Shadowing Practice: Gallstones (cholelithiasis) - Learn English Speaking with Video
בחר מצב תרגול
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89 משפטים
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What?
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you Gallstones are hard deposits, or simply stones, that form inside the gallbladder.
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This condition is also known by the Greek name cholelithiasis.
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"Kola" means bile, "lith" comes from the word lithos meaning stone, and "iasis" refers to an abnormal condition in the body.
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Put it all together and cholelithiasis means having bile stones.
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Now, picture yourself enjoying a creamy plate of Greek Musica.
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As those fats move through your digestive system, they finally reach the small intestine.
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But fats are difficult to process, and that's where the small, pear -shaped organ gallbladder steps in.
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The gallbladder acts as a storage tank for bile produced by the liver.
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The liver carefully blends this digestive smoothie with just the right mix of bile salts, phospholipids, cholesterol, and bilirubin.
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The liver starts the recipe by converting cholesterol into bile acids such as cholic acid.
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Then it mixes these bile acids with amino acids like taurine to create water -soluble bile salts
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that flow smoothly into the bile.
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But not all cholesterol takes this path.
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Some slip directly into bile as free cholesterol, where it mixes with bile salts and phospholipids like lecithin.
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These ingredients act like tiny detergents, wrapping around cholesterol molecules to keep them from crystallizing and clumping.
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Another key ingredient in bile is bilirubin, which comes from the natural breakdown of red blood cells.
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When red blood cells reach the end of their life, they release hemoglobin, which is further broken down into heme and globin.
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The body converts heme into biliverdin and biliverdin to unconjugated bilirubin.
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However, unconjugated bilirubin isn't water -soluble, so it binds to albumin to hitch a ride to the liver.
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In the liver, the body transforms unconjugated bilirubin into water -soluble conjugated bilirubin ready for excretion into bile.
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The liver produces bile continuously, sending it either directly to the small intestine or to the gallbladder for storage.
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The gallbladder walls, which are lined and coated with protective mucus, absorb water and electrolytes, concentrating the bile up to 10 times its original strength.
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Most of the time, the liver blends this bile smoothie perfectly.
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But sometimes, things go off the recipe.
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the bile becomes too thick, or the gallbladder doesn't empty as it should.
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That's when gallstones form, and depending on their main ingredient, they can be cholesterol stones and pigmented stones.
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Cholesterol stones are the most common ones, and they develop exclusively in the gallbladder for several reasons.
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The main one is supersaturation with cholesterol, which happens when the bile recipe is off.
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Basically, the liver adds too much free cholesterol, but not enough bile salts and phospholipids.
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It's like pouring too much protein powder into your smoothie.
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Instead of blending smoothly, it starts to clump together.
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The second reason is gallbladder stasis, also known as gallbladder hypomotility, which means the gallbladder isn't contracting the way it should.
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Just like a smoothie that sits out too long and starts to separate, a stagnant bile gives cholesterol molecules time to clump together.
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Finally, the gallbladder can produce more mucus than it should.
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This thick layer creates the perfect environment to trap cholesterol crystals, allowing them to clump together.
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It's like adding too much syrup to your smoothie.
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As cholesterol crystals clump together within the gallbladder, they slowly grow into oval and firm cholesterol stones.
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Sometimes there's just one, but more often there are several stones lying side by side.
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As they grow, they press against each other and develop flat, smooth surfaces where they touch.
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When made of pure cholesterol, cholesterol stones have a pale yellow color.
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However, they can also pick up substances such as calcium carbonate, phosphates, and bilirubin, so their color can range from gray to white or even black.
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On the other hand, pigment stones make up a smaller portion of gallstones and can appear anywhere along the biliary tree.
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These stones come in two colors and form when bile contains too much unconjugated bilirubin.
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Black pigment stones usually form in the sterile bile of the gallbladder and develop in people with chronic hemolytic anemias.
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In these individuals, high levels of unconjugated bilirubin overwhelm the liver's ability to process it.
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As a result, unconjugated bilirubin, along with conjugated, appears in bile.
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Unconjugated bilirubin binds with calcium to form black stones made of calcium bilirubinate, which are usually small, numerous, and fragile to the touch.
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Next, brownstones usually form in people with biliary tract infections, such as liver flukes.
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These pathogens often release an enzyme called beta -glucuronidase, which converts conjugated bilirubin back into its unconjugated form.
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This unconjugated bilirubin then binds with calcium, leading to the formation of brownstones made of calcium bilirubinate.
