Test 53 OET Reading Obstetric Ultrasound
Test 53 OET Reading Obstetric Ultrasound
Test 53 OET Reading Obstetric Ultrasound
Text A
An ultrasound scan, also referred to as sonography, uses high frequency sound waves to create an image of some
part of the inside of the body, such as the stomach or muscles, by bouncing sound energy off tissue and
translating the returning sound information into a visual representation. The word "ultrasound", in physics, refers
to all sound with a frequency humans cannot hear; in diagnostic ultrasound this is usually between 2 and 10 MHz.
Higher frequencies provide better quality images, but are more readily absorbed by the skin and other tissue, so
they cannot penetrate as deeply as lower frequencies. Lower frequencies can penetrate deeper, but the image
quality is inferior. Obstetric ultrasound is performed routinely in most U.S. medical communities at about 20
weeks of gestation. Benefits include accurate dating, placental location, the diagnosis of multiple gestation or
congenital abnormalities and the possible detection of maternal health risks.
Text B
Text C
Poor maternal and child health (MCH) outcomes are a global, yet highly preventable problem. Evidence informs
that the developing world accounts for the majority of the maternal mortality burden. Half a million women died
of complications related to pregnancy in 2005, half of these in Africa and another third in South East Asia. Infant
mortality is closely related and the trend is similar. About 3.1 million babies died before 28 days of age with 99%
of these deaths occurring in middle and low income countries. Maternal mortality is the health indicator that
shows the widest gap between rich and poor, both between and within countries. In Africa the maternal mortality
ratio is 620 per 100,000 live births compared to 14 per 100,000 live births in developed countries. Within
countries there are also disparities between urban and rural populations, with rural areas suffering worse
outcomes. The potential to reduce maternal and neonatal deaths through the use of ultrasound is significant and
addresses two of the millennium development goals (MDGs) including (i) MDG 4 which aims to reduce child
mortality and (ii) MDG 5 which aims to improve maternal health. Improving the level of obstetric care is critical to
address MCH outcomes and to accelerate progress toward achieving MDG 4 and 5 targets.
Text D
It has been proposed that natural-appearing 3-D ultrasound images of the fetus could improve parent fetal
bonding. Given the recognized importance of maternal-child bonding immediately postpartum, it seems
reasonable that extending this bonding experience into the fetal period could be beneficial. However, a
psychological benefit of viewing fetal photos has not been proven, and obtaining such images largely remains in
the realm of "entertainment". In some countries, parents are able to enter a photography studio with ultrasound
facilities and leave with pictures suitable for framing: no physician involvement is needed for this event. The use
of ultrasound for non-diagnostic purposes has been condemned by the American Institute of Ultrasound in
Medicine and the American College of Obstetricians and Gynecologists. Concerns that were raised in their policy
statements include possible adverse bio-effects of ultrasound energy, the possibility that an examination could
give false reassurance to women, and the fact that abnormalities may be detected in settings where personnel
are not prepared to discuss and provide follow-up for concerning findings.
END OF PART A
THIS TEXT BOOKLET WILL BE COLLECTED
Part A
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.
TIME: 15 minutes
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.
________
Questions 8-15
Answer each of the questions, 8-15, with a word or short phrase from one of the texts. Each answer may include
words, numbers or both.
________
9. What does ‘MDG’ stand for based on the information given in the texts?
________
10. How many participants were there in the study conducted in rural Africa?
________
________
________
14. What is the maternal mortality ratio in comparison with live births in developed nations?
________
15. How many transverse presentations were identified in the study conducted in rural Africa?
________
Questions 16-20
Complete each of the sentences, 16-20, with a word or short phrase from one of the texts. Each answer may
include words, numbers or both.
17. The adverse bio-effects of ultrasound energy is a major _________________ brought up by the American
Institute of Ultrasound in Medicine.
18. Advancements in ____________________________ is vital to eliminate the adverse outcomes of MCH globally.
19. ____________________________ can penetrate through skin and provide superior image quality.
20. The significance of ____________________________ is identified as essential, soon after the fetal period.
END OF PART A
THIS QUESTION PAPER WILL BE COLLECTED
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.
Mark your answers on this Question Paper by filling in the circle using a 2B pencil.
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.
Multidisciplinary Care
Given the increasing complexity of the residents care needs combined with the call for a palliative approach to
care delivery suggests that the adoption of a multi-disciplinary team approach to care planning and delivery is
required. Multidisciplinary care is the vehicle for providing an integrated team approach to the provision of health
care and this occurs when medical, nursing and allied health professionals consider all treatment options,
including all of the potential benefits and disadvantages of treatment decisions, personal preferences of the
resident and collaboratively develop an individual care plan that best meets the needs of each resident and their
family. There is compelling evidence to suggest that a multi-disciplinary approach to care helps to enhance the
residents quality of life by addressing the problems that are of most concern to the resident are addressed,
reduces ambiguity around treatment and the goals of care, ensures that care decisions are based on best
evidence based practice.
