臨牀醫學英語

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Part I Vocabulary (30 points)

Section A

Directions: Choose the definition from choices marked A), B), C) and D) that best matches the stem or affix given in each item.

1. therm/o-

A) temperature B) suture C) fracture D) structure

2. –ary

A) contrary to B) related to C) parallel with D) coupled with

3. meno-

A) period B) perineal C) parturient D) plaque

4. lev/o-

A) right B) left C) upper D) lower

5. lenti-

A) molecule B) massage C) slow D) serum

6. scler/o-

A) focus B) strengthen C) intensify D) harden

7. –scopy

A) predisposition B) presentation C) circulation D) examination

8. lapar/o-

A) cervix B) abdomen C) pleura D) breech

9. cholecyst/o-

A) bile B) spleen C) pancreas D) gall bladder

10. neo-

A) excessive B) deficient C) new D) few

11. hyster/o-

A) placenta B) uterus C) viscera D) striatum

12. estr/o-

A) felid B) fomite C) forceps D) female

13. ser/o-

A) saturation B) sedation C) serum D) sodium

14. -poietic

A) productive B) conductive C) progressive D) indicative

15. gynec/o-

A) felid B) fomite C) female D) forceps

16. –meter

A) infusion B) instrument C) incontinence D) increment

17. -on

A) probe B) plaque C) particle D) pleura

18. chole-

A) bile B) spleen C) pancreas D) gall bladder

19. tele-

A) titer B) thermal C) futile D) far

20. –ectomy

A) exception B) excision C) exertion D) examination

Section B

Directions: There are 25 incomplete sentences in this section. For each sentence there are four choices marked A), B), C), and D). Choose the ONE answer that best completes the sentence.

bral thrombotic strokes often occur at night or first thing in the morning, when blood

pressure is low. They’re often preceded by a transient __________ attack, also called a TIA

or “mini-stroke.”

A) irreversible B) inexorable C) idiopathic D) ischemic

th care workers with__________ exposures to HIV-containing blood, however, are infected fewer than 1 in 300 times.

A) prognostic B) pleuritic C) percutaneous D) proviral

23. A __________ infection is just a fancy way of saying an infection caught while staying in the hospital. These infections can be caused by bacteria, viruses, parasites, fungi or other agents.

A) nosocomial B) terminal C) precordial D) intracranial

24. Obesity, diabetes, and hypertension also affect the kidneys. Diabetic __________ develops in about one third of patients with diabetes, and its incidence is sharply increasing in the developing world.

A) neuropathy B) neuralgia C) nephropathy D) nephralgia

25. General __________, administered by inhalation or intravenous injection, cause unconsciousness as well as insensibility to pain, and are used for major surgical procedures.

A) akinesia B) anesthesia C) asphyxia D) anorexia

26. Gene therapy is a technique for correcting defective genes responsible for disease development.

For example, an abnormal gene could be swapped for a normal gene through __________ recombination.

A)hematopoietic B) heterogeneous C) homologous D) hormonal

27.__________ are a class of viruses with double-strained DNA genomes that cause respiratory, intestinal and eye infections in humans.

A) Retroviruses B) Adenoviruses C) Lentiviruses D) Virions

ors, rigidity, __________, poor balance, and difficulty in walking are characteristic primary symptoms of Parkinson’s disease.

A) bradycardia B) bradykinesia C) tachypnea D) tachyarrhythmia

29. __________ is a condition in which the placenta covers the cervix partially or completely, making vaginal delivery impossible.

A) Placenta previa B) Placental abruption

C) Placenta accreta D) Placental probe

30. A blood clot that breaks off and travels to another part of the body is called a/an __________.

A) thrombus B) thrombosis C) embolus D) bolus

31. Medical experts think __________ tends to carry cholesterol away from the arteries and back to the liver, where it is passed from the body.

A) VLDL B) HDL C) IDL D) LDL

32. Patients with inadequate oxygen delivery to their myocardium are admitted for the management

of __________ and myocardial infarction.

A) acidosis B) adenoma C) angina D) aphasia

33. Not breathing, which is also called __________, is the lack of spontaneous breathing. It requires

immediate medical attention.

A) acuity B) apnea C) asystole D) aspiration

34. A __________ refers to a group of organisms of the same species, having distinctive characteristics but not usually considered a separate breed or variety.

A) specter B) spectrum C) sphere D) strain

35. Tuberculosis was popularly known as __________ for a long time. Scientists know it as an infection caused by M. tuberculosis.

A) constipation B) consolidation C) consumption D) cardioversion

36. Doctors say that only 3% of infants with breech _____________who are delivered vaginally will have traumatic injury.

A) palpation B) presentation C) incubation D) induction

37. If tuberculosis __________ are not tested for drug susceptibility from the outset, resistance may be detected too late to permit a cure.

