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Malaria In pregnancy oet
Reading Methods In Elem. Ed. (ED 315)
St Joseph's University
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READING SUB-TEST – TEXT BOOKLET: PART A
INSTRUCTIONS TO CANDIDATES
You must NOT remove OET material from the test room.
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Malaria in Pregnancy: Texts
Malaria occurs mainly in the tropical areas of Africa, Asia and Latin America. Malaria is a parasitic disease spread by the bite of the female Anopheles mosquito, which results in infection of the red blood cell. Five main species of the malaria parasite infect humans: Plasmodium falciparum (the severest form), Plasmodium vivax, Plasmodium ovale, Plasmodium malarie, Plasmodium knowlesi. Australia was declared malaria-free by the World Health Organization in 1981, and since then, only a small number of cases of locally acquired malaria have been reported from North Queensland. Severe malaria may lead to foetal loss and high maternal mortality due to hypoglycaemia and acute respiratory distress syndrome (ARDS). All forms of malaria in pregnancy may adversely affect the mother and foetus. The main complications are: miscarriage, stillbirth, preterm birth, low infant birth weight, severe maternal and neonatal anaemia. Pregnant women should be advised to avoid travel to malaria-endemic areas. For pregnant women who cannot avoid travelling, the medical officer should consult with an Infectious Diseases specialist or experienced Travel Medicine doctor to determine the appropriate chemoprophylaxis agent.
Text A
Text B
infection of the red blood cell. Five main species of the malaria parasite infect humans:
Plasmodium falciparum (the severest form), Plasmodium vivax, Plasmodium ovale, Plasmodium
malarie, Plasmodium knowlesi.
Australia was declared malaria-free by the World Health Organization in 1981, and since
then, only a small number of cases of locally acquired malaria have been reported from
North Queensland. Severe malaria may lead to foetal loss and high maternal mortality
due to hypoglycaemia and acute respiratory distress syndrome (ARDS). All forms of
malaria in pregnancy may adversely affect the mother and foetus. The main
complications are: Miscarriage, stillbirth, preterm birth, low infant birth weight, severe
maternal and neonatal anaemia.
Pregnant women should be advised to avoid travel to malaria-endemic areas. For
pregnant women who cannot avoid travelling, the medical officer should consult with an
Infectious Diseases specialist or experienced Travel Medicine doctor to determine the
appropriate chemoprophylaxis agent.
TEXT B
Clinical symptoms of malaria:
Fever Malaise Headache
Abdominal discomfort Muscle and joint aches
Chills, sweats, rigours
May present as a respiratory or gastrointestinal illness
Incubation period:
� 95% of malaria cases develop symptoms within one month
� Incubation period depends on the species:
⁃ P. falciparum 9 – 14 days
⁃ P. vivax and P 12 – 18 days
⁃ P. malariae 18 – 40 days
⁃ P. knowlesi 9 – 12 days
Malaria should be considered in pregnant women with a fever who have travelled to
malaria-endemic areas.
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####### 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 in the spaces provided in 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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READING SUB-TEST – QUESTION PAPER: PART A
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11 Which medication is contraindicated during the later stages of pregnancy?
12 Which species of malaria parasite may have an incubation period of over a month
13 Among the complications resulting from malaria in pregnancy, which condition may affect both mother and infant?
14 Which is the most dangerous species of malaria parasite for humans?
Questions 15-
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 If a pregnant woman who has been to a tropical region of Africa presents with a , she should be tested for malaria
16 Malaria patients may have symptoms of illnesses affecting their breathing or functions..
17 Malaria antigens in a patient’s blood can be detected by means of a
18 When considering malaria, tests should be carried out to determine how well the patient’s is working.
19 In severe cases of malaria in pregnancy, the woman may die as a result of low blood sugar and
20 Patients should receive their third dose of artesunate hours after admission.
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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.
A B C
- What does the email tell staff about the update to asthma guidelines?
Objective testing is now given greater emphasis. Comparison of medication types is now possible. The stages of treatment are now easier to understand.
Fill the circle in completely. Example:
A B C
To: From: General Hospital
All local GPs
The updated national asthma guideline has now been published. The update focuses on the chapters on diagnosis and pharmacological therapy. The updated Diagnosis chapter continues to reinforce the importance of proceeding towards a diagnosis based on the probability of asthma, and that asthma is a variable condition for which there is no definitive diagnostic test. It suggests that objective testing can be useful, but should take place in the context of a ‘structured clinical assessment’. In the Pharmacology chapter, there are some significant changes to the presentation of the familiar steps of asthma management, and to comparing inhaled corticosteroid (ICS) strengths. A phased approach to treatment is still recommended, but the numbering of the steps has been replaced by more helpful descriptions. The new banding of ICS by strength should be more accurate and straightforward in practice.
