Reading sub-test

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Answer Key – Part A

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198 PRACTICE TEST 3

 READING SUB-TEST – ANSWER KEY

PART A: QUESTIONS 1-20

1 B

2 A

3 C

4 D

5 C

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6 B

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7 D

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8 clindamycin (and) penicillin

9 diabetes mellitus

10 septic shock

11 VAC/ vacuum-assisted closure

12 alcohol pads

13 daptomycin (and) linezolid

14 vibrio (infection)

15 32.2%
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16 seafood
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17 limbs
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18 polymicrobial
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19 7%
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20 physical therapy
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PRACTICE TEST 3 199

 Reading sub-test

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Answer Key – Parts B & C

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200 PRACTICE TEST 3

 READING SUB-TEST – ANSWER KEY

PART B: QUESTIONS 1-6

1 A stop dates aren’t relevant in all circumstances.

2 B improves precision during radiation.

3 B position electrodes correctly.

4 C its short-term benefits are explained to them.

5 B the use of a particular method of testing pH levels.

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6 A the amount of oxytocin given will depend on how the patient reacts.

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PART C: QUESTIONS 7-14

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7 D the need for the phobia to be confronted repeatedly over time.

8 D unpleasant memories are aroused in response to certain prompts.

9 A makes use of an innate function of the brain.

10 A the anxiety that patients feel during therapy

11 C affects how neurons in the brain react to stimuli.

12 A its benefits are likely to be of limited duration.

13 D the emotional force of a memory is naturally retained.

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14 B increase patients’ tolerance of key triggers.

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PART C: QUESTIONS 15-22

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A he saw for himself how it could work in practice.

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15
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16 A research indicates that they are effective even without deceit.

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17 D they are very widely used

18 A The way a treatment is presented is significant even if it is a placebo.

19 B reduce the number of people who experience them.

20 C a growing body of research

21 B Evers is exploiting a response which Ader discovered by chance.

22 D their effect is more psychological than physical.

PRACTICE TEST 3 201

 Reading test

Variations in HIV testing: Texts

Text A

What is an ELISA?

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An ELISA or enzyme-linked immunosorbent assay, is a method used in the laboratory to aid in the diagnosis

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of a wide range of diseases. This test is performed on blood or urine and is used for measuring the amount

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of a particular protein or substance in these bodily fluids, such as infectious agents, allergens, hormones or

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drugs.

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This test relies on the interaction between components of the immune system called antigens and antibod-
ies. Antibodies are proteins produced by the body to identify and neutralise any foreign substances that may
be encountered, such as viruses and bacteria. The substances to which antibodies are produced are known
as the antigens as they stimulate an immune response.

What is the test used for?

ELISAs are used for numerous types of tests in the laboratory which can assist in the diagnosis of many
different conditions.

It is most commonly requested if it is suspected you have been exposed to viruses such as HIV and Hepatitis
B or C, or bacteria and parasitic infections such as Toxoplasmosis, Lyme disease and Helicobacter pylori. It
can also measure levels of antibodies to see if you have been vaccinated against certain diseases such as
mumps and rubella.
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Other uses of the ELISA include:

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• Measuring certain hormone levels such as HCG in the pregnancy test, thyroid hormones
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• Detecting dust and food allergies

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• Detection of illicit drugs such as cocaine and methamphetamines.

TO

• Measuring antibodies which are produced in auto-immune conditions such as Lupus and rheuma-
'S

toid arthritis.
BY
JO

Some kits are also available for the general public to use for example; the home pregnancy test is based on
the ELISA principle and detects the presence of a hormone known as human chorionic gonadotrophin (hCG)
which is excreted in the urine of a pregnant woman.

20 Study guide for OET © IRS Group 2018

 Text B

How accurate are different types of HIV tests?

Modern HIV tests are extremely accurate. There are a variety of different HIV tests and your healthcare worker
should explain which test you will be given and how you will get your result. Normally, testing involves taking a
small sample of blood from either your finger or your arm, or a sample of oral fluid.

How long an HIV test takes to give you an accurate result depends on the type of test you are taking. If you are
taking a rapid test, you will be given your results within 20 minutes. Other types of tests will be sent to a
laboratory and you may have to wait for the result which may take between a few days to a few weeks for you

ED
to receive a final result.

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Study guide for OET © IRS Group 2018 21

Text C

Baseline risk-assessment

How to identify those at risk of HIV

PrEP is indicated for those at greater risk of HIV acquisition and therefore comprehensive history taking and
risk assessment, including both sexual and drug taking histories, are required to identify those most likely to
benefit.

