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标题: GWD-24-Q 22:脚裸拍X-Ray,仍旧支持答案为B [打印本页]

作者: 罗马青年    时间: 2007-6-22 00:01
标题: GWD-24-Q 22:脚裸拍X-Ray,仍旧支持答案为B

CD-V-10GWD-24-Q 22:

Often patients with ankle fractures that are stable, and thus do not

require surgery, are given follow-up x-rays because their orthopedists

are concerned about possibly having misjudged the stability of the frac-

ture. When a number of follow-up x-rays were reviewed, however, all

the fractures that had initially been judged stable were found to have

healed correctly. Therefore, it is a waste of money to order follow-up

x-rays of ankle fracture initially judged stable.

 

Which of the following, if true, most strengthens the argument?

A.      Doctors who are general practitioners rather than orthopedists are

less likely than orthopedists to judge the stability of an ankle frac-

ture correctly.

B.      Many ankle injuries for which an initial x-ray is ordered are revealed

by the x-ray not to involve any fracture of the ankle.

C.      X-rays of patients of many different orthopedists working in several

hospitals were reviewed.

D.     The healing of ankle fractures that have been surgically repaired is

always checked by means of a follow-up x-ray.

E.      Orthopedists routinely order follow-up x-rays for fractures of bone

other than ankle bones.

我的理解:

脚裸有问题去医院——>来了就拍第1次X ——>治疗直至愈合 ——>医生担心是否真的愈合,再拍X核实——>如没愈合则要做手术

B加强:一些脚裸受伤的患者,在1次拍X就发现没有任何骨折。这样就连骨折愈合的问题也不用考虑,医生又何来担心是否骨折愈合的必要呢?!这种担心就没必要了!这部分连骨折都没发生的,人家也许就是脚裸走路崴了,小伤而已,第1次拍X就发现没骨折,第2天也许就屁颠屁颠地满地跑了!脚裸有问题也要分清是轻伤还是重伤至骨折了,我第1次X就检查没骨折,何来骨折是否愈合的问题呢?您的担心是多余的借口吧!呵呵!再拍第2次X,纯粹浪费银子,属医院强制病人消费,呵呵!建议取缔浪费人民银子的行为!

这题和另一道有异曲同工之妙:警察逮捕犯人必须经过上级领导再次审批是否符合标准,但发现每次都符合,于是有人建议取消这道审批手续。但那题问的是weaken。

而本题则是分清原因,具体原因具体分析,而不是一刀切,都要第2次拍X。有点马列主义的味道,呵呵!

 


作者: jandjshi    时间: 2007-6-22 04:06

Look at the first sentence: Often patients with ankle fractures that are stable, and thus do not require surgery, are given follow-up x-rays because their orthopedists are concerned about possibly having misjudged the stability of the fracture. The subject of this question is clearly“patient with ankle fractures”.

B is talking about patients without any fracture of the ankle. We don’t know whether these patients will receive a second X-ray. So B is irrelevant


作者: 罗马青年    时间: 2007-6-22 12:43

谢谢jandjshi的建议,非常好的提醒。主要是这道题目的C选项,自己困惑很久,从 X-rays of……several hospitals were reviewed.这个角度加强?

 

我对C的困惑:几家医院医生拍的X-rays were reviewed, C选项并没说这些reviewed的结果是什么?结果有2种可能:第1种可能:reviewed结果显示病人的骨折成功愈合,则加强原结论;但在C中并没有给出reviewed的结果,如果是第2种可能:reviewed以后查出没有成功愈合呢?则削弱原结论,因为reviewed的结果告诉医生该病人需要继续手术,这样follow-up X-rays对医生病人都是必须了,不能取消。

 

除非C说:X-rays……. were reviewed and indicated that the fractures that had initially been judged stable were found to have healed correctly
            
才能加强原结论。

 

另外:查了微软百科:common problems of the ankle,

…..Other acute injuries require more time to heal, sometimes as long as five or six months. These may include injuries to the musculoskeletal system—especially to the knees and ankles—such as bone fractures, tears in ligaments and tendons, sprains, and muscle strains. These types of athletic injuries typically result from twisting, such as when a gymnast lands improperly, tearing ligaments in the ankle, or from lateral force, such as the blows to the side of the knee commonly sustained by football and basketball players.

 

Injuries
            
包括
            
fractures
            

            
其他状况.

 

ankle injuries 包含了ankle fractures
            
这种状况和其他状况。
            
如果有些ankle injuries 在第1次拍X时,被判断没有出现骨折;那其后医生就没有必要担心“骨折是否愈合”的问题,因而有些ankle injuries不用第2次拍片。这是从ankle injuries这个大范围来strengthen(因为本题不是support题,是否可以考虑从大范围来加强呢?)。

 

困惑。。。。。。想出病来了,呵呵!无论如何,谢谢你的建议啊!


作者: gonghao    时间: 2007-6-22 22:02

C说明文章说的a number of follow-up x-rays were reviewed, however, all the fractures that had initially been judged stable were found to have healed correctly.是有代表性的

B是有问题的:看看文章的结论:Therefore, it is a waste of money to order follow-up
                x-rays of ankle fracture initially judged stable.  B说initial x-ray 很多都是没有骨折的,和结论的关系不大。无关了。


作者: 罗马青年    时间: 2007-6-23 00:09

谢谢gonghao!

每天在讨论帖里看到你、mindfree,lawyer,ethyl等的讨论,就像翻开老照片一样有种回到校园的感觉,这种氛围是每一个CDer珍惜感动的。

只有更加努力了,呵呵!


作者: 罗马青年    时间: 2007-8-21 12:39
这题8月考了,XDJM别和我犯一样的错!
作者: smartsky11    时间: 2009-3-15 12:28

作者: jasonleo    时间: 2009-7-25 20:13

这题有点诡异


作者: vickeysa    时间: 2009-7-26 21:37

UP


作者: laura466    时间: 2009-7-27 00:50
up
作者: gundam00    时间: 2009-7-30 03:16

作者: angusco    时间: 2010-4-22 17:13
up
作者: kaikaichen    时间: 2010-9-6 10:58
感觉是这样解释的:如果这个情况只发生在个别医院或个别医生身上,有可能是因为这些医院和医生的医术高超,判断准确,后续x-ray和最初诊断的结论一致。如果换了个医院或医生,也许他们就没那么高明,后续x-ray检查就是必要的

C就是排除这种可能,说明这是一种普遍情况
作者: 双鱼游    时间: 2010-9-25 20:07


作者: 大过天的跟班    时间: 2011-3-23 23:17
丿up
作者: 脏兮兮    时间: 2012-6-4 19:34
我觉得B是错的
第一  “many”指的是许多病人,而题干是说“所有” stable的病人都correctly治愈了才说xray浪费。因此不能加强
第二   题干的是被判定为stable的病人没必要做。而B中说的是ankle injuries而不是被判定为stable的病人,样本不同。
C选项是在说证据有效!从而说明题干的情况不是特殊情况
作者: Vivian1091    时间: 2013-8-2 15:08
http://forum.chasedream.com/thread-848982-1-1.html




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