Disease is a fluid concept influenced by societal and cultur..

第1题

【简答题】Case file study（You can answer the questio...

【简答题】Case file study（You can answer the question either in Chinese or English) A 50-year-old Hispanic female presents to your clinic with complaints of excessive thirst, fluid intake, and urination. She denies any urinary tract infection symptoms. She reports no medical problems, but has not seen a doctor in many years. On examination she is an obese female in no acute distress. Her physical exam is otherwise normal. The urinalysis revealed large glucose, and a serum random blood sugar level was 320mg/dL. 1.What is the most likely diagnosis？ 2.What other organ systems can be involved with the disease？ 3.What is the biochemical basis of this disease？

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第2题

Disease is a fluid concept influenced by societal and cultural attitudes thatchange diachr

Disease is a fluid concept influenced by societal and cultural attitudes that

change diachronically in response to new scientific and medical discoveries.

Historically, doctors defined a disease according to a cluster of symptoms, and

as their clinical descriptions became more sophisticated, they started to classify

(5) diseases into separate groups, so that from this medical taxonomy came new

insights into disease etiology. Before the 20th century, schizophrenia and

syphilitic insanity were treated as the same disease, but by early 1900 it became

evident that psychoses without associated dementia represented a separate

disease for which the term schizophrenia was then coined. The definition of

(10) schizophrenia continues to evolve from the psychiatric disease of the 1960s to an

illness with a suspected genetic etiology, though the existence of such an

etiology remains uncertain. While an optimistic hunt is still on for the genes

involved, we must continue to define schizophrenia in terms of the presence or

absence of "positive" and "negative" symptoms.

(15) Labeling someone as diseased, however, has enormous individual, social,

financial, and physical implications, for irrespective of disease symptoms, the

label itself may lead to significant distress. Individuals with asymptomatic

conditions, including genetic variations, may be perceived by themselves or

others as having a disease. It is not that labeling someone as diseased is always

(20) positive—it does have severe ramifications, affecting decisions to have children

or resulting in unjust treatment by life, medical, and disability insurers--but it

can be beneficial, legitimizing symptoms, clarifying issues of personal

responsibility, and improving accessibility to health care. Nevertheless,

deviations from normal that are not associated with risk should not be

(25) considered synonymous with disease. Two schools—nominalist and essentialist

or reductionist—have debated the clinical criteria used to label a patient as

diseased. Nominalists label symptoms with a disease name, such as

schizophrenia, and do not offer an explanation of the underlying etiology, while

essentialists contend that for every disease there is an underlying pathological

(30) etiology, and now argue that the essential lesion defining the disease state is a

genetic abnormality.

It has been suggested that diseases defined according to the essentialist

tradition may be precisely wrong, whereas those defined in the nominalist

traditional may be roughly accurate. But in labeling a disease state, we must

(35) consider both the phenotype (symptoms) or the genotype (genetic

abnormality), for the former describes a state that places individuals at some

definable risk of adverse consequences, while the latter helps suggest specific

genetic or pharmacologic therapies. Thus, both clinical criteria and genetic

abnormalities should be used to define a disease state, and the choice of a

(40) disease definition will vary according to what one wishes to achieve, the genetic

counseling of family members or the effective treatment of the patient.

The author of the passage is primarily concerned with

A．revealing a commonly ignored distinction

B．proposing a return to a traditional taxonomical system

C．describing an way to resolve a taxonomical dilemma

D．assessing the success of a new taxonomical method

E．predicting a change in future taxonomy

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第3题

补充习题： Down on the brick floor of the Universit...

