执业医师 1.局部浸润麻醉的基本操作步骤； 2.按无菌操作原则进行如下操作：戴手套、消毒及辅单（以椎管内麻醉术为例）； 3.蛛网膜下腔阻滞（腰麻）的穿刺步骤，术后常见并发症与最严重并发症； 4.硬膜外麻醉穿刺步骤与穿刺成功的指征 5.硬膜外麻醉术中并发症及其处理要点； 6.麻醉机的基本结构； 7.心肺复苏时，胸外心脏挤压和人工呼吸的基本操作方法以及呼吸道的管理； 8.麻醉中基本生命体征的观察与监测； 9.气管内插管（经口腔明视插管）操作技术； 10.常用局麻药（局部浸润、神经阻滞）的一次用药限量， 局麻药毒性反应的预防与处理。 执业助理医师 1.局部浸润麻醉的基本操作步骤； 2.按无菌操作原则进行如下操作：戴手套、消毒及辅单（以椎管内麻醉术为例）； 3.蛛网膜下腔阻滞（腰麻）的穿刺步骤，术后常见并发症与最严重并发症； 4.硬膜外麻醉穿刺步骤与穿刺成功的指征 5.硬膜外麻醉术中并发症及其处理要点； 6.常用局麻药（局部浸润、神经阻滞）的一次用药限量， 局麻药毒性反应的预防与处理。 Part Ⅰ Vocabulary and Structure (20 minutes, 20 points) Directions: Beneath each of the following sentences, there are four .choice marked A, B, C and D. You should choose the one that best completes the sentence and mark the corresponding letter on the Answer Sheet with a single line through the center.
1. Most of us agree that the black fumiture against the white wall makes an interesting __________
A. spectacle B. contrast C. uniform D. comparison
2. Each country has its shifting population of vagrants. But__________ they are poor people.
A. in the case B. in any case C. in most cases D. in case
3. John and his sister are each going to visit their__________ friends.
A. homely B . Relative C. respectful D. respective
4. __________the book reviews are handed in to Prof Smith's office before ten next Monday morning.
A. Seeing that B. See that C. See to it that D. Seeing tO it that .
5. He has gone to San Francisco __________his clients.
A. with intention of meeting B. with the intent to meeting
C. with the intention to meeting D. with the intention of meeting
6. As is commonly known, fresh air, enough exercise and nutritious food __________to good healih .
A. contribute B. add C. attribute D.distribute
7. We regret to inform you that the equipment you ordered is__________ .
A. out of work B. out of stock
C. out of reach D. out of practice
8. On hearing the approaching footsteps, Mary held her breath for fear that she might__________ her hiding place.
A. give out B. give up C. give in D. give away
9. Such a problem has__________ mainly because you didn't follow the coach's instruction.
A. raised B. risen C. arisen D. aroused
l 0. It's no good to one's health to__________ drinking.
A. take on B. take to C. take in D. take off
1 1 . There are two American teachers in our college, __________teaches spoken English. A. the younger one of whom B. the youngest of which
C. the younger of them D. the youngest of that
l 2. __________no personal computers, there would have been no intenet today.
A. Had there been B. If there were
C. Should there be D. If there are
1 3. __________the difficulty of the task, I shall be lucky to complete it by next month.
A. Regarding B. Given C. Presuming D. Accepted
l 4. The problem with the law is not just that some of its rules are unfair but__________ it is administered.
A. the way B. the path C. that D. what
1 5. A headache is nothing to this kind of patients__________ it is merely a headache; but it some times becomes a danger.
A. no matter B. even though C. so long as D. so long if
l 6. Hardly__________ the house he was caught.
A. the burglar had entered … when
B. entered the burglar … than
C. was the burglar entered … than
D. had the burglar entered … when
l 7. It is my first time__________ I come to New York.
A. that B. in which C. when D. which
l 8. If__________, the company is sure to go bankrupt in the end.
A. not being managed well B. not well manage
C. not managing well D. not well managed
1 9. When Bob found the pelt, he knew that he had lost his__________ for good.
A. beautiful white little lamb
B. white beautiful little lamb
C. little beautiful white lamb
D. beautiful little white lamb
20. Tom did not share his secret with many people but he__________ in his sister.
A. confessed B. concealed . C. consented D. confided Part II Cloze
Directions: There are 20 blanks in each of the following two passages. For each blank there are four choices marked A, B, C, and D. You should choose the one answer that best fits into the passage and mark the corresponding letter on the Answer Sheet with a single line through the center.
