2017年全国医学考博英语统一考试真题09

希赛网英语频道为大家整理2017年全国医学博士英语统一考试真题。

Part IV Reading Comprehension (30%)

Passage Six

In a poor, inland, gang-infested part of Los Angeles, there is a clinic for people with type 1 diabetes. As part of the country health care system, it serves persons who have fallen through all other safety-net options, the poorest of the poor. Although type 2 diabetes is rampant in this part of town, type 1 diabetes exists as well. Yet these latter individuals generally lack access to any specialty care一a type of treatment they desperately need due to a complexity of dealing with type 1 diabetes in the setting of poverty and psychosocial stress.The Type 1 Clinic meets one morning per week and is staffed by four endocrinology fellows and a diabetologist, often me. I have the unique perspective of working part of the time in a county setting and the other part of the time in a clinic for people with health insurance, in Beverly Hills. I know what is possible in the treatment of type 1 diabetes. East Los Angeles teaches me what happens when access to care is not available. Most of our patients, in their 20s and 30s and 40s, already have complications of their diabetes； many near end stage. Concepts about maintaining near-normal blood glucose levels often miss their mark—lack of education or money or motivation or factors I can’t even imagine make the necessity of a patient acting as his or her own exogenous pancreas nearly impossible, especially when there are acute consequences to hypoglycemia and few to moderate hyperglycemia.

Historically, in spite of these barriers, we persisted and thought we made a difference. Often, teaching simple carbohydrate counting or switching therapy to long-acting insulin improved patients control and their quality of life. The fellows felt they made a positive impact in the health of their patients. Driving home I would be encouraged by what we had accomplished, although saddened by the severity of the complications suffered by many of our patients. Yet everything changed with the recession of 2008. In Beverly Hills I heard a lot about the demise of

the financial markets. Patients of mine had invested with Bermie Madoff. Some, once billionaires, were now millionaires. Personal assistants and housekeepers were laid off, vacation homes were put on the market, and parties became less lavish. But all still live in safe, clean homes, wear designer clothes, and eat high-quality food. The landscape is very different for many of my East LA patterns. The temporary, parttime jobs they had cobbled together to keep food on the table and pay for housing are gone. I一-naively didn’t realize how much worse poverty could get. But now many of our patients are young without food and are becoming homeless. One young man, a college student trying to work his way out of poverty by going to school, lost his job and is living in his car. He is still taking classes but is unable to afford more than a dollar meal from a fastfood restaurant once every day or two. Management of his diabetes involves simply keeping him alive with his erratic, poor eating habit.

86. At the beginning, the author describes the patients with an emphasis on .

A. their financial status B, their living in injustice

C. their specialty care of any kind D. their ignorance of type 1 diabetes

87. As a diabetologist working for the Type 1 Clinic, the author is quite concerned about those who .

A. misunderstand the concepts on blood glucose maintenance

B.have no ideas about what medical problem they are having

C. don’t care about acting as their own exogenous pancreas

D. lack access to property and sufficient clinical care

88. Not until the recession of 2008 did the medical staff .

A. feel proud of their dedication and persistence in clinical practice

B.know how severe the complications of type 1 diabetes could be

C. regret about more they could have done for the patients

D. feel a sense of accomplishments in treating the patients

89. As witnessed by the dialectologist during the recession of 2008, many poor patients .

A. developed poor eating habits with the progression of type 1 diabetes

B.struggled with their survival, iet alone with their medical care

C. became loser in the investment with Bernie Madoff

D. switched from full-time to part-time jobs

90. Which of the following tones does the passage most probably carry?

A, Indifference. B. Sympathy. C. Passion. D. Guilt.

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