OET 2.0 READING EXERCISES - 1 File Download · 2020. 9. 26. · Overview of OET 2.0 Reading...

OET 2.0READINGSUB-TEST

EXERCISES& ANSWER KEY

VOL. 3

All rights reserved. No part of this book shall be reproduced, storedin a retrieval system, or transmitted by any means, electronic,

mechanical, photocopying, recording, or otherwise, without writtenpermission from the publisher, No patent liability is assumed withrespect to the use of the information contained herein, Although

every precaution has been taken in the preparation of this book, thepublisher and author assume no responsibility for errors or

omissions. Nor is any liability assumed for damages resulting fromthe use of the information contained herein.

OET is a registered trademark of Cambridge Boxhill LanguageAssessment Trust, which was not involved in the production of,

and does not endorse, this product.

PREFACEThis book is specifically designed for Amazon free kindle-reading app, which is supported on anydevice( smartphones, laptops, computers, ebook readers, etc) on any platforms (windows, android,apple ios, etc). Therefore, you can read this book on multiple devices you own.

How this book is different from other books available in themarket?Unlike paper books and other e books, you don’t have to scroll or turn pages back and forth whileanswering questions. One-touch navigation links (with one single touch you will execute the intendedaction) are available between each questions and their respective texts/paragraphs, and vice versa. Thiswill save you a lot of time, and makes your answering quicker.Apart from this, one-touch reference links are available for every word in this book (including anywords from paragraphs, questions, instructions, or even these words, which you are reading right now).There are mainly five types of reference links are available in this book. They are:1. Dictionary:– in-built dictionaries are available for referring any word you touch and hold. Thisfeature helps you save a lot of time by:

a. You don’t have to search through a paper bind dictionary to find the meaning of the word.b. You don’t have to check out a word list under the heading ‘vocabulary’ to improve your

vocabulary. While reading this book you can learn the meaning of words that you don’tknow, by just a single touch and hold over the unknown word that you find.

c. There is an in-built Oxford English dictionary available for your reference, which showsthe meaning in a pop up dialogue box. If you prefer detailed meaning or the meaning ofphrases related to the word, then you can easily choose full definition in the pop-up box forfurther details and pronunciation.

d. In-built English – Native languages dictionaries are also available, if you desire to knowmore about the word in your mother tongue. This will increase levels of understanding theword in detail and helpful to remember quickly later.

2. Wikipedia:– in-built Wikipedia reference is available for referring any word you touch and hold.This feature helps you save a lot of time by:

a. You don’t have to manually browse internet to find the Wikipedia reference of the word.

b. You can read Wikipedia reference without closing or minimizing the kindle app in whichyou are reading the book.

c. Wikipedia reference of the word you selected is available in both pop-up dialog box and indetail as you choose.

d. This helps in the better understanding of technical and technological terms.

3. Translation:– in-built quick translation to selected native language is available for referring anyword you touch and hold.4. Web-search:– helps you search about the word in your browser for an extended research.

5. In book search:– helps you find the selected word appearing in the book itself in other locations.

In addition to above-mentioned features, this book is totally customizable in kindle reading app. Youcan adjust the text size, font style, spacing and margins. You can also change color theme (backgroundcolor) from white(default) to black (for reading during night) or sepia (if you like background of realpaper bind book) or green (for vision(eye) –friendly reading). These options can be accessed byclicking ‘Aa’ button on the top tool bar that appear on every page.This book is fully supported in Amazon free kindle reading app; so, use only free kindle reading app toenjoy all the mentioned features.

ContentsEase of AccessOverview of OET 2.0 Reading Sub-TestMethod of AnsweringPractice Test 1Practice Test 2Practice Test 3Practice Test 4Practice Test 5Practice Test 6Practice Test 7Practice Test 8Practice Test 9Practice Test 10Practice Test 11Practice Test 12Practice Test 13Practice Test 14Practice Test 15Practice Test 16Practice Test 17Practice Test 18Practice Test 19Practice Test 20Answer Key

MOREOET 2.0 BOOKS

BYMAGGIE RYAN

Overview of OET 2.0 Reading Sub-Test

The topics are of generic healthcare interest and are therefore accessible tocandidates across all professions. The Reading sub-test contains three partsand a total of 42 question items, Part A accounts for 20 marks, Part Baccounts for 6 marks and Part C accounts for 16 marks. All three parts take atotal of 60 minutes to complete. You will not be given extra time at the end ofthe sub-test to check your answers, and it is up to you to manage your time.The test is designed so that the time available is enough for you to read,choose your answers, and check your work.

NB: Abbreviations are not accepted in the Reading sub-test unless theyappear in the texts.

NB: You must use correct spelling in the Reading sub-test to get the marks.Responses that are not spelled correctly will not receive any marks. Americanand British English spelling variations are accepted, e.g., color and colour areboth acceptable.

Part A – 15 minutes

Reading Part A tests your ability to skim and scan quickly across differenttexts on a given topic in order to locate specific information. For thatpurpose, Part A is strictly timed and you must complete all 20 question itemswithin the allocated 15 minutes. To complete the task successfully, you willalso need to understand the conventions of different medical text types andunderstand the presentation of numerical and textual information. The 20questions consist of matching, sentence completion and short answerquestions.

NB: In Part A you should write your answers clearly in the spaces given inthe question booklet.

NB: Please remember that there is a strict time limit for Part A, and Part Amaterials will be collected from you after 15 minutes. You will therefore nothave any time to check your Part A answers later in the test.

NB: In Part A you must use exactly the same form of the word or shortphrase as given in the four texts.

Part B and Part C – 45 minutes

NB: In Part B and Part C, you must shade the circle next to the appropriateanswer. Answers written elsewhere in your booklet will not be marked.

Part B

Part B assesses your ability to identify the detail or main point of six shorttexts sourced from the healthcare workplace. The texts might consist ofextracts from policy documents, hospital guidelines, manuals or internalcommunications, such as emails or memos. For each text, there is one three-option multiple-choice question. To complete the task successfully, you willneed to identify specific ideas at sentence level.

Part C

Part C assesses your ability to identify detailed meaning and opinion in twotexts on topics of interest to healthcare professionals. For each text, you mustanswer eight four-option multiple choice questions. Reading Part C tests yourability to understand the explicit or implied meaning as well as the attitude oropinion presented in a longer text. To complete the task successfully, youwill need to identify the relationship between ideas at sentence and paragraphlevel. Part C also tests your ability to accurately understand lexical referencesand complex phrases within the text.

METHOD OF ANSWERINGSTEP 1.

FLASH READINGFlash reading refers to high-speed reading of the whole reading passage infew minutes, without thinking anything in your head (not even trying to guessmeaning of the unfamiliar words/phrases). It helps to provide a vague ideaabout the matters that are discussed in the reading passage. It also forms aclear map in mind showing the order of statements as they appear in thepassage, which eases locating the extract/paragraph referred in questionswhile answering.

STEP 2.FOCUSED READING

After finishing flash reading, start answering the questions. Eliminate all theirrelevant and impossible options from the multiple choices. Find a quick fixon location of the extract/paragraph referred in the questions and read theextract/paragraph quickly (strictly not more than twice, if it is a paragraphand not more than thrice if it is a short extract) with complete focus. Write theanswer you had found only if you are sure enough.If the answer is confusing (if you find more than one possible answer for thequestion), write the answer you think to have more possibility to be correcton your answer sheet, along noting the question and two or three otherpossible answer for later reference. This will avoid wastage of time due tofixating over confusing questions.If the question is so tough that you fail to find a proper answer to it, thenleave it blank and note the question number for later reference. Focusedreading helps to answer all easy question in the reading test correctly, insteadof losing marks on them in the last minute rush.

STEP 3.THOROUGH READING

After finishing all the questions in the test, you can start answering the toughquestions by reading thoroughly the referred extract/paragraph by reading.Thorough reading refers to slow reading with maximum concentration to findall possible meanings between the lines, so that you arrive at a possibleanswer. Don’t read more than twice.

After finishing tough questions, start answering questions with confusinganswers in the same manner. If you follow these three steps you can spendtime wisely, while attending a reading test. Avoid wasting time by going aftertips for reading, when you are not getting desired results.There are only two things that can improve your OET reading score:1. Efficient management of time2. Practicing more and more reading sample tests.

WORK HARD, SCORE MORE!

Practice Test 1

READING SUB-TEST – QUESTION PAPER: PART A

TIME: 15 MINUTES

INSTRUCTIONS TO CANDIDATES:

DO NOT open this Question Paper or the Text Booklet until you are toldto do so. Write your answers on the spaces provided on this Question Paper.You must answer the questions within the 15-minute time limit.One mark will be granted for each correct answer.Answer ALL questions. Marks are NOT deducted for incorrect answers.At the end of the 15 minutes, hand in this Question Paper and the TextBooklet. DO NOT remove OET material from the test room.

Text A

ALZHEIMER’S DISEASE

When one is affected by disease, neurons in the brain are progressivelydestroyed and the transmission of signals across the synapses is disrupted.Over time, nerve cell death and tissue loss results in dramatic shrinkage ofthe brain and loss of brain function, affecting learning and memory, thinkingand planning, speech and communication, and eventually involving virtuallyall areas of brain function. It is normal to suffer occasional lapses of memory,especially with advancing age. However, serious memory loss, confusion anddifficulties with thinking that interfere with daily functioning could indicatesome form of dementia. Alzheimer’s disease accounts for 50 to 70 per cent ofdementia.

While it is more common in older people, even people in their 30s and 40smay have early-stage of Alzheimer’s. While there is no cure, there aretreatments that may help slow or delay progression and assist with symptoms.Symptoms may be cognitive {affecting memory, language. judgment andplanning) or behavioural and psychiatric {such as emotional distress,

uncontrolled outbursts, yelling and paranoia}. Depending on the nature andseverity of symptoms, a doctor can advise which medicines and supportivemeasures may help. Early diagnosis and assessment is vital for futureplanning as well as to maximise opportunities to take advantage of availabletreatments.

Go toQuestions

“1” “2” “3” “4” “5” “6” “7” “8” “9” “10”“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”

Text B

Treatment OptionsMEDICATIONSCholinesteraseinhibitors

Most effective at early stage of disease.

PROCEDURESCounselling Helps patients cope with trauma and

loss.Physical therapies Improve mobility, speech, daily

function.NATURAL METHODSHerbs Ginkgo biloba and huperzine AVitamins Antioxidants help protect brain coils

Go toQuestions

“1” “2” “3” “4” “5” “6” “7” “8” “9” “10”“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”

Text C

Launch of Australia’s first dementia and exercise study

National Ageing Research Institute [NARI] has started recruiting volunteersfor an Australian-first study to assess whether physical activity can improvethe memory, concentration and well being of people with Alzheimer’sDisease [AD]. The collaborative study, officially launched at NARI in June,also involves the Universities of Melbourne, Western Australia and

Queensland. Alzheimer’s Australia is also supporting Fitness at the AgeingBrain Study II [known as FABS II]. At the launch, Professor NicolaLautenschlager, who heads the study, highlighted how her earlier researchhad shown that regular exercise improved brain function in older people. Thehope is that a physical activity program will also benefit people with mild tomoderate AD.

“Several medications are available to treat AD but this isn’t enough to helpfamilies deal with this complex problem. We are pleased to be looking at anon-pharmacological option,” says Professor Lautenschlager. The physicalactivity program involves a commitment of 150 minutes a week, which isabout 20 minutes daily. Walking is the most popular physical activity forolder people but the program will be tailored to each person’s interests.Before stoning the program, participants will be assessed on aspects likemuscle strength, flexibility, balance and memory function.

Go toQuestions

“1” “2” “3” “4” “5” “6” “7” “8” “9” “10”“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”

Text D

Exercise and Alzheimer’s disease (University of Washington study published in Annals of InternalMedicine)

The study followed 1,740 people aged 65 and older over a six-yearperiod. At the start of the study none showed signs of dementia.After six years, 158 participants had developed dementia, of which 107had been diagnosed with Alzheimer’s disease.People who exercised three or more times a week had a 30% to 40%lower risk of developing dementia compared with those who exercisedfewer than three times per week.Lead researcher Dr. Eric Larson said walking for 15 minutes threetimes a week was enough to out the risk.

Go toQuestions

“1” “2” “3” “4” “5” “6” “7” “8” “9” “10”“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”

Part ATIME: 15 minutes• Look at the four texts, A-D, in the separate Text Booklet.• For each question, 1-20, look through the texts, A-D, to find the relevantinformation.• Write your answers on the spaces provided in this Question Paper.• Answer all the questions within the 15-minute time limit.• Your answers should be correctly spelt.

QUESTIONS

Questions 1-7For each question, 1-7, decide which text (A, B, C or D) the information comes from. You may use anyletter more than once.

In which text can you find information about1. what is the most effective medications at early stage of AD? _____

Goto

“TextA”

“TextB”

“TextC”

“TextD”

2. where did the study by the University of Washington was published? _____Goto

“TextA”

“TextB”

“TextC”

“TextD”

3. what are the cognitive symptoms of Alzheimer’s disease? _____Goto

“TextA”

“TextB”

“TextC”

“TextD”

4. what does ‘NARI’ stands for? _____Goto

“TextA”

“TextB”

“TextC”

“TextD”

5. who was the lead researcher in the University of Washington study? _____Goto

“TextA”

“TextB”

“TextC”

“TextD”

6. who is supporting FABS II? _____Goto

“TextA”

“TextB”

“TextC”

“TextD”

7. what are the behavioural and psychiatric symptoms of AD? _____Go “Text “Text “Text “Text

to A” B” C” D”

Questions 8-13Answer each of the questions, 8-13, with a word or short phrase from one of the texts. Each answermay include words, numbers or both.

8. How many subjects were there in the University of Washington study?Goto

“TextA”

“TextB”

“TextC”

“TextD”

9. What is the most popular physical activity in the physical activity program?Goto

“TextA”

“TextB”

“TextC”

“TextD”

10. Which procedure helps the patients cope with trauma and loss?Goto

“TextA”

“TextB”

“TextC”

“TextD”

11. Who can advise medicines and supportive measures for AD?Goto

“TextA”

“TextB”

“TextC”

“TextD”

12. Which procedures improve the mobility of the patients with AD?Goto

“TextA”

“TextB”

“TextC”

“TextD”

13. what can improve the brain function in older people?Goto

“TextA”

“TextB”

“TextC”

“TextD”

Questions 14-20Complete each of the sentences, 14-20, with a word or short phrase from oneof the texts. Each answer may include words, numbers or both.14. According to_____, walking for 15 minutes three times a week canminimize the risk of AD.

Goto

“TextA”

“TextB”

“TextC”

“TextD”

15. _____ aren’t enough to help families deal with the complex problem ofAD.

Go “Text “Text “Text “Text

to A” B” C” D”16. _____ like Ginkgo biloba, are used for the treatment of AD.

Goto

“TextA”

“TextB”

“TextC”

“TextD”

17. _____ is hoped to benefit people with mild to moderate AD.Goto

“TextA”

“TextB”

“TextC”

“TextD”

18. _____ contains antioxidants that help to protect the brain coils.Goto

“TextA”

“TextB”

“TextC”

“TextD”

19. At the start of the University of Washington study _____ showed signs ofdementia.

Goto

“TextA”

“TextB”

“TextC”

“TextD”

20. When one is affected by AD, neurons in the brain are ______.Goto

“TextA”

“TextB”

“TextC”

“TextD”

Answer Key“Practice Test 1”

Practice Test 2READING SUB-TEST – QUESTION PAPER: PART B & C

TIME: 45 MINUTES


DO NOT open this Question Paper or the Text Booklet until you are toldto do so. Write your answers on the spaces provided on this Question Paper.You must answer Part B & C within the 45-minute time limit.One mark will be granted for each correct answer.Answer ALL questions. Marks are NOT deducted for incorrect answers.At the end of the 45 minutes, hand in this Question Paper and the TextBooklet. DO NOT remove OET material from the test room.

