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2023年全國(guó)醫(yī)學(xué)英語(yǔ)水平考試（METS四級(jí)）考前沖刺試題及答案三,更多相關(guān)資訊請(qǐng)繼續(xù)查看易考吧全國(guó)醫(yī)護(hù)英語(yǔ)水平考試
1). (一)■Allergies Are on the Rise， but So Are Treatments■1Environmental allergies are becoming more prevalent and are not likely to recede any time soon.Treatment options， though， are expanding and improving，giving internists and allergists a wide range of therapy options.According to the American College of Allergy， Asthma， and Immunology， allergies are the sixth leading cause of chronic illness in the U.S.， with an annual cost of around$18 billion.One in 5 Americans have some kind of allergy， many of which are environmental in nature.The Centers for Disease Control and Prevention estimates that the rate of asthma in the United States grew 28% from 2001 to 2011 .Allergy sufferers are more likely to develop asthma， and allergic asthma is the most common form of the condition， accounting for more than half of cases.The most common allergic asthma triggers are environmental and include seasonal pollen， dust mites， pet dander， and cockroaches.■2“The prevalence seems to be increasing，” said Rohit K.Katial， MD， FACP，a professor of medicine， co-director of The Cohen Family Asthma Institute，and director of the allergy and clinical immunology fellowship at the National Jewish Health medical center in Denver.“There are all sorts of theories for this.”Although there is no clear cause， a sprawling blend of societal changes may be driving up pollen counts and human sensitivity.Perhaps the most prominent theory， allergies said， is the so-called hygiene hypothesis， which posits that over-sanitization reduces everyday bacterial exposures and makes one more likely to develop allergies early in life.Modern home weatherproofing exacerbates the situation by sealing occupants against the outdoors and increasing exposure to indoor allergens.On the other end of the hypothetical spectrum， pollen may be more widespread because of climate change.Warmer temperatures lead to increased pollen counts and longer allergy seasons.■3The symptoms most frequently associated with hay fever or allergic rhinitis -sneezing， runny nose， nasal congestion， itchy or watery eyes - are familiar.But they are not the only ones.According to John Kelso， MD， an allergist /immunologist managing allergies begins with the patient history.“Ask if a symptom appears to be seasonal or if there are any particular triggers，” Dr.Kelso said.“If either of those is true， it′s more likely to be allergic rhinitis.” He also noted that allergic shiners， or dark circles under the eyes， while not always caused by allergies， may be a tipoff， as can itching in the palette or ears.Oral allergy syndrome， characterized by itching or swelling in the mouth or throat after patients eat certain fresh fruits or vegetables， can also be a giveaway.This syndrome represents cross -reactivity of proteins in some raw fruits and vegetables and those of specific pollens.The food-related symptoms can tip physicians off to an associated pollen allergy.■4 Just as environmental allergies arise from various factors， so， too， is there a wealth of treatment combinations.Some therapeutic options are tried and true.Others are more novel.The cornerstone of treatment remains the simplest， almost to the point of tautology： Fighting environmental allergies begins with the environment.Environmental control strategies vary by allergen.A pet dander allergy， for example， means bathing pets regularly， keeping them out of bedrooms， and using filters in vacuum cleaners and heating and air conditioning systems that meet the high-efficiency particulate arrestance (HEPA) standard.Dust mite allergies mean using hot water to wash bedding and allergen-proof cases for pillows and mattresses.A more fluid part of the treatment equation is the spectrum of available medication.■5 Over-the- counter corticosteroid nasal sprays and antihistamines remain popular.Nasal corticosteroids help with congestion and inflammation； antihistamines address runny nose， sneezing， and itching.“A relatively new entry into the field is topical antihistamine nasal sprays，” Dr.Kelso said.“You can take these if you don′t get enough relief from the nasal corticosteroid spray alone.” Some manufacturers combine corticosteroid and antihistamine into 1 nasal spray.This can deliver relief and convenience， but is usually more costly than purchasing each medication separately and combining them at home with a physician′s guidance， Dr.Kelso noted.Because many allergy medications (both over- the-counter and prescription)have the same or similar formulations， Dr.Kelso recommends those that are least expensive， depending on patient insurance status.■6 One of the most effective treatment options is allergen immunotherapy.Almost anyone， including children and adults， is eligible to receive the injections， and efficacy is high.(The American Academy of Allergy， Asthma， and Immunology does not typically recommend allergy shots for children younger than 5， and older adults may require closer oversight because of various potential conditions，including heart disease.) Another， newer immunotherapy iteration is also emerging.In 2014， the U.S.Food and Drug Administration approved sublingual immunotherapy (SLIT) allergy tablets， which administer allergy medications under the tongue， rather than via injections.So far， the FDA has approved SLIT treatments for grass and ragweed pollens.■7The first dose must be taken at a clinician′s office， where the patient remains for at least 30 minutes in case of potential adverse reactions.One of the downsides to immunotherapy injections is the time commitment involved.Because of a small but real risk of anaphylactic shock， patients wait 30 minutes in the physician′s office after the injection.Patients typically receive 2 injections a week for 3to 6 months， then monthly maintenance doses for about 5 years.“Shots are exceedingly effective，” Dr.Kelso said.“For people with typical hay fever， the overwhelming majority has complete or near complete relief with those.People can still continue with oral medicines in addition to the shots， but the shots work so well they often don′t need to take any more medicine.”■8 According to a 2011 practice parameter published by the American Academy of Allergy， Asthma， and Immunology， “the physician′s office should have the expertise， personnel， and procedures in place for the safe and effective administration of immunotherapy…A physician or qualified physician extender(nurse practitioner or physician′s assistant) should be present and immediately available and be prepared to treat anaphylaxis when immunotherapy injections are administered.Regular practice drills with the office staff for handling systemic reactions to immunotherapy reactions should be considered.” “It all boils down to quality of life，” Dr.Castells said.“If a primary care physician can manage symptoms with a steroid and over-the-counter medication， you may not need an allergist.If a patient is waking up in the middle of the night or can′t go to the park and play with their kids or do sports despite medication， they may need to be seen by an allergist.”■(二)■Allergies are the sixth leading cause of chronic illness in the U.S.， with an annual cost of around $18 billion and the prevalence seems to be increasing.Although there is no clear cause， the most prominent theory is the so-called hygiene hypothesis which( ) .that over-sanitization reduces the chance of ( )to bacteria.Hay fever or allergic rhinitis are the most frequent symptoms， but for oral allergy syndrome and the food-related symptoms seem to be different.■Corticosteroid and antihistamine are popular to be seen in nasal sprays respectively，which are useful for congestion and( )，runny nose， sneezing， and itching.One of the most effective treatment options is allergen immunotherapy.Both children and adults are ( )which is almost for everyone with high efficacy.But the disadvantage of immunotherapy injections is the time ( )involved.There is an argument that if a primary care physician can manage symptoms with a steroid and over-the-counter medication， you may not need an ( ).( )
A.allergist
B.exacerbates
C.triggers
D.eligible
E.inflammation
F.spectrum
G.specific
H.commitment
I.posits
J.anaphylactic
A.exposures
A.expertise

