Tıp Terimleri Sözlüğü

Botulinum toxin type A (BT-A) is a potent inhibitor of the neuron end plate. After intramuscular injection, BT-A is taken up selectively by neuronal cells via specific membrane-bound acceptor molecules. Intracellularly, a proteolytic subunit is cleaved off, which interferes with neuronal acetylcholine release. This results in a flaccid paralysis of the corresponding muscles that may last for several months until acetylcholine release is restored by sprouting of new nerve endings and finally regeneration of the original end plate. On the basis of this unique mechanism, BT-A has become a precise and highly effective tool for many types of therapeutic muscle denervations. Reduction of facial expression lines, originally observed as an anecdotal event after BT-A injections for blepharospasm, has opened doors to a rampantly expanding use of BT-A among dermatologists to treat wrinkles, which were formed as hyperkinetic mimic expression lines.

Parçaya göre BT-A aşağıdakilerden hangisi üzerinde etkilidir?

• Nöron membranı
• Nöron aksoplazması
• Nöron uç plağı
• Kas membranı
• Kas hücre çekirdeği

Botulinum toxin type A (BT-A) is a potent inhibitor of the neuron end plate. After intramuscular injection, BT-A is taken up selectively by neuronal cells via specific membrane-bound acceptor molecules. Intracellularly, a proteolytic subunit is cleaved off, which interferes with neuronal acetylcholine release. This results in a flaccid paralysis of the corresponding muscles that may last for several months until acetylcholine release is restored by sprouting of new nerve endings and finally regeneration of the original end plate. On the basis of this unique mechanism, BT-A has become a precise and highly effective tool for many types of therapeutic muscle denervations. Reduction of facial expression lines, originally observed as an anecdotal event after BT-A injections for blepharospasm, has opened doors to a rampantly expanding use of BT-A among dermatologists to treat wrinkles, which were formed as hyperkinetic mimic expression lines.

Parçaya göre BT-A etki mekanizması aşağıdakilerden hangisinin engellenmesiyle gerçekleşir?

• Asetilkolinin hücre içine girmesi
• Proteolizin başlaması
• Kas membranının aktivasyonu
• Nöronlarda elektrik deşarjı
• Asetil kolinin salıverilmesi

Botulinum toxin type A (BT-A) is a potent inhibitor of the neuron end plate. After intramuscular injection, BT-A is taken up selectively by neuronal cells via specific membrane-bound acceptor molecules. Intracellularly, a proteolytic subunit is cleaved off, which interferes with neuronal acetylcholine release. This results in a flaccid paralysis of the corresponding muscles that may last for several months until acetylcholine release is restored by sprouting of new nerve endings and finally regeneration of the original end plate. On the basis of this unique mechanism, BT-A has become a precise and highly effective tool for many types of therapeutic muscle denervations. Reduction of facial expression lines, originally observed as an anecdotal event after BT-A injections for blepharospasm, has opened doors to a rampantly expanding use of BT-A among dermatologists to treat wrinkles, which were formed as hyperkinetic mimic expression lines.

Parçaya göre BT-A’nın kozmetik amaçlı kullanımı nasıl başlamıştır?

• Deneme-yanılma yoluyla
• In vitro araştırmalarla
• Klinik araştırmalarla
• Anektodal olarak
• Tarihi bilgilerle

Botulinum toxin type A (BT-A) is a potent inhibitor of the neuron end plate. After intramuscular injection, BT-A is taken up selectively by neuronal cells via specific membrane-bound acceptor molecules. Intracellularly, a proteolytic subunit is cleaved off, which interferes with neuronal acetylcholine release. This results in a flaccid paralysis of the corresponding muscles that may last for several months until acetylcholine release is restored by sprouting of new nerve endings and finally regeneration of the original end plate. On the basis of this unique mechanism, BT-A has become a precise and highly effective tool for many types of therapeutic muscle denervations. Reduction of facial expression lines, originally observed as an anecdotal event after BT-A injections for blepharospasm, has opened doors to a rampantly expanding use of BT-A among dermatologists to treat wrinkles, which were formed as hyperkinetic mimic expression lines.

Parçada cilt kırışıklıkları neye bağlanmaktadır?

• Hiperkinetik ifade çizgileri
• Kaslarda asetilkolin eksikliği
• Sinirlerde asetilkolin fazlalığı
• Ciltaltı yağ dokusunun azlığı
• Kasların denervasyonu

Botulinum toxin type A (BT-A) is a potent inhibitor of the neuron end plate. After intramuscular injection, BT-A is taken up selectively by neuronal cells via specific membrane-bound acceptor molecules. Intracellularly, a proteolytic subunit is cleaved off, which interferes with neuronal acetylcholine release. This results in a flaccid paralysis of the corresponding muscles that may last for several months until acetylcholine release is restored by sprouting of new nerve endings and finally regeneration of the original end plate. On the basis of this unique mechanism, BT-A has become a precise and highly effective tool for many types of therapeutic muscle denervations. Reduction of facial expression lines, originally observed as an anecdotal event after BT-A injections for blepharospasm, has opened doors to a rampantly expanding use of BT-A among dermatologists to treat wrinkles, which were formed as hyperkinetic mimic expression lines.

Parçanın beşinci cümlesinde geçen "unique" sözcüğünün Türkçe karşılığı aşağıdakilerden hangisidir?

• Farklı
• Karmaşık
• Ayrıntılı
• Ortak
• Kendine özgü

Short postpartum stays are common. Current guidelines provide scant guidance on how routine follow-up of newly discharged mother-infant pairs should be performed. The aim of this study is to compare 2 short-term (within 72 hours of discharge) follow-up strategies for low-risk mother-infant pairs with postpartum length of stay (LOS) of<48 hours: home visits by a nurse and hospital-based follow-up anchored in group visits. Researchers used a randomized clinical trial design with intention-to-treat analysis in an integrated managed care setting. Mother-infant pairs that met LOS and risk criteria were randomized to the control group (hospital-based follow-up) or to the intervention group (home nurse visit). Clinical utilization and costs were studied using computerized databases and chart review. Breastfeeding continuation, maternal depressive symptoms, and maternal satisfaction were assessed at 2 weeks postpartum.

Parçada sözü edilen çalışmada aşağıdakilerden hangisinin kıyaslanması amaçlanmıştır?

• İki farklı doğum sonrası takip stratejisinin
• Farklı sürelerde taburcu edilen annelerin durumunun
• Farklı sürelerde taburcu edilen bebeklerin durumunun
• Düşük ve yüksek riskli anne-bebek ikililerinin durumunun
• Hekim ile ebe izlemlerinin

Short postpartum stays are common. Current guidelines provide scant guidance on how routine follow-up of newly discharged mother-infant pairs should be performed. The aim of this study is to compare 2 short-term (within 72 hours of discharge) follow-up strategies for low-risk mother-infant pairs with postpartum length of stay (LOS) of<48 hours: home visits by a nurse and hospital-based follow-up anchored in group visits. Researchers used a randomized clinical trial design with intention-to-treat analysis in an integrated managed care setting. Mother-infant pairs that met LOS and risk criteria were randomized to the control group (hospital-based follow-up) or to the intervention group (home nurse visit). Clinical utilization and costs were studied using computerized databases and chart review. Breastfeeding continuation, maternal depressive symptoms, and maternal satisfaction were assessed at 2 weeks postpartum.

Parçada sözü edilen çalışmanın türü aşağıdakilerden hangisidir?

• Olgu çalışmaları
• Meta analiz
• Retrospektif klinik araştırma
• Randomize klinik araştırma
• Çift kör araştırma

Short postpartum stays are common. Current guidelines provide scant guidance on how routine follow-up of newly discharged mother-infant pairs should be performed. The aim of this study is to compare 2 short-term (within 72 hours of discharge) follow-up strategies for low-risk mother-infant pairs with postpartum length of stay (LOS) of<48 hours: home visits by a nurse and hospital-based follow-up anchored in group visits. Researchers used a randomized clinical trial design with intention-to-treat analysis in an integrated managed care setting. Mother-infant pairs that met LOS and risk criteria were randomized to the control group (hospital-based follow-up) or to the intervention group (home nurse visit). Clinical utilization and costs were studied using computerized databases and chart review. Breastfeeding continuation, maternal depressive symptoms, and maternal satisfaction were assessed at 2 weeks postpartum.

Aşağıdakilerden hangisi parçada sözü edilen çalışmada incelenen değişkenlerden biridir?

• Babanın memnuniyet durumu
• Annenin işe başlama isteği
• Emzirmenin sürekliliği
• Bebeğin ağlama miktarı
• Annenin uyku düzeni

Short postpartum stays are common. Current guidelines provide scant guidance on how routine follow-up of newly discharged mother-infant pairs should be performed. The aim of this study is to compare 2 short-term (within 72 hours of discharge) follow-up strategies for low-risk mother-infant pairs with postpartum length of stay (LOS) of<48 hours: home visits by a nurse and hospital-based follow-up anchored in group visits. Researchers used a randomized clinical trial design with intention-to-treat analysis in an integrated managed care setting. Mother-infant pairs that met LOS and risk criteria were randomized to the control group (hospital-based follow-up) or to the intervention group (home nurse visit). Clinical utilization and costs were studied using computerized databases and chart review. Breastfeeding continuation, maternal depressive symptoms, and maternal satisfaction were assessed at 2 weeks postpartum.

Parçada sözü edilen çalışmadaki çalışma grubundan hangi yolla veri elde edilmiştir?

• Hastaneye kontrole gelmek
• Hemşirenin ev ziyareti
• Telefonla izlem
• Annenin bilgisayara veri girmesi
• Doktorun ev ziyareti

Short postpartum stays are common. Current guidelines provide scant guidance on how routine follow-up of newly discharged mother-infant pairs should be performed. The aim of this study is to compare 2 short-term (within 72 hours of discharge) follow-up strategies for low-risk mother-infant pairs with postpartum length of stay (LOS) of<48 hours: home visits by a nurse and hospital-based follow-up anchored in group visits. Researchers used a randomized clinical trial design with intention-to-treat analysis in an integrated managed care setting. Mother-infant pairs that met LOS and risk criteria were randomized to the control group (hospital-based follow-up) or to the intervention group (home nurse visit). Clinical utilization and costs were studied using computerized databases and chart review. Breastfeeding continuation, maternal depressive symptoms, and maternal satisfaction were assessed at 2 weeks postpartum.

Parçanın ilk cümlesinde geçen "common" terimi aşağıdakilerden hangisini ifade etmektedir?

• Zor
• Raslantısal
• Geçici
• Yoğun
• Olağan

Polypseudophakia, also known as two piggyback intraocular lens (IOL) implantation, was first described in a case of extreme hypermetropia in a nanophthalmic eye undergoing cataract surgery. As a +46 dioptres IOL was not available, two IOLs were used with the first plano-convex lens implanted within the capsular bag (plano side facing anteriorly) and the second implanted in the ciliary sulcus (plano side facing posteriorly). Foldable piggyback IOLs have the added advantage of increased depth of focus due to mutual compression of the central optical zone of the implants. Primary polypseudophakia (primary implantation of two or more intraocular lenses at the time of cataract removal) has been used not only in short hypermetropic eyes after cataract surgery but also after refractive lensectomy, in myopic keratoconic eyes with cataract, and for the correction of paediatric aphakia. Secondary polypseudophakia has been used for the correction of refractive errors after cataract surgery.

Parçaya göre polipsödofaki terimi aşağıdakilerden hangisini ifade etmektedir?

• Göz merceği yerinden oynamış gözlere göziçi merceği yerleştirilmesi
• Birden çok göziçi lensinin birlikte katarkt ameliyatı yapmaksızın göze yerleştirilmesi
• Birden çok kırma gücü olan bir lensin katarakt ameliyatını takiben göze yerleştirilmesi
• Katarakt ameliyatını takiben iki tane göziçi lensinin birlikte göze yerleştirilmesi
• Değişken kırma gücü olan bir lensin katarakt ameliyatı yapmaksızın göze yerleştirilmesi

Polypseudophakia, also known as two piggyback intraocular lens (IOL) implantation, was first described in a case of extreme hypermetropia in a nanophthalmic eye undergoing cataract surgery. As a +46 dioptres IOL was not available, two IOLs were used with the first plano-convex lens implanted within the capsular bag (plano side facing anteriorly) and the second implanted in the ciliary sulcus (plano side facing posteriorly). Foldable piggyback IOLs have the added advantage of increased depth of focus due to mutual compression of the central optical zone of the implants. Primary polypseudophakia (primary implantation of two or more intraocular lenses at the time of cataract removal) has been used not only in short hypermetropic eyes after cataract surgery but also after refractive lensectomy, in myopic keratoconic eyes with cataract, and for the correction of paediatric aphakia. Secondary polypseudophakia has been used for the correction of refractive errors after cataract surgery.

Parçada sözü edilen yaklaşım ilk kez nasıl bir hastaya uygulanmıştır?

• Orta-yüksek hipermetropik gözlü
• Nanoftalmik gözlü
• Gözlerinde lens lüksasyonu olan
• Mikrofakik gözlü
• Gözlerinde lens kolobomu olan

Polypseudophakia, also known as two piggyback intraocular lens (IOL) implantation, was first described in a case of extreme hypermetropia in a nanophthalmic eye undergoing cataract surgery. As a +46 dioptres IOL was not available, two IOLs were used with the first plano-convex lens implanted within the capsular bag (plano side facing anteriorly) and the second implanted in the ciliary sulcus (plano side facing posteriorly). Foldable piggyback IOLs have the added advantage of increased depth of focus due to mutual compression of the central optical zone of the implants. Primary polypseudophakia (primary implantation of two or more intraocular lenses at the time of cataract removal) has been used not only in short hypermetropic eyes after cataract surgery but also after refractive lensectomy, in myopic keratoconic eyes with cataract, and for the correction of paediatric aphakia. Secondary polypseudophakia has been used for the correction of refractive errors after cataract surgery.

Parçaya göre "piggyback" göziçi lenslerinin ek avantajı aşağıdakilerden hangisidir?

• Uzak görme keskinliğini artırması
• Yakın gözlüğü gerektirmemesi
• Geniş alan netliği sağlaması
• Fokus derinliğini artırması
• Karanlıkta görme keskinliğini artırması

Polypseudophakia, also known as two piggyback intraocular lens (IOL) implantation, was first described in a case of extreme hypermetropia in a nanophthalmic eye undergoing cataract surgery. As a +46 dioptres IOL was not available, two IOLs were used with the first plano-convex lens implanted within the capsular bag (plano side facing anteriorly) and the second implanted in the ciliary sulcus (plano side facing posteriorly). Foldable piggyback IOLs have the added advantage of increased depth of focus due to mutual compression of the central optical zone of the implants. Primary polypseudophakia (primary implantation of two or more intraocular lenses at the time of cataract removal) has been used not only in short hypermetropic eyes after cataract surgery but also after refractive lensectomy, in myopic keratoconic eyes with cataract, and for the correction of paediatric aphakia. Secondary polypseudophakia has been used for the correction of refractive errors after cataract surgery.

Parçada primer polipsödofaki ameliyatının kullanıldığı durumlar arasında aşağıdakilerden hangisi sayılmamıştır?