Part B

In this part of the test, there are six short extracts relating to the work ofhealth professionals. For questions 1-6, choose the answer (A, B or C)which you think fits best according to the text.

Biopotential Amplifiers

Biosignals are recorded as potentials, voltages, and electrical field strengthsgenerated by nerves and muscles. The signals need to be amplified to makethem compatible with devices such as displays, recorders, or A/D convertersfor computerized equipment. Amplifiers adequate to measure these signalshave to satisfy very specific requirements. They have to provideamplification selective to the physiological signal, reject superimposed noiseand interference signals, and guarantee protection from damages throughvoltage and current surges for both patient and electronic equipment.Amplifiers featuring these specifications are known as biopotentialamplifiers.

1. The manual informs us that the Biopotential Amplifiers

A. record potentials, voltages, and electrical field strengths generated bynerves and musclesB. amplify biosignals to make them compatible with devices such as displaysor recordersC. provide amplification selective to superimposed noise and interferencesignals

Implantable Cardiac Pacemakers

The modern pacing system is comprised of three distinct components: pulsegenerator, lead, and programmer. The pulse generator houses the battery andthe circuitry which generates the stimulus and senses electrical activity. Thelead is an insulated wire that carries the stimulus from the generator to theheart and relays intrinsic cardiac signals back to the generator. Theprogrammer is a telemetry device used to provide two-way communicationsbetween the generator and the clinician. It can alter the therapy delivered bythe pacemaker and retrieve diagnostic data that are essential for optimallytitrating that therapy.

2. What does this manual tell us about the programmer ?A. used to provide communications between generator and leadB. can alter the therapy delivered by the pacemakerC. retract essential diagnostic data for optimally titrating the therapyExternal Defibrillators

Defibrillators are devices used to supply a strong electric shock to a patient inan effort to convert excessively fast and ineffective heart rhythm disorders toslower rhythms that allow the heart to pump more blood. Externaldefibrillators have been in common use for many decades for emergencytreatment of life-threatening cardiac rhythms as well as for elective treatmentof less threatening rapid rhythms. The most serious arrhythmia treated by adefibrillator is ventricular fibrillation. Without rapid treatment using adefibrillator, ventricular fibrillation causes complete loss of cardiac functionand death within minutes.

3. What does this extract from a handbook tell us about externaldefibrillators?

A. used only in the treatment of life-threatening cardiac rhythmsB. used mostly for elective treatment of less threatening rapid rhythmsC. convert excessively fast and ineffective heart rhythms to slower rhythmsThermopositive (warm) wet treatment

The warm wet treatment includes showers and baths, i.e. used therapeuticallyin addition to washing. They have an overall effect. They are used in thetreatment of scars, burns, when preheating the body before exercise, whenreplacing bandages after surgery, etc. Baths are used on part of or all of thebody. Essential oils can be also used in bath therapy. Warm wet therapy iswidely used in balneology.

4. The notice is giving information aboutA. therapeutic uses of showers and bathsB. importance of essential oils in bath therapyC. when and where the warm wet treatment is usedSpecial oral care

Patients with febrile illnesses, after a stroke, with paralysis of the facialnerve, after surgery, after injury, or unconscious and dying patients sufferfrom an accumulation of mucus in their mouth and coated mucousmembrane. A patient can breathe in the accumulated mucus and the mucousmembrane coatings cause bad breath. Defects on the tongue make suckingand chewing difficult. Oral hygiene must be administered as required, severaltimes per day.

5. The guidelines establish that the healthcare professional shouldA. administer oral hygiene several times per dayB. aware of accumulation of mucus in certain patientsC. provide oral care several times per day, if neededPlaster bandages

Plaster bandages are impregnated with plaster. They provide reliable fixationof the broken bone. It is a hydrofile bandage which is impregnated with fineplaster. The bandages are wrapped in moisture-proof packaging; moisturewould harden the plaster and the bandage would be spoiled. Before use, thebandage is soaked in a 40 °C hot water; the bandage is not moved at thispoint so as not to spill the plaster. Then it is removed and gently wrung andthen immediately attached. Attaching requires experience as it must be done

quickly – the time for moulding the bandage is short (2 - 3 minutes).

6. The guidelines require those undertaking the preparation of plasterbandages toA. do attaching quickly, only if you are experiencedB. avoid spilling the plaster during the processC. soak plaster and the bandage in a 40 °C hot water


Practice Test 3

READING SUB-TEST – QUESTION PAPER: PART B & C

TIME: 45 MINUTES



Part CIn this part of the test, there are two texts about different aspects ofhealthcare. Choose the answer (A, B, C or D) which you think fits bestaccording to the text.

Does Tamiflu really work?Paragraph 1 The British Medical Journal (BMJ) was dominated in 2009 by a cluster ofarticles on oseltamivir (Tamiflu). Between them the articles conclude that theevidence that oseltamivir reduces complications in otherwise healthy peoplewith pandemic influenza is now uncertain and that we need a radical changein the rules on access to trial data.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”

Paragraph 2 The use of meta-analysis is governed by the Cochrane review protocol.Cochrane Reviews investigate the effects of interventions for prevention,treatment and rehabilitation in a healthcare setting. They are designed tofacilitate the choices that doctors, patients, policy makers and others face inhealth care. Most Cochrane Reviews are based on randomized controlled

trials, but other types of evidence may also be taken into account, ifappropriate.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 3 If the data collected in a review are of sufficient quality and similar enough,they are summarised statistically in a meta-analysis, which generally providesa better overall estimate of a clinical effect than the results from individualstudies. Reviews aim to be relatively easy to understand for non-experts(although a certain amount of technical detail is always necessary). Toachieve this, Cochrane Review Groups like to work with “consumers”, forexample patients, who also contribute by pointing out issues that areimportant for people receiving certain interventions. Additionally, theCochrane Library contains glossaries to explain technical terms.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 4 Briefly, in updating their Cochrane review, published in late 2009. TomJefferson and colleagues failed to verify claims, based on an analysis of 10drug company trials, that oseltamivir reduced the risk of complications inhealthy adults with influenza. These claims have formed a key part ofdecisions to stockpile the drug and make it widely available.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 5 Only after questions were put by the BMJ and Channel 4 News has themanufacturer Roche committed to making “full study reports” available on apassword protected site. Some questions remain about who did what in theRoche trials, how patients were recruited, and why some neuropsychiatricadverse events were not reported. A response from Roche was published inthe BMJ letters pages and their full point by point response is publishedonline.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 6 Should the BMJ be publishing the Cochrane review given that a morecomplete analysis of the evidence may be possible in the next few months?

Yes, because Cochrane reviews are by their nature interim rather thandefinitive. They exist in the present tense, always to be superseded by thenext update. They are based on the best information available to thereviewers at the time they complete their review. The Cochrane reviewershave told the BMJ that they will update their review to incorporate eightunpublished Roche trials when they are provided with individual patient data.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 7 Where does this leave oseltamivir, on which governments around the worldhave spent billions of pounds? The papers in last years journal relate only toits use in healthy adults with influenza. But they say nothing about its use inpatients judged to be at high risk of complications- pregnant women, childrenunder 5, and those with underlying medical conditions; and uncertainty overits role in reducing complications in healthy adults still leaves it as a usefuldrug for reducing the duration of symptoms. However, as Peter Doshi pointsout on this outcome it has yet to be compared in head to head trials with non-steroidal inflammatory drugs or paracetamol. And given the drug’s knownside effects, the risk-benefit profile shifts considerably if we are talking onlyin terms of symptom relief.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 8 We don’t know yet whether this episode will turn out to be a decisive battleor merely a skirmish in the fight for greater transparency in drug evaluation.But it is a legitimate scientific concern that data used to support importanthealth policy strategies are held only by a commercial organisation and havenot been subject to full external scrutiny and review. It can’t be right that thepublic should have to rely on detective work by academics and journalists topatch together the evidence for such a widely prescribed drug. Individualpatient data from all trials of drugs should be readily available for scientificscrutiny.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”QUESTIONS

Q1. A cluster of articles on oseltamivir in the British Medical Journalconclude__________

a. complication are reduced in healthy people by oseltamivirb. the efficacy of Tamiflu in now in doubtc. complications from pandemic influenza are currently uncertaind. a series of articles supporting Tamiflu

Back to “1”“2”“3”“4”Paragraphs“5”“6”“7”“8”

Q2. Cochrane Reviews are designed to __________a. set randomized controlled trials to specific valuesb. compile literature meta-analysisc. peer review articlesd. influence doctors choice of prescription


Q3. According to the article, which one of the following statements aboutTamiflu is FALSE?a. The use of randomized controls is suspectb. The efficacy of Tamiflu is certainc. Oseltamivir induces complications in healthy peopled. Cochrane reviews are useful when examining the efficacy of Tamiflu


Q4. According to the article, Cochrane Review Groups __________a. like to work for “consumers”.b. are being overhauled.c. use language suitable for expert to expert communication.d. evaluate a clinical effect better than individual studies.


Q5. Which would make the best heading for paragraph 4?a. Analysis of 10 drug company trialsb. The stockpiling of Oseltamivirc. Risk of complications in healthy adultsd. Tamiflu claims fail verification

Back to “1”“2”“3”“4”

Paragraphs“5”“6”“7”“8”Q6. According to the article, which one of the following statements aboutRoche is TRUE?a. Full study reports were made freely available on the internetb. Patients were recruited through a double blind trialc. The identities and roles of researcher in the Roche trials are not fullyaccounted ford. Not all neuropsychiatric adverse events were reported


Q7. Cochrane reviews should __________a. use a more complete analysisb. not be published until final data is availablec. be considered interim rather than definitive adviced. be superseded by a more reliable method of reporting results


Q8. Which would make the best heading for paragraph 7?a. Risk-benefit profile of Tamiflub. Studies limited to healthy adultsc. High risk of complicationsd. Oseltamivir only for high risk patients


Answer Key“”“Practice Test 3”

Practice Test 4


TIME: 45 MINUTES




Miracle Jab Makes Fat Mice Thin

Paragraph 1After a four-week course of treatment with a protein called ob, the fat simplyfalls off, leaving vastly overweight mice slim, active and sensible eaters. Ifthe protein has the same effect on people, it could be the miracle curemillions have been waiting for that at least, is the theory. But skeptics warnthat too little is known about the way the human version of the ob proteinworks to be sure that extra doses would help people lose weight.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 2 But when the results of the tests were leaked last week, Amgen, theCalifornian biotechnology company which owns exclusive rights to developproducts based on the protein, saw an overnight jump in its share price.

Questions

“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 3 Last December, a team led by Jeffrey Friedman and his colleagues at theHoward Hughes Medical Institute at the Rockefeller University, New York,discovered a gene, which they called ob. In mice, a defect in this gene makesthem grow hugely obese. Humans have an almost identical gene, suggestingthat the product of the gene - the ob protein - plays a part in appetite control,The ob protein is a hormone, which Friedman has dubbed leptin.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 4In April, Amgen, which is based in Thousand Oaks, California, paid theinstitute $20 million for exclusive rights to develop products based on thediscovery. Amgen will carry out safety tests on the protein in animals nextyear, and hopes to begin clinical trials on people within a year.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 5 The excitement began last week when the journal Science published thefindings of three groups which have been working on the protein. The resultsin obese mice with a defective gene that prevents them making the proteinwere dramatic. Mary Ann Pelleymounter and her colleagues at Amgen gaveobese mice shots of the protein every day for a month. Those on the highestdose lost an average of 22 percent of their weight.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 6 “Before treatment, these mice overate, had lower metabolic rates thannormal, lower temperatures, and raised E levels of insulin and glucose intheir blood.” says Pelleymounter. “The protein brought all of these back tonormal levels,” she says.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 7 More significantly, in terms of the potential for a human slimming drug, thetreatment also worked on normal mice, which lost what little spare fat theyhad. They lost between 3 and 5 percent of their body weight, almost all of it

in the form of fat, according to Pelleymounter. This is important because noone has identified a mutation in the human ob gene that might lead to obesity,suggesting that whatever the cause for obesity, the ob protein might still helppeople lose weight.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 8 Friedman and his team carried out similar experiments. In just one month,their obese mice shed around half their body fat. In the average obese mouse,fat makes up about 60 percent as much as untreated animals. Their fat ispractically melted away, falling to 28 per cent of their body weight after amonth. In normal mice, treatment reduced the amount of fat from an averageof 12.22 percent of body weight to a spare 0.67 percent.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 9 Friedman and Pelleymounter believe that the protein, which is produced byfat cells, regulates appetite. “We think it’s something like a circulatinghormone to tell the brain there are normal amounts of fat, or too much, inwhich case the brain turns down your appetite,” says Pelleymounter.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 10 The experiments also show that treated mice have an increased metabolicrate, suggesting that they burn fat more efficiently. Their appetites decrease— and they are less sluggish, becoming as active as normal mice.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 11 The third group of researchers from the Swiss Pharmaceuticals companyHoffman-La Roche, are more skeptical about how significant the ob proteinmight be in treating obesity. From their studies, they conclude that the proteinis just one of many factors that control appetite and weight. “This is a veryimportant signal, but it’s one of several.” says Arthur Campfield, who led theteam.


Paragraph 12 Campfield doubts whether the ob protein alone will have much effect inoverweight humans. His team hopes to unravel the whole signaling systemthat regulates weight, and is particularly keen to find the receptor in the brainthat responds to the ob hormone. Hoffman-La Roche, excluded by the Amgenlicense to deal from developing products based on the ob protein itself, hopesto develop pills that interfere with message pathways in appetite control.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 13 Stephen Bloom, professor of endocrinology at London s HammersmithHospital, agrees, “l think the work with ob is a major advance, but we’ve notgot the tablet yet. That will come when people have made a pill thatstimulates the ob receptor in the brain so it switches off appetite.”

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 14 Even Pelleymounter at Amgen cautions against over optimism at this stage.“We don’t know whether it would be true that people would lose weight, butyou can predict from mice that it would have some positive effect,” she says.“However, I don’t think obese people should hold out for this. They shouldcarry on with their exercises and dieting.


Q1. The first paragraph informs the reader that.a) A protein treatment has caused mice to lose weight dramatically.b) A protein treatment for mice cannot be adapted for use in humans.c) Scientists agree that a new protein treatment will make people lose weight.d) A scientific method of making obese people slim has been developed.

Back to “1”“2” “3” “4” “5” “6” “7”Paragraphs“8”“9”“10”“11”“12”“13”“14”

Q2. The reader can infer from the second paragraph thata) The public is skeptical about the possibility of developing a scientificslimming method.b) The Californian company, Amgen, is eager to share its new-found

technical knowledge.c) Several companies will be able to develop products based on the results ofthe research.d) Many people are confident that a product which guarantees weight losswill sell very well.


Q3. Friedman and his colleagues found that a genetic defect in the genecalled oba) Causes obesity in mice.b) Causes obesity in humans and mice.c) Has the same structure in mice and humans.d) Produces a protein called leptin.


Q4. According to Friedman and his colleagues, the ob proteina) May be transferred from mice to humans.b) May be a factor in appetite control.c) Is produced by the ob hormone.d) Is mainly found in obese mice.


Q5. According to the article, the Californian company called Amgena) Was paid $20 million by the Howard Hughes Institute.b) Intends to use humans to test new products based on the ob protein.c) Has begun to trial new products based on the ob protein.d) Is one of several companies trialling products based on the ob protein.


