第一章MedicalEnglish:FeaturesandLearning醫(yī)學(xué)英語的學(xué)習(xí)特點(diǎn)分析和醫(yī)學(xué)交流過程的特點(diǎn)分析2.MedicalLiteracyandTerminology(專業(yè)術(shù)語的構(gòu)成和專有符號(hào)等)3.CriticalReadingSkills（批判性閱讀能力的形成）4.LiteratureandDocumentsinMedicalSciences（醫(yī)學(xué)專業(yè)不同類型文獻(xiàn)及文件的分析）5.CommunicationinClinicMedicines（醫(yī)學(xué)臨床中的交流）6.BalanceBetweenChineseandEnglish:MedicinesInvolved(醫(yī)學(xué)專業(yè)中中英交流的平衡和互動(dòng))8.AcademicWritingABCinMedicines（醫(yī)學(xué)學(xué)術(shù)寫作初步）9.communicationandMedicalStudy第一章MedicalEnglish:FeaturesandLearning醫(yī)學(xué)英語的學(xué)習(xí)特點(diǎn)分析和醫(yī)學(xué)交流過程的特點(diǎn)分析第1題a) Thepossibilityofmovingtoward_____patientsandtheresponsibilitiesthatitimpliesundoubtedlywithchangepsychologist’sfuturerole.AmeditatingBmedicatingCmediatingDmediatizing正確答案：B第2題b) Themaincompositionsoftherespiratory______aretheairwaysandlungs.AsynthesisBsyngeneicCsystemDsystole正確答案：C第3題c) Heartfailureoccurswhentheheartisunabletomaintain______cardiacoutputforthebody’sneed.AsufficientBsubsequentCsuffocationDsuccessive正確答案：A第4題d) Thephysicianmusthavetheexactdosageandtime_____foradministrationwrittenonthechart.AdurationBspanCfrequencyDinterval正確答案：D第5題e) Recentstudiessuggestangiotensinhasalong-termpressor_____.AefficacyBeffectorCeffectDeffusion正確答案：C第6題Whatistype2diabetes?Thecellsinyourbodyneedinsulintochangeglucose,thesugarthatcomesfromthefoodyoueat,intoenergyyouneedtolive.Withoutinsulin,thissugarcannotgetintoyourcellstodoitswork.Itstaysinyourbloodinstead.Yourbloodsugarlevelthengetstoohigh.Type2diabetesusuallybeginswithinsulinresistance.Thismeansthatyourpancreasismakingenoughinsulin,butyourcellsarenotabletouseit.Whenyourcellsdon’tgetthesugartheyneed,yourpancreasworksharderatfirsttomakemoreinsulin.Butafterawhile,yourpancreasstopsbeingabletomakeenoughinsulin.Highbloodsugarcanharmmanypartsofthebody.Itcandamagebloodvesselsandnervesthroughoutyourbody.Youwillhaveabiggerchanceofgettingeye,heart,bloodvessel,nerve,andkidneydisease.Yourweight,levelofphysicalactivity,andfamilyhistoryaffecthowyourbodyrespondstoinsulin.Peoplewhoareoverweight,getlittleornoexercise,orhavediabetesinthefamilyaremorelikelytogettype2diabetes.Type2diabetesisusuallyfoundinadults,whichiswhyitusedtobecalledadult-onsetdiabetes.Butnowmoreandmorechildrenandteensaregettingittoo.Type2diabetesisadiseasethatyouwillalwayshave,butyoucanlivealongandhealthylifebylearninghowtomanageit.Howistype2diabetesdiagnosed?Mostlikelyyoufoundoutthatyouhavediabeteswhenyousawyourdoctorforaregularcheckuporforsomeotherproblem.Yourdoctorprobablydiagnosedtype2diabetesbyexaminingyou,askingaboutyourhealthhistory,andlookingattheresultsofbloodsugartests.Howisittreated?Ahealthydiethelpskeepyourbloodsugarundercontrolandhelpspreventheartdisease.Eatingtherightamountofcarbohydrateateachmealisveryimportant.Carbohydrateisfoundinsugarandsweets,grains,fruit,starchyvegetablesandmilkandyogurt.Adietitianoracertifieddiabeteseducatorcanhelpyouplanyourmeals.Eatingrightandgettingmoreexerciseareenoughforsomepeopletocontroltheirbloodsugarlevels.Othersalsoneedtotakeoneormoremedicines,includinginsulin.Youmayneedtotakeotherstepstopreventotherproblemsfromdiabetes.Theseproblemsarecalledcomplications.Peoplewithdiabetesaremorelikelytodiefromheartandbloodvesselproblemslikeheartattackandstroke.Ifyouare30orolder,talktoyourdoctorabouttakingalow-doseaspirineachdaytohelppreventtheseorotherlargebloodvesseldiseases.Youmayalsoneedmedicineforhighbloodpressureorhighcholesterol.Ifyousmoke,quittingmayhelpyouavoidproblemswithyourheartandlargebloodvessels.