正確答案：A
2). Patients Are a Virtue■Many years ago at dental school I wrote a sketch for the hospital Christmas Revue about a lady with the first name of Patience who married a man with the surname Patient.Attempting to make an appointment in a busy department of the dental hospital she had to keep holding on the telephone and thus became Patience Patient the Patient Patient.( )■When I travel on a train or a plane I think of myself as a passenger， when I eat in a restaurant I am a diner and when I consult a health professional I am a patient.Am I old-fashioned? ( )Do the majority of those who seek our help， care and treatment on a regular basis think of themselves as patients or as consumers?■( )Thus various parties involved in dentistry have become muddled of recent times about the meaning of service in the context of dental practice.Way back in the last century we were all shocked by the contentions of certain business gurus who declared that dentists were in competition for the spending power of consumers who might instead choose foreign holidays or haircuts over dental care.The consequent tailspin resulted in acres of new carpet being laid in waiting rooms (excuse me， reception lounges) ， hundreds of pounds being spent annually on floral displays and gallery-worths of prints being nailed to practice walls to make the whole “patient journey” more palatable.■While this may have been the beginnings of treating patients more like people and less like items on a conveyer belt， it did not and should not have heralded a change in the actual dental care they received.( )the outcome remained the same； quality clinical dentistry provided by a trained and experienced professional.I am sure that the overwhelming majority of the patients of every reader of this editorial choose to return to see him or her for advice and treatment not because they are reminded of a supermarket chain， nor because they have gone to a price comparison website to discover if they are getting the best deal， but because they like and trust you.■What we each like and trust varies enormously， that is the nature of the human condition.Amongst these decisions are the supermarkets we patronise， or not.W hat makes us choose?( )Probably a combination of all these things and probably a similar process of selection as we might make in choosing， and maintaining， visits to a dentist or dental practice.■So， there is nothing wrong with choice， ( ).The key essential here is that dentists are competent and that the treatment they provide is safe and effective as dictated and guided by scientific rigor， regulation and standards as generated and applied personally， institutionally， legally and ethically.I get the feeling that there is a lack of perspective at work here.As I have written previously the current furor over the rise in complaints needs to be set against the background of the huge number of dental professionals registered and the millions of courses of treatment successfully provided in the U.K.year in， year out.We need to differentiate more carefully though.Failure to provide good clinical care is quite different from a complaint that someone in the practice“l(fā)ooked at me in a funny way.”■Patient care is something that we are individually and collectively extremely good at.( )We must be clear and vocal that this is quite different from customer care，client care， consumer care or any other type of care.Patience was under no illusion all that time ago and her care is as relevant to us today as it was then.A lady became impatient when she attempted to make an appointment with a dentist.( )
A.True
B.False
C.Not mentioned

正確答案：B

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