Subject: Update to asthma guidelines
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A B C
- According to the policy document, valuables belonging to a hospital in-patient who dies should
be labelled and stored in a secure manner. be documented and deposited for safekeeping. be kept with the body until the family is contacted.
Patients’ property
When a patient is admitted, relatives should be asked to take valuables/property home if possible. If this is not possible any valuables will be recorded in the Property Book and placed in a sealed envelope.
Where a patient dies in the care of the hospital and no relatives are present, valuables should be recorded using the Property Book and sent to the cashier’s office. All clothing should be placed in a sealed bag marked with the patient’s name and hospital and transferred with the body to the mortuary.
If a patient is certified dead on arrival then his/her property, clothing and valuables should not be removed, but should be transferred with the body to the mortuary.
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A B C
- What can staff find out from this policy statement?
where to transport different kinds of hospital waste who is responsible for the disposal of infectious waste how to identify the various categories of waste receptacle
Waste management policy
The transportation of waste is a process that should begin at the site of generation where infectious (orange bag), offensive (yellow/black tiger stripe bag) and domestic (black bag) waste must be properly collected and segregated in specific bags and containers.
The housekeeping staff/site manager/porter are to ensure that trolleys are checked for cleanliness after every use, cleaned if required and that all equipment has the periodic deep clean as per National Standards of Cleanliness.
Waste bags must never be transported in the same trolley at the same time as sharps boxes, pharmacy waste containers (blue lidded bin) or placenta containers (red bin), as the hard containers are likely to split the plastic bags.
All waste streams when being transported must be segregated at all times to ensure no contamination. A separate trolley/collection is required for each waste stream.
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A B C
- What should determine whether or not to use a wipe to disinfect an ICMD?
the design of the device the number of devices available the time needed to disinfect the device
Guidelines for the disinfection of ICMDs (intracavity medical devices)
It is important that the disinfectant is in contact with all surfaces of the ICMD and that it remains liquid for the recommended contact time. This is more easily achievable with an automated washer-disinfector or by partial immersion in disinfectant. Disinfectant-impregnated wipes are widely used, but the assurance that all surfaces are in contact with liquid disinfectant for the required time is not easy to achieve as a high-quality assurance standardized process. Therefore, best practice is the use of an automated system or partial immersion, with manual disinfection of any parts that cannot be thus treated. If this is not practical due to the complexity of the device, then wipes may be used. The lack of sufficient devices and requirement for a rapid turnaround should not be seen as the sole reasons for the acceptability of disinfectant wipes.
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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.
Text 1: Organ Donation in Australia
Australia has some of the world’s highest organ transplant success rates, but rates of organ donation from the deceased are among the lowest in the developed world. For many years now, enormous attention - and funding - has been devoted to finding ways of raising low organ donation rates. Between 1989 and 2008, more than twenty public and government-led initiatives were launched to address matters believed to be its cause. Unfortunately, they proved ineffective and cumulatively resulted not in an increase, but rather in a decline of around 20%. These outcomes illustrate some fundamental misconceptions about why Australia has such a low rate of organ donation, based on five myths.
The first myth is the assumption that Australians are less altruistic than other people. The truth, however, is that Australia compares favourably with other developed countries in terms of how much money is given to those in need. In fact, it ranks sixteenth in the world for Official Development Assistance donations, ahead of the USA, Portugal and Italy – countries leading the world in organ donation rates. What’s more, Australia’s living-kidney donation rates are high — several times higher, in fact, than those in Spain, France, Austria and Italy, which have the world’s highest deceased organ donor rates.
A second myth concerns the consent rate: the percentage of people who agree to donate their deceased relatives’ organs. Many believe that Australia has a very low consent rate for organ donation and, as a result, a low deceased donation rate. In fact, whilst Australia’s current consent rate of 57% is not as high as world-leading Spain (82%), it’s similar to other top donor countries such as France (63%) and the USA (50%). And the fact that other countries maintain much higher donation rates with similar or even lower rates of consent shows that consent alone isn’t a sufficient explanation for Australia’s low rate of deceased organ donation.
Another myth is the idea that the registration of one’s wishes regarding organ donation ensures that individuals will become donors when they die. This is false, for two important but very different reasons. First, the odds that an individual’s death will lead to donation is slim (less than one in four-hundred) because types of death that allow donation are very rare, and typically involve very specific types of brain trauma. Second, even if a person has registered with all the relevant bodies and stipulated in their will that they wish to be a donor, should the opportunity arise, their family will make the final decision. Australian families refuse organ donation requests about 40% -50% of the time.
