学术英语医学课后问题问题详解

1、实用标准 文档大全 Unit1 1、Some factors that may lead to the complaint: Neuron overload Patients* high expectations Mistrust and misunderstanding between the patient and the doctor 2、 Mrs. Osorios condition: A 56-year-old woman Somewhat overweight Reasonably well-controlled diabetes and hypertension Choleste

2、rol on the high side without any medications for it Not enough exercises she should take Her bones a little thin on her last DEXA scan 3、 Good things: Blood tests done Glucose a little better Her blood pressure a little better but not so great Bad things: Cholesterol not so great Her weight a little

3、 up Her bones a little thin on her last DEXA scan 4 4、The situation: The author was in a moderate state of panic: juggling so many thoughts about Mrs. Osorios conditions and trying to resolve them all before the clock ran down. Mrs. Osorio made a trivial request, not so important as compared to her

4、conditions. Mrs. Osorio seemed to care only about her “innocent and completely justified request”： the form signed by her doctor. The doctor tried to or at least pretended to pay attention to the patient while 实用标准 文档大全 completing documentation. 5、Similarities: In computer multitasking, a microproce

5、ssor actually performs only one task at a time. Like microprocessors, we human beings carft actually concentrate on two thoughts at the same exact time. Multitasking is just an illusion both in computers and human beings. Differences: The concept of multitasking originated in computer science. At be

6、st, human beings can juggle only a handful of thoughts in a multitasking manner, but computers can do much better. The more thoughts human beings juggle, the less human beings are able to attune fully to any given thought, but computers can do much better. 6、 7 medical issues to consider 5 separate

7、thoughts, at least, for each issue 7 x 5 = 35 thoughts 10 patients that afternoon 35 x 10 = 350 thoughts 5 residents under the authors supervision 4 patients seen by each resident 10 thoughts, at least, generated from each patient 5 x 4 x 10 = anther 200 thoughts 350 + 200 = 550 thoughts to be handl

8、ed in total If the doctor does a good job juggling 98% of the time, that still leaves about 10 thoughts that might get lost in the process. 7、Possible solutions: Computer-generated reminders 实用标准 文档大全 Case managers Ancillary services The simplest solution: time Unit2 1、The author implies: ? Peoples

9、inadequate consciousness about the consequence of neglecting the re- emerging infectious diseases Unjustifiability of peoples complacency about the prevention and control of the infectious diseases Unfinished war against infectious diseases 2、Victory declarations: Surgeon General William Stewarts hy

10、perbolic statement of closing “the book on infectious disease”. A string of impressive victories incurred by antibiotics and vaccines The thought that the war against infectious diseases was almost over What followed ever since: Appearance of new diseases such as AIDS and Ebola Comeback of the old a

11、fflictions: ? Diphtheria in the former Soviet Union ? TB in urban centers like New York City ? Rising Group A streptococcal conditions like scarlet fever The fear of a powerful new flu strain sweeping the world 3、Elaborate on the joined battle: 实用标准 文档大全 WHO established a new division devoted to wor

12、ldwide surveillance and control of emerging disease in October 1995. CDC launched a prevention strategy in 1994. Congress raised fund from $6.7 million in 1995 to $26 million in 1997. 4、The borders are meaningless to pathogenic microbes, which can travel from one country to another remote country in

13、 a very short time. 5、TB: Prisons and homeless shelters as ideal places for TB spread Emerging of drug-resistant strain or even multi-drug-resistant strain A ride on the HIV won by attacking the immunocompromised Group A strep: A change in virulence Mutation in the exterior of the bacterium Flu: Con

14、stant changes in its coat (surface antigens) and resultant changes in its level of virulence 6、Examples: Experiment in England is seeing the waning immunity because of no vaccination. Due to poor vaccination efforts, the diphtheria situation in the former Soviet Union is serious. ? The vaccination r

15、ates are dropping in some American cities, and it will lead to more diphtheria and whooping cough. 7、The four areas of focus: 实用标准 文档大全 The need for surveillance Updated science capable of dealing with discoveries in the field Appropriate prevention and control Strong public health infrastructure 8、

16、The infectious diseases such as TB, flu, diphtheria and scarlet fever will never really go away, and the war against them will never end. Unit3 1、Terrys life before She loved practicing Tae Kwon Do She loved the surge of adrenaline that came with the controlled combat of tournaments. She competed na

17、tionally, even won bronze medal in the trials for the Pan American Games. She attended medical school, practiced as an internal medicine resident, and became an academic general internist. She got married and got a son and a daughter. 2、The symptoms of MS and autoimmune disease: Loss of stamina and

18、strength Problems with balance Bouts of horrific facial pain Dips in visual acuity 实用标准 文档大全 3、Terry did the following before she self-experimented: She started injections. She adopted many pharmacotherapies. She began her own study of literature: ? She read articles on websites such as PubMed. ? Sh

19、e searched for articles testing new MS drugs in animal models. ? She turned to articles concerning neurodegeneration of all types dementia， Parkinsons disease, Huntingtons disease, and Lou Gehrigs disease. ? She relearned basic sciences such as cellular physiology, biochemistry, and neurophysiology.