补充习题： Down on the brick floor of the University of Maryland’s Davidge Hall, a noted professor of medicine is about to perform a most unusual postmortem. Although this domed amphitheater with its steeply rising seats has hosted medical lectures and demonstrations for more than 200 years, today’s offering is exceptional, for the deceased’s remains are nowhere in sight. And at the conclusion of the autopsy, a string quarter will present a program of 18th-century music. The occasion is the university’s sixth annual historical clinical pathology conference. Each year the university’s medical school invites a physician to diagnose the mysterious maladies of historical figures ranging from Edgar Allan Poe to Alexander the Great. This year’s patient is a 35-year-old male who died in Vienna after a two-week illness. His body was consigned to a common grave, but his genius still resounds in concert halls the world over. Controversy has surrounded this particular case history, Fitzgerald explains, because of the deceased’s celebrity status: Wolfgang Amadeus Mozart’s death “wouldn’t have been mysterious at all if Wolfgang Amadeus Muller had died that December night.” Strastruck physicians have since ascribed Mozart’s death to more than 100 causes. “Each of these [diagnoses] is argued with a passion disproportionate to the data,” Fitzgerald points out. “And of course, Mozart died of syphilis as well as everything else, because every great man dies of syphilis.” According to musicologist Neal Zaslaw of Cornell University, who sketches a brief Mozart biography, the death and burial entries in two church registers list the cause of death as “severe miliary fever,” a generic descriptor at the time for any syndrome marked by a seedlike rash. Press reports of his passing supplied such colorful and sinister diagnosis as poisoning, venereal disease, and dropsy of the heart, the 18th-century term for fluid retention and severe swelling. Thus, overweight imaginations and the sands of time have turned tragedy into a medical mystery aching to be solved. That’s just the sort of material that appeals to the school’s vice chair of medicine, Philip Mackowiak, who launched the conference six years ago after reading an account in a Maryland historical magazine of Edgar Allan Poe’s final days. He hired an actor to play Poe and asked his colleague Michael Benitez to review the writer’s medical history. The diagnosis — death by rabies — was topped off, appropriately enough, with a monologue from Poe’s story The Black Cat. The rabies theory attracted enough attention to become a question on the TV game show Jeopardy. It’s instructive, too, to watch another physician work through a case without the benefit of modern technology, says Sehdev. In Mozart’s example, the most compelling symptom — anasarca— has three common causes: liver disease, kidney disease, and congestive heart failure. Lacking modern lab techniques, Fitzgerald must use deductive reasoning. 26. Fitzgerald points of _________ is the fundamental cause of Mozart's death.

A、miliary fever

B、rheumatic fever

C、kidney disease

D、delirium

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第4题

听力原文：I found myself facing a dry-cleaning store which has once been one of the best re

听力原文： I found myself facing a dry-cleaning store which has once been one of the best restaurants in New York. On Sundays the old man would take my mother and me for dinner. There had been a balcony where a baker in a tall white hat baked fresh rolls and whenever a customer entered, the baker would look down and put in a fresh batch. I could smell the rolls through the odor of cleaning fluid on Lenox Avenue. I could see the manager who always sat down will4 us while we ate. He had some disease, I suppose, because the right side of his face was swollen out like a balloon, but he always wore a hard wing collar and a white tie, and never seemed sick. A Negro with a moustache was looking through the store window at me. For a moment I had the urge to go and tell him what I remembered, to describe this avenue when no garbage cans were on the street, when the Daimlers and Minervas and Fords had cruised by, and the cop on the corner threw back the ball when it got through the outfield on 114th street. I did not go into the store, nor even toward our house. Any claim I had to anything had lapsed. I went downtown instead and sat in my room, trying to read.

According to the speaker, the dry-cleaning store used to be a ______.

A．hote

B．restaurant

C．bakery

D．garage

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第5题

听力原文： Today, as AIDS licks the whole world, we should no longer term it as taboo, but

take a scientific view of it.

AIDS is the fifth leading cause of death among persons between ages 25 and 44 in the United States. About 47 million people worldwide have been infected with HI~ since the start of the epidemic.

AIDS stands for "Acquired Immune Deficiency Syndrome". It is caused by the Human Immunodeficiency Virus(HIV). AIDS is the final and most serious stage of HIV disease, in which the signs and symptoms of severe immune deficiency have developed.