Clinicians will need to make pragmatic decisions with patients about future HIV risk, their need for PrEP and
individual-level assessment of the benefit versus potential harms of PrEP. At a population level, given limited

ED
resources and a desire to achieve the maximum impact of PrEP, clinicians should use clinical criteria and

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recommendations as outlined in these guidelines, along with local and national criteria for NHS or clinical

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trial eligibility to provide PrEP to those at highest risk of HIV acquisition.

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E
It is well recognised that there are other risk behaviours and vulnerability factors that increase the risk of HIV

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acquisition and these should be taken into consideration on a case-by-case basis by clinicians when
considering eligibility for PrEP and assessing HIV risk. Although this lacks a clear evidence base, the writing
group has considered this in terms of those who are ‘hi h risk’, and therefore PrEP would be recommended,
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22 Study guide for OET © IRS Group 2018

 Text D

Summary table of recommendations for PrEP

Recommend PrEP

(i) HIV-negative MSM and trans women who report condomless anal sex in the previous 6 months and on-
going condomless anal sex.

(ii) HIV-negative individuals having condomless sex with partners who are HIV positive, unless the partner
has been on ART for at least 6 months and their plasma viral load is <200 copies/mL.

Consider PrEP on a case-by-case basis

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PrEP may be offered on a case-by-case basis to HIV-negative individuals considered at increased risk of HIV

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acquisition through a combination of factors that may include the following:

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Population-level indicators Clinical indicators

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• Heterosexual black African men and women • Rectal bacterial STI in the previous year
• Recent migrants to the UK • Bacterial STI or HCV in the previous year
• Transgender women • Post-exposure prophylaxis following sexual expo-
• People who inject drugs sure (PEPSE) in the previous year; particularly
where repeated courses have been used
• People who report sex work or transactional sex

Sexual behaviour/sexual-network indicators Drug use

• High-risk sexual behaviour: reporting condomle • Sharing injecting equipment
sex with partners of unknown HIV status, and • Injecting in an unsafe setting
particularly where this is condomless anal sex or
• No access to needle and syringe programmes or
with multiple partners
opioid substitution therapy
• Condomless sex with partners from a population
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group or country with high HIV prevalence

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Sexual health autonomy

• Condomless sex with sexual partners who may fit
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Other factors that may affect sexual health autonomy

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the criteria of ‘high risk of HIV’ detailed above

• Inability to negotiate and/or use condoms (or
PP

• Engages in chemsex or group sex

employ other HIV prevention methods) with sexual
TO

• Reports anticipated future high-risk sexual

partners
behaviour
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• Coercive and/or violent power dynamics in relation-

BY

• Condomless vaginal sex should only considered

ships (e.g. intimate partner/domestic violence)
JO

high risk where other contextual factors or vulner-

• Precarious housing or homelessness, and/or other
abilities are present
factors that may affect material circumstances
• Risk of sexual exploitation and trafficking

Study guide for OET 23

 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.

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Variations in HIV testing: Questions

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Questions 1-7

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For each of the questions 1-7, decide which text (A,B, C or D) the information comes from. You may use any

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letter more than once.

1. Time taken to receive 4th generation antigen tests ________________________________

2. Factors that are observed to affe n sexual autonomy ________________________________

3. The differing conditions that are diagnosed with ELISA test ________________________________

4. Talking to patients about pragmatic decisions on future ________________________________

5. Antibodies are the substances produced for antigen ________________________________

6. PrEP for partners from a high HIV risk population group ________________________________

7. Health care worker should explain the test given ________________________________

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Questions 8 - 13
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PP

Answer each of the questions, 8 – 13, with a word or short phrase from one of the texts. Each answer may
TO

include words, numbers or both. Your answers should be correctly spelled.

'S
BY

8. What does an ELISA test measure for in pregnancy?

JO

___________________________________________________________________________

9. How is acquisition considered for HIV negative individuals?

___________________________________________________________________________

10. How long does it take to receive results of a rapid test?

___________________________________________________________________________

11. What are the examples of autoimmune conditions detected by ELISA?

___________________________________________________________________________

24 Study guide for OET ©

 12. What kind of histories are required to identify those who need PrEP ?

___________________________________________________________________________

13. How long will it take to detect HIV with self-testing kits?

___________________________________________________________________________

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. Your answers should be correctly spelled.

Particular are measured for diagnosis of an ELISA test.

