1st READING TEST PDF

READING SUB-TEST
Text B
Globally 2% cause-specific disability-adjusted life years (DALYs) for young people are attributed to illicit
drug including cannabis. The study conducted revealed that cannabis and other illegal drugs accounted for
approximately $8.2 billion of the nearly $40 billion cost of substance abuse in Canada in 2002. The probability
of cannabis addiction in heavy or daily user is enormous. The vulnerability increases in adolescents whose risk
of addiction is 16%, while adults have 5–10% risk of becoming addicted. Canadian community health survey
reported that the prevalence of cannabis dependence among adolescent and young adult in 2012 was 5%. A
three-year prospective study in the Netherlands on high-risk young adults reporting heavy use in 2013 found
that nearly 40% developed cannabis dependence.
Text C
Another study in Holland revealed that cannabis dependence was 42%. In 2013 the prevalence of cannabis
abuse or dependence was 7.4% among youth in the USA and the rate was about half (3.55) among adolescents.
National Survey on Drug Use and Health (NSDUH) revealed that cannabis was the illicit drug with the largest
number of persons with past-year dependence or abuse in 2013. Of the 6.9 million persons aged 12 or older
who were classified with illicit drug dependence or abuse in 2013, 4.2 million persons had cannabis
dependence or abuse. Another study conducted in the USA reported that 38.5% of daily cannabis users met
criteria for cannabis dependence. A longitudinal cohort study conducted in Australia in 2002 among young
adults shows a 7% prevalence of cannabis dependence according to DSM-IV criteria for cannabis dependence.
A community household-based survey with a cross-sectional design in Rwanda that aimed to determine the
prevalence of cannabis dependence among adolescent and young adults shows 2.54% prevalence of cannabis
dependence.
BRITISH ACADEMY
READING SUB-TEST
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 increase of the drug influence.
Answer :
2 Use of the drug in the USA.
Answer :
3 lifetime prevalence of cannabis use disorder.
Answer :
4 use of cannabis despite clinically significant distress or impairment.
Answer :
5 common determinants of drug addiction.
Answer :
6 addiction to drug common among young community.
Answer :
7 Prevalence of the drug abuse, drug usage.
Answer :
BRITISH ACADEMY
READING SUB-TEST
Questions 15-20
Complete each of the sentences, 15-20, with a word or short phrase from one of the texts. Each answer may
include words, numbers or both.
15 In the United States, in 2013, the drug was used by of people.
16 Commonly, adults may have about risk of becoming a drug addict
17 The studies in the landlocked East African country shows of cannabis dependence.
18 The sequence of the drug use may end with .
19 It is very much likely that is of higher level among drug addicts
20 explained that the sequence of drug use occurring starts with legal drug and proceeds to
illegal drugs.
BRITISH ACADEMY
READING SUB-TEST
Pulmonary embolism
Pulmonary embolism (PE) is regarded as an elusive diagnosis with a non-specific clinical presentation and has
a tendency to be both over- and underdiagnosed in clinical practice. In the United States of America, venous
thromboembolism (VTE) has been reported as the 3rd commonest cause of mortality. Most patients with PE
are clinically asymptomatic. In fact, PE has been shown to be present in 60–80% of individuals with
confirmed deep vein thrombosis (DVT), despite the absence of symptom in more than half of these patients.
Cardiac arrest following PE has an associated mortality of up to 70% within the first hour of presentation and
an overall mortality of up to 95%. Approximately 90% of episodes of cardiac arrests occur within 1-2 hours
after the onset of symptoms of PE.
Clinically, the cephalic vein is preferred for haemodialysis in patients with chronic renal failure (CRF), to
remove waste products from the blood. The cut-down of the cephalic vein in the deltopectoral groove is
preferred when superior vena caval infusion is necessary. However, cephalic veins exhibit a wide array of
developmental variations in terms of formation, course, and termination. During routine gross anatomy
dissection of the neck of the patient, a rare case of variation of the termination of the cephalic vein in both
right and left upper limbs have been observed. Knowledge of the variations of cephalic vein is important not
only for anatomists but also for surgeons and clinicians as the vein is frequently used for different surgical
procedures and for obtaining peripheral venous access as well.
BRITISH ACADEMY
READING SUB-TEST
Total 126 18.2%
Marketed formulations of liposomes.
Product name Marketed by Uses
Removes wrinkles and dark spots and has

Capture Totale Dior
radiance effect with sunscreen
Dermosome Microfluidics Moisturizer
Decorte Moisture Liposome Face

Decorte Moisturizer
Cream
Decorte Moisture Liposome Eye Moisturizes, firms, and brightens the

Decorte
Cream delicate skin around the eyes
Natural Progesterone Liposomal Skin

NOW Solutions Maintenance of healthy feminine balance
Cream
Hydration, boosts collagen synthesis,

C-Vit Liposomal Serum Sesderma enhances the skin’s elasticity and
firmness, and brightens the complexion
BRITISH ACADEMY
READING SUB-TEST
Questions 1-6
1 Chronic urticaria;
A Is caused by an allergic reaction to a food or drug.
B Arises spontaneously and its cause is unknown.
C Is a genetic disorder that is very rare.
2 Arterial aneurysms;
A Are caused by narrowing of arteries.
B are abnormal dilations of the peripheral arteries.
C Occur due to change in structure and function of the Fibrillin-1.
3 What is correct?
A PE occurs when a clump of material, most often a blood clot, gets wedged into an artery in your lungs.
B Patients with DVT are susceptible to PE.
C PE symptoms, in most of the cases, do not get revealed easily.
4 What is the notice talking about?
A Cleaning of the blood of toxins.
B A major a superficial vein in the arm and disease associated with it.
C A case report.
5 What does the table indicate?
A Tenofovir goes well in coordination with Cycloferon.
BRITISH ACADEMY
READING SUB-TEST
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: What is Creutzfeldt-Jakob Disease?
Creutzfeldt-Jakob disease is a degenerative brain disorder that leads to dementia and, ultimately, death.
Symptoms of Creutzfeldt-Jakob disease (CJD) sometimes resemble those of other dementia-like brain
disorders, such as Alzheimer`s, but Creutzfeldt-Jakob disease usually progresses much more rapidly.
Creutzfeldt-Jakob disease captured public attention in the 1990s when some people in the United Kingdom
developed a form of the disease — variant CJD (vCJD) — after eating meat from diseased cattle. However,
"classic" Creutzfeldt-Jakob disease has not been linked to contaminated beef. Although serious, CJD is rare,
and vCJD is the least common form. Worldwide, there is an estimated one case of Creutzfeldt-Jakob disease
diagnosed per million people each year, most frequently in older adults, if not among children.
Creutzfeldt-Jakob disease is marked by rapid mental deterioration, usually within a few months. Initial signs
and symptoms of CJD typically include personality changes, anxiety, depression, memory loss, impaired
thinking, blurred vision, insomnia, difficulty speaking, difficulty swallowing and sudden, jerky movements. As
the disease progresses, mental symptoms worsen; most people eventually lapse into a coma. Heart failure,
respiratory failure, pneumonia or other infections are generally the cause of death. The disease usually runs its
course in about seven months, although a few people may live up to one or two years after diagnosis. In people
with the rarer CJD, psychiatric symptoms may be more prominent in the beginning, with dementia — the loss
of the ability to think, reason and remember - developing later in the course of the illness. In addition, this
variant affects people at a younger age than classic CJD does, and appears to have the slightly longer duration
of 12 to 14 months.
Creutzfeldt-Jakob disease and its variants belong to a broad group of human and animal diseases known as
transmissible spongiform encephalopathies (TSEs). The name derives from the spongy holes, visible under a
microscope, that develops in affected brain tissue. The cause of Creutzfeldt-Jakob disease and other TSEs
appears to be abnormal versions of a kind of protein called a prion. Normally, these proteins are harmless, but
when they`re misshapen they become infectious and can wreak havoc on normal biological processes. The risk
BRITISH ACADEMY
READING SUB-TEST
placed on your scalp, this test measures your brain`s electrical activity. People with CJD and vCJD show a
characteristically abnormal pattern. Magnetic resonance imaging (MRI): this technique uses radio waves and a
magnetic field to create cross-sectional images of your head and body. It`s especially useful in diagnosing
brain disorders because of its high-resolution images of the brain`s white matter and gray matter. Spinal fluid
tests: cerebrospinal fluid surrounds and cushions your brain and spinal cord. In a test called a lumbar puncture
— popularly known as a spinal tap - doctors use a needle to withdraw a small amount of this fluid for testing.
The presence of a particular protein in spinal fluid is often an indication of CJD or vCJD.
No effective treatment exists for Creutzfeldt-Jakob disease or any of its variants. A number of drugs have been
tested - including steroids, antibiotics and antiviral agents - and have not shown benefits. For that reason,
doctors focus on alleviating pain and other symptoms and on making people with these diseases as comfortable
as possible.
Text 2: Heat Rash
The skin`s job is to protect the inside of the body from the outside world. It acts as a preventive barrier against
intruders that cause infection, chemicals, or ultraviolet light from invading or damaging the body. It also plays
an important role in the body`s temperature control. One way that the body cools itself is by sweating, and
allowing that sweat or perspiration to evaporate. Sweat is manufactured in sweat glands that line the entire
body (except for a few small spots like fingernails, toenails, and the ear canal). Sweat glands are located in the
dermis or deep layer of the skin, and are regulated by the temperature control centers in the brain. Sweat from
the gland gets to the surface of the skin via a duct. A heat rash occurs when sweat ducts become clogged and
the sweat can`t get to the surface of the skin. Instead, it becomes trapped beneath the skin`s surface causing a
mild inflammation or rash. Heat rash is also called prickly heat or miliaria.
It is uncertain why some people get heat rashes and others don`t. The sweat gland ducts can become blocked if
excessive sweating occurs, and that sweat is not allowed to evaporate from a specific area. Some examples of
how blockage may occur include the following: creases in the skin, for example the neck, armpit, or groin
which have skin touching adjacent skin, making it difficult for air to circulate, therefore preventing sweat
evaporation; tight clothing that prevents sweat evaporation; bundling up in heavy clothing or sheets - this may
occur when a person tries to keep warm in the winter or when chilled because of an illness with fever. Heavy
creams or lotions can also clog sweat ducts. Babies have immature sweat glands that aren`t able to remove the
BRITISH ACADEMY
READING SUB-TEST
process may depend more on treating heat rash with remedies such as over-the-counter creams and sprays.
Medical treatment for heat rash may involve antibiotics if the sweat glands become infected.
Text 1 : Questions 7-14
7 Which disease progresses faster?
A Alzheimers
B Jakob
C Both Alzheimer`s and Jakob
D Not given
8 Creutzfeldt-Jakob disease is commonly found among adults or elderly people;
A False
B True
C False, because it is found among children too.
D Not given
9 People affected with the disease may die after;
BRITISH ACADEMY
READING SUB-TEST
D 50% false
13 â€œConfirmation of the Creutzfeldt-Jakob disease can be done only after the death of the
person.â€•
A True
B False
C True in some cases
D Not given
14 What is most helpful in detecting CJD?
A Electroencephalogram (EEG)
B Spinal fluid exams
C MRI
D All of the above
BRITISH ACADEMY
READING SUB-TEST
18 Paragraph 3 talks more about;
A Risk factors
B Who is at risk
C Symptoms
D Development of the disease
19 Heat rash is common in;
A Cold areas
B Areas with higher humidity
C Desert areas
D B and C
20 What is the central idea of paragraph 4?
A Heat rash symptoms.
B Mode of occurrence.
C What heat rash looks like.
DB&C
BRITISH ACADEMY
READING SUB-TEST
ANSWERS
PART A
1. Correct Answer Is: B
2. Correct Answer Is: C

4. Correct Answer Is: A
5. Correct Answer Is: D
8. Correct Answer Is: Six
9. Correct Answer Is: 5%
10. Correct Answer Is: 4.2 Million
11. Correct Answer Is: Young people
12. Correct Answer Is: Rastafarians
13. Correct Answer Is: 7.4%
14. Correct Answer Is: longitudinal cohort study
15. Correct Answer Is: 80.6%
16. Correct Answer Is: 5â€“10%
17. Correct Answer Is: 2.54% prevalence
18. Correct Answer Is: illegal drugs
19. Correct Answer Is: cannabis addiction
20. Correct Answer Is: Gateway hypothesis
PART B & C
1. Correct Answer Is: B Arises spontaneously and its cause is unknown.

2. Correct Answer Is: A Are caused by narrowing of arteries.
3. Correct Answer Is: B Patients with DVT are susceptible to PE.
4. Correct Answer Is: A Cleaning of the blood of toxins.
5. Correct Answer Is: C Adefovir goes well in coordination with Cycloferon.
6. Correct Answer Is: C Microfluidics, Decorte.
7. Correct Answer Is: B Jakob
8. Correct Answer Is: B True
9. Correct Answer Is: D Not given
10. Correct Answer Is: C Transmission
11. Correct Answer Is: D B and C
12. Correct Answer Is: A 100% true
13. Correct Answer Is: C True in some cases
14. Correct Answer Is: D All of the above
15. Correct Answer Is: A Sweat ducts become clogged
16. Correct Answer Is: A Excessive sweat is not allowed to evaporate from the skin
17. Correct Answer Is: B Overdressing
18. Correct Answer Is: B Who is at risk
19. Correct Answer Is: B Areas with higher humidity
20. Correct Answer Is: C What heat rash looks like.
21. Correct Answer Is: A True in some cases
22. Correct Answer Is: A Blockage is high.
BRITISH ACADEMY
READING SUB-TEST
Text B
In the modern era, whole world has experienced tremendous boost in the field of molecular diagnosis by use of
DNA sequencing technology. The human genome contains more than 3 billion base pairs that contain all the
information about our health and well-being. The first whole genome sequence of human was published
successfully before decades. It was very expensive and paid billion dollars to complete. The cost paid for, was
much more worthy as it was providing the first fundamental understanding of the structure and biology of
human genome and relation with diseases. Initially, Next Generation Sequencing technology was generated
huge amount data of human variant later it was proved that this NGS technology is much more effective in the
diagnosis human diseases by use of bioinformatic tools to select pathogenic variants. In present days,
sequencing costs have dramatically declined and therefore it is now routinely using for diagnosis of many rare
inherited diseases including hematology and blood disorder. Genome Wide sequence analysis is already
playing an important role in the hematology field. This new sequencing technology is going to solve the
challenges that researchers in the field of hematology are going forward.
Text C
Nowadays researchers are making disease-specific targeted NGS panel, which is helping more quickly and
precise diagnosis of specific disease in the field of hematology. Keeping in mind the growing research in the
area of molecular diagnosis, how genome-wide analysis has unlocked new avenues of research, diagnosis, and
therapy for benign hematologic disorders. Recent advances in molecular technologies, mainly next-generation
sequencing, inspire us to apply these technologies as a first-line approach for the identification of potential
mutations and to determine the novel causative genes in patients with blood disorders. Researcher have started
preparing targeted NGS panels for diagnosis of hematologic malignancies, Red cell congenital hemolytic
anemia for diagnosis of all rare cause of hemolytic anemia which covers around 70-80 genes associated with
hemoglobinopathies, which will cover gene related alpha (HBA1/2) and beta (HBB) globin gene locus
analysis, HBD sequence analysis, gene related to RBC membrane protein disorders, RBC enzymopathies
BRITISH ACADEMY
READING SUB-TEST
Questions 1-7
more than once.
1 Modern technologies of DNA sequencing
Answer :
2 Determination of the precise sequence of nucleotides in a sample of DNA.
Answer :
3 A source of inspiration
Answer :
4 Early DNA sequencing technologies
Answer :
5 Cost-effective solutions in sequencing
Answer :
6 Clinical databases
Answer :
7 Detection of the disease-causing genes
Answer :
BRITISH ACADEMY
READING SUB-TEST
Questions 15-20
15 Red blood cell affect genes encoding red blood cell enzymes..
16 Today, researchers are busy developed targeted NGS panels which can effectively be used for the purpose
of diagnosis of .
17 The variants obtained were studied by mapping in the of the human reference genome.
18 The key feature of the Sanger method reaction mixture is the inclusion of .
19 analysis is effective and can solve challenges which researchers grappling with
20 NGS is considered the for detection of the disease.
BRITISH ACADEMY
READING SUB-TEST
Huntington’s disease (HD)
Huntington’s disease (HD) is a genetic neurodegenerative disorder that results in chorea, balance and gait
impairments, changes in behavior and declines in cognition. Cognitive decline occurs early in the disease
course, occasionally preceding chorea and motor impairment, and continues to progress throughout the
disease process. Cognitive deficits include difficulty with executive function including trouble with
planning and organizing, problems with working, visual and verbal memory, and impaired concentration.
While gait dysfunction is typically thought to arise primarily from damage to the motor circuitry of the
basal ganglia, studies in elderly populations and other neurologic populations indicate that gait dysfunction
may also be related to changes in cognitive function.
Hypertension - Prevention or Treatment
Adequate changes in lifestyle are the cornerstone for the prevention and treatment of hypertension.
Although rapid medical initiation is necessary for the patients in a high level of risk, lifestyle changes are
fundamental for the therapy. According to the previous report, lowering effects for stable blood pressure
can be equivalent to monotherapy of medicine. Contrarily, the weak point would be the low level of
compliance or adherence associated with necessary time for adequate action. Adequate changes in lifestyle
would be effective for some group of subjects. For grade 1 hypertensive patients, it can prevent or delay
medical therapy. Moreover, for hypertensive patients continuing on medical therapy, it can contribute to
BP reduction of blood pressure and allow reduction of the number and doses of antihypertensive agents.
Appropriate changes in lifestyle would decrease other cardiovascular risk factors and improve several
clinical conditions.
BRITISH ACADEMY
READING SUB-TEST
 Electrocardiogram with disturbance of repolarization only

attributable to RBBB
 The patient developed acute renal failure and haemodialysis was
48 h post-arrival initiated
 During a haemodialysis session, he developed sustained ventricular

tachycardia with degeneration in asystole
After 5 days.  CPR was initiated, there wasn’t a return of spontaneous circulation
 Patient decease
Questions 1-6
1 What does the report indicate?
A Jugular venous engorgement and diffuse pulmonary rales were not found.
B The electrocardiogram (ECG) showed broad R waves.
C The patient was dyspnoeic with SaO2 74%.
2 What does the table indicate?
A Major significant differences were observed in 24-h, daytime and nighttime SBP or DBP when using
the conventional or custom-made pillow.
B No significant differences were observed in 24-h, daytime and nighttime SBP or DBP when using the
conventional or custom-made pillow.
C There are significant changes in Systolic Blood Pressure and Diastolic Blood Pressure.
BRITISH ACADEMY
READING SUB-TEST
Part C
Text 1: Renal Artery Stenosis
Renal artery stenosis (narrowing) is a decrease in the diameter of the renal arteries. The resulting restriction of
blood flow to the kidneys may lead to impaired kidney function (renal failure) and high blood pressure
(hypertension), referred to as renovascular hypertension, or RVHT ("reno" for kidney and "vascular" for blood
vessel). Renovascular hypertension is as likely to occur with bilateral stenosis (when arteries to both kidneys
are narrowed) as with unilateral stenosis (when the artery to one kidney is narrowed). The decreased blood
flow to the kidneys impairs renal function. Renal artery stenosis may cause renal failure in some patients.
There is no predictable relationship between renal failure and renal artery stenosis. Some patients have very
severe bilateral stenosis and normal renal function. Most cases of renal failure are related to diabetes,
hypertension, glomerular sclerosis, contrast nephropathy, drug toxicity and other causes.
The majority of renal artery stenosis is caused by atherosclerosis (hardening and narrowing of blood vessel
wall from the inside) similar to the process that occurs in blood vessels in the heart and other parts of the body.
Risk factors for atherosclerosis include high cholesterol levels, high blood pressure, age, cigarette smoking,
diabetes etc. Less common causes of renal artery stenosis are fibromuscular dysplasia of the vessels
(narrowing of the vessel due to internal thickening of the blood vessel wall), arteritis (inflammation of the
blood vessel), or dissection (tearing and division of the blood vessel wall).
Narrowing of the kidney arteries is more common in individuals 50 years of age and older. It is estimated that
some degree of narrowing (greater than 50%) is found in about 18% of adults between 65-75 years of age and
42% of those older than 75 years of age. This may be due to the fact that atherosclerosis is more common in
this age group. In younger patients, the narrowing of the renal artery is usually due to the thickening of the
artery (fibromuscular dysplasia) and it is more common in women than in men. It is estimated that renal artery
stenosis accounts for approximately 1% of mild to moderate cases of high blood pressure. It may be
responsible for more than 10% of cases of severely elevated or difficult to treat high blood pressure
(hypertension).
BRITISH ACADEMY
READING SUB-TEST
bleeding and how quickly the stool moves through the digestive tract. Sometimes, the bleeding is too little to
be seen by the naked eye but can be tested for by a healthcare professional.
Depending upon where and why the bleeding has taken place in the digestive tract, the stool consistency and
color may vary greatly: the stool color may be bright red, maroon, dark red or black. The bleeding might be
hidden, unseen to the naked eye, but able to be detected by a fecal occult blood test. There may be blood just in
the bowel movement or there may be associated feces. If the feces are formed, the blood may be mixed in with
the stool or it may just coat the surface. The stool may be well-formed or it may lose and diarrhea like. It may
be normal in shape in size or it may become pencil thin. There may be associated with abdominal pain or the
bleeding may be painless.
Hemorrhoids are the most common cause of blood in the stool. Blood vessels located in the walls of the rectum
can swell, become inflamed and bleed. Hemorrhoids can be caused by straining at stool, diarrhea, pregnancy,
obesity and prolonged sitting on the commode. All these factors increase the pressure within the hemorrhoidal
vessels, causing them to swell. The bleeding is often associated with anal burning or itching. Bleeding can also
occur because of an anal fissure, or a split in the skin of the anus. Hard constipated stool may cause the skin to
split; other causes include pregnancy and anal intercourse. Anal fissures are also associated with other diseases
including inflammatory bowel disease (Crohn`s disease, ulcerative colitis), cancer and infections. Anal fissures
tend to be very painful, even when sitting. The blood in the stool can also be due to swallowed blood from a
nosebleed, dental work, or other mouth injuries that cause bleeding.
Rectal bleeding is often diagnosed by history. The health care professional may ask questions about the
circumstances surrounding the rectal bleeding including the color, the amount of bleeding, any associated
symptoms and past medical history. A variety of medications and food can mimic blood in the stool. Iron
supplements and bismuth (Pepto-Bismol, Kaopectate) can turn stool black, as can beets and licorice. Red food
coloring and beets can turn stool into a reddish hue. Patients who take blood thinners (anticoagulation
medications) are more prone to rectal bleeding. Examples of blood thinners include warfarin (Coumadin),
enoxaparin (Lovenox), aspirin and other antiplatelet drugs including clopidogrel (Plavix), prasugrel and
rivaroxaban (Xarelto).
Physical examination is important to assess the patient`s stability. Vital signs are important and may include
orthostatic vital signs, where the blood pressure and pulse rate are taken both lying and standing. In a patient
with reduced blood volume, the blood pressure may fall, the pulse rate may rise, and the patient may become
BRITISH ACADEMY
READING SUB-TEST
Text 1: Questions 7-14
7 Renovascular hypertension is likely to occur with;
A Bilateral stenosis.
B Unilateral stenosis.
C Both bilateral and unilateral stenosis.
D When arteries to one or both kidneys are narrowed.
8 Which one of these statements is true, according to paragraph 1?
A The increase or decrease in blood flow leads to improper functioning of the kidneys
B Renal failure and renal artery stenosis are closely connected to each other
C A patient may have normal renal function even if there is higher bilateral stenosis
D In some cases, bilateral stenosis may affect renal functions too.
9 Renal Artery Stenosis is caused by;
A Hardening of the blood vessel wall from inside.
B Hardening of the blood vessels similar to that of the blood vessels in the heart.
C Narrowing and hardening of the walls like that of blood vessels in the heart.
D Hardening and narrowing of the blood vessels from inside.
BRITISH ACADEMY
READING SUB-TEST
13 The best possible treatment for renal artery stenosis is;
A Controlling the blood pressure.
B Using ARB medications for the quality functioning of the kidneys.
C Improving the function of the kidney through proper medications.
D None
14 Renal artery stenosis is closely associated with;
A Kidney dysfunction.
B High blood pressure.
C Low blood pressure.
DA&B
15 Rectal bleeding describes;
A Blood in the bowels.
B Blood in the digestive tract.
C Blood in the stools.
D Blood in the rectum.
16 Paragraph 2 talks more about;
A Which symptoms are associated with rectal bleeding.
BRITISH ACADEMY
READING SUB-TEST
20 According to paragraph 4, which of the following statements is true?
A Blood thinners can cause rectal bleeding.
B Blood thinners may sometimes cause rectal bleeding.
C It is not fully established that rectal bleeding is the direct result of the use of blood thinners.
D None
21 Which one of the following statements is not included in paragraph 5?
A Physical examiners will always look for orthostatic vital signs.
B A patient may have low blood pressure with a higher pulse rate.
C Palpitations of the abdomen is performed to look for tender areas.
D Rectal bleeding is identified through taking a stool sample.
22 Which one of these is the preferred blood clotting test?
A PT
B INR
C PTT
D Not given
BRITISH ACADEMY
READING SUB-TEST
19. Correct Answer Is: D All of the above

