Professional Documents
Culture Documents
Reading Oet Vol 1
Reading Oet Vol 1
0
READING
SUB-TEST
EXERCISES
& ANSWER KEY
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Language Assessment Trust, which was not involved
in the production of, and does not endorse, this
product.
PREFACE
This book is specifically designed for Amazon free kindle-reading app, which
is supported on any device( smartphones, laptops, computers, ebook readers,
etc) on any platforms (windows, android, apple ios, etc). Therefore, you can
read this book on multiple devices you own.
How this book is different from other books
available in the market?
Unlike paper books and other e books, you don’t have to scroll or turn pages
back and forth while answering questions. One-touch navigation links (with
one single touch you will execute the intended action) are available between
each questions and their respective texts/paragraphs, and vice versa. This will
save you a lot of time, and makes your answering quicker.
Apart from this, one-touch reference links are available for every word in
this book (including any words from paragraphs, questions, instructions, or
even these words, which you are reading right now).
There are mainly five types of reference links are available in this book. They
are:
1. Dictionary:– in-built dictionaries are available for referring any word you
touch and hold. This feature helps you save a lot of time by:
a. You don’t have to search through a paper bind dictionary to find the
meaning of the word.
b. You don’t have to check out a word list under the heading
‘vocabulary’ to improve your vocabulary. While reading this book
you can learn the meaning of words that you don’t know, by just a
single touch and hold over the unknown word that you find.
c. There is an in-built Oxford English dictionary available for your
reference, which shows the meaning in a pop up dialogue box. If you
prefer detailed meaning or the meaning of phrases related to the
word, then you can easily choose full definition in the pop-up box for
further details and pronunciation.
d. In-built English – Native languages dictionaries are also available,
if you desire to know more about the word in your mother tongue.
This will increase levels of understanding the word in detail and
helpful to remember quickly later.
Part A – 15 minutes
Reading Part A tests your ability to skim and scan quickly across
different texts on a given topic in order to locate specific
information. For that purpose, Part A is strictly timed and you must
complete all 20 question items within the allocated 15 minutes. To
complete the task successfully, you will also need to understand the
conventions of different medical text types and understand the
presentation of numerical and textual information. The 20
questions consist of matching, sentence completion and short
answer questions.
NB: In Part A you should write your answers clearly in the spaces
given in the question booklet.
NB: Please remember that there is a strict time limit for Part A, and
Part A materials will be collected from you after 15 minutes. You
will therefore not have any time to check your Part A answers later
in the test.
NB: In Part A you must use exactly the same form of the word or
short phrase as given in the four texts.
Part B
Part B assesses your ability to identify the detail or main point of
six short texts sourced from the healthcare workplace. The texts
might consist of extracts from policy documents, hospital
guidelines, manuals or internal communications, such as emails or
memos. For each text, there is one three-option multiple-choice
question. To complete the task successfully, you will need to
identify specific ideas at sentence level.
Part C
Part C assesses your ability to identify detailed meaning and
opinion in two texts on topics of interest to healthcare
professionals. For each text, you must answer eight four-option
multiple choice questions. Reading Part C tests your ability to
understand the explicit or implied meaning as well as the attitude or
opinion presented in a longer text. To complete the task
successfully, you will need to identify the relationship between
ideas at sentence and paragraph level. Part C also tests your ability
to accurately understand lexical references and complex phrases
within the text.
METHOD OF ANSWERING
STEP 1.
FLASH READING
Flash reading refers to high-speed reading of the whole reading
passage in few minutes, without thinking anything in your head
(not even trying to guess meaning of the unfamiliar words/phrases).
It helps to provide a vague idea about the matters that are discussed
in the reading passage. It also forms a clear map in mind showing
the order of statements as they appear in the passage, which eases
locating the extract/paragraph referred in questions while
answering.
STEP 2.
FOCUSED READING
After finishing flash reading, start answering the questions.
Eliminate all the irrelevant and impossible options from the
multiple choices. Find a quick fix on location of the
extract/paragraph referred in the questions and read the
extract/paragraph quickly (strictly not more than twice, if it is a
paragraph and not more than thrice if it is a short extract) with
complete focus. Write the answer you had found only if you are
sure enough.
If the answer is confusing (if you find more than one possible
answer for the question), write the answer you think to have more
possibility to be correct on your answer sheet, along noting the
question and two or three other possible answer for later reference.
This will avoid wastage of time due to fixating over confusing
questions.
If the question is so tough that you fail to find a proper answer to it,
then leave it blank and note the question number for later reference.
Focused reading helps to answer all easy question in the reading
test correctly, instead of losing marks on them in the last minute
rush.
STEP 3.
THOROUGH READING
After finishing all the questions in the test, you can start answering
the tough questions by reading thoroughly the referred
extract/paragraph by reading. Thorough reading refers to slow
reading with maximum concentration to find all possible meanings
between the lines, so that you arrive at a possible answer. Don’t
read more than twice.
After finishing tough questions, start answering questions with
confusing answers in the same manner. If you follow these three
steps you can spend time wisely, while attending a reading test.
Avoid wasting time by going after tips for reading, when you are
not getting desired results.
There are only two things that can improve your OET reading
score:
1. Efficient management of time
2. Practicing more and more reading sample tests.
WORK HARD, SCORE MORE!
Practice Test 1
READING SUB-TEST – QUESTION PAPER: PART A
TIME: 15 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer the questions within the 15-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 15 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Text A
Aspirin Resistance
Abstract
In the last few years, the concept of aspirin resistance has been
largely emphasised in the medical literature, although its definition,
mechanism, and specific guidelines for its management remain
unclear. Aspirin displays good antithrombotic activity. Various
laboratory parameters assessing the efficacy of aspirin like
bleeding time, platelet reactivity, thromboxane-A2 (TX-A2)
production, and measurement of platelet aggregation, have
confirmed the lack of its uniform effect on the platelets. Few
studies have reported aspirin resistance to the tune of 5 - 45%.
Various extrinsic and intrinsic factors influence the resistance.
Numerous studies reveal that aspirin resistance can be overcome by
combining it with another antithrombotic agent, i.e., clopidogrel.
Further, clopidogrel resistance has also been reported. So, much is
expected in the field of diagnostic tests in order to know the true
picture of aspirin resistance.
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Text B
Mechanisms of aspirin resistance
The exact mechanisms are not clear:
True aspirin resistance:
The proposed factors for this type of resistance include:
i. Decreased bioavailability of aspirin.
ii. Accelerated platelet turnover introducing newly formed, non-
aspirinated platelets into the blood stream.
iii. Competition of aspirin with other NSAIDs (like ibuprofen)
preventing aspirin access at Serine 530 of Cox-I.
iv. Transcellular formation of TxA2 by aspirinated platelets from
PGH2 released by other blood cells or vascular cells.
v. TxA2 production by aspirin insensitive Cox-2 in newly formed
platelets or other cells.
vi. (Theoretical) presence of variant Cox-I which is less sensitive to
aspirin inhibition.
vii. Poor compliance by the patient.
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Text C
Aspirin dosage
According to the Antithrombotic Trialists’ Collaboration, daily
doses of aspirin (75 - 150 mg) are as effective as higher doses for
prevention of thrombotic events and are associated with low risk of
bleeding. Bornstein et al in their study have shown that even 100
mg of aspirin completely inhibits Cox-1 enzyme, thus further
substantiating the fact that patients with resistance established
during low dose aspirin therapy may respond to higher doses. The
results of this study showed that aspirin in doses of 500 mg/day
significantly prolonged the time between first and second stroke (p
= 0.002) compared with lower doses. Helgason et al revealed that
an increase in the dose of aspirin to 625 that suboptimal reduction
of urinary 11-dehydro TxB2 level during aspirin treatment is
associated with increased risk for future MI and cardiovascular
death, thereby suggesting that “true aspirin resistance” may be a
clinically relevant phenomenon. Inadequate inhibition of TxA2
biosynthesis by aspirin can be seen in patients on ibuprofen
therapy, because of competition of these 14 mg/day in five patients
who were aspirin resistant with 325 mg/day showed aspirin
sensitivity. Another study has revealed that these patients remained
resistant with aspirin 1,300 mg. This shows that inadequate dose
cannot explain aspirin resistance in all subjects.
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Text D
Management of aspirin resistance
Currently there are no specific guidelines for the management of
aspirin resistance. The first step is to enquire about the patient’s
compliance. Regarding optimal aspirin dosing, it is controversial.
No convincing data are available showing that the antithrombotic
effect of aspirin is dose related. The meta-analysis by Anti-
Thrombotic Trialist’s Collaboration refuted the claim that high
doses of aspirin (500 - 1,500 mg/day) were effective than low
doses (75 - 150 mg/day). Other method to manage aspirin
resistance is by addition of another antiplatelet agent – clopidogrel,
because CAPRIE trial has shown greater benefit of combination of
aspirin and clopidogrel compared with aspirin alone. The
combination of aspirin with clopidogrel is an ideal one since
clopidogrel inhibits another pathway of platelet activation.
However, till date, it is not clear whether the superiority of a
combination of clopidogrel and aspirin over aspirin is due to
clopidogrel compensation for aspirin non-responders. Resistance to
even clopidogrel has been reported, which is associated with an
increased risk of recurrent thrombotic events in patients with acute
MI.
.
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Questions“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”
Part A
TIME: 15 minutes
• Look at the four texts, A-D, in the separate Text Booklet.
• For each question, 1-20, look through the texts, A-D, to find the
relevant information.
• Write your answers on the spaces provided in this Question
Paper.
• Answer all the questions within the 15-minute time limit.
• Your answers should be correctly spelt.
QUESTIONS
Questions 1-7
For each question, 1-7, decide which text (A, B, C or D) the information
comes from. You may use any letter more than once.
In which text can you find information about
1. what are the factors of true aspirin resistance? _____
Go “Text “Text “Text “Text
to A” B” C” D”
2. how much of aspirin completely inhibits Cox-1 enzyme? _____
Go “Text “Text “Text “Text
to A” B” C” D”
3. what will happen if aspirin compete with other NSAIDs? _____
Go “Text “Text “Text “Text
to A” B” C” D”
4. how the the true picture of aspirin resistance is revealed? _____
Go “Text “Text “Text “Text
to A” B” C” D”
5. what are the parameters for assessing the efficacy of aspirin?
_____
Go “Text “Text “Text “Text
to A” B” C” D”
6. list the methods to manage aspirin resistance? _____
Go “Text “Text “Text “Text
to A” B” C” D”
7. whether true aspirin resistance is a clinically relevant
phenomenon? _____
Go “Text “Text “Text “Text
to A” B” C” D”
Questions 8-13
Answer each of the questions, 8-13, with a word or short phrase from one of
the texts. Each answer may include words, numbers or both.
Answer Key
“Practice Test 1”
Practice Test 2
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part B
In this part of the test, there are six short extracts relating to the
work of health professionals. For questions 1-6, choose the answer
(A, B or C) which you think fits best according to the text.
Anaesthetic Machines
The anaesthetic machine (or anaesthesia machine in America) is used by
anaesthesiologists and nurse anaesthetists to support the administration of
anaesthesia. The most common type of anaesthetic machine is the
continuous-flow anaesthetic machine, which is designed to provide an
accurate and continuous supply of medical gases (such as oxygen and nitrous
oxide), mixed with an accurate concentration of anaesthetic vapour (such as
halothane or isoflurane), and deliver this to the patient at a safe pressure and
flow. Modern machines incorporate a ventilator, suction unit, and patient
monitoring devices.
1. The manual is giving information about
A. how to use anaesthetic machines
B. types of anaesthetic machines
C. an overview of anaesthetic machines
mHealth
The use of mobile technologies for data collection about individuals and
interactive information services are a part of a growing area of eHealth called
mHealth. The GOe published a volume on this subject in 2011 which
documents the uptake of mHealth worldwide by types of initiatives and main
barriers to scale. Mobile technologies are emerging as a powerful tool for
health information transfer including making patient information portable.
Such technologies can be more fully utilized through electronic patient
information such as EMRs and EHRs. Electronic records will work best,
however, if there are standards in place for their use and interoperability.