Q6. A study by Mary Ann Pelleymounter and her colleagues found thata) The ob protein caused subjects in the study to decrease their metabolicrate.b) The ob protein caused people to lose about twenty percent of their weight.c) A deficiency in the ob protein had caused obesity in the subjects.d) A defective ob gene resulted in the production of the ob protein.


Q7. According to the Friedman and Pelleymounter studies, treatment with obproteina) May be useful only for people with a defective ob gene.b) May be useful for anyone who wants to lose Weight.c) Is effective only on mice with a defective ob gene.d) Will not be effective on people who want to lose weight.


Q8. The evidence gathered in Friedman’s and Pelleymounter’s studiesa) Demonstrates conclusively that the ob protein controls appetite.b) Proves that the ob protein causes animals to lose 40 percent of theirWeight.c) Suggests that the ob protein is a factor in determining appetite.d) Suggests that the normal amount of fat is 0.67 percent of bodyweight.



Practice Test 5


TIME: 15 MINUTES



GlaucomaText AGlaucomaDescriptionGlaucoma is the name given to a group of eye diseases in which the opticnerve at the back of the eye is slowly destroyed. In most people this damageis due to an increased pressure inside the eye - a result of blockage of thecirculation of aqueous, or its drainage. In other patients the damage may becaused by poor blood supply to the vital optic nerve fibers, a weakness in thestructure of the nerve, and/or a problem in the health of the nerve fibresthemselves. Over 146,000 Australians have been diagnosed with glaucoma.While it is more common as people age, it can occur at any age. Glaucoma isalso far less common in the indigenous population.SymptomsChronic (primary open-angle) glaucoma is the commonest type. It has nosymptoms until eyesight is lost at a later stage.PrognosisDamage progresses very slowly and destroys vision gradually, starting withthe side vision. One eye covers for the other, and the person remains unawareof any problem until a majority of nerve fibres have been damaged, and a

large part of vision has been destroyed. This damage is irreversible.TreatmentAlthough there is no cure for glaucoma it can usually be controlled andfurther loss of sight either prevented or at least slowed down. Treatmentsinclude: Eyedrops - these are the most common form of treatment and mustbe used regularly. Laser (laser trabeculoplasty) - this is performed when eyedrops do not stop deterioration in the field of vision. Surgery(trabeculectomy) - this is performed usually after eye drops and laser havefailed to control the eye pressure. A new channel for the fluid to leave the eyeis created. Treatment can save remaining vision but it does not improve eyesight.

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Text BTable 1: Study of eye pressure and corneal thickness as predictors ofGlaucoma.

Intraocular pressure (IOP) Central corneal thickness (CCT) andGlaucoma correlations.

Centralcorneal

thickness

Intraocularpressure

Intraocular pressure +Central corneal

thickness

Predictor ofdevelopment ofglaucoma (r²)

thickness of555 microns orless

.36*

thickness ofmore than 588microns

-.13*

pressure ofless than 21mmHg

.38*

pressure ofmore than 22mmHg

.07*

Thickness less than 555 -.49*

and pressure less than 21mmHg

*power >.05

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Text COther forms of Glaucoma.• Low-tension or normal tension glaucoma. Occasionally optic nerve damagecan occur in people with so-called normal eye pressure.• Acute (angle-closure) glaucoma. Acute glaucoma is when the pressureinside the eye rapidly increases due to the iris blocking the drain. An attack ofacute glaucoma is often severe. People suffer pain, nausea, blurred vision andredness of the eye.• Congenital glaucoma. This is a rare form of glaucoma caused by anabnormal drainage system. It can exist at birth or develop later.• Secondary glaucomas. These glaucomas can develop because of otherdisorders of the eye such as injuries, cataracts, eye inflammation. The use ofsteroids (cortisone) has a tendency to raise eye pressure and thereforepressures should be checked frequently when steroids are used.

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Text D

Overview of Glaucoma Facts• Glaucoma is the leading cause of irreversible blindness worldwide.• One in 10 Australians over 80 will develop glaucoma.• First degree relatives of glaucoma patients have an 8-fold increased risk ofdeveloping the disease.• At present, 50% of people with glaucoma in Australia are undiagnosed.• Australian health care cost of glaucoma in 2017 was $342 million.• The total annual cost of glaucoma in 2017 was $1.9 billion.• The total cost is expected to increase to $4.3 billion by 2025.• The dynamic model of the economic impact of glaucoma enables cost-effectiveness comparison of various interventions to inform policydevelopment.

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QUESTIONS


In which text can you find information about1. which is the rare form of glaucoma? _____

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2. what is the leading cause of irreversible blindness in the world? _____Goto

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3. what has the highest value for the predictor of development of glaucoma?_____

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4. which is the most common form of glaucoma?? _____Goto

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5. what has the lowest value for the predictor of development of glaucoma?_____

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6. what was the total annual cost of glaucoma in 2017? _____

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7. what is the most common form of treatment for glaucoma? _____Goto

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8. Which form of glaucoma can develop due to eye inflammation?Goto

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9. What is the predicted total cost of glaucoma in 2025?Goto

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10. What is the predictor of development of glaucoma for intraocular pressure morethan 22 mmHg?

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11. How many Australians have been diagnosed with glaucoma?Goto

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12. What was the Australian health care cost of glaucoma in 2017?Goto

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13. what is the current percentage of undiagnosed glaucoma patients inAustralia?

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Questions 14-20Complete each of the sentences, 14-20, with a word or short phrase from oneof the texts. Each answer may include words, numbers or both.14. Glaucoma is a group of eye diseases in which the _____ is slowly

destroyed.Goto

“TextA”

“TextB”

“TextC”

“TextD”

15. First degree relatives of glaucoma patients have _____ increased risk ofdeveloping the disease.

Goto

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“TextD”

16. _____ can cause pain, nausea, blurred vision and redness of the eye.Goto

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17. Steroids such as _____ has a tendency to raise eye pressure.Goto

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“TextC”

“TextD”

18. Glaucoma is far less common in the _____.Goto

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19. _____ has no symptoms until eyesight is lost at a later stage.Goto

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20. Laser trabeculoplasty is performed when ____ don’t stop deterioration inthe field of vision.

Goto

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“TextB”

“TextC”

“TextD”



TIME: 45 MINUTES



Part B


Parenteral Infusion Devices

Intravenous (IV) and intraarterial access routes provide an effective pathwayfor the delivery of fluid, blood, and medicants to a patient’s vital organs.Consequently, about 80% of hospitalized patients receive infusion therapy. Avariety of devices can be used to provide flow through an intravenouscatheter. An intravenous delivery system typically consists of three majorcomponents: (1) fluid or drug reservoir, (2) catheter system for transferringthe fluid or drug from the reservoir into the vasculature through avenipuncture, and (3) device for regulation and/or generating flow.

1. What does this extract tell us about parenteral infusion devices?A. used to provide flow through an intravenous catheterB. 80% of hospitalized patients receive parenteral infusion devices

C. provide an effective pathway for the delivery of fluid, bloodBiomedical Lasers

Three important factors have led to the expanding biomedical use of lasertechnology, particularly in surgery. These factors are: (1) the increasingunderstanding of the wave-length selective interaction and associated effectsof ultraviolet- infrared (UV-IR) radiation with biologic tissues, includingthose of acute damage and long-term healing, (2) the rapidly increasingavailability of lasers emitting (essentially monochromatically) at those wave-lengths that are strongly absorbed by molecular species within tissues, and(3) the availability of both optical fiber and lens technologies as well as ofendoscopic technologies for delivery of the laser radiation to the often remoteinternal treatment site.

2. The purpose of these notes about Biomedical Lasers is toA. state the factors that led to the expanding biomedical use of lasertechnologyB. give valid reasons for the increase in the biomedical use of lasers insurgeryC. recommend an alternate for ultraviolet- infrared (UV-IR) radiation inbiomedical use

Infant Monitor

Many infants are being monitored in the home using apnea monitors becausethey have been identified with breathing problems. These include newbornpremature babies who have apnea of prematurity, siblings of babies who havedied of sudden infant death syndrome, or infants who have had an apparentlife-threatening episode related to lack of adequate respiration. Rather thankeeping infants in the hospital for a problem that they may soon outgrow,doctors often discharge them from the hospital with an infant apnea monitorthat measures the duration of breathing pauses and heart rate and sounds analarm if either parameter crosses limits prescribed by the doctor.

3. The notice is giving information aboutA. the circumstances for prescribing the infant monitor by the doctorB. why infants shouldn’t be discharged from the hospital with infant monitorC. why infants unidentified with breathing problems need infant monitor

Postoperative complications

Surgery and anesthesia are stressful events for the patient. The patienthandles stress in accordance with their overall condition, the nature of thesurgery and associated diseases. Post traumatic stress disorder (stresssyndrome) can be expected in all patients following surgery. This is anoverall and local response of the organism to stress and its effort to cope withthe strain. It is a physiological reaction of the organism to stress, which in theworst case scenario can become a pathological or a post-operativecomplication.

4. What does this extract tell us about post traumatic stress disorder?A. It is a physiological reaction of the patient to stress.B. It is only a local response of the patient to stress.C. It can definitely turn into a post-operative complication.

Rinses

These are prescribed when redressing necrotic, infected wounds. The rinse,especially with antiseptic solution for clean, granulating and epithelizingwounds is not substantiated. The wound rinse helps to clean the wound ofearly leaching residues, coatings, necrotic tissue, pus, blood clots, toxins orresidues of bacterial biofilm. Rinsing a colonized chronic wound reduces theexisting microbial population.• Solutions suitable for application to wounds: Prontosan solution, Ostenisept,Dermacin, DebsriEcaSan• Less suitable solutions: Betadin, Braunol, saline, Permanganate• Solutions not suitable for application to wounds: Chloramin, Persteril,Rivanol, Jodisol.

5. The email is reminding staff that theA. benefits of rinses to patients using suitable solutions.B. solutions less suitable should not be applied to wounds.C. epithelizing wounds should be rinsed with antiseptic solution.

Drains and drainage systems

Drains are used to drain physiological or pathological fluids from the body.

The use of drains and drainage systems in surgery significantly affects theoverall healing process. The accumulated fluid can endanger the whole bodyas it has a mechanical and toxic effect on the surrounding tissue and is abreeding ground for microorganisms. Drains are used to drain fluids frombody cavities, organs, wounds and surgical wounds (e.g. blood, woundsecretion, bile, intestinal contents, pus etc.) and air (chest drainage).

6. The purpose of these notes about drains and drainage systems is toA. help maximize efficiency of healing process.B. give guidance on certain medical procedures.C. avoid accumulation of fluid in body cavities.Answer Key

“Practice Test 6”

Practice Test 7


TIME: 45 MINUTES




AIDS deaths blamed on immune therapy

Paragraph 1THE DEATHS of three patients during trials of an experimental immunetherapy for people with AIDS have renewed controversy over experimentscarried out by the French scientist Daniel Zagury. The affair has alsohighlighted shortcomings in the system of checks and controls over clinicalresearch. The French health minister, Bruno Durieux, recently announced thatan inquiry had cleared Zagury and his team at the Pierre and Marie CurieUniversity in Paris of alleged irregularities in the way they conducted tests ofa potential vaccine and an experimental immune therapy in patients at theSaint-Antoine Hospital (This Week, 13 April). But Durieux made no mentionof three deaths which the inquiry had reported.


Paragraph 2Following revelations about the circumstances in which the patients died,Durieux has now announced a new assessment of the tests. to be undertakenby ANRS, the national agency for AIDS research. Last July, Zagury and hiscolleagues reported in a letter to The Lancer (vol 336, p 179) a trial onpatients with AIDS or AIDS-related complex. The patients received apreparation based on proteins from HIV that was designed to boost theirimmune systems.


Paragraph 3The preparation was made from samples of the patients’ own white bloodcells, purified and cultured in the laboratory. The researchers had infected thewhite blood cells with a genetically engineered form of the vaccinia virus thathad genes from HIV inserted into its DNA. The vaccinia, or cowpox, virus,had first been inactivated with formaldehyde, said the researchers. Last week,the Chicago Tribune and Le Monde alleged that at least two of the deathswere caused by vaccinia disease, a rare complication of infection withvaccinia virus. Vaccinia is harmless in healthy people and has been used inits live form as the vaccine against smallpox worldwide. But, in peoplewhose immune systems are suppressed, the virus can ‘occasionally spreadrapidly in the body and kill.


Paragraph 4A Paris dermatologist, Jean-Claude Guillaume, said that when he warnedZagury’s team that he was convinced one of their patients had contractedvaccinia disease “the response was that this was not possible” because thevaccinia had been inactivated. Shortly before his death, the patient hadconsulted Guillaume about large, rubbery lesions across his abdomen.Guillaume consulted a colleague, Jean-Claude Roujeau, about the raredisease. Roujeau told the Chicago Tribune that his tests on the tissue samplestaken from two patients before they died had detected vaccinia virus in theirskin cells.


Paragraph 5The Saint-Antoine team’s postmortem tests did not reveal vaccinia. OdilePicard, who is in charge of administering the treatment, says there were threepossible causes of death - vaccinia disease, herpes or a toxic reaction to theprocedure used to prepare white blood cells before injecting them intopatients. Zagury, however, insisted that “nothing allows us to affirm it [wasvaccinia]. It could have been herpes or Kaposi’s sarcoma”. The tests arecontinuing, he says.


Paragraph 6Luc Montagnier, co-discoverer of HIV, called for an immediate halt to theexperiments. He says that intravenous injections could lead to generalisedvaccinia disease. His team at the Pasteur Institute has already shown inlaboratory tests that vaccinia virus maybe dangerous if the immune system isunable to resist it. The findings at the Pasteur Institute were apparentlyunknown to Zagury’s team, which works with Montagnier’s rival, theresearcher Robert Gallo. Gallo’s collaboration with Zagury has beensuspended by the National Institutes of Health in the US because of allegedirregularities.


Paragraph 7Zagury and his team have also denied charges that they covered up thedeaths, which are not mentioned in their report in The Lancet. “They werenot covered up,” Picard said. “They were accepted [into the trial] oncompassionate grounds.” The Lancet report concerns 28 patients. 14 whowere treated and 14 controls who were not able to receive the treatment.Picard says that five other patients were also treated with the preparation butwere not compared with the controls. Their T4 cell counts had fallen too lowto be comparable with the control group, so they were excluded from thestudy and not mentioned in its report.


Paragraph 8

AIDS patients are particularly vulnerable to infection. Furthermore, theFrench ethics council had specified that volunteers should be chosen because“their state was so advanced it excluded treatment with AZT”. At least someof the patients were being treated with AZT at the same time as immunetherapy. The council had also asked to be informed of the results of the trialscase by case, but had not been told of the deaths. The geneticist André Boué,a member of the council, said: “The ethics council does not have judicialpowers; we are not the fraud squad.”


Paragraph 9The director of the -AIDS research agency ANRS, Jean-Paul Levy, isconcerned that all the controversy may lead to a crisis of public confidencebut laid the blame firmly at the door of the media where “excessive praise isfollowed by excessive rejection”. Levy, who had still heard nothing, “eveninformally” from the health ministry the day after Durieux told parliamentthat ANRS would assess immune therapy trials, said he wanted to study theproblems “in depth, but not in the atmosphere of a tribunal”.


Paragraph 10ANRS has a panel of experts in therapeutic trials, which, says Levy, “mightseek international contacts to obtain a broad consensus” on the issuesinvolved. The research agency’s role is to carry out a purely scientificevaluation, not to assess whether there was a breach of ethical guidelines,according to Levy. “If the government called on us to examine this case, wecould act very quickly,” said Philippe Lucas of the ethics council.