• Presbiyopi
• Refraktif lensektomi
• Katarakt miyopik keratokoni
• Pediatrik afaki
• Kısa hipermetropi

Polypseudophakia, also known as two piggyback intraocular lens (IOL) implantation, was first described in a case of extreme hypermetropia in a nanophthalmic eye undergoing cataract surgery. As a +46 dioptres IOL was not available, two IOLs were used with the first plano-convex lens implanted within the capsular bag (plano side facing anteriorly) and the second implanted in the ciliary sulcus (plano side facing posteriorly). Foldable piggyback IOLs have the added advantage of increased depth of focus due to mutual compression of the central optical zone of the implants. Primary polypseudophakia (primary implantation of two or more intraocular lenses at the time of cataract removal) has been used not only in short hypermetropic eyes after cataract surgery but also after refractive lensectomy, in myopic keratoconic eyes with cataract, and for the correction of paediatric aphakia. Secondary polypseudophakia has been used for the correction of refractive errors after cataract surgery.

Parçada sekonder polipsödofakinin hangi hastalara uygulandığı söylenmektedir?

• Refraktif cerrahi uygulanmayan hastalar
• Keratoplasti uygulanan hastalar
• Katarakt cerrahisinden sonra kırma kusuru olan hastalar
• Kontakt lens kullanmayan hastalar
• Refraktif cerrahiden sonra kırma kusuru kalan hastalar

Tonsillectomy with or without adenoidectomy is one of the most commonly performed surgical procedures in the United States. Traditionally, recommendation for tonsillectomy in adults has depended primarily on the frequency of the acute episodes of tonsillitis in the setting of recurrent (chronic) disease. Recent clinical indicators specify that patients with 3 or more infections of the tonsils and/or adenoids per year, despite adequate medical therapy, may be considered candidates for tonsillectomy. In addition, chronic or recurrent tonsillitis associated with the streptococcal carrier state may be considered an appropriate indication for tonsillectomy. In reality, however, quality-of-life assessments and patient preferences often influence or temper traditional guidelines in deciding whether to recommend tonsillectomy for adult patients with chronic tonsillitis. The efficacy of tonsillectomy for chronic tonsillitis in children has been well-studied, but similar data are lacking for adults. The goal of this study was to determine the quality-of-life benefit derived from adult tonsillectomy and the specific impact of tonsillectomy on antibiotic use, frequency of physician visits, and workdays missed.

Parçaya göre, eskiden beri erişkinlere aşağıdaki durumlardan hangisinde tonsillektomi uygulanması önerilmektedir?

• Akut ataklar sık olduğunda
• Apse oluşumu sık olduğunda
• Sistemik hastalık varlığında
• Kronik hastalığın süresi uzun olduğunda
• Çok sık antibiyotik kullanıldığında

Tonsillectomy with or without adenoidectomy is one of the most commonly performed surgical procedures in the United States. Traditionally, recommendation for tonsillectomy in adults has depended primarily on the frequency of the acute episodes of tonsillitis in the setting of recurrent (chronic) disease. Recent clinical indicators specify that patients with 3 or more infections of the tonsils and/or adenoids per year, despite adequate medical therapy, may be considered candidates for tonsillectomy. In addition, chronic or recurrent tonsillitis associated with the streptococcal carrier state may be considered an appropriate indication for tonsillectomy. In reality, however, quality-of-life assessments and patient preferences often influence or temper traditional guidelines in deciding whether to recommend tonsillectomy for adult patients with chronic tonsillitis. The efficacy of tonsillectomy for chronic tonsillitis in children has been well-studied, but similar data are lacking for adults. The goal of this study was to determine the quality-of-life benefit derived from adult tonsillectomy and the specific impact of tonsillectomy on antibiotic use, frequency of physician visits, and workdays missed.

Parçaya göre, tonsillektomi endikasyonlarına eklenen durumlardan biri aşağıdakilerden hangisidir?

• Kalp tutulumu
• Tıbbi tedavi kontrendikasyonu
• Streptokok taşıyıcılığı
• Her üç yılda bir tonsillit olma durumu
• Eklem tutulumu

Tonsillectomy with or without adenoidectomy is one of the most commonly performed surgical procedures in the United States. Traditionally, recommendation for tonsillectomy in adults has depended primarily on the frequency of the acute episodes of tonsillitis in the setting of recurrent (chronic) disease. Recent clinical indicators specify that patients with 3 or more infections of the tonsils and/or adenoids per year, despite adequate medical therapy, may be considered candidates for tonsillectomy. In addition, chronic or recurrent tonsillitis associated with the streptococcal carrier state may be considered an appropriate indication for tonsillectomy. In reality, however, quality-of-life assessments and patient preferences often influence or temper traditional guidelines in deciding whether to recommend tonsillectomy for adult patients with chronic tonsillitis. The efficacy of tonsillectomy for chronic tonsillitis in children has been well-studied, but similar data are lacking for adults. The goal of this study was to determine the quality-of-life benefit derived from adult tonsillectomy and the specific impact of tonsillectomy on antibiotic use, frequency of physician visits, and workdays missed.

Parçaya göre, erişkinler hakkında eksik olan bilgi aşağıdaki konuların hangisindedir?

• Eklem tutulumunun sıklığı
• Streptokok taşıyıcılığının tehlikesi
• Kalp tutulumunun sıklığı
• Tonsillektominin etkililiği
• Tonsillektomi ile birlikte adenoidektomi endikasyonu sıklığı

Tonsillectomy with or without adenoidectomy is one of the most commonly performed surgical procedures in the United States. Traditionally, recommendation for tonsillectomy in adults has depended primarily on the frequency of the acute episodes of tonsillitis in the setting of recurrent (chronic) disease. Recent clinical indicators specify that patients with 3 or more infections of the tonsils and/or adenoids per year, despite adequate medical therapy, may be considered candidates for tonsillectomy. In addition, chronic or recurrent tonsillitis associated with the streptococcal carrier state may be considered an appropriate indication for tonsillectomy. In reality, however, quality-of-life assessments and patient preferences often influence or temper traditional guidelines in deciding whether to recommend tonsillectomy for adult patients with chronic tonsillitis. The efficacy of tonsillectomy for chronic tonsillitis in children has been well-studied, but similar data are lacking for adults. The goal of this study was to determine the quality-of-life benefit derived from adult tonsillectomy and the specific impact of tonsillectomy on antibiotic use, frequency of physician visits, and workdays missed.

Parçaya göre, erişkinlerde tonsillektomi önerilmesinde yaşam kalitesi değerlendirmeleri yanısıra önemli olan kriter aşağıdakilerden hangisidir?

• Hastanın genel sağlık durumu
• Hastanın tercihi
• Hastanın maddi durumu
• Doktorun tercihi
• Doktorun deneyimi

Tonsillectomy with or without adenoidectomy is one of the most commonly performed surgical procedures in the United States. Traditionally, recommendation for tonsillectomy in adults has depended primarily on the frequency of the acute episodes of tonsillitis in the setting of recurrent (chronic) disease. Recent clinical indicators specify that patients with 3 or more infections of the tonsils and/or adenoids per year, despite adequate medical therapy, may be considered candidates for tonsillectomy. In addition, chronic or recurrent tonsillitis associated with the streptococcal carrier state may be considered an appropriate indication for tonsillectomy. In reality, however, quality-of-life assessments and patient preferences often influence or temper traditional guidelines in deciding whether to recommend tonsillectomy for adult patients with chronic tonsillitis. The efficacy of tonsillectomy for chronic tonsillitis in children has been well-studied, but similar data are lacking for adults. The goal of this study was to determine the quality-of-life benefit derived from adult tonsillectomy and the specific impact of tonsillectomy on antibiotic use, frequency of physician visits, and workdays missed.

Parçada sözü edilen erişkin tonsillektomisiyle ilgili çalışmanın amaçları arasında aşağıdakilerden hangisinin belirlenmesi sayılmamıştır?

• Yaşam kalitesine etkisi
• Antibiyotik kullanımına etkisi
• Ülke ekonomisine etkisi
• Hekim ziyareti sıklığına etkisi
• İşgücü kaybına etkisi

The efficacy of hormonal therapy for recurrent bleeding from gastrointestinal angiodysplasia remains uncertain. Researchers investigated the efficacy of long-term estrogen-progesteron therapy in the prevention of rebleeding from gastrointestinal angiodysplasia. Seventy-two noncirrhotic patients bleeding from gastrointestinal angiodysplasia confirmed by endoscopy and angiography were randomized to receive in double-blind conditions treatment with ethinylestradiol plus norethisterone or placebo for a minimum period of 1 year. Four patients could not be assessed because they did not attend the first follow-up visit. Failure of treatment occurred in 13 of 33 patients in the treatment group and in 16 of 35 patients in the placebo group. No significant differences between groups were found according to number of bleeding episodes and transfusional requirements. Severe adverse events and mortality were similar between the treatment and placebo groups.

Parçada sözü edilen çalışmada aşağıdakilerden hangisi araştırılmıştır?

• Gastrointestinal anjiodisplazide hormonların durumu
• Gastrointestinal anjiodisplazide uzun süreli östrojen-progesteron tedavisi
• Gastrointestinal anjiodisplazide kanamanın nedeni
• Kısa süreli östrojen-progesteron tedavisinin gastrointestinaI anjiodisplazide kanama yapma mekanizması
• Uzun süreli gastrointestinaI anjiodisplazinin prognozu

The efficacy of hormonal therapy for recurrent bleeding from gastrointestinal angiodysplasia remains uncertain. Researchers investigated the efficacy of long-term estrogen-progesteron therapy in the prevention of rebleeding from gastrointestinal angiodysplasia. Seventy-two noncirrhotic patients bleeding from gastrointestinal angiodysplasia confirmed by endoscopy and angiography were randomized to receive in double-blind conditions treatment with ethinylestradiol plus norethisterone or placebo for a minimum period of 1 year. Four patients could not be assessed because they did not attend the first follow-up visit. Failure of treatment occurred in 13 of 33 patients in the treatment group and in 16 of 35 patients in the placebo group. No significant differences between groups were found according to number of bleeding episodes and transfusional requirements. Severe adverse events and mortality were similar between the treatment and placebo groups.

Parçada sözü edilen çalışma kapsamına alınan hastaların özellikleri arasında aşağıdakilerden hangisi sayılmamıştır?

• Erişkin olmaları
• Sirozlu olmamaları
• GastrointestinaI kanamaları olması
• GastrointestinaI anjiodisplazilerinin endoskopi ile gösterilmiş olması
• En az bir yıl ilaç veya plasebo kullanmaları

The efficacy of hormonal therapy for recurrent bleeding from gastrointestinal angiodysplasia remains uncertain. Researchers investigated the efficacy of long-term estrogen-progesteron therapy in the prevention of rebleeding from gastrointestinal angiodysplasia. Seventy-two noncirrhotic patients bleeding from gastrointestinal angiodysplasia confirmed by endoscopy and angiography were randomized to receive in double-blind conditions treatment with ethinylestradiol plus norethisterone or placebo for a minimum period of 1 year. Four patients could not be assessed because they did not attend the first follow-up visit. Failure of treatment occurred in 13 of 33 patients in the treatment group and in 16 of 35 patients in the placebo group. No significant differences between groups were found according to number of bleeding episodes and transfusional requirements. Severe adverse events and mortality were similar between the treatment and placebo groups.

Parçaya göre, aşağıdakilerden hangisi grupların karşılaştırılmasında kullanılan faktörlerden biri değildir?

• Transfüzyon gereği
• Olumsuz etkiler
• Kanama epizodları sayısı
• Hastanede kalma süresi
• Mortalite

The efficacy of hormonal therapy for recurrent bleeding from gastrointestinal angiodysplasia remains uncertain. Researchers investigated the efficacy of long-term estrogen-progesteron therapy in the prevention of rebleeding from gastrointestinal angiodysplasia. Seventy-two noncirrhotic patients bleeding from gastrointestinal angiodysplasia confirmed by endoscopy and angiography were randomized to receive in double-blind conditions treatment with ethinylestradiol plus norethisterone or placebo for a minimum period of 1 year. Four patients could not be assessed because they did not attend the first follow-up visit. Failure of treatment occurred in 13 of 33 patients in the treatment group and in 16 of 35 patients in the placebo group. No significant differences between groups were found according to number of bleeding episodes and transfusional requirements. Severe adverse events and mortality were similar between the treatment and placebo groups.

Parçaya göre tedavi grubundaki kaç hastada tedavi başarısız olmuştur?

• 4
• 13
• 16
• 33
• 35

The efficacy of hormonal therapy for recurrent bleeding from gastrointestinal angiodysplasia remains uncertain. Researchers investigated the efficacy of long-term estrogen-progesteron therapy in the prevention of rebleeding from gastrointestinal angiodysplasia. Seventy-two noncirrhotic patients bleeding from gastrointestinal angiodysplasia confirmed by endoscopy and angiography were randomized to receive in double-blind conditions treatment with ethinylestradiol plus norethisterone or placebo for a minimum period of 1 year. Four patients could not be assessed because they did not attend the first follow-up visit. Failure of treatment occurred in 13 of 33 patients in the treatment group and in 16 of 35 patients in the placebo group. No significant differences between groups were found according to number of bleeding episodes and transfusional requirements. Severe adverse events and mortality were similar between the treatment and placebo groups.

Parçanın altıncı cümlesinde geçen "significant" sözcüğünün Türkçe karşılığı aşağıdakilerden hangisidir?

• Farklı
• Sorunlu
• Önemli
• Ayrıntılı
• Sıradan

The aim of this study is to determine whether a newly identified thrombophilia factor, activated factor VII (FVIIa), is associated with retinal vein occlusion (RVO). 54 consecutive cases with RVO seen between March and September 1999 were included in the study. 30 were male, 24 were female, age ranged between 30-52 (mean:46). 22 cases had central retinal vein occlusion (CRVO) and 32 had branch retinal vein occlusion (BRVO). Ophthalmoscopic examination with detailed medical history was followed by blood analyses for liver and renal functions, cholesterol, triglycerides, complete blood count, and coagulation factors including protein C activity, free protein S, antithrombin III, and factor VIIa. Data were compared with those of the control group, composed of 19 cases under ophthalmological follow up for refractive errors, presbyopia, or senile cataract. Hypertension was highly prevalent in cases with BRVO.

Parçada sözü edilen çalışmanın amacı aşağıdakilerden hangisinin belirlenmesidir?

• RVO da yeni trombofilik faktör aranmasının nedeninin
• RVO’da trombofilik faktörlerinin yerinin
• RVO’da trombofilik faktörlerinin kullanımının
• RVO nun FVIIa aktivasyonuna etkisinin
• FVIIa’nın RVO’la ilişkisinin

The aim of this study is to determine whether a newly identified thrombophilia factor, activated factor VII (FVIIa), is associated with retinal vein occlusion (RVO). 54 consecutive cases with RVO seen between March and September 1999 were included in the study. 30 were male, 24 were female, age ranged between 30-52 (mean:46). 22 cases had central retinal vein occlusion (CRVO) and 32 had branch retinal vein occlusion (BRVO). Ophthalmoscopic examination with detailed medical history was followed by blood analyses for liver and renal functions, cholesterol, triglycerides, complete blood count, and coagulation factors including protein C activity, free protein S, antithrombin III, and factor VIIa. Data were compared with those of the control group, composed of 19 cases under ophthalmological follow up for refractive errors, presbyopia, or senile cataract. Hypertension was highly prevalent in cases with BRVO.

Parçaya göre çalışmaya alınan olguların kaçında retina ven dal tıkanması vardır?