5. The note tells us that the mHealth
A. is a published volume on the GOe
B. is a powerful tool for information transfer
C. makes patient information portable
Answer Key
“Practice Test 2”
Practice Test 3
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part C
In this part of the test, there are two texts about different aspects of
healthcare. Choose the answer (A, B, C or D) which you think fits
best according to the text.
Answer Key
“Practice Test 4”
Practice Test 5
READING SUB-TEST – QUESTION PAPER: PART A
TIME: 15 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer the questions within the 15-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 15 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Text A
Morgellons disease
lf you have fatigue, skin lesions, aches and pains and a sensation that insects
are crawling around under your skin, you most probably have Morgellons
disease. But this disease may actually not exist. Whether or not Morgellons is
a real disease, no one knows. Something like the symptoms described above,
supplemented by the appearance of strange fibres or filaments growing on or
just beneath the skin, was reported by the 17th-century physician Thomas
Browne. There were no other reported cases, and the disease seemed to
disappear. Then, in 2002, the mother of a child with a skin ailment
championed its comeback. Her child, she insisted, had Morgellons.
Delve into the medical literature, though, and Morgellons disease is
frequently described as “unexplained dermopathy” or “delusional parasitosis”
- a psychiatric illness that results in people mistakenly believing their skin to
be infested with parasites. We may soon find out more. The US Centers for
Disease Control and Prevention (CDC) is in the middle of a large, systematic
study into Morgellons. The study aims to determine whether there is actually
a physiological basis to the disease. The CDC is keeping an open mind on
Morgellons, says Michele Pearson, who is leading the study. “CDC has
approached this as an unexplained condition,” she says.
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Text B
CDC, Kaiser to study puzzling illness
The Centers for Disease Control and Prevention and Kaiser Permanente‘s
Northern California Division of Research announced they are launching a
study to learn more about an unexplained skin condition called Morgellons
disease. The CDC will identify patients with the condition in Kaiser‘s
Northern California health plan. The study is expected to take at least 12
months. Reports of cases have been made in every state and 15 countries.
Many reported cases have been clustered in California, Texas and Florida,
according to the Mayo Clinic.
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Text C
Delusional Parasitosis
Delusional Parasitosis is an uncommon psychiatric disorder presented by
persons with an unremitting false belief that they are infested with
ectoparasites or infected with endoparasites. The delusion is usually long-
standing and well integrated into the patient’s persona. Patients with the
disorder are predominantly older women, although younger people and men
can be affected. Most cases involve patient beliefs that the skin has been
invaded by insects, but some involve delusions that internal parasites are the
cause of their condition.
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Text D
The causes for the disorder are not clear, but sufferers are generally of
average or higher intelligence and are otherwise functional. Patients with
delusional parasitosis generally have a long history of visiting physicians
seeking information of their diagnosis and help with their condition. The
patients have certain characteristics or exhibit behaviors that strongly suggest
the presence of the disorder. Moreover, these patients can be antagonistic and
relentless in their need to find someone who will agree with their self-
diagnosis and help them. Because these delusional patients may seek help
from non-physician medical professionals, such as parasitologists, clinical
microbiologists, entomologists, or biologists, such individuals should be
aware of this disorder. Delusional parasitosis can be treated with
antipsychotic medication and psychiatric consultations but generally does not
respond well to such treatment.
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Questions“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”
Part A
TIME: 15 minutes
• Look at the four texts, A-D, in the separate Text Booklet.
• For each question, 1-20, look through the texts, A-D, to find the
relevant information.
• Write your answers on the spaces provided in this Question
Paper.
• Answer all the questions within the 15-minute time limit.
• Your answers should be correctly spelt.
QUESTIONS
Questions 1-7
For each question, 1-7, decide which text (A, B, C or D) the information
comes from. You may use any letter more than once.
In which text can you find information about
1. what is the minimum expected time period for CDC’s study to learn more
about Morgellons disease? _____
Go “Text “Text “Text “Text
to A” B” C” D”
2. what are the treatments for Morgellons disease? _____
Go “Text “Text “Text “Text
to A” B” C” D”
3. name the places where Morgellons disease reported so far? _____
Go “Text “Text “Text “Text
to A” B” C” D”
4. what is the aim for CDC’s study to learn more about Morgellons disease?
_____
Go “Text “Text “Text “Text
to A” B” C” D”
5. which are the age groups predominantly affected by Morgellons
disease? _____
Go “Text “Text “Text “Text
to A” B” C” D”
6. what is the current approach of CDC’s towards Morgellons disease?
_____
Go “Text “Text “Text “Text
to A” B” C” D”
7. what are the other names of Morgellons disease? _____
Go “Text “Text “Text “Text
to A” B” C” D”
Questions 8-13
Answer each of the questions, 8-13, with a word or short phrase from one of
the texts. Each answer may include words, numbers or both.
8. Who reported a medical condition similar to Morgellons disease
for the first time?
Go “Text “Text “Text “Text
to A” B” C” D”
9. Name the person who leads CDC’s study to learn more about Morgellons
disease?
Go “Text “Text “Text “Text
to A” B” C” D”
10. Name the type of medications used to treat Morgellons disease?
Go “Text “Text “Text “Text
to A” B” C” D”
11. How many countries reported Morgellons disease?
Go “Text “Text “Text “Text
to A” B” C” D”
12. Name the type of illness under which the Morgellons disease is
classified?
Go “Text “Text “Text “Text
to A” B” C” D”
13. what is the popular delusion of the people affected by Morgellons
disease?
Go “Text “Text “Text “Text
to A” B” C” D”
Questions 14-20
Complete each of the sentences, 14-20, with a word or short phrase
from one of the texts. Each answer may include words, numbers or
both.
14. Morgellons disease is frequently described as _____ or “delusional
parasitosis”.
Go “Text “Text “Text “Text
to A” B” C” D”
15. Morgellons disease is a psychiatric illness that results in people
mistakenly believing their skin to be infested with _____.
Go “Text “Text “Text “Text
to A” B” C” D”
16. Many reported cases have been clustered in California, Texas and
Florida, according to the _____.
Go “Text “Text “Text “Text
to A” B” C” D”
17. The _____ will identify patients with the condition in Kaiser‘s Northern
California health plan.
Go “Text “Text “Text “Text
to A” B” C” D”
18. The delusion is usually long- standing and well integrated into the
patient’s _____.
Go “Text “Text “Text “Text
to A” B” C” D”
19. Patients with delusional parasitosis generally have a long history of
visiting ______.
Go “Text “Text “Text “Text
to A” B” C” D”
20. Patients with delusional parasitosis can be antagonistic and ______.
Go “Text “Text “Text “Text
to A” B” C” D”
Answer Key
“Practice Test 5”
Practice Test 6
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part B
In this part of the test, there are six short extracts relating to the
work of health professionals. For questions 1-6, choose the answer
(A, B or C) which you think fits best according to the text.
Electronic Diagnostic Equipment
There are many items of equipment in a hospital that use electronics for
operation. The maintenance of such equipment is a task for specialised and
trained staff. However, regular inspection and cleaning will help such
equipment last for a long time and deliver safe function. These are tasks that
the equipment user can carry out and should be done regularly, as laid out on
the checklists on the next pages. The types of equipment that might be
included in this category are for instance audiometers, blood gas analyzers,
cardiac monitors, cryoprobes, infusion pumps and stimulators. The steps in
this section can also be applied to most laboratory equipment, although it
should be noted that the WHO publication Maintenance Manual for
Laboratory Equipment deals with these in much better detail.
1. The type of equipment that might not be included in the category of
Electronic Diagnostic Equipment is
A. cardiac analyzers
B. stimulators
C. audiometers
Electrosurgical Units (ESU) and Cautery Machines
Electrosurgery is the application of a high-frequency electric current to
biological tissue as a means to cut, coagulate, desiccate, or fulgurate tissue.
Its benefits include the ability to make precise cuts with limited blood loss in
hospital operating rooms or in outpatient procedures. Cautery, or
electrocautery, is the application of heat to tissue to achieve coagulation.
Although both methods are sometimes referred to as surgical diathermy , this
chapter avoids the term as it may be confused with therapeutic diathermy,
which generates lower levels of heat within the body.
2. What does this manual tell us about electrocautery?
A. make precise cut with limited blood loss
B. uses high-frequency electric current
C. application of heat to tissue to achieve coagulation
Endoscopy
Endoscopy means looking inside the body using an endoscope, an instrument
used to examine the interior of a hollow organ or cavity of the body.
Endoscopes are inserted directly into the organ. An endoscope can consist of
a rigid or flexible tube, a light delivery system (light source), an optical fibre
system, a lens system transmitting the image to the viewer, an eyepiece and
often an additional channel to allow entry of medical instruments, fluids or
manipulators. There are many different types of endoscopy, including
arthroscopy, bronchoscopy, colonoscopy, colposcopy, cystoscopy,
laparoscopy and laryngoscopy.
3. What does this extract from a handbook tell us about endoscopes?
A. are inserted directly into the organ
B. used to examine the exterior of a hollow organ or cavity of the body
C. there are mainly 7 types
Messaging standards
Messaging is the electronic communication of health information from the
point of collection or storage to a point of use. This can be a short distance
such as within a clinic or larger distances across facilities or districts.
Messages can be used to retrieve historical data as well as current data. A
health message includes health data that is expressed in a standard
vocabulary. It may also include metadata about the definitions or
environment of the data. The message itself is in a precisely defined format
so that it can be received by a computer program which will understand its
meaning.
4. The email is reminding staff that the
A. health message should include health data expressed in a standard
vocabulary
B. health message should include metadata about the definitions or
environment of the data
C. health message should be precise in any format to be received by a
computer program
Communication skills during medical examination
An appropriate contact with the patient requires applying professional
knowledge about psychological aspects of interpersonal relations. While
examining the patient, most doctors apply just the experience or abilities to
establish interpersonal contacts that have been acquired on a social level. This
knowledge would definitely be insufficient in unusual and problematic
situations. For many years, clinical and social aspects of doctors’
psychological education have been neglected. The ability of conversation
should be based on appropriate education, not only on personal intuition or
own experience.
5. The notice is giving information about
A. necessity of communication based on appropriate psychological education
B. necessity of establishing interpersonal contacts with patient
C. necessity of appropriate contact based on personal experience
Liver Palpation
Liver palpation is performed with the right hand placed flat under right costal
chest border, parallel to the long body axis, then applying pressure at the
depth of inspiration in an attempt to move under the costal border in the right
middle clavicular line and towards its right side. In normal conditions, the
lower liver border is not touched. During the respiration, the lower liver
border is slightly moving down and upwards.
If the liver edge can be detected on palpation, some additional features have
to be determined as there are various abnormalities related with specific
diseases.
6. What must all staff involved in liver palpation do?
A. should place right hand flat under right chest
B. should apply pressure at the depth of aspiration
C. should place left hand flat under right chest
Answer Key
“Practice Test 6”
Practice Test 7
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part C
In this part of the test, there are two texts about different aspects of
healthcare. Choose the answer (A, B, C or D) which you think fits
best according to the text.
Tufts University faculty debunks common dental myths
Paragraph 1
Brushing, flossing, and twice-yearly dental check-ups are standard for oral
health care, but there are more health benefits to taking care of your pearly
whites than most of us know. In a review article, a faculty member at Tufts
University School of Dental Medicine (TUSDM) debunks common dental
myths and outlines how diet and nutrition affects oral health in children,
teenagers, expectant mothers, adults and elders.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 2
Myth 1: The consequences of poor oral health are restricted to the
mouth
Expectant mothers may not know that what they eat affects the tooth
development of the fetus. Poor nutrition during pregnancy may make the
unborn child more likely to have tooth decay later in life. “Between the ages
of 14 weeks to four months, deficiencies in calcium, vitamin D, vitamin A,
protein and calories could result oral defects,” says Carole Palmer, EdD, RD,
professor at TUSDM and head of the division of nutrition and oral health
promotion in the department of public health and community service. Some
data also suggest that lack of adequate vitamin B6 or B12 could be a risk
factor for cleft lip and cleft palate formation
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 3
In children, tooth decay is the most prevalent disease, about five times more
common than childhood asthma. “If a child’s mouth hurts due to tooth decay,
he/she is less likely to be able to concentrate at school and is more likely to
be foods that are easier to chew but that are less nutritious. Foods such as
donuts and pastries are often lower in nutritional quality and higher in sugar
content than nutritious foods that require chewing, like fruits and vegetables,”
says Palmer. Oral complications combined with poor diet can also contribute
to cognitive and gr problems and can contribute to obesity
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 4
Myth 2: More sugar means more tooth decay
It isn’t the amount of sugar you eat; it is the amount of time that the sugar has
contact with the teeth. “Foods such as slowly-dissolving candies and soda are
in the mouth for longer periods of time. This increases the amount of time
teeth are exposed to the acids formed by oral bacteria from the sugars,” says
Palmer.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 5
Some research shows that teens obtain about 40 percent of their carbohydrate
intake from soft drinks. This constant beverage use increases the risk of tooth
decay. Sugar-free carbonated drinks and acidic beverages, such as lemonade,
are often considered safer for teeth than sugared beverages but can also
contribute to demineralization of tooth enamel if consumed regularly.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 6
Myth 3: Losing baby teeth to tooth decay is okay
It is a common myth that losing baby teeth due to tooth decay is insignificant
because baby teeth fall out anyway. Palmer notes that tooth decay in baby
teeth can result in damage to the developing crowns of the permanent teeth
developing below them. If baby teeth are lost prematurely, the permanent
teeth may erupt mal-positioned and require orthodontics later on.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 7
Myth 4: Osteoporosis only affects the spine and hips
Osteoporosis may also lead to tooth loss. Teeth are held in the jaw by the face
bone, which can also be affected by osteoporosis. “So, the jaw can also suffer
the consequences of a diet lacking essential nutrients such as calcium and
vitamins D and K,” says Palmer. “The jawbone, gums, lips, and soft and hard
palates are constantly replenishing themselves throughout life. A good diet is
required to keep the mouth and supporting structures in optimal shape.”
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 8
Myth 5: Dentures improve a person’s diet
If dentures don’t fit well, older adults are apt to eat foods that are easy to
chew and low in nutritional quality, such as cakes or pastries. First, denture
wearers should make sure that dentures are fitted properly. In the meantime,
if they are having difficulty chewing or have mouth discomfort, they can still
eat nutritious foods by having cooked vegetables instead of raw, canned fruits
instead of raw, and ground beef instead of steak. Also, they should drink
plenty of fluids or chew sugar-free gum to prevent dry mouth,” says Palmer.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 9
Myth 6: Dental decay is only a young person’s problem
In adults and elders, receding gums can result in root decay (decay along the
roots of teeth). Commonly used drugs such as antidepressants, diuretics,
antihistamines and sedatives increase the risk of tooth decay by reducing
saliva production. “Lack of saliva means that the mouth is cleansed more
slowly. This increases the risk of problems,” says Palmer. “In this case,
drinking water frequently can help cleanse the mouth.”
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 10
Adults and elders are more likely to have chronic health conditions, like
diabetes, which are risk factors for periodontal disease (which begins with an
inflammation of the gums and can lead to tooth loss). “Type 2 diabetes
patients have twice the risk of developing periodontal disease of people
without diabetes. Furthermore, periodontal disease exacerbates diabetes
mellitus, so meticulous oral hygiene can help improve diabetes control,” says
Palmer.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
QUESTIONS
Q1. This article is about
a. how the nutritional needs of children, teenagers and expectant mothers has
an effect on oral health
b. how the oral health is affected by nutritional needs of children, teenagers,
expectant mothers and other groups.
c. how diet and nutritional needs of children, teenagers, mothers-to-be, and
adults affects one’s oral health
d. disproving some long held beliefs
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q2. Carole Palmer observes that
a. pies and pastries have low food value and require more chewing
b. lower nutritional quality food needs more chewing
c. nutritious foods like fruits and vegetables have less sugar and require more
chewing
d. too much vitamin B6 or B12 could lead to problems with cleft palate
formation
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q3. According to Palmer
a. asthma is five times less common in childhood than tooth decay
b. school kids with tooth decay pain may have concentration problems at
school
c. mouth and dental problems plus a poor diet can affect thinking abilities and
be a factor later on in obesity
d. all of the above
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q4. According to the article :
a. it’s important to make sure you retain baby teeth
b. It’s important that teeth are not exposed for a long time to acids formed by
oral bacteria as a result of eating sugary foods
c. it’s important to look after your baby teeth
d. it’s important that teeth are not exposed to acids formed by oral bacteria
from sugary foods
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q5. According to the article, baby teeth
a. are dispensable
b. develop to help eat food
c. if lost prematurely, may result in poor development of permanent teeth
d. help with correct development of permanent teeth
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q6. Dental health in older people requires
a. properly fitting dentures
b. a calcium rich diet
c. nutritious food containing vitamins D and K
d. all of the above
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q7. The article says that Osteoporosis
a. may prevent loss of teeth
b. may affect jaw bones
c. jaw bone health may be affected by chewing sugar-free gum
d. none of the above
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q8. Lack of saliva
a. all of the following
b. results in mouth being cleansed more slowly
c. can be addressed by chewing sugar-free gum
d. may increase the risk of tooth decay
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Answer Key
“Practice Test 7”
Practice Test 8
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part C
In this part of the test, there are two texts about different aspects of
healthcare. Choose the answer (A, B, C or D) which you think fits
best according to the text.
Global Health Care Workforce
Paragraph 1
Health care systems worldwide continue to be plagued by difficulties in
recruiting and retaining health workers, resulting in a shortage of health care
professionals that is now considered a global crisis. However, although the
gap between the need for health care workers and the supply is experienced
globally, it widens disproportionately, so that the regions with the greatest
need have the fewest workers. For example sub-Saharan Africa and south-
east Asia together have 53% of the global disease burden but only 15% of the
world’s health care workforce. Moreover, the shortage experienced by
countries that can least afford it is exacerbated by health worker migration to
high-income countries. South Africa, for example, has fewer than 7 doctors
per 10,000 people, but reported in 2002 that 14% of the physicians who had
trained there had emigrated to the US or to Canada.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 2
And the problem is not going away as in the UK, US, Canada and Australia,
23% C: to 28% of all physicians are international graduates. Efforts to reduce
migration usually focus on reducing recruitment by high-income countries,
and these efforts are gaining a higher profile. Improving the working
conditions in source countries has not received the same attention, however,
even though this would help counter the factors that push health professionals
to seek better conditions elsewhere. It would also make work healthier for
those who remain in lo income countries, and thereby reduce occupational
concerns such as injuries violence and stress, and exposure to biological,
chemical and physical hazards.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 3
Although concerns about healthy work conditions exist to varying degrees
around the world, they are greatest in nations with few resources, and
particularly in Africa, where work conditions are the most challenging. It is
we] documented that health workers in low and middle-income countries
experience fear and frustration when caring for patients with tuberculosis and
blood—borne diseases, and that they do so often in difficult work
environments. Health workers may also be ostracised by their own
communities due to the ever present stigma associated with exposure. It is
now also well established that health workers are indeed at higher risk of
acquiring numerous infectious diseases.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 4
International organizations are recognizing the importance of promoting and
protecting the health of the global health care workforce, which is
conservatively estimated to be 59 million, and are undertaking constructive
initiatives to do so. The World Health Organization (WHO) has explicitly
recognized the need to improve the environment of health care workers in
order to increase retention and is promoting the use of workplace audit
checklists to help guide the reduction of infectious disease transmission in
health care. WHO is also promoting the immunization of all health care
workers against hepatitis B, and, is working to move forward specific
Healthy Hospital Initiatives, which include projects that involve both
infection control and occupational health practitioners, and that train
practitioners along with health and safety representatives in conducting
workplace inspections.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 5
Canada and other countries that receive health care workers from low
resource settings compromise the workforce in the source country as they
supplement their own. The situation is inequitable and, over time, will
undermine those low resources further, worsening the already challenging
working conditions and creating even more pressure for health care workers
to emigrate. To offset this effect, high-income countries can reciprocate by
improving working conditions in source countries. British Columbia, which
attracts the highest number of South African physicians of all Canadian
provinces, has taken a step in this positive direction by sharing expertise in
occupational health and infectious p disease transmission control through the
Pelonomi Hospital project.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 6
At the university level, researchers and practitioners can contribute to this
knowledge exchange by partnering with their colleagues in low-income
countries. Such collaborations are essential. Also needed are intensified
efforts to promote further integration of worker safety and patient safety. To
ensure information systems being developed support this goal, we need to
promote evidence based decision making and share our information with
those who can; benefit from it. That way, each region will not need to find
millions of dollars annually to design, implement and maintain separate
systems that could b easily shared and reproduced.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 7
To achieve this aim, we need international collaboration in order to reach
consensus on a data dictionary and complete the programming of non-
proprietary information systems such as OHASIS, which can be tailored to
different technological environments and made widely available using
Creative Commons licensing. Much of what needs to be done can be
accomplished with simple and effective solutions that benefit both patients
and workers. What it will take is commitment from high-income countries to
assist in the development, refinement and implementation of these tools in
collaboration with low-income countries. Such endeavours can be made
possible by making them a priority at the national funding level.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
QUESTIONS
Q1. The main idea presented in paragraph 1 is__________
a. Recruiting health care workers is a problem in most countries
b. There is a shortage of health care workers in Sub-Saharan Africa and
Southeast Asia
c. There are not enough health care Workers in places which have the highest
need for medical treatment
d. A significant number of South African doctors are migrating to the US and
Canada
Paragraphs“1”“2”“3”“4”“5”“6”“7”
Q2. The main point raised by the authors in paragraph 2 is that__________
a. there are too many international graduates in UK, US, Canada and
Australia
b. high income countries must reduce recruitment of overseas heal
professionals
c. more effort is required to improve work conditions in source
d. work conditions in poorer countries are dangerous
Paragraphs“1”“2”“3”“4”“5”“6”“7”
Q3. According to paragraph 3 which of the following is false regarding
conditions in low & middle income countries?
a. Work conditions are most difficult in Africa
b. Health Workers fear exposure to contagious diseases
c. Health Workers feel frustration towards patients
d. Being exposed to infectious diseases may lead to shame within local
communities.
Paragraphs“1”“2”“3”“4”“5”“6”“7”
Q4. Regarding the size of the global health care workforce, we can infer
paragraph 4 that__________
a. there may be more than 59 million Workers
b. there may be less than 59 million workers
c. there are exactly 59 million Workers
d. the number of health care workers in unknown
Paragraphs“1”“2”“3”“4”“5”“6”“7”
Q5. According to paragraph 4, which of the following statements is true
regarding WHO?
a. WHO realises that improvements in the working environment of healthcare
workers is necessary
b. WHO wants to increase immunisation rates of health care workers against
hepatitis B
c. WHO is advancing Healthy Hospital Initiatives including training and
infection control
d. All of the above
Paragraphs“1”“2”“3”“4”“5”“6”“7”
Q6. In paragraph 5 the authors infer that__________
a. High-income countries have a responsibility to help build better working
conditions in low-income countries
b. High income countries should not recruit health professionals from low-
income countries
c. The working conditions in low-income countries is improving
d. British Columbia has stopped recruiting South African doctors
Paragraphs“1”“2”“3”“4”“5”“6”“7”
Q7. Which of the following is closest in meaning to the word reciprocate?
a. help
b. give back
c. support
d. take back
Paragraphs“1”“2”“3”“4”“5”“6”“7”
Q8. According to paragraph 6, which of the following statements is true?
a. Researchers and medical practitioners in low & high income countries have
expressed a desire to work together
b. Improved safety of health workers and patients is a priority
c. Millions of dollars are needed to develop information systems that can be
shared between countries
d. None of the above
Paragraphs“1”“2”“3”“4”“5”“6”“7”
Answer Key
“Practice Test 8”
Practice Test 9
READING SUB-TEST – QUESTION PAPER: PART A
TIME: 15 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer the questions within the 15-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 15 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Tuberculosis, AIDS, and Death among Substance Abusers on Welfare in
New York City
Text A
Background
In New York City, the incidence of tuberculosis has more than doubled
during the past decade. We examined the incidence of tuberculosis and the
acquired immunodeficiency syndrome (AIDS) and the rate of death from all
causes in a very-high-risk group —indigent subjects who abuse drugs,
alcohol, or both.
