کنکور کارشناسی ارشد مجموعه علوم آزمایشگاهی (1) وزارت بهداشت سال 1404-1405

Part two: Reading ComprehensionnDirections: Read the following passages carefully. Each passage is followed by some questions.
Complete each question with the most suitable choice (a, b, c, or d). Base your answers on theninformation given in the passage only.
Passage 1nThe control of the deadly diseases of childhood is the greatest medical achievement in this century. Because of vaccines and antibiotics, many more children survive childhood than in the past. Because of better nutrition, today's children grow centimeters taller and kilos heavier than their parents. But for all that modern medicine has done to protect and nourish the child's body, very little has been done to assure him of an equally healthy mind. The number of emotionally disturbed and mentally ill children in the world is very high and growing larger all the time. Most children who are emotionally disturbed are autistic or schizophrenic. They are helplessly withdrawn from reality and exist in an inner world that is seldom penetrated by outsiders. They may sit alone for hours or even days, completely still and silent, seemingly unaware of the world around them. Many can neither feed nor dress themselves and withdraw from or react violently to any person's attempts to help them. Many are put in institutions once their families feel that there is nothing more they can do for them. There, they may stay for years or even, in some cases, for the rest of their lives. Although the specific causes of childhood mental disorders are not certain, psychiatrists feel that the disturbances arise as a result of three influences: physical and hereditary factors, forces within early family life, and stress brought about by modern life.

Passage 2.
The decision to quit smoking initiates a remarkable series of positive physiological changes, many of which begin within minutes. A mere 20 minutes after cessation, heart rate and blood pressure begin to normalize. Within 12 hours, carbon monoxide levels in the bloodstream drop, enhancing the blood's capacity to transport oxygen efficiently. Over the subsequent weeks, circulatory function improves, and pulmonary capacity increases, making physical activity less taxing. The respiratory system starts to recover as cilia—microscopic structures responsible for clearing mucus and pathogens—regain their function, significantly lowering the risk of infection. The long-term benefits of quitting are even more profound. After one year, the risk of coronary heart disease is reduced by approximately 50%. By the five-year mark, the likelihood of stroke can equal that of someone who has never smoked. Moreover, the probability of developing cancers of the mouth, throat, bladder, and esophagus continues to decline with each smoke-free year. A decade post-cessation, the mortality rate from lung cancer drops to roughly half that of a current smoker. After 15 years, cardiovascular risk approaches that of a lifelong no
-smoker. Beyond internal health improvements, smoking cessation enhances one’s appearance and sensory experience. Skin often regains its elasticity and tone, teeth may whiten, and the senses of taste and smell typically sharpen within days. In essence, quitting smoking is not merely a behavioral change—it is a life-saving intervention with immediate and lasting effects on nearly every system of the body.

Passage 3nThe placebo effect refers to an improvement in symptoms as a result of medical treatment with an inactive substance like a sugar pill or even a staged medical procedure such as surgery. In other words, a patient recovers even though there has been no genuine medical intervention. One of the most dramatic examples of the placebo effect involves a study of patients with acute arthritis knee pain. In an effort to determine which aspects of knee surgery were most effective, Dr. Bruce Moseley conducted a controlled experiment involving three groups. In the first group, surgery included shaving off thin layers of the damaged cartilage; in the second group, the doctor flushed out the knee joint and disposed of the unhealthy tissue. In the third group, he simulated surgery by anesthetizing the patients and making the necessary incision. However, no actual knee surgery was performed. In fact, the patients were not informed until a full two years afterwards that their operations were staged. The results were astonishing. While knee pain for all three groups diminished significantly, there was no difference in the level of pain decrease for any one group over another. Rather, the uniform results seemed to be mediated by the placebo effect or the patient’s belief in the benefit of the surgical procedure. As one of the placebo patients, Tim Perez, was later quoted as saying, “In this world anything is possible when you put your mind to it. I know that your mind can work miracles.” Perez, who previously could only get around with the aid of a cane, is now able to shoot baskets with his grandchildren.

Passage 4nDigital tools that collect data and support interventions outside the clinical setting offer meaningful opportunities to identify risks and engage patients. Consumer-facing apps and clinical monitors that actively or passively collect data can also serve as an early warning system for prevention and disease management. During the COVID-19 pandemic, digital contact tracing apps provided patients with notifications about potential exposure to COVID-19. Beyond COVID-19, some tools generate warnings to individuals or caregivers regarding changes in environmental risks, such as pollen or air pollution alerts, while other platforms generate alerts to patients, families, and providers in the event of disease exacerbation. Additionally, while not widely acceptable or accessible by all populations, use of remote patient monitoring (RPM) tools increased during the COVID-19 pandemic. RPM enables clinicians to assess symptoms for patients at home with mild cases of COVID-19 and observe no
-COVID-19-related health outcomes in the context of daily living for patients with chronic conditions. Digital tools have also expanded care delivery for providers beyond the hospital or exam room. A 2020 analysis found that virtual urgent care visits could reduce the need for emergency room care by approximately 20%, and 20% of all office care, outpatient, and home health services could be delivered virtually or near-virtually. No
-acute care visits for many conditions were implemented virtually during the COVID-19 pandemic to reduce risk of exposure for patients and providers. Even with the sharp decline in telehealth in 2021—after the steep rise associated with COVID-19 in 2020—a review by a large payer in 2022 supported the value of virtual care.