Passage 1
The medical views were as funny as they always are about anything. Whenever any new (21) is put forward, (22) for it and those against it can always find (23) men to approve or condemn. The anti-railway group produced doctors who said that (24) would be most dangerous to public health: they would produce colds, catarrhs and consumptions. The deafening noise, the gloom, the glare of the engine fire, would have a (25) effect on the nerves. Further. Being moved (26) the air at a high speed would do grave injury to delicate lungs. In those with high blood-pressure, the movement of the (27) might produce apoplexy. The sudden plunging of a train into the (28) of a tunnel and the equally (29) rush into full daylight, would cause great damage to eyesight. But the pro-railway group was of course able to produce equally well-known doctors to say the (30). They said that the speed and swing of the train would equalize the circulation, promote digestion, calm the nerves and ensure good sleep.
21. A. drug B. inventiOn C. method D. therapy
22. A. Many B. ThOse C. NObOdy D. AnyOne
23. A. police B. business C. fire D. medical
24. A. stations B . Restaurants C. tunnels D. bridges
25. A. bad B. exciting C. general D. strange
26. A. by B. through C. on D. under
27. A. train B. air C. body D. light
28. A. entrance B. darkness C. inside D. coldness
29. A. quick B. sudden C. noisy D. bad
30. A. same B. truth C. opposite D. fact
Passage 2
Several people have been instrumental in the field of psychology. Wilhelm Wudt set up the (31) psychological laboratory in Leipzig, Germany, in 1879. Ivan Paviov, (32) is noted for his experiments with (33) in which he studied (34) relaxes and reactions. Around 1900, Sigmund Freud (35) his theory that (36) try to repress any memories or thoughts (37) they believed were not good. Psychologists should not be confused (38) psychiatrists.
Psychiatrist deals with (39) illness. They are (40) doctors who treat peopie.
31. A. new B. last C. big D. first
32. A. a Russian B. a French C. a German D. an American
33. A. pigs B. chickens C. mice D. dogs
34. A. his B. their C. every D. some
35. A. who stated B. who states C. stated D. stating
36. A. people B. some people C. fewer people D. no one
37. A. that B. if C. what D. though
38. A. with B. from C. to D. by
39. A physical B. mental C. emotional D. spiritual
40. A. medical B. foreign C. ordinny D. good
Part III Reading Comprehension
Directions: There are 6 reading passages in this part. Each passage is followed by some questions or unfinished statements. For each of them there are four choices marked A, B, C and D. You should decide on the best choice and mark the corresponding letter on the Answer Sheet with a single line through the center.
Question 41-45 are based on thefollowiiig passage:
Many students trying to increase their effective reading speed become discouraged when they find that if they try to race through a passage faster, they fail to take in what they have read. At the end, they have been so busy 'reading faster' that they cannot remember what the passage was about. The problem here is that the material they are practising on is either too difficult for them in vocabulary or content , or not sufficiently interesting. We hope that the passages in this course material will be both interesting and fairly easy, but you should also practice as much as you can in your own time. Read things you like reading. Go to the subject catalogue in the library. Biography, sport, domestic science, the cinema …. There is bound to be some area that interests you and in which you can find books of about your level of ability or just below.
If you want a quick check on how easy a book is, read through three or four pages at random. If there are, on average , more than five or six words on each page that are completely new to you, then the book is not suitable for reading-speed improvement.
4 1 . This passage is mainly about how to__________.