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14. _________________________________________

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15. People who engage in _________________________________________ sex falls under population level indicators.

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16. HIV tests involve taking sample from _________________________________________ or the arm for detailed blood study.

17. _________________________________________ for PrEP must be considered on the basis of vulnerability factors for HIV.

18. Interaction between components of _________________________________________ is relied on for ELISA test results.

19. _________________________________________ of self testi kits is satisfactory but requires further medical scrutiny.

20. Individuals who have _________________________________ _____ with HIV positive partners must be recommended

PrEP.
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Study guide for OET © IRS Group 2018 25

 Part B
In this part of the test, there are four 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.

1. The changes in standards as per the revised protocol was necessitated due to

A more evidence of associated risks seen

B inconsistent responses to new findings

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C protocols that prioritize peadiatricians only

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Executive Summary

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Intravenous fluids are important components of appropriate care for hospitalised children. Reports in the
medical literature and warnings issued in other countries have highlighted the risks associated with use of
low sodium content fluids. The importance of appropriate glucose content has also been identified, and
emerging evidence suggests risks associated with high chloride. Individual or facility based responses to
the changing literature, along with the interim recommendations of a national expert group convened under
the auspices of Children’s Healthcare Australasia (CHA), have led to variable practices across NSW Health
hospitals with consequent inconsistenci d risks. The NSW Chief Paediatrician was tasked to engage
clinical experts, HealthShare and a range of other partners in the development of statewide standards
across all NSW facilities. The resultant Standards for Paediatric IV Fluids: NSW Health addresses fluid
content, bag size, labelling, administration, procurement and storage. A succinct Statement of the Stan-
dards presents the key messages and related actions on a single page.
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26 Study guide for OET 8

 2. The guidelines on CDCT aims to enumerate the

A importance of eliciting personal preference

B morbidity rates noticed in clinical observations
C conservative estimates of procedural effectiveness

Updates on early lung cancer detection with Low-Dose Helical

Computed Tomography
Key Discussion Points for the Process of Shared Decision Making Related to Screening for Early Lung

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Cancer Detection With Low-Dose Helical Computed Tomography

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• Benefit: Screening with LDCT has been shown to substantially reduce the risk of dying from lung cancer

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• Limitations: LDCT will not detect all lung cancers or all lung cancers early, and not all patients who have

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a lung cancer detected by LDCT will avoid death from lung cancer

• Harms: There is a significant chance of a false-positive result, which will require additional periodic
testing and, in some instances, an invasive procedure to determine whether or not an abnormality is lung
cancer or some nonlung-related incidental finding; <1 in 1000 patients with a false-positive result expe-
riences a major complication resulting from a diagnostic workup; death within 60 d of a diagnostic
evaluation has been documented but is rare and most often occurs in patients with lung cancer

• Individuals who value the opportunity to reduce their risk of dying from lung cancer and who are willing
to accept the risks and costs associated with having an LDCT and the relatively high likelihood of the
need for further tests, even tests that have the rare but real risk of complications and death, may opt to
be screened with LDCT every year.
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Study guide for OET © 27

3. The evaluation and management exercise requires students to

A perform in the presence of a billing physician

B document services accorded in the medical record
C record significant decision making exercises involved

Evaluation and Management Documentation Provided by Students

Any contribution and participation of a student to the performance of a billable service (other than review of
systems and/or past family/social history which are not separately billable, but are taken as part of an E/

ED
M service) must be performed in the physical presence of a teaching physician or the physical presence of

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a resident in a service that meets the requirements in this section for teaching physician billing. Students

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may document services in the medical record; however, the teaching physician must verify in the medical

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record all student documentation or findings, including history, physical exam, and/or medical decision

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making. The teaching physician must personally perform (or re-perform) the physical exam and medical
decision making activities of the E/M service being billed and may verify any student documentation of
them in the medical record rather than re-documenting this work.
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28 Study guide for OET ©

4. On suspecting a disorder it is important to

A convey the gist of the problem

B articulate the symptoms with patient
C focus on associated illness outcomes

How to approach the consultation

• Adopt a non-judgmental approach through what is said and not said. Listen and understand the patient’s
version of reality, however bizarre it may appear, in order to discover more about what is going on in their

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world

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• Ask focused questions if psychosis is suspected and do not too readily dismiss symptoms as the results

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of depression, anxiety, or substance misuse

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• Avoid arguing with the patient—for example, by saying, “Of course there aren't devils under the bed.” It
works better to say, “I understand that this is how it appears to you, but this is how it appears to me”