QUESTIONS

Q1. “Which of the following is FALSE?a) Zagury’s experiments have been controversial before.b) An inquiry found obvious irregularities in Zagury’s work.c) ANRS is to re-evaluate Zagury’s tests.d) Zagury’s intention had been to increase patients’ immune systems with

proteins.Back to “1”“2”“3”“4” “5”

Paragraphs“6”“7”“8”“9”“10”

Q2. The preparation which the patients received _______a) had been accidentally infected with a form of the vaccinia virus.b) was made from white blood cells which had been manufactured in thelaboratory.c) had been stored in formaldehyde. ,d) contained laboratory-treated white blood cells which had been taken fromthem.

Back to “1”“2”“3”“4” “5”Paragraphs“6”“7”“8”“9”“10”

Q3. According to the article, vaccinia _______a) is potentially lethal for all humans.b) has been used to fight both cowpox and smallpox all around the world.c) can be dangerous in people who have abnormal immune systems.d) in none of the above.


Q4. Jean-Claude Guillaume _______a) was also a member of Zagury’s team.b) examined one of the patients who had been referred to him by Zagury’steam.c) informed the Chicago Tribune about the results of the tests on the tissuesamples.d) was/did none of the above.


Q5. Which of the following people does NOT work with Zagury?a) Odile Picard.b) Luc Montalgnier.c) Robert Gallo.d) None of the above works with Zagury.

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Paragraphs“6”“7”“8”“9”“10”Q6. It is FALSE that findings at the Pasteur institute _______a) were ignored by Zagury’s team.b) did not lead to intervention by the National institutes of Health.c) showed that intravenous injections were not good for patients with weakerimmune systems.d) led to Zagury’s team keeping quiet about the patients who had died.


Q7. How many people were injected with the preparation in the trial?a) Fourteenb) Nineteenc) Twenty eightd) Thirty three ’


Q8. Which of the following statements best describes the initial condition ofthe people who took part in the trial?a) Fewer than half of them had AIDSb) Half of them had AIDSc) Most of them had AIDSd) All of them had AIDS



Practice Test 8


TIME: 45 MINUTES




Going blind in AustraliaParagraph 1 Australians are living longer and so face increasing levels of visualimpairment. When we look at the problem of visual impairment and theelderly, there are three main issues. First, most impaired people retire withrelatively “normal” eyesight, with no more than presbyopia, which iscommon in most people over 45 years of age. Second, those with visualimpairment do have eye disease and are not merely suffering from “old age”.Third, almost all the major ocular disorders affecting the older population,such as cataract, glaucoma and age-related macular degeneration (AMD), areprogressive and if untreated will cause visual impairment and eventualblindness.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 2 Cataract accounts for nearly half of all blindness and remains the most

prevalent cause of blindness worldwide. In Australia, we do not know howprevalent cataract is, but it was estimated in 1979 to affect the vision of 43persons per thousand over the age of 64 years. Although some risk factors forcataract have been identified, such as ultraviolet radiation, cigarette smokingand alcohol consumption, there is no proven means of preventing thedevelopment of most age-related or senile cataract. However cataractblindness can be delayed or cured if diagnosis is early and therapy, includingsurgery, is accessible.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 3 AMD is the leading cause of new cases of blindness in those over 65. In theUnited States, it affects 8-1 1% of those aged 65-74, and 20% of those over75 years. In Australia, the prevalence of AMD is presently unknown butcould be similar to that in the USA. Unlike cataract, the treatmentpossibilities for AMD are limited. Glaucoma is the third major cause ofvision loss in the elderly. This insidious disease is often undetected until opticnerve damage is far advanced. While risk factors for glaucoma, such asethnicity and family history, are known, these associations are poorlyunderstood. With early detection, glaucoma can be controlled medically orsurgically.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 4 While older people use a large percentage of eye services, many more maynot have access to, or may underutilise, these services. In the United States33% of the elderly in Baltimore had ocular pathology requiring furtherinvestigation or intervention. In the UK, only half the visually impaired inLondon were known by their doctors to have visual problems, and 40% ofthose visually impaired in the city of Canterbury had never visited anophthalmologist. The reasons for people underutilising eye care services are,first, that many elderly people believe that poor vision is inevitable oruntreatable. Second, many of the visually impaired have other chronicdisease and may neglect their eyesight. Third, hospital resources andrehabilitation centres in the community are limited and, finally, social factorsplay a role.

Questions

“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 5 People in lower socioeconomic groups are more likely to delay seekingtreatment; they also use fewer preventive, early intervention and screeningservices, and fewer rehabilitation and after-care services. The poor use morehealth services, but their use is episodic, and often involves hospital casualtydepartments or general medical services, where eyes are not routinelyexamined. In addition, the costs of services are great deterrent for those withlower incomes who are less likely to have private health insurance. Forexample, surgery is the most effective means of treatment for cataract, andtimely medical care is required for glaucoma and AMD. However, inDecember 1991, the proportion of the Australian population covered byprivate health insurance was 42%. Less than 38% had supplementaryinsurance cover. With 46% of category 1 (urgent) patients waiting for morethan 30 days for elective eye surgery in the public system, and 54% ofcategory 2 (semi-urgent) patients waiting for more than three months, costappears to be a barrier to appropriate and adequate care.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 6 With the proportion of Australians aged 65 years and older expected todouble from the present 11% to 21% by 2031, the cost to individuals and tosociety of poor sight will increase significantly if people do not have accessto, or do not use, eye services. To help contain these costs, generalpractitioners can actively investigate the vision of all their older patients,refer them earlier, and teach them self-care practices. In addition, thegovernment, which is responsible to the taxpayer, must provide everyonewith equal access to eye health care services. This may not be achievedmerely by increasing expenditure - funds need to be directed towardsprevention and health promotion, as well as treatment. Such strategies willmake good economic sense if they stop older people going blind.


Q1. In paragraph 1, the author suggests that __________ A. many people have poor eyesight at retirement age. B. sight problems of the aged are often treatable.

C. cataract and glaucoma are the inevitable results of growing older. D. few sight problems of the elderly are potentially damaging.

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Q2. According to paragraph 2, cataracts __________ A. may affect about half the population of Australians aged over 64. B. may occur in about 4—5% of Australians aged over 64. C. are directly related to smoking and alcohol consumption in old age. D. are the cause of more than 50% of visual impairments.


Q3. According to paragraph 3, age-related macular degeneration (AMD)__________ A. responds well to early treatment. B. affects 1 in 5 of people aged 65—74. C. is a new disease which originated in the USA. D. causes a significant amount of sight loss in the elderly.


Q4. According to paragraph 3, the detection of glaucoma __________ A. generally occurs too late for treatment to be effective.B. is strongly associated with ethnic and genetic factors.C. must occur early to enable effective treatment.D. generally occurs before optic nerve damage is very advanced.


Q5. Statistics in paragraph 4 indicate that __________A. existing eye care services are not fully utilised by the elderly.B. GPs are generally aware of their patients’ sight difficulties.C. most of the elderly in the USA receive adequate eye treatment.D. only 40% of the visually impaired visit an opthalmologist.


Q6. According to paragraph 4, which one of the following statements is Qtrue?

A. Many elderly people believe that eyesight problems cannot be treatedeffectively.B. Elderly people with chronic diseases are more likely to have pooreyesight.C. The facilities for eye treatments are not always readily available.D. Many elderly people think that deterioration of eyesight is a product ofageing.


Q7. In discussing social factors affecting the use of health services inparagraph 5, the author points out that__________A. wealthier people use health services more often than poorer people.B. poorer people use health services more regularly than wealthier people.C. poorer people deliberately avoid having their eye sight examined.D. poorer people have less access to the range of available eye care services.


Q8. According to paragraph 6, in Australia in the year 2031__________A. about one tenth of the country’s population will be elderly.B. about one third of the country’s population will be elderly.C. the proportion of people over 65 will be twice the present proportion.D. the number of visually impaired will be twice the present number.



Practice Test 9


TIME: 15 MINUTES



Text A

Illness floors RobbA depressive illness is forcing senior Coalition frontbencher Andrew Robb totake three months’ leave from his shadow cabinet duties. Columnist LaurieOakes reveals in today’s Herald Sun that Mr. Robb has been diagnosed witha biochemical disorder known as diurnal variation. Mr. Robb, 58, is goingpublic with his battle lest there be any misunderstanding why he istemporarily vacating Malcolm Turnbull‘s front bench. In an interview withOakes, Mr. Robb explains he has suffered for as long as he can remember —without actually knowing his condition had a name. “I thought it was just thatI wasn’t good in the mornings,” Mr. Robb says.

“It’s like a little black dog has been visiting me every morning for most ofmy life.” Mr. Robb tells how he wakes up feeling flat and negative buteventually settles into the positive and confident mindset needed to tacklepolitics on the front line. As a youngster, he recalls suffering but tellingnobody. “I can remember as a 12-year old, walking to the station on the wayto school at 7.15 in the morning. I’d see old fellows who had retired and I’dwish I was one of them.” A telephone call to Beyond Blue chairman Jeff

Kennett six weeks ago led to Mr. Robb visiting a psychiatrist who diagnosedthe condition. Treatment, however, has proved more gruelling than Mr. Robbexpected. Drugs are sending him into deeper depression before any benefitsemerge, prompting his decision to temporarily move to the back bench.

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Text B

Diagnosis of depression

If you are clinically depressed you would have at least two of the followingsymptoms for at least 2 weeks.

An unusually sad mood that does not go awayLoss of enjoyment and interest in activities that used to be enjoyableTiredness and lack of energy

As well, people who are depressed often have other symptoms such as:

Loss of confidence in themselves or poor self-esteemFeeling guilty when they are not at faultWishing they were deadDifficulty concentrating or making decisionsMoving more slowly or, sometimes becoming agitated and unable tosettleHaving sleeping difficulties or, sometimes, sleeping too muchLoss of interest in food or, sometimes eating too much. Changes ineating habits may lead to either loss of weight or putting on weight.

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Text C

Not every person who is depressed has all these symptoms. People who aremore severely depressed will have more symptoms than those who are mildlydepressed. Here is a guide to severity of depression:

Mild depression - 4 of the 10 symptoms listed above over the past 2

weeks.Moderate depression - 6 of the 10 symptoms of the past 2 weeks.Severe depression - 8 of the 10 symptoms over the past 2 weeks.

Occasionally, depression is a sign of another illness or is caused by the sideeffects of medications. Your doctor will want to check out whether there areany other medical problems or pills that could be causing your depression.

(WHO, The ICD-10 Classification of Mental and Behavioural Disorders,Geneva.)

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Text D

Antidepressant drugs

Occasional sadness or loss of heart are normal, and they usually pass quickly.However, more severe depression that is accompanied by feelings of despair,lethargy, loss of sex drive, and often poor appetite may call for medicalattention. Such depression can arise from life stresses such as the death ofsomeone close, an illness, or sometimes from no apparent cause. Three maintypes of antidepressant are used to treat depression: tricyclic antidepressants(TCAs), selective serotonin re-uptake inhibitors (SSRls), and monoamineoxidase inhibitors (MAOIs). These groups of drugs are equally effective.Treatment usually begins with an SSRI.

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QUESTIONS


In which text can you find information about1. How the severity of depression is assessed? _____

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2. what are the symptoms of depression? _____Goto

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3. who is Mr. Andrew Robb? _____Goto

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4. what does ‘TCA’ stands for? _____Goto

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5. how can you check whether you’re clinically depressed? _____Goto

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6. what are the symptoms of severe depression? _____Goto

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7. what does ‘MAOI’ stands for? _____Goto

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8. Which antidepressant is given first in the treatment of depression?Goto

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9. Who classified depression on the basis of severity?Goto

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10. Who diagnosed the condition of Mr. Robb?Goto

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11. Which type of depression can arise from stress caused by death ofsomeone close?

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12. How many symptoms are minimum required for a moderate depression?Goto

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13. who reported the condition of Mr. Robb?Goto

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Questions 14-20Complete each of the sentences, 14-20, with a word or short phrase from oneof the texts. Each answer may include words, numbers or both.14. _____ or loss of heart are normal and pass quickly.

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15. Occasionally, depression is a sign of _____ or is caused by the sideeffects of medications.

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16. Changes in _____ may lead to either loss of weight or putting on weight.Goto

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17. If you are clinically depressed you would have the symptoms for at least_____.

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18. The chairman of _____ Jeff Kennett led Mr. Robb to visit a psychiatrist.Goto

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19. Three main types of _____ used to treat depression are equally effective.Goto

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20. _____ shows four of the ten symptoms over the past two weeks.Goto

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TIME: 45 MINUTES



Part B


Method of BP measurement using a digital tonometer

The procedure involves the correct positioning of the cuff on the appropriateplace after previously positioning the disposable circular PVC cuff. Thisprotection cuff helps to prevent the transmission of infection between patientsin the healthcare facility. After positioning the cuff, the tonometer is activatedby pressing a button and the cuff is automatically inflated. After a while, thedisplay will show the blood pressure systolic and diastolic values and sometypes of tonometers also display the pulse value.

1. The manual informs us that the tonometerA. is activated by pulling a button by the patient or the staffB. display mostly the blood pressure systolic and diastolic valuesC. display only the pulse value of the patient immediately

Single-Use Medical Equipments

Critical and semi-critical medical equipments labeled as single-use must notbe reprocessed and reused unless the reprocessing is done by a licensedreprocessor. Health care settings that wish to have their single-use medicalequipments reprocessed by a licensed reprocessor should ensure that thereprocessor’s facilities and procedures have been certified by a regulatoryauthority or an accredited quality system auditor to ensure the cleanliness,sterility, safety and functionality of the reprocessed equipments.

2. What must all staff involved in the reprocessing process do?A. certify their facilities and procedures by a regulatory authority or anaccredited quality system auditorB. ensure the cleanliness, sterility, safety and functionality of the reprocessedequipmentsC. All of the above.

Preventive maintenance (PM)

PM involves maintenance performed to extend the life of the device andprevent failure. PM is usually scheduled at specific intervals and includesspecific maintenance activities such as lubrication, cleaning or replacing partsthat are expected to wear or which have a finite life. The procedures andintervals are usually established by the manufacturer. In special cases the usermay change the frequency to accommodate local environmental conditions.Preventive maintenance is sometimes referred to as ‘planned maintenance’ or‘scheduled maintenance’.

3. The purpose of this email is toA. report on a rise in special cases such as local environmental conditionsB. explain the background to conduct preventive maintenanceC. remind staff about procedures and intervals for preventive maintenance

Micro-enema

This is a form of enema administration, i.e. small liquid volumes (in adults 60- 180 ml). An example of a micro-enema solution used for cleansing therectum is Yal, which is already prepared by the manufacturer in a transparentbottle with an attached applicator. The contents of the bottle must bethoroughly shaken before use and the sealed end of the applicator cut off. If

administering a micro-enema with another solution, not originally preparedby the manufacturer, rinsing is done with a Janet rectal syringe and anappropriate sized rectal tube. Other aids are the same as for other types ofenema.

4. The guidelines require those undertaking micro-enema toA. administer the solution with a Janet rectal syringeB. administer the other solution with a rectal tubeC. thoroughly shake the contents of the Yal bottle

Intensity of pain

The intensity of pain is expressed by the question “How much does it hurt?”It is not easy to assess pain as it is a subjective symptom. We cannot objectifythe intensity of pain or measure the strength of the impulse in a particularpatient. Experiencing pain is influenced by many internal and externalfactors. The nursing staff should monitor the overall behaviour of the patient,especially the quality of sleep, appetite, communication with other patients,family members, staff etc.