• 22
• 30
• 32
• 52
• 54

The aim of this study is to determine whether a newly identified thrombophilia factor, activated factor VII (FVIIa), is associated with retinal vein occlusion (RVO). 54 consecutive cases with RVO seen between March and September 1999 were included in the study. 30 were male, 24 were female, age ranged between 30-52 (mean:46). 22 cases had central retinal vein occlusion (CRVO) and 32 had branch retinal vein occlusion (BRVO). Ophthalmoscopic examination with detailed medical history was followed by blood analyses for liver and renal functions, cholesterol, triglycerides, complete blood count, and coagulation factors including protein C activity, free protein S, antithrombin III, and factor VIIa. Data were compared with those of the control group, composed of 19 cases under ophthalmological follow up for refractive errors, presbyopia, or senile cataract. Hypertension was highly prevalent in cases with BRVO.

Parçada sözü edilen çalışmaya alınan hastalara yapılan pıhtılaşma testleri arasında aşağıdakilerden hangisi sayılmamıştır?

• FVIIa
• Protein C aktivitesi
• Serbest protein S
• Antitrombin III
• Fibrinojen

The aim of this study is to determine whether a newly identified thrombophilia factor, activated factor VII (FVIIa), is associated with retinal vein occlusion (RVO). 54 consecutive cases with RVO seen between March and September 1999 were included in the study. 30 were male, 24 were female, age ranged between 30-52 (mean:46). 22 cases had central retinal vein occlusion (CRVO) and 32 had branch retinal vein occlusion (BRVO). Ophthalmoscopic examination with detailed medical history was followed by blood analyses for liver and renal functions, cholesterol, triglycerides, complete blood count, and coagulation factors including protein C activity, free protein S, antithrombin III, and factor VIIa. Data were compared with those of the control group, composed of 19 cases under ophthalmological follow up for refractive errors, presbyopia, or senile cataract. Hypertension was highly prevalent in cases with BRVO.

Parçaya göre aşağıdakilerden hangisi kontrol grubuna alınan hastaların problemlerinden biridir?

• Senil makula dejenerasyonu
• Senil katarakt
• Santral arter tıkanması
• Dal arter tıkanması
• Retinal ven oklüzyonu

The aim of this study is to determine whether a newly identified thrombophilia factor, activated factor VII (FVIIa), is associated with retinal vein occlusion (RVO). 54 consecutive cases with RVO seen between March and September 1999 were included in the study. 30 were male, 24 were female, age ranged between 30-52 (mean:46). 22 cases had central retinal vein occlusion (CRVO) and 32 had branch retinal vein occlusion (BRVO). Ophthalmoscopic examination with detailed medical history was followed by blood analyses for liver and renal functions, cholesterol, triglycerides, complete blood count, and coagulation factors including protein C activity, free protein S, antithrombin III, and factor VIIa. Data were compared with those of the control group, composed of 19 cases under ophthalmological follow up for refractive errors, presbyopia, or senile cataract. Hypertension was highly prevalent in cases with BRVO.

Parçaya göre, araştırmaya alınan BRVO’lu hastalarda oldukça sık rastlanan durum aşağıdakilerden hangisidir?

• Hipertansiyon
• Bozuk karaciğer fonksiyonu
• Bozuk böbrek fonksiyonu
• Düşük protein C aktivitesi
• Düşük serbest protein S düzeyi

In the management of acute tubulary necrosis, it is crucial to identify and treat the underlying disease process, with the aim of preventing progression to parenchymal renal disease. It is also important to distinguish between extrarenal azotemia and acute parenchymal renal failure. The former may result from congestive heart failure, hypovolemia, infection, trauma, hemorrhage, and urinary tract obstruction. In acute renal failure, volume correction should always precede the use of diuretics, with the exception of mannitol, which is a volume expander and an osmotic diuretic. Mannitol may reduce swelling of the endothelial cells and thus improve renal blood flow. If the patient is volume expanded and not hypotensive, then mannitol is contraindicated and furosemide is the diuretic of choice. During the oliguric phase, fluids should be restricted to avoid hypertension and pulmonary edema. Life-threatening hyponatremia, hyperkalemia, and acidosis may develop rapidly; thus, electrolyte and acid-base status must be carefully monitored.

Parçada, akut tübüler nekrozda aşağıdakilerden hangisinin tanı ve tedavisinin, çok önemli olduğu vurgulanmaktadır?

• Parankim hasarının
• Böbrek dışı hastalıkların
• Akut böbrek yetmezliğinin
• Altta yatan hastalık sürecinin
• Renal kan akımının

In the management of acute tubulary necrosis, it is crucial to identify and treat the underlying disease process, with the aim of preventing progression to parenchymal renal disease. It is also important to distinguish between extrarenal azotemia and acute parenchymal renal failure. The former may result from congestive heart failure, hypovolemia, infection, trauma, hemorrhage, and urinary tract obstruction. In acute renal failure, volume correction should always precede the use of diuretics, with the exception of mannitol, which is a volume expander and an osmotic diuretic. Mannitol may reduce swelling of the endothelial cells and thus improve renal blood flow. If the patient is volume expanded and not hypotensive, then mannitol is contraindicated and furosemide is the diuretic of choice. During the oliguric phase, fluids should be restricted to avoid hypertension and pulmonary edema. Life-threatening hyponatremia, hyperkalemia, and acidosis may develop rapidly; thus, electrolyte and acid-base status must be carefully monitored.

Parçaya göre, böbrek dışı nedenlere bağlı azotemi, aşağıdakilerden hangisinin sonucu olarak gelişebilir?

• Travma
• Parankimal böbrek hastalığı
• Hipertansiyon
• Akut renal yetmezlik
• Diüretik kullanımı

In the management of acute tubulary necrosis, it is crucial to identify and treat the underlying disease process, with the aim of preventing progression to parenchymal renal disease. It is also important to distinguish between extrarenal azotemia and acute parenchymal renal failure. The former may result from congestive heart failure, hypovolemia, infection, trauma, hemorrhage, and urinary tract obstruction. In acute renal failure, volume correction should always precede the use of diuretics, with the exception of mannitol, which is a volume expander and an osmotic diuretic. Mannitol may reduce swelling of the endothelial cells and thus improve renal blood flow. If the patient is volume expanded and not hypotensive, then mannitol is contraindicated and furosemide is the diuretic of choice. During the oliguric phase, fluids should be restricted to avoid hypertension and pulmonary edema. Life-threatening hyponatremia, hyperkalemia, and acidosis may develop rapidly; thus, electrolyte and acid-base status must be carefully monitored.

Parçaya göre, akut böbrek yetmezliğinde, aşağıdakilerden hangisi, hipovolemi düzeltilmeden önce de hastaya verilebilir?

• Antihipertansifler
• Mannitol
• Sodyum
• Potasyum
• Bikarbonat

In the management of acute tubulary necrosis, it is crucial to identify and treat the underlying disease process, with the aim of preventing progression to parenchymal renal disease. It is also important to distinguish between extrarenal azotemia and acute parenchymal renal failure. The former may result from congestive heart failure, hypovolemia, infection, trauma, hemorrhage, and urinary tract obstruction. In acute renal failure, volume correction should always precede the use of diuretics, with the exception of mannitol, which is a volume expander and an osmotic diuretic. Mannitol may reduce swelling of the endothelial cells and thus improve renal blood flow. If the patient is volume expanded and not hypotensive, then mannitol is contraindicated and furosemide is the diuretic of choice. During the oliguric phase, fluids should be restricted to avoid hypertension and pulmonary edema. Life-threatening hyponatremia, hyperkalemia, and acidosis may develop rapidly; thus, electrolyte and acid-base status must be carefully monitored.

Parçada, mannitol ile ilgili olarak aşağıdakilerden hangisi söylenmemiştir?

• Renal kan akımını artırır.
• Ozmotik etkilidir.
• Diürez yapar.
• Hipotansiyonda verilmez.
• Endotel hücre şişmesini azaltır.

In the management of acute tubulary necrosis, it is crucial to identify and treat the underlying disease process, with the aim of preventing progression to parenchymal renal disease. It is also important to distinguish between extrarenal azotemia and acute parenchymal renal failure. The former may result from congestive heart failure, hypovolemia, infection, trauma, hemorrhage, and urinary tract obstruction. In acute renal failure, volume correction should always precede the use of diuretics, with the exception of mannitol, which is a volume expander and an osmotic diuretic. Mannitol may reduce swelling of the endothelial cells and thus improve renal blood flow. If the patient is volume expanded and not hypotensive, then mannitol is contraindicated and furosemide is the diuretic of choice. During the oliguric phase, fluids should be restricted to avoid hypertension and pulmonary edema. Life-threatening hyponatremia, hyperkalemia, and acidosis may develop rapidly; thus, electrolyte and acid-base status must be carefully monitored.

Parçaya göre, sıvı kısıtlaması aşağıdaki durumlardan hangisinde yapılmalıdır?

• Hiponatremi
• Oligüri
• Hiperkalemi
• Asidoz
• Periferik ödem

Research conducted in recent years has shown that there are certain causes of death common to both males and females. Heart disease in women has gained attention in recent years. More women die of heart disease than men. In general, heart disease in males has an earlier onset, by approximately 10 years. The later onset in women has been attributed to a protective effect of the female hormones, and accumulating data suggest that estrogen may provide cardiovascular benefits through a wide variety of mechanisms. It is possible that heart disease is more related to age than to hormonal status (i.e. menopause). As age increases, the male and female death rates approach each other because of a subtle decline in the rate of increase for men. Among all ages, malignancy is the number two cause of death. Although men are beginning to see a decline in death rates from lung cancer, the lung cancer death rate for women is continuing to climb. This point deserves attention because lung cancer is one cancer that can be reduced by decreasing cigarette smoking. A decrease has been reported for the third most common cause of death, cerebrovascular disease.

Parçaya göre, kadınlarda son yıllarda ilgi odağı haline gelen hastalık, aşağıdakilerden hangisidir?

• Akciğer hastalıkları
• Kanser
• Kalp hastalığı
• Diabetes mellitus
• Alzheimer hastalığı

Research conducted in recent years has shown that there are certain causes of death common to both males and females. Heart disease in women has gained attention in recent years. More women die of heart disease than men. In general, heart disease in males has an earlier onset, by approximately 10 years. The later onset in women has been attributed to a protective effect of the female hormones, and accumulating data suggest that estrogen may provide cardiovascular benefits through a wide variety of mechanisms. It is possible that heart disease is more related to age than to hormonal status (i.e. menopause). As age increases, the male and female death rates approach each other because of a subtle decline in the rate of increase for men. Among all ages, malignancy is the number two cause of death. Although men are beginning to see a decline in death rates from lung cancer, the lung cancer death rate for women is continuing to climb. This point deserves attention because lung cancer is one cancer that can be reduced by decreasing cigarette smoking. A decrease has been reported for the third most common cause of death, cerebrovascular disease.

Parçada kalp hastalığıyla ilişkili olarak aşağı- dakilerden hangisi söylenmemektedir?

• Yaş ilerledikce, erkeklerle kadınlardaki ölüm oranları birbirine yaklaşır.
• Erkekler kadınlara göre daha erken ölür.
• Genel olarak, kadınlarda ölüm oranları, erkeklere göre daha yüksektir.
• Yaşın ilerlemesi, hormonal durumdan daha önemli olabilir.
• Kadınlarda estrojen, kalp ve damar hastalıklarından koruyucu olabilir.

Research conducted in recent years has shown that there are certain causes of death common to both males and females. Heart disease in women has gained attention in recent years. More women die of heart disease than men. In general, heart disease in males has an earlier onset, by approximately 10 years. The later onset in women has been attributed to a protective effect of the female hormones, and accumulating data suggest that estrogen may provide cardiovascular benefits through a wide variety of mechanisms. It is possible that heart disease is more related to age than to hormonal status (i.e. menopause). As age increases, the male and female death rates approach each other because of a subtle decline in the rate of increase for men. Among all ages, malignancy is the number two cause of death. Although men are beginning to see a decline in death rates from lung cancer, the lung cancer death rate for women is continuing to climb. This point deserves attention because lung cancer is one cancer that can be reduced by decreasing cigarette smoking. A decrease has been reported for the third most common cause of death, cerebrovascular disease.

Parçada kanser ile ilişkili olarak, aşağıdakilerden hangisi söylenmemiştir?

• Sigara içenler arasında bir numaralı kanser, akciğer kanseridir.
• Sigara içiminin azaltılması, akciğer kanserini de azaltır.
• Akciğer kanseri erkeklerde giderek azalma eğilimindedir.
• Kadınlarda akciğer kanseri artmaya devam etmektedir.
• Tüm yaşlarda, en sık görülen ölüm nedenleri arasında ikinci sıradadır.

Research conducted in recent years has shown that there are certain causes of death common to both males and females. Heart disease in women has gained attention in recent years. More women die of heart disease than men. In general, heart disease in males has an earlier onset, by approximately 10 years. The later onset in women has been attributed to a protective effect of the female hormones, and accumulating data suggest that estrogen may provide cardiovascular benefits through a wide variety of mechanisms. It is possible that heart disease is more related to age than to hormonal status (i.e. menopause). As age increases, the male and female death rates approach each other because of a subtle decline in the rate of increase for men. Among all ages, malignancy is the number two cause of death. Although men are beginning to see a decline in death rates from lung cancer, the lung cancer death rate for women is continuing to climb. This point deserves attention because lung cancer is one cancer that can be reduced by decreasing cigarette smoking. A decrease has been reported for the third most common cause of death, cerebrovascular disease.

Parçada dikkat çekmesi gerektiği söylenen nokta, aşağıdakilerden hangisidir?

• Sigaranın bırakılması ile tüm kanserlerdeki azalma
• Kanser türlerinin her yaşta görülebilmesi
• Kanser türlerinin her iki cinste de ikinci sıradaki ölüm nedeni olmaları
• Akciğer kanserinin sigarayla ilişkisi
• Akciğer kanserinin erkeklerde azalırken, kadınlarda artmaya devam etmesi

Research conducted in recent years has shown that there are certain causes of death common to both males and females. Heart disease in women has gained attention in recent years. More women die of heart disease than men. In general, heart disease in males has an earlier onset, by approximately 10 years. The later onset in women has been attributed to a protective effect of the female hormones, and accumulating data suggest that estrogen may provide cardiovascular benefits through a wide variety of mechanisms. It is possible that heart disease is more related to age than to hormonal status (i.e. menopause). As age increases, the male and female death rates approach each other because of a subtle decline in the rate of increase for men. Among all ages, malignancy is the number two cause of death. Although men are beginning to see a decline in death rates from lung cancer, the lung cancer death rate for women is continuing to climb. This point deserves attention because lung cancer is one cancer that can be reduced by decreasing cigarette smoking. A decrease has been reported for the third most common cause of death, cerebrovascular disease.

Parçada serebrovasküler hastalıkla ilişkili olarak aşağıdakilerden hangisi ifade edilmiştir?

• Üçüncü en sık ölüm nedenidir.
• Hastalığa bağlı ölüm oranları düşmektedir.
• Ölüm oranı iki cinste birbirine yakındır.
• Sıklığı artsa da giderek daha az rapor edilmektedir.
• En sık görülen üç hastalıktan bir tanesidir.

