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2015考研英语阅读理解精读P23―医学

考研考试网 2014-05-04 16:00:41

Passage 23

The widely held assumption that people would volunteer for AIDS-tests in droves once treatment became available was wrong. 61) And the reason for that appears to be that the government has not managed to reduce the disgrace associated with AIDS, and thus with seeking out a test for it if you suspect you might be infected.

To combat this, the whole basis of AIDS testing in Botswana has just been changed. The idea is to“downgrade” the process into something low-key, routine and stigma-free. 62)Until now, a potential test subject had to opt in, by asking for a test; having asked, he was given 40 minutes of counseling to make sure he really knew what he was doing before any test was carried out. The new policy is to test people routinely when they visit the doctor. That way, having a test cannot be seen as an indication that an individual believes he may be infected. The test is not compulsory, but objectors must actively opt out. Silence is assumed to be consent, and no counseling is offered—just as would be the case for any other infectious disease.

This policy shift is probably just the first of many that will take place in Botswana, South Africa and other African countries that are planning the mass provision of anti-AIDS drugs in public hospitals. Dwain Ndwapi, a doctor at Botswana’s largest AIDS clinic, thinks that there are circumstances in which testing should be compulsory. 63) In particular, he believes that the currently high rate of transmission from mothers to new-born children could be reduced to zero if expectant mothers were always tested—and if those who proved positive were treated with an appropriate drugs before they gave birth.

Another controversial change in the air is to reduce the frequency of two costly tests of patients’ blood. Viral-load tests and CD4-cell counts both measure how acute an individual’s infection has become. That helps a patient’s doctor to decide when to prescribe anti-retroviral. 64) But laboratory capacity in Africa is inadequate for regular testing of the millions of people that need such drugs—at least if the tests are carried out as frequently as they would be in a rich country. Less frequent testing of each individual would allow more individuals to be given at least some tests.

But that must be balanced against the need to treat more people faster. Doctors in Botswana are staggered at how desperately sick many patients are when they first arrive. They had expected people to walk into clinics for AIDS tests. Instead, many come in on stretchers on the verge of death. 65) Treating the very ill takes much more time and money than giving anti-AIDS pills to relatively healthy people, and it means that these people may have been unconsciously infecting others for longer. If routine tests persuade more patients to get help before they slump on a stretcher, all the better.

1. Why few people would volunteer for AIDS-test if treatment is readily prepared?

[A] Because people do not know whether they need the treatment.

[B] Because people could not afford to pay the expensive drugs.

[C] Because people are afraid to find out that they are infected.

[D] Because people cannot bear the shame the tests bring.

2. According to the text, how to “downgrade” the test process?

[A] By forcing those potential AIDS patient to take the test.

[B] by going down to the patients’ homes to take the test.

[C] by testing patients as a regular thing in their hospital visits.

[D] by asking them whether they would like to have a test.

3. it can be inferred from the text that

[A] the new policy will be able to include every patient who visits the doctor.

[B] more policy like the new one will be carried out in a lot of African countries.

[C] the old policy is better than the new one in that it provides patients with counseling.

[D] the silence of the patient indicates his consent to any treatment that is available.

4. the purpose of reducing the frequency of two expensive blood tests is to

[A] help the patients save some money for treatments.

[B] enable more people to take tests of some kind.

[C] make sure that patients can receive in-time treatment.

[D] prevent patients from possible further infection.

5. persuading patients to get treatment early will have the following advatages except

[A] saving anti-AIDS pills to relatively healthy people.

[B] cutting down the costs in the treatment.

[C] avoiding transmitting the virus to more people.

[D] shortening doctors’ treatment time.

词汇注释

in droves 成群结队

stigma 耻辱

downgrade 降级

low-key 低调的

expectant mother 孕妇

anti-retroviral 抗病毒

staggered 吃惊的

inadvertently 无意中地

slump 躺

难句讲解

1. And the reason for that appears to be that the government has not managed to reduce the disgrace associated with AIDS, and thus with seeking out a test for it if you suspect you might be infected.

[简析] 本句话的主干是“the reason for that appears to be that…”。第一个that指的是前面句子的内容;第二个that引导的是表语从句;and thus…引导的段与作伴随状语,其中的it指的是sigma,if 引导的是条件状语从句。

2. Having asked, he was given 40 minutes of counseling to make sure he really knew what he was doing before any test was carried out.

