READING SUB-TEST – TEXT BOOKLET: PART A

CANDIDATE NUMBER:

LAST NAME:

FIRST NAME:
Passport Photo
OTHER NAMES: Your details and photo will be printed here.
PROFESSION:

VENUE:

TEST DATE:

CANDIDATE SIGNATURE:

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Hemorrhoids: Texts

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Page 48 of 121
 READING SUB-TEST – QUESTION PAPER: PART A

CANDIDATE NUMBER:

LAST NAME:

FIRST NAME:
Passport Photo
OTHER NAMES: Your details and photo will be printed here.

PROFESSION:

VENUE:

TEST DATE:

CANDIDATE SIGNATURE:

TIME: 15 MINUTES

INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until you are told to do so.
Write your answers on the spaces provided on this Question Paper.

You must answer the questions within the 15-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions. Marks are NOT deducted for incorrect answers.
At the end of the 15 minutes, hand in this Question Paper and the Text Booklet.
DO NOT remove OET material from the test room.

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 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.

Hemorrhoids: Questions

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 Importance of abdominal examination?

2 Indications of surgery in hemorrhoids?

3 Factors precipitating for blood vessels swelling?

4 Role of chemicals injection in treating piles?

5 Ethics of examining a patient with piles?

6 Symptoms associated with hemorrhoids?

7 Advantages of ligasure hemorrhoidectomy?

Questions 8-14

Answer each of the questions, 8-14, with a word or short phrase from one of the texts. Each answer may
include words, numbers or both.

8 What does ligasure hemorrhoidectomy help reduce when compared with other methods?

9 How do the lumps protruding from the anus look and feel like?

10 What are the dietary habits that should be adopted to reduce the risk of
piles?

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 11 What is the mean operating time when performing ligasure hemorrhoidectomy?

12 What do surgeons use to snare hemorrhoids?

13 What does abdominal examination help us rule out?

14 What is the color of blood that you may notice on the toilet paper in cases of

complicated piles?

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. .......................... out of every ten people aged over 40 have some degree of hemorrhoidal disease.

16. Hemorrhoids develop from pads of ........................... around the anal canal.

17. An ............................ examination should be done to exclude other possible conditions.

18. ................................. of chemicals is used to reduce the size of hemorrhoids.

19. People who are overweight, pregnant or .......................... are more liable to develop hemorrhoids.

20. Surgical intervention is indicated in cases of ............................. and .............................. degree

hemorrhoids.

END OF PART A
THIS QUESTION PAPER WILL BE COLLECTED

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Page 52 of 121
READING SUB-TEST – QUESTION PAPER: PARTS B & C

CANDIDATE NUMBER:

LAST NAME:

FIRST NAME:
Passport Photo
OTHER NAMES: Your details and photo will be printed here.
PROFESSION:

VENUE:

TEST DATE:

CANDIDATE SIGNATURE:

TIME: 45 MINUTES

INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper until you are told to do so.

One mark will be granted for each correct answer.

Answer ALL questions. Marks are NOT deducted for incorrect answers.
At the end of the test, hand in this Question Paper.
DO NOT remove OET material from the test room.

HOW TO ANSWER THE QUESTIONS:

Mark your answers on this Question Paper by filling in the circle using a 2B pencil.

Example:
A
B
C

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 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. The guidelines establish that:

A- The student should always be under supervision when performing high risk
procedure.
B- The student should not be under supervision when performing naso-gastric
tube insertion.
C- A student who is uncomfortable with performing a simple procedure, should
be forced to do it in order to learn properly.

Students performing high risk and most moderate risk procedures

should always be supervised. Exceptions would be NG tube
placement and suturing. A student who wants to be supervised for
any procedure should be, and no student who feels uncomfortable
should ever be made to feel pressured to do it without supervision.

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2. According to the extract:
A- Only the patient has the right to or not to perform the procedure.
B- The doctor should advice the patient against performing the procedure.
C- Refusing to do the procedure is a decision that a doctor can make even if
the patient is refusing this decision.

The medical practitioner who will perform the procedure should

discuss other options with the patient, including medical procedures
or treatment offered by other health practitioners and the option of
not having the procedure. A medical practitioner should decline to
perform a cosmetic procedure if they believe that it is not in the best
interests of the patient.

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3. This policy states that in case of overpayment by the organization:
A- Initiation of recovery should be made within 45 days.
B- A refund should be made within 24 months.
C- The organization may overcharge you on the next payment you make.