Treatment of children with rheumatic diseases is complicated. The efforts of a team of health care professionals need to be melded into a wellregulated system of care that is individualized to meet the needs of each patient and that is sensitive to the capabilities and psychosocial resources of each family. In addition, the rheumatic diseases are not static targets. In each child, disease manifestations vary in severity over time, and treatment needs to be adjusted accordingly. The therapeutic program must provide active treatments for currently symptomatic problems, such as arthritis, and must also include appropriate screening methods for often clinically silent problems such as uveitis in patients with juvenile rheumatoid arthritis and early nephritis in patients with systemic lupus erythematosus. Nor should the treatment regimen focus only on the child with the rheumatic disease. When rheumatic disease afflicts a child, all family members are affected. Indeed, studies have indicated that siblings of a child with a rheumatic disease are often more adversely affected psychosocially than the patient. Several studies have shown that the emotional status of the parents at the time of diagnosis of rheumatic disease in their child is one of the strongest predictors of treatment outcomes 5-10 years later.

Parçada romatizmal hastalığı olan çocukların yönetiminde, tıbbi bakımdan sorumlu ekibin yapması gerekenler arasında, aşağıdakilerden hangisi söylenmemektedir?

• Düzenli bir sistem içerisinde çaba gösterilmelidir.
• Tedavinin karmaşık ve zor çözülebilir olduğu, aileye baştan anlatılmalıdır.
• Her bir hastanın ihtiyaçlarına cevap verecek şekilde bireyselleştirilmelidir.
• Ailelerin olanaklarına duyarlı olunmalıdır.
• Ailelerin psikososyal kaynaklarına duyarlı olunmalıdır.

Treatment of children with rheumatic diseases is complicated. The efforts of a team of health care professionals need to be melded into a wellregulated system of care that is individualized to meet the needs of each patient and that is sensitive to the capabilities and psychosocial resources of each family. In addition, the rheumatic diseases are not static targets. In each child, disease manifestations vary in severity over time, and treatment needs to be adjusted accordingly. The therapeutic program must provide active treatments for currently symptomatic problems, such as arthritis, and must also include appropriate screening methods for often clinically silent problems such as uveitis in patients with juvenile rheumatoid arthritis and early nephritis in patients with systemic lupus erythematosus. Nor should the treatment regimen focus only on the child with the rheumatic disease. When rheumatic disease afflicts a child, all family members are affected. Indeed, studies have indicated that siblings of a child with a rheumatic disease are often more adversely affected psychosocially than the patient. Several studies have shown that the emotional status of the parents at the time of diagnosis of rheumatic disease in their child is one of the strongest predictors of treatment outcomes 5-10 years later.

Parçada, romatizmal hastalıklarla ilgili olarak aşağıdakilerden hangisi söylenmemektedir?

• Tedavi, belirtilerin değişen şiddetine göre düzenlenmelidir.
• Durağan hedefler değildir.
• Belirtilerin şiddeti zamanla değişebilir.
• Artrit gibi sorunların çocuklardaki tedavisi, uzun zamana yayılmalıdır.
• Mevcut semptomatik soruna göre aktif tedaviler sağlanmalıdır.

Treatment of children with rheumatic diseases is complicated. The efforts of a team of health care professionals need to be melded into a wellregulated system of care that is individualized to meet the needs of each patient and that is sensitive to the capabilities and psychosocial resources of each family. In addition, the rheumatic diseases are not static targets. In each child, disease manifestations vary in severity over time, and treatment needs to be adjusted accordingly. The therapeutic program must provide active treatments for currently symptomatic problems, such as arthritis, and must also include appropriate screening methods for often clinically silent problems such as uveitis in patients with juvenile rheumatoid arthritis and early nephritis in patients with systemic lupus erythematosus. Nor should the treatment regimen focus only on the child with the rheumatic disease. When rheumatic disease afflicts a child, all family members are affected. Indeed, studies have indicated that siblings of a child with a rheumatic disease are often more adversely affected psychosocially than the patient. Several studies have shown that the emotional status of the parents at the time of diagnosis of rheumatic disease in their child is one of the strongest predictors of treatment outcomes 5-10 years later.

Parçada, tarama yapılması ve taramada aranması gereken durumlar arasında aşağıdakilerden hangisi sayılmamıştır?

• Juvenil romatoid artrit
• Üveit
• Lupus eritematosus
• Erken nefrit
• Kardit

Treatment of children with rheumatic diseases is complicated. The efforts of a team of health care professionals need to be melded into a wellregulated system of care that is individualized to meet the needs of each patient and that is sensitive to the capabilities and psychosocial resources of each family. In addition, the rheumatic diseases are not static targets. In each child, disease manifestations vary in severity over time, and treatment needs to be adjusted accordingly. The therapeutic program must provide active treatments for currently symptomatic problems, such as arthritis, and must also include appropriate screening methods for often clinically silent problems such as uveitis in patients with juvenile rheumatoid arthritis and early nephritis in patients with systemic lupus erythematosus. Nor should the treatment regimen focus only on the child with the rheumatic disease. When rheumatic disease afflicts a child, all family members are affected. Indeed, studies have indicated that siblings of a child with a rheumatic disease are often more adversely affected psychosocially than the patient. Several studies have shown that the emotional status of the parents at the time of diagnosis of rheumatic disease in their child is one of the strongest predictors of treatment outcomes 5-10 years later.

Parçada, tedavi rejiminde aşağıdakilerden hangisine odaklanmakla yetinilmemesi gerektiği belirtilmektedir?

• Hasta çocuğun ailesinin psikolojisine
• Romatizmal hastalığın etkilediği doku ya da organa
• Tüm aile üyelerine
• Romatizmal hastalığı olan çocuğa
• Özgün tedavi yöntemine

Treatment of children with rheumatic diseases is complicated. The efforts of a team of health care professionals need to be melded into a wellregulated system of care that is individualized to meet the needs of each patient and that is sensitive to the capabilities and psychosocial resources of each family. In addition, the rheumatic diseases are not static targets. In each child, disease manifestations vary in severity over time, and treatment needs to be adjusted accordingly. The therapeutic program must provide active treatments for currently symptomatic problems, such as arthritis, and must also include appropriate screening methods for often clinically silent problems such as uveitis in patients with juvenile rheumatoid arthritis and early nephritis in patients with systemic lupus erythematosus. Nor should the treatment regimen focus only on the child with the rheumatic disease. When rheumatic disease afflicts a child, all family members are affected. Indeed, studies have indicated that siblings of a child with a rheumatic disease are often more adversely affected psychosocially than the patient. Several studies have shown that the emotional status of the parents at the time of diagnosis of rheumatic disease in their child is one of the strongest predictors of treatment outcomes 5-10 years later.

Parçada sözü edilen çalışmalara göre, aşağıdakilerden hangisi tedavinin 5-10 yıl sonraki sonuçlarını öngören en güçlü faktörlerden birisidir?

• Sağlık ekibinin tedavi süresindeki titiz izlemi
• Ailenin tanı konulan andaki duygusal durumu
• Tedavi programı içerisinde yer alan tarama yönteminin başarısı
• Tedaviyi oluşturan ilaçların etkililiği
• Hasta çocuğun tanı anındaki psikolojik durumu

When a child is born with multiple congenital anomalies or a family is diagnosed with a genetic disorder, talking with the family is not easy. Giving bad news is always difficult, and the information is often somewhat technical. However, it is important to provide the family with as much information as possible so that they can make informed decisions. Genetic counseling has been defined as "an educational process that seeks to assist affected and/or at risk individuals to understand the nature of a genetic disorder, its transmission and the options available to them in management and family planning." Although the task of providing information about genetic diseases is often done by a team of highly trained medical geneticists and genetic counselors, the information can also be provided by a family physician, pediatrician, or nurse. Genetic counseling must be done based on an understanding of genetic principles, the ability to recognize and diagnose genetic diseases and rare syndromes, and knowledge of the natural history of the disorder and its recurrence risk. Awareness of prenatal diagnosis and screening programs available in a particular region and access to information about new advances in genetic disorders and medical techniques are also necessary.

Parçada bir ailede genetik hastalık tanısı konulması durumunda, ailenin bilgilendirilmesiyle ilgili olarak aşağıdakilerden hangisi söylenmemektedir?

• Anomali sayısı fazlaysa, bilgilendirme daha da güçleşir.
• Aileyle konuşmak kolay değildir.
• Bilgilendirme genetikçi, aile hekimi, çocuk doktoru veya hemşire tarafından yapılabilir.
• Verilecek bilgi çoğunlukla teknik niteliktedir.
• Ailenin karar verebilmesi için, olabildiğince fazla bilgi verilmesi önemlidir.

When a child is born with multiple congenital anomalies or a family is diagnosed with a genetic disorder, talking with the family is not easy. Giving bad news is always difficult, and the information is often somewhat technical. However, it is important to provide the family with as much information as possible so that they can make informed decisions. Genetic counseling has been defined as "an educational process that seeks to assist affected and/or at risk individuals to understand the nature of a genetic disorder, its transmission and the options available to them in management and family planning." Although the task of providing information about genetic diseases is often done by a team of highly trained medical geneticists and genetic counselors, the information can also be provided by a family physician, pediatrician, or nurse. Genetic counseling must be done based on an understanding of genetic principles, the ability to recognize and diagnose genetic diseases and rare syndromes, and knowledge of the natural history of the disorder and its recurrence risk. Awareness of prenatal diagnosis and screening programs available in a particular region and access to information about new advances in genetic disorders and medical techniques are also necessary.

Parçaya göre, aşağıdakilerden hangisi, genetik konsültasyon verilebilmesi için şart olan temel dayanaklardan birisi değildir?

• Hastalığın doğal öyküsü konusunda bilgi sahibi olunması
• Genetik prensiplerin anlaşılması
• Ailenin olası tepkisini öngörebilme tecrübesi
• Genetik hastalıkları ve nadir sendromları tanıyabilme yeteneği
• Genetik bozukluğun tekrarlama riskininin bilinmesi

When a child is born with multiple congenital anomalies or a family is diagnosed with a genetic disorder, talking with the family is not easy. Giving bad news is always difficult, and the information is often somewhat technical. However, it is important to provide the family with as much information as possible so that they can make informed decisions. Genetic counseling has been defined as "an educational process that seeks to assist affected and/or at risk individuals to understand the nature of a genetic disorder, its transmission and the options available to them in management and family planning." Although the task of providing information about genetic diseases is often done by a team of highly trained medical geneticists and genetic counselors, the information can also be provided by a family physician, pediatrician, or nurse. Genetic counseling must be done based on an understanding of genetic principles, the ability to recognize and diagnose genetic diseases and rare syndromes, and knowledge of the natural history of the disorder and its recurrence risk. Awareness of prenatal diagnosis and screening programs available in a particular region and access to information about new advances in genetic disorders and medical techniques are also necessary.

Parçaya göre, aşağıdakilerden hangisi, genetik danışma hizmeti verenlerin aynı zamanda sahip olmaları istenen özelliklerden birisi değildir?

• Mevcut tarama programlarından haberdar olmak
• Mevcut doğum öncesi tanı programlarından haberdar olmak
• Genetik hastalıklar konusundaki yeni gelişmelerin bilgilerine ulaşabilmek
• Ailenin ulaşabileceği bir bölgede hizmet vermek
• Tıbbi tekniklerdeki yeni gelişmelerin bilgilerine ulaşabilmek

When a child is born with multiple congenital anomalies or a family is diagnosed with a genetic disorder, talking with the family is not easy. Giving bad news is always difficult, and the information is often somewhat technical. However, it is important to provide the family with as much information as possible so that they can make informed decisions. Genetic counseling has been defined as "an educational process that seeks to assist affected and/or at risk individuals to understand the nature of a genetic disorder, its transmission and the options available to them in management and family planning." Although the task of providing information about genetic diseases is often done by a team of highly trained medical geneticists and genetic counselors, the information can also be provided by a family physician, pediatrician, or nurse. Genetic counseling must be done based on an understanding of genetic principles, the ability to recognize and diagnose genetic diseases and rare syndromes, and knowledge of the natural history of the disorder and its recurrence risk. Awareness of prenatal diagnosis and screening programs available in a particular region and access to information about new advances in genetic disorders and medical techniques are also necessary.

Parçanın üçüncü cümlesindeki "they" adılı aşağıdakilerden hangisinin yerine kullanılmıştır?

• Toplum
• Hastalıklı çocuklar
• Genetikçiler
• İlgili klinisyenler
• Aile

When a child is born with multiple congenital anomalies or a family is diagnosed with a genetic disorder, talking with the family is not easy. Giving bad news is always difficult, and the information is often somewhat technical. However, it is important to provide the family with as much information as possible so that they can make informed decisions. Genetic counseling has been defined as "an educational process that seeks to assist affected and/or at risk individuals to understand the nature of a genetic disorder, its transmission and the options available to them in management and family planning." Although the task of providing information about genetic diseases is often done by a team of highly trained medical geneticists and genetic counselors, the information can also be provided by a family physician, pediatrician, or nurse. Genetic counseling must be done based on an understanding of genetic principles, the ability to recognize and diagnose genetic diseases and rare syndromes, and knowledge of the natural history of the disorder and its recurrence risk. Awareness of prenatal diagnosis and screening programs available in a particular region and access to information about new advances in genetic disorders and medical techniques are also necessary.

Parçanın üçüncü cümlesindeki "however" sözcüğünün Türkçe karşılığı aşağıdakilerden hangisidir?

• Çünkü
• Ek olarak
• Benzer şekilde
• Ancak
• Sonuç olarak

Just how intrauterine devices (IUD) act to prevent conception is not known. The most widely observed phenomenon is mobilization of leukocytes in response to the presence of the foreign body. The leukocytes aggregate around the IUD in the endometrial fluids and mucosa and, to a lesser extent, in the stroma and underlying myometrium. It is hypothesized that the leukocytes produce an environment hostile to the fertilized ovum. In laboratory animals, this leukocytic infiltration apparently is not dependent on microbial invasion. In human beings, the uterine cavity sterilizes itself, usually within 2-4 weeks after the device is inserted. Other theories regarding the mechanism of action are spermicidal activity and inhibition of endometrial enzymes with copper devices, disruption of endometrial maturation and inhibition of sperm survival with the progesterone-releasing device, alteration of normal tubal cilial action, and even disruption of normal oocyte maturation. Following removal of IUD’s, there is no delay, regardless of duration of use, in achieving pregnancy at normal rates, which belies the assertion that IUD use is associated with infection leading to infertility.

Parçada, rahim içi araçların etkileriyle ilgili olarak aşağıdakilerden hangisi söylenmektedir?

• Endometriyal olgunlaşmayı bozmaz.
• Yumurta hücresi oluşumunu engeller.
• Spermleri öldürerek yok eder.
• Gebeliği nasıl önledikleri tam olarak bilinmemektedir.
• Yumurta hücrelerinin döllenme kapasitelerini düşürür.

Just how intrauterine devices (IUD) act to prevent conception is not known. The most widely observed phenomenon is mobilization of leukocytes in response to the presence of the foreign body. The leukocytes aggregate around the IUD in the endometrial fluids and mucosa and, to a lesser extent, in the stroma and underlying myometrium. It is hypothesized that the leukocytes produce an environment hostile to the fertilized ovum. In laboratory animals, this leukocytic infiltration apparently is not dependent on microbial invasion. In human beings, the uterine cavity sterilizes itself, usually within 2-4 weeks after the device is inserted. Other theories regarding the mechanism of action are spermicidal activity and inhibition of endometrial enzymes with copper devices, disruption of endometrial maturation and inhibition of sperm survival with the progesterone-releasing device, alteration of normal tubal cilial action, and even disruption of normal oocyte maturation. Following removal of IUD’s, there is no delay, regardless of duration of use, in achieving pregnancy at normal rates, which belies the assertion that IUD use is associated with infection leading to infertility.