HIV has been found in saliva, tears, nervous system tissue, blood, semen, vaginal fluid, and breast milk. However, only blood, semen, vaginal secretions, and breast milk have been proven to transmit infection to others.

Transmission of the virus occurs through sexual contact, blood transfusions or needle sharing, and from mother to child. A pregnant woman can passively transmit the virus to her fetus, or a nursing mother can transmit it to her baby.

Other transmission methods are rare and include accidental needle injury, artificial insemination through donated semen, and through a donated organ.

HIV infection is not spread by casual contact such as hugging and touching, by touching dishes, doorknobs, or by mosquitoes. It is not transmitted to a person who donates Blood or organs. However, it can be transmitted to the person receiving blood or organs from an infected donor. This is why blood banks and organ donor programs screen donors' blood and tissues thoroughly.

How many people worldwide have been infected with HIV since the start of the epidemic？

A．47 million.

B．4 billion.

C．25 million.

D．44 million.

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第6题

A the incidence of mesothelioma is extremely lowB which may extend from 25 to 30 year af

A the incidence of mesothelioma is extremely low

B which may extend from 25 to 30 year after initial exposure

C whereas the latter consist of a collection of fluid in the chest region outside the lungs

D on the other hand, are exclusively associated with exposure to the less harmful white asbestos

E suspect that exposure to even minimal levels of asbestos is unacceptable

F causing scarring which limits the functioning of the lungs

G resulting from inadequate ventilation

H develop the barrel-shaped chests associated with emphysema 肺气肿(where the skin assumes a bluish color) and club fingers

The inhalation of asbestos particles is associated with a number of lung diseases, such as asbestosis and lung cancer. Asbestosis is caused by the entry of asbestos particles into the walls of the alveoli, 【B1】______ . The lung loses its elasticity and may change shape. The initial symptoms of asbestosis are a tightness in the chest and breathlessness. In its later stages, sufferers 【B2】______ .

Lung cancer, the genetic term for malignant tumors of the alveoli and bronchial tubes, has been shown to be directly related to the inhalation of asbestos particles. As in the case of asbestosis, there is generally a period of latency 【B3】______ , despite the absence of further exposure. Research suggests that there is a direct correlation between the degree of exposure to asbestos and the incidence of lung cancers. Where exposure occurs, the level of risk is further increased by cigarette smoking. Asbestos workers who smoke cigarettes have a 90% greater risks of contracting lung cancer than workers who do not smoke.

Exposure to blue asbestos has been shown to produce mesothelioma, a rare cancer of the outer lining of the lung or pleura. In a normal population 【B4】______ . Where epidemiological surveys have revealed a higher incidence of the disease, it is almost always related to asbestos exposure.

【B1】______

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第7题

Common cold is a viral infection that starts in the upper respiratory tract, sometimes spr

eads to the lower structures, and may contribute secondary infeeti9ns in the eyes or middle ears. The main differences between the common cold and other respiratory infections are the absence of fever and the relative mildness of the symptoms.

About 200 different strains of virus are capable of producing colds. Frequently two or more different viruses can be isolated during a single episode. The cold is spread by person-to-person contact. People can carry the virus and communicate it without themselves experiencing any of the symptoms. Incubation is short—usually one to four days. The viruses start spreading from an infected person before the symptoms appear, and the spread reaches its peak during the symptomatic phase. The incidence of colds peaks during the autumn, and minor epidemics commonly Occur throughout the winter. The reason for this incidence is unknown; it may not stem mainly from stresses imposed by chilly weather but rather result from the greater amount of time spent indoors, which increases the likelihood of close contact with those persons carrying cold viruses.

Pathologic changes occurring in the mucous membrane that lines the nose, the nasal sinuses, the nasoharynx, and other upper respiratory passages may include tissue swelling, congestion of blood, and oozing of fluids. During the acute phase of the disease, the respiratory secretions are. altered by increase in serum proteins. Parts of cells may 'also be found in the fluids. Tissue repair is rapid and seems complete, although a relationship might exist between colds and more serious respiratory conditions.