A. use the passages in a reading course C. improve reading speed
B. develop reading comprehension D. make a good use of the library
42. The expression "books of about your level of ability …" in paragraph I is closest in meaning tO __________.
A. the books about your ability C. the books that you could find
B. the books about your height D. the books that you can understand
43. According to this passage, if you could not understand a passage, you__________.
A. may not sit in the library
B. probably don't know its background
C. may not have practised on reading it
D. probably think it is too easy for you to read
44. If a book has seven or more new words on each page, a reader who wants to practice reading speed__________.
A. will probably drop it
B. will probably read it very fast
C. may study it very carefully
D. may read it with a dictionny
45. Which of the following is NOT mentioned for fast reading purpose ?
A. Books about tennis playing.
B. Books about rurining family.
C. Books about language testing.
D. Books about personal life history.
Quesiions 46-50 are based on the following passage:
Should babies doomed to a blighted life be enabled to survive? And who should decide? The doctors? Parents? Courts? There are other complex ethical issues. Doctors now have drugs and machinery to prolong the lives of the terminally ill and the hopelessly injured, for example. Should they always do so? These issues affect all our lives. And a new discipline, known as bioethics, has emerged to try to deal with them. Nearly every U.S. medical school now offers courses in ethics. No wholly satisfactory way has yet been found to deal with the issue of the hopelessly ill or dying patient. Doctors are sometimes accused of carrying heroic measures too far, a result, perhaps, of their naturai instinct and training. "The doctor's responsibility is to do everything he can to sustain lives," says Dr. Marshell. "Cures can come any day. To stand idly by and watch a person die is intolerable." But where does it stop? Where do you draw the line? Should hospitals, then, use all the technological tools at their disposal to prolong lives that can't be saved? Today, many physicians believe it more ethical to permit the death of a hopelessly ill patient than to treat him aggressively. "There is a time and a place where prolonging suffering is not doing my job as a physician," says Dr. George, former associate dean of Columbia Medical School. If the patient is an adult and mentally aware, most physicians will honour his wish to end treatment. Dr. Bcy Benjamin, a New York City intemist , recalls a 32-year-old woman who had been on kidney dialysis for 12 years and wanted to end the painful regimen. After several psychiatrists who had worked with her determined that she wasn't motivated purely by depression, Benjamin agreed to take her off the machine and prescribed narcotics to make her comfortable until she died a short time later.
46. The questions at the beginning of this passage are about the ethical question over __________.
A. who should decide the survival of babies.
B. who should decide whether to terminate a life.
C. whether courts should decide who lives or dies.
D. whether doctors should prolong the life of the terminally ill.
47. When people blame doctois for "carrying heroic measures too far", they accuse the doctors Of __________.
A. trying too hard to become a hero.
B. shortening the sufferings of the ill.
C. standing idiy and watching a peraon die.
D. prolonging the lives of the hopelessly ill.
48. Who thinks that it is difficult to set tbe conditionsfor permitting death ?
A. Dr. Benjamin. B. Dr. Marehell. C. Dr. George. D. The Author.
49. The underlined word "ethics" in the first paragraph refers to __________.
A. the research on the various causes of death.
B. the study of questions about what is morally right.
C. the experiment on ending the life of the hopelessly ill.
D. the principles which doctors and nurses should follow.
50. The case of the woman undergoing kidney dialysis is given as an example of__________.
A. shortening the time of treatment.
B. a wrong decision to let a patient die.
C. permitting death according to a patient's wish.
D. a doctor's difficulty in making a life-and-death decision. Questions 61 - 65 are based on the following passage:
"It's not what you know but who you know that counts." People who get on in life may be successful not because they deserve it, but because of influential friends or the right background. This is the widespread belief it is a comforting belief too. If your boss strikes you as incompetent, it is tempting to believe that he only got the job because his father pulled some strings And yet, if we can get what we want by 'having a word' with so-and-so, or by getting so-and-so to put in a good word for us, which of us would not take advantage of the opportunity? Often it is quite harmless. For instance, when Miguel went with Julia to visit Michelle in hospital, he bumped into someone he knew, a doctor who had been at medical school with his father. As a result of this chance, Miguel was able to find out a great deal about Michelle's condition. At the other extreme it can be very destructive. I once met a brilliant young engineer who worked in a chemical plant. Because of her knowledge and experience, she should have been promoted to Production Manager. Instead, the job went to a man who was totally unsuited for the post. Every one knew that he only got it because he was politically acceptable to his superiors. This injustice demoralized the young engineer and many of her colleagues. It also meant that the factory was much less efficient than it could have been.
All the same, we should not be pessimistic. More and more, the modern world depends on having people who are in the job because they are good enough, not just because their face fits. There is a story of a faciory owner who sent for an engineer to see to a machine which would not work. He examined it, then took out a hammer and tapped it, once. The machine started up immediately. When he presented his bill, the owner protested, "This can`t be right! $100 just for tapping a machine with a hammer ?" The engineer wrote out a new bill: "For tapping a machine, $l ; for knowing where to tap it, $99." maybe it is what you know that really counts, after all.