20. Correct Answer Is: A Blood thinners can cause rectal bleeding.
21. Correct Answer Is: D Rectal bleeding is identified through taking a stool sample.
BRITISH ACADEMY
READING SUB-TEST
microbiota. Next, DCs present the captured antigens on MHCI and MHCII molecules to T cells, resulting in
the priming and activation of effector T cell responses against the cancer-specific antigens that are viewed as
foreign or against which central tolerance has been incomplete. The nature of the immune response is
determined at this stage, with a critical balance representing the ratio of T effector cells versus T regulatory
cells being key to the final outcome.
Text C
Finally, the activated effector T cells traffic to and infiltrate the tumor bed, specifically recognize and bind to
cancer cells through the interaction between its T cell receptor (TCR) and its cognate antigen bound to MHCI,
and kill their target cancer cell. The killing of the cancer cell releases additional tumor-associated antigens
(step 1 again) to increase the breadth and depth of the response in subsequent revolutions of the cycle. In
cancer patients, the Cancer-Immunity Cycle does not perform optimally. Tumor antigens may not be detected,
DCs and T cells may treat antigens as self rather than foreign thereby creating T regulatory cell responses
rather than effector responses, T cells may not properly go well with tumors, may be inhibited from infiltrating
the tumor, or (most importantly) factors in the tumor microenvironment might suppress those effector cells
that are produced.
The goal of cancer immunotherapy is to initiate or reinitiate a self-sustaining cycle of cancer immunity,
enabling it to amplify and propagate, but not so much as to generate unrestrained autoimmune inflammatory
responses. Cancer immunotherapies must, therefore, be carefully configured to overcome the negative
feedback mechanisms. Although checkpoints and inhibitors are built into each step that opposes continued
amplification and can dampen or arrest the antitumor immune response, the most effective approaches will
involve selectively targeting the rate-limiting step in any given patient. Amplifying the entire cycle may
provide anticancer activity but at the potential cost of unwanted damage to normal cells and tissues. Many
recent clinical results suggest that a common rate-limiting step is an immunostat function, immunosuppression
that occurs in the tumor microenvironment
BRITISH ACADEMY
READING SUB-TEST
Questions 1-7
more than once.
1 Seven crucial progression acts.
Answer :
2 Initiating Anticancer Immunity.
Answer :
3 Checkpoints and (immunostat function)
Answer :
4 Didn`t achieve any proper result.
Answer :
5 Talking about the process of removal of cancer cells.
Answer :
6 Killing of target cancer cell.
Answer :
7 Immune editing.
Answer :
BRITISH ACADEMY
READING SUB-TEST
Questions 15-20
15 Destroying the cancer cell releases additional .
16 is referred to as partial or complete suppression of the immune response of an individual
17 Majority of the processes with respect to activation of the T-cells comprises use of .
18 Presently, the challenge is how to effectively use this understanding and develop .
19 In , activated effector T cells may entirely infiltrate the tumor bed.
20 The initial step can provide a response only when it is along with , which can clearly show
immunity.
BRITISH ACADEMY
READING SUB-TEST
screening may also be considered based on family history. Screening guidelines continue to be updated as new
research clarifies what recommendations are beneficial, but few participants receive repeat genetic counseling
to update surveillance and surgical recommendations based on a patient’s specific LS gene mutation and
family history.
Hereditary breast cancers account for approximately 10% of all breast cancers, and approximately 23% of all
ovarian cancers are considered hereditary. According to Plakhins et al., BRCA1pathogenic founder mutations
contribute to 3.77% of all consecutive primary breast cancers and 9.9% of all consecutive primary ovarian
cancers. BRCA1 and BRCA2 pathogenic founder mutation analysis is a relatively straightforward and cost-
effective screening strategy to identify mutation carriers.In Latvia, all consecutive breast and ovarian cancer
cases are eligible for BRCA1 pathogenic founder mutations (c.181 T > G, c.4035delA, c.5266dupC) screening,
and the costs of the test are covered by the public health care system.
The average age of PMR patients
Total (female & male)
Female
Male
PMR versus Ath
0,4494
0,2972
0,4217
PMR with Ath versus without Ath
BRITISH ACADEMY
READING SUB-TEST
Patient clinical data.
Features Description Ranges
Age Age (in years) 30–86
Gender 1: male; 0: female 0–1
HTN Hypertension, 0: no; 1: yes 0–1
RBS Random blood sugar 57–180
Chest pain type 0: nonspecific chest pain 0–2
1: atypical chest pain
2: typical angina
HT Height (cm) 133–188
WT Weight (kg) 33–110
DBP Diastolic blood pressure (mmHg) 46–110
SBP Systolic blood pressure (mmHg) 100–170
CAD Coronary artery disease 0: no; 1: yes
BRITISH ACADEMY
READING SUB-TEST
5 What is correct?
A The average age of PMR patients with amyloidosis is higher than the average age of PMR patients
without TA.
B the average age of PMR patients without TA (p < 0.0164) is significantly lower than the average age of
PMR patients without amyloidosis.
C The average age of PMR patients with TA is significantly higher.
6 Patient clinical data shows that the patient;
A is suffering from BP.
B is suffering from heart disease.
C is suffering from chest pain.
6 Patient clinical data shows that the patient;
A is suffering from BP.
B is suffering from heart disease.
C is suffering from chest pain.
BRITISH ACADEMY
READING SUB-TEST
Bacterial infections mostly come from staphylococci and streptococci organisms that can come from your own
skin or upper respiratory tract. The indicating symptoms of bacterial infections are thick, ropy mucus discharge
accompanied with red, irritated and inflamed eyes. Luckily, bacterial eye infections are easily treated with
antibiotic eye drops and, in most cases, will clear up within a few short days. Viral infections are commonly
caused by an enterovirus and often associated with an upper respiratory infection or common cold. Eyes are
red and inflamed and become watery and runny. One of the most common viral infections is epidemic
keratoconjunctivitis, also known as EKC; it is highly contagious and can last up to 2 weeks or more. This viral
conjunctivitis is caused by an adenovirus and does not have a specific treatment to cure the infection. The
doctor may prescribe steroid eye drops and artificial tears to help decrease inflammation, but mostly the virus
simply needs to run its course.
Conjunctivitis may also result from chlamydia and gonococcal infections or STD`s. Usually, the inner eyelid
becomes infected. This condition is more commonly noted in teens and young adults who are sexually active.
When left untreated, this condition may affect newborn infants born to mothers infected with an STD. Signs
may include a history of pelvic pain or vaginitis as well. Patients with Gonococcal infections may feel like a
foreign object is chronically present within their eye, and are more likely to experience burning and
inflammation. It is possible to transfer these conditions to the eye from hand contact so it is important, to help
prevent the spread of infection, that frequent hand washing is adopted by patients and family members.
Treatment usually involves use of antibiotics taken topically or orally and concomitant treatment may be
necessary to treat genital and eye infections.
Text 2: Osteomyelitis is an infection of the bone.
Osteomyelitis is an infection of the bone. Osteomyelitis can occur in infants, children, and adults. Different
types of bacteria typically affect the different age groups: in children, osteomyelitis most commonly occurs at
the ends of the long bones of the arms and legs, affecting the hips, knees, shoulders, and wrists, whereas in
adults, it is more common in the bones of the spine (vertebrae), feet, or in the pelvis. There are several
different ways to develop the bone infection of osteomyelitis. The first is for bacteria to travel through the
bloodstream (bacteremia) and spread to the bone, causing an infection. This mostly occurs when the patient
has an infection elsewhere in the body, such as pneumonia or a urinary tract infection that spreads through the
blood to the bone. An open wound over a bone can lead to osteomyelitis. A recent surgery or injection around
BRITISH ACADEMY
READING SUB-TEST
antibiotics is usually four to eight weeks but varies depending on the type of infection and the response to the
treatments. In some cases, the affected area will be immobilized with a brace to reduce the pain and speed up
the treatment. Sometimes, surgery may be necessary. If there is an area of localized bacteria (abscess), this
may need to be opened, washed out, and drained. If there is damaged soft tissue or bone, this may need to be
removed. If bone needs to be removed, it may need to be replaced with bone graft or stabilized during surgery.
With early diagnosis and appropriate treatment, the prognosis for osteomyelitis is good. Antibiotics regimes
are used for four to eight weeks and sometimes longer in the treatment of osteomyelitis depending on the
bacteria that caused it and the response of the patient. Usually, patients can make a full recovery without
longstanding complications.
However, if there is a long delay in diagnosis or treatment, there can be severe damage to the bone or
surrounding soft tissues that can lead to permanent deficits or make the patient more prone to recurrence. If
surgery or bone grafting is needed, this will prolong the time it takes to recover.
BRITISH ACADEMY
READING SUB-TEST
10 What is the most common symptom of conjunctivitis?
A Mild pain in the eye.
B Watery eyes.
C Reddening of the inner and outer eyelid.
D All of the above.
11 The color of discharge from eyes may be;
A Yellow and green.
B White, yellow and green.
C Yellow or green.
D White or green.
12 Paragraph 3 is focused more on;
A Types of conjunctivitis.
B Types of bacterial conjunctivitis.
C Types of viral conjunctivitis.
D Types of bacterial and viral conjunctivitis.
BRITISH ACADEMY
READING SUB-TEST
16 Which of the following can lead to osteomyelitis?
A Bacterial infection.
B An open wound.
C Underrated bone operation.
D None
17 Symptoms of osteomyelitis in children may include;
A Tenderness in the bone;
B High fever;
C Inability to walk;
D All of the above;
18 Which type of osteomyelitis is slow in the beginning?
A Chronic
B Acute
C Both chronic and acute
D None
BRITISH ACADEMY
READING SUB-TEST
22 According to paragraph 5, delay in treatment of diagnosis may result in;
A Inability to walk properly.
B Permanent damage to bone.
C Removal of affected bone.
D None
BRITISH ACADEMY
READING SUB-TEST
14. Correct Answer Is: C Inflammation of the eyes.

15. Correct Answer Is: C In most of the cases, people who have pneumonia may develop
osteomyelitis.
16. Correct Answer Is: B An open wound.
17. Correct Answer Is: D All of the above;
18. Correct Answer Is: A Chronic
19. Correct Answer Is: D None
20. Correct Answer Is: C Bacterial infected bone
21. Correct Answer Is: D Bone is often replaced with bone graft for perfect treatment.
22. Correct Answer Is: B Permanent damage to bone.
BRITISH ACADEMY
READING SUB-TEST
onset. According to Holmes, symptoms are only met if they begin at the time of the fatigue onset or following
onset. Another case criteria for CFS is referred to as the Oxford Criteria, which stipulate that CFS involves a
“definite” onset as well as clear evidence of infection at the time of onset or first symptoms. Similar to the
Oxford Criteria, the Fukuda criteria describe the onset of the fatiguing illness as “new” and “definite”.
Text B
The terms Myalgic Encephalomyelitis (ME) and Myalgic Encephalomyelitis/chronic fatigue syndrome
(ME/CFS) have corresponding case criteria, which are different from the Fukuda criteria in that they require
what are considered by many to be key symptoms of the illness (e.g. post-exertional malaise and cognitive
dysfunction). The criteria for ME/CFS specify that an individual must have a “significant degree of new onset”
fatigue. Similar to the Holmes criteria for CFS, the case criteria for ME/CFS stipulate that symptoms can only
be counted as meeting criteria if they occur or become significantly worse after the onset of the illness.
Carruthers et al. describe onset as “distinct” and assert that most individuals experience an acute onset;
however, they also assert that some individuals are unhealthy prior to their ME/CFS onset and may not be able
to identify a specific trigger for the development of ME/CFS, or they may experience a more “gradual” or
“insidious” onset.
Text C
Hyde’s Nightingale Definition of ME stipulates that ME is both chronic and disabling and is characterized by
an acute onset. Additionally, Hyde describes ME as an epidemic or an endemic occurring in two phases.
Additionally, Hyde indicates that ME often follows multiple, minor infections in individuals with susceptible
immune systems or immune systems that are weakened by severe stressors. Hyde describes the initial phase of
ME as the Primary Infection Phase, which is characterized as an epidemic or endemic infectious disease with
an incubation period of between four and seven days. He describes the second phase as the Secondary Chronic
Phase, occurring with two to seven days of the Primary Infection Phase. In this phase, Hyde asserts that there
are measurable changes in the central nervous system (CNS) of an affected individual and that this phase is the
BRITISH ACADEMY
READING SUB-TEST
Questions 1-7
more than once.
1 Occurs in two different phases.
Answer
2 All patterns are gradual.
Answer
3 He believed that ME is more complicated.
Answer
4 Controversy over the disease conditions.
Answer
5 No clear definition.
Answer
6 Theory which suggests beginning of body weakening.
Answer
BRITISH ACADEMY
READING SUB-TEST
13 Whose statement signifies that the affected patient may go through a highly secretive and detrimental
beginning?
Answer
14 Who described onset as more debilitating fatigue?
Answer
Similar to the Oxford Criteria
Questions 15-20
15 described the onset phase of ME as the Primary Infection
16 ME may follow infections in patients with not-so-strong immune system
17 CFS criteria are said to have much more similarity with respect to
18 CFS may comprise a onset and strong evidence of infection when there are first signs of
symptoms.
19 The distinction is made between and insidious/gradual onset, but the duration length
prescribed to each category differs.
20 may occur due to an infectious or autoimmune agent.
BRITISH ACADEMY
READING SUB-TEST
IV Insulin Infusions
Patients that have required IV insulin infusions can be transitioned to subcutaneous insulin once infusion rates
are stable and glucose controlled, particularly if a diet has been initiated. Because IV insulin has a very short
half-life, the subcutaneous insulin should be administered prior to discontinuation of IV insulin. The basal
infusion rate during fasting is a good predictor of basal subcutaneous insulin requirements, however, providers
often reduce the amount by 20% upon transition. For instance, if a patient required 1.5 unit/hour of IV insulin
overnight, this would suggest a basal need of approximately 36 units of insulin daily. However, reducing this
by 20% would result in a starting basal dose of 30 units of insulin daily.
Molecule-altering technologies
The advent of molecule-altering technologies and improved synthetic methods has led to the finding of newer
proteins and peptides that resemble human proteins and peptides. Although, capable of producing potential
therapeutic benefits, protein molecules have serious biopharmaceutical concerns such as, poor shelf- life, rapid
degradation in the physiological environment, poor solubility, immunogenicity and antigenicity. These
concerns can be overcome by utilizing the beneficial properties of polyethylene glycols and PEGylation.
‘PEGylation’ is the process of chemical attachment of PEG to bioactive proteins and peptides, to modify their
pharmacokinetic and pharmacodynamic properties.
BRITISH ACADEMY
READING SUB-TEST
Amikacin and gentamicin dosing in critically and noncritically ill patients
Critically ill (%) Non Critically ill (%) P
Dose of amikacin
500 mg every 8 h 9/11 (81.8) 2/5 (40) 0.087*
500 mg every 12 h 1/11 (9.1) 3/5 (60)
500 mg every 24 h 1/11 (9.1) 0/0
Dose of gentamicin
(mg/kg)
5 3/9 (33.3) 0/22 0.003*
4 1/9 (11.1) 0/22
3 3/9 (33.3) 3/22 (13.6)
2.5 1/9 (11.1) 2/22 (9.1)
2 1/9 (11.1) 17/22 (77.3)
BRITISH ACADEMY
READING SUB-TEST
5 Zidovudine can;
Increase decrease of lactate.
Lead to fatty change
Be used for treating anemia
6 The table
doesnt show a much significant difference in gentamicin doses between two groups of patients
Use of gentamicin dose is significantly lower
Dose of 2 mg/kg is higher in noncritically ill patients.
Part C
BRITISH ACADEMY
READING SUB-TEST
Children are infected more often than adults, and the infection is more common in the winter. Y. enterocolitica
infections are generally diagnosed by detecting the organism in stools. Many laboratories do not routinely test
for Y. enterocolitica, so it is important to notify laboratory personnel when infection with this bacterium is
suspected so that special tests can be done. The organism can also be recovered from other sites, including the
throat, lymph nodes, joint fluid, urine, bile, and blood. Uncomplicated cases of diarrhea due to Y.
enterocolitica usually resolve on their own without antibiotic treatment. However, in more severe or
complicated infections, antibiotics such as aminoglycosides, doxycycline, trimethoprim-sulfamethoxazole, or
fluoroquinolones may be useful.
There are many things which can be done to prevent the infection or the spread of the infection:
Avoid eating raw or undercooked pork. Consume only pasteurized milk or milk products. Wash hands with
soap and water before eating and preparing food, after contact with animals, and after handling raw meat. After
handling raw chitterlings, clean hands and fingernails scrupulously with soap and water before touching infants
or their toys, bottles, or pacifiers. Someone other than the food handler should care for children while
chitterlings are being prepared. Prevent cross-contamination in the kitchen - use separate cutting boards for
meat and other foods, carefully clean all cutting boards, counter-tops, and utensils with soap and hot water
after preparing raw meat. Dispose of animal feces in a sanitary manner.
Text 2 : What is an MRI scan?
An MRI (or magnetic resonance imaging) scan is a radiology technique that uses magnetism, radio waves, and
a computer to produce images of body structures. The MRI scanner is a tube surrounded by a giant circular
magnet. The patient is placed on a moveable bed that is inserted into the magnet. The magnet creates a strong
magnetic field that aligns the protons of hydrogen atoms, which are then exposed to a beam of radio waves.
This spins the various protons of the body, and they produce a faint signal that is detected by the receiver
portion of the MRI scanner. The receiver information is processed by a computer, and an image is produced.
The image and resolution produced by MRI are quite detailed and can detect tiny changes of structures within
the body. For some procedures, contrast agents, such as gadolinium, are used to increase the accuracy of the
BRITISH ACADEMY
images.
An MRI scan can be used as an extremely accurate method of disease detection throughout the body. In the
head, trauma to the brain can be seen as bleeding or swelling. Other abnormalities often found include brain
READING SUB-TEST
trained to interpret images of the body. The interpretation is transmitted in the form of a report to the
practitioner who requested the MRI scan. The practitioner can then discuss the results with the patient and/or
family.

BRITISH ACADEMY
7 Yersiniosis occurs more commonly in;
Children
READING SUB-TEST
Prevention of the disease
Spread of the infection
How common the infection of Y. enterocolitica is
Reports by Active Surveillance Network.
12 Paragraph 5 talks about;
Diagnosis
Treatment
Spread of the infection and its control.
A&B
13 Which of these can be derived from Paragraph 5?
Treatment is not required for the infection caused by Y. enterocolitica.
BRITISH ACADEMY
Diarrhea requires no treatment
Complications which are mild can be resolved easily.
None
14 What is said about chitterlings?
Handling raw chitterlings with care is necessary

READING SUB-TEST
Brain tumours and spinal cord injury.
All
18 An MRI can;
Detect brain tumors.
Give a clear picture of spinal cord injury and other soft tissues related to it.
Give clear pictures to evaluate the structure of the heart and aorta.
All
19 Paragraph 3 talks about;
Detection of the diseases through an MRI scan.
Importance of taking an MRI scan.
Risks of an MRI scan.
None
20 Metallic materials mentioned in paragraph 3 include;
Surgical clips. BRITISH ACADEMY
Artificial joints, metallic bone plates.

