OTIS笔试题 ZZ.doc

OTIS笔试题 ZZ OTIS笔试题 全英的 Pleasereadthefollowingtwosectionsandpletethequestionswithin40minutes. Section1: DoctorsDividedOverHeartPills AgroupofdrugsnowbeingmarketedintheUnitedStatesunderavarietyofbrandnameshavebeenprobedtoreducedeathsamongheartattacksurvivorsbymorethan40%overfiveyears.Thedrugsarecollectivelyknownasstatins,andarecurrentlybeingtakenbyover10millionAmericans.Doctorsarecurrentlywonderingifstatinswillbejustaseffectiveinpreventingheartattacksinpeoplewhodonotnecessarilyfittheprofileofa“highrisk”patient. ThepeoplethedoctorsaretargetingforpossibleprescriptionofstatinsarethosewhoseLDL,or“bad”cholesterol,issomewhathigh,ortheirHDL,or“good”cholesterolisalittlelow.Again,maybetheyhavediabetes,whichmonlyleadstocardiovasculardisease,butdonotyetshowsymptomsofthelatter.AstudyreportintheBritishMedicalJournalconcludedthatstatinscouldreduceby30%theriskofdyingfromaheartattack,evenamongpeoplewithnormalcholesterollevelsandnosignsofcardiovasculardisease. LeadingpharmaceuticalpanieshavegonesofarastopetitiontheUSFoodandDrugAdministration(FDA)toallowconsumerstobuysomelowdosestatinswithouthavingtofirstobtainaphysiciansprescription,or“overthecounter”. Statinsworkbypartlyblockinganenzyme,knownasHMG,foundinliverthatturnsomeofthefoodthatyoueatintocholesterol.Thebody,infact,needssomecholesteroltoproducehormonesandVitaminD.Excesscholesterolbuildsupinthearteries,reducingthebloodflowandincreasingthedangerofheartdisease.ByslowingdownthefunctionoftheHMGenzyme,statinsreducetheamountofcholesterolenteringthebloodstream,andforcethebodytodrawonthecholesterolalreadyinthearteriestomakeuptheshortfallinitsneeds.Thus,thereisaregularclearingoutofcholesterolfromthearteries.Doctorsemphasizethatstatinsworkbestwhenapersonadoptsalowfatdiet. Thereare,however,certaindrawbackstostatins.Apartfromthefactthattheyareexpensiveabout$3perpill,andyouwouldpresumablyhavetotakethemfortherestofyourlifetheycancauseliverdamageorabreakdownofmuscletissue.Anyonetakingstatinsneedstoundergoperiodicbloodteststocheckforsignsoflivertrouble.Mostpeopleonthepillsreportnoplaints;thosewhodomonlylistfatigueasthemajorsideeffect. CompaniesmanufacturingdietarysupplementsbecameinterestedinstatinswhenitwasdiscoveredthatChineseredyeastfermentedonricecontainssmallamountofthesameactiveingredientfoundinstatins.Theythenmadeadietarysupplementcontainingthisingredientandpublicizeditasawonderdrugforpreventingheartattacks.TheFDAbanneditssaleoverthecounter,andthetwosidesarestilllockedinalengthycourtcase. Inthemeantime,anotherintriguingpossibilityhasconvinceddoctorsthatmakingstatinsmorefreelyavailablemaybeagoodthing.Researchhasshownthattakinganaspirinadaycanreduceaheartpatientsriskofsufferingaheartattack.Wouldbiningaspirinwithastatinhaveapowerfuleffectinpreventingheartdisease?Similarly,manycardiologistsareimpressedbytheabilityofagroupofdrugscalledACEinhibitorstonormalizehighbloodpressureandreducethestrainontheheart.Dotheyworkbetteralone,orwouldabinationofACEinhibitorsandstatinsenhancetheirefficacy? 2 Pleasegiveyourownopiniononthetopicbelowwithin30minutes. Somepeoplepref