Прочитайте текст и выполните задания Etiology of anorexia nervosa 1. The etiology of anorexia nervo...: ответ на тест 992278 - Английский язык

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                                            Etiology of anorexia nervosa
1. The etiology of anorexia nervosa is unknown but appears to involve a combination of psychological, biologic, and cultural risk factors. Risk factors, such as sexual or physical abuse and a family history of mood disturbance, are best viewed as nonspecific risk factors that increase vulnerability to a range of psychiatric disorders, including anorexia nervosa.
2. Patients who develop anorexia nervosa are inclined to be more obsessional and perfectionist than their peers. The disorder often begins as a diet not distinguishable at the outset from those undertaken by many adolescents and young women. As weight loss progresses, the fear of gaining weight grows; dieting becomes stricter; and psychological, behavioral, and medical aberrations increase.
3. Numerous physiologic disturbances, including abnormalities in a variety of neurotransmitter systems, have been described in anorexia nervosa. It is difficult to distinguish neurochemical, metabolic, and hormonal changes that may have a role in the initiation or perpetuation of the syndrome from those that are secondary to the disorder.
4. Genetic factors contribute to the risk of development of anorexia nervosa, as its incidence is greater in families with one affected member and the concordance in monozygotic twins is greater than in dizygotic twins. However, specific genes have not been identified.
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What factors contribute to the initiation of anorexia nervosa?

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                                            Etiology of anorexia nervosa
1. The etiology of anorexia nervosa is unknown but appears to involve a combination of psychological, biologic, and cultural risk factors. Risk factors, such as sexual or physical abuse and a family history of mood disturbance, are best viewed as nonspecific risk factors that increase vulnerability to a range of psychiatric disorders, including anorexia nervosa.
2. Patients who develop anorexia nervosa are inclined to be more obsessional and perfectionist than their peers. The disorder often begins as a diet not distinguishable at the outset from those undertaken by many adolescents and young women. As weight loss progresses, the fear of gaining weight grows; dieting becomes stricter; and psychological, behavioral, and medical aberrations increase.
3. Numerous physiologic disturbances, including abnormalities in a variety of neurotransmitter systems, have been described in anorexia nervosa. It is difficult to distinguish neurochemical, metabolic, and hormonal changes that may have a role in the initiation or perpetuation of the syndrome from those that are secondary to the disorder.
4. Genetic factors contribute to the risk of development of anorexia nervosa, as its incidence is greater in families with one affected member and the concordance in monozygotic twins is greater than in dizygotic twins. However, specific genes have not been identified.
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Anorexia nervosa is initiated …

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             The Dichotomy of Inpatient and Outpatient Internal Medicine
1. The hospital environment has transformed dramatically over the past few decades. In more recent times, emergency departments and critical care units have evolved to identify and manage critically ill patients, allowing them to survive formerly fatal diseases. There is increasing pressure to reduce the length of stay in the hospital and to manage complex disorders in the outpatient setting. This transition has been driven not only by efforts to reduce costs but also by the availability of new outpatient technologies, such as imaging and percutaneous infusion catheters for long-term antibiotics or nutrition, and by evidence that outcomes are often improved by minimizing inpatient hospitalization.
2. Hospitals now consist of multiple distinct levels of care, such as the emergency department, procedure rooms, overnight observation units, critical care units, and palliative care units, in addition to traditional medical beds. Clearly, one of the important challenges in internal medicine is to maintain continuity, of care and information flow during these transitions, which threaten the traditional one-to-one relationship between patient and physician.
3. In the current environment, teams of physicians, specialists, and other health care professionals have often replaced the personal interaction between doctor and patient. The patient can benefit greatly from effective collaboration among a number of health care professionals; however, it is the duty of the primary physician to provide cohesive guidance through an illness. In order to meet this challenge, the primary physician must be familiar with the techniques, skills, and objectives of specialist physicians and allied health professionals.
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                                                  The Era of Genomics
1. In the spring of 2003, the complete sequencing of the human genome was announced, officially ushering in the genomic era. Today, gene expression profiles are being used to guide therapy and inform prognosis for a number of diseases; the use of genotyping is providing a new means to assess the risk of certain diseases as well as variation in response to a number of drugs; we are understanding better the role of certain genes in the causality of certain common conditions such as obesity and allergies. Despite these advances, we are still in the infancy of understanding and utilizing the complexities of genomics in the diagnosis, prevention, and treatment of disease.
2. Our task is still complicated nowadays by the fact that phenotypes are generally determined not by genes alone but by the interplay of genetic and environmental factors. Indeed, we have just begun to scratch the surface of possibilities that the era of genomics will provide to the practice of medicine.
3. The rapidity of these advances may seem overwhelming to the practicing physician. However, he or she has an important role to play in ensuring that these powerful technologies and sources of new information are applied with sensitivity and intelligence to the patient. Since genomics is such a rapidly evolving field, physicians and other health care professionals must continue to educate themselves so that they can apply this new knowledge to the benefit of their patients' health and well-being.
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