Parçada, lökositlerle ilgili olarak aşağıdakilerden hangisi söylenmemektedir?

• Lökosit birikmesi, endometriyumun bakteriler tarafından istilasına bağımlıdır.
• Lökositler IUD’nin etrafındaki endometriyal sıvıda kümeleşir.
• Lökositler döllenmiş yumurta için düşmanca bir ortam hazırlar.
• Yabancı cisim varlığına cevap olarak lökositler serbestleşir.
• Lökosit kümelenmesi daha az olarak stroma ve miyometriyumda da gözlenir.

Just how intrauterine devices (IUD) act to prevent conception is not known. The most widely observed phenomenon is mobilization of leukocytes in response to the presence of the foreign body. The leukocytes aggregate around the IUD in the endometrial fluids and mucosa and, to a lesser extent, in the stroma and underlying myometrium. It is hypothesized that the leukocytes produce an environment hostile to the fertilized ovum. In laboratory animals, this leukocytic infiltration apparently is not dependent on microbial invasion. In human beings, the uterine cavity sterilizes itself, usually within 2-4 weeks after the device is inserted. Other theories regarding the mechanism of action are spermicidal activity and inhibition of endometrial enzymes with copper devices, disruption of endometrial maturation and inhibition of sperm survival with the progesterone-releasing device, alteration of normal tubal cilial action, and even disruption of normal oocyte maturation. Following removal of IUD’s, there is no delay, regardless of duration of use, in achieving pregnancy at normal rates, which belies the assertion that IUD use is associated with infection leading to infertility.

Parçaya göre, genellikle araç takıldıktan sonraki birkaç hafta içinde aşağıdakilerden hangisi gerçekleşir?

• Gebelik oluşmuş olsa bile artık implante olamaz.
• Sperm hareketi azalır.
• İltihabi reaksiyon belirginleşir.
• Gebelikten koruma etkisi başlar.
• İnsanlarda rahim boşluğu kendisini bakterilerden temizler.

Just how intrauterine devices (IUD) act to prevent conception is not known. The most widely observed phenomenon is mobilization of leukocytes in response to the presence of the foreign body. The leukocytes aggregate around the IUD in the endometrial fluids and mucosa and, to a lesser extent, in the stroma and underlying myometrium. It is hypothesized that the leukocytes produce an environment hostile to the fertilized ovum. In laboratory animals, this leukocytic infiltration apparently is not dependent on microbial invasion. In human beings, the uterine cavity sterilizes itself, usually within 2-4 weeks after the device is inserted. Other theories regarding the mechanism of action are spermicidal activity and inhibition of endometrial enzymes with copper devices, disruption of endometrial maturation and inhibition of sperm survival with the progesterone-releasing device, alteration of normal tubal cilial action, and even disruption of normal oocyte maturation. Following removal of IUD’s, there is no delay, regardless of duration of use, in achieving pregnancy at normal rates, which belies the assertion that IUD use is associated with infection leading to infertility.

Parçada, bakır ya da projesteron yüklü IUD’lerin etki mekanizmalarıyla ilgili teoriler arasında aşağıdakilerden hangisi sayılmamıştır?

• Spermisidal etki
• Kimyasal ortamın bozulması
• Enzimlerin baskılanması
• Sperm yaşamının baskılanması
• Normal yumurta olgunlaşmasının bozulması

Just how intrauterine devices (IUD) act to prevent conception is not known. The most widely observed phenomenon is mobilization of leukocytes in response to the presence of the foreign body. The leukocytes aggregate around the IUD in the endometrial fluids and mucosa and, to a lesser extent, in the stroma and underlying myometrium. It is hypothesized that the leukocytes produce an environment hostile to the fertilized ovum. In laboratory animals, this leukocytic infiltration apparently is not dependent on microbial invasion. In human beings, the uterine cavity sterilizes itself, usually within 2-4 weeks after the device is inserted. Other theories regarding the mechanism of action are spermicidal activity and inhibition of endometrial enzymes with copper devices, disruption of endometrial maturation and inhibition of sperm survival with the progesterone-releasing device, alteration of normal tubal cilial action, and even disruption of normal oocyte maturation. Following removal of IUD’s, there is no delay, regardless of duration of use, in achieving pregnancy at normal rates, which belies the assertion that IUD use is associated with infection leading to infertility.

Parçada IUD kullanımı ve infertilite ilişkisiyle ilgili olarak aşağıdakilerden hangisi söylenmemektedir?

• IUD’nin uterusta kalış süresiyle gebelik oluşması arasında ilişki yoktur.
• Çıkarıldığında gecikme olmaksızın gebelik oluşur.
• Çıkarıldığında gebelik oranları normaldir.
• IUD’ler enfeksiyona bağlı infertilite ile ilişkilidir.
• IUD’lerin infertilite yaptığı iddiaları asılsızdır.

The geographic variation in incidence rates of breast cancer is considerable, and it has been correlated with the amount of animal fat in the diet. Lean women, however, have an increased incidence of breast cancer, although this increase is limited to small, localized, solitary and well-differentiated tumors.There is a correlation between intraabdominal fat and the risk of breast cancer, a consequence of excessive caloric consumption, however, not a specific dietary component. The common denominator in breast cancer may be the peripheral insulin resistance and hyperinsulinemia that become prevalent with aging in affluent, modern societies. This specific metabolic change is becoming a common theme in various clinical conditions, particularly noninsulin-dependent diabetes mellitus, anovulation and polycystic ovaries, hypertension, and dyslipidemia. Hyperinsulinemia is found more often in women with breast cancer. In this subgroup of women, the risk of breast cancer may be unfavorably influenced by hormonal changes.

Parçada, meme kanseriyle aşağıdaki faktörlerden hangisi arasında bir ilişkiden söz edilmemektedir?

• Coğrafik durum
• Genetik yatkınlık
• Periferik insülin direnci
• Hiperinsülinemi
• Diyetteki hayvansal yağ oranı

The geographic variation in incidence rates of breast cancer is considerable, and it has been correlated with the amount of animal fat in the diet. Lean women, however, have an increased incidence of breast cancer, although this increase is limited to small, localized, solitary and well-differentiated tumors.There is a correlation between intraabdominal fat and the risk of breast cancer, a consequence of excessive caloric consumption, however, not a specific dietary component. The common denominator in breast cancer may be the peripheral insulin resistance and hyperinsulinemia that become prevalent with aging in affluent, modern societies. This specific metabolic change is becoming a common theme in various clinical conditions, particularly noninsulin-dependent diabetes mellitus, anovulation and polycystic ovaries, hypertension, and dyslipidemia. Hyperinsulinemia is found more often in women with breast cancer. In this subgroup of women, the risk of breast cancer may be unfavorably influenced by hormonal changes.

Parçada meme kanseri sıklığında artış olduğu söylenen kadınların özellikleri arasında aşağıdakilerden hangisi sayılmamıştır?

• Küçük tümör kitlesi
• Tek tümör kitlesi
• Tedaviye dirençli tümör
• Lokal kanser
• İyi diferansiye kanser

The geographic variation in incidence rates of breast cancer is considerable, and it has been correlated with the amount of animal fat in the diet. Lean women, however, have an increased incidence of breast cancer, although this increase is limited to small, localized, solitary and well-differentiated tumors.There is a correlation between intraabdominal fat and the risk of breast cancer, a consequence of excessive caloric consumption, however, not a specific dietary component. The common denominator in breast cancer may be the peripheral insulin resistance and hyperinsulinemia that become prevalent with aging in affluent, modern societies. This specific metabolic change is becoming a common theme in various clinical conditions, particularly noninsulin-dependent diabetes mellitus, anovulation and polycystic ovaries, hypertension, and dyslipidemia. Hyperinsulinemia is found more often in women with breast cancer. In this subgroup of women, the risk of breast cancer may be unfavorably influenced by hormonal changes.

Parçada, aşağıdakilerden hangisi, hiperinsülineminin özellikleri arasında sayılmamıştır?

• Özgün bir metabolik değişikliktir.
• Hormonal değişimler, görülme sıklığını olumsuz yönde etkiler.
• Zengin ve modern toplumlarda, artan yaşla birlikte yaygınlaşabilir.
• Değişik klinik durumlarda ortak payda olabilir.
• Meme kanserli kadınlarda daha sık bulunur.

The geographic variation in incidence rates of breast cancer is considerable, and it has been correlated with the amount of animal fat in the diet. Lean women, however, have an increased incidence of breast cancer, although this increase is limited to small, localized, solitary and well-differentiated tumors.There is a correlation between intraabdominal fat and the risk of breast cancer, a consequence of excessive caloric consumption, however, not a specific dietary component. The common denominator in breast cancer may be the peripheral insulin resistance and hyperinsulinemia that become prevalent with aging in affluent, modern societies. This specific metabolic change is becoming a common theme in various clinical conditions, particularly noninsulin-dependent diabetes mellitus, anovulation and polycystic ovaries, hypertension, and dyslipidemia. Hyperinsulinemia is found more often in women with breast cancer. In this subgroup of women, the risk of breast cancer may be unfavorably influenced by hormonal changes.

Parçada hiperinsülineminin aşağıdaki klinik durumlardan hangisiyle ilişkisinden söz edilmemiştir?

• Hipertansiyon
• Ovülasyon yokluğu
• Polikistik overler
• İnsüline bağımlı şeker hastalığı
• Dislipidemi

The geographic variation in incidence rates of breast cancer is considerable, and it has been correlated with the amount of animal fat in the diet. Lean women, however, have an increased incidence of breast cancer, although this increase is limited to small, localized, solitary and well-differentiated tumors.There is a correlation between intraabdominal fat and the risk of breast cancer, a consequence of excessive caloric consumption, however, not a specific dietary component. The common denominator in breast cancer may be the peripheral insulin resistance and hyperinsulinemia that become prevalent with aging in affluent, modern societies. This specific metabolic change is becoming a common theme in various clinical conditions, particularly noninsulin-dependent diabetes mellitus, anovulation and polycystic ovaries, hypertension, and dyslipidemia. Hyperinsulinemia is found more often in women with breast cancer. In this subgroup of women, the risk of breast cancer may be unfavorably influenced by hormonal changes.

Parçanın ilk cümlesinde geçen "considerable" sözcüğünün Türkçe karşılığı aşağıdakilerden hangisidir?

• Kayda değer
• Değişken
• Dayanaksız
• Tutarsız
• Güven veren

Fever, or “pyrexia,” is an elevation of body temperature to a level above normal, i.e., to>37.5 ºC, due to resettings of the thermoregulatory center in the medulla. To detect fever, oral, rectal, tympanic membrane, and pulmonary artery measurements are more reliable than axillary temperatures. Fever is a useful marker of inflammation; usually the height of the fever reflects the severity of the inflammatory process. Anorexia, malaise, myalgias, headache, and other constitutional symptoms often occur concomitantly. When the body temperature changes rapidly, chills and sweats are also observed. Fever with night sweats is a feature of many chronic inflammatory conditions. Hyperthermia is a term for fever due to a disturbance of thermal regulatory control: excessive heat production (e.g., with vigorous exercise or as a reaction to some anesthetics), decreased dissipation (e.g., with dehydration), or loss of regulation (e.g., due to injury to the hypothalmic regulatory center). Most febrile patients have tenderness, redness, and swelling at the site of inflammation, and in this case, the cause of the fever is readily identified. In otherwise healthy individuals, fever alone is not a cause for hospitalization unless it is quite high (>39 ºC) or accompanied by shaking, chills, hypotension, a change in the sensorium, or other symptoms suggesting bacteremia.

Parçada ateş yükselmesine neden olan durumlar arasında aşağıdakilerden hangisinden söz edilmemektedir?

• Su kaybı
• İshal
• Ağır egzersiz
• Anestetiklere tepki
• Hipotalamusta düzenleyici merkezde hasar

Fever, or “pyrexia,” is an elevation of body temperature to a level above normal, i.e., to>37.5 ºC, due to resettings of the thermoregulatory center in the medulla. To detect fever, oral, rectal, tympanic membrane, and pulmonary artery measurements are more reliable than axillary temperatures. Fever is a useful marker of inflammation; usually the height of the fever reflects the severity of the inflammatory process. Anorexia, malaise, myalgias, headache, and other constitutional symptoms often occur concomitantly. When the body temperature changes rapidly, chills and sweats are also observed. Fever with night sweats is a feature of many chronic inflammatory conditions. Hyperthermia is a term for fever due to a disturbance of thermal regulatory control: excessive heat production (e.g., with vigorous exercise or as a reaction to some anesthetics), decreased dissipation (e.g., with dehydration), or loss of regulation (e.g., due to injury to the hypothalmic regulatory center). Most febrile patients have tenderness, redness, and swelling at the site of inflammation, and in this case, the cause of the fever is readily identified. In otherwise healthy individuals, fever alone is not a cause for hospitalization unless it is quite high (>39 ºC) or accompanied by shaking, chills, hypotension, a change in the sensorium, or other symptoms suggesting bacteremia.

Parçada, vücut sıcaklığının artışına bağlı olarak görülen durumlar arasında aşağıdakilerden hangisi sayılmamıştır?

• Halsizlik
• Başağrısı
• İştahsızlık
• Kusma
• Kas ağrısı

Fever, or “pyrexia,” is an elevation of body temperature to a level above normal, i.e., to>37.5 ºC, due to resettings of the thermoregulatory center in the medulla. To detect fever, oral, rectal, tympanic membrane, and pulmonary artery measurements are more reliable than axillary temperatures. Fever is a useful marker of inflammation; usually the height of the fever reflects the severity of the inflammatory process. Anorexia, malaise, myalgias, headache, and other constitutional symptoms often occur concomitantly. When the body temperature changes rapidly, chills and sweats are also observed. Fever with night sweats is a feature of many chronic inflammatory conditions. Hyperthermia is a term for fever due to a disturbance of thermal regulatory control: excessive heat production (e.g., with vigorous exercise or as a reaction to some anesthetics), decreased dissipation (e.g., with dehydration), or loss of regulation (e.g., due to injury to the hypothalmic regulatory center). Most febrile patients have tenderness, redness, and swelling at the site of inflammation, and in this case, the cause of the fever is readily identified. In otherwise healthy individuals, fever alone is not a cause for hospitalization unless it is quite high (>39 ºC) or accompanied by shaking, chills, hypotension, a change in the sensorium, or other symptoms suggesting bacteremia.

Parçada aşağıdaki ölçüm yollarından hangisinin daha az güvenilir olduğundan söz edilmektedir?

• Pulmoner
• Rektal
• Oral
• Timpanik membran
• Aksiller

Fever, or “pyrexia,” is an elevation of body temperature to a level above normal, i.e., to>37.5 ºC, due to resettings of the thermoregulatory center in the medulla. To detect fever, oral, rectal, tympanic membrane, and pulmonary artery measurements are more reliable than axillary temperatures. Fever is a useful marker of inflammation; usually the height of the fever reflects the severity of the inflammatory process. Anorexia, malaise, myalgias, headache, and other constitutional symptoms often occur concomitantly. When the body temperature changes rapidly, chills and sweats are also observed. Fever with night sweats is a feature of many chronic inflammatory conditions. Hyperthermia is a term for fever due to a disturbance of thermal regulatory control: excessive heat production (e.g., with vigorous exercise or as a reaction to some anesthetics), decreased dissipation (e.g., with dehydration), or loss of regulation (e.g., due to injury to the hypothalmic regulatory center). Most febrile patients have tenderness, redness, and swelling at the site of inflammation, and in this case, the cause of the fever is readily identified. In otherwise healthy individuals, fever alone is not a cause for hospitalization unless it is quite high (>39 ºC) or accompanied by shaking, chills, hypotension, a change in the sensorium, or other symptoms suggesting bacteremia.