READING SUB-TEST

8. Correct Answer Is: Hyde
9. Correct Answer Is: DeLuca
10. Correct Answer Is: Oxford Criteria
11. Correct Answer Is: Holmes
12. Correct Answer Is: DeLuca et al.
13. Correct Answer Is: Carruthers
14. Correct Answer Is: Bell
15. Correct Answer Is: Hyde
16. Correct Answer Is: Multiple Minor
17. Correct Answer Is: Fukuda Criteria
18. Correct Answer Is: Sudden Correct Answer Is: Acute Onset
19. Correct Answer Is: Hydes
20. Correct Answer Is: Primary Me
PART B & C
1. Correct Answer Is: A hemiplegic gait may include body asymmetry, decreased weight bearing on the
affected side.
2. Correct Answer Is: Postoperative care.
3. Correct Answer Is: has flared up more concerns.
4. Correct Answer Is: best exercise timing
5. Correct Answer Is: Lead to fatty change
6. Correct Answer Is: Use of gentamicin dose is significantly lower
7. Correct Answer Is: Children
8. Correct Answer Is: 1-3 weeks
9. Correct Answer Is: Y. pestis
10. Correct Answer Is: Blood transfusion
11. Correct Answer Is: How common the infection of Y. enterocolitica is
12. Correct Answer Is: A & B
13. Correct Answer Is: None
14. Correct Answer Is: Washing hands with soap before touching infants or their toys is vital
15. Correct Answer Is: Only when the information, detected by the receiver is processed by a computer.
16. Correct Answer Is: Dense
17. Correct Answer Is: All
18. Correct Answer Is: All
19. Correct Answer Is: Risks of an MRI scan.
21. Correct Answer Is: How a patient prepares for an MRI scan and how it is performed.
22. Correct Answer Is: All of the above.
OET 2.0 READING TASK 5

BRITISH ACADEMY
READING SUB-TEST
NSIP is the more common subtype of inflammation in ILD. 77% of SSc-ILD is NSIP. A large number of
clinical and pathological studies have confirmed that a high-resolution CT (HRCT) pattern in patients is
correlated with pathologic NSIP and pathologic UIP. NSIP pattern is associated with better patient outcome
than UIP pattern. It includes reticular, frosted glass shadows, hollow, thickened honeycomb lung nodules,
emphysema, bronchial vascular bundles, bullae, traction bronchiectasis, cobblestone-like appearance,
bronchial tree, bronchiectasis and so on. The most common manifestation of NSIP is lobular reticular
formation in the pleural and basal regions. UIP is mainly represented by grid or honeycomb shadow. Different
patterns in HRCT can reflect NSIP and UIP. The extent of ILD lesions can be graded according to HRCT. At
present, the commonly used methods for clinical detection of ILD are HRCT, pulmonary function tests (PFTs)
(react as per sensitivity), bronchoalveolar lavage fluid (BALF), lung biopsy. HRCT has now become the most
common and sensitive imaging method for diagnosing ILD as it offers the most detailed images of the lungs.
Text C
KL-6
Krebs von den Lungen-6 (KL-6) is an important serum marker for ILD. It is a high molecular weight, mucin-
like glycoprotein secreted by type-II alveolar pneumocytes and bronchial epithelial cells in response to cellular
damage and regeneration in patients with ILD. KL-6 is a mucin-associated glycoprotein, which may be a
trigger for TGF-β signaling and fibrosis. The level of KL-6 as a predictive factor could be used to identify the
clinical development of ILD. Hideaki et al retrospectively analyzed the medical records of 29 patients with
SSc-ILD. They found serum KL-6 correlated positively with diffusing capacity of the lung for carbon
monoxide (DLCO)(% predicted) and disease extent on HRCT, and the changes in serum levels of KL-6 were
significantly related to the changes in forced vital capacity (FVC) in SSc -associated ILD. Their study suggests
KL-6 can be a useful monitoring tool of SSc-ILD activity.
Text D
BRITISH ACADEMY
READING SUB-TEST
1 One of the major aspects of assessment of the how ILD may develop.
Answer
2 Detection or assessment of the ILD lesions.
Answer
3 Talk of naturally occurring molecule, gene, or characteristic by which a particular pathological or

physiological process, disease, etc. can be identified.
Answer
4 Common features of the disease.
Answer
5 Production of the protein in response to damage to cell.
Answer
6 SSc more commonly occurs with the ILD.
Answer BRITISH ACADEMY

READING SUB-TEST
13 What can be considered a perfect monitoring tool of SSc-ILD activity?
Answer
14 Which lipoprotein complex plays an essential role in reducing surface tension at the air-liquid interface of
the lung?
Answer
Questions 15-20
15 is a form of lung disease characterized by progressive scarring of both lungs
16 are recorded to have shown a remarkable increase with more deteriorating ILD conditions.
17 As per HRCT, it can be easy to analyze the extent of the
18 The sensitivities in detecting CT-positive ILD was SP-D.
19 The surfactant may include and hydrophilic proteins.
20 There are four major methods for clinical detection of
Part B BRITISH ACADEMY

READING SUB-TEST
Granulomatous– Lymphocytic Interstitial Lung Disease (GLILD)
Granulomatous– Lymphocytic Interstitial Lung Disease (GLILD is an inflammatory pulmonary complication

of common variable immunodeficiency (CVID) with distinctive patterns in the biopsy; granulomatous disease,
lymphocytic interstitial disease, follicular bronchiolitis and areas of organizing pneumonia. The
immunological data of the pathophysiology suggests that it is initiated by an infiltration of T as well as B
lymphocytes and macrophages, that will further lead the progression of the inflammatory process to fibrosis.
Regarding the treatment of this disease there are many immunomodulatory treatments with few standardized
protocols, but recent studies suggest that the combination of Rituximab and Azathioprine could be effective for
preserving the pulmonary function.
CCL2 is known as monocyte chemoattractant protein-1 (MCP-1). MCP-1 is a member of the C-C chemokines.
In vivo studies suggest that MCP-1 recruits monocytes/ macrophages to sites of inflammation in a wide variety
of pathological conditions, including ILD. The plasma level of CCL2 is correlated with FVC value in SSc.
However, there was no correlation between ILD severity and primary fibrotic genes such as collagen. That
might be because skin fibrosis peaks early during the course of SSc and improves later, while fibrosis in
pulmonary tissue continues to progress even at later stages of disease. A study examined serum levels,
spontaneous production by peripheral blood mononuclear cells (PBMC), and histological distribution in the
affected skin, of MCP-1. Elevated serum levels of MCP-1 significantly correlated with the presence of
pulmonary fibrosis. MCP-1 was expressed in mononuclear cells or vascular endothelial cells in 41% (9/22) of
SSc patients. The frequency of infiltrating mononuclear cells and endothelial cells that produced MCP-1 was
significantly higher in SSc patients with early onset than in SSc patients with late onset.
BRITISH ACADEMY
READING SUB-TEST
Antibody Positive Antibody Negative P-value
SSA 247.07 ± 146.30 (n=14) 221.91 ± 135.50 (n=28) 0.78
ANA 247.56 ± 139.76 (n=12) 223.49 ± 139.22 (n=30) 0.56
RF 253.14 ± 134.46 (n=31) 153.46 ± 128.09 (n=11) 0.04
CCP 244.02 ± 130.55 (n=26) 206.01 ± 152.86 (n=16) 0.22
1 What does this notice explain?

BRITISH ACADEMY
Effects of obesity.
Effects of weight loss.

READING SUB-TEST
The thresholds based on the FRAX HF risk score with or without DXA.
6 The table clearly shows that;
there are high differences in serum CXCL10 concentration between SSA positive and SSA negative
subjects.
The RF-positive group had significantly elevated score.
The RF-positive group had an average CXCL10 concentration for the RF-negative group.
Part C
In this part of the test, there are two texts about different aspects of healthcare.BRITISH
For questions
ACADEMY7-22, choose the
READING SUB-TEST
patients with secondarily generalized tonic-clonic seizures may be candidates for curative epilepsy surgery,
whereas primarily generalized tonic-clonic seizures are not surgical candidates, because there is no seizure
origin site (focus) to remove.
Atonic seizures are epileptic drop attacks. Atonic seizures typically occur in children or adults with widespread
brain injuries. People with atonic seizures suddenly become limp and may fall to the ground and football
helmets are sometimes required to protect against serious injuries. A myoclonic seizure is a brief un-sustained
jerk or series of jerks, less organized than the rhythmic jerks seen during a generalized tonic-clonic seizure.
Other specialized seizure types are occasionally encountered. Tonic seizures involve stiffening of muscles as
the primary seizure manifestation: arms or legs may extend forward or up into the air; consciousness may or
may not be lost. By definition, the clonic (jerking) phase is absent. Classification can be difficult, because
stiffening is a feature of many complex partial seizures. Tonic seizures, however, are much less common than
complex partial or tonic-clonic seizures. Patients can have more than one seizure type. One seizure type may
progress into another as the electrical activity spreads throughout the brain. A typical progression is from a
simple partial seizure, to a complex partial seizure (when the patient becomes confused), to a secondarily
generalized tonic-clonic seizure (when the electrical activity has spread throughout the entire brain). The brain
has control mechanisms to keep seizures localized. Antiepileptic medications enhance the ability of the brain
to limit the spread of a seizure.
Text 2: Fascioliasis Infection

BRITISH ACADEMY
Fascioliasis is a parasitic infection typically caused by Fasciola hepatica, which is also known as "the common
liver fluke" or "the sheep liver fluke." A related parasite, Fasciola gigantica, can also infect people. Fascioliasis
is found in all 5 continents, in over 50 countries, especially where sheep or cattle are reared. People usually
become infected by eating raw watercress or other water-based plants contaminated with immature parasite
larvae. The immature larval flukes migrate through the intestinal wall, the abdominal cavity, and the liver
READING SUB-TEST
themselves by not eating raw watercress and other water plants, especially from endemic grazing areas. As
always, travelers to areas with poor sanitation should avoid food and water that might be contaminated
(tainted). Vegetables grown in fields that might have been irrigated with polluted water should be thoroughly
cooked, as should viscera from potentially infected animals.
In the early (acute) phase, symptoms can occur as a result of the parasite's migration from the intestine to and
through the liver. Symptoms can include gastrointestinal problems such as nausea, vomiting, and abdominal
pain/tenderness. In addition, fever, rashes and difficulty breathing may occur. During the chronic phase (after
the parasite settles in the bile ducts), the clinical manifestations may be similar or more discrete, reflecting
inflammation and blockage of bile ducts, which can be intermittent. Inflammation of the liver, gallbladder and
pancreas can also occur.
7 Motor seizures are; BRITISH ACADEMY
Simple partial seizures
Partial seizures
READING SUB-TEST
None
11 Which type of seizure occurs in childhood and may persist into adulthood?
Grand mal seizures
Petit mal seizures
Both A and B
None
12 Which seizures arise from a focally abnormal part of the brain?
Petit mal seizures
Grand mal seizures
Secondarily generalized seizures
Both B and C
13 As per the given information, who may undergo surgery?
Patients with grand mal seizures BRITISH ACADEMY
Patients with secondarily generalized seizures
Patients with primarily generalized tonic-clonic seizures

READING SUB-TEST
A and B
17 Paragraph 3 talks about which of the following;
Biology of Fasciola hepatica
Time period in a snail
Initial stages of the development of the parasite
Complete life cycle
18 Which of these forms survives for a longer period of time?
Cercariae
Metacercariae
Miracidia
Fasciola eggs
19 Which of these topics does paragraph 4 talk about?
BRITISH ACADEMY
How infection occurs in humans
How animals get infected
How plants get infected

READING SUB-TEST
Possibility of infection spreading to other parts of the body
ANSWERS
PART A
BRITISH ACADEMY

READING SUB-TEST
OET 2.0 READING TASK 6BRITISH ACADEMY
Part A
TIME: 15 minutes
READING SUB-TEST
various inflammatory cytokines. Several studies have shown that serum chemokines including CX3CL1,
CCL5, CXCL9, and CXCL10 are increased in active RA patients compared to healthy controls.. Particularly,
several studies have found that CXCL10 could serve as a disease activity marker in RA. Elevated CXCL10
and CXCL13 levels have been shown to be predictive of a favorable response to TNF inhibitor therapy.
Studies have also shown that serum chemokine levels, including CXCL9, CXCL10 and CXCL16 decrease
after treatment with disease-modifying antirheumatic drugs or biologic agents.
Text C
Previous studies have shown a wide variation in anti-SSA prevalence across different RA populations. It is
possible that the increased frequency of anti- SSA in AA subjects may be due to an increased frequency of
secondary Sjogren’s Syndrome. Co-existent RA and SS may then partially explain the increased disease
activity and worse clinical outcomes seen in AA RA patients. However, it was not possible to determine the
prevalence of Sjogren’s Syndrome in our cohort with the available data. The AA group also had a higher
prevalence of anti-SSB than the CAU group (4.26% vs. 1.08%). This was not a statistically significant
difference; however, there were only 5 total patients that were anti-SSB positive. The biological and clinical
implications of the increased prevalence of anti-SSA and ANA in AA RA patients are currently unknown.
However, several studies have suggested that autoantibody profiles may be clinically significant. Specifically,
anti-SSA has been shown to be associated with more severe disease in multiple connective tissue disease and it
is also involved in the molecular pathogenesis of immune dysregulation in Sjogren’s Syndrome.
Text D
BRITISH ACADEMY
In RA, a predominance of Th17 cytokines, including IFN-γ and TNF have been suggested to be of
pathological importance. IFN-γ induces several chemokines including CXCL9, CXCL10, and CXCL11.
Increased CXCL10 has been detected in the serum and synovial fluid of RA patients and in the saliva of
Sjogren’s Syndrome patients compared to healthy controls. Additionally, this chemokine may have clinical
significance as a human phase II clinical trial using an anti-CXCL10 monoclonal antibody (MDX-1100)
READING SUB-TEST
Answer
2 Enhanced clinical response observed in AA RA patients.
Answer
3 doesn’t create a more effective response with respect to drug.
Answer
4 Their name is derived from their ability to induce directed chemotaxis in nearby responsive cells.
Answer
5 Despite differences in autoantibody prevalence, it is currently unknown if there is a higher. occurrence of

clinically diagnosed Sjogren’s Syndrome in AA RA patients.
Answer
6 The AA group is reported to have a large number of anti-SSB.
Answer BRITISH ACADEMY
7 signaling protein involved in systemic inflammation.
Answer
READING SUB-TEST
14 What does the study suggest with respect to CXCL10?
Answer
Questions 15-20
15 levels often go down when target-specific drugs are used.
16 Anti-SSA is found in between of RA patients
17 can be defined as having or being a positive serum reaction especially in a test for the
presence of an antibody
18 Increased levels are known to be predictive of a favorable response to TNF inhibitor

therapy.
19 The reason for the increased frequency of can be directly linked to enhanced frequency of
secondary Sjogren’s Syndrome.
20 The research performed clearly indicate that there is no association between anti-SSA positivity
and
BRITISH ACADEMY
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.
1
READING SUB-TEST
Anti-reabsorption medications
Presently, anti-reabsorption medications are most widely used for treating osteoporosis. Zoledronic acid
(Aclasta) is a common clinical anti-reabsorption medication. As the third generation of bisphosphonates (BPs),
it outperforms the previous nitrogen-containing BPs in improving patients’ balance and quality of life by
inhibiting bone resorption and increasing bone mineral density (BMD). It is administered via intravenous drip
infusion once a year, which, therefore, brings good compliance with treatment. However, those who have been
treated with zoledronic acid intravenously are likely to suffer from acute side effects, such as fever, bone and
joint pain and flu-like symptoms, especially after the first administration. Although the common adverse
reactions generally disappear within 72 h, or in rare cases, last 7 to 10 days without recurrence, they have
serious impacts on the aging population, especially those with underlying diseases. Thus, the patients who are
afraid of any adverse reactions or have suffered from any side effects during the first administration may show
poor compliance with the second dose and refuse the clinical application of zoledronic acid.
Cancer - Brief Overview
Historically, individuals with cancer have rarely survived past the latency periods inherent to the development
of treatment-induced malignancies, but improvements in systemic and radiation therapy have increased the
time for these second primaries to emerge. In the past 15 years, advances in cancer diagnostics, therapy and
supportive care have significantly increased disease-free survival and overall survival rates in cancer patients.
BRITISH ACADEMY
A proper care plan is reported to have increased 10 or more years beyond their initial diagnosis and introduced
the potential for secondary cancers induced by therapy. It is possible that the incidence of treatment-induced
cancers may increase in the future. Long-term toxicity of cancer treatments both from systemic chemotherapy
and radiation therapy become an important survivorship concern for patients and their physicians.
5
READING SUB-TEST
Distribution of the personal profile of evaluated patients.
Factor evaluated n % p-value¹
Gender
Male 17 21.0
<0.001
Female 64 79.0
Age
Less than 60 years 19 23.5
60 to 70 years 38 46.9 0.028
Over 70 years 24 29.6
BRITISH ACADEMY
1 The manual talks about;
Steps to improving interpersonal communication with patients.
How to effectively deal with the patients.
Steps with regard to clinician-patient communication.
2 Duodenal duplication;
READING SUB-TEST
The majority of the patients were male.
People who are aged 60-70 are more in number.
The majority of the patients were females.
Part C
BRITISH ACADEMY
Text 1: Paget's Disease

READING SUB-TEST
normal bone growth. Your physician may prescribe an oral medication such as Alendronate (Fosamax) or
etidronate (Didronel) to be taken orally every day for 6 months; Tiludronate (Skelid) to be taken orally every
day for 3 months, Risedronate (Actonel) to be taken orally every day for 2 months. All oral medications should
be taken with a large glass of water (6-8 oz) upon rising in the morning. Patients should remain upright for the
next 30 minutes and not eat until that time has passed. Any of these treatments can be repeated if necessary.
Side effects of these medicines may involve heartburn and sometimes an increase in bone pain for a short
period of time.
There are also injectable medications that can be given to a patient for Paget's which include Pamidronate
(Aredia), which is injected into the vein once a month or once every few months. The injection takes a few
hours. Unusually, there is inflammation of the eye or loss of bone around the teeth (osteonecrosis);
Zoledronate (Reclast), which is injected in the vein once a year. The injection takes less than 30 minutes;
Calcitonin, a hormone that is injected under the skin several times a week. Surgery for arthritis caused by
Paget's disease is effective in reducing pain and improving function. Medical treatment is not expected to
correct some of the changes of the Paget's disease that have already occurred, such as hearing loss, deformity
or osteoarthritis.
Text 2: Pancreatic Cancer
Cancer is a class of diseases characterized by out-of-control cell growth, and pancreatic cancer occurs when
this uncontrolled cell growth begins in the pancreas. Rather than developing into healthy, normal pancreas
tissue, these abnormal cells continue dividing and form lumps or masses of tissue called tumors. Tumors then
interfere with the main functions of the pancreas. If a tumor stays in one spot and demonstrates limited growth,
it is generally considered to be benign. More dangerous, or malignant, tumors form when the cancer cells
BRITISH ACADEMY
migrate to other parts of the body through the blood or lymph systems. When a tumor successfully spreads to
other parts of the body and grows, invading and destroying other healthy tissues, it is said to have
metastasized. This process itself is called metastasis, and the result is a more serious condition that is very
difficult to treat. In the United States each year, over 30,000 people are diagnosed with pancreatic cancer.
Europe sees more than 60,000 diagnosed each year. In Asian countries, numbers can be even higher than that.
READING SUB-TEST
These include cirrhosis or scarring of the liver, Helicobacter pylori infection (infection of the stomach with the
ulcer-causing bacteria H. pylori), diabetes mellitus, chronic pancreatitis (inflammation of the pancreas), and
gingivitis or periodontal disease.
In order to detect pancreatic cancer, physicians will request a complete physical examination as well as
personal and family medical histories. The way in which cancer presents itself will differ depending on
whether the tumor is in the head or the tail of the pancreas. Tail tumors present with pain and weight loss while
head tumors present with steatorrhea, weight loss, and jaundice. Doctors also look for recent onset of atypical
diabetes mellitus, Trousseau's sign, and recent pancreatitis. In general, when making a pancreatic cancer
diagnosis, physicians pay special attention to common symptoms such as abdominal or back pain, weight loss,
poor appetite, tiredness, irritability, digestive problems, gallbladder enlargement, blood clots (deep venous
thrombosis (DVT) or pulmonary embolism), fatty tissue abnormalities, diabetes, swelling of lymph nodes,
diarrhea, steatorrhea, and jaundice.
BRITISH ACADEMY
7 Pagets disease;
Affects more women than men;

READING SUB-TEST
All of the above.
11 Which of the following statements is right as per the given information in the passage?
If one member of the family is affected with Pagets disease then other members will also be affected.
If one member of the family is known to have Pagets disease then others can also be affected.
Pagets disease is highly hereditary.
Pagets disease, is both heritable and inheritable.
12 Pick the correct statement as per the given information in the passage;
Those who reach the age of 40 shall undergo blood tests and urine tests for the identification of Pagets
disease.
Physicians should always advise the patients to go for a non-invasive bone scan.
Increase is indicative of the development of the bone at a rapid speed.
It is necessary to do a biopsy of the bone to understand the nature of the disease.
BRITISH ACADEMY
13 What is right about oral medications?
May increase bone pain.
Should be taken only during the morning.
May disturb physiological function.

READING SUB-TEST
When tumors are grown automatically in other parts of the body.
17 Pancreatic cancer is most commonly associated with.
Endocrine gland
Exocrine gland
Cystadenomas
Adenocarcinomas
18 Ampullary cancer is associated with.
Endocrine gland
Exocrine gland
Pancreatic duct
None
19 Failure of apoptosis results in;
Pancreatic cell growth
Enlargement of the pancreatic duct
Cancerous tissues in the pancreas

BRITISH ACADEMY
B&C
20 A cancerous growth in the pancreas is a result of;
Specific carcinogens
Family Genes
READING SUB-TEST

8. Correct Answer Is: CXCL9
9. Correct Answer Is: Th17 cytokines
10. Correct Answer Is: variation in anti-SSA prevalence
11. Correct Answer Is: Anti SSA
12. Correct Answer Is: CXCL10
13. Correct Answer Is: serum chemokines
14. Correct Answer Is: relation between RF seropositivity & CXCL10 levels
15. Correct Answer Is: Serum Chemokine
16. Correct Answer Is: 3-16%
17. Correct Answer Is: Seropositivity
18. Correct Answer Is: Cxcl10 And Cxcl13
19. Correct Answer Is: Anti- Ssa In Aa
20. Correct Answer Is: Cxcl10
PART B & C
1. Correct Answer Is: Steps to improving interpersonal communication with patients.