Methods
In 2009 we began to study prospectively a cohort of welfare applicants and
recipients 18 to 64 years of age who abused drugs or alcohol. The incidence
rates of tuberculosis, AIDS, and death for this group were ascertained
through vital records and New York City’s tuberculosis and AIDS registries.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”
Text B
Results
The cohort was followed for eight years. Of the 858 subjects;
Text C
Deaths in the cohort
There were 183 deaths in the cohort during follow-up (21.3 percent) of the
subjects, a rate of 2842 deaths per 100,000 person-years, 5.2 times that of the
age-matched general population.
Causes of death - Table 3
CAUSES OF DEATH IN THE STUDY GROUP
Causes of death No. of subjects Average Age at Death
(%) (years)
AIDS 66 (36.1%) 40
Infectious diseases 18 (9.8%) 43
Cirrhosis of the liver 16 (8.7%) 43
TB 11 (6%) 42
Coronary artery disease 10 (5.5%) 47
Pneumonia 9 (4.9%) 42
Cancer 8 (4.4%) 54
Overdose of non- narcotic 8 (4.4%) 42
substance
Other heart disease 7 (3.8%) 43
Drug dependence 4 (2.2%) 37
Alcohol abuse 3 (1.6%) 43
Cerebrovascular disease 3 (1.6%) 47
Diabetes 3 (1.6%) 53
Upper gastrointestinal bleeding 3 (1.6%) 44
Wound 3 (1.6%) 47
Chronic renal failure 2(1.1%) 59
Respiratory arrest 2(1.1%) 46
Other 7 (3.8%) 48
Total 183 43
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”
Text D
Conclusions
Part A
TIME: 15 minutes
• Look at the four texts, A-D, in the separate Text Booklet.
• For each question, 1-20, look through the texts, A-D, to find the
relevant information.
• Write your answers on the spaces provided in this Question
Paper.
• Answer all the questions within the 15-minute time limit.
• Your answers should be correctly spelt.
QUESTIONS
Questions 1-7
For each question, 1-7, decide which text (A, B, C or D) the information
comes from. You may use any letter more than once.
In which text can you find information about
1. what was the percentage of deaths caused by diabetes in the study group?
_____
Go “Text “Text “Text “Text
to A” B” C” D”
2. what was the rate of incidence per 100,000 person per years for
tuberculosis? _____
Go “Text “Text “Text “Text
to A” B” C” D”
3. name the city where the study was conducted? _____
Go “Text “Text “Text “Text
to A” B” C” D”
4. how the incidence rates of diseases and death for the study group were
ascertained? _____
Go “Text “Text “Text “Text
to A” B” C” D”
5. how many died before the end of 2017 without completing anti-TB
therapy? _____
Go “Text “Text “Text “Text
to A” B” C” D”
6. what was the average age of subjects died due to other causes in the study
group? _____
Go “Text “Text “Text “Text
to A” B” C” D”
7. how many years the cohort was followed? _____
Go “Text “Text “Text “Text
to A” B” C” D”
Questions 8-13
Answer each of the questions, 8-13, with a word or short phrase from one of
the texts. Each answer may include words, numbers or both.
8. How many of the study subjects with only AIDS died before the end of
2017?
Go “Text “Text “Text “Text
to A” B” C” D”
9. In how many of the study subjects wound was the cause of death?
Go “Text “Text “Text “Text
to A” B” C” D”
10. What was the age limits of the study subjects?
Go “Text “Text “Text “Text
to A” B” C” D”
11. When did the study begin?
Go “Text “Text “Text “Text
to A” B” C” D”
12. What was the total number of deaths in the study group?
Go “Text “Text “Text “Text
to A” B” C” D”
13. What was the percentage of deaths caused by respiratory arrest in the
study group?
Go “Text “Text “Text “Text
to A” B” C” D”
Questions 14-20
Complete each of the sentences, 14-20, with a word or short phrase
from one of the texts. Each answer may include words, numbers or
both.
14. The study shows that number of the incidence of tuberculosis in
New York City has more than _____ during the past decade.
Go “Text “Text “Text “Text
to A” B” C” D”
15. In conclusion, 12 of those who died had both AIDS and _____.
Go “Text “Text “Text “Text
to A” B” C” D”
16. In the cohort during follow-up of the subjects, rate of deaths was 5.2
times that of the _____ general population..
Go “Text “Text “Text “Text
to A” B” C” D”
17. In the group of welfare clients, the rate of ____ was 10.0 times as high.
Go “Text “Text “Text “Text
to A” B” C” D”
18. The study was conducted among _____ who abuse drugs, alcohol,
or both.
Go “Text “Text “Text “Text
to A” B” C” D”
19. ______ subjects died suffering from coronary artery disease.
Go “Text “Text “Text “Text
to A” B” C” D”
20. There were _____ subjects in the study group.
Go “Text “Text “Text “Text
to A” B” C” D”
Answer Key
“Practice Test 9”
Practice Test 10
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part B
In this part of the test, there are six short extracts relating to
the work of health professionals. For questions 1-6, choose the
answer (A, B or C) which you think fits best according to the
text.
Incubators for Infant
The general principle is that air is processed before it reaches baby.
An electric fan draws room air through a bacterial filter which
removes dust and bacteria. The filtered air flows over an electric
heating element. The filtered and heated air then passes over a
water tank where it is moistened. It then flows on to the incubator
canopy. The incubator canopy is slightly pressurized. This allows
expired carbon dioxide to pass back into the room via the vent
holes and most of the air to be re-circulated. It also prevents
unfiltered air entering the system.
1. The extract informs us that the incubators
A. is likely to circulate most of the air again.
B. may not work correctly in close proximity to some other
devices.
C. prevents filtered air entering the system.
Nebulizers
A nebulizer is a device used to administer medication in the form
of a mist inhaled into the lungs. Nebulizers are commonly used for
treatment of cystic fibrosis, asthma and other respiratory diseases.
The reason for using a nebulizer for medicine to be administered
directly to the lungs is that small aerosol droplets can penetrate into
the narrow branches of the lower airways. Large droplets would be
absorbed by the mouth cavity, where the clinical effect would be
low. The common technical principle for all nebulizers is to use
oxygen, compressed air or ultrasonic power as means to break up
medical solutions or suspensions into small aerosol droplets.
2. The notice is giving information about
A. ways of checking that a nebulizer has been placed correctly.
B. how the use of nebulizer is authorised.
C. why nebulizer are being used.
Oxygen Concentrators
Atmospheric air consists of approximately 80% nitrogen and 20%
oxygen. An oxygen concentrator uses air as a source of oxygen by
separating these two components. It utilizes the property of zeolite
granules to selectively absorb nitrogen from compressed air.
Atmospheric air is gathered, filtered and raised to a pressure of 20
pounds per square inch (psi) by a compressor. The compressed air
is then introduced into one of the canisters containing zeolite
granules where nitrogen is selectively absorbed leaving the residual
oxygen available for patient use. After about 20 seconds the supply
of compressed air is automatically diverted to the second canister
where the process is repeated enabling the output of oxygen to
continue uninterrupted.
3. What does this manual tell us about zeolite granules?
A. leave residual oxygen for patient use
B. selectively absorb nitrogen from air
C. absorb only nitrogen from compressed air
Arterial blood pressure
The arterial blood pressure (BP) is connected with the force, which is exerted
by the blood volume on the walls of the arteries. The level of BP is dependent
on two factors: the heart minute ejection volume and the elasticity of arterial
walls. Other factors affecting BP include: the volume and viscosity of the
blood, body position and emotional state. The BP at the top of pulse wave
(due to the constriction of heart ventricles) is called systolic BP, whereas the
respective one during the diastole is called diastolic BP. The difference
between systolic and diastolic BP is defined as amplitude or pulse pressure.
4. Which is the main factor behind BP level?
A. the heart minute rejection volume
B. volume and viscosity of the blood
C. elasticity of the arterial wall
Basic Life Support
Basic Life Support means saving lives by maintaining airway, supplying
ventilation (rescue breathing by blowing air to the victim’s mouth) and
supplying circulation (external cardiac massage – chest compressions)
performed without additional equipment. It is the first step in cardio-
pulmonary resuscitation (CPR) that should be initiated by bystanders and
continued until qualified help arrives. Next step is Advanced Life Support
(ALS), which is performed by medical services. People with cardiac arrest
(CA) need immediate CPR. First aid means BLS that is started by witnesses
before the emergency service arrival and is the key action in achieving patient
survival.
5. What does this manual tell us about cardio-pulmonary resuscitation?
A. should be initiated by bystanders
B. should be initiated immediately only for cardiac arrest
C. should be performed by medical services
Types of surgical threads
Materials, which the threads are made of, are divided into absorbable and
non- absorbable ones or natural and synthetic sutures. Non-absorbable
sutures are applied on the skin and in septic wounds. Absorbable threads,
depending on their structure are divided into monofilament, polifilament,
braided, plaits, coated and uncoated ones. Time of their absorbing is varied
and depends on material properties; it can take from 14 days to 6 months.
Absorbing progresses due to enzymatic disintegration and hydrolysis.
6. What does this extract from a handbook tell us about absorbable threads?
A. absorbing progresses due to enzymatic integration and hydrolysis
B. absorbing time is varied and depends on material properties
C. are divided into monofilament, polifilament, braided, plaits and uncoated
ones
Answer Key
“Practice Test 10”
Practice Test 11
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part C
In this part of the test, there are two texts about different aspects of
healthcare. Choose the answer (A, B, C or D) which you think fits
best according to the text.
Answer Key
“Practice Test 11”
Practice Test 12
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part C
In this part of the test, there are two texts about different aspects of
healthcare. Choose the answer (A, B, C or D) which you think fits
best according to the text.
Fluoride
Paragraph 1
Globalization has provoked changes in many facets of human life,
particularly in diet. Trends in the development of dental caries in population
have traditionally followed developmental patterns where, as economies
grow and populations have access to a wider variety of food products as a
result of more income and trade, the rate of tooth decay begins to increase.
As countries become wealthier, there is a trend to greater preference for a
more “western” diet, high in carbohydrates and refined sugars. Rapid
globalization of many economies has accelerated this process. These dietary
have a substantial impact on diseases such as diabetes and dental caries.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 2
The cariogenic potential of diet emerges in areas where fluoride
supplementation is inadequate. Dental caries is a global health problem and
has a significant negative impact on quality of life, economic productivity,
adult and children’s general health and development. Untreated dental caries
in pre-school children is associated with poorer quality of life, pain and
discomfort, and difficulties in ingesting food that can result in failure to gain
weight and impaired cognitive development. Since low-income countries
cannot afford dental restorative treatment and in general the poor are most
vulnerable to the impacts of illness, they should be afforded a greater degree
of protection.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 3
By WHO estimates, one third of the world‘s population have inadequate
access to needed medicines primarily because they cannot afford them.
Despite the inclusion of sodium fluoride in the World Health Organization‘s
Essential Medicines Model List, the global availability and accessibility of
fluoride for the prevention of dental caries remains a global problem. The
optimal use of fluoride is an essential and basic public health strategy in the
prevention and control of dental caries, the most common non-
communicable disease on the planet. Although a whole range of effective
fluoride vehicles are available for fluoride use (drinking water, salt, milk,
varnish, etc.), the most widely used method for maintaining a constant low
level of fluoride in the oral environment is fluoride toothpaste.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 4
More recently, the decline in dental caries amongst school children in Nepal
has been attributed to improved access to affordable fluoride toothpaste. For
many low-income nations, fluoride toothpaste is probably the only realistic
population strategy for the control and prevention of dental caries since
cheaper alternatives such as water or salt fluoridation are not feasible due to
poor infrastructure and limited financial and technological resources. The use
of topical fluoride e.g. in the form of varnish or gels for dental caries
prevention is similarly impractical since it relies on repeated applications of
fluoride by trained personnel on an individual basis and therefore in terms of
cost cannot be considered as part of a population based preventive strategy.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 5
The use of fluoride toothpaste is largely dependent upon its socio-cultural
integration in personal oral hygiene habits, availability and the ability of
individuals to purchase and use it on a regular basis. The price of fluoride
toothpaste is believed to be too high in some developing countries and this
might impede equitable access. In a survey conducted at a hospital dental
clinic in Lagos, Nigeria 32.5% of the respondents reported that the cost of
toothpaste influenced their choice of brands and 54% also reported that the
taste of toothpastes influenced their choice.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 6
Taxes and tariffs on fluoride toothpaste can also significantly contribute to
high prices, lower demand and inequity since they target the poor.