Parçaya göre, inflamasyon bölgesinde aşağıdakilerden hangisi olduğunda ateşin nedeni kolaylıkla bulunur?

• Ağrı
• Kaşıntı
• Solukluk
• Kızarıklık
• Kabuklanma

Fever, or “pyrexia,” is an elevation of body temperature to a level above normal, i.e., to>37.5 ºC, due to resettings of the thermoregulatory center in the medulla. To detect fever, oral, rectal, tympanic membrane, and pulmonary artery measurements are more reliable than axillary temperatures. Fever is a useful marker of inflammation; usually the height of the fever reflects the severity of the inflammatory process. Anorexia, malaise, myalgias, headache, and other constitutional symptoms often occur concomitantly. When the body temperature changes rapidly, chills and sweats are also observed. Fever with night sweats is a feature of many chronic inflammatory conditions. Hyperthermia is a term for fever due to a disturbance of thermal regulatory control: excessive heat production (e.g., with vigorous exercise or as a reaction to some anesthetics), decreased dissipation (e.g., with dehydration), or loss of regulation (e.g., due to injury to the hypothalmic regulatory center). Most febrile patients have tenderness, redness, and swelling at the site of inflammation, and in this case, the cause of the fever is readily identified. In otherwise healthy individuals, fever alone is not a cause for hospitalization unless it is quite high (>39 ºC) or accompanied by shaking, chills, hypotension, a change in the sensorium, or other symptoms suggesting bacteremia.

Parçada ateşin tek başına hastane bakımı gerektireceği durumlar arasında aşağıdakilerden hangisi sayılmamıştır?

• Tansiyonun yükselmesi
• Ateşin 39 ºC’den yüksek olması
• Titreme
• Ürperme
• Duyu değişimleri

Mastocytosis is a interesting disease characterized by an abnormal increase in mast cells in the bone marrow, liver, spleen, lymph nodes, gastrointestinal tract, and skin. Mastocytosis may present in any age group and demonstrates a slight male predominance. The prevalence of the disease is unknown. Familial occurrence is unusual. The disease is divided into four categories on the basis of clinical presentation, pathologic findings, and prognosis. Patients in the first category have a good prognosis, whereas patients in the other three groups do poorly. Indolent mastocytosis is divided into two subgroups: those with isolated skin involvement and those with systemic disease. In most cases such patients gradually accrue more mast cells with progression of symptoms but can be managed successfully for decades using medications that provide symptomatic relief. The second most common form of mastacytosis is that associated with a hematologic disorder, in which examination of the bone marrow and peripheral blood reveals the hematologic abnormality. The prognosis in these patients is determined by the associated hematologic disorder. The third category of mast cell disease is mast cell leukemia; it is the rarest form and has the most fulminant behavior. Mast cell leukemia is distinguished by its unique pathologic and clinical picture. The peripheral blood smear shows immature mast cells.

Parçada mastositoz ile ilgili olarak aşağıdakilerden hangisi söylenmemektedir?

• Sıklığı bilinmiyor.
• Ailevi geçiş azdır.
• Mast hücrelerinin anormal çoğalmasıdır.
• Herhangi bir yaşta görülebilir.
• Erkeklerde nadir görülür.

Mastocytosis is a interesting disease characterized by an abnormal increase in mast cells in the bone marrow, liver, spleen, lymph nodes, gastrointestinal tract, and skin. Mastocytosis may present in any age group and demonstrates a slight male predominance. The prevalence of the disease is unknown. Familial occurrence is unusual. The disease is divided into four categories on the basis of clinical presentation, pathologic findings, and prognosis. Patients in the first category have a good prognosis, whereas patients in the other three groups do poorly. Indolent mastocytosis is divided into two subgroups: those with isolated skin involvement and those with systemic disease. In most cases such patients gradually accrue more mast cells with progression of symptoms but can be managed successfully for decades using medications that provide symptomatic relief. The second most common form of mastacytosis is that associated with a hematologic disorder, in which examination of the bone marrow and peripheral blood reveals the hematologic abnormality. The prognosis in these patients is determined by the associated hematologic disorder. The third category of mast cell disease is mast cell leukemia; it is the rarest form and has the most fulminant behavior. Mast cell leukemia is distinguished by its unique pathologic and clinical picture. The peripheral blood smear shows immature mast cells.

Parçaya göre uzun zamandır kullanılan ilaçların hastalığa etkisi hangi şekildedir?

• Tedaviyi tümüyle sağlama
• Hücre çoğalmasını durdurma
• Sadece belirtilerde iyileşme
• Erken dönemde yararlı olma
• Yüksek dozda etkili olma

Mastocytosis is a interesting disease characterized by an abnormal increase in mast cells in the bone marrow, liver, spleen, lymph nodes, gastrointestinal tract, and skin. Mastocytosis may present in any age group and demonstrates a slight male predominance. The prevalence of the disease is unknown. Familial occurrence is unusual. The disease is divided into four categories on the basis of clinical presentation, pathologic findings, and prognosis. Patients in the first category have a good prognosis, whereas patients in the other three groups do poorly. Indolent mastocytosis is divided into two subgroups: those with isolated skin involvement and those with systemic disease. In most cases such patients gradually accrue more mast cells with progression of symptoms but can be managed successfully for decades using medications that provide symptomatic relief. The second most common form of mastacytosis is that associated with a hematologic disorder, in which examination of the bone marrow and peripheral blood reveals the hematologic abnormality. The prognosis in these patients is determined by the associated hematologic disorder. The third category of mast cell disease is mast cell leukemia; it is the rarest form and has the most fulminant behavior. Mast cell leukemia is distinguished by its unique pathologic and clinical picture. The peripheral blood smear shows immature mast cells.

Parçaya göre mastositozun en nadir şekli aşağıdakilerden hangisidir?

• Mast hücre lösemisi
• Kan yapımına bağlı
• Deri ile ilişkili
• Prognozu düşük
• Birinci kategorideki

Mastocytosis is a interesting disease characterized by an abnormal increase in mast cells in the bone marrow, liver, spleen, lymph nodes, gastrointestinal tract, and skin. Mastocytosis may present in any age group and demonstrates a slight male predominance. The prevalence of the disease is unknown. Familial occurrence is unusual. The disease is divided into four categories on the basis of clinical presentation, pathologic findings, and prognosis. Patients in the first category have a good prognosis, whereas patients in the other three groups do poorly. Indolent mastocytosis is divided into two subgroups: those with isolated skin involvement and those with systemic disease. In most cases such patients gradually accrue more mast cells with progression of symptoms but can be managed successfully for decades using medications that provide symptomatic relief. The second most common form of mastacytosis is that associated with a hematologic disorder, in which examination of the bone marrow and peripheral blood reveals the hematologic abnormality. The prognosis in these patients is determined by the associated hematologic disorder. The third category of mast cell disease is mast cell leukemia; it is the rarest form and has the most fulminant behavior. Mast cell leukemia is distinguished by its unique pathologic and clinical picture. The peripheral blood smear shows immature mast cells.

Parçada, mast hücreli lösemide periferik kanın incelenmesi ile gözlenen mast hücrelerinin hangi özellikte olduğundan söz edilmektedir?

• Koloni şeklinde
• Çok sayıda
• Olgunlaşmamış
• Parçalanmış
• Çok büyük

Mastocytosis is a interesting disease characterized by an abnormal increase in mast cells in the bone marrow, liver, spleen, lymph nodes, gastrointestinal tract, and skin. Mastocytosis may present in any age group and demonstrates a slight male predominance. The prevalence of the disease is unknown. Familial occurrence is unusual. The disease is divided into four categories on the basis of clinical presentation, pathologic findings, and prognosis. Patients in the first category have a good prognosis, whereas patients in the other three groups do poorly. Indolent mastocytosis is divided into two subgroups: those with isolated skin involvement and those with systemic disease. In most cases such patients gradually accrue more mast cells with progression of symptoms but can be managed successfully for decades using medications that provide symptomatic relief. The second most common form of mastacytosis is that associated with a hematologic disorder, in which examination of the bone marrow and peripheral blood reveals the hematologic abnormality. The prognosis in these patients is determined by the associated hematologic disorder. The third category of mast cell disease is mast cell leukemia; it is the rarest form and has the most fulminant behavior. Mast cell leukemia is distinguished by its unique pathologic and clinical picture. The peripheral blood smear shows immature mast cells.

Parçanın sekizinci cümlesinde geçen "gradually" sözcüğünün Türkçe karşılığı aşağıdakilerden hangisidir?

• Belirsiz bir şekilde
• Aşamalı olarak
• Zaman zaman
• Azalarak
• Kolayca

During the last 30 to 40 years, outbreaks of scarlet fever in the Western world have been notably mild, and the illness has been referred to as “pharyngitis with a rash” or “benign scarlet fever”. The fatal or malignant forms of scarlet fever have been described as either septic or toxic. “Septic scarlet fever” refers to patients who develop local invasion of the soft tissues of the neck and complications such as upper airway obstruction, otitis media with perforation, meningitis, mastoiditis, invasion of the jugular vein or carotid artery, and bronchopneumonia. “Toxic scarlet fever” is rare today, but historically patients initially developed severe sore throat, marked fever, delirium, skin rash, and painful cervical lymph nodes. In severe toxic cases, fevers of 41ºC, pulses of 130 to 160 beats per minute, severe headache, delirium convulsions, little if any skin rash, and death within 24 hours were common. These cases occurred before the advent of antibiotics, antipyretics, and anticonvulsants, and sudden deaths were the result of uncontrolled seizures and hyperpyrexia. In contrast, children with septic scarlet fever had prolonged courses and ceased 2 to 3 weeks after the onset of pharyngitis. Complications of streptococcal pharyngitis and malignant forms of scarlet fever have been less common in the antibiotic era. Even before antibiotics became available, necrotizing fasciitis and myositis were not described in association with scarlet fever.

Parçada son yıllardaki kızıl salgınları için aşağı- dakilerden hangisi söylenmektedir?

• Yavaş seyreden
• Belirgin biçimde çok
• Oldukça zararsız
• Dikkati çekecek şekilde hafif
• Önemli oranda değişken

During the last 30 to 40 years, outbreaks of scarlet fever in the Western world have been notably mild, and the illness has been referred to as “pharyngitis with a rash” or “benign scarlet fever”. The fatal or malignant forms of scarlet fever have been described as either septic or toxic. “Septic scarlet fever” refers to patients who develop local invasion of the soft tissues of the neck and complications such as upper airway obstruction, otitis media with perforation, meningitis, mastoiditis, invasion of the jugular vein or carotid artery, and bronchopneumonia. “Toxic scarlet fever” is rare today, but historically patients initially developed severe sore throat, marked fever, delirium, skin rash, and painful cervical lymph nodes. In severe toxic cases, fevers of 41ºC, pulses of 130 to 160 beats per minute, severe headache, delirium convulsions, little if any skin rash, and death within 24 hours were common. These cases occurred before the advent of antibiotics, antipyretics, and anticonvulsants, and sudden deaths were the result of uncontrolled seizures and hyperpyrexia. In contrast, children with septic scarlet fever had prolonged courses and ceased 2 to 3 weeks after the onset of pharyngitis. Complications of streptococcal pharyngitis and malignant forms of scarlet fever have been less common in the antibiotic era. Even before antibiotics became available, necrotizing fasciitis and myositis were not described in association with scarlet fever.

Parçada aşağıdakilerden hangisinin septik kızılda görüldüğünden söz edilmemektedir?

• Üst solunum yolu tıkanıklığı
• Ağrılı lenf düğümü
• Orta kulak iltihabı ve delinme
• Bronkopnemoni
• Menenjit

During the last 30 to 40 years, outbreaks of scarlet fever in the Western world have been notably mild, and the illness has been referred to as “pharyngitis with a rash” or “benign scarlet fever”. The fatal or malignant forms of scarlet fever have been described as either septic or toxic. “Septic scarlet fever” refers to patients who develop local invasion of the soft tissues of the neck and complications such as upper airway obstruction, otitis media with perforation, meningitis, mastoiditis, invasion of the jugular vein or carotid artery, and bronchopneumonia. “Toxic scarlet fever” is rare today, but historically patients initially developed severe sore throat, marked fever, delirium, skin rash, and painful cervical lymph nodes. In severe toxic cases, fevers of 41ºC, pulses of 130 to 160 beats per minute, severe headache, delirium convulsions, little if any skin rash, and death within 24 hours were common. These cases occurred before the advent of antibiotics, antipyretics, and anticonvulsants, and sudden deaths were the result of uncontrolled seizures and hyperpyrexia. In contrast, children with septic scarlet fever had prolonged courses and ceased 2 to 3 weeks after the onset of pharyngitis. Complications of streptococcal pharyngitis and malignant forms of scarlet fever have been less common in the antibiotic era. Even before antibiotics became available, necrotizing fasciitis and myositis were not described in association with scarlet fever.

Parçaya göre ciddi toksik olgularda daha az görülen belirti aşağıdakilerden hangisidir?

• Bir günde ölüm
• Boğaz ağrısı
• Taşikardi
• Belirgin ateş
• Deride kızarıklık

During the last 30 to 40 years, outbreaks of scarlet fever in the Western world have been notably mild, and the illness has been referred to as “pharyngitis with a rash” or “benign scarlet fever”. The fatal or malignant forms of scarlet fever have been described as either septic or toxic. “Septic scarlet fever” refers to patients who develop local invasion of the soft tissues of the neck and complications such as upper airway obstruction, otitis media with perforation, meningitis, mastoiditis, invasion of the jugular vein or carotid artery, and bronchopneumonia. “Toxic scarlet fever” is rare today, but historically patients initially developed severe sore throat, marked fever, delirium, skin rash, and painful cervical lymph nodes. In severe toxic cases, fevers of 41ºC, pulses of 130 to 160 beats per minute, severe headache, delirium convulsions, little if any skin rash, and death within 24 hours were common. These cases occurred before the advent of antibiotics, antipyretics, and anticonvulsants, and sudden deaths were the result of uncontrolled seizures and hyperpyrexia. In contrast, children with septic scarlet fever had prolonged courses and ceased 2 to 3 weeks after the onset of pharyngitis. Complications of streptococcal pharyngitis and malignant forms of scarlet fever have been less common in the antibiotic era. Even before antibiotics became available, necrotizing fasciitis and myositis were not described in association with scarlet fever.

Parçaya göre, ilaç tedavilerinin bilinmediği dönemlerde septik kızıl hastalıklı çocuklarda faranjiti takiben 2-3 hafta sonra görülen durum aşağıdakilerden hangisidir?