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Sometimes they can also include other calcium salts and cholesterol.
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Compared to black stones, brown stones are usually fewer in number and softer, with a greasy, soap -like texture.
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This soapy feel comes from another enzyme released by pathogens.
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It's called phospholipase, which breaks down phospholipids and enables the formation of calcium salts of fatty acids.
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Several factors can tip the balance toward stone formation.
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and you can use the mnemonic "magics" to remember them.
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M stands for metabolic factors, like obesity.
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A stands for age as risk increases with age, and G represents gallbladder stasis, like an individual's on total parenteral nutrition.
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Next, I stands for inherited because family history is a risk factor.
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C stands for childbearing and oral contraceptives, both of which are associated with elevated estrogen levels.
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Finally, "S" refers to sex because biologically female individuals have a higher risk, again thanks to estrogen activity.
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Most of the time, gallstones stay silent.
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But for some, that calm can be shattered by biliary colic, unleashing sharp, intense pain in the upper right abdomen or just below the ribs.
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Biliary colic typically follows a fatty meal, as fat triggers the gallbladder to contract, pushing a stone against its outlet and causing pressure to build.
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As pressure rises, the gallbladder walls stretch, making the pain peak within 15 to 60 minutes.
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The pain holds steady for one to four hours before gradually easing as the stone shifts back or passes through the duct.
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Often, symptoms like nausea, vomiting, and sweating accompany biliary colic, while people typically feel normal between episodes.
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Diagnosis primarily relies on abdominal ultrasound, which identifies gallbladder stones in over 90 % of cases.
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Ultrasound may also show bile duct dilation if a stone has recently passed or is still present.
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Abdominal x -ray can be done if the cause of the pain is uncertain, but most cholesterol stones are radiolucent and don't show up.
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However, if they contain calcium salts, such as calcium carbonate, they become radiopaque and visible.
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Similarly, black pigment stones contain high concentrations of calcium bilirubinate, which makes them radiopaque, while brown pigment stones contain calcium salts of fatty acids,
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which makes them radiolucent.
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If needed, you can turn to more advanced tools like Magnetic Resonance Cholangiopancreatography, which maps the bile ducts and identifies stones as filling defects.
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Also, during the endoscopic retrograde cholangiopancreatography, you can inject dye into the bile ducts and take x -rays to locate stones.
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If present, you can remove them during the same procedure.
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Most gallstones don't cause symptoms, so surgery is usually not worth the risks unless they start causing problems.
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When symptoms do occur, the go -to treatment is laparoscopic cholecystectomy, which is the surgical removal of the gallbladder through small cuts with the help of a tiny camera.
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For individuals who can't have surgery, alternatives include medications that help dissolve the stones, like ursodeoxycholic acid.
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Alright, as a quick recap: Gallstones, or colovithiasis, form when substances in bile,
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primarily cholesterol or unconjugated bilirubin, crystallize within the gallbladder.
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Cholesterol stones develop if there's too much cholesterol or insufficient bile salts, while pigment stones arise when excess unconjugated bilirubin binds calcium,
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often due to increased red blood cell breakdown or infections.
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Vocabulary and speaking notes for this lesson
This video has 89 sentences and 1339 words to shadow. The speech runs for 10:13. The speaker talks at a steady 131 words per minute, a comfortable pace for shadowing. Only 65% of the words are among the 3,000 most common in English, so the vocabulary is demanding.