Toothpastes are u; classified as a cosmetic product and as such often highly
taxed by governments. For example, various taxes such as excise tax, VAT,
local taxes as well as taxation on the ingredients and packaging contribute to
25% of the retail cost of toothpaste in Ne and India, and 50% of the retail
price in Burkina Faso. WHO continues to recommend the removal taxes and
tariffs on fluoride toothpastes. Any lost revenue can be rest by higher taxes
on sugar and high sugar containing foods, which are common risk factors for
dental caries, coronary heart disease, diabetes and obesity.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 7
The production of toothpaste within a country has the potential to make
fluoride toothpaste more affordable than imported products. In Nepal,
fluoride toothpaste was limited to expensive imported products. However,
due to successful advocacy locally manufactured fluoride toothpaste, the least
expensive locally manufactured fluoride toothpaste is now 170 times less
costly than the most expensive imported Philippines, local manufacturers are
able to satisfy consumer preferences and compete against multinationals by
discounting the price of toothpaste by as much as 55% against global brands;
and typically receive a 40% profit margin compared to 70% for multinational
producers.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 8
In view of the current extremely inequitable use of fluoride throughout
countries and regions, all efforts to make fluoride and fluoride toothpaste
affordable and accessible must be intensified. As a first step to addressing the
issue of affordability of fluoride toothpaste in the poorer countries in-depth
country studies should be undertaken to analyze the price of toothpaste in the
context of the country economies.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
QUESTIONS
Q1. Which of the following would be the most appropriate heading for the
paragraph 1?
a. High sugar intake and increasing tooth decay
b. Globalisation, dietary changes and declining dental health
c. Dietary changes in developing nations
d. Negative health effects of a western diet
Para- “1”“2”“3”“4”
graphs“5”“6”“7”“8”
Q2. Which of the following is not mentioned as a negative effect of untreated
dental caries in pre-school children?
a. Decreased mental alertness
b. Troubling chewing and swallowing food
c. Lower life quality
d. Reduced physical development
Para- “1”“2”“3”“4”
graphs“5”“6”“7”“8”
Q3. According to paragraph 3, which of the following statement is correct?
a. Dental caries is the most contagious disease on earth.
b. Fluoride in drinking water is effective but rarely used
c. Fluoride is too expensive for a large proportion of the global population.
d. Fluoride toothpaste is widely used by 2/3 of the world’s population.
Para- “1”“2”“3”“4”
graphs“5”“6”“7”“8”
Q4. Fluoride toothpaste is considered the most effective strategy to reduce
dental caries in low income countries because.....
a. it is the most affordable.
b. topical fluoride is unavailable.
c. it does not require expensive infrastructure or training.
d. it was effective in Nepal.
Para- “1”“2”“3”“4”
graphs“5”“6”“7”“8”
Q5. Which of the following is closest in meaning to the word impede?
a. stop
b. prevent
c. hinder
d. postpone
Para- “1”“2”“3”“4”
graphs“5”“6”“7”“8”
Q6. Regarding the issue of taxation in paragraph 6 which of the following
statements is most correct?
a. Income tax rates are higher in Burkina Faso than India or Nepal.
b. WHO recommends that tax on toothpaste be reduced.
c. Governments would like to reduce tax on toothpastes but can’t as it is
classified as a cosmetic.
d. WHO suggests taxing products with a high sugar content instead of
toothpastes.
Para- “1”“2”“3”“4”
graphs“5”“6”“7”“8”
Q7. Which of the following is closest in meaning to the word advocacy?
a. marketing
b. demand
c. development
d. support
Para- “1”“2”“3”“4”
graphs“5”“6”“7”“8”
Q8. Statistics in paragraph 7 indicate that....
a. local products can’t compete with global products and make a profit at the
same time.
b. Philippine produced toothpaste is profitable while being less than half the
price of global brands.
c. in Nepal, fluoride toothpaste is limited to imported products which are very
expensive
d. toothpaste produced in the Philippines has a higher profit margin than
internationally produced toothpaste.
Para- “1”“2”“3”“4”
graphs“5”“6”“7”“8”
Answer Key
“Practice Test 12”
Practice Test 13
READING SUB-TEST – QUESTION PAPER: PART A
TIME: 15 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer the questions within the 15-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 15 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Text A
Economy Class Syndrome
International flights are suspected of contributing to the formation of DVT in
susceptible people, although the research evidence is currently divided. Some
airlines prefer to err on the side of caution and offer suggestions to
passengers on how to reduce the risk of DVT. Suggestions include:
Text B
Previous research
Venous thrombosis was first linked to air travel in 1954, and as air travel has
become more and more common, many case reports and case series have
been published since. Several clinical studies have shown an association
between air travel and the risk of venous thrombosis. English researchers
proposed, in a paper published in the Lancet, that flying directly increases a
person’s risk. The report found that in a series of individuals who died
suddenly at Heathrow Airport, death occurred far more often in the arrival
than in the departure area.
Two similar studies reported that the risk of pulmonary embolism in air
travelers increased with the distance traveled. In terms of absolute risk, two
studies found similar results: one performed in New Zealand found a
frequency of 1% of venous thrombosis in 878 individuals who had traveled
by air for at least 10 hours. The other was a German study which found
venous thrombotic events in 2.8% of 964 individuals who had traveled for
more than 8 hours in an airplane. In contrast, a Dutch study found no link
between DVT and long distance travel of any kind.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”
Text C
Symptoms
Text D
Travel-Related Venous Thrombosis: Results from a Large Population-
Based Case Control
Study
Background
Recent studies have indicated an increased risk of venous thrombosis after air
travel. Nevertheless, questions on the magnitude of risk, the underlying
mechanism, and modifying factors remain unanswered.
Methods
We studied the effect of various modes of transport and duration of travel on
the risk of venous thrombosis in a large ongoing case-control study on risk
factors for venous thrombosis in an unselected population. We also assessed
the combined effect of travel in relation to body mass index, height, and oral
contraceptive use. Since March 2015, consecutive patients younger than 70
years of age with a first venous thrombosis have been invited to participate in
the study, with their partners serving as matched control individuals.
Information has been collected on acquired and genetic risk factors for
venous thrombosis.
Results
Of 1,906 patients, 233 had traveled for more than 4 hours in the 8 weeks
preceding the event. Traveling in general was found to increase the risk of
venous thrombosis. The risk of flying was similar to the risks of traveling by
bus or train. The risk was highest in the first week after traveling. Travel by
bus, or train led to a high relative risk of thrombosis in individuals with factor
V Leiden, in those who had a body mass index of more than 30, those who
were more than 190 cm tall, and in those who used oral contraceptives. For
air travel these people shorter than 160 cm had an increased risk of
thrombosis after air travel as well.
Conclusions
The risk of venous thrombosis after travel is moderately increased for all
modes of travel. Subgroups exist in which the risk is highly increased.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”
Part A
TIME: 15 minutes
• Look at the four texts, A-D, in the separate Text Booklet.
• For each question, 1-20, look through the texts, A-D, to find the
relevant information.
• Write your answers on the spaces provided in this Question
Paper.
• Answer all the questions within the 15-minute time limit.
• Your answers should be correctly spelt.
QUESTIONS
Questions 1-7
For each question, 1-7, decide which text (A, B, C or D) the information
comes from. You may use any letter more than once.
In which text can you find information about
Questions 8-13
Answer each of the questions, 8-13, with a word or short phrase from one of
the texts. Each answer may include words, numbers or both.
8. What is the type of skin discolouration seen in DVT patients?
Go “Text “Text “Text “Text
to A” B” C” D”
9. What type of clothes reduce the risks of DVT?
Go “Text “Text “Text “Text
to A” B” C” D”
10. Which type of flights are more suspected of contributing to the formation
of DVT?
Go “Text “Text “Text “Text
to A” B” C” D”
11. Name the physical activity which was found to increase the risk of
DVT in general?
Go “Text “Text “Text “Text
to A” B” C” D”
12. Which type of population was the subject for travel related
DVT study?
Go “Text “Text “Text “Text
to A” B” C” D”
13. Name the body part/s were tenderness was observed as a symptom of
DVT?
Go “Text “Text “Text “Text
to A” B” C” D”
Questions 14-20
Complete each of the sentences, 14-20, with a word or short phrase
from one of the texts. Each answer may include words, numbers or
both.
14. The risk of flying was similar to the risks of traveling by _____.
Go “Text “Text “Text “Text
to A” B” C” D”
15. Recent studies have indicated an increased risk of venous thrombosis
after _____.
Go “Text “Text “Text “Text
to A” B” C” D”
16. _____ of the lower leg, ankle and foot is a symptom of DVT.
Go “Text “Text “Text “Text
to A” B” C” D”
17. Several _____ have shown an association between air travel and the risk
of venous thrombosis.
Go “Text “Text “Text “Text
to A” B” C” D”
18. _____ in general was found to increase the risk of venous thrombosis.
Go “Text “Text “Text “Text
to A” B” C” D”
19. Venous thrombosis was first linked to air travel in ______.
Go “Text “Text “Text “Text
to A” B” C” D”
20. Some airlines offer _____ to passengers on how to reduce the risk of
DVT.
Go “Text “Text “Text “Text
to A” B” C” D”
Answer Key
“Practice Test 13”
Practice Test 14
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part B
In this part of the test, there are six short extracts relating to
the work of health professionals. For questions 1-6, choose the
answer (A, B or C) which you think fits best according to the
text.
Flowmeter
A flowmeter is an instrument used to measure the flow rate of a
liquid or a gas. In healthcare facilities, gas flowmeters are used to
deliver oxygen at a controlled rate either directly to patients or
through medical devices. Oxygen flowmeters are used on oxygen
tanks and oxygen concentrators to measure the amount of oxygen
reaching the patient or user. Sometimes bottles are fitted to
humidify the oxygen by bubbling it through water.
1. The purpose of bottles that are fitted with flowmeter is to
A. humidify the oxygen tanks by bubbling it through water
B. humidify the oxygen reaching the patient or user
C. dehumidify the gas in the flowmeter
Pulse Oximeters: Non-invasive monitors
The coloured substance in blood, haemoglobin, is carrier of oxygen
and the absorption of light by haemoglobin varies with the amount
of oxygenation. Two different kinds of light (one visible, one
invisible) are directed through the skin from one side of a probe,
and the amount transmitted is measured on the other side. The
machine converts the ratio of transmission of the two kinds of light
into a % oxygenation. Pulse oximeter probes can be mounted on
the finger or ear lobe.
2. What does this notes tell us about pulse oximeters?
A. levels varies with amount of oxygenation
B. converts percent of light into a % oxygenation
C. probes can be mounted either on finger or earlobe
Measuring Patient Weight
Measuring patient weight is an important part of monitoring health
as well as calculating drug and radiation doses. It is therefore vital
that scales continue to operate accurately. They can be used for all
ages of patient and therefore vary in the range of weights that are
measured. They can be arranged for patients to stand on, or can be
set up for weighing wheelchair bound patients. For infants, the
patient can be suspended in a sling below the scale or placed in a
weighing cot on top of the scale.
3. These notes are reminding staff that the
A. importance of precise reading of scales to monitor health of
patient
B. infants should stand in a weighing cot on top of the scale
C. wheelchair bound patients should be suspended in a set up
Breast Examination
Detection of changes in the breast depends on routine medical
check-ups, especially by an oncologist, regular breast scanning and
mammography, and women’s self-examination. If early detected, a
tumor is usually small, and the smaller it is, the less probability of
metastases. Early detection considerably improves prognosis in
women with breast cancer. Mammography enables detection of
breast cancer at least one year ahead of its manifestations. The
smallest clinically palpable tumor is about 1 cm in size.
