醫(yī)學英語試題(3)
A) Bacteremia B) Toxemia C) Uremia D) Septicemia
35. A cough may be dry, or it may produce a lot of _______.
A) sputum B) saliva C) serum D) semen
36. The ________ test will measure the amount of air in your lungs and the amount you can breathe out in one second. This will help to determine how your lungs are functioning.
A) spirometry B) endoscopy C) hemodialysis D) manometry
37. A _________ refers to a collection of gas in the pleural space resulting in collapse of the lung on the affected side.
A) pneumomediastinum B) pneumoperitoneum
C) pneumonia D) pneumothorax
38. The secretion of _______, a hormone secreted by glands in the mucous membrane of the stomach, is stimulated by the presence of food.
A) pepsinogen B) gastrin C) lipase D) thyrotropin
39. Anterior tibialis _________ readings were recorded during the first night to detect periodic limb movements.
A) electrocardiographic B) electroencephalographic
C) electromyographic D) electro-oculographic
40. If all genes in the human ____ are sequenced, gene therapy will be greatly enhanced.
A) germs B) germinoma C) genome D) germogen
Part III Reading Comprehension (50 points)
Directions: Each of the passages below is followed by some questions. For each question there are four answers marked A), B), C), and D). Read the passages carefully and choose the best answer to each of the questions. .
Passage 1
Asthma is manifested by widespread narrowing of the airways that changes in severity, either spontaneously, or as a result of treatment. The reversible airway obstruction is caused by smooth muscle contraction and mucosal edema. Secretion clearance is diminished and production may be increased. Bronchial hyperreactivity is not unique to asthma, however. A small number of healthy subjects, and as many as 50% of patients with allergic rhinitis, manifest abnormal airway reactivity to bronchial challenge. The etiology of bronchial hyper-reactivity is unknown. Possible mechanisms include an increased responsiveness of the smooth muscle itself, an abnormality in the autonomic nervous system control of the smooth muscle or an increase in the accessibility of the stimulus to the target cells. An increase in airway wall thickness and smooth muscle mass probably contributes to the reactive state. Irritant receptors located in the airways, nose, larynx, and lungs respond to mechanical and chemical irritants, inhalation of dust, and drugs such as histamine. When stimulated, these receptors cause reflex bronchoconstriction through vagal efferent pathways.
Several interrelated physiologic abnormalities occur in patients with significant bronchoconstriction. Airway resistance increases five to six times above normal and specific conductance is therefore decreased. Expiratory time is prolonged and the forced vital capacity is low, averaging approximately 50% of predicted normal. The forced expired volume in one second (FEV1) is diminished, averaging 30% ～ 35% of predicted normal while maximum midexpiratory flow rate (MMEFR) and the peak expiratory flow rate (PEFR) usually are only 15% ～ 20% of normal. Hyperinflation is manifested by an increase in the residual volume and functional residual capacity (FRC) but diminished vital capacity and elastic recoil. Total lung capacity may be normal or only slightly increased. Pathophysiologic changes include ventilation-perfusion mismatching which results in hypoxemia. Increased airway resistance leads to progressive alveolar hypoventilation and hypercapnia, while the increased work of breathing results in lactic acidemia. The combined respiratory and metabolic acidosis may be life threatening.
41. ________ can cause asthma, a widespread narrowing of the airways that changes in severity.
A) Aging B) Treatment C) Sputum D) Immunoglobulin
42. Which of the following statements is NOT TRUE according to the above passage?
A) In asthma, secretion clearance is decreased.
B) In asthma, airway obstruction is reversible.
C) Bronchial hyperreactivity is unique to asthma.
D) The etiology of bronchial hyperreactivity is unknown.
43. Possible mechanism of bronchial hyperreactivity includes ______.
A) an increased responsiveness of the smooth muscle itself.
B) inhalation of mechanical and chemical irritants.
C) autonomic nervous system control of the smooth muscle.
D) irritant receptors located in the airways.
44. In asthma, the forced vital capacity averages approximately ______ of predicted normal.
A) 15% B) 20% C) 50% D) 75%
45. Which of the following statements concerning asthma is TRUE according to the above passage?
A) Pathophysiologic changes include ventilation-perfusion mismatching which results in hyperxemia.
B) Total lung capacity may be normal or only slightly decreased.
C) The increased work of breathing results in hypercapnia.
D) The combined respiratory and metabolic acidosis may be fatal.
Passage 2
Most patients who have a haematemesis are in no doubt that the blood was vomited. However, blood discovered in the mouth may have originated from the postnasal space or lower respiratory tract. This can cause confusion unless time is taken to elicit an accurate history. The haematemesis may consist either of fresh blood mixed with gastric fluid or changed blood in the form of “coffee grounds”. All such patients should be referred to hospital for admission because haematemesis indicates a recent haemorrhage.
The patient’s estimate of how much blood has been vomited is seldom helpful in assessing the true severity of the bleed. In contrast, vomitus saved by the patient or produced in the presence of the practitioner is a useful guide. Haematemesis may be accompanied by melaena but because most patients who vomit blood rapidly seek medical attention, it is not always initially present. If no stool has been passed, rectal examination may reveal melaena. This can sometimes be helpful when there is doubt about the validity of haematemesis. Malaena without haematemesis often indicates a less severe bleed. However, when melaena is fresh or has been present for 3 days or less, admission to hospital is still required. A patient with a longer history of melaena who is not anaemic and remains otherwise healthy does not necessarily require admission, providing early investigation can be arranged. Confusion can sometimes arise in patients taking iron or bismuth containing preparations because they both cause darkening of the stool. Neither gives a positive occult blood test.