5. The guidelines establish that the healthcare professional shouldA. should monitor the overall behaviour of the patient.B. evaluate the strength of the impulse in a particular patient.C. note internal and external factors influencing the pain.

Patient malnutrition

Poor nutrition brings a number of negative aspects for both treatment andfurther patient prognosis. It is reported that the frequency of complications ofthe disease in these patients is 27 % higher; the mortality of these patients is12.4 % higher, hospitalization time is 7 – 13 days longer and the cost oftreatment is 210% higher. According to international studies, 40% ofhospitalized patients and 40-80 % of institutionally treated elderly patientsare at risk of malnutrition. Patients with malnutrition should be identifiedearly and provided with a sufficiently nutritional diet.

6. The purpose of this email is toA. report on a rise in patient malnutrition complications.B. explain the background that cause patient malnutrition.C. remind staff to identify patient malnutrition early.


Practice Test 11


TIME: 45 MINUTES




Pandemic Flu The Bird FluParagraph 1What everyone should know about the avian influenza?A growing number of avian influenza (bird flu) cases are turning up amongbird populations around the world. While the flu has yet to have a large-scaleinfluence on human lives, the World Health Organization (WHO) and theUnited States Center for Disease Control (CDC) warns that it is not a matterof if we will be affected, but when. The first step you can take is to educateyourself and stay informed. What follows are questions and answers that willhelp you to take this first step.What is the bird flu (avian influenza)?The bird flu is an infection caused by avian (bird) influenza (flu) virus. Theseflu viruses occur naturally among birds. Wild birds worldwide carry the virusin their intestines, but usually do not get sick from it. However, avianinfluenza is very contagious among birds and can make some domesticated

birds, including chickens, ducks, and turkeys, very sick and kill them.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 2How does the bird flu virus differ from seasonal flu viruses that infecthumans?Of the few bird flu viruses that have crossed the species barrier to infecthumans, the most recent virus that you are hearing about in the news hascaused the largest number of reported cases of severe disease and death inhumans. In Asia, more than half of the people infected with the virus havedied. Most cases have occurred in previously healthy children and youngadults. However, it is possible that the only cases currently being reported arethose in the most severely ill people and that the full range of illness causedby the current bird flu virus has not yet been defined. Unlike seasonalinfluenza, in which infection usually causes only mild respiratory symptomsin most people, bird flu infection may follow an unusually aggressive clinicalcourse, with rapid deterioration and high fatality.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 3How does the bird flu spread among birds?Infected birds shed influenza virus in their saliva, nasal secretions, and feces.Susceptible birds become infected when they have contact with contaminatedexcretions or with surfaces that are contaminated with excretions orsecretions. Domesticated birds may become infected with avian influenzavirus through direct contact with infected waterfowl or other infected poultryor through contact with surfaces (such as dirt or cages) or materials (such aswater or feed) that have been contaminated with the virus.Do bird flu viruses infect humans?Bird flu viruses do not usually infect humans, but more than 100 confirmedcases of human infection with bird flu viruses have occurred since 1997.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 4What would make the bird flu a ‘pandemic flu’?A ‘pandemic flu’ is defined as a global outbreak of disease that occurs whena new virus appears in the human population and then spreads easily from

person to person. Three conditions must be met for a pandemic to start: 1) anew virus subtype must emerge; 2) it must infect humans and cause seriousillness; and 3) it must spread easily and continue without interruption amonghumans. The current bird flu in Asia and Europe meets the first twoconditions: it is a new virus for humans and it has infected more than 100humans.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 5How do people become infected with bird flu viruses?Most cases of the bird flu infection in humans have resulted from direct orclose contact with infected poultry (e.g., domesticated chicken, ducks, andturkeys) or surfaces contaminated with secretions and excretions frominfected birds. The spread of bird flu viruses from an ill person to anotherperson has been reported very rarely, and transmission has not been observedto continue beyond one person. During an outbreak of bird flu amongpoultry, there is a possible risk to people who have direct or close contactwith infected birds or with surfaces that have been contaminated withsecretions and excretions from infected birds.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 6What are the symptoms of avian influenza in humans?Symptoms of the bird flu in humans have ranged from typical human flu-likesymptoms (fever, cough, sore throat, and muscle aches) to eye infections,pneumonia, severe respiratory diseases (such as acute respiratory distresssyndrome), and other severe and life-threatening complications. Thesymptoms of the bird flu may depend on type of virus causing the infection.How is avian influenza detected in humans and treated?A laboratory test is needed to confirm bird flu in humans. Studies done inlaboratories suggest that the prescription medicines approved for human fluviruses should work in treating bird infection in humans. However, fluviruses can become resistant to these drugs, so these medications may notalways work. Additional studies are needed to determine the effectiveness ofthese medicines.


Paragraph 7Does a seasonal flu vaccine protect me from avian influenza?No. Seasonal flu vaccines do not provide protection against the bird flu.However, it is always a good idea to obtain a vaccine for your well-being.Should I Wear a surgical mask to prevent exposure to the bird flu?Currently, wearing a mask is not recommended for routine use (e.g., inpublic) for preventing flu virus exposure.Is there a risk for becoming infected with avian influenza by eatingchicken, turkey, or duck?There is no evidence that properly cooked poultry or eggs can be a source ofinfection for bird flu viruses. The U.S. government carefully controlsdomestic and imported food products, and in 2004 issued a ban onimportation of poultry from countries affected by bird flu viruses.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 8What can I do to help reduce the risk for infection from wild birds in theUnited States?As a general rule, the public should observe wildlife, including wild birds,from a distance. This protects you from possible exposure to pathogens andminimizes disturbance to the animal. Avoid touching wildlife. If there iscontact with wildlife do not rub eyes, eat, drink, or smoke before washinghands with soap and water. Do not pick up diseased or dead wildlife.Consumer Services for issues related to poultry flocks or the Fish andWildlife Conservation Commission for issues relating to wild birds.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 9Is there a vaccine to protect humans from the bird flu virus?There currently is no commercially available vaccine to protect humansagainst the bird flu virus that is currently being detected in Asia and Europe.However, vaccine development efforts are taking place. Research studies totest a vaccine that will protect humans against the current bird flu virus beganin April 2005, and a series of clinical trials is under way.Does CDC recommend travel restrictions to areas with known bird fluoutbreaks?CDC does not recommend any travel restrictions to affected countries at this

time. However, CDC currently advises that travelers to countries with knownoutbreaks of avian influenza avoid poultry farms, contact with animals in livefood markets, and any surfaces that appear to be contaminated with fecesfrom poultry or other animals.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 10Is there a risk to importing pet birds that come from countriesexperiencing outbreaks of the bird flu ?The U.S. government has determined that there is a risk to importing petbirds from countries experiencing outbreaks of the avian influenza. CDC andthe U.S. Department of Agriculture (USDA) have both taken action to banthe importation of birds from areas where avian influenza has beendocumented.Can a person become infected with the bird flu virus by cleaning a birdfeeder?There is no evidence of the avian influenza having caused disease in birds orpeople in the United States. At the present time, the risk of becoming infectedwith the virus from bird feeders is low. Generally, perching birds are the typeof birds commonly at feeders. While there are documented cases of avianinfluenza causing death in such birds (e.g., house sparrow, Eurasian tree-sparrow, house finch), most of the wild birds that are traditionally associatedwith bird flu viruses are waterfowl and shore birds.


QUESTIONS

Q1. Which of the following statements is NOT true?a) Wild birds carry the virus in their intestines.b) Avian influenza is very contagious among birds.c) Avian flu can make domestic birds very ill and may be fatal.d) Wild birds often die from Avian flu.


Q2. Which of the following statements is NOT true?a) 50% of the people in Asia infected with bird flu have died.b) Healthy people have been infected.

c) Bird flu causes mild respiratory symptoms in most people.d) It’s likely that we don’t yet know the full range of illnesses caused by thebird flu virus.


Q3. How does a bird become infected?a) Contact with the saliva, nasal secretions or faeces of an infected bird.b) Contact with surfaces that have been contaminated by excretions orsecretions from infected birds.c) Direct contact with an infected bird.d) Any of the above.


Q4. How many confirmed cases of human infection with bird flu viruses haveoccurred since 1997?a) 100+b) 50c) Over a thousand.d) 25


Q5. Is the current outbreak a ‘pandemic?’a) Yesb) Noc) The information is not given in the text.d) Not sure.


Q6. Which of the following statements is NOT true?a) Bird flu can be transmitted from bird to birdb) Bird flu can be transmitted from bird to human.c) Bird flu can be transmitted from one person to another person.d) Bird flu can be transmitted from one person to another person and beyond.


Q7. Which of these are typical symptoms of bird flu in humans?a) fever, cough, sore throat and muscle aches.b) vomiting and diarrhoea.c) insomniad) swollen limbs and earache.


Q8. If you have had a seasonal flu vaccine this year, are you also protectedagainst bird flu?a) Yesb) Noc) Yes, if the virus doesn’t mutate.d) The information is not given in the text.



Practice Test 12


TIME: 45 MINUTES




The Mental Health Risks of Adolescent Cannabis UseParagraph 1Since the early 1970s, when cannabis first began to be widely used, theproportion of young people who have used cannabis has steeply increasedand the age of first use has declined. Most cannabis users now start in themid-to-late teens, an important period of psychosocial transition whenmisadventures can have large adverse effects on a young person’s lifechances. Dependence is an underappreciated risk of cannabis use. There hasbeen an increase in the numbers of adults requesting help to stop usingcannabis in many developed countries, including Australia and theNetherlands. Regular cannabis users develop tolerance to many of the effectsof delta-9- tetrahydrocannabinol, and those seeking help to stop often reportwithdrawal symptoms. Withdrawal symptoms have been reported by 80% ofmale and 60% of female adolescents seeking treatment for cannabisdependence.

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Paragraph 2In epidemiological studies in the early 1980s and 1990s, it was found that 4%of the United States population had met diagnostic criteria for cannabis abuseor dependence at some time in their lives and this risk is much higher fordaily users and persons who start using at an early age. Only a minority ofcannabis-dependent people in surveys report seeking treatment, but amongthose who do, fewer than half succeed in remaining abstinent for as long as ayear. Those who use cannabis more often than weekly in adolescence aremore likely to develop dependence, use other illicit drugs, and developpsychotic symptoms and psychosis.


Paragraph 3Surveys of adolescents in the United States over the past 30 years haveconsistently shown that almost all adolescents who had tried cocaine andheroin had first used alcohol, tobacco, and cannabis, in that order; that regularcannabis users are the most likely to use heroin and cocaine; and that theearlier the age of first cannabis use, the more likely a young person is to useother illicit drugs. One explanation for this pattern is that cannabis usersobtain the drug from the same black market as other illicit drugs, therebyproviding more opportunities to use these drugs.


Paragraph 4In most developed countries, the debate about cannabis policy is oftensimplified to a choice between two options: to legalize cannabis because itsuse is harmless, or to continue to prohibit its use because it is harmful. As aconsequence, evidence that cannabis use causes harm to adolescents isembraced by supporters of cannabis prohibition and is dismissed as “flawed”by proponents of cannabis legalisation.


Paragraph 5A major challenge in providing credible health education to young peopleabout the risks of cannabis use is in presenting the information in apersuasive way that accurately reflects the remaining uncertainties aboutthese risks. The question of how best to provide this information to youngpeople requires research on their views about these issues and the type ofinformation they find most persuasive. It is clear from US experience that it isworth trying to change adolescent views about the health risks of cannabis; asustained decline in cannabis use during the 1980s was preceded by increasesin the perceived risks of cannabis use among young people.


Paragraph 6Cannabis users can become dependent on cannabis. The risk (around 10%) islower than that for alcohol, nicotine, and opiates, but the earlier the age ayoung person begins to use cannabis, the higher the risk. Regular users ofcannabis are more likely to use heroin, cocaine, or other drugs, but thereasons for this remain unclear. Some of the relationship is attributable to thefact that young people who become regular cannabis users are more likely touse other illicit drugs for other reasons, and that they are in socialenvironments that provide more opportunities to use these drugs.


Paragraph 7It is also possible that regular cannabis use produces changes in brainfunction that make the use of other drugs more attractive. The most likelyexplanation of the association between cannabis and the use of other illicitdrugs probably involves a combination of these factors. As a rule of thumb,adolescents who use cannabis more than weekly probably increase their riskof experiencing psychotic symptoms and developing psychosis if they arevulnerable—if they have a family member with a psychosis or other mentaldisorder, or have already had unusual psychological experiences after usingcannabis. This vulnerability may prove to be genetically mediated.

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Question“Q5”“Q6”“Q7”“Q8”QUESTIONS

Q1. In paragraph 1, which of the following statements does not match theinformation on cannabis use?a. The use of cannabis by teenagers has been increasing over the past 40years.b. Cannabis use has adverse effects on young people.c. Withdrawal symptoms are more common in males.d. People try cannabis for the first time at a younger age than previously.

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Q2. Epidemiological studies in the 1980s & 1990s have found that _______a. 4% of the US population currently suffer from cannabis abuse ordependence.b. starting cannabis use at a young age increases the risk of dependence orabuse.c. only a minority of surveys researched treatment options for cannabisdependent people.d. people who start cannabis use at a young age have high risk of becomingdaily users.


Q3. The main point of paragraph 3 is that _______a. alcohol, tobacco and cannabis can lead to the use of heroin and cocaine.b. most adolescents who have used cocaine or heroin first try alcohol,followed by tobacco and then cannabis.c. there is a clear link between habitual cannabis use and the use of heroinand cannabis.d. the black market is the main source of illicit drugs.


Q4. Which of the following would be the most appropriate heading forparagraph 4?a. Opinion on an effective cannabis policy is divided.b. Cannabis use is harmful to adolescents and should be prohibited.

c. Cannabis use is a serious problem in a majority of developed countries.d. Cannabis use should be legalised.


Q5. The word closest in meaning credible in paragraph 5 is _______a. believableb. possiblec. high qualityd. inexpensive


Q6. Cannabis use in the US declined during the 1980s because _______a. parents were able to explain the health risks of cannabis use.b. there was good health education regarding the health risks associated withcannabis use available at that time.c. cannabis had increased in priced. young people had became more worried about its effect on their health


Q7. The word relationship in paragraph 6 refers to the connection between_______a. legal drugs such as alcohol and nicotine and illegal drugs such as cannabis,cocaine and heroin.b. cannabis use and dependency.c. the use of hard drugs such as heroin and cocaine and cannabis use.d. regular users and their partners.


Q8. Which of the following statements best matches the information in thelast paragraph?a. Regular cannabis use produces changes in brain function.b. Regular adolescent cannabis users with a genetic predisposition to mentaldisorders have an increased risk of encountering psychosis.c. Regular adolescent users of cannabis are vulnerable to psychosis.d. Occasional use of cannabis can make other drugs more appealing.



Practice Test 13READING SUB-TEST – QUESTION PAPER: PART A

TIME: 15 MINUTES


DO NOT open this Question Paper or the Text Booklet until you are toldto do so. Write your answers on the spaces provided on this Question Paper.You must answer the questions within the 15-minute time limit.One mark will be granted for each correct answer.Answer ALL questions. Marks are NOT deducted for incorrect answers.At the end of the 15 minutes, hand in this Question Paper and the TextBooklet. DO NOT remove OET material from the test room.Text ALead exposure in Australia• Exposure to lead in Australia has dropped significantly over recent decadesas a result of measures restricting the use of lead in paint, petrol andconsumer goods. As a result, the average blood lead level in Australia isestimated to be less than 5 micrograms per decilitre.• NHMRC recommends that if a person has a blood lead level greater than 5micrograms per decilitre, the source of exposure should be investigated andreduced, particularly if the person is a child or pregnant woman.• Investigating the source of exposure where blood lead levels are greaterthan 5 micrograms per decilitre will reduce the risk of harm not only to theindividual, but others in the community, including those who may be morevulnerable to the effects of lead (such as children).