4. The purpose of these notes about mammography is to
A. help maximise awareness about its efficiency
B. give guidance on early detection and prognosis
C. decrease probability of metastases
Catheterization
Regardless of the instrumental examination carried out in the
urinary tract, it is obligatory to maintain perfectly sterile
conditions, to apply analgesic and sedative drugs in order to
alleviate patient’s suffering, and to use gel substances that facilitate
the introduction of the instrument into the urinary tract. While
introducing instruments into the bladder, it is necessary to
remember about overcoming the resistance of the urethral sphincter
gently.
5. What must all staff involved in the catheterization process do?
A. maintain perfect aseptic conditions
B. use non lubricant substances
C. inhibit analgesic and sedative drugs
Ophthalmoscopy
Direct ophthalmoscopy is the most common method of examining
the eye fundus. It provides a 15x magnified upright image of the
retina. Ophthalmoscopy is much easier through a dilated pupil.
Tropicamide 1% drops (0.5% for children) are recommended. The
pupil mydriasis starts 10 to 20 minutes after installation and lasts
for 6-8 hours. There is a small risk of angle closure glaucoma
caused by mydriasis in eyes with shallow anterior chambers,
particularly in elderly patients.
6. The guidelines establish that the healthcare professional should
A. recommend 1% drops of Tropicamide for elderly patients
B. recommend 5% drops of Tropicamide for children
C. recommend 10% drops of Tropicamide for elderly patients
Answer Key
“Practice Test 14”
Practice Test 15
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part C
In this part of the test, there are two texts about different aspects of
healthcare. Choose the answer (A, B, C or D) which you think fits
best according to the text.
Is ADHD a valid diagnosis in adults?
Paragraph 1
Attention deficit hyperactivity disorder (ADHD) is well established in
childhood, with 3.6% of children in the United Kingdom being affected.
Most regions have child and adolescent mental health or paediatric services
for ADHD. Follow-up studies of children with ADHD find that 15% still
have the full diagnosis at 25 years, and a further 50% are in partial remission,
with some symptoms associated with clinical and psychosocial impairments
persisting.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 2
ADHD is a clinical syndrome defined in the Diagnostic and Statistical
Manual of Mental Disorders, fourth edition, by high levels of hyperactive,
impulsive, and inattentive behaviours in early childhood that persist over
time, pervade across situations, and lead to notable impairments. ADHD is
thought to result from complex interactions between genetic and
environmental factors.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 3
Proof of validity. Using the Washington University diagnostic criteria, the
National Institute for Health and Clinical Excellence (NICE) reviewed the
validity of the system used to diagnose ADHD in children and adults.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 4
Symptoms of ADHD are reliably identifiable. The symptoms used to define
ADHD are found to cluster together in both clinical and population samples.
Studies in such samples also separate ADHD symptoms from conduct
problems and neuro developmental traits. Twin studies show a distinct
pattern of genetic and environmental influences on ADHD compared with
conduct problems, and overlapping genetic influences between ADHD and
neuro developmental disorders such as autism and specific reading
difficulties. Disorders that commonly, but not invariably, occur in adults with
ADHD include antisocial personality, substance misuse, and depression.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 5
Symptoms of ADHD are continuously distributed throughout the population.
As with anxiety and depression, most people have symptoms of ADHD at
some time. The disorder is diagnosed by the severity and persistence of
symptoms, which are associated with high levels of impairment and risk for
developing co—occurring disorders. ADHD should not be diagnosed to
justify the use of stimulant drugs to enhance performance in the absence of a
wider range of impairments indicating a mental health disorder.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 6
ADHD symptoms have been tracked from childhood through adolescence
into adult life. They are relatively stable over time with a variable outcome in
which around two thirds show persistence of symptoms associated with
impairments. Current evidence defines the syndrome as being associated with
academic difficulties, impaired family relationships, social difficulties, and
conduct problems. Cross sectional and longitudinal follow-up studies of
adults with ADHD have reported increased rates of antisocial behaviour, drug
misuse, mood and anxiety disorders, unemployment, poor work performance,
lower educational performance, traffic violations, crashes, and criminal
convictions.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 7
Several genetic, environmental, and neurobiological variables distinguish
ADHD from non-ADHD cases at group level, but are not sufficiently
sensitive or specific to diagnose the syndrome. A family history of ADHD is
the strongest predictor—parents of children with ADHD and offspring of
adults with ADHD are at higher risk for the disorder. Heritability is around
76%, and genetic associations have been identified. Consistently reported
associations include structural and functional brain changes, and
environmental factors (such as maternal stress during pregnancy and severe
early deprivation).
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 8
The effects of stimulants and atomoxetine on ADHD symptoms in adults are
similar to those seen in children. Improvements in ADHD symptoms and
measures of global function are greater in most studies than are reported in
drug trials of depression. The longest controlled trial of stimulants in adults
showed improvements in these response measures over six months.
Stimulants may enhance cognitive ability in some people who do not have
ADHD, although we are not aware of any placebo controlled trials of the
effects of stimulants on work or study related performance in healthy
populations. This should not, however, detract from their specific use to
reduce symptoms and associated impairments in adults with ADHD.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 9
Psychological treatments in the form of psychoeducation, cognitive
behavioural therapy, supportive coaching, or help with organising daily
activities are thought to be effective. Further research is needed because the
evidence base is not strong enough to recommend the routine use of these
treatments in clinical practice.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 10
Conclusions. ADHD is an established childhood syndrome that often (in
around 65% of cases) persists into adult life. NICE guidelines are a milestone
in the development of effective clinical services for adults with ADHD.
Recognition of ADHD in primary care and referral to secondary or tertiary
care specialists will reduce the psychiatric and psychosocial morbidity
associated with ADHD in adults.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
QUESTIONS
Q1. The article reports what proportion of diagnosed children present with
ADHD in adulthood?
a. Half
b. 3.6%
c. A quarter
d. 15%
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q2. According to the article __________
a. ADHD is triggered by genetic factors
b. ADHD is the result of environmental factors
c. both A and B.
d. neither A nor B.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q3. According to the article symptoms __________
a. vary across clinical and population samples.
b. varies across situational factors.
c. need to pervade across time and situations for a diagnosis to be made.
d. are not reliably identifiable.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q4. Which co-occurring disorders does ADHD frequently present with?
a. Antisocial personality disorder.
b. Substance misuse.
c. Depression.
d. All of the above.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q5. According to the article, which one of the following statements about
ADHD is FALSE?
a. The use of stimulants is justified in the absence of a wider range of
impairments.
b. Symptoms of ADHD are evenly prevalent throughout the population.
c. The criteria for diagnosis measure the severity and persistence of
symptoms.
d. High levels of impairment and risk for developing co-occurring disorders
are related with ADHD.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q6. Which heading would best describe paragraph 6?
a. Symptoms associated with impairments.
b. ADHD and outcomes in adulthood.
c. Further definition of the syndrome.
d. none of the above
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q7. The strongest predictor of ADHD is__________
a. Diagnostic and Statistical Manual of Mental Disorders, fourth edition.
b. Social and academic impairment.
c. Heritability.
d. Family environment.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q8. The effectiveness of atomoxetine on ADHD symptoms is __________
a. less than described in drug trials of depression.
b. greater when measured over six months.
c. reduced in adults with ADHD.
d. known to improve measures of global functioning.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Answer Key
“Practice Test 15”
Practice Test 16
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part C
In this part of the test, there are two texts about different aspects of
healthcare. Choose the answer (A, B, C or D) which you think fits
best according to the text.
Risks and Benefits of Hormone Replacement Therapy
Paragraph 1
Several recent large studies have provoked concern amongst both health
professionals and the general public regarding the safety of hormone
replacement therapy (HRT). This article provides a review of the current
literature surrounding the risks and benefits of HRT in postmenopausal
women, and how the data can be applied safely in everyday clinical practice.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 2
Worldwide, approximately 47 million women will undergo the menopause
every year for the next 20 years. The lack of circulating oestrogens which
occurs during the transition to menopause presents a variety of symptoms
including hot flushes, night sweats, mood disturbance and vaginal atrophy,
and these can be distressing in almost 50% of women.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 3
For many years, oestrogen alone or in combination with progestogens,
otherwise known as hormone replacement therapy (HRT), has been the
treatment of choice for control of problematic menopausal symptoms and for
the prevention of osteoporosis. However, the use of HRT declined worldwide
following the publication of the first data from the Women’s Health Initiative
(WHI) trial in 2002.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 4
The results led to a surge in media interest surrounding HRT usage, with the
revelation that there was an increased risk of breast cancer and, contrary to
expectation, coronary heart disease (CHD) in those postmenopausal women
taking oestrogen plus progestogen HRT. Following this, both the Heart and
Estrogen/Progestin Replacement Study Follow-up (HERS II) and the Million
Women Study published results which further reduced enthusiasm for HRT
use, showing increased risks of breast cancers and venous thromboembolism
(VTE), and the absence of previously suggested cardioprotective effects in
HRT users. The resulting fear of CHD and breast cancer in HRT users left
many women with menopausal symptoms and few effective treatment
options.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 5
Continued analysis of data relating to these studies has been aimed at
understanding whether or not the risks associated with HRT are, in fact,
limited to a subset of women. A recent publication from the International
Menopause Society has stated that HRT remains the first-line and most
effective treatment for menopausal symptoms. In this article we examine the
evidence that has contributed to common perceptions amongst health
professionals and women alike, and clarify the balance of risk and benefit to
be considered by women using HRT.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 6
One of the key messages from the WHI in 2002 was that HRT should not be
prescribed to prevent age-related chronic disease, in particular CHD. This
was contradictory to previous advice based on observational studies.
However, recent subgroup analysis has shown that in healthy individuals
using HRT in the early postmenopausal years (age 50-59 years), there was no
increased CHD risk and HRT may potentially have a cardioprotective effect.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 7
Recent WHI data has suggested that oestrogen-alone HRT in compliant
women under 60 years of age delays the progression of atheromatous disease
(as assessed by coronary arterial calcification). The Nurses Health Study, a
large observational study within the USA, demonstrated that the increase in
stroke risk appeared to be modest in younger women, with no significant
increase if used for less than five years.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 8
Hormone replacement therapy is associated with beneficial effects on bone
mineral density, prevention of osteoporosis and improvement in osteoarthritic
symptoms. The WHI clearly demonstrated that HRT was effective in the
prevention of all fractures secondary to osteoporosis. The downturn in HRT
prescribing related to the concern regarding vascular and breast cancer risks
is expected to cause an increase in fracture risk, and it is predicted that in the
USA there will be a possible excess of 243,000 fractures per year in the near
future.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 9
The WHI results published in 2002 led to a significant decline in patient and
clinician confidence in the use of HRT. Further analysis of the data has
prompted a re-evaluation of this initial reaction, and recognition that many
women may have been ‘denied’ treatment. Now is the time to responsibly
restore confidence regarding the benefit of HRT in the treatment of
menopausal symptoms when used judiciously. Hormone replacement therapy
is undoubtedly effective in the treatment of vasomotor symptoms, and
confers protection against osteoporotic fractures.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 10
The oncologic risks are relatively well characterised and patients considering
HRT should be made aware of these. The cardiovascular risk of HRT in
younger women without overt vascular disease is less well defined and
further work is required to address this important question. In the interim,
decisions regarding HRT use should be made on a case—by—case basis
following informed discussion of the balance of risk and benefit. The lowest
dose of hormone necessary to alleviate menopausal symptoms should be
used, and the prescription reviewed on a regular basis.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
QUESTIONS
Q1. Which statement is the closest match to the description of the recent
studies in Paragraph1?
a. They demand a prompt review of current HRT practices.
b. They have shown that HRT can be used safely in clinical practice.
c. They have decreased the confidence of doctors and the public in HRT.
d. They have given menopausal women a new confidence to undergo HRT.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q2. Which statement is the closest match to the description of projected
menopause figures in Paragraph 2?
a. 47 international women will enter menopause annually for the next 20
years.
b. All women are likely to go through menopause if they live long enough.
c. 47 million women globally will enter menopause each year for the next 20
years.
d. Most women will succumb to menopause if they do not undertake HRT.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q3. What cause does the article cite for the symptoms of menopause?
a. Lack of circulation
b. Age
c. Low progesterone levels
d. Low circulating estrogen levels
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q4. What has been the effect of the 2002 WHI study?
a. HRT has become less popular.
b. HRT has increased in popularity as the treatment of choice for problematic
menopause symptoms.
c. There has been an increase in combined estrogen and progesterone therapy.
d. The women’s health initiative has since been established to investigate
HRT.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q5. Why were many women left with menopausal symptoms and no
effective treatment?
a. They were unable to afford HRT treatments.
b. They were concerned about coronary heart disease and breast cancer.
c. They were concerned about breast cancer and venous thromboembolism.
d. They were concerned about breast cancer and the cardioprotective effects.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q6. Which of these statements is a TRUE summary of Paragraph 5?
a. Surveys since WHI have attempted to find out if the WHI results are
representative
b. Results of past surveys are only valid for a subset of women, whether or
not the public is aware of this.
c. The present study aims to show that HRT is safer than previously believed.
d. Women should ask their doctors to clarify the balance of risks and benefits
of HRT
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q7. Which study showed an increased risk of VTE?
a. The Nurses Health Study
b. The Million Women Study
c. The Women‘s Health Initiative Study
d. The WISDOM Study
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Q8. Which of the following does the article recommend HRT should NOT be
used to treat’?
a. Vasomotor symptoms
b. Atheromatous disease
c. Age-related chronic disease
d. Osteoarthritic symptoms
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”
Answer Key
“Practice Test 16”
Practice Test 17
READING SUB-TEST – QUESTION PAPER: PART A
TIME: 15 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer the questions within the 15-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 15 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Text A
START ‘EM YOUNG — ‘CIGARETTE WITH YOUR MORNING
BREAST MILK?’