(478)AdoptedfromNorthShoreUniversityHealthSystem(NorthShore)at:/globalassets/diabetes/patienteducation/educationpackettypeiidiabetes.pdff) Fromthefirstparagraphwemaygettoknowthatthesugarwetake-inviafoodshouldbedigestedtothecellsotherwiseitwill_________.AhurtourinsulinBaccumulatedatthebloodstreamCerodeourpancreasDpoisonourbloodvessels正確答案：B第7題g) Insulinresistanceastheauthormentionedinthepassageisthatyourbodycannotmakefulluseof______,andthenthepancreasstopstoproduceitinanormalway.AinsulinthatpancreasproducedBinsulinthatthecellsproducedCinsulinthatproducedforbloodDinsulinthatproducedforpancreas正確答案：A第8題h) Accordingtothepassage,whichofthefollowingitemisNOTmentionedtothesufferersoftype2diabetes?ATheageofthesufferers.BThegenderofthesufferers.CThelife-longdurationofthedisease.DThediseasecanbecontrolled正確答案：B第9題i) Whendiagnosingtype2diabetes,whichofthefollowingtestindexisnotthemajorreferencefactor?APhysicalcheck-upresults.BResultsofbloodssugar.CInterviewofyourhealthhistory.DX-rayreportsforyourchest.正確答案：D第10題j) Asforthetreatmentmethod,ifapatientover30yearsoldthedoctorwouldsuggestthepatienttotake__________asaspecialmeanstopreventthelesionstobloodvessels.Aalow-doseaspirineachdayBmedicinesforcomplicationsCaspecialdietDaspecialinsulininjection正確答案：A第11題Anesthesiologyisthepracticeofmedicinewhichinvolvestheperioperativecareofpatientsandthetreatmentofpain.Thefieldispredominatelya(k)_________specialty,whichcaresforpatients(l)_____pre-operatively,post-operativelyandincriticalcareunits.Italsoinvolvesthetreatmentofacuteandchronicpainasoneofitsmajor(m)_____.Thepracticeofanesthesiologyincludesawide(n)______ofpatients:allages,alldegreesofillnessesandbothsexes.Thesubspecialtiesinclude:pediatric,cardiac,neuro,obstetrical,ambulatoryanesthesiaaswellascriticalcaremedicineandpainmanagement.Individualsinterestedinanesthesiologyarethosewhoenjoyphysiologyandapplied(o)_______intheclinicalsetting.Theymustbecomfortablewithmanagingacutelifethreateningproblemsandenjoyworkingintheoperatingroom.k)Aclinic-focusedBhospital-basedCbed-sidedDproblem-based正確答案：B第12題l)AacutelyBseverelyCadvancedDsharply正確答案：A第13題m)AkindsBranksCfieldsDsubspecialties正確答案：D第14題n)ArangesBraysCspectrumDcategories正確答案：C第15題o)AmedicineBpharmacologyCpathologyDanatomy正確答案：B2.MedicalLiteracyandTerminology(專業(yè)術(shù)語第1題1)Selectthebestanswerandwritetheletterofyourchoiceofeachnumber.a)Theword“carcinogenic“isformedwithprefixofAcardio-Bcarbo-Ccarcin-Dcarbam-正確答案：C第2題b)Theword“earwax”isa______wordwithearandwax.AcompoundingBprefixingCcombatingDcomplexing正確答案：A第3題c)Thesuffixes“-ate”“-fy”and“-ize”inwordusuallyform_____.AadverbsBadjectivesCconjunctionsDverbs正確答案：D第4題d)Inthewords“dysphagia”,”dysrhythmia”,dystonia”“dys-“functionsasprefixandhasameaningas________.AfirmBdifficultCacuteDpain正確答案：B第5題e)Thesuffixed“-ic”“-ous”,“-al”arefoundin_________.AverbsBnounsCpronounsDadjectives正確答案：D第6題2)Completethefollowingsentenceswiththerightmedicaltermsgivenbelowf).Thechainofeventsbetween________ofadrugandproductionoftheseeffectsinthebodycanbedividedintotwoimportantcomponents,bothofwhichcontributetovariabilityindrugactions.AadministrationBpreparationCproscriptionDinjection正確答案：A第7題g)Preoperativecardiac________isroutinelyperformedtoprovidedefinitiveassessmentofaorticvalveareaandthepressuregradient,aswellastoassessthecoronaryarteriesforsignificantstenosis.AinvolvementBtransformationCalterationDcatheterization正確答案：D第8題h)Thenervoussystemcontrolsthesecretionofmany______glands,andsomehormonesinturnaffectthefunctionofthenervoussystem.AexocrineBendocrineCendocardialDentoderm正確答案：B第9題i)Thesecretionofinsulin—whichactstolowertheplasmaglucose_____—isstimulatedbyariseinglucoseconcentration,forexample,andisinhibitedbyafallinbloodglucose.AconcentrationBaccumulationCheap-upDsummary正確答案：A第10題j)Bleedingmayalsooccurspontaneouslyinpatientswhohavereceived______orthrombolyticdrugs,orwhohavecoagulationdisorderssuchashemophilia.AanticoagulantsBcoenzymeCcoplanarDcircumoral正確答案：ACriticalReadingSkills第1題1)Readthefollowingpassageanddothecomprehensivequestionsin5minutes.ThetwomaincategoriesofAlzheimer'sdisease(AD)arefamilialandsporadic.FamilialAlzheimer'sdiseasereferstoageneticformofthediseasethatistransmittedfromonegenerationtothenext.Only5percentofallcasesofAlzheimer'sdiseasehavebeenassociatedwithageneticcomponent.TheseindividualscomefromfamiliesinwhichasmanyashalfofthemembersdevelopAlzheimer'sdisease.Fortunately,thisformofthedisorderisrare.Theremaining95percentofAlzheimer'sdiseasecasesaresporadic,orrandomlyoccurringinthepopulation.Avarietyof"riskfactors"havebeenidentifiedinindividualsdiagnosedwithAD.Infact,itisquitecommontopickupanewspaperortoturnontheTVandhearaboutthenewest"riskfactor"thathasbeenidentified.Whilesomeofthesefactorsmayturnouttobeuseful,itisimportanttorememberthatmuchoftheresearchthathasbeendoneinthisareaisretrospectiveresearch.ThismeansthattheresearchisconductedbycomparingagroupofpatientsdiagnosedwithADwithagroupofhealthyage-matchedadults.ThesetypesofanalysesprovideinformationaboutthenumberofindividualsdiagnosedwithADwhohaveacertaincharacteristiccomparedwiththehealthyindividuals.Whiletheseresultsareusefulindirectingfutureresearchstudies,theydonotprovideinformationaboutcauseandeffect.WhatisneededisaprospectivestudyinwhichlargenumbersofindividualsarefollowedfromanearlyagetotheageatwhichADdevelops.Theterm"dementia"isusedtodescribethegradualdeteriorationof"intellectual"abilitiesandbehaviorthateventuallyinterfereswithcustomarydailylivingactivities."Customarydailylivingactivities"includebalancingthecheckbook,keepinghouse,drivingthecar,involvementinsocialactivities,andworkingatone'susualoccupation.Theremayalsobechangesinpersonalityandemotions.Contrarytopopularbelief,dementiaisnotanormaloutcomeofaging,butiscausedbydiseasesthataffectthebrain.Dementiainfluencesallaspectsofmindandbehavior,includingmemory,judgment,language,concentration,visualperception,temperament,andsocialinteractions.Althoughdementiasymptomsareeventuallyobvioustoeveryone,intheearlystagesspecialevaluationsarenecessarytodemonstratetheabnormalities.Inpeopleovertheageof65,themostcommoncauseofdementiaisAlzheimer'sdisease.Alzheimer'sdiseaseisaformofbraindegenerationinwhichabnormalparticlescalledneurofibrillarytanglesandneuriticplaquesforminthebrainanddestroyhealthyneurons(braincells).Theseabnormalitiestendtosettleinbrainareasthatcontroltheabilitytolearnanewfactandrememberit30minutes,oradaylater,askillwerefertoas"memory".YearsofstudyingdementiashaveshownthatAlzheimer'sdiseaseisnottheonlytypeofbraindegeneration.Thereareotherformsofbraindegeneration,manyofwhichcanaffectpeopleintheir50'soreven40's.Finishthereadingexercisesforthreecommonkindsasgiveninthewebsite.a)Readthefollowingmedicalcartoonthentelltheclasswhatyouhaveseen.