A) isolates B) germlines C) alleles D) swabs

38. Human influenza is transmitted by inhalation of infectious droplets and droplet nuclei, by direct contact, and perhaps, by indirect contact, with self-inoculation on the upper respiratory tract or conjunctival _______________.

A) mucous B) mucus C) mucosa D) serosa

39. Almost all patients have clinically apparent pneumonia; radiographic changes include diffuse, multifocal, or patchy infiltrates; interstitial infiltrates; and segmental or lobular consolidation with air _____________.

A) bronchospasm B) bronchography C) bronchograms D) bronchostaxis

40. The ultimate aim in preventing disease onset will require a major multidisciplinary effort to identify the genes that ____________type 1 diabetes and to identify the interacting environment factors that trigger the disease.

A) destine to B) susceptible to C) predispose to D) liable to

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. Then mark your answer on the answer sheet by blackening the corresponding letter in the brackets.

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 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.

r 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

For surgery to be curative, it must be performed before the cancer has spread into organs and tissues that cannot be safely removed. Since the late 19th century increasingly radical operations for cancer have become standard. Despite the increasing extent of these procedures, risk has been reduced by improvements in surgical techniques, anesthesiology, and preoperative and postoperative care, especially in the control of infection. Heart-lung pumps, artificial kidneys, and methods of maintaining electrolyte balance and metabolic equilibrium have permitted patients with impaired cardiovascular and kidney functions or poor general metabolism to survive cancer surgery.

Major advances have been made in the restoration of structures altered by cancer surgery and in the rehabilitation of people who have undergone radical surgery. Patients undergoing certain surgical procedures for cancer of the colon or rectum, for instance, can be equipped with simple devices for the elimination of solid waste. For patients with cancer of the head and neck, the use of grafting methods and of tissue flaps make it possible to apply reconstructive techniques at the time the cancer is removed.

Rehabilitation of the patient also plays an important role. Women who have extensive surgery for breast cancer are given treatment for restoration of muscle tone needed for movement of the arms. Progress has also been made in teaching new mechanisms of speech to people who have undergone surgical removal of the larynx.

In addition to saving lives by eradicating cancer, surgery also may improve the remaining months or years of life for persons whose cancers cannot be eradicated, restoring comfort and a sense of usefulness. When severe pain accompanies cancer, surgery may bring relief by severing the nerve pathways that carry the painful sensations. In addition, surgery is sometimes necessary to treat abscesses resulting from either the tumour or infection and to relieve intestinal obstructions.

Surgery is also valuable as a preventive measure in controlling cancer. It may be used to elimination precancerous conditions in the mouth, chronic ulcers (ulcerative colitis) that may lead to cancer of the colon, and certain precancerous polyps in the colon and rectum. It may be used to remove burn scars that may lead to cancer, precancerous nodules in the thyroid gland, and certain precancerous pigmented moles.

51. The first paragraph is mainly about _________.

A) the increasingly radical operations for cancer

B) the rapid improvement of cancer surgery

C) the improvements in surgical techniques

D) the standardized cancer surgery

52. Which of the following statements is true according to this passage?

A) The structures altered by cancer surgery can hardly be restored

B) Simple devices for the elimination of solid waste have been designed for breast cancer patients

C) Surgery may help alleviate the sufferings of the incurable cancer patients

D) Surgery is an effective means to restore muscle tone

53. According to this passage, which of the following statements is not true?

A) Methods of maintaining homeostasis is used to help the cancer patients to be operated.

B) The colon cancer patients can be equipped with devices for the elimination of fluid.

C) The neck cancer patients can undergo a transplant during the cancer surgery.

D) Cancer surgery can be used to help the patients to be more positive to life.

54. The underlined word “It” in the last paragraph refers to _______

A) surgery B) a preventive measure

C) to remove burn scars D) that may lead to cancer

55. The proper title for this passage should be ______.

A) Controlling cancer B) Eradicating Cancer

C) Cancer surgery D) Rehabilitation of Cancer Patients

Passage 4

A big advantage of using genetic engineering to produce drugs is that it’s possible to mass-produce chemicals that might otherwise be difficult and costly to extract, or simply unavailable by conventional means. Another important advantage is that drugs produced in this way are pure and, if made using human genes, fully compatible with use in people.

For example, before engineered bacteria were cloned to manufacture human insulin, the main source of this hormone (used to treat diabetes) was the pancreas of cattle or pigs. Although similar to human insulin, animal insulin is not identical and causes allergic reactions in some patients. The human protein produced by bacteria with recombinant DNA, however, has no such effect.