Cold symptoms vary from person to person, but in the individual the same symptoms tend to recur in succeeding bouts of infection. Manifestations may include sneezing, headaches, fatigue, chilling, sore throat, inflammation of the nose (rhinitis), and nasal discharge. There is usually no fever. The symptoms usually last for only a few days. Tile nasal discharge is the first warning. The secretions become watery, clear, and excessive. Later, they thicken, increase in mucus and pus content, and may colour a yellow-green, with traces of blood. Coughing can be dry or produce amounts of mucus. Other, more serious diseases with similar general symptoms may be mistaken for a cold; some of these are tuberculosis, bronchitis, lung abscesses, and inflammation around the heart.

Treatment is, in most instances, directed toward allaying of symptoms, coupled with rest and adequate fluid intake. Occasionally antibiotics are given to prevent secondary infections.

According to this passage, common cold is ______.

A．a hereditary disease

B．generally accompanied with mild fever

C．a kind of popular respiratory infection

D．caused by spending a lot of time outdoors in chilly weather

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第8题

■ Section B Directions: There are 2 passages in this section. Each passage is followed by

some questions or unfinished sentences. For each of them there are four choices marked A), B), C) and D). You should decide on the best choice.

Passage One

Questions 21 to 25 are based on the following passage.

During the past seven or eight years, researchers have made some new and exciting discoveries about osteoarthritis (骨关节炎), a common and debilitating problem. No longer considered an inevitable consequence of the wear and tear associated with aging, osteoarthritis is now understood to be an active process that progressively damages cartilage (软骨) , the normally resilient (有弹性的) connective tissue cushioning every joint in the body. Osteoarthritis is caused by damaged cartilage that the body cannot properly repair. As we age, our cartilage becomes more prone to damage. When this damage occurs, cells within the cartilage may release mediators (substances that cause local inflammation), along with other cartilage-destroying chemicals. This process of damage upon more damage results in osteoarthritis.

Researchers have been able to identify what puts people at risk of developing osteoarthritis. Age is not necessarily an issue, although the disease is certainly more common in the elderly. Obesity is an overwhelmingly strong risk factor. For those already diagnosed, losing weight has been shown to slow the disease’s progression and substantially ease joint pain. Injury to a bone or joint may make that area more prone to arthritis in the future. For example, ankle fractures and knee surgery are linked to osteoarthritis, as are injuries due to some vigorous contact sports. Repetitive activities such as the movements involved in certain fields of work can contribute to osteoarthritis.

A number of recent studies have emphasized the importance of exercise in reducing pain and maintaining function in people with osteoarthritis. Weight reduction is another key component of treatment. Shoe inserts and knee braces can also relieve knee pain caused by osteoarthritis. Although basic pain medications can help, non-steroidal anti-inflammatory drugs such as ibuprofen (布洛芬，一种抗炎、镇痛药) are more effective in relieving pain. However, these drugs carry the risk of kidney damage, high blood pressure, fluid retention and stomach bleeding. Glucosamine sulfate (氨基葡萄糖硫酸盐) is a component of normal joint cartilage. Recent studies have shown that 1,500 mg per day of this medication, available without a prescription, can decrease pain and improve function for patients with osteoarthritis of the knee.

第22题：According to the passage, osteoarthritis ________.

A) is inevitably caused by wear and tear due to aging

B) is an active process in which cartilage is damaged abruptly

C) is caused by damaged cartilage that the body cannot properly repair

D) is caused by cells within the cartilage that may release mediators

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第9题

The pressure at point in a fluid is the same in all directions only when the fluid is :

A.perfect gas

B.imcompressible

C.at rest

D.Newtonian fluid

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第10题

The PO2 is highest at

A、arterial blood

B、venous blood

C、blood in the capillary

D、intracellular fluid

E、extracellular fluid

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