for asking me to see this 21-year-old telecommunications engineer.Presentation and (7) ...:He complains of long-standing nasal (8) ... on both sides with only partial (9) ... to Beconase nasalspray. He also says that his ears pop occasionally and he gets some facial (10) ... and post nasal (11). . . . On (12)... toda}f his nose showed congested nasal mucosa and polypoid middle turbinate and smallmiddle meatal polyps.Impressions and plan:In the first (13) .... I have started him on a course of Nasonex nasal spray which is a more modernsteroid man Becouase. I shall see him again in two months' time to see how he (14) ... .

Yours sincerelyHolger Bauer

Ilolger BaueiConsultant Otolaryngolegist

B CONFUSING WORDSChoose the correct word in each of the following.1. She nervously waited for the post to find out whether she had past/passed her final nursingexamination. 2. He seems to have put on a lot of weight/wait in the last few months. 3. A new sight/si te

: on the edge of the city has now been fQUiidjojjJie_neadaQ5pital,J...One quality that all nurses musthave is patience/patieiits. 5. "She" is~very concerned that her hair loss will result in her becomingballed/bald. 6, During the procedure she began to feel unwell and felt she was going to feint/faint. 7.He has been experiencing pain in the lumbar/lumber region of the back. 8. The surgeon uses a largenumber of slobs/swabs to mop up the blood. 9. Muscular dystrophy is a disease where the muscleswaist/waste away. 10. He suffers from a muscular tic/tick in his left eye. 11. hi the accident he suffereda major break/brake to his right femur. 12. After sneezing or coughing, some microbial pathogens maybe bom/borne 011 the wind, enhancing the spread of infection. 13. Before going off duty the doctorshould cheque/check that all intravenous cannulae are working satisfactorily. 14. The wound has beenvery slow to heel/heal. 15. The doctor was called when the child began to grown/groan with pain. ] 6.The skin was badly pitted/pitied with the scars of acne. 17. As the infection took hold his temperaturebegan to soar/sore. .

E DISEASESMatch the common name for a disease with its medical equivalent.

Medical namealopeciaCandidadyspepsiahaemorrhoidsherpes zosteroedemarubellaurticaria

arteriosclerosiscerebral palsyeructationhalitosisinfectious mononucleosispoliomyelitisrubeola; morbillivaricella

bursitiscerebral infarction / bleedingflatulenceherpes simplexmyocardial infarctionpyrosistendonitisverrucas

Common nameGerman measles, polio, thrush, warts , heart attack, heat spots /neetle rash, cold sore, swelling, (to be)spastic, belching, glandular fever, heartburn, baldness, chickenpox. hardening of the arteries, measles,bad breath, indigestion, housemaid's knee, piles, shingles, tennis elbow, stroke, wind.

• Match the definitions with the folowing terms: signs, sequelae, differential diagnosis,consultation, syndrome, aetiology, history, prognosis, abnormality, complications, prevention,symptoms, disease, examination, diagnosis.

1. the long-term results of an illness or treatment.2. identifying several illnesses which the patient may have.3. things wrong with the body which the patient complains of or experiences.4. a study of the patient's body.5. the causes leading to an iiness.6. an unusual feature which ma}' be worrying or dangerous.7. a meeting between patient and doctor to discuss problems.S. the identification of a particular illness.9. a change in the structure or function of the organs or tissue of the body.10. talcing away the cause of illness or finding it early.11. a group of signs which are characteristic of a particular illness.12. additional problems to the original illness.13. likely outcome of an illness.14. a patient's medical background, problems, behaviour and lifestyle.15. what the doctor can see of the illness.

INFECTIOUS DISEASES - Word BuildingUse the words on the right to form a noun that fits suitably in the blank space.

1. The ... of equipment is necessary to kill spores. STERILE2. Safe practice includes the safe ... of waste. DISPOSE3. Hands must be carefully washed after ... with body fluids. CONTAMINATE4. A patient with a highly infectious disease may have to be cared for in .... ISOLATE5. Some disease organisms may trigger an inflammatory .. .in the body. RESPOND6. The ... of influenza depends on the strain of virus causing it. SEVERE7. In the case of mumps the period of . . . is very long. INCUBATE8. hi most European countries, ... against many childhood diseases is available. VACCINATE9. A long ... is often required after glandular fever. CONVALESCE10. Many viral diseases are known to cause ... of the tonsils. INFLAME11. A programme of . . . has made diphtheria a very rare disease in Britain, IMMUNE12. Tetanus is an ... by the Closiridiuin tetani bacillus. INFECT13. Typhoid fever is spread by ... of food or drink contaminated by bacillus from infected faeces.

INGEST14. If plaque is not removed from teeth it may lead to the ... of the enamel. DESTROY

£; PrepositionsFill in the missing prepositions in the sentences below. Choose from the following. Some of theprepositions are used more than once: about, against, along, by, down, from, in, into. of. on. to, with.

1. Disease can spread to another person through direct contact with the patient.2. Infection may be carried in water contaminated . . . sewage.3. Malaria is transmitted . . . the bite of a mosquito.4. Toxins released ... the blood circulation may produce fever.5. A rash is probably due ... a viral infection.6. The severity of the disease depends ... the particular viral strain.7. A secondary infection can be treated ... the appropriate antibiotics.8. These are six patients suffering ... the flu.9. Patients must be warned ... the dangers of secondary infection.10. The measles rash appears ... the forehead and then spreads ... the body.11. The German measles rash consists ... pink macules.12. Girls should be vaccinated ... rubella if they have never had it.13. Laryngeai spasm may cause difficulty . . . swallowing.14. Antibiotics are effective ... the Bordetella pertussis bacillus.15. hi the past many people died ... smallpox.16. Children are routinely immunized ... polio, whooping cough and other diseases.17. Typhoid fever is caused ... Salmonella typhi.18. Precautions must be taken to prevent the spread ... infection.19. Children are often concerned ... a rash on their skin.20. You're coming ... fine. We'll have you home in no time!21. The baby is growing quickly and putting ... weight.22. She fainted but quickly came ...23. She's done something ... her back. She's having difficulties moving24. Try to keep ... tin's diet for the next four weeks.