In the event of any overpayment, duplicate payment, or other

payment by us in excess of the member's benefits payable
according to the member's benefit plan ("Overpayment") and all
Blue Cross NC policies, you shall promptly remit the
overpayment to Blue Cross NC. In addition to other remedies, if
within forty-five (45) days of a request for a refund by us, the
requested refund has not been made we may recover the
overpayment amount by offset of future amounts payable to
you. Neither Blue Cross NC nor you may initiate recovery of
overpayments or underpayments, respectively, any later than
twenty-four (24) months after the date of the original claim
payment with the following exceptions: Fraud,
misrepresentations and other intentional misconduct

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4. The allowance is:
A- 100% for the first lower limb X-ray performed for the patient.
B- 80% for the third ECHO performed for the patient.
C- 75% for the second fundoscopy performed for the patient.

When multiple diagnostic cardiovascular services are performed during

the same outpatient patient session, the allowance for the technical
component of the primary procedure is 100%. The allowance for the
technical component of the second and each subsequent imaging
procedure is 75%. When multiple diagnostic ophthalmology services are
performed during the same outpatient patient session, the allowance for
the technical component of the primary procedure is 100%. The
allowance for the technical component of the second and each
subsequent imaging procedure is 80%. The multiple procedure payment
reduction on diagnostic imaging applies when multiple services are
furnished by the same physician or physicians in the same group
practice, to the same patient, in the same session, on the same day. The
allowance for the technical component of the primary procedure is
100%. The allowance for the technical component of the second and
each subsequent imaging procedure is 50%.

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5. According to the extract:
A- The device automatically downloads your HR and BP to the computer.
B- The device automatically measures your HR and BP when turned on.
C- When measured, systolic BP number flashes on the top left corner of the
monitor.

The Colin STBP-780 is an automated electronic heart rate and blood pressure
(BP) monitor capable of accurate readings at rest and during exercise. The unit
assesses heart rate via wires connected to four electrodes placed on the thorax
and abdomen. Blood pressure is assessed during deflation of the cuff via two
microphones in the cuff. The front display provides clear, easy to read
measurements of heart rate, systolic and diastolic BP, elapsed time, and error
messages. When turning the system on, a Self-Check is performed
automatically. The field for the systolic blood pressure at the top left corner of
the blood pressure monitor displays an estimate of systolic BP during deflation.
This number flashes as the measurement is being taken. Once the systolic and
diastolic blood pressure and the heart rate are measured, all three values are
displayed on the monitor and downloaded to the computer screen and system
database during the test.

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6. According to the extract, choose in INCORRECT answer:
A- The endoscope cannot withstand repeated cycles of sterilization.
B- Flexible endoscopes are easier to clean when compared to fixed ones.
C- Data that is available to assess the efficiency of sterilization over HLD is not
enough. .

Traditionally, sterilization of endoscopes and accessories has been indicated

for the rare occasions when they are to be used as critical medical devices,
when there is a potential for contamination of an open surgical field.
Sterilization can be achieved by using a variety of methods, including ethylene
oxide gas treatment, and it can be achieved with appropriately long exposure
to liquid chemical germicides. Because of the complexity of the instrument
channel design, sterilization of flexible endoscopes is difficult to accomplish. In
addition, endoscope durability and function are potentially compromised with
repeated cycles of sterilization. Users report that endoscopes experience a
shortened use life because of material degradation issues when processed
repeatedly in ethylene oxide. Because of these factors as well as a lack of data
for demonstrable benefits to the further reduction in endoscope bacterial
spore counts achieved by sterilization instead of HLD, sterilization with
ethylene oxide is not recommended over HLD for standard GI endoscopes.
However, an FDA-cleared liquid chemical sterilant processing system has been
approved to provide sterilization of cleaned, immersible, reusable, and heat-
sensitive critical and semi critical medical devices.

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 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.

Text1: Building a human heart in a dish

Stem cell transplants smell like creamed corn, apparently. Petras learned this as he
was undergoing treatment for non-Hodgkin's lymphoma. He'd already received
chemotherapy to kill the cancerous cells coursing through his lymphatic system, but
the disease had bounced back. The best option to save his life was to carpet-bomb
his immune system — killing the cancer-ridden cells alongside the healthy ones —
then reboot it with a transplant of healthy bone marrow stem cells harvested before
the treatment. The approach is a modern take on the oldest form of stem cell
therapy, namely bone marrow transplants, the first of which was performed nearly
half a century ago. Since then, stem cell scientists have been working to understand
just what stem cells are, how to control them, and — most importantly — what can
be done with them.