(readingforpleasure)b)Readthefollowingpassagethendothereadingcomprehensionexercises(readingforinformation)BianQue,alsoknownasCh’inYueh-jen,probablylivedinthesecondcenturyBC.Hehadgreatgiftsasadiagnosticianandwentoutofhiswaytodemystifymedicalpractice.TheachievementsofthislegendarymedicalmanwererecordedintheImperialAnnalsoftheHanDynasty.Heissaidtohavecarriedoutaheart-swapoperationbetweentwopatientswhoseillnessesstemmedfromopposingmalfunctionsofthatorgan.Ifalltheexploitsattributedtohimaretrue,hemusthavebeenaroundfor400years,andtravelledthelengthandbreadthofChina.Infactitisthoughtthatthenamemayactuallyhavebeenarespectfultitleappliedtogifteddoctorsoverthecourseoffourcenturies,andtheexperiencesofanumberofthemmayhavebeenerroneouslyattributedtooneman.HemadeamajorcontributiontotraditionalChinesemedicine,andanumberofstoriesillustratethis.Inone,thesonoftheKingofGuolaydying,andthecourtphysicianscoulddonothingtohelp.TherewasjustonedoctorinthewholeofChinawhoseskillsmightsavetheboy,ifonlyhecouldbebroughtthereintime.BianQuewasdulysummonedandarrivedattheroyalpalacetofindthecourtinmourning.Thecrownprincewasbeingpreparedforburial.‘Mysonmighthavebeenaliveifyouhadcomesooner,’lamentedtheking,butthesageaskedtobeshownthebody.Hisexaminationconfirmedhissuspicionthattheprincehadactuallylapsedintoadeepcoma.Heimmediatelygaveacupuncturetreatmenttorevivehim,thenappliedcompressessoakedinadecoctionofherbs.Withinhoursofhisarrival,thepatientwasabletogettohisfeet.Thedoctorthenprescribedmedicineswhichrestoredhimtofullhealthintwentydays.Unsurprisingly,outsidethegatesofthecourtamongthecommonpeople,rumoursspreadthatherewasamiracle-workerwhocouldraisepeoplefromthedead.PienCh’iaoassuredthem:‘Icannotbringthedeadbacktolife.Theprincestillhadsomelifeleftinhim.Isimplyfoundthesparkandfanneditintoaflame.’1AccordingtothepassageBianQuemadethefirst_______fortwopatientswithmalfunctionsoftheorgan.AA)hearttransplantationoperationsBB)operationonheartexchangeCC)operationonheartrepairingDD)heartoperationsonarrhythmia正確答案：A第2題2Accordingtotheauthor,BianQuewasbelievedtobeagreatfigureas______.AA)hehadtouredaroundagreatpartoftheCentralChinaatthatageBB)hehadworkedforaroundfourcenturiesoftimeCC)collectivedeedsofgreatdiagnosticiansofthatageinChinaDD)agodwhosavedthepeopleofthewholeChina正確答案：A第3題3Whichofthefollowingisnottrueaccordingtothepassage?AA)BianQue’sexaminationconfirmedhissuspicionthattheprincewasnotdeadbutjustinadeepcoma.BB)BianQueusedhismagiccuresavetheprincewhenhewasdying.CC)TheKingcomplainedBianQuefornotarrivingintimetosavehisson.DD)ThepublicbelievedandrumoredthatBianQuewasamiraclefigurethatcouldsavedyingpatients.正確答案：A第4題4Whatisthewriter’sattitudetowardsthestoryofBianQue?AA)Highly-respected.BB)Story-narration.CC)Criticizingwithmildtune.DD)Neutral.正確答案：A4.基礎(chǔ)練習(xí)1第1題Readthefollowingpassageandthendotheexercises(multiplechoice)givenbelow.ClassificationofMuscleActionsItisusefultobeabletodescribetheeffectofmusclecontractiononajointintermswhichmaybeappliedthroughoutthebodyandwhicharerelatedtotheanatomicalposition.Thedescriptivetermsexpressverypoorly,however,thecomplexitiesofmovement,sincetheyresolvemovementtoarbitraryplanesofaction.Flexionisthetermusedtodescribethebendingofapanorthemakingofanangle,mosteasilyvisualizedinthebendingoftheelbowortheknee.Theoppositetermextensionfundamentallymeansastraightening.Intheanatomicalpositionmostofthemembersofthebodyareintheextendedposition