• Ölüm
• Baygınlıklar
• Hiperpreksi
• Aşırı titreme
• Kasılma

During the last 30 to 40 years, outbreaks of scarlet fever in the Western world have been notably mild, and the illness has been referred to as “pharyngitis with a rash” or “benign scarlet fever”. The fatal or malignant forms of scarlet fever have been described as either septic or toxic. “Septic scarlet fever” refers to patients who develop local invasion of the soft tissues of the neck and complications such as upper airway obstruction, otitis media with perforation, meningitis, mastoiditis, invasion of the jugular vein or carotid artery, and bronchopneumonia. “Toxic scarlet fever” is rare today, but historically patients initially developed severe sore throat, marked fever, delirium, skin rash, and painful cervical lymph nodes. In severe toxic cases, fevers of 41ºC, pulses of 130 to 160 beats per minute, severe headache, delirium convulsions, little if any skin rash, and death within 24 hours were common. These cases occurred before the advent of antibiotics, antipyretics, and anticonvulsants, and sudden deaths were the result of uncontrolled seizures and hyperpyrexia. In contrast, children with septic scarlet fever had prolonged courses and ceased 2 to 3 weeks after the onset of pharyngitis. Complications of streptococcal pharyngitis and malignant forms of scarlet fever have been less common in the antibiotic era. Even before antibiotics became available, necrotizing fasciitis and myositis were not described in association with scarlet fever.

Parçanın üçüncü cümlesinde geçen "have been described" ifadesinin Türkçe karşılığı aşağıdakilerden hangisidir?

• Ayırt edilmiştir
• Görülmüştür
• Anlaşılmıştır
• Bilinmiştir
• Tanımlanmıştır

Syphilis is a chronic infectious disease caused by the bacterium Treponema pallidum. It is usually acquired by sexual contact with another infected individual. Syphilis is remarkable among infectious diseases in its large variety of clinical presentations. It progresses, if untreated through primary, secondary, and tertiary stages. The early stages (primary and secondary) are infectious. Spontaneous healing of early lesions occurs, followed by a long latent period. In about 30 % of untreated patients, late disease of the heart, central nervous system, or other organs ultimately develops. At one time this disease was termed “the great imitator.” Although the disease is less common now than previously, it remains a great challenge to the clinician because of its protean manifestations and is of great interest to biologists as well because of the long and tenuous balance between the host and the invading spirochete.

Parçada frengi, bulaşıcı hastalıklar arasında hangi yönüyle dikkate değer bulunmaktadır?

• Merkezi sinir sistemini etkilemesiyle
• Cinsel yolla bulaşmasıyla
• Çok çeşitli klinik belirtileriyle
• Hızlı ilerlemesiyle
• Geç dönemde görülen yaralarıyla

Syphilis is a chronic infectious disease caused by the bacterium Treponema pallidum. It is usually acquired by sexual contact with another infected individual. Syphilis is remarkable among infectious diseases in its large variety of clinical presentations. It progresses, if untreated through primary, secondary, and tertiary stages. The early stages (primary and secondary) are infectious. Spontaneous healing of early lesions occurs, followed by a long latent period. In about 30 % of untreated patients, late disease of the heart, central nervous system, or other organs ultimately develops. At one time this disease was termed “the great imitator.” Although the disease is less common now than previously, it remains a great challenge to the clinician because of its protean manifestations and is of great interest to biologists as well because of the long and tenuous balance between the host and the invading spirochete.

Parçaya göre, hastalık için bir zamanlar yapılan tanımlama aşağıdakilerden hangisidir?

• Bulaşıcı yara
• Gizli düşman
• Sinsi hastalık
• Büyük darbe
• Büyük taklitçi

Syphilis is a chronic infectious disease caused by the bacterium Treponema pallidum. It is usually acquired by sexual contact with another infected individual. Syphilis is remarkable among infectious diseases in its large variety of clinical presentations. It progresses, if untreated through primary, secondary, and tertiary stages. The early stages (primary and secondary) are infectious. Spontaneous healing of early lesions occurs, followed by a long latent period. In about 30 % of untreated patients, late disease of the heart, central nervous system, or other organs ultimately develops. At one time this disease was termed “the great imitator.” Although the disease is less common now than previously, it remains a great challenge to the clinician because of its protean manifestations and is of great interest to biologists as well because of the long and tenuous balance between the host and the invading spirochete.

Parçaya göre, frenginin günümüzdeki durumu geçmişteki durumuyla karşılaştırıldığında aşağıdakilerden hangisi doğrudur?

• Tanısı daha kolaydır.
• Daha geniş bir yaş aralığında görülür.
• Daha seyrek rastlanır.
• Daha kolay tedavi edilir.
• Klinisyen için artık güçlük oluşturmaz.

Syphilis is a chronic infectious disease caused by the bacterium Treponema pallidum. It is usually acquired by sexual contact with another infected individual. Syphilis is remarkable among infectious diseases in its large variety of clinical presentations. It progresses, if untreated through primary, secondary, and tertiary stages. The early stages (primary and secondary) are infectious. Spontaneous healing of early lesions occurs, followed by a long latent period. In about 30 % of untreated patients, late disease of the heart, central nervous system, or other organs ultimately develops. At one time this disease was termed “the great imitator.” Although the disease is less common now than previously, it remains a great challenge to the clinician because of its protean manifestations and is of great interest to biologists as well because of the long and tenuous balance between the host and the invading spirochete.

Parçaya göre, biyologların spirokette ilgisini çeken aşağıdakilerden hangisidir?

• Konakçıyla kurduğu denge
• Çoğalma biçimi
• Proteinlerinin çeşitliliği
• Tiplerinin çokluğu
• Yaşam döngüsü

Syphilis is a chronic infectious disease caused by the bacterium Treponema pallidum. It is usually acquired by sexual contact with another infected individual. Syphilis is remarkable among infectious diseases in its large variety of clinical presentations. It progresses, if untreated through primary, secondary, and tertiary stages. The early stages (primary and secondary) are infectious. Spontaneous healing of early lesions occurs, followed by a long latent period. In about 30 % of untreated patients, late disease of the heart, central nervous system, or other organs ultimately develops. At one time this disease was termed “the great imitator.” Although the disease is less common now than previously, it remains a great challenge to the clinician because of its protean manifestations and is of great interest to biologists as well because of the long and tenuous balance between the host and the invading spirochete.

Parçanın yedinci cümlesinde geçen "ultimately develops" ifadesinin Türkçe karşılığı aşağıdakilerden hangisidir?

• Birlikte görülür
• Yavaşça ilerler
• Mutlaka oluşur
• Sonunda gelişir
• Hızla etkiler

The most frequently encountered causes of loss of smell are congenital abnormalities, viral infections, head injuries that sever the neurons crossing through the cribriform plate, and normal aging. Patients can lose their sense of smell not only from chronic allergies and sinusitis but also from the nasal sprays and drops that they use to treat these conditions. The most common causes of loss of the sense of taste are viral infections and drug ingestion, particularly antirheumatic and antiproliferative drugs. Many of the systemic disorders probably have their effect by decreasing the rate of turnover of sensory receptors on the tongue and olfactory epithelia. Disturbances of smell and taste in malnourished patients may be due to specific deficiencies in vitamins and minerals, such as zinc. Viral illnesses such as influenza and viral hepatitis produce disorders of both taste and smell. Multifocal neurologic disorders such as multiple sclerosis can affect the central olfactory and gustatory pathways at multiple levels, and therefore abnormalities of taste and smell are common in such patients. Treatment of olfactory dysfunction due to nasal disease is aimed at opening the air passageways while preserving the olfactory epithelium. Intranasal steriods, antibiotics, and allergic therapies are useful in selected cases. Drugs known to affect taste or smell should be removed for a trial. Vitamin and mineral therapies are of unproven benefit.

Parçada aşağıdakilerden hangisi koku duyusu kaybının en sık nedenleri arasında sayılmamıştır?

• Sinüzit
• Viral enfeksiyonlar
• Kafa travmaları
• Yaşlanma
• Doğuştan anomaliler

The most frequently encountered causes of loss of smell are congenital abnormalities, viral infections, head injuries that sever the neurons crossing through the cribriform plate, and normal aging. Patients can lose their sense of smell not only from chronic allergies and sinusitis but also from the nasal sprays and drops that they use to treat these conditions. The most common causes of loss of the sense of taste are viral infections and drug ingestion, particularly antirheumatic and antiproliferative drugs. Many of the systemic disorders probably have their effect by decreasing the rate of turnover of sensory receptors on the tongue and olfactory epithelia. Disturbances of smell and taste in malnourished patients may be due to specific deficiencies in vitamins and minerals, such as zinc. Viral illnesses such as influenza and viral hepatitis produce disorders of both taste and smell. Multifocal neurologic disorders such as multiple sclerosis can affect the central olfactory and gustatory pathways at multiple levels, and therefore abnormalities of taste and smell are common in such patients. Treatment of olfactory dysfunction due to nasal disease is aimed at opening the air passageways while preserving the olfactory epithelium. Intranasal steriods, antibiotics, and allergic therapies are useful in selected cases. Drugs known to affect taste or smell should be removed for a trial. Vitamin and mineral therapies are of unproven benefit.

Parçada aşağıdakilerden hangisi hem tat hem de koku duyusunu bozacağından söz edilen etkenlerden biri değildir?

• Multiple skleroz
• Viral hepatit
• Vitamin ve mineral eksikliği
• Zatürre
• Kronik alerji

The most frequently encountered causes of loss of smell are congenital abnormalities, viral infections, head injuries that sever the neurons crossing through the cribriform plate, and normal aging. Patients can lose their sense of smell not only from chronic allergies and sinusitis but also from the nasal sprays and drops that they use to treat these conditions. The most common causes of loss of the sense of taste are viral infections and drug ingestion, particularly antirheumatic and antiproliferative drugs. Many of the systemic disorders probably have their effect by decreasing the rate of turnover of sensory receptors on the tongue and olfactory epithelia. Disturbances of smell and taste in malnourished patients may be due to specific deficiencies in vitamins and minerals, such as zinc. Viral illnesses such as influenza and viral hepatitis produce disorders of both taste and smell. Multifocal neurologic disorders such as multiple sclerosis can affect the central olfactory and gustatory pathways at multiple levels, and therefore abnormalities of taste and smell are common in such patients. Treatment of olfactory dysfunction due to nasal disease is aimed at opening the air passageways while preserving the olfactory epithelium. Intranasal steriods, antibiotics, and allergic therapies are useful in selected cases. Drugs known to affect taste or smell should be removed for a trial. Vitamin and mineral therapies are of unproven benefit.

Parçada, sistemik bozuklukların dil ve koku epitelindeki duyu hücre reseptörlerinin hangi özelliğini etkiliyor olabileceği söylenmektedir?

• Dönüşüm hızını
• Değişim hızını
• Sayısal oranını
• Kimyasal yapısını
• Duyarlılık oranını

The most frequently encountered causes of loss of smell are congenital abnormalities, viral infections, head injuries that sever the neurons crossing through the cribriform plate, and normal aging. Patients can lose their sense of smell not only from chronic allergies and sinusitis but also from the nasal sprays and drops that they use to treat these conditions. The most common causes of loss of the sense of taste are viral infections and drug ingestion, particularly antirheumatic and antiproliferative drugs. Many of the systemic disorders probably have their effect by decreasing the rate of turnover of sensory receptors on the tongue and olfactory epithelia. Disturbances of smell and taste in malnourished patients may be due to specific deficiencies in vitamins and minerals, such as zinc. Viral illnesses such as influenza and viral hepatitis produce disorders of both taste and smell. Multifocal neurologic disorders such as multiple sclerosis can affect the central olfactory and gustatory pathways at multiple levels, and therefore abnormalities of taste and smell are common in such patients. Treatment of olfactory dysfunction due to nasal disease is aimed at opening the air passageways while preserving the olfactory epithelium. Intranasal steriods, antibiotics, and allergic therapies are useful in selected cases. Drugs known to affect taste or smell should be removed for a trial. Vitamin and mineral therapies are of unproven benefit.

Parçada vitamin ve mineral tedavisi hakkında aşağıdakilerden hangisi söylenmektedir?

• Kötü beslenmenin etkisini düzeltir.
• Yararı kanıtlanmamıştır.
• Deneme amacıyla uygulanmaktadır.
• Aralıklı olarak uygulanmalıdır.
• Bazı durumlarda uygulanabilir.

The most frequently encountered causes of loss of smell are congenital abnormalities, viral infections, head injuries that sever the neurons crossing through the cribriform plate, and normal aging. Patients can lose their sense of smell not only from chronic allergies and sinusitis but also from the nasal sprays and drops that they use to treat these conditions. The most common causes of loss of the sense of taste are viral infections and drug ingestion, particularly antirheumatic and antiproliferative drugs. Many of the systemic disorders probably have their effect by decreasing the rate of turnover of sensory receptors on the tongue and olfactory epithelia. Disturbances of smell and taste in malnourished patients may be due to specific deficiencies in vitamins and minerals, such as zinc. Viral illnesses such as influenza and viral hepatitis produce disorders of both taste and smell. Multifocal neurologic disorders such as multiple sclerosis can affect the central olfactory and gustatory pathways at multiple levels, and therefore abnormalities of taste and smell are common in such patients. Treatment of olfactory dysfunction due to nasal disease is aimed at opening the air passageways while preserving the olfactory epithelium. Intranasal steriods, antibiotics, and allergic therapies are useful in selected cases. Drugs known to affect taste or smell should be removed for a trial. Vitamin and mineral therapies are of unproven benefit.

Parçanın sekizinci cümlesinde geçen "while preserving" ifadesinin Türkçe karşılığı aşağı- dakilerden hangisidir?

• Sunarken
• Açarken
• Korurken
• Düzeltirken
• Etkilerken

A recent unintended weight loss of 5 kg or more than 5 % of usual weight should prompt efforts to diagnose the underlying disorder or social circumstance. Weight loss alone does not distinguish the composition of tissue loss, which can range from 25 to 30 % lean tissue in semistarvation to 50 % lean tissue loss following starvation plus injury. Therefore, unintentional weight loss of more than 5 kg indicates a need for thorough nutritional assessment. Weight loss in excess of 10 % of usual weight should be considered to represent protein-energy malnutrition that will impair physiologic function, particularly muscle strength and endurance. Weight loss in excess of 20 % should be considered severe proteinenergy malnutrition that will substantially impair most organ systems. If major elective surgery is planned, such individuals would benefit from adequate feeding preoperatively. If radiotherapy is planned, adequate feeding during therapy with the use of supplemental formulas, tube feeding, or parenteral nutrition (in that order) is indicated.

Parçaya göre, istemdışı kilo kaybının altında yatan hastalığın teşhisi aşağıdakilerden hangisini gerektirir?

• İlginin yoğunlaştırılmasını
• Çalışmaların yapılmasını
• Dikkatlice yaklaşılmasını
• Çabaların başlatılmasını
• Cevaplara ulaşılmasını

A recent unintended weight loss of 5 kg or more than 5 % of usual weight should prompt efforts to diagnose the underlying disorder or social circumstance. Weight loss alone does not distinguish the composition of tissue loss, which can range from 25 to 30 % lean tissue in semistarvation to 50 % lean tissue loss following starvation plus injury. Therefore, unintentional weight loss of more than 5 kg indicates a need for thorough nutritional assessment. Weight loss in excess of 10 % of usual weight should be considered to represent protein-energy malnutrition that will impair physiologic function, particularly muscle strength and endurance. Weight loss in excess of 20 % should be considered severe proteinenergy malnutrition that will substantially impair most organ systems. If major elective surgery is planned, such individuals would benefit from adequate feeding preoperatively. If radiotherapy is planned, adequate feeding during therapy with the use of supplemental formulas, tube feeding, or parenteral nutrition (in that order) is indicated.

Parçaya göre, kas gücünü etkileyecek düzeydeki kilo kaybı aşağıdakilerden hangisidir?