Key vocabulary in this video
15 words from the video worth learning, with pronunciation and meaning:
| Word | Pronunciation | Meaning |
|---|---|---|
| boil verb | /bɔɪ(ə)l/ | To heat to the point where it begins to turn into a gas. |
| cholesterol noun | /kəˈlɛstəɹɒl/ | A sterol lipid synthesized by the liver and transported in the bloodstream to the membranes of all animal cells; it plays a central role in many biochemical… |
| calcium noun | /ˈkælsi.əm/ | The chemical element (symbol Ca) with atomic number 20: a soft, silvery-white alkaline earth metal which occurs naturally as carbonate in limestone and as… |
| acid noun | /ˈæsɪd/ | A sour substance. |
| bind verb | /ˈbaɪ̯nd/ | To tie; to confine by any ligature. |
| duct noun | /dʌkt/ | A pipe, tube or canal which carries gas or liquid from one place to another. |
| recipe noun | /ˈɹɛs.ɪ.pi/ | Any set of instructions for preparing a mixture of ingredients. |
| convert verb | /kənˈvɝt/ | To transform or change (something) into another form, substance, state, or product. |
| blend verb | /blɛnd/ | To mingle; to mix; to unite intimately; to pass or shade insensibly into each other. |
| ingredient noun | /ɪnˈɡɹiːdi.ənt/ | One of the substances present in a mixture, especially food. |
| symptom noun | /ˈsɪm(p)təm/ | A perceived change in some function, sensation or appearance of a person that indicates a disease or disorder, such as fever, headache or rash; strictly, a… |
| primarily adverb | /ˈpɹaɪ.mə.ɹə.li/ | Of a primary or central nature, first and foremost. |
| thick adjective | /θɪk/ | Relatively great in extent from one surface to the opposite in its smallest solid dimension. |
| refer verb | /ɹɪˈfɜː/ | To direct the attention of (someone toward something). |
| crystal noun | /ˈkɹɪstəl/ | A solid composed of an array of atoms or molecules possessing long-range order and arranged in a pattern which is periodic in three dimensions. |
Phrasal verbs you will hear
| Word | Pronunciation | Meaning |
|---|---|---|
| break down verb | To stop functioning. | |
| go off verb | To explode. | |
| make up verb | /ˌmeɪk ˈʌp/ | To constitute, to compose. |
| pass through verb | To go through, to travel through, to transit or lie across a place or from one place to another. | |
| pick up verb | To lift; to grasp and raise. | |
| show up verb | To appear, arrive, or attend, especially suddenly or erratically. | |
| sit out verb | To decline to participate; particularly, to decline to dance. | |
| wrap around verb | To move (text or other content) to the beginning of the next line when unable to fit it at the end of the current line. |
דקדוק בסרטון הזה
המבנים שהדובר משתמש בהם הכי הרבה, עם המילים המדויקות מהסרטון:
| מבנה | בסרטון |
|---|---|
| משפטי זיקה (Relative clauses) who / which + clause — מידע נוסף על אדם או דבר | hemoglobin, which is · walls, which are · hypomotility, which means |
| סביל (Passive voice) be + past participle — הדגש הוא על מה שקורה, לא על מי שעושה את הפעולה | is also known · are lined · are associated |
Pronunciation to watch
The speaker uses 6 contractions and reduced forms, such as don't, isn't, can't. Say them the short way, as you hear them.
- The “th” sounds: thick /θɪk/, smoothly /ˈsmuːðli/, smooth /smuːð/, thrive /θɹajv/, smoothie /ˈsmuːði/
- The “sh” and “zh” sounds: infection /ɪnˈfɛkʃən/, sharp /ʃɑɹp/, concentration /ˌkɑn.sənˈtɹeɪ.ʃən/, medication /mɛdɪˈkeɪʃən/, nutrition /njuːˈtɹɪʃ.ən/
- Long words — get the stress right: cholesterol /kəˈlɛstəɹɒl/, ingredient /ɪnˈɡɹiːdi.ənt/, primarily /ˈpɹaɪ.mə.ɹə.li/, similarly /ˈsɪm.ə.lə.li/, concentration /ˌkɑn.sənˈtɹeɪ.ʃən/
How to practise with this video
- Listen to the whole video once without speaking and note the words you do not know.
- Shadow it sentence by sentence at normal speed, repeating each one until your rhythm matches the speaker.
- Record yourself and compare with the original, paying attention to words like boil, cholesterol, calcium.
מהי טכניקת השאדואינג?
שאדואינג היא טכניקת למידת שפה מבוססת מדע שפותחה במקור להכשרת מתורגמנים מקצועיים ופופולרית על ידי הפוליגלוט ד"ר אלכסנדר ארגואלס. השיטה פשוטה אך עוצמתית: אתה מקשיב לאודיו באנגלית ילידית וחוזר עליו בקול רם מיד — כמו צל העוקב אחרי הדובר עם עיכוב של 1–2 שניות בלבד. בניגוד להאזנה פסיבית או תרגילי דקדוק, שאדואינג מכריח את המוח והשרירים בפה לעבד ולשחזר דפוסי דיבור אמיתיים בו זמנית. מחקרים מראים שזה משפר משמעותית את דיוק ההגייה, האינטונציה, הקצב, הדיבור המחובר, הבנת השמיעה ושטף הדיבור — מה שהופך אותו לאחת השיטות היעילות ביותר להכנה לIELTS Speaking ולתקשורת באנגלית בעולם האמיתי.