61 . Miguel knew the doctor at the hospital because__________
A. Miguel's father and the doctor had been students together .
B. Miguel's father was a doctor
C. his son had been at school with Miguel
D. the doctor was an old friend of Miguel
62. The underlined phrase "pulled some strings" in the second paragraph means__________ .
A. taking advantage of somebody
B. putting in a good word for somebody
C. using one's influence to get something.
D. persuading people into doing something
63. Miguel took advantage of the fact that he knew the doctor in order to get more information about Michelle`s condition. According to the writer, Miguers action is an example of how people__________.
A. have an unfair advantage over others
B. behave in using such opportunities
C. use such opportunities without hurting anyone else
D. use such opportunities to get to know someone 'on the inside'.
64. The engineer at the chemical plant was not promoted because__________.
A. her boss did not approve of her political opinions
B. the man who got promoted was more experienced than she was
C. her bosses did not think she was good enough for the post
D. it is hard for a woman to get promoted to a managerial position
65. The engineer who repaired the machine was right to charge $ 100 because__________.
A. he was the only one who could find out what was wrong with it
B. the factory owner could not have repaired it himself .
C. he was charging for his knowledge and experience
D. the machine was very important for the factory .
Questions 66- 70 are based on thefollowing passage:
The idea has reigned for years that the aging brain's neurons die off by as many as 1 00,000 a day -- taking with their life's cherished memories. But, in fact, neurobiologist such as Alan Peters of Boston University have shown in recent studies that, while brain cells may shrink in old age, they don't die off in large numbers. What's more, say neuroscientists it's primarilj the brain's "hardware" -- the billions of telephone-line-like connections and relay switches which act as processing equipment-that is vulnerable to wearing out with age. The brain's "software"-the actual information that fills up the mind over a lifetime-doesn't necessarily deteriorate. If anything, it can grow more sophisticated. So, just as running the latest software program on an old computer will take more time and may involve some glitches, one can still possess a first-rate intelligence while losing some cognitive speed later in life.
When mental abilities do pass their peak, memory isn't the first to go, Powell and others say. It's usually the brain's capacity to make sense of spatial relationships-map-reading or finding your car at the mall-which may begin to get difficult in your 40s. A decade later, the abstract reasoning required to make analogies dips downward.Next to drop is "verbal memory after delay" --remembering details of a story after having turned attention to other tasks. But some mental skills, such as the ability to concentrate or calculate math, seem to remain sturdy long into old age. And "procedural" memory-how to play golf or ride a bike-is usually not touched by aging.Even "common" memory loss, however, shouldn't be considered normal. It could be treatable. Neurologists at Harvard are finding that, later in life, the brain often produces less acetylcholine, a neurotransmitter involved in memory. Tentative results suggest that drugs could mimic the missing chemical. At least a dozen other substances (estrogen, for example) are also being studied as potential memory boosters.
66. According to the neuroscientists, the information in our mind__________.
A. is easy to be lost at old ages.
B. does not change at old ages.
C. wears out easily with age.
D. can be more complicated at old ages.
67. The neuroscientists compare our brain with computer to show that__________.
A. when people get old , their brains work slowly as old machines
B. human beings are as intelligent as computers.
C. the structure of our brains is very complicated.
D. a great deal of information can be stored in our brains.
68. According to the passage, at what age do our brains work bost?
A. When we are younger than thirty.
B. When we are about forty.
C. When we are over fifty.
D. Our brains will work well until we are very old.
69. What might happen when we are in our 50s?
A. We begin to forget whero we have put our things.
B. We begin to have difficulty in explain the state in which two things are alike in many Ways .
C. We begin to forget the massage that we have been told.
D. We begin to forget how to operate a machine.
70. Which of the following is the best title of this passage?
A. How to Keep Our Memories at Old Ages
B. Memories Goes First When We Are Old
C. Exploding the Myth of Our Memory
D. How to Stay Mentally Alert
Answers:
l. B 2. C 3. D 4. B 5. D 6. A 7. B 8. D 9. C 10.B
ll.A 12.A 13.B 14.A 15.C 16.D 17.A 18.D 19.D 20.D .
21.B 22.B 23.D 24.A 25.A 26.B 27.A 28.B 29.B 30.C
31.D 32.A 33.D 34.B 35.C 36.A 37.A 38.A 39.B 40.A
41.C 42.D 43.B 44.A 45.C 46.B 47.D 48.D 49.B 50.C
5l.B 52.C 53.D 54.A 55.A 56.C 57.A 58.B 59.D 60.D
61.A 62.C 63.C 64.A 65.C 66.D 67.A 68.B 69.C 70.C
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