• Be true to the person as they were when well. Remember hostility can be a symptom of the illness

• Avoid diagnostic labels at too early a stage; instead, focus the discussion around the patient’s symptoms
and experiences

• Avoid using stigmatising language. For example, some patients prefer “a person who experiences schizo-
phrenia” rather than “schizophrenic”
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Study guide for OET © I 29

5. The statutory catalogue informs

A appropriate dispensation of information is legal

B judicious consideration is required for data sharing
C consent of the individual must be maintained

Restricted sharing of information

There are circumstances where it is not permissible to make information publicly available, however it may
be permissible and appropriate to share that information with other organisations so that they may make

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reasonable use of it. Such restricted sharing of information may include sharing information to support the

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delivery of care for individuals, for managing systems of care for a population or for other purposes.

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1. Under common law, any restricted sharing of information must not identify any individual unless

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there is a legal means and purpose to do so. Permissible legal means will include cases when:

a. the person that the information is about has consented, or

2. b. there is a statutory basis for disclosure or court order, or

3. c. there is a public interest justification for disclosure, or

4. d. there is another basis in law for disclosure.

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30 Study guide for OET © I

 6. The health guide advices individuals to

A prepare for long term wellness plan

B entrust a confidant for future care
C use informed choices for later care

Advance Care Planning

Advance care planning is a helpful way for people of all ages to prepare for the future. Both healthy people
and people with health conditions do advance care planning.

ED
Advance care planning is:

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• Making decisions now about the types of health care you would and would not want to receive if you

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become very sick or injured and couldn’t speak for yourself in the future

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• Choosing a person you want to make decisions for you if you’re unable to do so for yourself. This person
is called a health care agent

• Talking with your doctors and loved ones about the types of health care you want to receive so they’ll
respect and honor your values and health care goals

• Writing down your health care goals in MyCare, an advance directive. This form guides your health care
providers as to what types of health care you want. It also helps your loved ones understand your wishes
in case they have to make health care decisions for you
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Study guide for OET 31

 Part C
In this part of the test, there are two texts about different aspects of healthcare. For questions 7-22, choose the
answer (A, B, C or D) which you think fits best according to the text..

Text 1: Pancreatic cancer: gradual rise, increasing relevance

Pancreatic cancer is the 10th most frequently occurring cancer but the fifth most common cause of cancer
death in Australia, as is also seen in other developed regions of the world. A gradual increase in incidence has

ED
been observed since the 1980s in almost all age groups in both sexes. Increases have been attributed only to

IT
trends in smoking, which is considered causal, with local published data suggesting a lag of about 30 years

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between smoking trends and incidence. However, being overweight and obesity may also have contributed, in

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part, to incidence trends.

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In developed countries, only about 50%–70% of cases of pancreatic cancer are histologically confirmed
based on review of the primary tumour, because pancreatic biopsy procedures have been associated with
significant risks and are often avoided. But improvements in imaging modalities, particularly endoscopic
ultrasound and pancreas-specific computed tomography, and magnetic resonance imaging protocols, together
with endoscopically guided biopsy procedures, are likely to have led to some of the increase in incidence
through improved detection.

In 2011, the latest year for which results are available, 5-year survival from pancreatic cancer was 5.2% in
Australia and 7.3% in the United States (among patients on selected Surveillance, Epidemiology and End
Results Program registers) with modest improvements observed over the past several decades. Five-year
survival from pancreatic cancer was about 3% in the mid1980s in both places. Between 1987 and 2007 in
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Australia there was only a 6% drop in mortality from pancreatic cancer in both sexes (in those aged less than
IN

75 years), compared with decreases in mortality of 34% from lung cancer, 47% from bowel cancer and 28%
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from all cancers overall. Current projections suggest that within 10 years, pancreatic cancer will be the
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second-highest cause of cancer death in the US as mortality and survival from the other four leading causes
TO

of cancer death (lung, bowel, prostate, and breast cancers) improves. If these trends are reflected in Australia,
it would be anticipated that pancreatic cancer will become one of the leading causes of cancer mortality there
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also.
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Complete resection of the primary tumour currently offers the only hope of cure. Beyond the setting of high-
risk families, screening to identify precursor or early invasive lesions is not feasible for two main reasons.
First, endoscopic ultrasound is invasive and can only be used in specialised settings, so does not meet
criteria for a population screening test. Second, the positive predictive value of screening is limited by the low
population prevalence of pancreatic cancer. Attempts to categorise the population using known risk factors,
including several known single nucleotide polymorphisms, have not yet identified population subgroups at
sufficiently high risk to warrant screening.