• % 5 oranında
• % 10 dan çok
• % 20 den çok
• % 25-30 civarında
• % 50 kadar

A recent unintended weight loss of 5 kg or more than 5 % of usual weight should prompt efforts to diagnose the underlying disorder or social circumstance. Weight loss alone does not distinguish the composition of tissue loss, which can range from 25 to 30 % lean tissue in semistarvation to 50 % lean tissue loss following starvation plus injury. Therefore, unintentional weight loss of more than 5 kg indicates a need for thorough nutritional assessment. Weight loss in excess of 10 % of usual weight should be considered to represent protein-energy malnutrition that will impair physiologic function, particularly muscle strength and endurance. Weight loss in excess of 20 % should be considered severe proteinenergy malnutrition that will substantially impair most organ systems. If major elective surgery is planned, such individuals would benefit from adequate feeding preoperatively. If radiotherapy is planned, adequate feeding during therapy with the use of supplemental formulas, tube feeding, or parenteral nutrition (in that order) is indicated.

Parçaya göre. radyoterapi planlandığında yeterli beslenme için ilk önce hangi yöntem kullanılır?

• Psikoterapi
• Tüple beslenme
• Parental beslenme
• İştah açıcılar
• Ek beslenme formülleri

A recent unintended weight loss of 5 kg or more than 5 % of usual weight should prompt efforts to diagnose the underlying disorder or social circumstance. Weight loss alone does not distinguish the composition of tissue loss, which can range from 25 to 30 % lean tissue in semistarvation to 50 % lean tissue loss following starvation plus injury. Therefore, unintentional weight loss of more than 5 kg indicates a need for thorough nutritional assessment. Weight loss in excess of 10 % of usual weight should be considered to represent protein-energy malnutrition that will impair physiologic function, particularly muscle strength and endurance. Weight loss in excess of 20 % should be considered severe proteinenergy malnutrition that will substantially impair most organ systems. If major elective surgery is planned, such individuals would benefit from adequate feeding preoperatively. If radiotherapy is planned, adequate feeding during therapy with the use of supplemental formulas, tube feeding, or parenteral nutrition (in that order) is indicated.

Parçanın beşinci cümlesinde geçen "will substantially impair" ifadesinin Türkçe karşılığı aşağıdakilerden hangisidir?

• Ciddi biçimde bozacak
• Sonunda etkileyecek
• Kesinlikle ulaşacak
• İlişkili bulunacak
• Temelden sarsacak

A recent unintended weight loss of 5 kg or more than 5 % of usual weight should prompt efforts to diagnose the underlying disorder or social circumstance. Weight loss alone does not distinguish the composition of tissue loss, which can range from 25 to 30 % lean tissue in semistarvation to 50 % lean tissue loss following starvation plus injury. Therefore, unintentional weight loss of more than 5 kg indicates a need for thorough nutritional assessment. Weight loss in excess of 10 % of usual weight should be considered to represent protein-energy malnutrition that will impair physiologic function, particularly muscle strength and endurance. Weight loss in excess of 20 % should be considered severe proteinenergy malnutrition that will substantially impair most organ systems. If major elective surgery is planned, such individuals would benefit from adequate feeding preoperatively. If radiotherapy is planned, adequate feeding during therapy with the use of supplemental formulas, tube feeding, or parenteral nutrition (in that order) is indicated.

Parçanın altıncı cümlesindeki "such individuals" ifadesi aşağıdaki gruplardan hangisi için kullanılmıştır?

• Hızla kilo veren sağlıklı kişiler
• Damardan beslenmek zorunda olanlar
• % 20’den fazla kilo kaybı olanlar
• Yeterli protein alamayanlar
• Beslenme bozukluğu dışındaki nedenlere bağlı olarak kilo kaybedenler

Alzheimer’s disease, the leading cause of senile dementia, is characterized by a selective neuronal degeneration affecting the hippocampus resulting in progressive memory loss, impairments in behavior, language and visual-spatial skills, and ultimately, death. Despite a multitude of studies aimed at forestalling the progression and onset of Alzheimer’s disease, current therapeutic management strategies for patients with Alzheimer’s disease have been limited to palliative treatment of symptoms. Unfortunately, this approach has only met with minimal success and, even with state of the art pharmaceutical intervention, continued and progressive cognitive decline in patients is inevitable. To date, the major obstacle in managing the disease and designing a rationale for therapeutic targets is our incomplete understanding of the pathogenesis of the disease.

Parçada, Alzheimer hastalığıyla ilgili olarak aşağıdakilerden hangisi söylenmemektedir?

• Yaşlılık bunamasının önde gelen nedenidir.
• Hipokampus dışındaki diğer kortikal beyin kısımlarını etkiler.
• Sinir hücrelerinin dejenerasyonu ile karakterizedir.
• Bilişsel bozulma ilerleyicidir.
• Konuşma yetisinin bozulmasına sebep olur.

Alzheimer’s disease, the leading cause of senile dementia, is characterized by a selective neuronal degeneration affecting the hippocampus resulting in progressive memory loss, impairments in behavior, language and visual-spatial skills, and ultimately, death. Despite a multitude of studies aimed at forestalling the progression and onset of Alzheimer’s disease, current therapeutic management strategies for patients with Alzheimer’s disease have been limited to palliative treatment of symptoms. Unfortunately, this approach has only met with minimal success and, even with state of the art pharmaceutical intervention, continued and progressive cognitive decline in patients is inevitable. To date, the major obstacle in managing the disease and designing a rationale for therapeutic targets is our incomplete understanding of the pathogenesis of the disease.

Parçada, Alzheimer hastalığının aşağıdakilerden hangisine yol açtığı söylenmemektedir?

• Ölüm
• İlerleyici hafıza kaybı
• Görsel-uzaysal yetilerde bozulma
• İşitsel işlev kaybı
• Davranış bozukluğu

Alzheimer’s disease, the leading cause of senile dementia, is characterized by a selective neuronal degeneration affecting the hippocampus resulting in progressive memory loss, impairments in behavior, language and visual-spatial skills, and ultimately, death. Despite a multitude of studies aimed at forestalling the progression and onset of Alzheimer’s disease, current therapeutic management strategies for patients with Alzheimer’s disease have been limited to palliative treatment of symptoms. Unfortunately, this approach has only met with minimal success and, even with state of the art pharmaceutical intervention, continued and progressive cognitive decline in patients is inevitable. To date, the major obstacle in managing the disease and designing a rationale for therapeutic targets is our incomplete understanding of the pathogenesis of the disease.

Parçada, hastalığın tedavisiyle ilgili olarak aşağıdakilerden hangisi söylenmektedir?

• Sadece belirtilerin düzeltilmesi, başarı olarak kabul edilmemelidir.
• Tedaviyle, sınırlı da olsa hastalığın iyileşmesi olanaklıdır.
• Mevcut tedavi yaklaşımları, belirtilerin hafifletilmesi ile sınırlıdır.
• Uygulanan tedavi yaklaşımları, eczacılığın sanatsal yönüne bir örnektir.
• Önemli olan, tedavi hedeflerini iyi saptayabilmektir.

Alzheimer’s disease, the leading cause of senile dementia, is characterized by a selective neuronal degeneration affecting the hippocampus resulting in progressive memory loss, impairments in behavior, language and visual-spatial skills, and ultimately, death. Despite a multitude of studies aimed at forestalling the progression and onset of Alzheimer’s disease, current therapeutic management strategies for patients with Alzheimer’s disease have been limited to palliative treatment of symptoms. Unfortunately, this approach has only met with minimal success and, even with state of the art pharmaceutical intervention, continued and progressive cognitive decline in patients is inevitable. To date, the major obstacle in managing the disease and designing a rationale for therapeutic targets is our incomplete understanding of the pathogenesis of the disease.

Parçaya göre, çalışmaların çoğunluğunda aşağıdakilerden hangisinin amaçlandığı ileri sürülmektedir?

• Hastalığın başlamasının ve ilerlemesinin önlenmesi
• Patogenezin aydınlatılması
• Tedavi yaklaşım stratejilerinin belirlenmesi
• Mortalite ve morbiditenin azaltılması
• Bilişsel bozukluklar arasında Alzheimer hastalı- ğının görülme sıklığının azaltılması

Alzheimer’s disease, the leading cause of senile dementia, is characterized by a selective neuronal degeneration affecting the hippocampus resulting in progressive memory loss, impairments in behavior, language and visual-spatial skills, and ultimately, death. Despite a multitude of studies aimed at forestalling the progression and onset of Alzheimer’s disease, current therapeutic management strategies for patients with Alzheimer’s disease have been limited to palliative treatment of symptoms. Unfortunately, this approach has only met with minimal success and, even with state of the art pharmaceutical intervention, continued and progressive cognitive decline in patients is inevitable. To date, the major obstacle in managing the disease and designing a rationale for therapeutic targets is our incomplete understanding of the pathogenesis of the disease.

Parçaya göre, bugüne kadar hastalığın yönetimindeki en önemli engel aşağıdakilerden hangisidir?

• İlaç çeşitliliğinin yetersiz olması
• Akla yatkın bir temel hedefin belirlenememesi
• Tedavi etkinliğinin kanıtlanamamış olması
• Patogenezin tam anlaşılamamış olması
• Tanı ve tedavi yöntemlerinin çok pahalı olmaları

Because similar symptoms and rashes can occur with many other viral infections, rubella is a difficult disease to diagnose clinically except when the patient is seen during an epidemic. A history of having had rubella or rubella vaccine is unreliable; immunity should be determined by antibody testing. Particularly in its more severe forms, rubella may be confused with the mild types of scarlet fever and rubeola. Roseola infantum is distinguished by a higher fever and the appearance of the rash at the end of the febrile episode rather than at the height of the signs and symptoms. Infectious mononucleosis may have a rash but is associated with generalized lymphadenopathy and characteristic atypical lymphocytosis. Enteroviral infections accompanied by a rash can be differentiated in some instances by accompanying respiratory or gastrointestinal manifestations and the absence of retroauricular lymphadenopathy. Drug rashes may be extremely difficult to differentiate from the rash of rubella, but the characteristic enlargement of the lymph nodes strongly supports a diagnosis of rubella.

Parçaya göre, aşağıdaki hangi durum dışında, kızamıkçığı diğer viral hastalıklardan klinik olarak ayırt etmek zordur?

• Döküntü yüksek ateşe eşlik ediyorsa
• Öyküde kızamıkçık geçirildiği belirtilmişse
• Daha önce aşı yaptırılmışsa
• Çok ağır klinik tablo varlığında
• Kızamıkçık epidemisi durumunda

Because similar symptoms and rashes can occur with many other viral infections, rubella is a difficult disease to diagnose clinically except when the patient is seen during an epidemic. A history of having had rubella or rubella vaccine is unreliable; immunity should be determined by antibody testing. Particularly in its more severe forms, rubella may be confused with the mild types of scarlet fever and rubeola. Roseola infantum is distinguished by a higher fever and the appearance of the rash at the end of the febrile episode rather than at the height of the signs and symptoms. Infectious mononucleosis may have a rash but is associated with generalized lymphadenopathy and characteristic atypical lymphocytosis. Enteroviral infections accompanied by a rash can be differentiated in some instances by accompanying respiratory or gastrointestinal manifestations and the absence of retroauricular lymphadenopathy. Drug rashes may be extremely difficult to differentiate from the rash of rubella, but the characteristic enlargement of the lymph nodes strongly supports a diagnosis of rubella.

Parçada, aşağıdakilerden hangisi kızamıkçığın karışabileceği hastalıklar arasında sayılmamıştır?

• Kızamık
• Kızıl
• Su çiçeği
• İlaç döküntüleri
• İnfeksiyöz mononükleoz

Because similar symptoms and rashes can occur with many other viral infections, rubella is a difficult disease to diagnose clinically except when the patient is seen during an epidemic. A history of having had rubella or rubella vaccine is unreliable; immunity should be determined by antibody testing. Particularly in its more severe forms, rubella may be confused with the mild types of scarlet fever and rubeola. Roseola infantum is distinguished by a higher fever and the appearance of the rash at the end of the febrile episode rather than at the height of the signs and symptoms. Infectious mononucleosis may have a rash but is associated with generalized lymphadenopathy and characteristic atypical lymphocytosis. Enteroviral infections accompanied by a rash can be differentiated in some instances by accompanying respiratory or gastrointestinal manifestations and the absence of retroauricular lymphadenopathy. Drug rashes may be extremely difficult to differentiate from the rash of rubella, but the characteristic enlargement of the lymph nodes strongly supports a diagnosis of rubella.

Parçaya göre, rozeola infantumda kızamıkçıktan farklı olarak aşağıdaki özelliklerden hangisi bulunur?

• Laboratuarda kan bulguları farklıdır.
• Döküntüler ateşli dönemden önce oluşur.
• Döküntüler bulgu ve belirtilerin en şiddetli olduğu dönemle eş zamanlıdır.
• Döküntülerin vücuttaki dağılımları farklıdır.
• Vücut sıcaklığı daha yüksektir.

Because similar symptoms and rashes can occur with many other viral infections, rubella is a difficult disease to diagnose clinically except when the patient is seen during an epidemic. A history of having had rubella or rubella vaccine is unreliable; immunity should be determined by antibody testing. Particularly in its more severe forms, rubella may be confused with the mild types of scarlet fever and rubeola. Roseola infantum is distinguished by a higher fever and the appearance of the rash at the end of the febrile episode rather than at the height of the signs and symptoms. Infectious mononucleosis may have a rash but is associated with generalized lymphadenopathy and characteristic atypical lymphocytosis. Enteroviral infections accompanied by a rash can be differentiated in some instances by accompanying respiratory or gastrointestinal manifestations and the absence of retroauricular lymphadenopathy. Drug rashes may be extremely difficult to differentiate from the rash of rubella, but the characteristic enlargement of the lymph nodes strongly supports a diagnosis of rubella.

Parçada lenf nodları ile ilgili olarak aşağıdakilerden hangisi söylenmemektedir?

• İlaca bağlı döküntülerde lenf nodları büyümez.
• Döküntülü hastalıklarda lenfadenopati daima ilk bulgudur.
• Kızamıkçıkta karakteristik olarak lenf nodları büyümüştür.
• Enteroviral enfeksiyonlarda kulak arkasında lenfadenopati görülmez.
• İnfeksiyöz mononükleozda yaygın lenfadenopati vardır.

Because similar symptoms and rashes can occur with many other viral infections, rubella is a difficult disease to diagnose clinically except when the patient is seen during an epidemic. A history of having had rubella or rubella vaccine is unreliable; immunity should be determined by antibody testing. Particularly in its more severe forms, rubella may be confused with the mild types of scarlet fever and rubeola. Roseola infantum is distinguished by a higher fever and the appearance of the rash at the end of the febrile episode rather than at the height of the signs and symptoms. Infectious mononucleosis may have a rash but is associated with generalized lymphadenopathy and characteristic atypical lymphocytosis. Enteroviral infections accompanied by a rash can be differentiated in some instances by accompanying respiratory or gastrointestinal manifestations and the absence of retroauricular lymphadenopathy. Drug rashes may be extremely difficult to differentiate from the rash of rubella, but the characteristic enlargement of the lymph nodes strongly supports a diagnosis of rubella.

Parçada, kızamıkçık için antikor testi aşağıdaki durumlardan hangisinde önerilmektedir?

• Kızamıkçık geçirmiş olana aşı uygulandığında
• Önceden kızamıkçık geçirme öyküsü olmadığında
• Hamilelerde her çeşit döküntülü hastalıkta
• Hastalığa karşı bağışıklığın araştırılmasında
• Yapılan aşının etkinliği konusunda şüpheler olduğunda