To take another example, vaccines against disease are traditionally prepared from killed or “disarmed” pathogens (disease-causing microbes). They are effective in the vast majority of people, but a small percentage of the population have allergic reactions to vaccines. There is also a very small risk of vaccine organisms reactivating to their former pathogenic state. Genetically engineered vaccines are safer because they contain no living organisms — only the proteins that stimulate the body to develop immunity.

Vaccines are the second-largest category of over 200 drugs now being produced by American pharmaceutical companies using biotechnology. Other products include hormones, inter

ferons, blood-clotting factors, antisense molecules, and enzymes. Most of these drugs are still undergoing clinical testing and are designed to combat cancer, AIDS, asthma, diabetes, heart disease, Lyme disease, multiple sclerosis, rheumatoid arthritis, and viral infections.

But the bottom line is that mapping and even sequencing genes is only a beginning. That knowledge alone won’t tell us the gene’s functions. Of the 2,000 or so genes whose locations are mapped today, we know the functions of only a few hundred. And knowing the functions won’t tell us how those functions are actually carried out — how genes are expressed and what the biochemical steps are between the coding for a protein and the symptoms of a disease.

Although advancing knowledge is rapidly closing in on these areas, we needn’t worry just yet about having all these secrets of life.

56. What makes it so successful to use genetic engineering to produce drugs?

A) mass-production at a low cost B) compatibility

C) purity D) all of the above

57. Human insulin has an advantage over animal insulin in _______.

A) dosage B) rejection

C) compatibility D) all of the above

58. What makes genetically engineered vaccines safely acceptable to those who are allergic to traditional ones?

A) capable of developing immunity

B) contributive to immune potency

C) full of “disarmed ” pathogens

D) free of living organisms

59. What researchers have done, according to the author, is far from enough in ____________.

A) mapping and sequencing genes

B) fully understanding genes’ functions and expressions

C) genes’ expressions making sense of the biochemical mechanisms

D) all of the above

60. At the end, the author is trying to tell us that the fear of having all the secrets of life is ________.

A) misleading B) impossible

C) reasonable D) unnecessary

Passage 5

In 1960 the proportion of people in Europe aged 60 or over was 14%; by 1980 it had risen to 17%, and by 2025 it is expected to be 25%. Meanwhile, fewer and fewer family members are available to care for the elderly. The best solution to this problem would be to create conditions allowing the elderly to remain healthy so that they could look after themselves.

At Present, the highest proportions of elderly people in Europe are in Germany and Greece; 25 years later, this distinction will be shared by Germany, Luxembourg, the Netherlands and Switzerland. The fastest projected rate of population growth for elderly people, however, will be Russia where the number of those aged 60 or over will have risen from 35 million in 1980 to 72 million in 2025.

Problems brought by success ：These developments, which reflect a general increase in life expectancy since the Second World War, produce new challenges that we must address if crucial problems are to be avoided.

The number of people aged 80 or more is rising particularly rapidly. These People consume a greater proportion of health care and social services than any other age group. Because women live longer than men on average, the socioeconomic and health problems of elderly people are largely borne by women. As more women enter the job market, there are fewer of them available to care for elderly people than formerly. This factor, together with increased migration by young people, is weakening family and community support and protection for the elderly.

Why is the life expectancy of men less than that of women? Why do some people lose their ability to function while others remain active and productive? What changes should be made in life-styles and behaviors to maintain our vital potential and autonomy? Most such queries are still unanswered, but it is now wide1y accepted that progress can be made only through the search for healthy aging, which was first discussed in 1990 by WHO's Regional Committee for Europe.

Old age is not a disease and cannot be prevented! The occurrence of chronic, degenerative diseases in old people can, however, be diminished, though not by means of curative medicine alone: middle-aged people should be the main target for health promotion, with a view to preventing disability in old age. It should also be noted that there are differences between European countries in life expectancy and morbidity and disability rates.

It is to be expected that the health and functional ability of people aged under 75 will improve and that they will look for better opportunities to remain active in society. At the same time, governments are likely to be seeking a balance between early retirement (to ease the job market) and late retirement (to reduce the cost of pensions). Meanwhile, a large increase in the proportion of people aged 85 or over can be expected to create a growing demand for personal care and help with the tasks of daily life.

Who will 1ook after the very old? In most European countries it seems probable that community-based care, and home care in particular, will provide the best solution to the problem of looking after the elderly. But as relatives and neighbors are likely to become decreasingly available as carers, it is important to consider who might replace them. Of course, institutional care will remain necessary for some people, among them those who are severely disabled or live alone.