US researchers have found altered sleep patterns amongst breastfed infants of
mothers who smoke. Julie Mannella from the Monell Chemical Senses
Centre in Philadelphia recruited 15 breastfeeding mothers who smoked. Sleep
and activity patterns in their babies, which were aged between two and six
months, were monitored on two occasions over a three-hour period after the
children were fed. On both occasions the mothers were asked to abstain from
smoking for 12 hours before the study, but on one of the two occasions they
were allowed to smoke just before they fed their babies. The women were
also asked to avoid caffeinated drinks during the study.
Text B
Tests on the milk from mothers who had recently smoked confirmed that the
babies were receiving a significant increase in nicotine dose, and the team
found that the amount of sleep taken during the following three hours by
these babies fell from an average of 85 minutes to 53 minutes, a drop of
almost 40%. This is probably due to the neuro-stimulatory effects of nicotine,
which has been shown to inhibit regions of the brain which are concerned
with controlling sleep. It may also, suggests Manella, explain why neonatal
nicotine exposure has been linked in the past with long-term behavioural and
learning deficits, since these could be the consequence of sleep disturbance.
In light of these findings, mothers who smoke might want to consider
planning their smoking around their breastfeeding. Nicotine levels in milk
peak 30-60 minutes after smelting, but take three hours to return to baseline,
so this might be feasible.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”
Text C
Cigarette smoke
What is in smoke?
Scientific studies show that there can be around 4000 chemicals in cigarette
smoke. They can be breathed in by anyone near a smoker. They can also stick
to clothes, hair, skin, walls and furniture.
Some of these chemicals are:
Text D
Passive smoking and respiratory function in very low birth weight
children
Abstract
Aim
To determine if an adverse relationship exists between passive smoking and
respiratory function in very low birth weight (VLBW) children at 11 years of
age.
Setting
The Royal Women’s Hospital. Melbourne.
Patients
154 consecutive surviving children of less than 1501 g birth weight born
during the 18 months from 1 October 2006.
Methods
Respiratory function of 120 of the 154 children (77.9%) at 11 years of age
was measured. Exposure to passive smoking was established by history; no
children were known to be actively smoking. The relationships between
various respiratory function variables and the estimated number of cigarettes
smoked by household members per day were analysed by linear regression
Results
Most respiratory function variables reflecting airflow were significantly
diminished with increasing exposure to passive smoking. In addition,
variables indicative of air-trapping rose significantly with increasing
exposure to passive smoking.
Conclusions
Passive smoking is associated with adverse respiratory function in surviving
VLBW children at 11 years of age. Continued exposure to passive smoking,
or active smoking, beyond 11 years may lead to further deterioration in
respiratory function in these children.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”
Part A
TIME: 15 minutes
• Look at the four texts, A-D, in the separate Text Booklet.
• For each question, 1-20, look through the texts, A-D, to find the
relevant information.
• Write your answers on the spaces provided in this Question
Paper.
• Answer all the questions within the 15-minute time limit.
• Your answers should be correctly spelt.
QUESTIONS
Questions 1-7
For each question, 1-7, decide which text (A, B, C or D) the information
comes from. You may use any letter more than once.
In which text can you find information about
1. how many chemicals are there in cigarette smoke? _____
Go “Text “Text “Text “Text
to A” B” C” D”
2. which chemical/s in cigarette smoke cause/s cancer? _____
Go “Text “Text “Text “Text
to A” B” C” D”
3. when does nicotine levels in breast milk reach at peak? _____
Go “Text “Text “Text “Text
to A” B” C” D”
4. How does exposure to passive smoking was established in the study?
_____
Go “Text “Text “Text “Text
to A” B” C” D”
5. what happened to respiratory function variables reflecting airflow in the
study? _____
Go “Text “Text “Text “Text
to A” B” C” D”
6. what are the side effects of neonatal nicotine exposure? _____
Go “Text “Text “Text “Text
to A” B” C” D”
7. what are the poisons in cigarette smoke? _____
Go “Text “Text “Text “Text
to A” B” C” D”
Questions 8-13
Answer each of the questions, 8-13, with a word or short phrase from one of
the texts. Each answer may include words, numbers or both.
8. How much percentage does the sleep drop in the babies who had
significant nicotine dose?
Go “Text “Text “Text “Text
to A” B” C” D”
9. How much percentage of children at 11 years of age was measured for
respiratory function?
Go “Text “Text “Text “Text
to A” B” C” D”
10. What was the maximum birth weight of babies who were considered for
the study?
Go “Text “Text “Text “Text
to A” B” C” D”
11. Which chemical component in cigarette smoke reduces the
oxygen in blood?
Go “Text “Text “Text “Text
to A” B” C” D”
12. Who recruited subjects for the study conducted by Monell
Chemical Senses Centre?
Go “Text “Text “Text “Text
to A” B” C” D”
13. Which chemical component in cigarette smoke is responsible for
heart disease?
Go “Text “Text “Text “Text
to A” B” C” D”
Questions 14-20
Complete each of the sentences, 14-20, with a word or short phrase
from one of the texts. Each answer may include words, numbers or
both.
14. If children are continually exposed to active smoking, it can lead to
_____ in respiratory function.
Go “Text “Text “Text “Text
to A” B” C” D”
15. Cigarette smoke can be breathed in by anyone near a _____.
Go “Text “Text “Text “Text
to A” B” C” D”
16. During the study some women were asked to avoid _____.
Go “Text “Text “Text “Text
to A” B” C” D”
17. _____ can also stick to clothes, hair, skin, walls and furniture.
Go “Text “Text “Text “Text
to A” B” C” D”
18. Variables indicative of _____ rose significantly with increasing exposure
to passive smoking.
Go “Text “Text “Text “Text
to A” B” C” D”
19. _____ of nicotine can inhibit regions of the brain which control sleep.
Go “Text “Text “Text “Text
to A” B” C” D”
20. The relationships between respiratory function variables and number of
cigarettes smoked per day were analysed by _____.
Go “Text “Text “Text “Text
to A” B” C” D”
Answer Key
“Practice Test 17”
Practice Test 18
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part B
In this part of the test, there are six short extracts relating to
the work of health professionals. For questions 1-6, choose the
answer (A, B or C) which you think fits best according to the
text.
B.P. sets: Functioning
The cuff on the arm is inflated until blood flow in the artery is
blocked. As the cuff pressure is decreased slowly, the sounds of
blood flow starting again can be detected. The cuff pressure at this
point marks the high (systolic) pressure of the cycle. When flow is
unobstructed and returns to normal, the sounds of blood flow
disappear. The cuff pressure at this point marks the low (diastolic)
pressure.
1. When should one note the diastolic pressure of patient?
A. blood flow is limited to make the sound disappear
B. blood flow is normal and the sound disappear
C. blood flow is obstructed and the sound disappear
Aspirators
Suction is generated by a pump. This is normally an electrically
powered motor, but manually powered versions are also often
found. The pump generates a suction that draws air from a bottle.
The reduced pressure in this bottle then draws the fluid from the
patient via a tube. The fluid remains in the bottle until disposal is
possible. A valve prevents fluid from passing into the motor itself.
2. The purpose of bottle in aspirator is to
A. deliver suction that draws air
B. draw the fluid from the patient
C. keep pressure stable if valve prevents fluid
Operating Theatre and Delivery Tables
Answer Key
“Practice Test 18”
Practice Test 19
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part C
In this part of the test, there are two texts about different aspects of
healthcare. Choose the answer (A, B, C or D) which you think fits
best according to the text.
Pancreatic Islet Transplantation
Paragraph 1
The pancreas, an organ about the size of a hand, is located behind the lower
part of the stomach. It makes insulin and enzymes that help the body digest
and use food. Spread all over the pancreas are clusters of cells called the
islets of Langerhans. Islets are made up of two types of cells: alpha cells,
which make glucagon, a hormone that raises the level of glucose (sugar) in
the blood, and beta cells, which make insulin.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 2
Islet Functions
Insulin is a hormone that helps the body use glucose f energy. If your beta
cells do not produce enough insulin, diabetes will develop. In type 1 diabetes,
the insulin shortage is caused by an autoimmune process in which the body’s
immune system destroys the beta cells.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 3
Islet Transplantation
In an experimental procedure called islet transplantation, islets are taken from
a donor pancreas and transferred into another person. Once implanted, the
beta cells in these is begin to make and release insulin. Researchers hope that;
transplantation will help people with type 1 diabetes live without daily
injections of insulin.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 4
Research Developments
Scientists have made many advances in islet transplantation recent years.
Since reporting their findings in the June issue of the New England Journal of
Medicine, researchers the University of Alberta in Edmonton, Canada, have
continued to use a procedure called the Edmonton protocol to transplant
pancreatic islets into people with type 1 diabetes. According to the Immune
Tolerance Network (ITN), as of June 2003, about 50 percent of the patients
have remained insulin—free up to g 1 year after receiving a transplant.
Researchers use specialized enzymes to remove islets from the pancreas of a
deceased donor. Because the islets are fragile, transplantation occurs soon
after they are removed.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 5
During the transplant, the surgeon uses ultrasound to guide placement of a
small plastic tube (catheter) through the upper abdomen and into the liver.
The islets are then injected through the catheter into the liver. The patient will
receive a local anesthetic. If a patient cannot tolerate local anesthesia, the
surgeon may use general anesthesia and do the transplant through a small
incision. Possible risks include bleeding or blood clots. It takes time for the
cells to attach to new blood vessels and begin releasing insulin. The doctor
will order many tests to check blood glucose levels after the transplant, and
insulin may be needed until control is achieved.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 6
Transplantation: Benefits, Risks, and Obstacles
The goal of islet transplantation is to infuse enough islets to control the blood
glucose level without insulin injections. For an average—size person (70 kg),
a typical transplant requires about 1 million islets, extracted from two donor
pancreases. Because good control of blood glucose can slow or prevent the
progression of complications associated with diabetes, such as nerve or eye
damage, a successful transplant may reduce the risk of these complications.