2. Correct Answer Is: is associated with various anomalies.
3. Correct Answer Is: Can have a detrimental effect on elderly people.
4. Correct Answer Is: Future course of action.
5. Correct Answer Is: The majority of patients remained hospitalized for 5 days or more
6. Correct Answer Is: The majority of the patients were females.
7. Correct Answer Is: Affects a higher number of men than women.
8. Correct Answer Is: Arthritis in its final stage.
9. Correct Answer Is: Rebuilding of bone is accelerated.
10. Correct Answer Is: Lower back pain, loss of hearing and discomfort.
11. Correct Answer Is: Pagets disease, is both heritable and inheritable.
12. Correct Answer Is: Increase is indicative of the development of the bone at a rapid speed.
13. Correct Answer Is: Should be taken only during the morning.
14. Correct Answer Is: Surgery can get rid of Pagets disease.
15. Correct Answer Is: Benign and malignant
16. Correct Answer Is: When harmful tumors invade and destroy other healthy tissues of the body.
17. Correct Answer Is: Exocrine gland
18. Correct Answer Is: Exocrine gland
19. Correct Answer Is: Cancerous tissues in the pancreas
20. Correct Answer Is: Genetic mutations
21. Correct Answer Is: Pesticides, dyes and chemicals used for refining metals
BRITISH ACADEMY
22. Correct Answer Is: Pulmonary edema and enlargement of the gallbladder
READING SUB-TEST
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.
Text A
Galectin-3
It is well known that there is a close relation between obesity-induced insulin resistance, immune cells
accumulation in white adipose tissue (WAT) and inflammation. Indeed, in obesity WAT is characterized by an
increased production and secretion of a wide range of inflammatory cytokines including TNF-alpha and
interleukin (IL)- 6, which may have local effects on endothelial, vasculature and target adipose tissues.
Therefore, activated macrophages and other antigen presenting cells that are accumulated in elevated number
in fat tissue in both types of obese actively secrete a broad spectrum of locally produced pro-inflammatory
cytokines including galectin-3 (Gal-3). Gal-3 is a beta-galactoside-binding lectin belonging to a
multifunctional protein family, which enhances chemotaxis of immune and antigen presenting cells, reduces
insulin-stimulated glucose uptake in myocytes and adipocytes and impairs insulin-mediated suppression of
glucose output in hepatocytes. Gal-3 may bind directly to the insulin receptor (IR) and thereby inhibit
downstream insulin resistance signaling via diminishing interleukin-1 beta production. Therefore, Gal- 3 is a
modulator of apoptosis, necrosis and fibrosis associated with extracellular remodeling.
BRITISH ACADEMY
Text B
Gal-3 is increased in obesity and mediates inflammation and fibrosis in the heart and vessels, as well as in the
WAT. The most preclinical and clinical studies suggest that this protein protects from inflammation in obese,
while there is a large body of evidence regarding the ability of Gal-3 to deteriorate glucose homeostasis,
modulate cell adhesion and induce pro-oxidant pathways. Interestingly, the low serum Gal-3 concentrations
are closely associated with insulin resistance in patients with type 2 diabetes mellitus. In contrast, an inverse
READING SUB-TEST
diabetes in obese individuals. The effect of brain NPs might relate to an ability of natriuretic peptides to
activate a thermogenic program in brown and white fat tissues, increase energy expenditure and inhibit food
intake. Thus, NPs might play several metabolic roles in the development of different phenotypes of obesity,
but their predictive role in CV disease development in obese patients is uncertain.
Questions 1-7
BRITISH ACADEMY
more than once.
1 Role of this metabolic hormones is not yet certain.
Answer
READING SUB-TEST
Answer
9 What are more associated with insulin resistance?
Answer
10 What can have the potential to have direct impact on insulin resistance?
Answer
11 What defines an abnormal amount of lipids?
Answer
12 What are the markers of biomechanical cardiac stress?
Answer
13 What is associated with programmed cell death? BRITISH ACADEMY
Answer
14 What causes the cardiac wall to stretch and volume overload of cardiac cavities?
Answer
Questions 15-20
READING SUB-TEST
genotype. Patients who have genotypes for slow acetylation are found to be more predisposed to sulfasalazine-
induced liver toxicity. Injury can be hepatocellular which presents with disproportionate elevation in serum
aminotransferases or cholestasis which presents with disproportionate elevation in alkaline phosphatase. Both
patterns of liver injury can have elevation in bilirubin and abnormal tests for liver synthetic function.
Adiponectin
Adiponectin accounts for 0.01% of plasma protein with a half-life of 2.5 h; normal adiponectin plasma level is
5–10 μg/mL with higher levels in females than males due to sexual dimorphism. Adiponectin plasma forms are
of two types, high-molecular-weight and low-molecular-weight. In addition, high-molecular-weight
adiponectin levels are positively associated with CAD and negatively associated with risk of type 2 diabetes
mellitus (DM), but this is not true to the low-molecular-weight adiponectin. Adiponectin serum levels are
inversely correlated with body mass index (BMI), visceral obesity, and insulin resistance (IR); thus, it is
regarded as an indicator and predictor of noninsulin dependent DM, insulin resistant, and overt hyperglycemia.
3 BRITISH ACADEMY
NFâ€‘induced pulmonary toxicity
NFâ€‘induced pulmonary toxicity can be seen in three different forms, that is, due to acute, subacute or
chronic reaction. The acute form is the most common. Side effects occurring up to the 1st month of receiving
the first treatment are classified as the acute form. Acute form develops secondary to hypersensitivity reaction
with peripheral demonstrating eosinophilia and thoracic CT showing groundâ€‘glass opacity. Chronic
NFâ€‘induced lung disease is seen predominantly in older women who present with respiratory symptoms
after a year or more of NF therapy. Characteristic pathologic finding in chronic NF pulmonary toxicity is
diffuse interstitial fibrosis, vascular sclerosis, fibrosis, and thickening of the alveolar septa, interstitial
READING SUB-TEST
Gender
128
Male
78
Female
Education qualification
164
Graduate(B. Pharm, D. Pharm)
42
Postgraduate(M. Pharm)
Professional status
142
Practicing Pharmacists
45
Working professional
10
Academicians
Working professional (involved in the manufacture, marketing, distributors, research of drugs)
6
BRITISH ACADEMY
READING SUB-TEST
Hepatotoxicity can arise either from direct toxicity of the drug or its metabolites.
In rare cases, it can be immune mediated.
Immune-mediated toxicity is believed to be due to an idiosyncratic delayed-type hypersensitivity

reaction.
2 Adiponectin;
Is a protein hormone which is involved in regulating glucose levels.
Can have positive impact on CAD.
Plays a role in the development of insulin resistance.
3 NFâ€‘induced pulmonary toxicity;
Is more common among women.
Is rare, but a serious toxic side effect may occur.
Can have the potential to negatively affect lungs.
4 Case Study gives information about;
A rare case of bilateral lower extremity edema in a young patient.
Talks of the effects of the low dose gabapentin therapy.
Worsening condition and management of the disease.
5 What is correct about the survey?
BRITISH ACADEMY
READING SUB-TEST
Text 1: Occupational Lung Diseases
Occupational lung diseases are a group of illnesses that are caused by either repeated, extended exposure or a
single, severe exposure to irritating or toxic substances that leads to acute or chronic respiratory ailments. The
rate of occupational lung conditions was highest for education and health service workers in the private sector
and local government workers at 3 .8 and 5 .9 per 10,000 full-time workers, respectively. There are two broad
categories of occupational lung diseases: (i) Diseases that are not occupation-specific, but are aggravated at
work, such as occupational asthma (ii) Diseases related to a specific occupation, such as asbestosis, coal
worker’s pneumoconiosis (black lung), berylliosis (brown lung), and farmer’s lung. Common occupational
lung diseases include mesothelioma, occupational asthma, silicosis, asbestosis, and sick building syndrome.
Adult-onset asthma can be triggered by occupational exposures.
The estimated yearly cost of occupational injuries and illnesses is between $128 and $150 billion. Although,
occupational lung diseases are often incurable, they are always preventable. Improving ventilation, wearing
protective equipment, changing work procedures, and educating workers are key factors for prevention.
Occupational Asthma (OA) is the most common form of occupational lung disease. Occupational asthma (also
known as work-related asthma) is asthma that is caused by or made worse by exposures in the workplace.
Estimates suggest that 15 to 23 percent of new asthma cases in adults are work related. Four states (California,
New Jersey, Massachusetts, and Michigan) tracked cases of occupational asthma over a seven-year period.
During this time, the occupations with the highest percentage of asthma cases were operators, fabricators, and
laborers (32.9%); managerial and professional specialty (20.2%), and technical, sales, and administrative
support jobs (19.2%). The four most common agents associated with occupational asthma were miscellaneous
chemicals (19.7%), cleaning materials (11.6%), mineral and inorganic dust (11.1%), and indoor air pollutants
(9.9%).
Malignant mesothelioma is a fatal type of cancer caused by exposure to asbestos. Millions of construction and
general industry workers have been exposed to asbestos while on the job. Occupations associated with
significantly higher mesothelioma deaths include plumbers, pipefitters, and steamfitters; mechanical engineers;
BRITISH ACADEMY
READING SUB-TEST
Inflammation—swelling, redness and heat—is part of the immune system’s first response to microbial
infections, but this defensive response is not limited to the bodily site of infection. Soon after infection, a
pattern develops that includes what is called the “acute phase response (APR)” and “sickness behavior.” Fever
is the most prominent feature of the APR and for good reason: many microorganisms reproduce best at
humans’ normal core body temperature, and many of the immune system’s agents for killing them are
bolstered by elevated temperature.
Sickness behaviors are well known to anyone who has had the flu. They include reductions in activity, food
intake, social interaction, mood sags; difficulty in forming new memories; sleep changes; and sensitivity to
pain increases (just think of how even a light touch hurts when you have the flu). These changes also reduce
the energetic costs of behavior to free available energy stores to fight the infection. Fever, for example, is quite
energy intensive, requiring an extra 10 to 12 percent in energy for each degree rise. It is obvious how all the
sickness behaviors, with the exception of memory disruption, fit the scheme of keeping us away from our
usual activities. Memory disruption serves a different purpose.
We now understand that all of the changes described above are accomplished through the CNS. Fever, for
example, occurs because the set point of temperature-sensitive cells in the hypothalamus is increased. Of
course, behavior, mood, and pain are all products of the CNS. This raises two issues: a) How does the CNS
“know” what is going on in the peripheral immune system, and b) What kinds of changes are produced in the
CNS that mediate fever and sickness behaviors? The same cytokines that participate in producing the
inflammatory response in the body also initiate the communication process to the CNS. They accumulate in
the bloodstream and thereby travel to the brain, where, although they are large proteins and cannot readily
cross the blood-brain barrier, these chemical signals are carried across the barrier by active transport. They
cross into the brain in regions where the barrier is weak, and they bind to receptors on the insides of the
cerebral vascular blood vessels, thereby inducing the production of soluble mediators within the epithelial cells
that can cross into the brain.
The cytokine interleukin-1 beta is released in response to pathogen recognition, and a) activates vagal fibers, b)
diffuses into the brain where the barrier is weak, and c) are actively transported across. In the brain, they act on
microglia, which then produce and secrete further cytokines that can act on neuronal cells, thereby producing
sickness behaviors.
BRITISH ACADEMY
READING SUB-TEST
7 The rate of OLC is reported to be higher in;
Healthcare service providers (private sectors)
Professionals in the field of education.
Government officials.
Local government workers and healthcare professionals in private industries.
8 One of these groups of diseases doesnâ€™t come under OLD;
Mesothelioma and occupational asthma.
Occupational asthma and silicosis, asbestosis.
Asbestosis and mesothelioma.
Asbestosis and silicosis.
9 According to paragraph 2, OLDs are;
Incurable
Curable
Preventable but not curable
Curable and preventable
10 According to paragraph 2, â€œwork-related asthmaâ€• means;
A disease which occurs due to more work BRITISH ACADEMY

READING SUB-TEST
1973
2007
2010
14 Silicosis is;
More dangerous than occupational asthma.
More dangerous than mesothelioma.
Not as fatal as occupational asthma and mesothelioma.
Not very fatal.
15 The first line of defense implies;
Macrophages
Immune system
Inflammation
All of the above
16 Chemical messengers have;
The ability to change the functioning of other cells. BRITISH ACADEMY

READING SUB-TEST
Reduction in social interaction and sleeping hours.
Change in mood and body language.
Body language and sleeping disorder.
20 Cytokines are described as;
Messenger cells.
Protein bodies and messenger cells.
Immune response bodies.
None
21 Cytokines cross the barrier;
Through active transport.
By bridging the blood-brain barrier.
By penetrating into the blood vessels.
Through the bloodstream and lymph vessels.
22 What happens if the responses become exaggerated?
Loss of memory may take place. BRITISH ACADEMY

READING SUB-TEST

8. Correct Answer Is: Lusitropy
9. Correct Answer Is: Low serum Gal-3 concentrations
10. Correct Answer Is: Gal-3
11. Correct Answer Is: Dyslipidemia
12. Correct Answer Is: NP levels
13. Correct Answer Is: Gal- 3
14. Correct Answer Is: NP secretion
15. Correct Answer Is: Interleukin 1 Beta
16. Correct Answer Is: Diabetes
17. Correct Answer Is: Fibrosis
18. Correct Answer Is: Predictive Marker
19. Correct Answer Is: Natriuresis
20. Correct Answer Is: Oxidative Degradation
PART B & C
1. Correct Answer Is: Hepatotoxicity can arise either from direct toxicity of the drug
or its metabolites.
2. Correct Answer Is: Plays a role in the development of insulin resistance.
3. Correct Answer Is: Can have the potential to negatively affect lungs.
4. Correct Answer Is: Talks of the effects of the low dose gabapentin therapy.
5. Correct Answer Is: 71% were practicing as pharmacists
6. Correct Answer Is: The majority of the patients were between the age bracket of 29
days to 24 months and
7. Correct Answer Is: Local government workers and healthcare professionals in
private industries.
8. Correct Answer Is: Asbestosis and mesothelioma.
9. Correct Answer Is: Preventable but not curable
10. Correct Answer Is: None of the above
11. Correct Answer Is: Air pollutants
12. Correct Answer Is: Exposure to asbestos on a regular basis
13. Correct Answer Is: 2007
14. Correct Answer Is: Not very fatal.
15. Correct Answer Is: Inflammation
16. Correct Answer Is: The ability to change the functioning of other cells.
17. Correct Answer Is: After the infection.
BRITISH ACADEMY
18. Correct Answer Is: The multiplication of the microbes, supported by the
temperature of the human body.
READING SUB-TEST
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.
Text A
Galectin-3
It is well known that there is a close relation between obesity-induced insulin resistance, immune cells
accumulation in white adipose tissue (WAT) and inflammation. Indeed, in obesity WAT is characterized by an
increased production and secretion of a wide range of inflammatory cytokines including TNF-alpha and
interleukin (IL)- 6, which may have local effects on endothelial, vasculature and target adipose tissues.
Therefore, activated macrophages and other antigen presenting cells that are accumulated in elevated number
in fat tissue in both types of obese actively secrete a broad spectrum of locally produced pro-inflammatory
cytokines including galectin-3 (Gal-3). Gal-3 is a beta-galactoside-binding lectin belonging to a
multifunctional protein family, which enhances chemotaxis of immune and antigen presenting cells, reduces
insulin-stimulated glucose uptake in myocytes and adipocytes and impairs insulin-mediated suppression of
glucose output in hepatocytes. Gal-3 may bind directly to the insulin receptor (IR) and thereby inhibit
downstream insulin resistance signaling via diminishing interleukin-1 beta production. Therefore, Gal- 3 is a
modulator of apoptosis, necrosis and fibrosis associated with extracellular remodeling.
BRITISH ACADEMY
READING SUB-TEST
Text D
Brutsaert et al. have reported that higher levels of brain NP have associated with decreased risk of diabetes in
middle-aged adults and that the interrelation has remained after adjustment for waist circumference, low
physical activity, estimated glomerular filtration rate and high sensitive C-reactive protein level. In contrast, it
is suggested that the low brain NP levels observed in obesity could causally associated with the incidence of
diabetes in obese individuals. The effect of brain NPs might relate to an ability of natriuretic peptides to
activate a thermogenic program in brown and white fat tissues, increase energy expenditure and inhibit food
intake. Thus, NPs might play several metabolic roles in the development of different phenotypes of obesity,
but their predictive role in CV disease development in obese patients is uncertain.
Questions 1-7
more than once. BRITISH ACADEMY

READING SUB-TEST
Answer each of the questions, 8-14, with a word or short phrase from one of the texts. Each answer may
8 What defines the rate of myocardial relaxation?
Answer
9 What are more associated with insulin resistance?
Answer
10 What can have the potential to have direct impact on insulin resistance?
Answer
11 What defines an abnormal amount of lipids?
Answer
12 What are the markers of biomechanical cardiac stress?
Answer
BRITISH ACADEMY
13 What is associated with programmed cell death?
Answer
READING SUB-TEST
Liver toxicity from sulfasalazine
Liver toxicity from sulfasalazine is a rare but serious side effect. It can range from mild elevation in LFTs to
hepatic failure and cirrhosis. The occurrence of severe liver toxicity such as acute hepatitis as seen in our
patient is <1%. After reaching the gut, sulfasalazine is broken down by the colonic bacteria into its
metabolites, i.e., sulfapyridine and 5-aminosalicylic acid. Sulfapyridine is absorbed in the gut and eliminated
after acetylation by enzyme N-acetyltransferase which can have variable activity based on the patient's
genotype. Patients who have genotypes for slow acetylation are found to be more predisposed to sulfasalazine-
induced liver toxicity. Injury can be hepatocellular which presents with disproportionate elevation in serum
aminotransferases or cholestasis which presents with disproportionate elevation in alkaline phosphatase. Both
patterns of liver injury can have elevation in bilirubin and abnormal tests for liver synthetic function.
Adiponectin
Adiponectin accounts for 0.01% of plasma protein with a half-life of 2.5 h; normal adiponectin plasma level is
5–10 μg/mL with higher levels in females than males due to sexual dimorphism. Adiponectin plasma forms are
of two types, high-molecular-weight and low-molecular-weight. In addition, high-molecular-weight
adiponectin levels are positively associated with CAD and negatively associated with risk of type 2 diabetes
mellitus (DM), but this is not true to the low-molecular-weight adiponectin. Adiponectin serum levels are
inversely correlated with body mass index (BMI), visceral obesity, and insulin resistance (IR); thus, it is
regarded as an indicator and predictor of noninsulin dependent DM, insulin resistant, and overt hyperglycemia.
BRITISH ACADEMY
NFâ€‘induced pulmonary toxicity
NFâ€‘induced pulmonary toxicity can be seen in three different forms, that is, due to acute, subacute or
READING SUB-TEST
The mean age of pharmacists was approximately 32 years with a majority in the young adult age group (20-50
years, 92.22%).
Sociodemographic parameter Respondents, N=206(%)
Age (yr) Mean (SD) 36
Gender
128
Male
78
Female
Education qualification
164
Graduate(B. Pharm, D. Pharm)
42
Postgraduate(M. Pharm)
Professional status
142
Practicing Pharmacists
45
Working professional
10
Academicians
Working professional (involved in the manufacture, marketing, distributors, research of drugs)
6
BRITISH ACADEMY
READING SUB-TEST
Hepatotoxicity can arise either from direct toxicity of the drug or its metabolites.
In rare cases, it can be immune mediated.
Immune-mediated toxicity is believed to be due to an idiosyncratic delayed-type hypersensitivity

reaction.
2 Adiponectin;
Is a protein hormone which is involved in regulating glucose levels.
Can have positive impact on CAD.
Plays a role in the development of insulin resistance.
3 NFâ€‘induced pulmonary toxicity;
Is more common among women.
Is rare, but a serious toxic side effect may occur.
Can have the potential to negatively affect lungs.
4 Case Study gives information about;
A rare case of bilateral lower extremity edema in a young patient.
Talks of the effects of the low dose gabapentin therapy.
Worsening condition and management of the disease.
5 What is correct about the survey?