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Text BHealth effects of lead• The health effects due to exposure to lead vary greatly between individualsand depend on a variety of factors such as a person’s age, the amount of lead

a person is exposed to and for how long, and if they have other healthconditions.• The possibility of health effects from lead in the body is higher for childrenand babies (including unborn babies) than for adults, because their bodies aresmaller and their brains are developing rapidly. Lead toxicity affects a rangeof molecular processes, in part due to its ability to inhibit and mimic theactions of calcium. This impacts on many organs and systems within thebody.• There is an association between blood lead levels of 5 to 10 micrograms perdecilitre and adverse cognitive effects (reduced Intelligence Quotient (IQ)and academic achievement) and behavioural problems (effects on attention,impulsivity and hyperactivity) in children. However, it is unclear whether thisassociation is causal.• For blood lead levels greater than 10 micrograms per decilitre there are wellestablished adverse effects on the body’s digestive, cardiovascular, renal,reproductive and neurological functions.

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Text CTesting blood lead levels• Measurement of blood lead should be considered when symptoms or healtheffects associated with lead are present and/or a source of lead exposure issuspected.• Testing of asymptomatic children should be conducted based on theindividual’s risk profile (eg. life stage, exposure of other household members,local environment and current health status).• A blood lead test is considered the most reliable biomarker for generalclinical use. Results tend to reflect more recent exposure but do notnecessarily provide information about stored lead in the body.• Other types of blood tests (e.g. plasma lead test or erythrocyteprotoporphyrin test) and tests of bone, teeth, sweat, nails or hair are notrecommended for clinical use.Management of individuals• Health practitioners should be aware of the requirements in their state orterritory for notification of blood lead levels to public health authorities.

• Collaboration between primary health practitioners and state and territoryenvironmental health agencies is recommended to identify and manageexposure.• Management approaches are based on individual blood levels and theperson’s overall health and social environment.• Testing family members, and others suspected of being exposed to the leadsource should be considered as part of the management plan.

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Text DInvestigating the source of exposure• The first step to reducing elevated blood lead levels in individuals is toidentify the source/s of exposure. A planned, logical process should befollowed to identify lead hazards, and the presence of multiple lead sourcesshould not be ruled out or overlooked.• Once the source has been identified, an exposure assessment should beundertaken to identify the extent and pathways of exposure.Interventions for reducing elevated blood lead levels• Management strategies should focus on breaking the exposure pathway.Addressing or removing the source of lead is the most effective intervention,provided it can be successfully applied. This should take place beforeattempts are made to change behaviour (e.g. through access restriction andeducation).• Substituting lead-containing products with lead-free products will have animmediate beneficial effect. Remediation of widespread diffuse sources oflead will require consultation with the local, state or territory health andenvironmental protection authorities.

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Part ATIME: 15 minutes• Look at the four texts, A-D, in the separate Text Booklet.• For each question, 1-20, look through the texts, A-D, to find the relevantinformation.• Write your answers on the spaces provided in this Question Paper.• Answer all the questions within the 15-minute time limit.

• Your answers should be correctly spelt.

QUESTIONS


In which text can you find information about1. what are the benefits of investigating the source of lead exposure? _____

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2. what is the first step to reduce the elevated blood lead levels in individuals?_____

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3. what is the most effective intervention for reducing the elevated blood leadlevels? _____

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4. what are the factors that determine health effects due to exposure to lead? _____Goto

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5. which blood tests are not recommended for clinical use? _____Goto

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6. what is the basis for testing blood lead levels of asymptomatic children? _____Goto

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7. which body functions are adversely affected by blood lead levels greaterthan 10 micrograms per decilitre? _____

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9. What is the most reliable biomarker to find lead exposure for general clinicaluse?

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Questions 14-20Complete each of the sentences, 14-20, with a word or short phrase from oneof the texts. Each answer may include words, numbers or both.14. The average blood lead level in ______ is estimated to be less than 5micrograms per decilitre.

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16. Blood lead levels of 5 to 10 micrograms per decilitre can have adverse_______ effects and behavioural problems.

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17. Tests of bone, teeth, sweat, nails or hair are not recommended for ______.Goto

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18. Management approaches are based on _____ and the person’s overallhealth and social environment.

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should be considered as part of the ______.Goto

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TIME: 45 MINUTES



Part B

In this part of the test, there are six short extracts relating to the work ofhealth professionals. For questions 1-6, choose the answer (A, B or C) whichyou think fits best according to the text.Factors affecting equipment failures

When investigating an unexplained failure, environmental factors should betaken into due consideration. For example, medical devices that requireelectrical power may be adversely affected by power issues. Ideally, electricalpower should have a steady voltage (of the appropriate value); be free oftransient distortions, such as voltage spikes, surges or dropouts; and bereliable, with only rare loss of power. Technical personnel should collaboratewith those responsible for the electrical power system in the health-careorganization to help make the system function as effectively as possible.

1. This guideline extract says that when investigating an unexplained failurethe technical personnelA. should cooperate with electrical power system managing staff in thehealth-care organization

B. should collaborate with staff who manages the electrical equipment in thehealth-care organizationC. All of the above.

CalibrationSome medical equipment, particularly those with therapeutic energy output(e.g. defibrillators, electrosurgical units, physical therapy stimulators, etc.),needs to be calibrated periodically. This means that energy levels are to bemeasured and if there is a discrepancy from the indicated levels, adjustmentsmust be made until the device functions within specifications. Devices thattake measurements (e.g. electrocardiographs, laboratory equipment, patientscales, pulmonary function analysers, etc.) also require periodic calibration toensure accuracy compared to known standards.

2. What does this extract tell us about calibration?A. medical equipment with therapeutic energy output needs to be calibratedperiodicallyB. medical equipment that take measurements needs to be calibratedperiodicallyC. All of the above.

Common descriptive nomenclature

Using common universal descriptive names from a single internationallyaccepted source is key to comparing inspection procedures, inspection times,failure rates, service costs and other important maintenance managementinformation from facility to facility. Although manufacturers have specificnames for devices, it is important to store the common name of the device aslisted in the nomenclature system.

3. The guidelines establish that the healthcare professional should useA. common universal descriptive names for devices from a internationallyaccepted sourceB. specific names for devices from the user manual given by themanufacturerC. common descriptive nomenclature from the directory of healthcare facility

Preadmission Preparation

The clinical staff will conduct preadmission planning for each scheduled

admission of patients. These discussions should address patient schedules andspecial needs. Physicians, dentists, and other licensed independentpractitioners, nursing staff, research nurses, and protocol coordinators mayparticipate in these meetings, which also may involve social workers,nutritionists, pharmacists, and other members of the multidisciplinary careteam. To maximize efficient use of patient-care unit resources and anticipatethe possible need to “board” patients on other units, meeting participants maydiscuss bed utilization.

4. The guidelines establish that the healthcare professional shouldA. maximize efficient use of patient-care unit resourcesB. attend preadmission planning meetingsC. discuss the necessary of bed utilization

Multidisciplinary Patient Care Rounds

All the relevant staff constituting a multidisciplinary team should hold anddocument clinical rounds at least weekly during patients’ hospitalizations andprior to discharge. The purpose of these multidisciplinary clinical rounds is todiscuss patient data, progress in the protocol, problems relating to thepatient’s care, evaluations by specialists, and recommendations formanagement. The primary care team can then use this information to devisetreatment plans, prepare patient education, and formulate recommendationsfor referring physicians.

5. The notice is giving information aboutA. staff who should conduct multidisciplinary clinical rounds at least weekly.B. importance of multidisciplinary clinical rounds in patient management.C. staff who should use information from multidisciplinary clinical rounds.

Patient Management And Treatment Guidelines

Even when the primary treatment is determined by a clinical researchprotocol, supportive care for seriously ill patients may benefit fromguidelines developed by institute and center specialists. The medical staffwill have access to treatment guidelines endorsed by national organizations.We encourage investigators and consultants, when appropriate, to considerpractice guidelines in developing their recommendations for patientmanagement. In addition, we encourage multi-specialty teams to develop

patient management and treatment guidelines for supportive care of patientsin clinical research protocols that are based on clinical trial data and expertopinions.

6. This guideline extract says that the medical staffA. will have access to treatment guidelines endorsed by nationalorganizationsB. to practice guidelines in developing recommendations for patientmanagementC. to develop patient management and treatment guidelines for supportivecare of patientsAnswer Key


Practice Test 15


TIME: 45 MINUTES




The senses of the newbornParagraph 1Tests for hearing and vision have improvedShakespeare’s description of the infant, “Mewling and puking in the nurse’sarms,” was echoed in the attitudes of doctors earlier this century. Thenewborn baby was thought to be either drowsy, asleep, or crying, and toexperience the world as a “great, blooming, buzzing confusion.” But, wehave learnt over the past 30 years that the healthy newborn baby candiscriminate between different sensations from the environment and respondselectively. ‘Within hours of birth the baby will look at the mother‘s face, andgiven the choice newborn babies prefer to look at a card showing the featuresof another human being rather than the same features jumbled up or thefeatures condensed into a large black patch.’


Paragraph 2The newborn baby spends only 11% of the time awake and alert in the firstweek of life, a proportion that rises to 21% in the fourth week. This smalltraction of wakefulness hindered the early development of methods of testingsenses. When eliciting responses it is important to record the baby’s state ofarousal - between deep sleep at one extreme and crying at the other - andPrechtl’s group first described five possible behavioural states. Brazeltonextended this work to include items of higher neurological function,including visual and auditory responses to a bail and rattle, and his neonatalbehavioural assessment scale is a means of scoring interactive behaviour.’

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 3Why do we need to test the senses of the newborn? We want to ensure thatthe baby is able to interact with the parents and with the environment and thatthere is no impairment to social, emotional, cognitive, and linguisticdevelopment. It is often difficult to prove that early intervention is effectivein minimising handicap, but there is evidence - for instance, that deaf childrenfined with hearing aids in the first six months of life have better speech thanthose fitted later. And all parents and most therapists agree that they wouldlike to know of any handicap as early as possible.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 4Finding reliable and methods of testing hearing and vision in newborn babieshas proved difficult. They show behavioural responses to sound, blinking andstartling to a sudden clap and “stilling” to interesting noise, with alteration intheir breathing pattern. Every mother recognises these responses, but theycannot be used to detect deaf babies reliably because of the spontaneousrandom movements that babies make and possible bias on the part of theobservers. The use of a simple rattle to produce head and eye turning hasbeen described, but the method has not found widespread acceptance.Behavioural responses may be recorded by devices incorporatingmicroprocessors such as the auditory response cradle (which should eliminateobserver bias). The sensitivity and specificity of this cradle have variedamong trials, and the sound stimulus has to be very loud (80-85 dB) to resultin a behavioural response by the baby, so that moderate hearing losses are

missed.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 5The electrophysiological response to sound may be detected by audiometrybased on evoked responses in the brain stun, and this is considerably moresensitive. Simpler and more portable brain stem screeners have now beendeveloped. Most recently newborn babies hearing has been tested by usingotoacoustic emissions, a phenomenon first reported by Kemp in 1978.” Aclick stimulus delivered to normal ear results in an “echo” sound generatedby the cochlea, which can be detected by a miniature microphone. Themethod is quicker and less invasive than brain stem audiometry and candetect even mild hearing losses. Stevens and his colleagues tested 346 infantsat risk and showed that 20 of the 21 surviving infants who gave negativeresults to brain stem audiometry also failed on the otoacoustic test.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 6This work also highlighted a major problem - that of validating methods oftesting senses in the newborn baby. This has to be by follow up, checking theoutcome with the testing methods that become possible in the older infant.Steven’s group found a poor correlation between distraction testing of thebabies’ hearing at 8 months of age and brain stem audiometry in thenewborn, a discrepancy confirmed by others. “We must now be morecautious in interpreting the results of electrophysiological rests in thenewborn. Babies who give negative results will need retesting several timesduring the first year. Though the early fitting of hearing aids is desirable, thedegree of hearing impairment needs to be clearly established, particularly asmaturation of the auditory pathways may be taking place, although delayed.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 7Similar problems and challenges occur in testing vision in newborn babies.Behavioural responses are familiar to the mother, with the baby blinking tobring light. Babes turn their heads to a diffuse light but (like turning to sound)this test may not be reliable, especially in preterm infants. All these responsesgive a qualitative indication of vision. Optokinetic nystagmus can be shown

when a striped tape or drum is moved in a temporal to nasal direction acrossthe newborn baby’s field of vision and gives a valuable but crude indicationthat vision is present. Electrophysiological recording of the visual evokedpotential to a flash gives limited useful information because of greatindividual variations and because it relates as much to general cerebralfunction as to visual outcome.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 8Visual evoked potentials to patterns may give a measure of visual functionbut only after the age of 2 months. The best method of measuring visualacuity is to use the preferential looking technique. This is based on theobservation of Fantz 30 years ago that patterned objects are visuallyinteresting to infants. The latest version, called the acuity card procedure,uses patterned and plain stimuli mounted in pairs on cards, and these can beused successfully even in the neonatal intensive care unit. Much fascinatingand enjoyable research is being done into the ability of babies to discriminateand respond to smell, taste, and touch. We should also be glad that at longlast there is widespread acceptance of fact that newborn babies do experiencereal pain and need postoperative analgesia like the rest of us.


QUESTIONS

Q1. Doctors now know ________a) that it is natural for a newborn baby to experience the world as a greatblooming buzzing confusion.b) that babies are much more responsive to visual and auditory cues in theirsurroundings than was previously thought.c) the newborn babies are slow to develop a response to visual and auditorystimulus, since they are awake only 11% of tile time.d)that babies are less able to discriminate between different features of theenvironment than was believed in the first half of this century.


Q2. According to research referred to in the article, a baby given a choice

about what to look at is more likely to choose ________a) a card showing human facial features. ‘b) a card showing jumbled human features.c) a card showing a large black patch.d) a black and white photograph of the mother.


Q3. The senses of the 4-week-old baby can only be tested ________a) 11% of the time.b) when it is crying.c) 21% of the time.d) none of the above.


Q4. Which of the following statements is true?a) There is some evidence that early intervention can prevent handicaps.b) There is much evidence that early intervention can minimize handicaps.c) There is some evidence that early intervention can minimize handicaps.d) There is no evidence that early intervention can minimize handicaps.


Q5. Testing hearing in newborn babies is difficult for all of the followingreasons, except ________a) Newborn babies show behavioural responses to sound such as blinking andstartling.b) Deaf babies sometimes make movements by chance when interestingnoises are made.c) Observers may be biased in their interpretation of babies’ responses.d) The auditory response cradle does not measure moderate hearing losses.


Q6. Otoacoustic emissions are ________a) sounds delivered to the cochlea.b) ‘echo‘ sounds caused by click stimuli.c) click stimuli delivered to a normal ear.

d) sounds generated by a miniature microphone.Back to “1”“2”“3”“4”

Paragraphs“5”“6”“7”“8”Q7. Compared with the use of otoacoustic emissions, brain stem audiometry________a) is quicker.b) can detect even mild hearing loss.c) is more invasive.d) is more sensitive.


Q8. Of the hearing testing methods described in the text ________a) brain stem audiometry correlated well with otoacoustic tests.b) brain stem audiometry correlated well with distraction testing.c) otoacoustic tests correlated poorly with brain stem audiometry.d) otoacoustic tests correlated well with distraction testing.