32 Study guide for OET ©

 An avenue to optimise outcomes for patients is to ensure that all receive high-quality care in the most
appropriate setting. There is evidence from the US that not all patients with potentially resectable tumours are
offered surgery. Detailed data are not currently available for Australia, but it appears that there is similar
underutilisation of surgery there. It is thus important that all patients without metastatic disease are reviewed
by a multidisciplinary team in a major centre to determine the resectability of their pancreatic tumours. In
addition, it is of great consequence that resections be performed in hospitals that carry out a large number of
these procedures annually, as this has been shown to improve survival.

In conclusion, while the rise in pancreatic cancer incidence is slow, as the population ages, more people will
be affected with this disease. The burden of pancreatic cancer relative to other cancer types is likely to

ED
increase. A multilevel approach is needed to control pancreatic cancer, including reducing the prevalence of
risk factors such as smoking and obesity, identifying effective biomarker screening tools and populations in

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whom screening or early detection might be feasible, discovering new treatment modalities and ensuring that

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all patients have access to optimal care.

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Study guide for OET © IRS Group 2018 33

Text 1: Questions 7 - 14

7. Opinion gauged from paragraph one on the eighties is that

A a rise in pancreatic cancer has occurred in all age groups.

B the rate of pancreatic cancer has risen in most age groups.
C the rate of pancreatic cancer has swiftly risen in all groups.
D the rate of pancreatic cancer rose in almost all age groups.

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8. For developing pancreatic cancer, it is suggested in paragraph 1 that ……

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A smoking trends have been attributed as the key factor.
B smokers lag by thirty years behind the incidence and trends.
C smoking and obesity combined is the exclusive cause.
D smokers have to wait a timespan of 30 years to get cancer.

9. From paragraph 2, what is suggested on pancreatic biopsy procedures?

A historically risky, leading to a detection rate of 50 to 70%.

B often avoided which has led to a 50 to 70% confirmation rate.
C are usually avoided due to being too risky to ever undertake.
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D have contributed to the microscopic amount of confirmation rates.

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The improvements in technology as is mentioned in paragraph 2 ……

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10.
TO

A have contributed little to detection rates of pancreatic cancer.

'S

B have detected more incidences of pancreatic cancer.

BY

C have led to the increase in early detection of most cancers.

JO

D have detected the abrupt increase of pancreatic cancer.

34 Study guide for OET © IRS Group 2018

 11. The word modest in paragraph 3 could NOT be replaced by ……

A Minor
B Marked
C Meagre
D Moderate

12. The figures for pancreatic cancer from the passage indicate

ED
A a considerable decline in mortality rates for between 87-07.

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B improved mortality rates within the next 10 years

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C it will become the leading cause of cancer mortality.

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D a highly probable rise in mortality rates in the near future.

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13. In paragraph 4, the word ‘categorise’ could be replaced by

A Justify
B Classify
C Rectify
D Objectify

14. The author’s use of language in paragraph 6, is best described as ……

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A Dismissive
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B Biased
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C Objective
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D Disapproving
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Study guide for OET © IRS Group 2018 35

Text 2: Role of oral health on overall well-being

The relationship between oral health and diabetes (Types 1 and 2) is well known and documented. In the last
decade, however, an increasing body of evidence has given support to the existence of an association between
oral health problems, specifically periodontal disease, and other systemic diseases, such as those of the
cardiovascular system. Adding further layers of complexity to the problem is the lack of awareness in much
of the population of periodontal disease, relative to their knowledge of more observable dental problems, as
well as the decreasing accessibility and affordability of dental treatment in Australia. While epidemiological
studies have confirmed links between periodontal disease and systemic diseases, from diabetes to autoimmune
conditions, osteoporosis, heart attacks and stroke, in the case of the last two the findings remain cautious

ED
and qualified regarding the mechanics or biological rationale of the relationship.

IT
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Periodontal diseases, the most severe form of which is periodontitis, are inflammatory bacterial infections

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that attack and destroy the attachment tissue and supporting bone of the jaw. Periodontitis occurs when

AT
gingivitis is untreated or treatment is delayed. Bacteria in plaque that has spread below the gum line release
toxins which irritate the gums. These toxins stimulate a chronic inflammatory response in which the body, in
essence, turns on itself, and the tissues and bone that support the teeth are broken down and destroyed.
Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected.
As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this
destructive process only has very mild symptoms. Eventually, however, teeth can become loose and may
have to be removed.