20、 4、Approaches Terry mainly used: Self-experimentation with various nutrients to slow neurodegeneration based on literature reports on animal models Self-experimentation with neuromuscular electrical stimulation which is not an approved treatment for MS Online search to identify the sources of micron

21、utrients and having a new diet Reduction of food allergies and toxic load 5、Cases mentioned in the text: Increased mercury stores in the brains of people with dental fillings High levels of the herbicide atrazine in private wells in Iowa The strong association between pesticide exposure and neurodeg

22、eneration The association of single nucleotide polymorphisms involving metabolism of sulfur and/or B vitamins Inefficient clearing of toxins 实用标准 文档大全 6、With 70% to 90% of the risk for diabetes, heart disease, cancer, and autoimmunity being due to environmental factors other than the genes, we can t

23、ake many health problems and the health care crisis under our control, for example, optimizing our nutrition and reducing our toxic load. Unit4 1、Two concepts: Complementary medicine refers to the use of conventional therapies together with alternative treatments such as using acupuncture in additio

24、n to usual care to help lessen pain. Complementary and alternative medicine is shortened as CAM. Alternative medicine refers to healing treatments that are not part of conventional therapies like acupuncture, massage therapy, or herbal medicine. They are called so because people used to consider pra

25、ctices like these outside the mainstream. 2 TCM does not require advanced, complicated, and in most cases, expensive facilities. TCM employs needles, cups, coins, to mention but a few. Most procedures and operations of TCM are noninvasive. The substances used as medicine are raw herbs or abstracts f

26、rom them, and they are indeed all natural, from nature. TCM has been practiced as long as the Chinese history, so the efficiency is proven and ensured. 实用标准 文档大全 Ongoing research around the world on acupuncture, herbs, massage and Tai Chi have shed light on some of the theories and practices of TCM

27、3、It may be used as an adjunct treatment, an alternative, or part of a comprehensive management program for a number of conditions: post-operative and chemotherapy induced nausea and vomiting, post-operative dental pain, addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fib

28、romyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma. 4、A well-justified NO: More intense research to uncover additional areas for the use of acupuncture Higher adoption of acupuncture as a common therapeutic modality not only in treatment but also in prevent

29、ion of disease and promotion of wellness Exploration and perfection of innovative methods of acupuncture point stimulation with technological advancement Improved understanding of neuroscience and other aspects of human physiology and function by basic research on acupuncture Greater interest by sta

30、keholders An increasing number of physician acupuncturists 5、 Appropriate uses of herbs depend on proper guidance: ? Proper TCM diagnosis of the zheng of the patient ? Correct selection of the corresponding therapeutic strategies and principles that guide the choice of herbs and herbal formulas Digr

31、ession from either of the above guidence will lead to misuses of herbs, and will result in complications in patient 实用标准 文档大全 6、 Randomized controlled trials Advantages: ? Elimination of the potential bias in the allocation of participants to the intervention group or control group ? Tendency to pro

32、duce comparable groups ? Guaranteed validity of statistical tests of significance Limitations: ? Difficulty in generalizing the results obtained from the selected sampling to the population as a whole ? A poor choice for research where temporal factors are an issue ? Extremely heavy resources, requi

33、ring very large sample groups ? Quasi-experiments Advantages: ? Control group comparisons possible ? Reduced threats to external validity as natural environments do not suffer the same problems of artificiality as compared to a well-controlled laboratory setting. ? Generalizations of the findings to

34、 be made about population since quasiexperiments are natural experiments Limitations： ? Potential for non-equivalent groups as quasi-experimental designs do not use random sampling in constructing experimental and control 实用标准 文档大全 groups. ? Potential for low internal validity as a result of not usi

35、ng random sampling methods to construct the experimental and control groups ? Cohort studies Advantages: ? Clear indication of the temporal sequence between exposure and outcome ? Particular use for evaluating the effects of rare or unusual exposure ? Ability to examine multiple outcomes of a single

36、 risk factor Limitations: ? Larger, longer, and more expensive ? Prone to certain types of bias ? Not practical for rare outcomes ? Case-control studies Advantages: ? The only feasible method in the case of rare diseases and those with long periods between exposure and outcome ? Time and cost effect

37、ive with relatively fewer subjects as compared to other observational methods Limitations： ? Unable to provide the same level of evidence as randomized controlled trials as it is observational in nature ? Difficult to establish the timeline of exposure to disease outcome ? “N=1” trials Advantages ?