46. According to the above passage, which of the following statements is TRUE?
A) All blood discovered in the mouth was vomited.
B) Most blood discovered in the mouth was vomited.
C) All blood discovered in the mouth originated from the postnasal space or lower respiratory tract.
D) Most blood discovered in the mouth originated from the postnasal space or lower respiratory tract.
47. According to the above passage, what may the haematemesis consist of?
A) Fresh blood mixed with “coffee grounds”.
B) Fresh blood in the form of “coffee grounds”.
C) Changed blood mixed with “coffee grounds”.
D) Changed blood in the form of “coffee grounds”.
48. _______ is usually helpful in assessing the true severity of the haemorrhage.
A) The patient’s estimate of how much blood has been vomited.
B) The patient’s estimate of how much food has been vomited.
C) The vomitus.
D) The melaena.
49. According to the above passage, which of the following statements is NOT TRUE?
A) Haematemesis without malaena often indicates a less severe bleed.
B) Haematemesis with malaena often indicates a less severe bleed.
C) Malaena without haematemesis often indicates a less severe bleed.
D) Malaena with anaemia often indicates a less severe bleed.
50.Under which of the following conditions the patient should be referred to hospital for admission?
A) When melaena is in the form of “coffee grounds”.
B) When melaena is fresh.
C) When anaemia is present.
D) When the stool is dark.
Passage 3
HIV-1 has been cultured from lymphocytes, monocytes, and macrophages obtained from blood, semen, and vaginal and cervical secretions of infected individuals. The virus also exists in a cell-free form in these fluids. It is not clear whether cell-to-cell contact or the exposure of uninfected cells to free virus is the more common or efficient way that new infections occur. The virus has also been obtained, less consistently, from the cerebrospinal fluid, and rarely in very low concentration from the saliva of patients infected by HIV-1. No clearly documented cases of HIV transmission via body fluids other than blood or genital secretions are known.
A second human immunodeficiency virus (HIV-2) was identified in Western Africa in the mid-1980’s. While HIV-2 has been associated with AIDS-like syndromes, the vast majority of HIV-2 seropositive persons are asymptomatic. Whether these seropositive individuals are infected with a less virulent strain, or simply represent more recent exposure to an equally virulent virus, is not yet known. Although HIV-2 shares many biologic and genetic characteristics with HIV-1, each of the two viruses also has genes that are unique. HIV-2 is more closely related to the simian immunodeficiency virus (SIV). Sporadic HIV-2 infections in the United States have occurred in persons of West African origin.
HTLV-I (human T-cell lymphotrophic virus-I), the first pathogenic human retrovirus, was identified several years prior to the recognition of HIV-1 as the cause of AIDS. HTLV-I is endemic in southern Japan and the Caribbean and in certain parts of Africa. It is also present among drug abusers in Europe and the United states and thus has the potential for further spread. Its modes of transmission are similar to those of HIV-1 and 2, but the perinatal routes (breast milk as well as transplacental) appear to account for a far greater proportion of the known cases of HTLV-I. Two distinct clinical illnesses, an aggressive adult T-cell leukemia and a relatively indolent spastic paraparesis (originally designated tropical spastic paraparesis), may be associated with HTLV-I infection. However, as compared to HIV-1, individuals infected with HTLV-I are much less likely to develop clinical illness. Fewer than 1 per cent of HTLV-I infected persons develop either T-cell malignancies or spastic paraparesis; both of the clinical syndromes most frequently develop through decades of life, 30 to 50 years after the presumed acquisition of the HTLV-I infection. The extent of subclinical neurological and/or immunological impairment in populations infected with both HTLV-I and HIV-1 appear to become immunocompromised more rapidly than those infected with HIV-1 alone.
51. HIV-1 also exists in a cell-free form in the following fluids except _______.
A) blood B) sweat C) semen D) genital secretions
52. According to the above passage, which of the following statement is TRUE.
A) The vast majority of HIV-2 seropoistive persons are asymptomatic because they are infected with a less virulent strain.
B) The vast majority of HIV-2 seropoistive persons are asymptomatic because they are more recently exposed to an equally virulent virus.
C) The vast majority of HIV-2 seropoistive persons are asymptomatic because HIV-2 is more closely related to the simian immunodeficiency virus.
D) None of the above.
53. Which of the following activities may transmit HTLV-I infection through perinatal routes?
A) Breast milk feeding.
B) Homosexual intercourse.
C) Sharing needles.
D) Transfusions of contaminated blood.
54. HIV-2 has a closer relationship with _______ .
A) HIV-1
B) HTLV-I
C) SIV
D) None of the above
55. According to the above passage, which of the following statement is TRUE.
A) When persons are infected with HIV-2, their immunities are impaired in a faster speed than those infected with HIV-1.
B) When persons are infected with HIV-1, their immunities are impaired in a faster speed than those infected with HIV-2.
C) When persons are infected with both HTLV-I and HIV-2, their immunities are impaired in a faster speed than those infected with HIV-2 alone.
D) When persons are infected with both HTLV-I and HIV-1, their immunities are impaired in a faster speed than those infected with HIV-1 alone.