But a transplant recipient will need to take immunosuppressive drugs that
stop the immune system from rejecting the transplanted islets.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 7
Researchers are trying to find new approaches that will allow successful
transplantation without the use of immunosuppressant drugs, thus eliminating
the side effects that may accompany their long—term use. Rejection is the
biggest problem with any transplant. The immune system is programmed to
destroy bacteria, viruses, and tissue it recognizes as “foreign,” including
transplanted islets. Immunosuppressive drugs are needed to keep the
transplanted islets functioning.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 8
Immunosuppressive Drugs
The Edmonton protocol uses a combination of immunosuppressive drugs,
also called antirejection drugs, including daclixrm (Zenapax), sirolimus
(Rapamune), and tacrolimus (Prograf). Dacliximab is given intravenously
right after the transplant and then discontinued. Sirolimus and tacrolimus, the
two drugs that keep the immune system from destroying the transplanted
islets, must be taken for life.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 9
These drugs have significant side effects and their long—term effects are still
not known. Immediate side effects of immunosuppressive drugs may include
mouth sores and gastrointestinal problems, such as stomach upset or diarrhea.
Patients may also have increased blood cholesterol levels, decreased white
blood cell counts, decreased kidney function, and increased susceptibility to
bacterial and viral infections. Taking immunosuppressive drugs increases the
risk of tumors and cancer as well.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 10
Researchers do not fully know what long—term effects this procedure may
have. Also, although the early results of the Edmonton protocol are very
encouraging, more research is needed to answer questions about how long the
islets will survive and how often the transplantation procedure will be
successful. Before the introduction of the Edmonton Protocol, few islet cell
transplants were successful. The new protocol improved greatly on these
outcomes, primarily by increasing the number of transplanted cells and
modifying the number and dosages of immunosuppressants. Of the 267
transplants performed worldwide from 1990 to 1999, only 8 percent of the
people receiving them were free of insulin treatments one year after the
transplant. The CITR’s second annual report, published in July 2005,
presented data on 138 patients. At six months after patients’ final infusions,
67 percent did not need to take insulin treatments. At one year, 58 percent
remained insulin independent. The recipients who still needed insulin
treatment after one year experienced an average reduction of 69 percent in
their daily insulin needs.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 11
A major obstacle to widespread use of islet transplantation will be the
shortage of islet cells. The supply available from deceased donors will be
enough for only a small percentage of those with type 1 diabetes. However,
researchers are pursuing avenues for alternative sources, such as creating islet
cells from other types of cells. New technologies could then be m employed
to grow islet cells in the laboratory.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
QUESTIONS
Q1. The pancreas is
a) in the hand
b) in the stomach
c) above the stomach
d) behind the lower part of the stomach
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”“11”
Q2. What is the main purpose of insulin?
a) It is a hormone
b) to destroy beta cells
c) to assist in energy production
d) to stimulate the auto immune process
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”“11”
Q3. According the article, is islet transplantation common practice?
a) Yes, it’s frequently used
b) No, it’s still being trialed
c) Not stated in the article
d) Yes, but only in Canada
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”“11”
Q4. What is the Edmonton Protocol?
a) A trade agreement
b) The journal of Alberta University
c) A way to transplant pancreatic islets
d) Not stated in the article
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”“11”
Q5. What’s the source of the pancreatic islets that are in the transplant
operation?
a) They are donated by relatives
b) They come from people who have recently died
c) They are grown in a laboratory
d) They come from foetal tissue
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”“11”
Q6. Which one of the sentences below is true?
a) A local anaesthetic is preferred where possible.
b) A general anaesthetic is preferred where possible.
c) A general anaesthetic is too risky due to the possibility of blood clots and
bleeding.
d) An anaesthetic is not necessary if ultrasound is used
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”“11”
Q7. How soon after the operation can the patient abandon insulin injections?
a) Immediately
b) After about two weeks
c) When the blood glucose levels are satisfactory
d) After the first year
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”“11”
Q8. How many islets are required per patient?
a) About a million
b) 70 kg
c) Whatever is available is used
d) it depends on the size of the patient
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”“10”“11”
Answer Key
“Practice Test 19”
Practice Test 20
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until
you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer Part B & C within the 45-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 45 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Part C
In this part of the test, there are two texts about different aspects of
healthcare. Choose the answer (A, B, C or D) which you think fits
best according to the text.
Seasonal Influenza Vaccination and the H1N1 Virus
Paragraph 1
As the novel pandemic influenza A (H1N1) virus spread around the world in
late spring 2009 with a well-matched pandemic vaccine not immediately
available, the question of partial protection afforded by seasonal influenza
vaccine arose. Coverage of the seasonal influenza vaccine had reached 30%-
40% in the general population in 2008-09 in the US and Canada, following
recent expansion of vaccine recommendations.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 2
Unexpected Findings in a Sentinel Surveillance System
The spring 2009 pandemic wave was the perfect opportunity to address the
association between seasonal trivalent inactivated influenza vaccine (TIV)
and risk of pandemic illness. In an issue of PLoS Medicine, Danuta
Skowronski and colleagues report the unexpected results of a series of
Canadian epidemiological studies suggesting a counterproductive effect of
the vaccine. The findings are based on Canada’s unique near-real-time
sentinel system for monitoring influenza vaccine effectiveness. Patients with
influenza-like illness who presented to a network of participating physicians
were tested for influenza virus by RT-PCR, and information on
demographics, clinical outcomes, and vaccine status was collected.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 3
In this sentinel system, vaccine effectiveness may be measured by comparing
vaccination status among influenza-positive “case” patients with influenza
negative “control” patients. This approach has produced accurate measures of
vaccine effectiveness for TIV in the past, with estimates of protection in
healthy adults higher when the vaccine is well-matched with circulating
influenza strains and lower for mismatched seasons. The sentinel system was
expanded to continue during April to July 2009, as the H1N1 virus defied
influenza seasonality and rapidly became dominant over seasonal influenza
viruses in Canada.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 4
Additional Analyses and Proposed Biological Mechanisms
The Canadian sentinel study showed that receipt of TIV in the previous
season (autumn 2008) appeared to increase the risk of H1N1 illness by 1.03-
to 2.74-fold, even after adjustment for the comorbidities of age and
geography. The investigators were prudent and conducted multiple sensitivity
analyses to attempt to explain their perplexing findings, importantly, TIV
remained protective against seasonal influenza viruses circulating in April
through May 2009, with an effectiveness estimated at 56%, suggesting that
the system had not suddenly become flawed. TIV appeared as a risk factor in
people under 50, but not in seniors—although senior estimates were
imprecise due to lower rates of pandemic illness in that age group.
Interestingly, if vaccine were truly a risk factor in younger adults, seniors
may have fared better because their immune response to vaccination is less
rigorous.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 5
Potential Biases and Findings from Other Countries
The Canadian authors provided a full description of their study population
and carefully compared vaccine coverage and prevalence of comorbidities in
controls with national or province-level age-specific estimates—the best can
do short of a randomized study. In parallel, profound bias in observational
studies of vaccine effectiveness does exist, as was amply documented in
several cohort studies overestimating the mortality benefits of seasonal
influenza vaccination in seniors.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 6
Given the uncertainty associated with observational studies, we belie would
be premature to conclude that TIV increased the risk of 2009 pandemic
illness, especially in light of six other contemporaneous observational studies
in civilian populations that have produced highly conflicting results. We note
the large spread of vaccine effectiveness estimates in those studies; indeed,
four of the studies set in the US an Australia did not show any association
whereas two Mexican studies suggested a protective effect of 35%-73%.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 7
Policy Implications and a Way Forward
The alleged association between seasonal vaccination and 2009 H1N1
remains an open question, given the conflicting evidence from available
research. Canadian health authorities debated whether to postpone seasonal
vaccination in the autumn of 2009 until after a second pandemic wave had
occurred, but decided to follow normal vaccine recommendations instead
because of concern about a resurgence of seasonal influenza viruses during
the 2009-10 season.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 8
This illustrates the difficulty of making policy decisions in the midst of a
public health crisis, when officials must rely on limited and possibly biased
evidence from observational data, even in the best possible scenario of a
well-established sentinel monitoring system already in place. What happens
next? Given the timeliness of the Canadian sentinel system, data on the
association between seasonal TIV and risk of H1N1 illness during the autumn
2009 pandemic wave will become available very soon, and will be crucial in
confirming or refuting the earlier Canadian results.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
Paragraph 9
In addition, evidence may be gained from disease patterns during the autumn
2009 pandemic wave in other countries and from immunological studies
characterizing the baseline immunological status of vaccinated and
unvaccinated populations. Overall, this perplexing experience in Canada
teaches us how to best react to disparate and conflicting studies and can aid in
preparing for the next public health crisis.
Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”
QUESTIONS
Q1. The question of partial protection against H1N1 arose__________
a. before spring 2009
b. during Spring 2009
c. after spring 2009
d. during 2008-09
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”
Q2. According to Danuta Skowronski__________
a. the inactivated influenza vaccine may not be having the desired effects.
b. Canada’s near-real-time sentinel system is unique.
c. the epidemiological studies were counterproductive
d. the inactivated influenza vaccine has proven to be ineffective.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”
Q3. The vaccine achieved higher rates of protection in healthy adults when
__________
a. it was supported by physicians.
b. the sentinel system was expanded.
c. used in the right season.
d. it was matched with other current influenza strains.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”
Q4. Which one of the following is closest in meaning to the word prudent?
a. anxious
b. cautious
c. busy
d. confused
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”
Q5. The Canadian sentinel study demonstrated that __________
a. age and geography had no effect on the vaccine’s effectiveness.
b. vaccinations on senior citizens is less effective than on younger people
c. the vaccination was no longer effective.
d. the risk of H1N1 seemed to be higher among people who received the TIV
vaccination.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”
Q6. Which of the following sentences best summarises the writers’ opinion
regarding the uncertainty associated with observational studies?
a. More studies are needed to determine whether TIV increased the risk of the
2009 pandemic illness.
b. It is too early to tell whether the risk of catching the 2009 pandemic illness
increased due to TIV.
c. The Australian and Mexican studies prove that there is no association
between TIV and increased risk of catching the 2009 pandemic illness.
d. Civilian populations are less at risk of catching the 2009 pandemic illness.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”
Q7. Which one of the following is closest in meaning to the word alleged?
a. reported
b. likely
c. suspected
d. possible
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”
Q8. Canadian health authorities did not postpone the Autumn 2009 seasonal
vaccination because __________
a. of a fear seasonal influenza viruses would reappear in the 2009-10 season.
b. there was too much conflicting evidence regarding the effectiveness of the
vaccine.
c. the sentinel monitoring system was well established.
d. observational data may have been biased.
Paragraphs“1”“2”“3”“4”“5”“6”“7”“8”“9”
Answer Key
“Practice Test 20”
Answer Key
Practice Test 1
1. B
2. C
3. B
4. A
5. A
6. D
7. C
8. 100 mg
9. ibuprofen therapy patients
10. clopidogrel
11. aspirinated platelets
12. 75 - 150 mg
13. CAPRIE
14. antithrombotic
15. 5 - 45%`
16. Cox-2
17. cardiovascular death
18. biosynthesis
19. compliance
20. aspirin
“Practice Test 2”
Practice Test 2
1. C
2. B
3. B
4. A
5. C
6. A
“Practice Test 3”
Practice Test 3
1. C
2. C
3. C
4. D
5. C
6. A
7. D
8. D
“Practice Test 4”
Practice Test 4
1. B
2. B
3. B
4. D
5. D
6. A
7. C
8. A
“Practice Test 5”
Practice Test 5
1. B
2. D
3. B
4. A
5. C
6. A
7. A
8. Thomas Browne
9. Michele Pearson
10. antipsychotic
11. 15
12. psychiatric illness
13. infested by parasites
14. unexplained dermopathy
15. parasites
16. Mayo Clinic
17. CDC
18. persona
19. physicians
20. relentless
“Practice Test 6”
Practice Test 6
1. A
2. C
3. A
4. A
5. A
6. B
“Practice Test 7”
Practice Test 7
1. C
2. C
3. D
4. B
5. C
6. D
7. B
8. A
“Practice Test 8”
Practice Test 8
1. C
2. C
3. C
4. A
5. D
6. A
7. B
8. B
“Practice Test 9”
Practice Test 9
1. C
2. B
3. A
4. A
5. D
6. C
7. B
8. 68
9. 3
10. 18 to 64 years
11. 2009
12. 183
13. 1.1%
14. doubled
15. tuberculosis
16. age-matched
17. AIDS
18. indigent subjects
19. 10
20. 858
1. C
2. C
3. D
4. B
5. C
6. D
7. B
8. C