Practice Test 16


TIME: 45 MINUTES




Insulin is still a hard act to swallow

Paragraph 1Research groups around the world are optimistic that they are makingprogress towards developing the drug insulin in a form that can be taken bymouth. Many diabetics must inject themselves every day with insulin to helpcontrol the level of sugar in their blood. For decades, scientists have beenlooking for an effective way to give people insulin by mouth instead. Insulinis an essential hormone for getting glucose from the bloodstream into bodycells, and most people produce it naturally in the pancreas. People withdiabetes mellitus produce either not enough insulin or none at all. Thehormone cannot normally be taken by mouth because insulin molecules aredestroyed by digestive enzymes in the gut. Thus, many diabetics must injectthem-selves with insulin daily.

Questions

“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 2Researchers have therefore been aiming to package the hormone in some wayso that it can survive intact in the gut and cross the gut wall into thebloodstream. The current experiments are all at an early stage. Even if theydo lead to an effective treatment, it may not be suitable for every diabetic.Those most likely to benefit are people who find injections difficult, such asblind people and younger children. This month a team in Ohio is applying forpermission to test its oral insulin on people. The tablet is a gelatin capsulewhich contains insulin and a drug similar to aspirin and sodium bicarbonate.The gelatin has a costing of waterproof plastic that becomes permeable in thegut.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 3Murray Saffran, who is leading the research at the Medical College of Ohioin Toledo, says the plastic based on a polymer whose structure containscertain nitrogen- nitrogen bonds known as azo bonds. In the gut, bacteriabreak down the azo bonds, and the plastic becomes permeable to water.Water enters the capsule and causes a reaction between the aspirin-like drugand the sodium bicarbonate, giving off carbon dioxide and rupturing thecapsule. The researchers believe the aspirin-like drug may also help theinsulin to be absorbed. The insulin is absorbed directly from the gut into thevein carrying blood to the liver.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 4Saffran and his colleagues have so far carried out trials of the capsule in ratsand - most recently - diabetic dogs. The researchers found that the level ofglucose in the animals’ blood fell, on average, from more than 400 to 120milligrams per decilitre after receiving the capsule. At the same time, theinsulin levels in their blood rose, showing they had absorbed the hormone.Reading Test - Version 2 Another group has already staned testing a differentinsulin capsule in humans, having first performed animal trials. Hanoch Bar-On and his colleagues at the Hadassah Hospital in Jerusalem have patentedtheir capsule, which is coated so that it is not destroyed by the stomach acid.Bar-On says the capsule contains insulin and “other ingredients” which help

to enhance the hormone’s absorption in the gut and to inhibit the enzymesthat destroy it.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 5So far, the trial in Jerusalem has been small, involving only eight healthvolunteers. In future, Bar-on wants to extend the trials to diabetics, but hestresses the need for more research before he can do so. The success of thetests so far has been limited, but encouraging, says Bar-On: in three of theeight, the level of sugar in their blood fell after they took the capsule from100 milligrams per decilitre to between 80 and 85. At the same time, theinsulin level in their blood was seen to rise to a peak then tail off. For theremaining five people, there was no significant effect from the capsule.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 6A third project is led by Yough Cho at Murdoch University in Perth,Australia, together with Cortecs, a company in Isle Worth near London. Chohas devised a combination of insulin and fatty molecules, encapsulated ingelatin. The fatty molecules, which occur naturally in the gut as a product ofthe digestion of fat, are easily absorbed from the gut and carried to the liver.Insulin attached to these molecules can enter the bloodstream.Cho gave three diabetic men this preparation, in liquid form. In each of themen there was a “substantial reduction” in the level of blood sugar. Theirinsulin levels were also seen to peak and tail off. The team has published thiswork in The Lancet, and clinical trials of the capsule are due to start soon atGuy’s Hospital, in London.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 7There are, however, several problems with oral insulin. First, it is relativelyinefficient: several times as much insulin is needed to achieve the same dropin blood sugar that a specific amount could achieve if injected. This suggeststhat a significant amount of insulin is still being destroyed in the gut. Also,the amount of insulin that will be absorbed is unpredictable and can bedisrupted, for example, by illness.

Questions

“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”QUESTIONS

Q1. According to the article, _______a) it is no longer desirable that diabetics should inject themselves with insulinb) a large number of diabetics no longer want to inject themselves withinsulinc) a viable oral form of insulin has been developedd) a viable oral form of insulin may soon be developed


Q2. The major problem with an oral form of insulin has been _______a) producing it in sufficient quantities outside the pancreasb) delivering it undamaged into the bloodstream ‘c) preventing it from attacking digestive enzymes in the gutd) its previous inability to cross the gut wall into the bloodstream


Q3. The capsule which is to be tested in Ohio _______a) will also be tested on blind people and younger childrenb) contains a combination of insulin, aspirin and sodium bicarbonatec) has protection which enables it to overcome the previous problemsd) none of the above


Q4. The reaction between the capsule and water in the gut _______a) is likely to destroy the insulinb) causes the insulin and the aspirin-like drug to “be taken into thebloodstreamc) produces carbon dioxide as a by-productd) allows the insulin and the sodium bicarbonate to pass into the bloodstream


Q5. Research at the Medical College of Ohio in Toledo _______a) has shown signs of being successful

b) has been carried out on diabetic rats and dogsc) has shown an increase in blood level in the animals testedd) all of the above


Q6. In tests carried out at the Hadassah Hospital in Jerusalem _______a) Saffran’s capsule has had similar results with humansb) Saffran’s capsule has not had similar results with humansc) the researchers have used a capsule which is almost identical to Saffran‘sd) the capsule being used contains substances to protect the insulin fromattacking in the stomach


Q7. Which of the following statements is TRUE?a) Bar-On has used healthy diabetic volunteers exclusively in his trialsb) Bar-On is ready to extend his trialsc) Bar-On has not been discouraged by results to dated) Less than 50% of Bar-On‘s subjects experienced minimal change ofinsulin level in the blood


Q8. In the Australian project, _______a) fatty molecules, similar to those found naturally-occurring in the body areused to cost the insulin-gelatin combinationb) the artificially-introduced fatty molecules solidify in the gutc) fatty molecules carry the insulind) the gelatin enters the bloodstream with the insulin



Practice Test 17


TIME: 15 MINUTES



Text A

Patchy and scratchyEuropean scientists say they can explain why nicotine patches designed tohelp smokers kick their habit can cause skin irritation. Nicotine activates aso-called ion channel in skin cells that unleashes an inflammatory responseby the immune system, leading to itching, they reported in the journal NatureNeuroscience on Sunday. Previously, the irritation had been blamed onstimulation of special nicotine receptors on nerve cells, causing pain signalsto be sent to the brain. The investigation, carried out on mice, could pave theway to smoking therapies with fewer side effects, the authors say.

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Text B

Pay poorer smokers to quit, heart lobby urgesAustralians should be paid to quit smoking to help reduce the burden of heartdisease in poorer outer suburban and regional areas, the head of the HeartFoundation of Victoria, Kathy Bell, says. The call came as a new survey of

about 20,000 people found the municipality of Dandenong in Melbourne’souter south-east had the highest rate of heart disease in Victoria, with nearly32 per cent of the population affected by it. Regional areas of Victoria,including East Girppsland and the Ovens-Murray strict, showed similarly badresults, whereas Ms Bell said only about 14 per cent of people in high-income areas, close to the city, had experienced heart disease.

“These regions are some of the lowest-income areas in Victoria, with a highproportion of households earning income of less than $350 per week,” shesaid. Ms Bell said research showed disadvantaged areas had high rates ofsmoking which needed to he addressed. She said financial incentives shouldbe considered alongside higher taxes on cigarettes — both recommendationsof a resort recently released by the Federal Government’s preventive healthtaskforce. A study of more than 800 General Electric employees in the USfound those who were offered rolling payments of up to $750 a year to quitsmoking and remain abstinent were about three times more likely to rantlong-term, compared with use who were not given money.

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Text CCyber aid to quitting smokingBattling one’s cigarette demons in a virtual world may prove to be aneffective way to help people quit smoking, a research team has found in apreliminary study. Scientists from Canada’s GRAP Occupational PsychologyClinic and the University of Quebec modified a three-dimensional videogame to create a computer-generated virtual reality environment as part of ananti-smoking program. Of 91 regular smokers enlisted in the 12-weekprogram, 46 of them crushed computer-simulated cigarettes as part ofpsychosocial treatment, while the other 45 grasped a computer-simulatedball. The group who crushed cigarettes had a “statistically significantreduction in nicotine addiction” compared with the ball graspers, according tothe study in the journal Cyber-Psychology and Behaviour.

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Text D

By the 12th week, abstinence among the cigarette-crushers was 15 per cent,compared with 2 per cent for the other group. The crushers also stayed in theprogram longer and, at a six- month follow-up, 39 per cent of them reportednot smoking during the previous week, compared with 20 per cent of the ball-graspers. “It is important to note that this study increased treatmentretention,” said Brenda Wiederhold, the journal’s (Cyber-Psychology andBehaviour) editor-in-chief, adding that such treatment should now becompared to other popular treatments such as the nicotine patch. The studysaid about 45 per cent of smokers in the US attempt to quit each year, withlimited success.

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QUESTIONS


In which text can you find information about1. which are the lowest-income areas in Victoria? _____

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2. who created the video game to as part of an anti-smoking program? _____Goto

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3. who are the cigarette-crushers? _____

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4. who is Brenda Wiederhold? _____Goto

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5. why the nicotine patches are causing skin irritation? _____Goto

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6. who proposed the idea to pay Australians to quit smoking? _____Goto

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“TextC”

“TextD”

9. How many regular smokers enlisted in the Canadian Cyber-aid program?Goto

“TextA”

“TextB”

“TextC”

“TextD”

10. Where did the European scientists’ published their findings?Goto

“TextA”

“TextB”

“TextC”

“TextD”

11. How many General Electric employees were offered payments to quitsmoking?

Goto

“TextA”

“TextB”

“TextC”

“TextD”

12. What was the trial subject for the study conducted by Europeanscientists?

Go

to “TextA”

“TextB”

“TextC”

“TextD”

13. How many crushed computer-simulated cigarettes?Goto

“TextA”

“TextB”

“TextC”

“TextD”

Questions 14-20Complete each of the sentences, 14-20, with a word or short phrase from oneof the texts. Each answer may include words, numbers or both.14. Nicotine activates an ion channel in skin cells that unleashes _____ by theimmune system.

Goto

“TextA”

“TextB”

“TextC”

“TextD”

15. In Australia, 14 per cent of people in high-income areas had experienced______.

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“TextA”

“TextB”

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16. By the 12th week, abstinence among the ball-graspers was _____.Goto

“TextA”

“TextB”

“TextC”

“TextD”

17. In the US, 45 per cent of smokers attempt to quit each year with ______.Goto

“TextA”

“TextB”

“TextC”

“TextD”

18. Previously, nicotine patch irritation was blamed on stimulation of _____on nerve cells.

Goto

“TextA”

“TextB”

“TextC”

“TextD”

19. ______ stayed in the Cyber aid program longer than the other group.Goto

“TextA”

“TextB”

“TextC”

“TextD”

20. Ms Bell’s research showed ______ had high rates of smoking.Goto

“TextA”

“TextB”

“TextC”

“TextD”



TIME: 45 MINUTES



Part B

In this part of the test, there are six short extracts relating to the work ofhealth professionals. For questions 1-6, choose the answer (A, B or C) whichyou think fits best according to the text.Safety inspections of medical equipments

These are performed to ensure the device is electrically and mechanicallysafe. These inspections may also include checks for radiation safety ordangerous gas or chemical pollutants. When these inspections are done, theresults are compared to country or regional standards as well as tomanufacturer’s specifications. The frequency of safety inspections may bedifferent than planned maintenance and performance inspections, and areusually based on regulatory requirements.

1. This guideline extract says that the safety inspections should notA. be performed to ensure the device is electrically and mechanically safeB. include checks for radiation safety or dangerous gas or chemical pollutantsC. be the same than planned maintenance and performance inspections

Operation and service manuals

Ideally, the maintenance programme will have an operation (user) manualand a service manual for each model of medical equipment. The operationmanual is valuable not only for equipment users but also for equipmenttechnicians who need to understand in detail how the equipment is used inclinical practice. The service manual is essential for inspection, preventivemaintenance, repair, and calibration. Unfortunately, operation manuals andservice manuals are not always available, or may be in a language not spokenby equipment technicians. Therefore, it is important to take steps that allowthem access to such manuals.

2. The purpose of this email is to take steps that allowA. both equipment users and equipment technicians access to operationmanualsB. only the equipment technicians access to operation manualsC. only the equipment users access to operation manuals

Scheduling maintenance

Efficient use of technician time will reduce down-time of equipment andminimize overall expenses. The most appropriate method for schedulingmaintenance in a particular health-care facility should be chosen. Forinspections, one approach is to plan for the equipment in a given clinicaldepartment to be inspected at the same time. This works very well forequipment that does not move from the department. Another approach wouldbe to schedule inspection of equipment of a given type (e.g. defibrillators)simultaneously.

3. The guidelines establish that the healthcare professional shouldA. use technician efficiently to reduce down-time of equipment and expensesB. only plan inspection for immobile equipment in a given clinicaldepartmentC. schedule inspection of equipment of different types simultaneously

Patient Discharge And Referring Physician Interface

Care teams that may include the attending physician or dentist, fellows, otherlicensed independent health-care practitioners, research nurses, and patient-care unit nursing staff will meet with patients at the time of their discharge toexplain their evaluation, treatment, and management recommendations as

well as the follow-up that may be required at the clinical center. The careteams will provide patients with a form containing discharge instructions,their medication list, and a contact phone number at the clinical center.Referring physicians will receive a concise summary of evaluation, treatment,and management recommendations from the responsible attending physicianor other designated licensed independent practitioner within a week ofdischarge, or earlier if necessary for appropriate continuity of care.

4. When referring a patient to physician, it is necessary toA. provide a concise summary of evaluation, treatment, and managementrecommendations of the patientB. provide a form containing discharge instructions, patient’s medication listand contact phone numberC. explain patient’s evaluation, treatment, and management recommendationsas well as the follow-ups

Quality Assurance

To review the occurrences and complications of procedures that caused—orhad the potential to cause—patient harm, the institutes and centers shouldconduct Quality Assurance Rounds on a regular basis. These rounds alsoprovide an appropriate opportunity to discuss especially serious outcomes ofprotocol participation—even when unassociated with an occurrence orprocedural complication. These conferences, which should be attended by alllevels of patient-care staff, will regularly include the unit nurse manager andother representatives from the nursing staff. When appropriate, other key staff(e.g., from the Pharmacy or Social Work Department) may be included.

5. The purpose of these notes about Quality Assurance is toA. provide an appropriate opportunity to discuss outcomes of protocolparticipationB. review the occurrences and complications of procedures that causedpatient harmC. ensure attendance of patient-care staff and appropriate key staff

Evaluation Of Transitions Of Care Measures

Monitor compliance with standardized forms, tools, and methods fortransitions of care. Use surveys and data collection to find root causes of

ineffective transitions and to identify patient and caregiver satisfaction withtransitions and their understanding of the care plan. For example, this three-item survey queries patients about key aspects of a care transition:• The hospital staff took my preferences and those of my family or caregiverinto account in deciding what my health care needs would be when I left thehospital.• When I left the hospital, I had a good understanding of the things I wasresponsible for in managing my health.• When I left the hospital, I clearly understood the purpose for taking each ofmy medications.