A. changes in protocols.
Employees access our office via main entrance or employee entrance. Main entrance is locked after hours and is
unlocked each morning at 8:00. The Office Manager has the key to both entrances and is responsible for
unlocking main entrance each AM. Employee entrance is accessed only via key. Employees or service personal
may gain entrance through the employee entrance by knocking on the door. All patients’ protected health
information (PHI) regardless of its form, mechanism of transmission, or storage is to be kept confidential. Only
individuals with a business need to know are allowed to view, read, or discuss any part of a patient’s PHI. An
employee who violates this confidentiality policy will be subject to sanctions up to immediate termination. All
employees are required to verify in writing that they have read and will comply with our policy regarding
confidentiality of all forms of PHI. Employees whose job functions require access to our computer system will be
given a secure, unique password to access the system.
Carcinogenicity
Carcinogenicity potential should be evaluated for devices with permanent contact. This includes devices in
contact with breached or compromised surfaces, as well as externally communicating and implanted devices. If
novel materials are used to manufacture devices in contact with breached or compromised surfaces, externally
communicating devices, or implant devices, we also recommend a review of the carcinogenicity literature. In the
absence of experimentally derived carcinogenicity information, structure activity relationship modeling for these
materials may be needed regardless of the duration of contact, to better understand the carcinogenicity potential
for these materials. Because there are carcinogens that are not genotoxins and carcinogenesis is multifactorial,
the assessment of carcinogenicity should not rely solely on genotoxicity information.
4. According to the extract, the best way to address the biocompatibility of a device is through
A. clinical testing
B. clinical studies
C. clinical experience
Clinical experience
Clinical experience should be considered in the overall benefit-risk profile for the device where the totality of the
data available for the device may inform whether more testing is needed, or if any testing is needed at all. For
example, clinical experience may be useful to mitigate problematic findings in an in vitro biocompatibility. In
other cases, testing to address long-term biocompatibility endpoints may not be necessary if the patient’s life
expectancy in the intended use population is limited. Generally, clinical studies are not sufficiently sensitive to
identify biocompatibility concerns. Clinical or sub-clinical symptoms that result from the presence of a non-
biocompatible material may not be identifiable, or may result in symptoms that are indistinguishable from the
disease state such that the clinical data may not be informative to the biocompatibility evaluation. For example,
blood vessel occlusion at the site of an implanted stent could be indicative of a toxic response to the stent
materials or be related to damage to the stent during implantation.
Drugs in Hospital
A hospital exists to provide diagnostic and curative services to patients. Pharmaceuticals are an integral part of
patient care. Appropriate use of medicines in the hospital is a multidisciplinary responsibility shared by
physicians, nurses, pharmacists, administrators, support personnel, and patients. A medical committee,
sometimes called the drug and therapeutics committee, pharmacy and therapeutics committee, or the medicine
and therapeutics committee, is responsible for approving policies and procedures and monitoring practices to
promote safe and effective medicine use. The pharmacy department, under the direction of a qualified
pharmacist, should be responsible for controlling the distribution of medicines and promoting their safe use. This
task is challenging because medicines are prescribed by physicians, administered by nurses, and stored
throughout the hospital. The control of narcotics is of particular concern in the hospital setting and requires a
systematic approach for the prevention and detection of abuse.
A. can assume a positive result for the devices containing genotoxic materials.
B. cannot absolutely negate the negative results for other device components.
Genotoxicity
Genotoxicity testing may be waived if chemical characterization of device extracts and literature references
indicate that all components have been adequately tested for genotoxicity. Genotoxicity testing may not be
informative for devices containing materials already known to be genotoxic, because a positive result will be
assumed to be due to the known genotoxin. Thus a second genotoxin from another source may be overlooked. If
genotoxicity testing is performed, a negative result should be interpreted as a negative for the other device
components or interaction products, but does not necessarily negate the risk of the known genotoxin. Chemical
characterization may be needed to demonstrate to what extent the genotoxin is released from the device. For
known genotoxins, the overall benefit-risk determination will depend on the device indication and human
exposure. Genotoxicity testing is requested when the genotoxicity profile has not been adequately established.
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.