BRITISH ACADEMY
READING SUB-TEST
Text 1: Occupational Lung Diseases
Occupational lung diseases are a group of illnesses that are caused by either repeated, extended exposure or a
single, severe exposure to irritating or toxic substances that leads to acute or chronic respiratory ailments. The
rate of occupational lung conditions was highest for education and health service workers in the private sector
and local government workers at 3 .8 and 5 .9 per 10,000 full-time workers, respectively. There are two broad
categories of occupational lung diseases: (i) Diseases that are not occupation-specific, but are aggravated at
work, such as occupational asthma (ii) Diseases related to a specific occupation, such as asbestosis, coal
worker’s pneumoconiosis (black lung), berylliosis (brown lung), and farmer’s lung. Common occupational
lung diseases include mesothelioma, occupational asthma, silicosis, asbestosis, and sick building syndrome.
Adult-onset asthma can be triggered by occupational exposures.
The estimated yearly cost of occupational injuries and illnesses is between $128 and $150 billion. Although,
occupational lung diseases are often incurable, they are always preventable. Improving ventilation, wearing
protective equipment, changing work procedures, and educating workers are key factors for prevention.
Occupational Asthma (OA) is the most common form of occupational lung disease. Occupational asthma (also
known as work-related asthma) is asthma that is caused by or made worse by exposures in the workplace.
Estimates suggest that 15 to 23 percent of new asthma cases in adults are work related. Four states (California,
New Jersey, Massachusetts, and Michigan) tracked cases of occupational asthma over a seven-year period.
During this time, the occupations with the highest percentage of asthma cases were operators, fabricators, and
laborers (32.9%); managerial and professional specialty (20.2%), and technical, sales, and administrative
support jobs (19.2%). The four most common agents associated with occupational asthma were miscellaneous
chemicals (19.7%), cleaning materials (11.6%), mineral and inorganic dust (11.1%), and indoor air pollutants
(9.9%).
Malignant mesothelioma is a fatal type of cancer caused by exposure to asbestos. Millions of construction and
general industry workers have been exposed to asbestos while on the job. Occupations associated with
significantly higher mesothelioma deaths include plumbers, pipefitters, and steamfitters; mechanical engineers;
BRITISH ACADEMY
READING SUB-TEST
Inflammation—swelling, redness and heat—is part of the immune system’s first response to microbial
infections, but this defensive response is not limited to the bodily site of infection. Soon after infection, a
pattern develops that includes what is called the “acute phase response (APR)” and “sickness behavior.” Fever
is the most prominent feature of the APR and for good reason: many microorganisms reproduce best at
humans’ normal core body temperature, and many of the immune system’s agents for killing them are
bolstered by elevated temperature.
Sickness behaviors are well known to anyone who has had the flu. They include reductions in activity, food
intake, social interaction, mood sags; difficulty in forming new memories; sleep changes; and sensitivity to
pain increases (just think of how even a light touch hurts when you have the flu). These changes also reduce
the energetic costs of behavior to free available energy stores to fight the infection. Fever, for example, is quite
energy intensive, requiring an extra 10 to 12 percent in energy for each degree rise. It is obvious how all the
sickness behaviors, with the exception of memory disruption, fit the scheme of keeping us away from our
usual activities. Memory disruption serves a different purpose.
We now understand that all of the changes described above are accomplished through the CNS. Fever, for
example, occurs because the set point of temperature-sensitive cells in the hypothalamus is increased. Of
course, behavior, mood, and pain are all products of the CNS. This raises two issues: a) How does the CNS
“know” what is going on in the peripheral immune system, and b) What kinds of changes are produced in the
CNS that mediate fever and sickness behaviors? The same cytokines that participate in producing the
inflammatory response in the body also initiate the communication process to the CNS. They accumulate in
the bloodstream and thereby travel to the brain, where, although they are large proteins and cannot readily
cross the blood-brain barrier, these chemical signals are carried across the barrier by active transport. They
cross into the brain in regions where the barrier is weak, and they bind to receptors on the insides of the
cerebral vascular blood vessels, thereby inducing the production of soluble mediators within the epithelial cells
that can cross into the brain.
The cytokine interleukin-1 beta is released in response to pathogen recognition, and a) activates vagal fibers, b)
diffuses into the brain where the barrier is weak, and c) are actively transported across. In the brain, they act on
microglia, which then produce and secrete further cytokines that can act on neuronal cells, thereby producing
sickness behaviors.
BRITISH ACADEMY
READING SUB-TEST
Healthcare service providers (private sectors)
Professionals in the field of education.
Government officials.
Local government workers and healthcare professionals in private industries.
8 One of these groups of diseases doesnâ€™t come under OLD;
Mesothelioma and occupational asthma.
Occupational asthma and silicosis, asbestosis.
Asbestosis and mesothelioma.
Asbestosis and silicosis.
9 According to paragraph 2, OLDs are;
Incurable
Curable
Preventable but not curable
Curable and preventable
10 According to paragraph 2, â€œwork-related asthmaâ€• means;
A disease which occurs due to more work
A disease which occurs due to less work
A disease which occurs due to exposure to work

BRITISH ACADEMY
READING SUB-TEST
More dangerous than occupational asthma.
More dangerous than mesothelioma.
Not as fatal as occupational asthma and mesothelioma.
Not very fatal.
15 The first line of defense implies;
Macrophages
Immune system
Inflammation
All of the above
16 Chemical messengers have;
The ability to change the functioning of other cells.
A greater level of mobility.
No capacity to move further away from cells.
None
17 APR develops;
At the time of infection.
After the infection.
After curing of the infection.

BRITISH ACADEMY
READING SUB-TEST
Through active transport.
By bridging the blood-brain barrier.
By penetrating into the blood vessels.
Through the bloodstream and lymph vessels.
22 What happens if the responses become exaggerated?
Loss of memory may take place.
Reduction in normal mood may be noted.
Cognitive impairment occurs.
Acute pain may begin.
ANSWERS
BRITISH ACADEMY
READING SUB-TEST
17. Correct Answer Is: After the infection.

18. Correct Answer Is: The multiplication of the microbes, supported by the
temperature of the human body.
19. Correct Answer Is: Body language and sleeping disorder.
20. Correct Answer Is: None
21. Correct Answer Is: Through active transport.
22. Correct Answer Is: Cognitive impairment occurs.

Part A BRITISH ACADEMY
READING SUB-TEST
degrade N-terminal tripeptides from their substrates. Therefore deficiencies lead to an accumulation, in
particular of subunit C of mitochondrial ATP synthase causing subsequent neuronal and retinal cell death. This
accumulation is seen on UV imaging as autofluorescent storage and on electron microscopy as curvilinear
bodies. Gene therapy is an attractive prospect for long-term therapy in LINCL because it is a monogenic
disorder. The process involves introducing CLN2 human complementary DNA (cDNA) into the central
nervous system under the control of a promoter and in a suitable vector. Adeno-associated viruses are
considered the ideal vector as they can transduce postmitotic cells, mediate long-term gene expression and
have an excellent safety record. Therefore, these vectors are considered potential delivery vectors for the
treatment of LINCL. The challenge is whether using a suitable AAV vector allows sufficient activity,
expression and distribution of TPP-1 to destroy existing lysosomal storage protein, prevent its on-going
formation and consequently halt the progression of the disease. One way of maximizing enzyme dispensation
is through cross-correction using mannose-6-phosphate pathway, this means that CLN2 cDNA does not need
not be introduced to the whole of the CNS. The target for gene expression is 1-5% normal expression of the
gene product which is sufficient to reverse pathology in other conditions.
Text C
One human trial evaluated the use of AAV2 vector to transfer human cCLN2 cDNA to the CNS of 10 children
with LINCL aged between 3 and 10 with five different mutation types. The study was an 18-month follow-up
to vector administration with a primary outcome measure being neurological assessment of disease status
using the modified Hamburg LINCL scale. Secondary measures were quantitative CNS Magnetic Resonance
Imaging assessment of the brain including grey matter and ventricular volume. Control comparisons were
made with data from 4 independent untreated LINCL children who had been assessed twice at 1-year intervals.
Participants received an average dose of 2.5 × 1012 particles (1.8-3.2 × 1012) of the AAV2Hcln2 vector. The
dose was shared equally through 6 burr holes (3 in each hemisphere) of the cranial vault, and 12 cortical
locations were targeted. Assessments were made on days 7 and 14 and at 1, 6, 12 and 18 months after therapy.
Adverse effects were assessed at 2 and 3 months.
BRITISH ACADEMY
READING SUB-TEST
Questions 1-7
more than once.
1 It is not currently known to cause disease, but causes a very mild immune response.
Asnwer
2 A disorder in which nerve cell activity in the brain is disturbed, causing seizures.
Asnwer
3 Not so prevalent disorder that primarily affects the nervous system.
Asnwer
4 Degeneration of the neurons.
Asnwer
5 Recent studies conducted on evaluation of the disease.
Asnwer
6 After effects of the treatment.
Asnwer
BRITISH ACADEMY
READING SUB-TEST
13 Which is the effective long-term therapy in LINCL?
Answer
14 What dosage of the AAV2Hcln2 vector did the participants receive?
Answer
Questions 15-20
15 can be described as spasmodic jerky contraction of groups of muscles.
16 The gene provides instructions for making an enzyme called tripeptidyl peptidase 1.
17 It is always not required to introduce to CNS.
18 made it all clear that the therapy can have more positive impact on the disease.
19 Out of all the mutations, are considered to be the major causes for the disease to appear in
infants and adults.
20 The gene provides instructions for making a protein whose function is not well understood
Part B
BRITISH ACADEMY
READING SUB-TEST
Spinal cord stimulation
For many years, Spinal cord stimulation has been used as a salvage treatment for intractable CRPS even
though many studies have not proven long-term benefit. In multiple studies published by a European
neurosurgical group, there has been great benefit from this technology in the first year but the vast majority of
patients experience a return of symptoms by year six. Newer dorsal root ganglion (DRG) stimulation
technology may be more promising. In the most recent DRG stimulation trial, patients with CRPS have been
shown to decrease pain by fifty percent or greater in 93% of patients with chronic intractable pain at three-
month follow-up, versus 72% of patients with an SCS implant. Unfortunately, this product is currently only
FDA approved for treatment in the lower extremity.
Stellate ganglion blocks (SGB)
Stellate ganglion blocks (SGB) are the most commonly performed interventional procedure for patients with
upper extremity CRPS. The stellate ganglion is located anterior to the 7th cervical transverse process on the
anterior surface of the longus coli muscle. It lies medial to the vertebral artery and anterolateral to the
ipsilateral common carotid artery. This ganglion can be accessed either through fluoroscopy, CT, or ultrasound
guidance. In a study published in 2006 by Ackerman and Zhang, 25 subjects underwent SGB at weekly
intervals for 3 weeks. At 6 months, 40% of patients had complete symptom relief while 24% of patients had
no pain relief. In a second study, published in 2009, three weekly blockades were completed at weekly
intervals in 22 patients with CRPS type I of the hand. Pain intensity and range of motion were assessed two
weeks after treatment. In this study patients had statistically significant improvement in wrist ROM (P>0.001)
and an overall decrease in VAS values from 8 to 1. While most physicians do not believe that SGB alone is
effective in curing the disease, we do know that stellate ganglion blocks at least offer temporary benefits that
last well beyond the effects of local anesthetic.
BRITISH ACADEMY
READING SUB-TEST
Treatment Groups - Recent Analysis
Total effective
Groups Cases excellent effective Ineffective exacerbated
rate, %
Control 40 19 9 10 2 70.0
Treatment 41 28 9 4 0 90.2*
Disease Treatment Results - Before and After
Control group (n=58) Observation group (n=59)
Before After Before After
Index treatment treatment treatment treatment
FBG, mmol/L 9.85 ± 1.25 8.53 ± 1.42 9.92 ± 1.25 7.21 ± 1.33*
PBG, mmol/L 13.54 ± 2.73 11.32 ± 2.89 14.07 ± 2.32 9.25 ± 1.08*
HbA1c, % 11.02 ± 2.34 10.32 ± 2.53 11.31 ± 1.97 8.79 ± 1.17*
Microalbuminuria, mg/L 81.24 ± 11.93 76.42 ± 12.33* 82.31 ± 10.64 45.22 ± 13.17*
BRITISH ACADEMY
READING SUB-TEST
total effectiveness of the control group is lesser than treatment group.
6 What does the result indicate?
The results indicate that subjects in the two groups improved after treatment.
The laboratory indexes of the treatment group significantly declined.
After treatment, the laboratory indexes of the observation group were also more declined than the control
group.
BRITISH ACADEMY
READING SUB-TEST
include aldosterone, maintain your body's balance of sodium and potassium to keep your blood pressure
normal. Androgens, male sex hormones, are produced in small amounts by the adrenal glands in both men and
women. They cause sexual development in men and influence muscle mass, libido and a sense of well-being in
men and women.
Addison's disease occurs when the cortex is damaged and doesn't produce its hormones in adequate quantities.
Doctors refer to the condition involving damage to the adrenal glands as primary adrenal insufficiency. The
failure of your adrenal glands to produce adrenocortical hormones is most commonly the result of the body
attacking itself (autoimmune disease). For unknown reasons, your immune system views the adrenal cortex as
foreign, something to attack and destroy. Other causes of adrenal gland failure may include tuberculosis, other
infections of the adrenal glands, spreading of cancer to the adrenal glands and bleeding into the adrenal glands.
Adrenal insufficiency can also occur if your pituitary gland is diseased. The pituitary gland produces a
hormone called adrenocorticotropic hormone (ACTH), which stimulates the adrenal cortex to produce its
hormones. Inadequate production of ACTH can lead to insufficient production of hormones normally produced
by your adrenal glands, even though your adrenal glands aren't damaged. Doctors call this condition secondary
adrenal insufficiency. Another more common cause of secondary adrenal insufficiency occurs when people
who take corticosteroids for treatment of chronic conditions, such as asthma or arthritis, abruptly stop taking
the corticosteroids. If you have untreated Addison's disease, an Addisonian crisis may be provoked by physical
stress (such as an injury), infection or illness. All treatment for Addison's disease involves hormone
replacement therapy to correct the levels of steroid hormones your body isn't producing. Some options for
treatment include oral corticosteroids, corticosteroid injections and androgen replacement therapy.
Text 2: Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition that may be caused by repeatedly performing stressful motions with
your hand or holding your hand in the same position for long periods of time. CTS is classified as a cumulative
trauma disorder, an ailment that attacks the body’s musculoskeletal system. The musculoskeletal system is
made up of muscles that pull on tendons and move the bones at joints. The joints are held together by
ligaments. Carpal tunnel syndrome specifically affects the sensitive nerves of - and the blood supply that feeds
- the hands and wrists.
BRITISH ACADEMY
READING SUB-TEST
Physical therapists can target and correct poor work habits and improper work designs, such as tools, furniture,
equipment, and workspace. They can also assess the potential risks of an individual and determine if that
person is physically unsuited to a particular job. Among their many responsibilities, physical therapists teach
health awareness and job safety. A typical education program includes exercises employees can do at work and
at home, adjustments to the overall work environment and individual workstations, plus early detection of
symptoms to avoid painful and costly surgery. Physical therapists also work with employers and their
engineering departments to design and modify the work environment, helping to remove the causal factors of
CTS. If anyone has symptoms of carpal tunnel syndrome, then consulting a physical therapist or other
qualified healthcare practitioners for an evaluation and individualized treatment is always recommended.
BRITISH ACADEMY
READING SUB-TEST
Mineralocorticoids
All of the above
11 Aldosterone maintains;
Body balance
Balance of sodium and potassium
High BP
Low BP
12 According to the information given in the passage, the statement that â€œAndrogen
influences muscle mass and physical and mental nature of men and womenâ€• is;
True
False
Canâ€™t say
Not given in the passage(s)
13 Doctors refer to the damage to the cortex of the kidney as;
Primary adrenal insufficiency.
Secondary adrenal insufficiency.
Other fatal infections.
Not given
14 Secondary adrenal insufficiency also occurs because of;
BRITISH ACADEMY
READING SUB-TEST
Wrists
18 CTS often occurs in;
Men
Women
Men and women of all ages
Only men of all ages
19 _____ complained of pain and loss of hand function in the 1860s;
Meat packers
Assembly line workers
Jackhammer operators
Employees who spend hours at a computer
20 CTS accounts for _____.of all industrial workplace illnesses;
50%
48%
84%
60%
BRITISH ACADEMY
READING SUB-TEST
ANSWERS
PART A

8. Correct Answer Is: mutation of the CLN2 gene
9. Correct Answer Is: Adeno-associated viruses
10. Correct Answer Is: epilepticus
11. Correct Answer Is: vomiting and thrombocytosis
12. Correct Answer Is: mannose-6-phosphate pathway
13. Correct Answer Is: Gene therapy
14. Correct Answer Is: 2.5 Ã— 1012 particles
15. Correct Answer Is: Myoclonus
16. Correct Answer Is: Tpp1
17. Correct Answer Is: Cln2 Cdna
18. Correct Answer Is: Primary Assessments
19. Correct Answer Is: Three
20. Correct Answer Is: Cln6
PART B & C
1. Correct Answer Is: Various ailments can lead to angina pectoris.

2. Correct Answer Is: ineffectiveness of the SCS.
3. Correct Answer Is: to provide temporary relief from pain.
4. Correct Answer Is: Metabolomics has seen a surge in popularity in recent scientific
research.
5. Correct Answer Is: The curative effect of improving disease condition in treatment
group is superior to the control group.
6. Correct Answer Is: The results indicate that subjects in the two groups improved
after treatment.
7. Correct Answer Is: One to four of every 1,000 people, including all age groups.
8. Correct Answer Is: Low production of ACTH.
9. Correct Answer Is: Slowly after many months
10. Correct Answer Is: Androgens
11. Correct Answer Is: Balance of sodium and potassium
12. Correct Answer Is: False
13. Correct Answer Is: Primary adrenal insufficiency.
14. Correct Answer Is: Stopping the use of corticosteroids.
BRITISH ACADEMY
READING SUB-TEST
Part A
TIME: 15 minutes
Text A
Autism Spectrum Disorder
Autism Spectrum Disorder (ASD) develops in early childhood. Recent population analysis indicates that the
number of cases of ASD is increasing in many countries, particularly in technologically developed countries.
The U.S. Center for Disease Control research claims that, in some states, one of every 68 children (one of 42
boys) has a diagnosis of the ASD, a 30% increase from 2012 (IACC Strategic Plan for Autism Spectrum
Disorder Research, 2013.
Multiple dysfunctional reflex patterns are characteristic in two separate groups of children diagnosed with
autism: 1) those whose patterns were immature or pathological and severely dysfunctional from birth, and 2)
those that developed normally but regressed into autism at age 2 or 3 unexpectedly. Reflexes of these children
may have been delayed and immature, but not noted by specialists or parents. Their nerve system, possibly,
was not resilient enough to cope with the stress that they experienced. Alternatively, their reflexes might not
BRITISH ACADEMY
READING SUB-TEST
trapezius) and with the opposite hypotonic abdominal muscles and diaphragm negatively affects development
of postural control. The child with ASD, in an attempt to release tension caused by this disproportion of
muscle tone in the back and front of their body, may often display reactivity in behavior and impulsive
movements triggering balance/equilibrium mechanisms (balancing reflex pattern), resulting in a state of being
overstimulated.
Text D
Problems in visual and auditory perception systems: The eyes of children diagnosed with ASD show a restless
state or lack of mobility and dilated pupils. They usually have a limited, narrow visual span, poor visual
attention and focus, and hyperactive peripheral vision. Their eye movements appear to freeze or jump rapidly
in saccades. Many children with ASD demonstrate an addictive tendency for computers and cell phones with
compulsive repetition of the same image, object, or program, often watching it at a very close range. The child
with ASD becomes over-focused, which over-stimulates their vestibular system and static balance. The
Pupillary Reflex in these children may become hypersensitive, over-stimulating the sympathetic system, with
either over-reactive or hypoactive motor activity. The visual system of children diagnosed with ASD copes
poorly with this visual chaos which leads to a visual processing disorder. A Bonding response in infants is
seen from their first months after birth. Bonding as a behavior trait matures during their first years of life.
Almost every child with ASD assessed presented signs of inadequate bonding – lack of attachment, tactile and
interactivity defensiveness, a tendency for self-isolation, a poor imitation, and poor learning of verbal
communication. When bonding is immature, there are problems with visual contact, focusing on the face/eyes
of their mother and other adults and poor emotional communication, inability to adequately smile, and poor
labeling of the objects in their environment.
BRITISH ACADEMY
READING SUB-TEST
7 Primitive reflex that normally emerges during the first year of an infant's life.
Answer
Questions 8-14
8 What MNRI will operate with?
Answer
9 How eye movements may appear?
Answer
10 What is the term which defines activation of the vestibular system which causes eye movement?
Answer
11 What is related to tendency to act on a whim, displaying behavior characterized by little or no forethought,
reflection?
Answer
12 What is the term used to define healthy stress?
Answer
BRITISH ACADEMY
READING SUB-TEST
UNAIDS Programme Coordinating Board
The 31st UNAIDS Programme Coordinating Board (PCB) meeting took place in Geneva from 11-13 June
2018. There were more than 700 000 less new HIV infections estimated globally in 2016 than in 2001. The
road from 2.5 million new HIV infections in 2011 to zero new HIV infections is a long one and significant
efforts are required to accelerate HIV prevention programmes. Sustained investments for access to
antiretroviral therapy by donors and national governments have led to record numbers of lives being saved in
the past six years. In 2011 more than half a million fewer people died from AIDS-related illnesses than six
years earlier. It’s a dramatic turning point. Numbers can quantify, but alone cannot express the impact of each
averted death on the whole community, including its children. The number of people dying from AIDS-related
causes began to decline in the mid-2000s because of scaled up antiretroviral therapy and the steady decline in
HIV incidence since the peak of the epidemic in 1997. In 2011, this decline continued, with evidence showing
that the drop in the number of people dying from AIDS-related causes is accelerating in several countries.
Radix Sophorae tonkinensis
Radix Sophorae tonkinensis was crushed and screened, then taking screened powder (approximately 0.5 g) gain
a respective weight, denoted M. Trichloromethane-methanol-ammonia (40:10:1) was used to dispose of the
radix Sophorae tonkinensis samples for 30 min, and all samples were subsequently obtained from organic
solvent extraction with 30 min ultrasonic treatment. All disposed of samples were filtered, then 10 mL of
BRITISH ACADEMY
filtrate was measured to recover solvents to dry under decompression at 38°C to obtain the residue, the residue
was diluted by methanol, then transferred to a 10 mL volumetric flask. After mixing and filtering with 0.45 μm
READING SUB-TEST
Total 200 200
Vitamin B12
Vitamin B12 is produced by the liver and is involved in several biochemical metabolic reactions. It promotes
the repair of damaged skin mucous membranes and vascular endothelial cells, reduces spasm and occlusion of
blood vessels, improves local blood flow and prevents the deterioration of wound infection. In addition, it
reduces the excitability of pain fibres C and AG, leading to an analgesic effect. Vitamin B12 injections to the
skin in the radiation field benefit the wound by reducing irritation and pain, preventing rupture and enhancing
new epithelial resistance to radiation, thereby promoting healing of the skin. Chen et al used a vitamin B12
solution to treat radiation-induced moist dermatitis. The cure rate at 10 days was 100%, which was
significantly different from the control group.
Age wise distribution of male patients showing percentage of distribution.
Age in years Male patients Age in years Female patients
20-30 4 (7.27) 20-30 0 (0)
30-40 54 (98.18) 30-40 32 (71.11)
40-50 24 (43.63) 40-50 38
50-60 18 50-60 10
60-70 10 60-70 6 (13.32)
BRITISH ACADEMY
READING SUB-TEST
Type A is known to produce more adverse reactions than all the others present in the table.
A total of 200 cases have been reported with respect to adverse reaction.
5 The notice clearly explains
Clinical trials using Vitamin B12.
Advantages of B12.
Study performed with focus on B12 usage.
6 What is correct about the given table?
The age wise male patients population ranges from 4.
18.18 patients were in the age group of 50-70 years.
32.72 patients were in the age group of 50-60 years.
Part C
BRITISH ACADEMY
READING SUB-TEST
Ebola epidemics have occurred because contaminated injection equipment wasn't sterilized between uses.
There's no evidence that the Ebola virus or Marburg virus can be spread via insect bites. Ebola and Marburg
hemorrhagic fevers are difficult to diagnose because many of the early signs and symptoms resemble those of
other infectious diseases, such as typhoid and malaria. But if doctors suspect that you have been exposed to the
Ebola virus or Marburg virus, they use laboratory tests that can identify the viruses within a few days.
Most people with Ebola or Marburg hemorrhagic fever have high concentrations of the virus in their blood.
Blood tests known as enzyme-linked immunosorbent assay (ELISA) and reverse transcriptase polymerase
chain reaction (PCR) can detect specific genes or the virus or antibodies to them. No antiviral medications
have proved effective in treating the Ebola virus or Marburg virus infections. As a result, treatment consists of
supportive hospital care; this includes providing fluids, maintaining adequate blood pressure, replacing blood
loss and treating any other infections that develop.
As with other infectious diseases, one of the most important preventive measures for the Ebola virus and
Marburg virus is frequent hand-washing. Use soap and water, or use alcohol-based hand rubs containing at
least 60 percent alcohol when soap and water aren't available. In developing countries, wild animals, including
nonhuman primates, are sold in local markets; avoid buying or eating any of these animals. In particular,
caregivers should avoid contact with the person's bodily fluids and tissues, including blood, semen, vaginal
secretions and saliva. People with Ebola or Marburg are most contagious during the later stages of the disease.
If you're a healthcare worker, wear protective clothing — such as gloves, masks, gowns and eye shields - keep
infected people isolated from others. Carefully disinfect and dispose of needles and other instruments; injection
needles and syringes should not be reused. Scientists are working on a variety of vaccines that would protect
people from Ebola or Marburg viruses. Some of the results have been promising, but further testing is needed.
Text 2: A Chronic Disease - Atopic Dermatitis
Atopic dermatitis is a common chronic skin disease. It is also called atopic eczema. Atopic is a term used to
describe allergic conditions such as asthma and hay fever. Both dermatitis and eczema mean inflammation of
the skin. People with atopic dermatitis tend to have dry, itchy and easily irritated skin. They may have times
when their skin is clear and other times when they have rash. In infants and small children, the rash is often
BRITISH ACADEMY
READING SUB-TEST
events can lead to or worsen the itch-scratch cycle.The medications used in atopic dermatitis include topical
steroids, topical immunomodulators, tar products, anti-infectives and antihistamines. Steroid medicines that are
applied to the skin are called topical steroids. Topical steroids are drugs that fight inflammation; they are very
helpful when a rash is not well controlled. Topical steroids are available in many forms such as ointments,
creams, lotions and gels. It is important to know that topical steroids are made in low to super potent
strengths. Steroid pills or liquids, like prednisone, should be avoided because of side effects and because the
rash often comes back after they are stopped.
BRITISH ACADEMY
READING SUB-TEST
Monkeys
11 Most known Ebola diseases occur due to;
Contamination
Bodily fluids
Contaminated needles and syringes
None
12 People with hemorrhagic fever show;
High number of viruses in their blood
Low concentrations of virus
High concentrations of antibodies
Low concentrations of antibodies
13 Pick one of the best preventive measures stated in the passage here;
Hand cleaning with medicinal soap.
Use of alcohol-based hand rubs, containing at least 60% alcohol, in absence of water & soap.
Only use of soap.
Avoiding direct contact with patients is a necessity.
14 As a healthcare worker, you should;
Keep infected people totally isolated from others.
Not reuse needles and syringes for the second time. BRITISH ACADEMY
READING SUB-TEST
Allergic diseases
Asthma and hay fever.
Allergic conditions like hay fever.
Allergic conditions like asthma.
19 _____ can worsen dermatitis symptoms;
Allergies
Pollen
Dust
Mold
20 According to the information given in the passage, avoiding allergens is;
Easy
Difficult
Sometimes easy and sometimes difficult
Canâ€™t say
BRITISH ACADEMY
21 â€œAllergic conditions like asthma in patients who have had a history of atopic dermatitis
can be easily diagnosed by health professionals,â€• this statement is;
READING SUB-TEST