At the recent International Society for Stem Cell Research conference in Melbourne,
stem cells showed they are ready for prime time. "There was a big buzz because it
was really clear that this is now moving to translation, and that's very exciting," says
Melissa Little, program leader of Stem Cells Australia and head of the Kidney
Research laboratory at the Murdoch Children's Research Institute. "I'm really
pleased to see over the 16 years that this society has existed, that we've moved from
a fundamental fascination with what a stem cell is, and what it can do, to clinical
trials, which is an amazing outcome in a pretty short period of time."

Stem cells are the cells from which every other cell in the body originates. They are
the progenitors of every cell type including heart muscle cells, neurons, bone marrow
cells, skin cells — even the light-sensitive cells at the back of your eye. For a long
time, embryos were the only source of stem cells. Then in a Nobel prize-winning
discovery in 2006, Japanese scientist Shinya Yamanaka and colleagues took
ordinary adult skin cells and reprogrammed them back into the most basic form of
stem cell — a pluripotent stem cell. This discovery opened up the field of stem cell
science. Now stem cells could be created from adult skin cells, then turned into
whatever cell type was needed, such as cardiomyocytes for hearts, glial cells for
brains, islet cells for the pancreas, even the cells that make teeth and bone. But
contrary to the promises made by the countless unregulated clinics that have
sprung up like mushrooms after rain, offering a host of untested and dubious
treatments, stem cell medicine is still very much in its infancy. Well-tested and
research-proven stem cell-based treatments are only just beginning to emerge on
the market. But not far behind are potentially game-changing treatments for
everything from age-related macular degeneration and Parkinson's disease to type 1
diabetes and HIV infection.

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So-called "autologous" stem cell transplants — transplants using a patient's own
stem cells, such as bone marrow stem cells — are well-established as part of
treatment for cancers such as lymphoma and myeloma. But these transplants are
also being taken in extraordinary new directions with gene-editing technologies. Last
year, Italian doctors treated a young Syrian refugee with skin grafts derived from his
own stem cells. However, the cells had also been engineered to correct the genetic
mutation responsible for a devastating blistering disease called junctional
epidermolysis bullosa. At the time of treatment, the boy had lost around 80 per cent
of the skin on his body because of the disease. But the skin grafts took, grew and
now behave just like healthy skin should. In the United States, a trial is currently
underway in people with HIV. The aim is to reboot their immune systems with their
own harvested stem cells. But these cells have been engineered to resist infection
with HIV by introducing a genetic mutation to the receptor that HIV uses to gain
access to the cells.

Autologous stem cell treatments, however, are very costly and labour-intensive, as
they require effectively creating a new treatment for every single patient. A more
attractive possibility is allogeneic stem cell treatments, which use donor cells that are
selected or engineered so as not to trigger the recipient's immune response.
Australian biotech company Mesoblast has developed a donor stem cell-based
treatment for graft-versus-host disease, a potentially deadly side effect of organ and
bone marrow transplants. Their product, which is licensed in Japan and recently
completed advanced clinical trials for the US Food and Drug Administration (FDA),
uses a class of stem cells that are invisible to the immune system. One effect of
these mesenchymal stem cells, as they're known, is to dampen down the patient's
immune reaction against their transplant. One of the most exciting medical
applications for stem cells is to replenish adult cells that have been lost to disease,
damage or simply old age. Earlier this year, British scientists managed to grow cells
from the back of the eye in a dish, using stem cells derived from embryos. These
retinal cells were implanted into the eyes of two people with age-related macular
degeneration, a leading cause of blindness. The patches grafted successfully, and
both patients showed significant improvements in their eyesight. Another application
still a few years from clinical trials is using stem cells to regrow the insulin-producing
cells of the pancreas in people with type 1 diabetes, a disease in which the body's
immune system attacks and destroys those cells. Researchers are also working on
how to use stem cells to replace damaged heart muscle cells, and regrow injured or
defective brain cells or liver cells, to name just a few examples. Further down the
track, it's even foreseeable that a patient with a new diagnosis will have some skin
cells taken, stem cells grown from them, and a model of the affected system or
organ developed in a dish so that it can be used to test which drug that person is
most likely to respond well to.