An investigation of the circulation of blood in the eyes of divers has produced the strongest evidence yet that
tissue damage is caused by diving is more common and more severe than previously thought. Researchers from
Moorefield’s Eye Hospital in London and Maurice Cross of the Diving Diseases Research Centre in Plymouth
examined the retinas of 80 divers of varying experience. The researchers found evidence of damage in nearly half
the divers. Although the damage tended to increase with diving experience some of the divers developed it within
two years of diving. The study is the first evidence of damage to the eye tissue in amateur divers and it suggests for
the first time that a career in diving almost inevitably leads to damage.Of the 26 professional divers studied all had
abnormal retinas. None of the divers taking part in the study had visual problems as a result of their damaged
retinas but Bird said that he "would not be surprised to find divers whose damage has progressed far enough to
affect their vision".
Evidence has mounted during recent years to show that exposure to pressure during diving subtly damages the
central nervous system. Doctors believe that the damage is due to obstruction in the flow of blood through the
tissues. People who take up diving as a sport know they are at risk of getting "the bends" or an air embolism, but if
they follow the correct procedures the risk is very low. All professional divers know they also run the risk of bone
necrosis. About 5 per cent of them develop small dead patches in their bones. Active professional divers have the
bones of their thighs and upper arms x-rayed as part of their annual medical examination. Doctors have been
concerned that if diving caused dead patches to appear on bones, other tissues may be suffering a similar fate.
Their concern increased in the early 2000s, when detailed neurological examinations and tests of the memory and
reactions of experienced professional divers suggested that some of them might have slight damage to the brain
and spinal cord.
Then, in 2006, nuclear magnetic resonance imaging revealed small areas of damage in the brains of apparently
healthy North Sea divers. The following year Ian Calder, a pathologist at the London Hospital in the city's East End,
published the results of a postmortem study of eleven professional divers. Seven of them had areas of damage in
the spinal cord that had not been detected while the divers were alive. The samples were too small for researchers
in the studies to draw conclusions as to how common such damage might be. The fact that few divers are currently
complaining of neurological symptoms does not mean that they will not experience problems later in life. There is
a great deal of extra capacity in the nervous system of young people that begins to diminish in middle age. Most
people who have dived deeper than 50 metres are still relatively young. Deeper diving did not become common
until the mid-1970s when drilling for offshore oil began in the deeper water of the North Sea. Over the same
period recreational diving became more popular and the amateur divers began to go deeper.
In order to determine the size of the problem, the researchers needed a method of looking for the damage in a
large sample of divers that did not involve surgery. The damage which occurs in the tissue of both the bones and
the nerves of divers is similar. Minute areas of tissue had died, probably because they had been starved of blood,
suggesting that capillaries that supplied blood to the areas had been blocked. The bone necrosis of divers closely
resembles that seen in victims of sickle-cell anemia whose capillaries are temporarily blocked during a sickle-cell
"crisis" when their red blood cells become too rigid to pass through. Sickle-cell disease damages the retina which
doctors can see using the technique known as retinal angiography. The process involves injecting Fluorescein dye
into the blood stream and photographing the back of the eye through the pupil. The technique can provide a
detailed photograph of the two vascular systems supplying blood to their retina without causing too much
discomfort to the patient.
The researchers used retinal angiography to assess the tissue damage in divers. The abnormalities that they
detected in the angiograms of divers were very similar to those seen in sickle-cell disease. There was clear
evidence of obstruction to the capillaries. The researchers suggested three mechanisms to explain how diving
causes this obstruction. When divers come back to the surface air bubbles sometimes form in their veins and their
lungs. If bubbles also form in the arteries, they would block the capillaries. Bubbles forming in the lungs trigger
changes in the body's clotting mechanism which could result in minute clots becoming trapped in the capillaries.
The third suggestion is that the mechanism might also be similar to that of sickle-cell disease. The pressure that
divers experience at 30 meters causes their white blood cells to become rigid just as red blood cells do during a
sickle-cell crisis. The researchers hope that clues to the cause of the obstruction will come from investigations into
the individual differences between divers. Some of the divers studied had relatively little damage even though they
had been diving for many years and done a great deal of deep diving. On the other hand, a few inexperienced
divers had quite extensive damage.
11. All of the following were used by doctors to examine the health of practicing divers except _____
B. post-mortem examinations.
D. neurological examinations.
Text 2: Plumbism
Paragraph 1
Plumbism is the technical term for lead poisoning, which represent a diseased condition, produced by the
absorption of lead, common among workers in this metal or in its compounds, as among painters, typesetters, etc.
Lead is a metal which is toxic to humans when ingested or inhaled. When lead enters the bloodstream, whether
the route of entry is the lungs or the gastrointestinal tract, it is distributed to the tissues and organs of the body,
including the brain, liver and kidneys. In the long term, lead is stored in the teeth and bones. Although it is
excreted gradually (mostly in the urine, but also in feces, sweat, hair and nails), repeated exposure and absorption
results in an accumulation of lead in the body. Cumulative doses of lead over time can result in chronic lead
poisoning, while acute lead toxicity may be observed in cases of short-term, high-dose exposures.