A balance has to be struck between the provision of community services for home care and the provision of institutional care. Rehabilitative facilities will have to be increasingly relied on to develop and maintain the functional ability of elderly people so that they can live as independently as possible. Changes in attitudes will have to be encouraged among health and allied professionals and the general public. Human and financial resources should be redistributed and people should become more closely involved in the development of medical ethics and play an active part in the choice of care and the protection of their own health.

61. According to the author, the key to solving the problem of taking care of the elderly is______.

A) to provide good conditions so as to help them remain healthy and look after themselves

B) to set up more hospitals and recovery centers

C) to forbid their children going abroad

D) to create more opportunities for them to work and exercise

62. Which of the following is NOT mentioned as a problem of aging?

A) Increased migration by young people.

B) More women's entry into the job market.

C) Growing demands for personal care and help.

D) Increasing chronic and degenerative diseases in old people.

63. For the purpose of preventing disability in old age, on what should emphasis be laid for health promotion?

A) Curative medicine B) Community support

C) Elderly people D) The middle-aged people

64. According to the passage, what factor is mainly responsible for the rapid growing of the number of old people aged 80 or more in many countries?

A) The longer lives of women.

B) The impact of the Second World War.

C) The contribution of WHO.

D) Medical professionals.

65. In discussing "who wi11 1ook after the very old?", ______.

A) the author questions whether to care for the elderly is worthwhile

B) the author stresses that relatives and neighbors should take on the task to look after the elderly

C) the author points out that the elderly like living alone and not being disturbed

D) the author makes several suggestions as to how to take care of the very old people .

Part III Translation ( 20 points)

Directions: Translate the following sentences into Chinese.

1. AIDS is caused by the human immunodeficiency virus, a retrovirus of the lentivirus family that was unknown until the early 1980’s, but since that time has been spread around the world to infect millions of persons. The result of HIV infection is relentless destruction of the immune system. All HIV infected persons are at risk for illness and death from opportunistic infectious and neoplastic complications as a result of the inevitable manifestations of AIDS. Retroviruses are unable to replicate outside of living host cells because they contain only RNA and do not contain DNA. The variant of HIV that is the cause for almost all infections is known as HIV-1.

2. At least 225,000 people in the U.S will die suddenly this year from coronary heart disease before they reach a hospital. In addition, an estimated 370,000 to 750,000 patients will have a cardiac arrest and undergo attempted resuscitation during hospitalization. The causes of cardiac arrest are numerous; by far the most common in adults is ischemic cardiovascular disease. The arrest is usually associated with the lethal arrhythmia of ventricular fibrillation triggered by an acutely ischemic or infracted myocardium or by a primary electrical disturbance. The precipitants of a life-threatening arrhythmia such as ventricular fibrillation are poorly understood.

Answer Sheet

Part III Translation ( 20 points)

分數閱卷人

1.______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

2.______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

參考答案：

Key

Part I Vocabulary ( 30% )

Section A

1-5 ABABC 6-10 DDBDC 11-15 BDCAC 16-20 BCADB

Section B

21-25 DCACB 26-30 CBBAC 31-35 BCBDC 36-40 BACCC

Part II Reading Comprehension ( 50% )

Passage 1 41----45 BCACD

Passage 2 46----50 BDCCB

Passage 3 51----55 BCBAC

Passage 4 56----60 DCDDD

Passage 5 61----65 ADDAD

Part III Translation ( 20% )

1. 艾滋病是由人類免疫缺陷病毒(HIV)引起的。HIV是一種逆轉錄酶病毒，慢病毒屬，直到20世紀80年代早期才被發現。但此後，該病毒在世界上廣爲傳播，數以百萬計的人感染了這種病毒。感染上這種病毒的結果就是對免疫系統的無情摧毀。所有HIV感染者由於艾滋病必然的臨牀表現而出現炎症併發症和腫瘤併發症面臨疾病和死亡的危險。逆轉錄酶病毒在宿主細胞外不能複製，因爲它們只含有核糖核酸，而沒有脫氧核糖核酸。這種稱爲HIV-1變種的HIV病毒幾乎是所有感染的原因。

2. 美國今年至少會有225,000人在送達醫院前死於突發性冠狀動脈心臟病。此外，據估計，還有370,000 - 750,000患者會因發生心跳驟停，而在醫院裏接受嘗試性復甦術。心跳驟停的原因很多，目前爲止在成人中最常見的原因是缺血性心血管疾病。心跳停止通常與致命的心室纖顫性心律失常相關，而心室纖顫是由急性心肌缺血或心肌梗塞或原發性心肌電活動紊亂引發的。心律不齊可能危及生命，而突發的原因(如心室纖顫)尚不明瞭。