2021年医师系列《中医助理医师》考试题库-中医助理医师-第七单元 妊娠病-

医药卫生-执业医师

5-Your doctor is recommending a surgical procedure you're unsure about. Or maybe you've just received a diagnosis you don't understand. Or perhaps your doctor isn't giving you any diagnosis at all and you still don't feel right. In all these situations, you should seek a second opinion from another physician. That's a message most Americans don't seem to get. According to a 2005 Gallup poll, about half of 5,000 Americans surveyed said they never seek a second opinion when their doctor “diagnoses a condition, or prescribes a treatment, drug, or operation” while just 3 percent say they always seek one.　　What's the problem? In most cases, it's ignorance of how the healthcare system works. Patients just don't understand that doctors think seeking a second opinion is routine. Many insurers recommend it and some even require it for certain procedures. (1)_________________.　　Doctors say that both men and women should seek a second opinion in virtually all types of non-emergency surgery, when your doctor recommends long-term medication that has potential side effects and if you are not feeling better despite repeated visits to your doctor. In the first two cases, studies indicate that the second physician is most likely to confirm the initial recommendation, but may also suggest alternatives for you to consider.　　(2)_________________. That's especially true if you a get a recommendation for a hysterectomy, an operation in which the uterus is removed. It's the second most common surgery among American women. And yet, many doctors think there are other ways to deal with some of the problems—such as uterine fibroids, pain or heavy bleeding—that lead to hysterectomies. Those other options might include medication or less drastic procedures.　　Women should also seek a second opinion for unresolved cardiac problems. Until recently, for example, doctors didn't understand that the signs of a heart attack in women can be very different from those in men. (3)_________________.　　Deciding you need another opinion is the first step. How do you find the right doctor? (4)_________________.　　Other resources include local medical societies, and academic medical centers, which often are the best place to find state-of-the-art treatment options. You want to find someone who is an expert on your particular problem.　　(5)_________________. Dr. Jonathan Schaffer, managing director of e-Cleveland Clinic, says online second opinions are appropriate when the condition has “objective criteria”—in other words, an imaging study, stress test or pathology results. But it's not appropriate for conditions that require more subjective interpretation, he says, such as earlier stages of breast cancer, when mammogram readings can vary and in-person consultation could be more useful.　　Most of the time, the second opinion confirms the first, Cummings says, but when there is a conflict, you may have to go to a third doctor. You can also ask both of the first two doctors to explain their decisions in more detail. When the time comes to make a decision, the Ottawa Personal Decision Guide offers a step-by-step worksheet.　　[A] But women in particular often say they feel awkward about consulting another doctor because they worry that their primary physician will be less than cordial in future visits. In fact, that's rarely the case.　　[B] Another possibility is an online consultation, offered by the Cleveland Clinic, among other places.　　[C] In addition to these general recommendations, women should get a second opinion for certain issues specific to gender.　　[D] Many physicians suggest starting with your primary-care doctor.　　[E] Consulting another doctor will be a fashion in developed countries, especially in the United States.　　[F] Tests given to detect heart disease in men may not always be sensitive to women's heart problems so if you get an all-clear but continue to experience symptoms such as shortness of breath or periods of rapid heartbeat, you should seek another opinion—preferably from a specialist in women's heart disease.　　[G] You must first get the permission of Ministry of Health, and under the supervision of Government's health care system if you need a second opinion.(此文选自Newsweek2008年刊)

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我个人认为这个应该是：1. A　本文首段提出人们接受第一位医生的诊断之后，多种情况下并不寻求第二位医生的意见，也并不关心医疗系统是如何运转的，这是一种社会现象，那么出现这种现象的原因是什么？七个选项中，只有A具体提到了妇女feel awkward about consulting another doctor，这样就尅可以看出其中的原因。而且but一词，与前文医生和保险公司的建议形成对比，进一步突出人们不愿寻求第二位医生意见的心理。故为正确答案。
 2. C　上文列举了医生建议在就医时应该寻求第二种意见的三种情况，在C中提到In addition to these general recommendations，与上文医生的建议相呼应，同时过渡到另一层意思：关于women应该寻求第二种意见的建议，这与下文提到的That's especially true…among American women衔接紧密，故C是本题答案。本体可能误选E

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