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 Text 2: Anxiety has a cost, but can also be a power for good

Anxiety doesn't recognize class or race. It ignores age and gender. And it gives no
deference to talent, wealth or perceived success. A popular blogger, a media celebrity,
but still at odds with the demands of the life she has chosen, Sarah talked of the terrible
toll taken by modern life: "Anxiety is on the increase. We are overstimulated. "We used
to have boundaries, and we had cultural mores and structures that protected us from
these kinds of primal blowouts. "We had a Sabbath because we all had an
understanding that we needed a day of rest just to be able to cope with the toil of hoeing
a field, and also to spend time with family; and we had set bedtime hours and we had
set work hours. There were boundaries that were placed by our culture and structures.
That has gone out the window in literally less than a generation." In the past Sarah shut
herself away, taking time off from the outside world — a forced retreat. But her new way
of dealing with her anxiety is to embrace it. To acknowledge its dangers, to be wary, and
then to try to harness it to her advantage as a tool for positive change.

A bit of anxiety in the right place at the right time could be a positive thing, agreed Black
Dog Institute clinical director Josephine Anderson — within limits. "A little anxiety, for
example, will generally improve our performance — whether it's running a race, working
to a deadline or performing at a writers' festival — and of course, the flight or fight
response saves lives every day. "But too much anxiety can really get in the way of our
doing what we want or need to do. "When anxiety threatens to overwhelm our minds,
then doing something mindful — meditating, exercising, writing, for example — can help
us focus, calm and filter out distracting, distressing anxiety-driven thoughts."

For acclaimed British novelist, Matt Haig, catastrophic thinking, brought on by anxiety,
has been a lifelong burden. "It's a total vicious circle, this is a total mental illness thing.
The human brain, said Haig, struggles to make sense of our frenetic and chaotic world,
where enough is never enough. "We are still essentially cave people. We haven't
actually evolved for 30,000 years, and we are all trying to run the software of 21st
century society on our systems and we need to switch ourselves off-and-on again a few
times. We live ever more unnatural lives, he said, and often the best solution is to
declutter, to undertake what he calls a "life-edit". "We are in an overloaded world and an
overloaded culture and we've got overloaded lives," he said. When people look for a
solution to things, they are often wanting something to be added into their life, but if you
are in an overloaded culture, the solution is often just taking things away.

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For first-time novelist Jarrah Dundler, being a finalist in this year's Vogel Australian
literary award brought pain, as well as a sense of achievement. A feeling of anxiety
along with the accolade. But that was to be expected. His novel Hey Brother centers on
a cast of characters dealing with the complexities and frustrations of mental illness; and
as a peer-support mental-health worker, he has his own and others' experiences to draw
upon. His personal experience of anxiety centers on fixation, where thoughts get "stuck
in his head" and become so exaggerated and urgent that they often lead to physical, as
well as mental illness: "I can be stuck on something for a week, and that's the only thing
I can focus on. "For whole days that's all I'm thinking of. Insane stuff and really getting
completely worked up about it." Jarrah lives and works in regional northern New South
Wales. He acknowledged a change in the way society now deals with mental illness, but
there's still a stigma. For Jarrah, like Sarah and Matt, writing about mental illness is as
much a form of therapy as it is a literary decision. "I can't write when I'm depressed, I
can't write when I'm anxious. I can try but ... so it helps for me because I get a lot out of
writing, like the buzz from when you are writing. "It's also a very mindful activity. When
you are in the flow of writing, you are lost, and your mind is occupied on something,
focused on something." But anxiety, he said, is never far away. A last-minute decision by
his publisher to change the name of his book saw him spiral into catastrophism.

Michael Abelman comes from a farming background, but his career has morphed over
the years into what his website calls "social enterprise" work. It's the largest such urban
farming scheme in North America. And as he told it, it's about producing healthy,
affordable food, reconnecting with the environment and helping the disadvantaged deal
with their anxiety and mental health. "It's where the term 'Skid Row' was actually
coined," he explained. "It's about 20 square blocks, entirely inhabited by folks who are
dealing with long-term addiction, mental illness and material poverty." "I'm not a mental
health professional, addiction expert or social worker," said Abelman. "We produce 25
tons of food on four acres of pavement, and we do it with the hands of people that no
one ever expected could accomplish anything. These are the untouchables. "These are
people that you see in broad daylight on the sidewalks with a needle in their arm or
pirouetting in the middle of the street high on crack. And yet, this work has provided a
reason for people to get out of bed each day, kind of a touchstone, a place to go."
Echoing the words of Sarah Wilson, he described anxiety as a gift: "For me anxiety has
been the trigger, the thing that gets me up every day and gets me out there doing good
work. "And if I didn't feel that way, I probably would not get out of bed." Dr Anderson
from the Black Dog Institute urged people not to try to weather anxiety disorders alone.
"It's important to remember that anxiety disorders are common and can be severe and
impairing," she said. "If, despite your best efforts, anxiety is interfering with your life or
your relationships, then it's important to get help. There are many effective treatments
available so don't delay — speak to your GP and or your mental health professional."