8. Correct Answer Is: autonomic nervous system
9. Correct Answer Is: freeze
10. Correct Answer Is: Ocular-Vestibular
11. Correct Answer Is: impulsivity
12. Correct Answer Is: Eustress
13. Correct Answer Is: asymmetrical tonic neck reflex
14. Correct Answer Is: visual processing disorder
15. Correct Answer Is: Saccades
16. Correct Answer Is: Bonding Response
17. Correct Answer Is: Babkin Palmomental
18. Correct Answer Is: Hypersensitive
19. Correct Answer Is: Inadequate Bonding
20. Correct Answer Is: Motor Programming
PART B & C
1. Correct Answer Is: AIDS-related deaths increased more significantly

2. Correct Answer Is: Preparing radix Sophorae tonkinensis samples.
3. Correct Answer Is: Trials performed produced negative results.
4. Correct Answer Is: Type A is known to produce more adverse reactions than all the others present in
the table.
5. Correct Answer Is: Study performed with focus on B12 usage.
6. Correct Answer Is: 32.72 patients were in the age group of 50-60 years.
7. Correct Answer Is: Africa
8. Correct Answer Is: Spread person to person after initial transmission from the infected animals.
9. Correct Answer Is: Five to ten days
10. Correct Answer Is: Monkeys
11. Correct Answer Is: Contaminated needles and syringes
12. Correct Answer Is: High number of viruses in their blood
13. Correct Answer Is: Use of alcohol-based hand rubs, containing at least 60% alcohol, in absence of
water & soap.
14. Correct Answer Is: Not reuse needles and syringes for the second time.
15. Correct Answer Is: Dry, itchy and irritated skin
16. Correct Answer Is: Around the knees
17. Correct Answer Is: All of the above
18. Correct Answer Is: Asthma and hay fever.
19. Correct Answer Is: Allergies
20. Correct Answer Is: Easy
21. Correct Answer Is: True
22. Correct Answer Is: Ointments, creams, lotions and gels.
BRITISH ACADEMY
READING SUB-TEST
Part A
TIME: 15 minutes
Text A
Brain Imaging In Children
A headache is a result of disorders that affect pain-sensitive sites, such as meninges, blood vessels, paranasal
sinuses and muscles; it is also one of the most common causes of pain in children. The prevalence of severe
and frequent headaches is 25.25 per thousand in children. A large number of physicians and parents of sick
children are concerned that inter-carcinoma lesions may be due to headaches. The most important means to
diagnose the cause of headaches is to take precise medical history and para-clinical measures. Brain imaging
method, including CT scan and MRI, is one of the diagnostic methods for children with headaches. The main
reason for performing MRI and CT scans in patients with a headache is the diagnosis of curable lesions, which
can increase the patient’s longevity or improve her quality of life. Cases such as brain tumors, hydrocephalus
vascular malformations, and subdural hematoma are in this category. Another important cause for conducting
MRI in headache patients is a way to alleviate their anxiety due to the presence of a brain tumor or intracranial
disease.
BRITISH ACADEMY
READING SUB-TEST
Text D
Total amount of 353 people were included in the study, of which 7 were excluded during the study. In the first
group, CT scan was performed on 217 patients, of which 85 subjects were girls and 132 were boys and 11.1%
were abnormal. In the second group, 136 people were subjected to MRI, of which 56 (41.1%) were female and
80 (58.8%) were male, and 24.3% were abnormal. Also, according to gender segregation, abnormal findings in
CT scan were significantly higher in boys (63% boys and 37% girls) (P = 0.03), and it was also found that
MRI findings were also significantly more common in boys in comparison to girls (66% vs. 34%) (P = 0.04).
The results of the study showed that the most common CT scan abnormal finding was mass (21%) and
hematoma (21%). Then, cysts (14%) and Ventriculomegaly (14%) were the most frequent forms of
abnormality. Prevalently found abnormality was cysts in MRI (30%). Atrophy (12%) and Ventriculomegaly
had the second and third frequencies (15%) (P> 0.05).
BRITISH ACADEMY
READING SUB-TEST
7 A small localized area of dead tissue resulting from failure of blood supply.
Answer
Questions 8-14
8 Which age group patients were included in the study?
Answer
9 What is the reason presented for taking MRI in children with headache?
Answer
10 What is define as inflammation of the air cavities within the passages of the nose?
Answer
11 Was any defect in medical records an inclusion criteria?
Answer
12 Who shows more peculiarities in CT imaging?
Answer
BRITISH ACADEMY
READING SUB-TEST
Nutrition
Between 2003 to 2004 and 2016 to 2017 in the United States, the mean AHA healthy diet score improved in
both children and adults. The prevalence of an ideal healthy diet score increased from 0.2 percent to 0.6
percent in children and from 0.7 percent to 1.5 percent in adults. These improvements were largely attributable
to increased whole grain consumption and decreased sugar-sweetened beverage consumption in both children
and adults, as well as a small, non-significant trend in increased fruit and vegetable consumption. No major
trends were evident in children or adults in progress toward the targets for consumption of fish or sodium.
Between 2012 and 2017, although AHA healthy diet scores tended to improve in all race/ethnicity, income,
and education levels, there has been constant inequalities as well. with generally smaller improvements seen in
minority groups and those with lower income or education.
About one in every three US adults or 30.4 percent, do not engage in leisure time physical activity. Hispanic
and Non-Hispanic black adults were more likely to be inactive. Among students in grades 9-12, only about
27.1 percent meet the American Heart Association recommendation of 60 minutes of exercise every day. More
high school boys (36 percent) than girls (17.7 percent) reported having been physically active at least 60
minutes per day on all 7 days.
2 BRITISH ACADEMY
READING SUB-TEST
Wild polio
Overall the Committee was encouraged by continued progress in WPV1 eradication, with the number of cases
globally falling to an all-time low in 2017. In addition, there has been no international spread of WPV since
the fifteenth meeting in November 2017.
The Committee commended the continued high level commitment seen in sub continents and the high degree
of cooperation and coordination, particularly targeting the high risk mobile populations that cross the
international border, such as nomadic groups, local populations straddling the border, seasonal migrant
workers and their families, repatriating refugees (official and informal), and guest children (children staying
with relatives across the border). Stopping transmission in these populations is going beyond efforts and
cannot be underestimated, underlining the critical continuing need for cross border activities in surveillance
and vaccination.
5
BRITISH ACADEMY
READING SUB-TEST
Distribution of Ebola virus disease cases by health zone in Democratic Republic of the Congo, 1 April – 9 July
2018
Description Bikoro Iboko Wangata Total
Cases
New Suspected 3 2 0 5
New Probable 0 0 0 0
New Confirmed 0 0 0 0
Total New Cases 3 2 0 5
Cumulative Cases
Total Suspected 3 2 0 5
Total Probable 11 4 0 15
Total Confirmed 10 24 4 38
Total Number of Cases 24 30 4 58
BRITISH ACADEMY
READING SUB-TEST
5 The notice talks more about
how ICD works
ICD purpose and uses
actions undertaken by the ICD
6 What is correct?
Ebola virus is common among Waganta population
There has been widespread prevalence of the virus in Iboko
Virus in Bikoro is spreading at a rate closer to Waganta
BRITISH ACADEMY
READING SUB-TEST
known to occur and you develop severe signs or symptoms of the disease. Even if you develop mild
symptoms, call your doctor. Yellow fever is caused by a virus that is spread by the Aedes aegypti mosquito.
These mosquitoes thrive in and near human habitations where they can breed in even the cleanest water. Most
cases of yellow fever occur in sub-Saharan Africa and tropical South America.
Humans and monkeys are most commonly infected with the yellow fever virus; mosquitoes transmit the virus
back and forth between monkeys, humans or both. When a mosquito bites a human or monkey infected with
yellow fever, the virus enters the mosquito's bloodstream and circulates before settling in the salivary glands.
When the infected mosquito bites another monkey or human, the virus then enters the host's bloodstream,
where it may cause the illness to develop.
You may be at risk of the disease if you travel to an area where mosquitoes continue to carry the yellow fever
virus. These areas include sub-Saharan Africa and tropical South America. Even if there aren't current reports
of infected humans in these areas, it doesn't necessarily mean you're risk-free. It's possible that local
populations have been vaccinated and are protected from the disease, or that cases of yellow fever just haven't
been detected and officially reported. If you're planning on travelling to these areas, you can protect yourself
by getting a yellow fever vaccine at least 10 to 14 days before travelling. Anyone can be infected with the
yellow fever virus, but older adults are at greater risk of becoming seriously ill.
Diagnosing yellow fever based on signs and symptoms can be difficult because, early in its course, the
infection can be easily confused with malaria, typhoid, dengue fever and other viral hemorrhagic fevers. To
diagnose your condition, your doctor will likely: Ask questions about your medical and travel history, collect a
blood sample for testing. If you have yellow fever, your blood may reveal the virus itself. If not, blood tests
called enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) can also detect
antigens and antibodies specific to the virus. Results from these tests may take several days. No antiviral
medications have proved helpful in treating yellow fever and, as a result, treatment consists primarily of
supportive care in a hospital. This includes providing fluids and oxygen, maintaining adequate blood pressure,
replacing blood loss, providing dialysis for kidney failure, and treating any other infections that develop. Some
people receive transfusions of plasma to replace blood proteins that improve clotting. If you have yellow fever,
you may also be kept away from mosquitoes, to avoid transmitting the disease to others.
BRITISH ACADEMY
READING SUB-TEST
People with certain genetic diseases are more likely to have an aortic dissection than other people. These
genetic diseases include Turner's syndrome, high blood pressure, heart problems, and a number of other health
conditions may be a result of this disorder. Marfan syndrome: This is a condition in which connective tissue,
which supports various structures in the body, is weak. People with this disorder often have a family history of
aneurysms of the aorta and other blood vessels. These weak blood vessels are prone to tears (dissection) and
rupture easily. Ehlers-Danlos syndrome: This group of connective tissue disorders is characterized by skin that
bruises or tears easily, loose joints and fragile blood vessels. Loeys-Dietz syndrome: This is a connective tissue
disorder marked by twisted arteries, especially in the neck. People who have Loeys-Dietz syndrome are
thought to be at risk of developing aortic dissections and aneurysms.
An aortic dissection can lead to death, due to severe internal bleeding, including into the lining around the
heart (pericardial sac), organ damage (such as kidney failure or life-threatening damage to the intestines),
strokes (possibly including paralysis), and aortic valve damage, such as causing the aortic valve to leak (aortic
regurgitation). Detecting an aortic dissection can be tricky because the symptoms are similar to those of a
variety of health problems. Doctors often suspect an aortic dissection if the following signs and symptoms are
present: sudden tearing or ripping chest pain, widening of the aorta on a chest X-ray, blood pressure difference
between the right and left arms.
BRITISH ACADEMY
READING SUB-TEST
10 Seizures may occur during;
Acute phase
Toxic phase
Sometimes in both the phases
Not given
11 Yellow fever, which is a viral disease, is spread by;
Aedes albopictus mosquito
Aedes aegypti mosquito
Female aedes mosquito
Male aedes mosquito
12 Mosquitoes transmit the virus from
Humans to monkeys
Monkeys to humans
Human to human
A&B
13 Travelling to areas where the disease is common is recommended after vaccination of;
10 days
12 days
14 days
BRITISH ACADEMY
READING SUB-TEST
Weak pulse in both arms
Loss of consciousness.
All of the above
18 Aortic dissection can also be caused due to;
High BP
Weak aortic wall
Inborn symptoms
Traumatic injury to chest during accidents
19 The most dangerous type of aortic dissection is;
Type A
Type B
Aortic aneurysm
Aortic coarctation
20 A condition in which connective tissue is weak is called;
Turners syndrome
Loeys-Dietz syndrome
Ehlers-Danlos syndrome
Marfans syndrome
BRITISH ACADEMY
READING SUB-TEST
ANSWERS
Part A

8. Correct Answer Is: below twelve years
9. Correct Answer Is: diagnosis of curable lesions
10. Correct Answer Is: sinusitis
11. Correct Answer Is: no
12. Correct Answer Is: boys
13. Correct Answer Is: non-parametric Mann-Whitney
14. Correct Answer Is: mass and hematoma
15. Correct Answer Is: Hematoma
16. Correct Answer Is: Statistical Analyzes
17. Correct Answer Is: 61%
18. Correct Answer Is: Ventriculomegaly
19. Correct Answer Is: Demyelinating Disease
20. Correct Answer Is: Atrophy
Part B & C
1. Correct Answer Is: many disparities present in 2012-2017 widened over time
2. Correct Answer Is: infantile reflex
3. Correct Answer Is: places women at the centre of the care
4. Correct Answer Is: disease control is a still a big problem
5. Correct Answer Is: ICD purpose and uses
6. Correct Answer Is: There has been widespread prevalence of the virus in Iboko
7. Correct Answer Is: Both
8. Correct Answer Is: Dry tongue
9. Correct Answer Is: B and C
10. Correct Answer Is: Toxic phase
11. Correct Answer Is: Aedes aegypti mosquito
13. Correct Answer Is: 10-14 days
14. Correct Answer Is: B and C
15. Correct Answer Is: Inner layer of aorta.
16. Correct Answer Is: Men
17. Correct Answer Is: Loss of consciousness.
18. Correct Answer Is: Traumatic injury to chest during accidents
19. Correct Answer Is: Type A
20. Correct Answer Is: Marfans syndrome
21. Correct Answer Is: Aneurysms
22. Correct Answer Is: Difficult
BRITISH ACADEMY
READING SUB-TEST
Text B
Patch testing
The mainstay of diagnosis in allergic contact dermatitis is the patch test. This test has a sensitivity and
specificity of between 70% and 80%15. Patch testing involves the reproduction under the patch tests of
allergic contact dermatitis in an individual sensitized to a particular antigen(s). The standard method involves
the application of the antigen to the skin at standardized concentrations in an appropriate vehicle and under
occlusion. The back is most commonly used principally for convenience because of the area available,
although the limbs, in particular the outer upper arms, are also used. Various application systems are available
of which the most commonly used are Finn chambers. With this system, the investigator adds the individual
allergens to test discs that are loaded on to adhesive tape. Available are available – the TRUE and the Epiquic
tests. There are few comparative studies between the different systems. Pre-prepared tests are significantly
more reliable than operator-prepared tests. There is also some evidence that larger chambers may give more
reproducible tests. However, this may only apply to some allergens. The open patch test, not so common, is
used where potential irritants or sensitizers are being assessed. It is also useful in the investigation of contact
urticaria and protein contact dermatitis. The open patch test is usually performed on the forearm but the upper
outer arm or scapular areas may also be used. The site should be assessed at regular intervals for the first 30–
60 min and a later reading should be carried out after 3–4 days. A repeated open application test, applying the
suspect agent on to the forearm, is also useful in the assessment of cosmetics, where irritancy or combination
effects may interfere with standard patch testing. This usually involves the application of the product twice
daily for up to a week, stopping if a reaction develops.
BRITISH ACADEMY
READING SUB-TEST
Questions 1-7
more than once.
1 One of the most common tests.
Answer :
2 The blockage or closing of a blood vessel or hollow organ.
Answer :
3 Important factors that may influence the testing results.
Answer :
4 The condition that occurs in response to excessive itching or rubbing of the skin.
Answer :
5 Two different types of tests which help in diagnosing the disease condition.
Answer :
6 The process or fact of irradiating or being irradiated.
Answer :
7 Splitting or cracking of the skin.
Answer :
BRITISH ACADEMY
READING SUB-TEST
Questions 15-20
15 as the cumulative irritant is known to create more worsening conditions.
16 The open patch is carried in order to examine the potentiality of the or irritants.
17 The chronic phase of a polymorphic pattern of inflammation is characterized by .
18 Carba mix is one of the in the standard series.
19 The standard method of testing involves the application of the .
20 As per recommendations, allergens be subjected to .
BRITISH ACADEMY
READING SUB-TEST
2q37 deletion syndrome
It is a condition that can affect many parts of the body. This condition is characterized by hypotonia in infancy,
mild to severe intellectual disability and developmental delay, behavioral problems, characteristic facial
features, and other physical abnormalities.
Most babies with 2q37 deletion syndrome are born with potentially chronic fatigue, which usually improves
with age. About 25 percent of people with this condition have autism, a developmental condition that affects
communication and social interaction.
The characteristic facial features associated with 2q37 deletion syndrome include a prominent forehead, highly
arched eyebrows, deep-set eyes, a flat nasal bridge, a thin upper lip, and minor ear abnormalities. Other
features of this condition can include short stature, obesity, unusually short fingers and brachymesophalangy,
sparse hair, heart defects, seizures, and an inflammatory skin disorder called eczema. A few people with 2q37
deletion syndrome have a rare form of kidney cancer called Wilms tumor.
Sterile technique
Surgical asepsis is used to maintain sterilize. Use of effective sterile technique means that no organisms are
carried to the client. Microorganisms are destroyed before they can enter the body. Sterile technique is used
when changing dressings, administering parenteral (other than the digestive tract) medications, and performing
surgical and other procedures such as urinary catheterization. With surgical asepsis, first articles are sterilized,
and then their contact with any unsterile articles is prevented. When a sterile article touches an unsterile
article, it becomes contaminated. It is no longer sterile.
BRITISH ACADEMY
READING SUB-TEST
Questions 1-6
1 The notice talks about;
A How blood clots occur.
B Blood clot doesn`t form. (if the reaction doesn`t occur the way it should)
C Blocking of clotting reaction.
2 What is correct?
A All types of Factor I deficiency affect both males and females.
B The fibrogen defect in impairment leads to disorder.
C Genes can be both recessive or dominant.
3 What is referred to as â€œweak muscleâ€•?
A Chronic fatigue
B Brachymesophalangy
C Hypotonia
4 The notice talks about;
A Every kind of procedure is used in the process of sterilization to keep sterile the objects or articles that
are to be introduced into a wound or body cavity or that is to penetrate the skin;
B General overview of sterilization techniques;
C The practices that the nurses will have to focus on;
BRITISH ACADEMY
READING SUB-TEST
Part C
Text 1: Cancer and Cervical Cancer
The body is made up of trillions of living cells. Normal body cells grow, divide, and die in an orderly fashion.
During the early years of a person`s life, normal cells divide faster to allow the person to grow. After the
person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries.
Cancer begins when cells in a part of the body start to grow out of control. There are many kinds of cancer, but
they all start due to out-of-control growth of abnormal cells. Cells become cancer cells because of damage to
DNA. DNA is in every cell and directs all its actions. In a normal cell, when DNA gets damaged the cell either
repairs the damage or the cell dies. In cancer cells, the damaged DNA is not repaired, but the cell doesn`t die
like it should. Instead, this cell goes on making new cells that the body does not need. These new cells will all
have the same damaged DNA as the first cell does.
No matter where cancer may spread, it is always named after the place where it started. For example, breast
cancer that has spread to the liver is still called breast cancer, not liver cancer. Likewise, prostate cancer that
has spread to the bone is metastatic prostate cancer, not bone cancer. Different types of cancer can behave very
differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates
and respond to different treatments. That is why people with cancer need the treatment that is aimed at their
particular kind of cancer. Not all tumors are cancerous. Tumors that aren`t cancer are called benign. Benign
tumors can cause problems – they can grow very large and press on healthy organs and tissues. But they
cannot grow into (invade) other tissues. Because they can`t invade, they also can`t spread to other parts of the
body (metastasize). These tumors are almost never life threatening.
The cervix is the lower part of the uterus (womb). It is sometimes called the uterine cervix. The body of the
uterus (the upper part) is where a baby grows. The cervix connects the body of the uterus to the vagina (birth
canal). The part of the cervix closest to the body of the uterus is called the endocervix. The part next to the
vagina is the exocervix (or ectocervix). The 2 main types of cells covering the cervix are squamous cells (on
the exocervix) and glandular cells (on the endocervix). The place where these 2 cell types meet is called the
BRITISH ACADEMY
READING SUB-TEST
Text 2: Hepatitis – Viral Liver Infection
Hepatitis (A, B, or C) can be caused by a virus (Viral Hepatitis), drugs, alcohol, medications, and blood
transfusions. Scientists estimate that between 3.5 and 5.3 million people in the USA are living with Hepatitis.
A blood test is required to diagnose Hepatitis infection. Hepatitis A is a viral liver infection. In most cases the
body easily defeats the virus (much like the flu, which is what you may feel like you have). Because of this it
does not lead to long term liver challenges. Hepatitis A is the most common form of Hepatitis. It is spread
through the feces of a contaminated person. This can easily be prevented by thoroughly washing hands after
using the restroom, before eating, and after changing a diaper.
Eating raw oysters and undercooked clams can increase your chances of contracting the virus. If you are
traveling in a country where Hepatitis is common make sure you wash your hands often and well, eat cooked
oysters and clams, and use an antiviral essential oil such as Lemon to help protect yourself. Hepatitis B is a
viral liver infection. Again, most adult bodies are able to fight off the virus. In this case, it is referred to as
Acute (something that does not last long) Hepatitis B. Hepatitis B is spread through contact with blood or
bodily fluids of an infected person. This can include unprotected sexual intercourse, sharing drug needles,
getting a tattoo with instruments that were not properly cleaned, or by sharing a personal item such as a razor
or toothbrush with an infected person.
A mother who is infected can pass the virus on to her baby during delivery. Again, the symptoms are flu-like
in nature, so it often goes undiagnosed. A person who has Chronic (lasting three months or more) Hepatitis B
may show no symptoms until liver damage has occurred. Hepatitis B can lead to liver damage or cancer; your
doctor may want to do a biopsy to determine the amount of damage your liver has experienced. Hepatitis C is
also a viral liver infection. A few people will contract Hepatitis C and get better. This is called Acute Hepatitis
C. Most, however, will develop Chronic Hepatitis C and go on to deal with liver damage, cirrhosis of the liver,
liver cancer, and possibly liver failure. Hepatitis C is the number one reason for liver transplants in the USA.
Hepatitis C is spread through contact with contaminated blood. This can occur by sharing a needle, receiving a
blood transfusion or organ transplant (blood and organs have been screened for Hepatitis in the USA since
1992), getting a tattoo with equipment that has not been properly cleaned, and, in rare cases, a mother can pass
the virus on to her baby during birth. Scientists are not sure, but think there may be a slim possibility that the
virus may be passed through unprotected sexual intercourse.
BRITISH ACADEMY
READING SUB-TEST
9 Cancer in liver having its origin in breast is a;
A Liver cancer
B Breast cancer
C Prostate cancer
D Bone cancer
8 The DNA in cancer cells is;
A Damaged, but can be repaired.
B Not totally damaged.
C Permanently damaged, but the cell doesn`t die.
D Damaged but creates new cells with damaged DNA.
7 When a person becomes an adult, the cells divide only to;
A Replace old cells
B Replace dying cells
C Repair injuries
D All of the above
10 Benign tumors;
A Can grow and invade the tissues.
B Can grow and press on healthy organs and tissues.
BRITISH ACADEMY
READING SUB-TEST
14 Pre-cancerous cells in women can go away;
A With growth in more number of new cells.
B With medications from doctors.
C Without treatment
D Can`t say
15 Hepatitis is caused by;
A Virus
B Alcohol consumption
C Medications
D All of the above
16 Which of the following spreads through feces of a contaminated person;
A Hepatitis A
B Hepatitis B
C Both
D Can`t say
17 Most adult bodies are able to fight off this virus;
A Hepatitis A virus
B Hepatitis B virus
BRITISH ACADEMY
READING SUB-TEST
21 A patient may experience jaundice when;
A The flu-like symptoms appear.
B The flu-like symptoms disappear.
C Eyes become yellow.
D All of the above.
22 â€œBe Young essential oilsâ€• are;
A Free from extenders
B EOBBD
C Full of synthetics
D Not given
BRITISH ACADEMY
READING SUB-TEST