Paragraph 2
A naturally occurring element, lead may be dispersed by natural processes such as erosion, volcanic eruptions and
forest fires. Overwhelmingly, however, hazardous human exposure to lead is due to its release into the
environment through industrial processes, and to the widespread use of lead-containing products, most
notoriously petrol, paints, and plumbing and building materials. Many everyday household items including
adhesives, batteries, ceramics, glassware and children's toys may also contain lead, particularly if manufactured in
the twentieth century. Other items that have traditionally contained lead include bullets and radiation shields.
Industrial sources of lead contamination of soil, water and air include mining and smelting of lead and lead-
containing ore, car manufacture and combustion of large quantities of fuels such as coal in the generation of
electricity. The leading cause of lead poisoning among adults is occupational exposure, particularly for those
working in the industries previously mentioned.
Paragraph 3
To alleviate the incidence of environmental exposure due to contact with building materials and other products
containing lead, industry guidelines and government legislation have been introduced in many countries: drinking
water is no longer prone to lead contamination where alternatives to lead pipes and lead-soldered fittings, roofs
and water tanks are required in new houses; maximum allowable lead content in domestic paint is now specified in 17
a growing number of jurisdictions; and the last two decades or so have seen leaded petrol banned in most
countries around the world. However, exposure to lead particles is still a significant health risk due to the lingering
contamination of soil and dust from past fuel emissions, from continuing industrial exposure, and from contact
with older lead-based products still in use.
Paragraph 4
Even small quantities of lead taken into the body are considered hazardous to human health. Adverse systemic
effects can extend to the neurological, cardiovascular, gastrointestinal and renal. Damage caused by lead poisoning
is known to be irreversible in some cases, such as severe neuro-behavioral impairment resulting from acute
intoxication. However, health outcomes are influenced by the timing, duration and amount of exposure (or
dosage), and by how much accumulation has occurred. Among the available biological markers of lead dose, blood
lead levels provide a more accurate measure if there has been recent exposure to lead, while levels of lead in 20
bone, measuring stored lead, are more accurate indicators of accumulation.
Paragraph 5
Among the most vulnerable to lead exposure and its effects are children under the age of six. Where lead is
present in soil, dust, paint or toys, young children are at an increased risk of ingesting lead, as they may touch lead-
based or contaminated materials with their fingers and mouths. A child's body is also more susceptible to lead 21
absorption -it has been estimated that a child's body can absorb 50% of lead particles on exposure compared with
only 10% for an adult's. The likely health effects for young children are even more dire considering the vulnerability
of the developing brain to permanent disadvantage as a result of the neurotoxicity of lead. Intelligence quota (IQ)
deficit has been linked to neuro-toxic effects in children with lead blood levels as low as five micrograms per
deciliter (5µg/dL). Less research has been conducted on the effects of lead exposure during prenatal development
but, because lead is able to cross the blood brain barrier and the placenta, the risk of significant harm to the brain
and to the developing fetus is a key concern. One study in Mexico led researchers to conclude that fetal
neurodevelopment is adversely affected by lead exposure and particularly so during the first trimester of
pregnancy.
Paragraph 6
Studies suggest that chronic lead toxicity in individuals could change behavior and cognitive function and even
trigger psychosocial disturbances that contribute to aggressive behavior. One study observed a significant decline
in rates of violent crime throughout the 1990s in the United States, a country where the use of leaded petrol was 22
phased out during the 1970s. The researchers hypothesized that this change in crime rate is attributable to a
reduction of childhood exposure to lead in the decades prior to the 1990s. Studies like this one, which documents
an association between childhood lead exposure and criminal behavior in adults, are supported by findings that
some adolescent criminals have blood lead levels quadrupling the average among teenagers. Despite these
alarming health effects, the World Health Organization has described lead poisoning as a completely preventable
disease.
B. cannot be reversed.
C. sometimes cause death.
20. The preferred method for measuring lead levels in the body depends on _____
21. Young children are at greater risk of lead poisoning than adults due to _____
22. In sixth paragraph research links a fall in incidents of violent crime to _____
1. B
2. A
3. D
4. C
5. D
6. B
7. C
8. 10 MHz
9. millennium development goals
10. 1744
11. lower frequencies
12. MDG 5
13. sonography
14. 620 per 100,000
15. 83
16. Ultrasound training
17. concern
18. obstetric care
19. Higher frequencies
20. maternal-child bonding