;thearmsandlegsarestraight,asisalsotheback.Inthecaseofthefoot,thesetermsleadtosomeconfusionsince,intheerectposition,theankleisalmostcontinuouslysemiflexed.Fromthisposition,furtherflexionismorereadilyunderstoodunderthetermdorsiflexionandextensionunderthetermplantarflexion.Plantarflexionisobviouslybendinginthedirectionofthesole;dorsiflexion,bendinginthedirectionofthedorsum.Formovementawayfromortowardthecentralaxisofthebodythetermsabductionandadductionareapplied.Thesetermsleadtonoconfusionexceptinthehandsandfeelwherethereismovementofthedigitsawayfromandtowardaplanewhollywithintheseparts.Rotationalmovementisalsorecognized.Rotationoftheanteriorsurfaceofamembertowardthemidplaneofthebodyismedialrotation;rotationawayfromthemidplaneislateralrotation.Therotaryactionoftheforearmandhand,whichcanhereadilyobservedasthehandisturnedpalmuporpalmdown,hasaspecialdesignation.Pronationisrotationsoastoturnthepalmdownwardorbackward;supinationcarriesthepalmupwardorforward.Thereisasimilarthoughlessextensivemovementofthefootinwhichrotationtakesplaceintiletarsaljoints.Therotationofthefootsothatthesoleturnsoutwardiseversion;theoppositemovementsothatthesoleturnsinwardisinversion.Aspecialcaseofrotationisthatwhichisseenintheveryimportantopposingactionofthethumb.Thismovementofrollingthethumboverontothehandsothatthepadsofthedigitsconvergeintoafirmgraspistermedopposition;itisexhibitedtoalesserdegreeinthelittlefingerandinthegreatandsmalltoes.Circumductioniscircularmovement;toproducethistypeofmotion,flexionandextension,abductionandadductionarecombinedinapropersequence.Specialterms,suchasprotrusionandretraction,elevationanddepression,willbereferredtointheirpropercontextbutarerelativelyself-evident.a)Muscleactionsinvariouspatterns,havebeenmentionedthispassageexcept________.AcontractionBflotationCflexionDextension正確答案：B第2題b)Theterm“flexion”refersbendingofajointmuscle,“semiflexion”meanshalfofthebending,while“dorsiflexion”maymean_________.AthemusclebendinginbackwarddirectionBthemusclebendinginforwarddirectionCthemusclebendinginoutwarddirectionDnoneofabove正確答案：A第3題c) “Plantarflexion”inthepassagemaymeans__________.Athebendingofone’sanglesinvariousdirectionsBthebendingofone’sthenarinvariousdirections.Cthebendingofone’sfiguresinrotativewaysDthebendingofone’sheadbothforwardandbackward正確答案：B第4題d)Inthispassagewecanseethemotionsofvariousmusclesthatareconnected_________.AwithourmotionalorganssuchasfootandhandBwithourneuralconnectiveorgansCwithourcraniumsandupperpartofourbodyDwiththearteryandveinsinourbody正確答案：B第5題e)Thelanguageusedinthispassagemaybedescribedas________.AinstructivewithconceptsinterpretationsBplainwithfigurativeillustrationsCcomplexitywithlogicalanalysisoftheoreticalideasDnarrativewithdefinitionstospecificterminanatomy正確答案：D4.基礎(chǔ)練習(xí)2第1題Readthefollowingpassageandthendotheexercises(multiplechoice)givenbelow.PRINCIPLESOFPHARMACODYNAMICSOnceadrugaccessesamolecularsiteofaction,italtersthefunctionofthatmoleculartarget,withtheultimateresultofadrugeffectthatthepatientorphysiciancanperceive.Fordrugsusedintheurgenttreatmentofacutesymptoms,littleornodelayisanticipated(ordesired)betweenthedrug-targetinteractionandthedevelopmentofaclinicaleffect.Examplesincludevascularthrombosis,shock,malignanthypertension,statusepilepticus,orarrhythmias.Formanyconditions,however,theindicationfortherapyislessurgent,andinfactadelaybetweentheinteractionofadrugwithitspharmacologictarget(s)andaclinicaleffectiscommon.Pharmacokineticmechanismsthatcancontributetosuchadelayincludeuptakeintoperipheralcompartmentsorgenerationandaccumulationofactivemetabolites.Acommonpharmacodynamicmechanismisthattheclinicaleffectdevelopsasadownstreamconsequenceoftheinitialmoleculareffectthedrugproduces.Thus,administrationofaproton-pumpinhibitororanH2-receptorblockerproducesanimmediateincreaseingastricpHbutulcerhealingthatisdelayed.Cancerchemotherapyinevitablyproducesdelayedtherapeuticeffects,oftenlongafterdrugisundetectableinplasmaandtissue.Translationofamoleculardrugactiontoaclinicaleffectcanthusbehighlycomplexanddependentonthedetailsofthepathologicstatebeingtreated.Thesecomplexitieshavemadepharmacodynamicsanditsvariabilitylessamenablethanpharmacokineticstorigorousmathematicalanalysis.Nevertheless,someclinicallyimportantprinciplescanbeelucidated.Atherapeuticdrugeffectassumesthepresenceofunderlyingpathophysiology.Thus,adrugmayproducenoaction,oradifferentspectrumofactions,inunaffectedindividualscomparedtopatients.Further,concomitantdiseasecancomplicateinterpretationofresponsetodrugtherapy,especiallyadverseeffects.Forexample,increasingdyspneainapatientwithchroniclungdiseasereceivingamiodaronetherapycouldbeduetodrug,underlyingdisease,oranintercurrentcardiopulmonaryproblem.Thusthepresenceofchroniclungdisease,andinterpretationofthesymptomofincreasingdyspnea,isonefactorthatshouldbeconsideredinselectionofantiarrhythmictherapies.Similarly,highdosesofanticonvulsantssuchasphenytoinmaycauseneurologicsymptoms,whichmaybeconfusedwiththeunderlyingneurologicdisease.Theconceptthatadruginteractswithaspeci?cmolecularreceptordoesnotimplythatthedrugeffectwillbeconstantovertime,evenifstabledrugandmetaboliteconcentrationsaremaintained.Thedrugreceptorinteractionoccursinacomplexbiologicmilieuthatitselfcanvarytomodulatethedrugeffect.Forexample,ionchannelblockadebydrugs,animportantanticonvulsantandantiarrhythmiceffect,isoftenmodulatedbymembranepotential,itselfafunctionoffactorssuchasextracellularpotassiumorischemia.Thus,theeffectsofthesedrugsmayvarydependingontheexternalmilieu.Receptorsmaybeup-ordownregulatedbydiseaseorbythedrugitself.Forexample,adrenergicblockersupregulate?-receptordensityduringchronictherapy.Whilethiseffectdoesnotusuallyresultinresistancetothetherapeuticeffectofthedrugs,itmayproducesevereagonist–mediatedeffects(suchashypertensionortachycardia)iftheblockingdrugisabruptlywithdrawn.(From:Kasper,etal.Ed;Harrison'sPrinciplesofInternalMedicine16th.?2005,byTheMcGraw-HillCompanies,Incp18.)a)Accordingtothepassagethedruginclinicapplicationmayachieveitsefficacyinthefollowingproceduresexcept________.AthedrugmoleculeaccessesthesiteofactionBthedrugmoleculesareaccumulatedinthebloodstreamrapidlyCthedrugmoleculealtersthefunctionofthemoleculetargetDthedrugmoleculeanddrug-targetinteractiontoformitseffect (B)正確答案：B第2題b)Thedelayinactionisknownascommoninthechemotherapyofthesymptom________inclinicpractice.AvascularthrombosisBstatusepilepticusCtachyarrhythmiaDhydronephrosis正確答案：D第3題c)Whenadministrationofaproton-pumpinhibitororanH2-receptorblockerproducesanimmediateincreaseingastricpHbutulcerhealingthatisdelayed,because_______.AthedrugproducesadownstreamconsequenceoftheinitialmoleculareffectBthedrugproducesanafterwardsresultofdelayedeffectCthedrugcombinesthetargetreceptorandmakesaprolongedeffectDthedrugimpactitseffectonthereceptorcellinanindirectway正確答案：A第4題d)Whichofthefollowingmaybethereasonforthenoclinicactionwhenadministratedacertaindrugforaspecificdiseaseorsymptom?AAstheunderlyingpathophysiology,asthediseaseandsymptommaycommitdifferentactionstoastrayorrejectthedrugofitsfunctions.BAstheunderlyingpathophysiology,thedrugmaytakenoeffectorotherspectrumofactioninaffectedindividualsbutitseffectormoleculeactswithotherfunctionsthanwedesired.CAstheunderlyingpathophysiology,thedrugmayreachtoawrongsiteandcombinedwithdifferentreceptorcellthusmadenocliniceffectDAstheunderlyingpathophysiology,thedrugmaytakenoeffectorotherspectrumofactioninunaffectedindividualsandtheconcomitantdiseasecancomplicateinterpretationofresponsetodrugtherapy,especiallyadverseeffects.正確答案：D第5題e) Inthispassagewecanlearnprinciplesthatamedicineinclinicadministrationmayhave__________.AclinicefficacyBnoactionCadvisereffectDallthethree正確答案：D4.基礎(chǔ)練習(xí)3第1題Readthefollowingpassageandthendotheexercises(multiplechoice)givenbelow.ObjectivesrelatingtoknowledgeGraduatescompletingbasicmedicaleducationshouldhaveknowledgeofthefollowingareas:1.Scientificmethodrelevanttobiological,behaviouralandsocialsciencesatalevelsufficienttounderstandthebasisforpresentmedicalpractice,andtoassimilatetheadvancesinknowledgethatwilloccurovertheirworkinglife.2.Thenormalstructure,functionanddevelopmentofthehumanbodyandmindatallstagesoflife,theinteractionsbetweenbodyandmind,andthefactorsthatmaydisturbthese.3.Theetiology,pathology,symptomsandsigns,naturalhistory,andprognosisofcommonmentalandphysicalailmentsinchildren,adolescents,adultsandtheaged.(Graduatesshouldhaveadetailedknowledgeoftheconditionsthatrequireurgenttreatmentandthosethatareofparticularlocalsignificance.)4.Commondiagnosticprocedures,theirusesandlimitations.5.Managementofcommonconditionsincludingpharmacological,physical,nutritionalandpsychologicaltherapies.6.Normalpregnancyandchildbirth,themorecommonobstetricalemergencies,theprinciplesofantenatalandpostnatalcare,andmedicalaspectsoffamilyplanning.7.Theprinciplesofhealtheducation,diseaseprevention,ameliorationofsufferinganddisability,rehabilitation,andthecareofthedying.8.Culturalandsocialfactorsaffectinghumanrelationships,thepsychologicalwell-beingofpatientsandtheirfamilies,andtheinteractionsbetweenhumansandtheirsocialandphysicalenvironment.9.Systemsofprovisionofhealthcareincludingtheiradvantagesandlimitations,thecostsassociatedwithhealthcare,theprinciplesofefficientandequitableallocationoffiniteresources,andmethodsofmeetingthehealthcareneedsofdisadvantagedgroupswithinthecommunity.10.Theprinciplesofethicsthatrelatetohealthcareandthelegalresponsibilitiesofthemedicalprofession.ObjectivesrelatingtoskillsGraduatescompletingbasicmedicaleducationshouldhavedevelopedthefollowingskillstoanappropriatelevelfortheirstageoftraining:1.Theabilitytotakeatactful,accurate,organizedandproblem-focusedmedicalhistory.2.Theabilitytoperformanaccuratephysicalandmentalstateexamination.3.Theabilitytochoosetheappropriateandpracticalclinicalskillstoapplyinagivensituation.4.Theabilitytointerpretandintegratethehistoryandphysicalexaminationfindingstoarriveatanappropriatediagnosisordifferentialdiagnosis.5.Theabilitytoselectthemostappropriateandcost-effectivediagnosticprocedures.6.Theabilitytoformulateamanagementplan,andtoplanmanagementinconcertwiththepatient.7.Theabilitytocommunicateclearly,consideratelyandsensitivelywithpatients,relatives,doctors,nurses,otherhealthprofessionalsandthecommunity.8