The current interest in the relationship between periodontal disease and systemic disease may best be
attributed to a report by Kimmo Mattila and his colleagues. In 1989, in Finland, they conducted a case-control
study on patients who had experienced an acute myocardial infarction and compared them to control subjects
selected from the community. A dental examination was performed on all of the subjects studied, and a dental
TE

index was computed. The dental index used was the sum of scores from the number of carious lesions,
IN

missing teeth, and periapical lesions and probing depth measures to indicate periodontitis and the presence
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ER

or absence of pericoronitis (a red swelling of the soft tissues that surround the crown of a tooth which has
PP

partially grown in). The researchers reported a highly significant association between poor dental health, as
TO

measured by the dental index, and acute myocardial infarction. The association was independent of other risk
factors for heart attack, such as age, total cholesterol, high-density lipoprotein triglycerides, C peptide,
'S
BY

hypertension, diabetes, and smoking.

JO

Since then, researchers have sought to understand the association between oral health, specifically periodontal
disease, and cardiovascular disease (CVD) – the missing link explaining the abnormally high blood levels of
some inflammatory markers or endotoxins and the presence of periodontal pathogens in the atherosclerotic
plaques of patients with periodontal disease. Two biological mechanisms have been suggested. One is that
periodontal bacteria may enter the circulatory system and contribute directly to atheromatous and thrombotic
processes. The other is that systemic factors may alter the immunoflammatory process involved in both
periodontal disease and CVD. It has also been suggested that some of these illnesses may in turn increase
the incidence and severity of periodontal disease by modifying the body’s immune response to the bacteria
involved, in a bi-directional relationship.

36 Study guide for OET © IRS Group 2018

 However, not only is ‘the jury out’ on the actual mechanism of the relationship, it also remains impossible to
say whether treating gum disease can reduce the risk of cardiovascular disease and improve health outcomes
for those who are already sufferers. Additional research is needed to evaluate disease pathogenesis. Should
the contributing mechanisms be identified, however, it will confirm the role of oral health in overall well-being,
with some implications of this being the desirability of closer ties between the medical and the dental professions,
and improved public health education, not to mention greater access to preventive and curative dental treatment.
In time, periodontal disease may be added to other preventable risk factors for CVD, such as smoking, high
blood cholesterol, obesity and diabetes.

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Study guide for OET © IRS Group 2018 37

Text 2: Questions 15 - 22

15. According to paragraph 1, periodontal disease is unknown to many Australians because ……

A dental treatment is no longer affordable.

B the problem has a high degree of complexity.
C information on dental problems is inaccessible.
D it is not as prominent as other dental issues.

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16. ‘Epidemiological’ in the first paragraph is used to denote

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A causative
B scientific
C plagiarised
D controlled

17. According to paragraph three, the 1989 study in Finland ……

A prompted further interest in the link between oral health and systemic disease.
B did not take into account a number of important risk factors for heart attacks.
C concluded that people with oral health problems were likely to have heart attacks.
TE

D was not considered significant when it was first reported but is very major now.
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The relationship between dental hygeine and heart attacks as is expressed in paragraph three is
PP

18.
TO

A inconclusive
'S

B coincidental
BY

C evident
JO

D inconsequential

38 Study guide for OE

 19. As per paragraph three, the dental index was primarily used to

A indicate whether periodontis was present

B assess the overall oral health of patients.
C establish whether pericoronitis was present.
D predict the onset of acute myocardial infarction.

20. According to paragraph four, the viewpoint expressed is that

ED
A cardiovascular disease could actually exacerbate periodontal disease.

IT
B periodontal disease could modify the body’s immune response.

M
LI
C there is a bi-directional relationship between periodontal disease and bacteria.

E
D systemic factors may contribute directly to atheromatous processes.

AT
21. If the processes by which gum disease affects CVD, there will be ……

A less need for doctors and dentists to work in conjunction.

B a reduced emphasis on other preventable risk factors for CVD.
C a concomitant link between smoking and periodontal disease.
D more support for dental care in the public health system.

22. The expression the jury (is) out in paragraph 5 means that a definitive conclusion is ……
TE
IN

A imminent.
S
ER

B impossible.
PP

C without any merit

TO

D yet to be attained.
'S
BY
JO

END OF READING TEST

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Study guide for OET 39