[简析] 本句话的主干是“he was given 40 minutes of counseling to make sure…”。Having asked 短语作时间状语;he指的是前面句子中提到的a potential test subject;he really knew…是一个省略了引导次的宾语从句,其中的what引导的是宾语从句,before引导的是时间状语从句。

3. In particular, he believes that the currently high rate of transmission from mothers to new-born children could be reduced to zero if expectant mothers were always tested—and if those who proved positive were treated with an appropriate drugs before they gave birth.

[简析] 本句话的主干是“he believes that…”。he 指的是Dwain Ndwapi;that引导的是宾语从句;from mothers to new-born children修饰transmission;if引导的是条件状语从句;破折号里面的内容是在进一步介绍条件,其中的those指的是expectant mothers,who引导的定语从句修饰those;before引导的是时间状语从句,其中的they指的也是expectant mothers。

4. But laboratory capacity in Africa is inadequate for regular testing of the millions of people that need such drugs—at least if the tests are carried out as frequently as they would be in a rich country.

[简析] 本句话的主干是“laboratory capacity is inadequate for…”。That引导的定语从句修饰people;破折号里面的内容是在介绍条件,其中的as…as 引导的是比较状语从句,其中的they指的是testes。

5. Treating the very ill takes much more time and money than giving anti-AIDS pills to relatively healthy people, and it means that these people may have been unconsciously infecting others for longer.

[简析] 本句话是一个并列句,其主干是“treating the very ill takes much more time and money…and it means that”。Than引导的是比较状语;it指的是前面的句子;that引导的是宾语从句。

答案与解析

1. D细节题。本题的问题是“如果治疗很容易准备的话,为什么几乎没有人自愿进行爱滋病检测?”文章第一段首先提到了人们的一种错误观点,随后解释了原因,指出,政府没有设法减少与爱滋病有关的耻辱,也没有减少如果你怀疑你自己可能被感染了爱滋病而去寻求检测的耻辱。这说明,原因是人们觉得,与爱滋病有关的东西是耻辱。[D]“因为人们不能忍受检测带来的羞耻”是对文中相关信息的改写,为正确答案。[A]“因为人们不知道他们是否需要治疗”和[B]“因为人们负担不起昂贵的药物”属于无中生有;[C]“因为人们担心查出他们受到了感染”是针对该段中“with seeking out a test for it if you suspect you might be infected”设置的干扰项,与文意不符。

2. C细节题。本题的问题是“根据本文,如何‘降级’检测的过程?”题干中的“downgrade”出自文章第二段第二句话中,表明本题与第二段有关。第二段在介绍人们采取的应对措施时提到,博茨瓦纳爱滋病检测的所有原则完被改变了,人们把检测过程“降级”为低调、常规并且没有耻辱感的事情,也就是在人们看病时对他们进行常规检测。这说明,人们是把检测看成是患者看病时的常规事情来“降级”检测过程的。[C]“把检测作为患者去医院时进行的常规事情”是对文中相关信息的概括,为正确答案。[A]“迫使那些可能的爱滋病患者去检测”明显与文意不符;[B]“去患者的家庭进行检测”属于无中生有;[D]“询问他们是否愿意进行检测”是针对文中“…make sure he re.ally knew what he was doing before any test was carTied out”这句话设置的干扰项,与文意不符。

3. B推论题。本题的问题是“根据本文,可以推知 ”。文章第二段介绍了人们采取的应对措施,第三段指出,这种原则上的改变可能只是博茨瓦纳、南非和其他非洲国家即将发生变化的第一步,这些国家正计划在公立医院大量供应抗爱滋病的药物,随后介绍了一名博茨瓦纳医生的新观点。由此可知,非洲一些国家将实施更多新措施。[B]“更多像新原则一样的原则将在许多非洲国家得到实施”是对文中相关信息的概括,为正确答案。[A]“新原则将能够包含任何看病的患者”属于无中生有;文中并没有比较新旧原则的好坏,所以[C]“旧原则比新原则更好,因为它为患者提供咨询”与文意不符;[D]“患者的沉默表示他同意进行任何可能的治疗”是针对文中“Silence is assummed to be consent, and no counseling is offered”这句话设置的干扰项,与文意不符。