.Theabilitytocounselsensitivelyandeffectively,andtoprovideinformationinamannerthatensurespatientsandfamiliescanbetrulyinformedwhenconsentingtoanyprocedure.9.Theabilitytorecognizeseriousillnessandtoperformcommonemergencyandlife-savingproceduressuchascaringfortheunconsciouspatientandcardiopulmonaryresuscitation.10.Theabilitytointerpretmedicalevidenceinacriticalandscientificmanner,andtouselibrariesandotherinformationresourcestopursueindependentinquiryrelatingtomedicalproblems.ObjectivesrelatingtoattitudesastheyaffectprofessionalbehaviourDuringbasicmedicaleducation,studentsshouldacquirethefollowingprofessionalattitudes,whichareregardedasfundamentaltomedicalpractice:1.Respectforeveryhumanbeing,withanappreciationofthediversityofhumanbackgroundandculturalvalues.2.Anappreciationofthecomplexityofethicalissuesrelatedtohumanlifeanddeathincludingtheallocationofscarceresources.3.Adesiretoeasepainandsuffering.4.Anawarenessoftheneedtocommunicatewithpatientsandtheirfamilies,andtoinvolvethemfullyinplanningmanagementoftheircondition.5.Adesiretoachievetheoptimalpatientcarefortheleastcosttoallowmaximumbenefitfromtheavailableresources.6.Recognitionthatthehealthinterestsofthepatientandthecommunityareparamount.7.Awillingnesstoworkeffectivelyinateamwithotherhealthcareprofessionals.8.Anappreciationoftheresponsibilitytomaintainstandardsofmedicalpracticeatthehighestpossiblelevelthroughoutaprofessionalcareer.9.Anappreciationoftheneedtorecognizewhenaclinicalproblemexceedstheircapacitytodealwithitsafelyandefficientlyandoftheneedtoreferthepatientforhelpfromotherswhenthisoccurs.10.Arealizationthatitisnotalwaysintheinterestsofpatientsortheirfamiliestodoeverythingwhichistechnicallypossibletomakeaprecisediagnosisortoattempttomodifythecourseofanillness.FromWorldHealthOrganizationWesternPacificRegion(2001),WHOGuidelinesforQualityAssuranceofBasicMedicalEducationintheWesternPacificRegiona)Accordingtothepassagemedicaleducationqualitysystemmayincludingallofthefollowingaspectsofcompetencesbut__________.Amasteringtheknowledgesthatrelatedtomedicalpracticeinallaspectsofbiologicsciencesandmedicines,humanitiesandsocialscienceBmasteringtheskillsthatrelatedtoclinicpractice,communicationandmakinguseofrespectiveinformationCunderstandingtheconceptsaboutmedicinethatmayfocusoninterpretationofhumanhimselfandtherelationswiththeworldaroundDdeveloptheattitudetowardtheirfutureprofessionandwhichmayaffecttheirbehaviourslater正確答案：C第2題b)Inthefirstsection,wecanlearnthattherequiredknowledgesamedicalstudentshouldmastermayconsist________________.AthenaturalprocessesofhumanindividualandthediseasesaswellashowtodealwiththemBthesourcesthatcauseourdiseasesoralimentsCtherelationsbetweenindividualandsocialcommunitythatmaydecideyoursocialstatusDtheprinciplesofnatureandtheearththatmayaffectourlifeandtheenvironment正確答案：A第3題c)Systemsofprovisionofhealthcaremayhavethecontentsof________.AhowmuchourhealthmaycostBhowtomakefulluseofthemedicalresourcesforthepeopleatlargeCmethodsformakeuseofthehealthfacilitatesDallabove正確答案：D第4題d)Theabilitytocounselsensitivelyandeffectively,andtoprovideinformationshouldbe_____________.AcontentedtotheneedsanddemandsofthepatientandthefamilyBfranklyandobjectivelytoensurethecolleaguesfortheircaseCtrulyandobjectivelyandtacticallyforthepatientandhisfamilyDdecisivelyandabsolutelyforthecaseoftreatmentprocedures正確答案：C第5題e)Inthecareerofmedicine,apersonshould_________allhumanbeing,asthefoundati