38、Easy to manage ? Inexpensive 实用标准 文档大全 Limitations： ? Findings difficult to be generalized to the whole population ? Weakest evidence due to the number of the subject 7、 ? Synthesis of evidence is completely dependent on: ? The completeness of the literature search (unavailable for foreign studies)

39、? The accuracy of evaluation There are situations in which no answer can be found for the questions of interest in RCTs and database analyses. Theres the requirement of using less stringent information rather than “hard data” 8、 Assessment of the intrinsic value of traditional medicine in society Re

40、search and education Political, economic, and social factors 实用标准 文档大全 Unit5 1、 Dis-ease refers to the imbalance arising from： ? Continuous stress ? Pain ? Hardships Disease is a health crisis ascribable to various dis-eases. Prompting elimination of dis-eases can alleviate some diseases. 2、 Wellnes

41、s is a state involving every aspect of our being: body, mind and spirit. Manifestations of a healthy person: ? Energy and vitality ? A certain zip in gait ? A warm feeling of peace of heart seen through behavior 3、 Constant messages, positive and negative，are sent to our mind about the health of our

42、 body. Physical symptoms are suppressed by people who go through life on automatic pilot. Being well equals to being disease- or illness-free in the minds of them. They confused wellness with an absence of symptoms. 4、 Peoples minds are infected by spin: ? Half-truth ? Fearful fictions ? Blatant dec

43、eit: some as a form of self-deceit Spin is a result of unconscious living. 实用标准 文档大全 The kind of falseness is pandemic. 5 Our body intelligence is suppressed or dormant from a lack of use. There are tremendous amount of stress on a daily basis. Our bodies are easily ignored for years because of a la

44、ck of recreation time. Limiting, self-defeating and even self-destructive behaviors undermine our wellbeing and keep them from achieving our full potential. 6 We grow more reluctant to take risks. We lose the ability to feel and acknowledge our deepest feelings and the courage to speak our truth. We

45、 continue to deny and repress our feelings to protect ourselves. Fear, denial and disconnection from our bodies and feelings become an unconscious, self-protective habit, a kind of default response to life. 7 A multi-faceted process: ? Looking for roots of and resolutions for the issues in different

46、 dimensions ? Building our wellness toolbox slowly ? Picturing our whole state of being Attention to the little stuff: ? Examining our lives honestly and setting clear intentions to change ? Striving to maintain a balance of our mind, body and spirit ? Taking small steps in the way to perceive and r

47、esolve conflict 8 Try to awaken and evolve in order to live more consciously. Get in touch with our genuine feelings and emotions. Come to terms with the toxic emotions 实用标准 文档大全 Unit6 1、In the past, most people died at home. But now, more and more people are cared in hospitals and nursing homes at

48、their end of life, which of course brings a new set of questions to consider. 2、 Sixty-four years old with a history of congestive heart failure Deciding to do everything medically possible to extend his life Availability of around-the-clock medical services and a full range of treatment choices, te

49、sts, and other medical care Relaxed visiting hours, and personal items from home 3、Availability of around-the-clock medical resources, including doctors, nurses, and facility. 4、 Taking on a job which is big physically, emotionally, and financially Hiring a home nurse for additional help Arranging f

50、or services (such as visiting nurses) and special equipment (like a hospital bed or bedside commode) 5、 Health insurance Planning by a professional, such as a hospital discharge plaimer or a social worker Help from local governmental agencies Doctors supervision at home 6、 Traditionally, it is only

51、about symptom care. Recently, it is a comprehensive approach to improving the quality of life for people who are living with potentially fatal diseases. 实用标准 文档大全 7、 Stopping treatment specifically aimed at curing an illness equals discontinuing all treatment. Choosing a hospice is a permanent decis

52、ion. Unit7 1、 A dying patient Decision whether to withdraw life-support machines and medication and start comfort measures The familys refusal to make any decision or withdraw any treatments 2、 The doctor as exclusive decision-maker The patient as participant with little say in the final choice 3、 R

53、espect for the patient, especially the patient s autonomy Patient-centered care The patient as decision-maker based on the information provided by the doctor 4、 Patients are forced to make decisions they never want to. Patients, at least a large majority of them, prefer their doctors to make final d

54、ecisions. Shifting responsibility of decision-making to patients will bring about more stress to patients and their families, especially when the best option for the patient is uncertain. 实用标准 文档大全 5、Doctors are very much cautious about committing some kind of ethical transgression. 6、 Shouldering r

55、esponsibility together with the patient may be better than having the patient make decisions on their own. Balancing between paternalism and respect for patients autonomy constitutes a large part of medical practice. Unit8 1、 Research: An activity to test hypothesis, to permit conclusions to be drawn, and thereby to deve