4. B细节题。本题的问题是“减少两种昂贵血检次数的目的是为了 ”。题干中的“two expensive blood tests”出自文章第四段第一句话中(文中用的是two costly tests of patients’ blood),表明本题与第四段有关。第四段首先提到了减少两种昂贵血检的次数问题,并解释了这两种血检的目的,随后指出,非洲的实验室没有能力对数百万需要这类药物的人进行常规检测,每个人的检测频率越少,更多的人得到至少某些检测的机会就越多。这说明,减少血检次数的目的是为了让更多的人可以接受检测。[B]“使更多的人可以接受某些检测”是对文中相关信息的概括,为正确答案。[A]“帮助患者节省治疗费用”明显与文意不符;文中没有提到及时治疗的问题,也没有提到进一步感染的问题,所以[C]“确信患者可以得到及时的治疗”和[D]“防止患者可能进一步感染”属于无中生有。

5. A细节题。本题的问题是“说服患者尽早治疗将有下列好处,除了 ”。题干中的 “Persuading patients to get treatment”出自文章后一段后一句话中(文中用的是persuade more patients to get help),表明本题与后一段有关。后一段提到,与给相对健康的人发放抗爱滋病药物相比,治疗非常严重的患者花费的时间和金钱多得多,并且这些人可能会在更长的时间内无意中感染其他人,随后提到了说服患者治疗这个问题,指出,如果常规检测可以说服更多患者寻求帮助的话,那么一切都会更好了。这说明,[B]“削减治疗费用”、[C]“避免把病毒传染给更多的人”和[D]“缩短医生的治疗时间”都是说服患者尽早治疗的好处。只有[A]“给相对健康的人节省抗爱滋病药物”不是文中提到的好处。

文译文

人们普遍认为,一旦爱滋病可以得到治疗,人们就会成群结队地自愿参加爱滋病的检测,这种观点是错误的。1)其中的原因似乎在于,政府没有设法减少与爱滋病有关的耻辱,因此也就没有减少如果你怀疑你自己可能被感染了爱滋病而去寻求检测的耻辱。

为了应付这种局面,博茨瓦纳爱滋病检测的所有原则完被改变了。其观念就是,把检测过程“降级,为低调、常规并且没有耻辱感的事情。到目前为止,一个可能的检测对象须提出要求才能接受检测。2)提出要求后,他会得到40分钟的咨询时间,以确信在实施检测前他确实了解自己的所作所为。新原则就是,在人们看病时对他们进行常规检测。这样,进行检测就不可能被看成是一种某个人认为他可能被感染的迹象。检测不是强制性的,但是,反对检测者须主动选择不检测。沉默被认为是同意接受检测,并且也不提供咨询,正如检测其他传染病一样。

这种原则上的改变可能只是博茨瓦纳、南非和其他非洲国家即将发生变化的第一步,这些国家正计划在公立医院大量供应抗爱滋病的药物。戴卫因·恩德沃皮是博茨瓦纳大的爱滋病诊所的一名医生,他认为,有些情况下,检测应该是强制性的。3)他特别认为,如果孕妇经常检测的话-如果那些检测结果被证实为阳性的孕妇在生孩子前得到适当的抗病毒治疗的话,目前母亲传染新生儿爱滋病的比率可以降为零。

另一个引起争议的变化就是减少患者进行两种昂贵血检的次数。病毒负荷检测和CD4细胞计数都可以测定某人感染的严重程度。这有助于医生决定何时开抗病毒药物。4)但是非洲的实验室没有能力对数百万需要这类药物的人进行常规检测,至少如果是这些检测像在富国那样经常进行的话。每个人的检测频率越少,更多的人得到至少某些检测的机会就越多。

但是,这须权衡更迅速治疗更多患者的需求。博茨瓦纳的医生在许多患者初次来看病时对他们病情的严重程度感到吃惊。他们期望人们走进诊所接受爱滋病检测。相反,许多人是在奄奄一息的情况下被担架抬来的。5)与给相对健康的人发放抗爱滋病药物相比,治疗非常严重的患者花费的时间和金钱多得多。这就意味着。这些人可能会在更长的时间内无意中感染其他人。在躺在担架上之前,如果常规检测可以说服更多患者寻求帮助的话,那么一切都会更好了。

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