6. The guidelines establish that the healthcare professional shouldA. monitor compliance with standardized forms, tools, and methods fortransitions of careB. use surveys and data collection to find root causes of effective transitionsC. identify patient and caregiver dissatisfaction with ineffective transitionsAnswer Key


Practice Test 19


TIME: 45 MINUTES




Exercise, fitness and healthParagraph 1 Physical inactivity is a substantial risk factor for cardiovascular disease.Exercise probably works by increasing physical fitness and by modifyingother risk factors. Among other benefits, it lessens the risk of stroke andosteoporosis and is associated with a lower all-cause mortality. Moreover, ithas psychological effects that are surely underexploited. A pervasive benefitis the gain in everyday reserve capacity - that is, the ability to do morewithout fatigue. Nevertheless, there is much debate about how intense theexercise should be. Some studies show a dose-response relation betweenactivity and reduction of risk, with a threshold of effect; some suggest thatvigorous aerobic activity is needed and others that frequent moderate exerciseis adequate - and indeed safer if ischaemic heart disease might be present. Afew surveys have found a slightly increased risk of heart attack with extremeactivity, though further analysis in one study suggested this applied only to

men with hypertension.


Paragraph 2 A commonly recommended minimum regimen for cardiovascular benefit isthrice weekly exercise for 20 minutes, brisk enough to produce sweating orhard breathing (or a heart rate 60-80% of maximum). Indeed, this is what theAllied Dunbar national survey of fitness among adults in the UKrecommends. It conveys a simple popular message of broad minimum targetsfor different age groups expressed in terms of activities of different intensity.The aim is to produce a training effect through exercise beyond what iscustomary for an individual.


Paragraph 3 The main reason why people fail to take exercise is lack of time. Thus animportant message is that exercise can be part of the daily routine - walkingor cycling to work or the shops, for instance. Relatively few people in thenational fitness survey had walked continuously for even 1-25 km in theprevious month (11-30% depending on age and sex), and other surveys havealso found little walking. Cycling is also beneficial, however many are putoff cycling to work by the danger. Certainly more cycle routes are needed,but even now life years lost through accidents are outweighed by theestimated life years gained through better health. Employers could encouragepeople to make exercise part of the working day by providing showers andchanging rooms, flexible working hours, individual counselling byoccupational health or personnel staff, and sometimes exercise facilities - orat least encouragement for exercise groups.


Paragraph 4 In the promotion of exercise children, women, middle aged men, and olderpeople need special thought. Lifelong exercise is most likely to be started inchildhood, but children may have little vigorous exercise. Women tend to be

much less active than men and are less fit at all ages. The proportion judgedon a treadmill test to be unable to keep walking at 5 km/h up a slight sloperose with age from 34% to 92% - and over half of those aged over 54 wouldnot be able to do so even on the level. Women have particular constraints:young children may prevent even brisk walking. Thus they need sensitivehelp from health professionals and women’s and children’s groups as well asthe media.


Paragraph 5 A high proportion of men aged 45-54, who have a high risk of coronary heartdisease, were not considered active enough for their health. Promotion ofexercise and individual counselling at work could help. Forty per cent of 65-74 year olds had done no “moderate” activity for even 20 minutes in a month.Yet older people especially need exercise to help them make the most of theirreduced physical capacity and counteract the natural deterioration of age.They respond to endurance training much the same as do younger people.Doctors particularly should take this challenge more seriously.


Paragraph 6 People need to be better informed, and much can be done through the media.For instance, many in the survey were mistaken in thinking that they wereactive and fit. Moreover, many gave “not enough energy” and “too old” asreasons for not exercising. Precautions also need publicity - for example,warming up and cooling down gradually, avoiding vigorous exercise duringinfections, and (for older people) having a medical check before startingvigorous activity. Doctors are in a key position. Some general practitionershave diplomas in sports medicine, and a few are setting up exerciseprogrammes. As the Royal College of Physicians says, however, all doctorsshould ask about exercise when they see patients, especially during routinehealth checks, and advise on suitable exercise and local facilities. Theirfrequent contact with women and children provides a valuable opportunity.Excluding ischaemic heart disease and also checking blood pressure beforevigorous activity is started are important precautions. But above all doctors

could help to create a cultural change whereby the habit of exercise becomesintegral to daily life.


QUESTIONS

Q1. All of the following are mentioned in paragraph 1 as benefits of exerciseEXCEPT __________ A. increase in the capacity to withstand strenuous activity. B. significant decrease in the risk of osteoporosis. C. reduction of the risk of heart disease. D. weight control and decrease in levels of body fat.


Q2. According to paragraph 2, the recommendations of the report on thenational fitness survey included__________ A. long, vigorous aerobic sessions for all men, women and children. B. no more than three, 20 minute exercise sessions per week. C. avoiding any exercise that brought on hard breathing. D. different levels of exercise intensity for different age groups.


Q3. According to paragraph 3, one reason many people do not exerciseis__________ A. they are unaware of its importance. B. difficulty in fitting it into their daily routine. C. they are unaware of its long-term health benefits. D. they live too far from work to walk or cycle.


Q4. Which one of the following is mentioned in paragraph 3 as a way inwhich employers can help improve the physical fitness and health of theirstaff? A. Making it mandatory for employees to exercise during lunch breaks.

B. Providing encouragement and advice from staff within the organisation. C. Hiring trained sports educators to counsel members of staff about exercise.D. Setting an example, as individuals, by regularly exercising themselves.


Q5. According to paragraphs 4 and 5, older men and women need to remainphysically active and fit because __________A. they need to counteract the risk of coronary disease.B. fitness levels decrease rapidly over the age of 54.C. they need to guard against poor health and inactivity.D. exercise works against the physical effects of ageing.


Q6. Which one of the following is NOT mentioned in paragraph 6 as aprecaution to be taken when considering exercise?A. The need to balance aerobic activity with stretching.B. The need to warm up before and cool down after exercise. C. The need to eliminate the risk of ischaemic heart disease before starting. ,D. The need to exclude strenuous exercise from the routine during infection.


Q7. Which one of the following needs in relation to the improvement ofnational fitness are NOT mentioned in the article?A. The need for people to make exercise a regular daily habit.B. The need to provide information on health and fitness to the community.C. The need for doctors themselves to improve their own fitness levels.D. The reed to consult a doctor before starting an exercise program.


Q8. According to the article, which one of the following is FALSE?A. It is unsafe for people with high blood pressure to do regular moderateexercise.B. Experts agree on the importance of both type and intensity of exercise.C. Men are generally fitter and more active than women.D. Cycling, though unsafe, is a beneficial form of exercise.



Practice Test 20


TIME: 45 MINUTES




Employment records reveal the detail of asbestos dangerParagraph 1About a quarter of the people who worked in an asbestos mine in WesternAustralia between 1963 and the closure of the pit in 1986 are alreadysuffering from diseases related to their exposure to the mineral, or do in thefuture. This is the estimate of researchers who say that the mine’semployment records have enabled them to carry out one of the most thoroughstudies ever of the long-term health effects of exposure to asbestos fibre. Theteam, based at the University of Western Australia and the Sir CharlesGairdner Hospital in Perth, says that it is the only study in which a well-defined group of people has been exposed to a single form of asbestos over aspecified period.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 2

Of the 6502 men and 410 women who worked at the mine, almost 2000 havedeveloped or will develop cancer and other diseases related to asbestos. TheAsbestos Diseases Society of Australia, a group formed to help peopleexposed” to asbestos, claims that 300 former workers have already died ofdiseases that are asbestos-related. The people, mostly migrant labourers fromEurope, worked in an asbestos mine and mill in Wittenoom, a town in theHamersley Range, about 1600 kilometres north of Perth. Wittenoom, oncethe home for 4000 people, is now virtually deserted. The state governmentcut essential services to the town last year. Blue asbestos, or crocidolite, wasmined there.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 3The researchers were able to determine how much asbestos the workers wereexposed to by making calculations based on readings of dust that were takenat various times during the mine’s operation. The most extensive exposure toasbestos occurred in the mill where ore was ground down and the fibreextracted. The Australian study was published last month in the MedicalJournal of Australia. Other records of exposure to blue asbestos - such asthose from South Africa - have not been as useful to researchers as the datafrom Wittenoom, says William Musk, from the University of WesternAustralia.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 4Blue asbestos fibres are very thin, straight and small - about 0.1 micrometresin diameter. As a result, they are more likely to enter the lungs than othertypes of asbestos fibres. They are also the least likely to adhere to and beintercepted by the protective mucus in the airways. Scientists have associatedthe fibres mined at Wittenoom with three types of disease: malignantmesothelioma, lung cancer and asbestosis, a scarring of the lung. Most of theworkers were at the mine for only short periods - months, rather” than years.The diseases may take up to 40 years to develop.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 5The records until 2006 show 94 cases of mesothelioma, 141 lung cancers and

356 cases of asbestosis among the Wittenoom workers. In the generalpopulation, mesothelioma, a cancer of the outer covering of the lung, is rare,occurring at the rate of less than one per million people each year. Thescientists say that exposure to asbestos can account for about 40 per cent ofthe cases of lung cancer at Wittenoom; the remainder were caused by theeffects of smoking. Over the next 30 years, there will be a sevenfold increasein the number of cases of mesothelioma, according to the researchers‘estimates. There will be as many as 25 cases of the disease a year by the year2030.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 6The team predicts that between 1997 and 2040, a total of 692 new cases ofmesothelioma will occur. Most will be in the lung (pleural mesothelioma),but some will be in the abdomen (peritoneal mesothelioma). Cases of lungcancer and asbestos among the workers will reach a peak by about 2020, witha total of 183 and 482 respectively by the year 2040. The Asbestos DiseasesSociety claims that the problem will not be confined to former workers.About 6000 of the 14 000 wives and children of workers at Wittenoom willalso suffer from asbestos-related disease, according to the society. “Forty-onepeople in their late 30s or 40s who were children at Wittenoom have died ofmesothelioma.” according to Robert Vojakovic, the President of the society.He obtained the statistics from death certificates. The university study onlyexamined the records of workers.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 7Last year, after a legal battle lasting 13 years, CSR, the mining companywhose subsidiary, Australian Blue Asbestos, operated the plant, agreed in anout-of-court settlement to pay compensation to former miners and residentsof Wittenoom. By 5 December, 350 people and their families had receivedcompensation totalling $42 million. The State Government InsuranceCommission will share the costs of compensation based on exposure toasbestos at Wittenoom after 1979. The payments, part of the largest industrialsettlement in Australian history, will range in size between A$30,000 andA$600,000.

Questions

“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”Paragraph 8However, Western Australia has another problem. The red gorges within theHamersley Range, including the Wittenoom Gorge, have become a touristattraction. The millions of asbestos tailings that still litter the area areregarded as a health hazard, especially to children who might be tempted toplay on the piles. Camping is forbidden in the Wittenoom Gorge. The stategovernment is considering burying the tailings or putting them under thewater. Both solutions will be expensive. The asbestos society is trying toobtain funds from Lang Hancock, the mining magnate who opened the minein the late 1950s, and CSR, to help restore Wittenoom Gorge, which it sayscould be made into a major tourist attraction. It also wants the town to berelocated within the gorge.


QUESTIONS

Q1. Of all workers in the Western Australian mine, 25%a) have died since 1986 of mine-related diseases.b) have already got symptoms of mine-related diseases.c) may suffer from mine-related diseases in the future.d) have developed mine-related diseases or may do so.


Q2.Which of the following is not unique to the West Australian study?a) The mine kept records of all workers.b) The effects of only one form of asbestos were studied.c) Data were collected during a clear period of time.d) The group studied was well defined. ’


Q3.The population of Wittenoom is nowa) around 4000 people.b) extremely small.c) around 1600 people.d) non-existent.


Q4. Which of the following is not typical of blue asbestos fibres?a) The fibres are so small that they enter the lungs easily.b) The fibres easily adhere to protective mucus in the airways.c) The fibres are usually not intercepted by mucus in the airways.d) The fibres are less than a micrometre in diameter.


Q5. Of the three types of diseases associated with asbestos fibres at theWittenoom mines.a) mesothelioma is the most frequently occurring type.b) asbestosis is the most frequently occurring type.c) asbestosis is the least frequently occurring type.d) lung cancer is the least frequently occurring type.


Q6. The research team predicts that by the year 2040 there will be a total of183 cases ofa) asbestosis.b) pleural mesothelioma.c) lung cancer.d) peritoneal mesothelioma.


Q7. Statistics quoted in the article are based ona) death certificates.b) mine employment records.c) research conducted at a university.d) all of the above.


Q8. A 13-year legal battle for compensation of disease victims resulted ina) an out-of-court settlement involving payment by two parties.b) compensation payments to former Wittenoom miners.

c) compensation payments to 350 Wittenoom residents.d) an out-of-court settlement involving payment only by CSR.



Answer Key

Practice Test 11. B2. D3. A4. C5. D6. C7. A8. 1,7409. walking10. counselling11. doctor12. physical therapies13. regular exercise14. Dr. Eric Larson15. Medications16. Herbs17. physical activity program18. vitamins19. none20. progressively destroyed

“Practice Test 2”Practice Test 21. B2. B3. C4. C5. C6. B

“Practice Test 3”Practice Test 3

1. b2. b3. b4. d5. d

6. a7. c8. a


1. a2. d3. a4. b5. b6. c7. b8. c

“Practice Test 5”Practice Test 51. C2. D3. B4. A5. B6. D7. A8. Secondary glaucoma9. $4.3 billion10. 0.711. Over 146,00012. $342 million13. 50%14. optic nerve15. an 8-fold16. Acute glaucoma17. cortisone18. indigenous population19. Chronic glaucoma20. eye drops


1. A2. A3. A4. A5. A6. C


1. b2. d3. c4. d5. b6. a7. b8. d

“Practice Test 8”Practice Test 81. b2. b3. d4. c5. a6. b7. d8. c

“Practice Test 9”Practice Test 91. C2. B3. A4. D5. B

6. D7. D8. SSRI9. WHO10. psychiatrist11. severe depression12. 613. Laurie Oakes14. Occasional sadness15. another illness16. eating habits17. 2 weeks18. Beyond Blue19. antidepressant20. Mild depression

“Practice Test 10”Practice Test 101. B2. C3. B4. C5. A6. C


1. d2. c3. d4. a5. b6. d7. a8. b

“Practice Test 12”Practice Test 121. b2.b

3. c4. a5. a6. d7. c8.b

“Practice Test 13”Practice Test 131. A2. D3. D4. B5. C6. C7. B8. Health practitioners9. blood lead test10. children and babies11. calcium12. more recent exposure13. Intelligence Quotient14. Australia15. Lead toxicity16. cognitive17. clinical use18. individual blood levels19. management plan20. lead hazards

“Practice Test 14”Practice Test 141. A2. C3. A4. A5. B6. A

“Practice Test 15”Practice Test 151. b

2. a3. c4. c5. a6. b7. c8. a

“Practice Test 16”Practice Test 161. d2. b3. c4. c5. a6. d7. c8. c

“Practice Test 17”Practice Test 171. B2. C3. C4. D5. A6. B7. D8. Brenda Wiederhold9. 9110. Nature Neuroscience11. 80012. mice13. 4614. an inflammatory response15. heart disease16. 2 per cent17. limited success18. special nicotine receptors19. cigarette-crushers20. disadvantaged areas

“Practice Test 18”Practice Test 181. C2. A3. A4. A5. B6. A

“Practice Test 19”Practice Test 191. d2. d3. b4. b5. d6. a7. c8. b

“Practice Test 20”Practice Test 201. d2. a3. b4. b5. b6. c7. d8. a

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