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  3. Skilled clinical history-taking and physical examination remain essential as the basis of the disease diagnosis and management,

Skilled clinical history-taking and physical examination remain essential as the basis of the disease diagnosis and management,

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问题     Skilled clinical history-taking and physical examination remain essential as the basis of the disease diagnosis and management, aided by investigations such as radiological or biochemical tests. Technological advances over the past few decades mean that such investigations now can be refined, or even replaced in some cases, by the measurement of genetic or genomic biomarkers. The molecular characteristics of a disorder or the genetic make-up of an individual can fine tune a diagnosis and inform its management. These new capabilities, often termed ‘stratified (分层的) ’ or ‘personalized’ medicine, are likely to have profound effect on the practice of medicine and service delivery.
    Genetic medicine, which uses genetic or genomic biomarkers in this way, has, until recently, been the province of a small minority of specialized physicians who have used it to diagnose or assess risk of inherited disease. Recognition that most disease has a genetic component, the development and application of new genetic tests to identify important disease subsets and the availability of cost-effective interventions mean that genetic medicine must be integrated more widely across healthcare services. In order to optimize benefit equitably across the population, physicians and services need to be ready to change and adapt to new ways of working.
    Perhaps the greatest challenge is to ensure the readiness of physicians to use these genomic technologies for maximum effect, so that genetic medicine is incorporated into mainstream specialties. For some clinicians, particularly those involved in clinical research, these advances are already a reality.
    However, a sizable majority do not yet recognize the relevance of genetics for their clinical practice, perceiving genetic conditions to be rare and untreatable. Maximizing genomic opportunities also means being aware of their limitations, media portrayals that indicate that genetic information gives clear-cut answers are often unrealistic. Indeed, knowing one’s entire genomic sequence is not the crystal ball of our future that many hope it to be, and physicians will need to be more familiar with what is hype (鼓吹) and what is reality for the integration of genetics into mainstream medicine to be successful.
    Finally, both the professional and public should have a realistic view of what is possible. Although the discovery of genetic risk factors in common diseases such as heart disease and cancer has led to important insights about disease mechanisms, the predictive power of individual genetic variants is often very low. Developments in bioinformatics will need to evolve considerably before the identification of a particular combination of genetic variants in an individual will have clinical utility for them.
Which of the following statements does the author most probably agree with?
选项 A、Personalized medicine will greatly change the practice of medicine.
B、Genetic biomarkers have been largely refined over the past.
C、Physical examination remains essential in fine tuning a diagnosis.
D、Clinical history-taking is no longer important in the genetic era.
答案A
解析 细节题。第一段先简述“分层的”或者personalized(个性化的)医学，最后一句话说 “个性化医学对行医可能有着深刻的影响”，因此本题正确答案为A。
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本试题收录于： 医学博士外语题库考研分类
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