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:

Wear loose clothes

Avoid cigarettes and alcohol
Move about the cabin whenever possible
Don’t sit with your legs crossed
Perform leg and foot stretches and exercises while seated
Consult with your doctor before travelling
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Questions“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”

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.
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Questions“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”
Text C
Symptoms

Pain and tenderness in the leg

Pain on extending the foot
Tenderness in calf (the most important sign)
Swelling of the lower leg, ankle and foot
Redness in the leg
 Bluish skin discoloration
Increased warmth in the leg
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Questions“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”

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.
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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 symptoms of DVT? _____

Go “Text “Text “Text “Text
to A” B” C” D”
2. how much risk of DVT is there in the first week after traveling? _____
Go “Text “Text “Text “Text
to A” B” C” D”
3. what is the most important sign of DVT? _____
Go “Text “Text “Text “Text
to A” B” C” D”
4. when did DVT was first linked to air travel? _____
 Go “Text “Text “Text “Text
to A” B” C” D”
5. what are the safe practices to reduce the risk of DVT? _____
Go “Text “Text “Text “Text
to A” B” C” D”
6. which exercises reduce the risk of DVT? _____
Go “Text “Text “Text “Text
to A” B” C” D”
7. what were the conclusions of the Dutch study on DVT? _____
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. 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”