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.
Text A
Atrial fibrillation (AF)
Atrial fibrillation (AF) is the most common cardiac arrhythmia. It affects >33 million individuals worldwide,
and its prevalence is projected to double by 2050. AF is associated with a 5- and 2-fold increased risk of stroke
and mortality, respectively. Furthermore, AF-related strokes are associated with higher morbidity, mortality,
and health care costs compared with non-cardioembolic strokes.
The mainstay of stroke prevention remains oral anticoagulation (OAC), with vitamin K antagonists and more
recently, direct oral anticoagulants (DOAC), reducing the risk of ischemic stroke and all-cause mortality in
patients with AF. However, more than one-third of AF patients at high risk for stroke still fail to receive
effective stroke prophylaxis in contemporary practice. Although the introduction of DOAC has overcome
some of the limitations of warfarin therapy, persistent barriers including costs, ongoing bleeding risks with no
reversal agent for most DOACs, noncompliance and high discontinuation rates may preclude a broader use of
DOAC in clinical practice.
BRITISH ACADEMY
READING SUB-TEST
Text D
The transseptal puncture is performed under fluoroscopic and preferably transesophageal echocardiography
(TEE; bicaval view followed by short-axis view) guidance in the inferoposterior portion of the fossa ovalis.
After transseptal puncture, a long extra-stiff J tipped 0.035-inch wire is advanced into the left upper pulmonary
vein and the transseptal sheath is exchanged over the wire for the access sheath. After removal of dilator and
guidewire, a 5F to 6F pigtail catheter is advanced through the access sheath into the left upper pulmonary vein.
By using TEE and fluoroscopic guidance, it will be easy to create some access. In the stage pertaining to it,
access sheath and pigtail are adjusted as required. Appropriate WATCHMAN device sizing is determined by
the maximum LAA ostium diameter (measured from the circumflex artery to 1-2 cm within the pulmonary
vein ridge at 0°, 45°, 90°, and 135°) and depth (from ostium to the tip of LAA). An oversizing of the device by
10 to 20 percent (corresponding to 2–4 mm) is generally recommended. A fluoroscopic right (20°–30°) and
caudal (20°–30°) projection, which usually opens the mid-distal portion of the LAA is the preferred one for the
deployment of the WATCHMAN device. After accurate LAA assessment, the delivery system is advanced
into the access sheath until the distal markers of the delivery catheter and the access sheath align. The device is
then deployed with a slow unsheathing movement.
BRITISH ACADEMY
READING SUB-TEST
Questions 8-14
8 What is generally recommended with respect to device sizing?
Answer :
9 When will the catheter be introduced into the left upper pulmonary vein?
Answer :
10 In how many sizes, the WATCHMAN device is available?
Answer :
11 What will be the outer diameter of the transseptal access sheath?
Answer :
12 What is recommended for the effective use of the Watchman Device?
Answer :
13 What is taken into account to measure the size of the device?
Answer :
14 What is the study more focused on?
Answer :
BRITISH ACADEMY
READING SUB-TEST
Part B
Nursing care of the heart transplant patient
Nursing care of the heart transplant patient is similar to the care of any cardiac surgery patient. Bleeding is a
major concern in the early postoperative period. Chest tube drainage is frequently monitored (initially every 15
minutes), as are the cardiac output, pulmonary artery pressures, and CVP. Cardiac tamponade can develop,
presenting as either a sudden event or a gradual process. Chest tubes are gently milked (not stripped) as needed
to maintain patency. Atrial dysrhythmias are relatively common following cardiac transplant. Temporary
pacing wires are placed during surgery because surgical manipulation or postoperative swelling may disrupt
the conduction system. Hypothermia is induced during surgery; postoperatively, the patient is gradually re-
warmed over a 1- to 2-hour period. Cardiac function is impaired in up to 50% of transplanted hearts during the
early postoperative period. Inotropic agents such as low-dose dopamine, dobutamine, or milrinone may be
required to bring more stability.
Cardiology Conference
With people from around the world focused on getting some answers concerning Cardiology, this is your
single most obvious opportunity to accomplish the greatest accumulation of individuals from the mending
focuses, Universities, bunch, etc. This Cardiology conference rather European Cardiology Congress in 2017
will coordinate appears, disperse information, meet with recurring pattern and potential investigators and get
name affirmation at this 3-day event. Broadly acclaimed speakers, the most recent frameworks,
methodologies, and the most current updates in Cardiology field are indications of this conference. This World
Cardiology Congress will help in frameworks organization, B2B uniting amidst specialists and academicians.
BRITISH ACADEMY
READING SUB-TEST
Medication Survey
In a survey of 598 communities in 18 countries, the availability of aspirin, β-blockers, ACEIs, and statins
varied widely In the low-income countries, only 1 of 30 rural and only 25 of 32 urban communities had all 4
medications available. The 4 medications were potentially unaffordable for 60% of households in low-income
countries. Availability rose to 37% (rural) and 62% (urban) in lower middle-income countries and 73% (rural)
and 80% (urban) in upper middle-income countries. Effective strategies for delivering medications are being
developed for LMIC where health system infrastructure is underdeveloped.
BiDil - Support Blacks
BiDil for in African Americans BiDil, a fixed-dose combination of two vasodilators (hydralazine and
isosorbide), is indicated as an adjunctive treatment in African Americans with heart failure. It has been shown
to reduce symptoms, decrease the number of hospitalizations, and prolong life in Blacks. The recommended
dose is one to two tablets three times per day, although the dose may be as low as 1/2 tablet three times a day
if side effects are intolerable. The approval of this combination drug has raised the ethical issue of race-
specific FDA approval.
BRITISH ACADEMY
READING SUB-TEST
5 According to the information given, what is correct?
A Only 40% of the household could have afforded the medications.
B 33% of households in lower middle-income countries managed to have used the mediations.
C 25% of households in upper middle-income countries got access to medications.
6 The given notice talks about;
A Bidil dosage use.
B Effectiveness of BiDil in treating heart failure.
C how it helped the community.
BRITISH ACADEMY
READING SUB-TEST
the Zika virus disease are fever, rashes, joint pain, and red eyes. Other symptoms include muscle pain and
headaches. Many people infected with Zika won`t have symptoms or will have mild symptoms, which can last
for several days to a week.
Currently, there is no evidence that a woman who has recovered from the Zika virus infection (the virus has
cleared her body) will have Zika-related pregnancy complications in the future. Based on information about
similar infections, once a person has been infected with the Zika virus and has cleared the virus, he or she is
likely to be protected from future Zika infections. If you`re thinking about having a baby in the near future and
you or your partner live in or travelled to an area with Zika, talk with your doctor or another healthcare
provider. Men who have travelled to any areas with Zika or who have had a Zika infection should wait at least
6 months after travel (or 6 months after symptoms started if they get sick) before trying to conceive with their
partner. Women should wait at least 8 weeks after travel (or 8 weeks after symptoms started if they get sick)
before trying to get pregnant.
Text 2: Avian Influenza - A Virus Infections in Humans
Although avian influenza A viruses usually do not infect humans, rare cases of human infection with these
viruses have been reported. Infected birds shed the avian influenza virus in their saliva, mucus and feces.
Human infections with bird flu viruses can happen when enough of the virus gets into a person`s eyes, nose or
mouth, or is inhaled. This can happen when the virus is in the air (in droplets or possibly dust) and a person
breathes it in, or when a person touches something that has the virus on it and then touches their mouth, eyes
or nose. Rare human infections with some avian viruses have occurred most often after unprotected contact
with infected birds or surfaces contaminated with avian influenza viruses. However, some infections have been
identified where direct contact was not known to have occurred.
The reported signs and symptoms of low pathogenic avian influenza (LPAI) A virus infections in humans have
ranged from conjunctivitis to influenza-like illness (e.g., fever, cough, sore throat, muscle aches) to lower
respiratory disease (pneumonia) requiring hospitalization. Highly pathogenic avian influenza (HPAI) LPAI
H7N9 and HPAI Asian H5N1 have been responsible for most human illness worldwide to date, including the
most serious illnesses and deaths. A virus infections in people have been associated with a wide range of
illness from conjunctivitis only to severe respiratory illness (e.g. shortness of breath, difficulty breathing,
BRITISH ACADEMY
READING SUB-TEST
avian influenza viruses. For example, the United States government always have access to the stockpiled
vaccine to protect against avian influenza A H5N1 vaccine. The stockpiled vaccine could be used if a similar
H5N1 virus were to begin transmitting easily from person to person. Creating a candidate vaccine virus is the
first step in producing a vaccine.
BRITISH ACADEMY
READING SUB-TEST
C They should inform their doctor before travelling.
D Not given
11 In paragraph 5, how many methods of prevention from Zika are described?
A Plenty of prevention measures
B2
C3
D4
12 Can a person who is completely recovered from Zika virus infection, get Zika infection
again?
A. Yes
B. No
C. Depends from person to person
D. Not given
13 According to paragraph 6, which one of the following statements is true?
A A woman`s future pregnancies will be at risk if she is infected with the Zika virus.
B There is no evidence that infected women will not face any complications in future pregnancies.
C Any woman who is infected with Zika is advised to wait for six months before getting pregnant.
DB&C
14 According to paragraph 6, which of the following is not true?
BRITISH ACADEMY
READING SUB-TEST
C H5N1
D LPAI H7N9
18 According to paragraph 3, what is not true?
A A molecular test is performed to see the presence of the virus in the collected specimen.
B Lab tests are aimed at growing the virus for the right detection purpose.
C A specimen for testing is usually collected right after the person gets the illness by infection.
D People who have recovered from the illness should also be diagnosed for further confirmation.
19 According to paragraph 3, the word â€œgargantuanâ€• may mean;
A Small-scale
B Trivial
C Very large
D Pint-sized
20 Which central idea is presented in paragraph 4?
A Treatment of the avian influenza disease.
B Effective medications for the viral disease.
C Research on effective medicine for the avian virus disease.
D None of the above.
BRITISH ACADEMY
READING SUB-TEST
ANSWERS
PART A

8. Correct Answer Is: Oversizing by 10 to 20 percent
9. Correct Answer Is: After removal of dilator and guidewire
10. Correct Answer Is: Five
11. Correct Answer Is: 14 F
12. Correct Answer Is: Fluoroscopic right and caudal projection
13. Correct Answer Is: Maximum diameter / LAA ostium diameter
14. Correct Answer Is: LAAC recipients
15. Correct Answer Is: oral anticoagulation (OAC)
16. Correct Answer Is: radio-opaque markers
17. Correct Answer Is: fluoroscopic guidance
18. Correct Answer Is: warfarin therapy
19. Correct Answer Is: 10% to 20%
20. Correct Answer Is: unsheathing movement
PART B & C
1. Correct Answer Is: C Support cardiac function and circulation.
2. Correct Answer Is: A Why medical professionals shall join the conference?
3. Correct Answer Is: C extra sensitivity to glare and dry eyes
4. Correct Answer Is: A Complications involved in DVT.
5. Correct Answer Is: A Only 40% of the household could have afforded the medications.
6. Correct Answer Is: B Effectiveness of BiDil in treating heart failure.
7. Correct Answer Is: C Severe disease
8. Correct Answer Is: C How do people get infected with Zika?
9. Correct Answer Is: B What health problems can result from getting Zika?
11. Correct Answer Is: C 3
12. Correct Answer Is: B. No
13. Correct Answer Is: A A woman`s future pregnancies will be at risk if she is infected with the Zika
virus.
14. Correct Answer Is: C In most of the cases, Zika complications may occur in future pregnancies.
15. Correct Answer Is: B The eyes
16. Correct Answer Is: A Uncommon
17. Correct Answer Is: B HPAI
18. Correct Answer Is: D People who have recovered from the illness should also be diagnosed for further
confirmation.
19. Correct Answer Is: C Very large
20. Correct Answer Is: A Treatment of the avian influenza disease.
21. Correct Answer Is: A Exposure
22. Correct Answer Is: D To be firm and determined in order to get what you want.
BRITISH ACADEMY
READING SUB-TEST
Text B
The molecular basis of post-transplantation erythrocytosis (PTE) remains unclear. It is found in 5-10% of renal
allograft recipients developing within 8-24 months following a successful renal transplantation. It resolves
spontaneously within 2 years in about 25% of patients. In congenital secondary polycythemia, mutations in the
haemoglobin can lead to increased oxygen affinity leading to decreased oxygen delivery and compensatory
polycythemia. A rare mechanism in this group is 2, 3 BPG deficiency. This compound is synthesised in red
blood cell and binds to haemoglobin reducing its affinity for oxygen. Its absence leads to increased affinity of
haemoglobin for oxygen resulting in a lifelong hypoxic stimulus and erythrocytosis. The fetal haemoglobin
has high oxygen affinity and many of the neonates may have markedly elevated hematocrits. Polycythemia
vera rises from the transformation of a single hematopoietic stem cell with a selective growth advantage that
gradually becomes the predominant myeloid progenitor. Recently a somatic mutation is detected in a gene on
chromosome 9p in a majority of polycythemia vera patients. This gene encodes for tyrosine kinase JAK. This
somatic mutation transforms this kinase into a constitutively active form and seems to be responsible for the
uncontrolled proliferation of the erythroid cells.
Text C
Clinical Approach
Symptoms of polycythemia are very nonspecific like a headache, weakness, pruritus, dizziness, sweating and
visual disturbances. Some of the patients are seen initially with complications of polycythemia like thrombosis
(cerebral, peripheral) and haemorrhage. Thrombosis may occur at unusual sites like hepatic vein.
Polycythemia may be diagnosed when Budd Chiari syndrome is being investigated. Hematocrit values above
51% in males and over 48% in females requires further evaluation.
Diagnostic criteria laid down by PVSG and WHO require demonstration of an elevated red cell mass as a
must. This is practically not possible in most centres. So, WHO has revised the criteria (2008) for the
diagnosis of PV6 .
Accordingly, there are 2 major and 3 minor criteria.
BRITISH ACADEMY
READING SUB-TEST
Age >60yrs or history of