Fill the circle in completely. Example:
A B C D
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Yet another myth is the theory that Australia has such a low organ-donor rate because of its low death rate. In other words, young people who could become donors don’t die as often in Australia due to high levels of public health and safety. While it’s true that Australia’s death rate is lower than many countries in the world, it’s on a par with that of countries such as the USA, which has a high organ-donation rate as well as a low death rate. Moreover, only certain infrequent types of death can lead to donation — most often linked to specific forms of trauma - such as accidents, gunshots and strokes. Rates for these types of deaths are similar in most developed countries.
The final myth is the misconception that the countries with high rates of organ donations from deceased individuals are those that have ‘presumed-consent’ systems. An individual is presumed to have given consent to donating their organs if they haven’t informed authorities that they’re opting out. While it’s true that the majority of countries with the highest donation rates have presumed consent (or ‘opt out’) legislation, so too do many of the worst-performing countries. It’s also incorrect to assume that presumed consent means that organs will necessarily be removed from deceased persons in these countries unless they’ve expressed prior written opposition to donation. Virtually all presumed consent countries won’t proceed with donation unless the family of the deceased approves.
Australia’s failure to increase organ-donation rates despite decades of effort suggests that many things aren’t understood about how to increase rates of donation there. But the idea that the country is somehow fundamentally different to world leading donor countries, in ways that make it impossible for it to become a world leader in organ donation, is false. The fact that there are similar rates of deaths that lead to high rates of organ donation in other countries represents a very real opportunity for Australia. By converting the tragedy of these deaths into opportunities to save the lives of others, Australia can become a world leader in organ donation – just as it currently leads the world in transplantation success. Taking this lead means abandoning the convenient mythologies of the past and the adoption of proven practices from other countries.
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A B C D A B C D A B C D A B C D
- The writer uses the phrase ‘on a par’ in the fifth paragraph to suggest that
a figure is surprisingly high. the figures may be misleading two figures are roughly similar. it’s hard to arrive at an exact figure.
- What does the word ‘those’ in the sixth paragraph refer to?
countries high rates organ donations deceased individuals
- What is stated in the sixth paragraph about ‘presumed consent‘ countries?
A large proportion of their citizens choose to opt out. The legislation they require is unnecessarily complex. Their authorities may overrule families’ objections. Some of them have rather poor donation rates.
- What is the writer doing in the final paragraph?
expressing optimism about Australia’s potential to improve donation rates outlining differences between Australia and countries with higher donation rates recommending a range of specific strategies for boosting Australia’s donation rates analysing the mistakes made in previous attempts to raise Australia’s donation rates
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Text 2: Breaking bad news
No one seems to find it easy to talk about bad news with a patient, and although much has been published about patients' reactions, there is relatively little documentation of medical professionals' feelings in this situation. By ‘bad news’ I mean any information likely to drastically alter a patient's view of their future, whether at the time of diagnosis or when facing the failure of curative intention. Naturally, how bad the news is will depend to some extent on the patient's expectations at the time, on how ill they actually feel, and on whether or not they already know or suspect their diagnosis or current state.
The worst fear for medical professionals - particularly less experienced ones - is that the patient will blame them personally for the bad news that they bring. Of course, the phenomenon of identifying the bad news with the bearer of it isn’t unique to our profession. At its heart is the issue of how easy it is to find a target for the blame: if someone officially in authority conveys the bad news, it becomes easier to direct the anger aroused by the news itself at this person. Therefore, as medical professionals, we should naturally expect this kind of reaction from our patients when it falls to us to deliver bad news.
Not every patient responds to bad news by blaming the medical professional who is caring for them, but it happens often enough for many of us to fear it before we start the conversation, or possibly not to have the conversation at all. Even those of us with many years' experience may find ourselves relieved when a patient says something like ‘actually I knew it was cancer anyway’, and we realise that we have been let off the hook. However, all of us need to bear in mind that the act of blaming is simply another reaction to be dealt with, as we would inflammation or haemorrhage, and isn’t to be taken personally.
By the time they qualify, all medical practitioners should have been trained in the management of common medical crises. Nevertheless, many of us may not have had any specific training in communication skills in general, or in talking to dying patients in particular. As we progress professionally, and get better at doing the things that we’ve been trained for, we feel more and more awkward when we encounter problems for which we haven’t been prepared, and this may put us off trying to face up to them.
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Malaria In pregnancy oet
Course: Reading Methods In Elem. Ed. (ED 315)
University: St Joseph's University
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