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 Text 1: Questions 7-14

7. In the first paragraph, what was the best option that was used to save Petras' life?

Ⓐ Repeated cycles of chemotherapy

Ⓑ Sacrificing his immune cells to achieve a greater purpose

Ⓒ Targeting the cancerous cells more aggressively

Ⓓ Bone marrow transplantation from a donor

8. In the second paragraph, the reason behind Melissa Little cheering up is

Ⓐ The application of theoretical concepts

Ⓑ The great impact of the use of stem cells

Ⓒ The international co-operation

Ⓓ Exciting cure rates and outcomes

9. In the third paragraph, what do we learn about stem cells?

Ⓐ Skin is the only source to harvest them

Ⓑ Pluripotent stem cells are highly specialized

Ⓒ Embryos are no longer used as sources of stem cells

Ⓓ Stem cells are precursors for skin cells

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10. The writer uses the phrase sprung up like mushrooms after rain to state that these
clinics are emerging

Ⓐ Suddenly and rapidly

Ⓑ without certain plans

Ⓒ illegally

Ⓓ in a way that is not organized

11. According to the fourth paragraph, gene-editing technologies had already been used is
the field of

Ⓐ Trans-species bone marrow transplantation

Ⓑ Preventive medicine

Ⓒ Infection control

Ⓓ Dermatology

12. In the fifth paragraph, the writer states that using the patient's own stem cells is

Ⓐ Unaffordable

Ⓑ Non-effective

Ⓒ Non-efficient

Ⓓ unavailable

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13. In the fifth paragraph, the writer is particularly impressed by

Ⓐ The ability to renew damaged cells

Ⓑ Implanting embryonic derived stem cells into a diseased eye

Ⓒ Our ability to treat type 1 DM

Ⓓ Our ability to replace damaged cardiac tissues

14. In the final paragraph, The word foreseeable means

Ⓐ unexpected

Ⓑ hoped

Ⓒ needless to say

Ⓓ being studied

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 Text 2: Questions 15-22

15. In the first paragraph, What does Sarah think is the reason behind the increased
prevalence of anxiety in society?

Ⓐ Increased life demands.

Ⓑ Loss of consistent cultural structure.

Ⓒ Lack of sufficient rest.

Ⓓ Not spending enough time with family.

16. in the first paragraph , The word it refers to

Ⓐ The new way

Ⓑ Dangers

Ⓒ Anxiety

Ⓓ Advantages

17. In the second paragraph, Josephine Anderson believes that anxiety might be vital to

Ⓐ Win at sport competitions

Ⓑ Finish duties on time

Ⓒ Get to a hyperarousal protective state

Ⓓ None of the above

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18. Matt Haig believes that the best way to solve the problem is by

Ⓐ Addressing the problem more clearly

Ⓑ Changing the approach that we adopt to solve it

Ⓒ Seeking perfection

Ⓓ Not trying to fight it.

19. That in the fourth paragraph refers to

Ⓐ winning the award

Ⓑ his sense of achievement

Ⓒ being a finalist

Ⓓ being anxious

20. According to Jarrah, what is it about writing can temporarily relieve anxiety?

Ⓐ Writing down the thoughts that bother you.

Ⓑ Providing a way to divert attention.

Ⓒ Providing a sense of purpose

Ⓓ A way to escape the stigma brought on by society.

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21. In the final paragraph, we learn that those who often become addicted lack

Ⓐ Money.

Ⓑ Healthy food.

Ⓒ Sincere guidance.

Ⓓ Reasons to live.

22. According to the final paragraph, both Michael and Dr Anderson believe that

Ⓐ Anxiety is not entirely a bad thing

Ⓑ Sufferers of anxiety should seek professional help

Ⓒ Anxiety is a common disorder

Ⓓ Different types of treatment are available for this condition

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