Cardiovascular risk factors
thrombosis
Risk category
Low No No
Intermediate No Yes
High Yes
Phlebotomy is the cornerstone of low-risk patients aimed at reaching and maintaining a target hematocrit of
45% in males and 42% in females. Low dose aspirin may be added to the treatment. High-risk patients should
receive myelosuppressive treatment in addition to phlebotomy. The drug of choice is hydroxyurea.
PV may infrequently occur during childbearing years. There is an increased incidence of abortion in about
30% of cases. Pre-eclampsia is also common. It is very interesting that some of the women may even reduce
their hematocrit. Their phlebotomy requirement is also found to be decreased. The possible explanations are
the erythropoietic suppressive effect of the high estrogen levels, expansion of the plasma volume and
nutritional deficiencies. If needed, the patient should be treated with phlebotomy, low dose aspirin or
interferon. After delivery the blood count will drift back to the original polycythemic level.
BRITISH ACADEMY
READING SUB-TEST
Answer
7 An enzyme that can transfer a phosphate group from ATP to a protein in a cell.
Answer
Questions 8-14
8 What is the term which refers to the use of the drug in the treatment of certain cancers?
Answer
9 What is found in a gene on chromosome 9p in patients?
Answer
10 When does a patient develop anaemia?
Answer
11 What is the condition in which bone marrow activity is decreased, resulting in fewer red blood cells, white
blood cells, and platelets?
Answer
12 What leads to the formation by peripheral blood mononuclear cells from patients with polycythemia vera?
BRITISH ACADEMY
READING SUB-TEST
Part B
6, choose the answer (A, B or C), which you think fits best according to the text.
The American Academy of Pediatrics recommends screening for dyslipidemia in children and adolescents who
have a family history of dyslipidemia or premature CVD, those whose family history is unknown, and those
youths with risk factors for CVD, such as being overweight or obese, having hypertension or DM, or being a
smoker 1 In 2011, the NHBLI Expert Panel recommended universal dyslipidemia screening for all children
between 9 and 11 years of age and again between 17 and 21 years of age 23.
Analysis of data from NHANES 1999 to 2006 showed that the overall prevalence of abnormal lipid levels
among youths 12 to 19 years of age was 20 3%. From 2005 to 2010, among adults with high LDL- C, age-
adjusted control of LDL-C increased from 22 3% to 29 5% 25 The prevalence of LDL-C control was lowest
among people who reported receiving medical care less than twice in the previous year (11 7%), being
uninsured (13 5%), being Mexican American (20 3%), or having income below the poverty level (21 9%) 2.
BRITISH ACADEMY
READING SUB-TEST
cycles of 30 compressions and 2 breaths. Increasing or decreasing the CPR time setting may increase or
decrease the number of actual cycles allowed during the CPR timeout period.
The geometric mean level of triglycerides for American adults ≥20 years of age was 103 5 mg/ dL in
NHANES 2011 to 2014. Approximately 24 2% of adults had high triglyceride levels (≥150 mg/dL) in
NHANES 2011 to 2014. Among males, the age-adjusted geometric mean triglyceride level was 111 6 mg/dL
in NHANES 2011 to 2014, with the following racial/ethnic breakdown: — 113 2 mg/dL for non-Hispanic
white males — 86 7 mg/dL for non-Hispanic black males — 124 1 mg/dL for Hispanic males — 115 3 mg/dL
for non-Hispanic Asian males
Relationship of a liver index and its parameters to HCC aggressiveness
β Se(β) p. 95% C.I
(A)
Liver Index score 0.2462 0.0247 <0.001 0.1978 to 0.2945
(B)
GGTP (IU/ml) 0.0013 0.0003 <0.001 0.0007 to 0.0020
Total Bilirubin
0.0585 0.0140 <0.001 0.0311 to 0.0859
(mg/dl)
Albumin (g/dl) -0.3821 0.0554 <0.001 -0.4908 to -0.2733
BRITISH ACADEMY
READING SUB-TEST
1 As per the following notice, what is correct?
Dyslipidemia in children is common.
Young committee mostly gets affected by the disease.
Statistics showing the curtailment ratio of the affected people.
2 Notice on debatable concepts gives information about;
Concepts which may have direct impact on splenectomy.
Conditions which might arise after splenectomy.
Situations requiring great effort.
3 The manual gives information about
Rescue Protocol
Emergency Care Plan
Adjustable Properties of Powerheart AED G3
4 As per the given notice, GM levels of triglycerides is;
Higher among people who are 20+ years.
Common among men.
Common among women.
BRITISH ACADEMY
READING SUB-TEST
Part C
Text 1: Anaplasmosis
Anaplasmosis is a tick-borne disease caused by the bacterium anaplasma phagocytophilum. It was previously
known as human granulocytic ehrlichiosis (HGE) and has more recently been called human granulocytic
anaplasmosis (HGA). Anaplasmosis is transmitted to humans by tick bites, primarily from the black-legged
tick (Ixodes scapularis) and the western black-legged tick (Ixodes pacificus). Of the four distinct phases in the
tick life-cycle (egg, larva, nymph, adult), nymphal and adult ticks are most frequently associated with
transmission of anaplasmosis to humans. Typical symptoms include fever, headache, chills, and muscle aches.
Usually, these symptoms which occur within 1-2 weeks of a tick bite can’t be known and in many cases can’t
even be averted. Anaplasmosis, which often can’t be thwarted, is initially diagnosed based on symptoms and
clinical presentation, and later confirmed by the use of specialized laboratory tests. The first line treatment for
adults and children of all ages is doxycycline. Anaplasmosis and other tick-borne diseases can be obviated.
Anaplasmosis is caused by the bacterium anaplasma phagocytophilum. This organism used to be known by
other names, including Ehrlichia equi and Ehrlichia phagocytophilum, and the disease caused by this organism
has been previously described as human granulocytic ehrlichiosis (HGE). However, a taxonomic change in
2001 identified that this organism belonged to the genus anaplasma, and resulted in a change in the name of
the disease to anaplasmosis. Anaplasmosis was first recognized as a disease of humans in the United States in
the mid-1990’s, but did not become a reportable disease until 1999. The number of anaplasmosis cases
reported has increased steadily since the disease became reportable, from 348 cases in 2000, to 1761 cases in
2010. The incidence (the number of cases for every million persons) of anaplasmosis has also increased, from
1.4 cases per million persons in 2000 to 6.1 cases per million persons in 2010. The case fatality rate (i.e. the
proportion of anaplasmosis patients that reportedly died as a result of infection) has remained low, at less than
1%.
BRITISH ACADEMY
READING SUB-TEST
Text 2: Candidiasis
Candidiasis is a fungal infection caused by yeasts that belong to the genus Candida. There are over 20 species
of Candida yeasts that can cause infection in humans, the most common of which is Candida albicans. Candida
yeasts normally reside in the intestinal tract and can be found on mucous membranes and skin without causing
infection; however, overgrowth of these organisms can cause symptoms to develop. Symptoms of candidiasis
vary depending on the area of the body that is infected.
Candidiasis that develops in the mouth or throat is called “thrush” or oropharyngeal candidiasis. Candidiasis in
the vagina is commonly referred to as a “yeast infection.” Invasive candidiasis occurs when Candida species
enter the bloodstream and spread throughout the body. The infection is not very common in the general
population. It is estimated that between 5% and 7% of babies less than one month old will develop oral
candidiasis. The prevalence of oral candidiasis among AIDS patients, (particularly women rather than men,
although not yet an established fact) is estimated to be between 9% and 31%, and studies have documented
clinical evidence of oral candidiasis in nearly 20% of cancer patients. Candidiasis of the mouth and throat, also
known as “thrush" or oropharyngeal candidiasis, is a fungal infection that occurs when there is an overgrowth
of a yeast called Candida. Candida yeasts normally live on the skin or mucous membranes in small amounts.
However, if the environment inside the mouth or throat becomes imbalanced, the yeasts can multiply and
cause symptoms. Candida overgrowth can also develop in the oesophagus, and this is called Candida
esophagitis, or esophageal candidiasis.
Candida infections of the mouth and throat can manifest in a variety of ways. The most common symptom of
oral thrush is white patches or plaques on the tongue and other oral mucous membranes. Other symptoms
include redness or soreness in the affected areas; difficulty swallowing; cracking at the corners of the mouth
(angular cheilitis) etc.
Candida infections of the mouth and throat are infrequent among adults who are otherwise healthy. Oral thrush
presents itself most recurrently among babies less than one month old, the elderly, and groups of people with
weakened immune systems. Other factors associated with oral and esophageal candidiasis include HIV/AIDS,
cancer treatments, organ transplantation, diabetes etc. Good oral hygiene practices may sporadically help to
prevent oral thrush in people with weakened immune systems. Some studies have shown that chlorhexidine
(CHX) mouthwash can help to prevent oral candidiasis in people undergoing cancer treatment. People who use
BRITISH ACADEMY
READING SUB-TEST
7 According to paragraph 1, what is not anaplasmosis?
A bacterial disease
A disease that is transmitted by tick bites
A disease in which people suffer from muscle pain
A disease that canâ€™t be prevented
8 Which word in paragraph 1 may mean â€œremoving difficultyâ€•?
Averted
Thwarted
Obviated
None of the above.
9 Paragraph 2 deals more with the;
Taxonomy of anaplasmosis.
Classification of the anaplasmosis.
How anaplasmosis entered the US.
Annual cases of anaplasmosis in the US.
10 What is not true about anaplasmosis, according to paragraph 2?
The old name of anaplasmosis was HGE.
The causal agent of anaplasmosis was recorded to be ehrlichia equi
BRITISH ACADEMY
READING SUB-TEST
14 According to paragraph 6, what is not true about anaplasmosis?
It is difficult to diagnose and treat anaplasmosis
Why tests for anaplasmosis appear negative
Different patients may show different symptoms
A patients medical history is often taken into consideration
15 According to paragraph 1, the abode for candida yeasts is;
Intestinal tract
Mucous membrane
Skin
All of the above
16 According to paragraph 2, oral candidiasis is;
Prevalent among children.
Prevalent among babies.
Common among people suffering from AIDS.
Common among female patients with AIDS.
17 According to paragraph 2, candida yeasts;
grow on the mucous membrane.
grow under the skin of the mouth.
BRITISH ACADEMY
READING SUB-TEST
21 The word â€œsporadicâ€• in paragraph 4 means;
Always
Not regular
Intermittently
Every so often
22 What is the central idea presented in paragraph 5?
The treatment process of candidiasis.
Treatment and outcome.
Medication for candidiasis.
None of the above.
BRITISH ACADEMY
READING SUB-TEST

READING SUB-TEST
Text B
Tumor Necrosis Factor α
TNF-α is a pro-inflammatory cytokine secreted by several cell types such as neutrophils, macrophages, T and
B lymphocytes, endothelial cells, mast cells, fibroblasts etc. In liver, hepatocytes and Kupffer cells are the
major contributors of TNF- α. TNF-α plays a central role in the initiation of inflammatory cascade and its
progression from steatosis to steatohepatitis. Experiments with mice models for obesity have shown the
importance of TNF-α in NAFLD, where anti- TNF-α drug therapy showed promising results. Increased free
fatty acid level in obesity stimulates the hepatocytes to secrete TNF-α, which elicits the free fatty acid induced
expression of inflammatory genes. A positive correlation has been observed between TNF-α level in serum
and degree of fibrosis in patients with NAFLD. A study with pentoxifylline - an inhibitor of TNF-α has shown
suppressive effect on elevation of serum transaminases and triglycerides in experimental NAFLD induced rats.
The study also demonstrated that NAFLD induced TNF-α expression stimulates endoplasmic reticulum stress,
which further mediate the progression of steatosis to fibrosis. c-Jun N-terminal Kinase 1 (JNK1) a stress
activated protein kinase is activated by TNF-α which leads to initiation of an autocrine/paracrine loop resulting
in enhanced TNF- α production in liver. TNF-α activates inhibitory kappa b kinase β (IKKβ) which
phosphorylates IKB resulting in the translocation of NFκB into nucleus.
BRITISH ACADEMY
READING SUB-TEST
accumulation in NAFLD patients as verified with CT-scans.
Questions 1-7
more than once.
1 Biological cell that synthesizes the extracellular matrix and collagen.
Answer
2 Arranged in a radiating pattern like that of a star.
Answer
3 Production or formation, development, and differentiation of blood cells.
Answer
4 Evokes a specific functional reaction in an organ or tissue.
Answer
BRITISH ACADEMY
READING SUB-TEST
11 What reduced the hepatic severity in NAFLD patients?
Answer
12 What does IL-6 secrete, as an acute phase inflammatory mediator?
Answer
13 What is known to be enhancing or contributing more to TNF- α?
Answer
14 What is the terms used to show the derivative, which decreases the viscosity of blood?
Answer
BRITISH ACADEMY
READING SUB-TEST
6, choose the answer (A, B or C), which you think fits best according to the text.
Variety of challenges by Obstetricians and Gynecologists
The biggest challenge lies in managing the care of patients of all ages from puberty through menopause and
beyond; treating both acute and chronic health conditions; and of course, managing risk through the pregnancy
and childbirth process. The United States has a higher ratio of maternal deaths than at least 40 other countries,
even though it spends more money per capita on maternity care than any other. The lack of a comprehensive,
confidential system of ascertainment of maternal death designed to record and analyse every maternal death
continues to subject U.S. women to the unnecessary risk of preventable mortality. Maternal deaths must be
reviewed to make motherhood safer.
The status of maternal deaths in the United States was part of a larger report on the global, regional, and
national levels and causes of maternal mortality from 1990-2015. The findings suggest that only 16 countries
will achieve a target of a 75% reduction in the maternal mortality ratio (or number of maternal deaths per
100,000 live births) by 2017.
BRITISH ACADEMY
READING SUB-TEST
ELECTIVE SPLENECTOMY
ITP : 57 %
Congenital spherocytosis : 12 %
Hemolytic anemia : 10 %
Hodgkin’s disease : 5 %
AIDSâ€•related thrombocytopenia : 3 %
Lymphoma : 3 %
Leukemia: 2.5 %
Others (sarcomas, splenic metastases,…)
2. SPLENECTOMY IN EMERGENCY:
Trauma
BRITISH ACADEMY
READING SUB-TEST
Questions 7-6
1 The given notice talks about;
US Death Rate with respect to maternity cases.
Scope and importance.
How to deal with preventable mortality?
2 As per the case study, pick the right statement;
The baby was born with the infection.
The infection surfaced itself when the child turns 1 year 6 months.
The child was normal at the age of 1 year and 6 months.
3 Pick the right statement;
Improper care during pregnancy can lead to complications.
Continous examination is necessary to thwart complications.
Major complications will always lead to death.
4 The notice gives information about;
Indications of splenectomy.
Percentage of disease conditions.
Various conditions, which arise due to Splenectomy.
BRITISH ACADEMY
READING SUB-TEST
Part C
Text 1: Brain Imaging Technologies
Brain imaging has greatly advanced in the last 20 years, due to a better understanding of the electromagnetic
spectrum and radiofrequency waves, in relation to protons in individual molecules within the cells of the brain.
New technologies allow non-invasive spatial mapping, (morphology), and observations of processes within the
brain during set tasks. By sequencing scanned sections of the brain, activity between neurons in different parts
of the brain can be observed and monitored. More recent technologies using a higher frequency resolution can
identify the distribution of individual metabolites (large complex molecules), and pharmaceutical drugs. There
are a number of scanning techniques, their purpose and limitations are described below.
A computerised tomography (CT) scans use X-rays to show the structure of the brain, with details such as
blood perfusion, (plates a and b); the resultant images are two dimensional and of comparatively low
resolution, however, the quality has been much improved since 1998. With improved technology, the single
section has now become as multisection and the speed has increased eight times, giving well-defined 3-D
pictures. A CT scan may reveal underdeveloped parts of the brain or sites of injury from impact, tumours,
lesions or infection. Before a CT scan, the patient may drink but is asked not to eat for four hours beforehand,
and not to take strenuous exercise. A CT brain scan, the preferable scanning method by doctors, will take about
30 minutes and the patient must lie still for the duration.
An MRI scanner uses a strong magnetic field and radio waves to create pictures of the tissues and other
structures inside the brain, on a computer. The magnetic field aligns the protons (positively charged particles)
in hydrogen atoms, like tiny magnets. Short bursts of radio waves are then sent to knock the protons out of
position, and as they realign, (relaxation time), they emit radio signals which are detected by a receiving device
in the scanner. The signals emitted from different tissues vary, and can, therefore, be distinguished in the
computer picture. An MRI scanner can create clear detailed pictures of the structure of the brain and detect any
abnormalities or tumours. Sometimes a dye, or tracer, such as gadolinium may be introduced via a vein in the
BRITISH ACADEMY
READING SUB-TEST
Text 2: A safer way to detect heart disease
Researchers have used a specialized type of MRI to detect 88% of cases of coronary artery disease in a group
of patients with chest pain. The results suggest that the imaging technique can detect heart disease as
accurately as conventional methods, but with much less risk. Coronary artery disease is the most common form
of heart disease and the leading cause of death in the United States. It occurs when fat and calcium accumulate
in the arteries that supply blood to the heart. Over time, less blood reaches the heart and heart muscle dies. If
the plaque blocks the arteries completely, a heart attack occurs.
Currently, the best way to detect the disease is through a coronary angiography. A physician threads a tube into
the heart, releases a dye, and uses X-ray images to look for decreased blood flow. But there’s a small risk in
this procedure that the tube will pierce an artery, resulting in bleeding, or else scrape plaque from artery walls,
which, once the chunks of plaque are in the bloodstream, can lead to a heart attack or stroke. Other,
noninvasive tests such as cardiac ultrasounds are less risky, but not as accurate. Ultrasound images can be poor
in patients with other conditions such as obesity, requiring doctors to resort to invasive tests.
While an MRI allows doctors to image the body using magnets and radio waves, until recently it could not
produce clear images of dynamically voyaging objects, such as a beating heart. In the past two years, though,
stronger magnets, more powerful computers, and new software have improved MRI scanning. “Recent
developments allow us to acquire images of the heart in motion,” says Ricardo Cury, director of clinical
cardiac MRI at Massachusetts General Hospital in Boston and leader of the study. Doctors can now watch the
heart beating in real-time and the images are now sharp. “It’s like opening up the heart and looking at it
directly,” says Renato Santos, a cardiologist at Wake Forest University Baptist Medical Center. “Until
recently, MRI was a research tool,” says Santos. “Now it’s really a clinical tool…ready for prime time.”
Cury combined two cardiac MRI tests to improve the technique’s ability to diagnose coronary artery disease.
In his study, published in the July issue of Radiology, researchers at MGH, Harvard Medical School, and
Beneficencia Portuguesa Hospital in Sao Paulo, Brazil, examined 46 patients. They began with an MRI stress
test, injecting a harmless dye and medicine that stresses the heart. As the heart pumped, they used MRI to look
for decreased blood flow or evidence that the heart was working abnormally. Next, they examined still MRI
images of the heart for damaged areas or evidence of prior heart attacks. If patients were abnormal in one or
both tests, the doctors deduced blocked arteries.
BRITISH ACADEMY
READING SUB-TEST
9 The word â€œitty-bittyâ€• in paragraph 3 may means;
Effective
Gigantic
Small
Strong
10 According to paragraph 3, what is not true about an MRI?
During the scan, the tissues produce different signals and thus easily get identified.
Dye may be used to improve the quality of the image produced by the scan.
Protons emit radio signals.
The receiving device collects the emitted protons.
11 According to paragraph 4, a fMRI scan;
Produces more efficient images of the brain than an MRI.
Can detect which parts of the brain are active during movement.
Obtains the picture by closely analysing the frequencies of the emitted waves.
Not given
12 According to paragraph 5, a PET is;
An advanced technique like an MRI.
A non-magnetic technique for the detection of brain functioning.
A technique in which a patient is given a radioactive material injection.
BRITISH ACADEMY
READING SUB-TEST
Fat gets deposited in arteries.
Arteries carry less blood to the heart.
All of these
17 What risk is mentioned in paragraph 2?
The tube may puncture the artery.
The tube can cut off plaque.
The artery walls may release more plaque into the bloodstream.
All of these
18 Paragraph 2 talks more specifically about;
Techniques that are risky.
Why conventional techniques should not be used.
How expensive techniques are.
How risky CA can be.
19 According to paragraph 3, what is true about MRI scanning?
MRI scans in previous years were less effective.
It was not possible to capture motion-based images.
MRI scans of the new generation are more effective with power imaging qualities.
use of powerful computers and software have made MRI scanning more effective.
BRITISH ACADEMY
READING SUB-TEST
Answers
Part A

8. Correct Answer Is: cytokines
9. Correct Answer Is: fibrosis
10. Correct Answer Is: degree of fibrosis
11. Correct Answer Is: Epigallocatechin gallate
12. Correct Answer Is: inflammatory serum proteins
13. Correct Answer Is: hepatocytes and Kupffer cells
14. Correct Answer Is: Pentoxifylline
15. Correct Answer Is: Paracrine
16. Correct Answer Is: Stress
17. Correct Answer Is: Il-6
18. Correct Answer Is: Tnf-Î± â€“drug Therapy
19. Correct Answer Is: Steatohepatitis
20. Correct Answer Is: Autocrine
Part B & C
1. Correct Answer Is: Scope and importance.

2. Correct Answer Is: The baby was born with the infection.
3. Correct Answer Is: Continous examination is necessary to thwart complications.
4. Correct Answer Is: Indications of splenectomy.
5. Correct Answer Is: Screening for NASH in Diabetic Care or Clinics shall be simple.
6. Correct Answer Is: Platelets (cut-off):Plt<100; 100 â‰¤ Plt â‰¤ 150; Plt â‰¥150; scores 1, 2, 3
respectively
7. Correct Answer Is: Can help identify how big complex parts are distributed
8. Correct Answer Is: It can help identify which parts of the brain are developed and which are not
9. Correct Answer Is: Small
10. Correct Answer Is: The receiving device collects the emitted protons.
11. Correct Answer Is: Can detect which parts of the brain are active during movement.
12. Correct Answer Is: A technique in which a patient is given a radioactive material injection.
13. Correct Answer Is: It relies on gamma rays for detection
14. Correct Answer Is: MRI
15. Correct Answer Is: A breakthrough in imaging.
16. Correct Answer Is: All of these
17. Correct Answer Is: The tube may puncture the artery.
18. Correct Answer Is: Techniques that are risky.
19. Correct Answer Is: It was not possible to capture motion-based images.
20. Correct Answer Is: It is easy to get more quality-based images
21. Correct Answer Is: Researchers began with the stress testing.
22. Correct Answer Is: To examine
BRITISH ACADEMY

1st READING TEST PDF

Transféré par

Informations du document

Titre original

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

1st READING TEST PDF

Transféré par

Droits d'auteur :

Formats disponibles

READING SUB-TEST

In which text can you find information about;

1 increase of the drug influence.

2 Use of the drug in the USA.

3 lifetime prevalence of cannabis use disorder.

4 use of cannabis despite clinically significant distress or impairment.

5 common determinants of drug addiction.

6 addiction to drug common among young community.

7 Prevalence of the drug abuse, drug usage.

15 In the United States, in 2013, the drug was used by of people.

16 Commonly, adults may have about risk of becoming a drug addict

18 The sequence of the drug use may end with .

19 It is very much likely that is of higher level among drug addicts

Total 126 18.2%

Marketed formulations of liposomes.

Product name Marketed by Uses

Removes wrinkles and dark spots and has

Dermosome Microfluidics Moisturizer

Decorte Moisture Liposome Face

Decorte Moisture Liposome Eye Moisturizes, firms, and brightens the

Natural Progesterone Liposomal Skin

Hydration, boosts collagen synthesis,

A Is caused by an allergic reaction to a food or drug.

B Arises spontaneously and its cause is unknown.

C Is a genetic disorder that is very rare.

A Are caused by narrowing of arteries.

B are abnormal dilations of the peripheral arteries.

C Occur due to change in structure and function of the Fibrillin-1.

B Patients with DVT are susceptible to PE.

C PE symptoms, in most of the cases, do not get revealed easily.

4 What is the notice talking about?

A Cleaning of the blood of toxins.

5 What does the table indicate?

A Tenofovir goes well in coordination with Cycloferon.

Text 1: What is Creutzfeldt-Jakob Disease?

Text 2: Heat Rash

Text 1 : Questions 7-14

7 Which disease progresses faster?

C Both Alzheimer`s and Jakob

8 Creutzfeldt-Jakob disease is commonly found among adults or elderly people;

C False, because it is found among children too.

9 People affected with the disease may die after;

C True in some cases

14 What is most helpful in detecting CJD?

B Spinal fluid exams

D All of the above

18 Paragraph 3 talks more about;

D Development of the disease

19 Heat rash is common in;

B Areas with higher humidity

20 What is the central idea of paragraph 4?

A Heat rash symptoms.

C What heat rash looks like.

1. Correct Answer Is: B

2. Correct Answer Is: C

1. Correct Answer Is: B Arises spontaneously and its cause is unknown.

In which text can you find information about;

1 Modern technologies of DNA sequencing

2 Determination of the precise sequence of nucleotides in a sample of DNA.

4 Early DNA sequencing technologies

5 Cost-effective solutions in sequencing

7 Detection of the disease-causing genes

20 NGS is considered the for detection of the disease.