hce_nchu
112年
英文
第 35 題
📖 題組：
PASSAGE 3 Much of the research of the past few decades has examined which therapies to use and how to use them. Which medication, what does, for how long? Which procedure? What’s the benefit? These are all questions commonly asked and that can now be regularly and reliably answered. Treatment guidelines for many diseases are published, available, and regularly used. And despite concerns and lamentations about “cookbook medicine,” these guidelines, based on a rapidly growing cornerstone of evidence have saved lives. These forms of evidence-based medicine allow patients to benefit from the thoughtful application of what’s been shown to be the most effective therapy. But effective therapy depends on accurate diagnosis. We now have at our disposal a wide range of tools—new and old—with which we might now make a timely and accurate diagnosis. And as treatment becomes more standardized, the most complex and important decision making will take place at the level of the diagnosis. The patient’s story and exam suggest a likely suspect and the technology of diagnosis rapidly confirms a hunch. An elderly man with a fever and a cough has an X-ray revealing a raging pneumonia. A man in his fifties has chest pain that radiates down his left arm and up to his jaw, and an EKG (_______) or blood test bears out the suspicion that he is having a heart attack. A teenage girl on the birth control pill comes in complaining of shortness of breath and a swollen leg, and a CT (Computed Tomography) scan proves the presence of a massive pulmonary embolus. This is the **bread and butter** of medical diagnosis—cases where cause and effect tie neatly together and the doctor can almost immediately explain to patient and family whodunit, how, and sometimes even why. But then there are the other cases: patients with complicated stories or medical histories; cases where the symptoms are less suggestive, the physical exam unrevealing, the tests misleading. Cases in which the narrative of disease strays off the expected path, where the usual suspects all seem to have alibis, and the diagnosis is elusive. For these, the doctor must don his/her deerstalker cap and unravel the mystery. It is in these instances where medicine can rise once again to the level of an art and the doctor-detective must pick apart the tangled strands of illness, understand which questions to ask, recognize the subtle physical findings, and identify which tests might lead, finally, to the right diagnosis.
PASSAGE 3 Much of the research of the past few decades has examined which therapies to use and how to use them. Which medication, what does, for how long? Which procedure? What’s the benefit? These are all questions commonly asked and that can now be regularly and reliably answered. Treatment guidelines for many diseases are published, available, and regularly used. And despite concerns and lamentations about “cookbook medicine,” these guidelines, based on a rapidly growing cornerstone of evidence have saved lives. These forms of evidence-based medicine allow patients to benefit from the thoughtful application of what’s been shown to be the most effective therapy. But effective therapy depends on accurate diagnosis. We now have at our disposal a wide range of tools—new and old—with which we might now make a timely and accurate diagnosis. And as treatment becomes more standardized, the most complex and important decision making will take place at the level of the diagnosis. The patient’s story and exam suggest a likely suspect and the technology of diagnosis rapidly confirms a hunch. An elderly man with a fever and a cough has an X-ray revealing a raging pneumonia. A man in his fifties has chest pain that radiates down his left arm and up to his jaw, and an EKG (_______) or blood test bears out the suspicion that he is having a heart attack. A teenage girl on the birth control pill comes in complaining of shortness of breath and a swollen leg, and a CT (Computed Tomography) scan proves the presence of a massive pulmonary embolus. This is the **bread and butter** of medical diagnosis—cases where cause and effect tie neatly together and the doctor can almost immediately explain to patient and family whodunit, how, and sometimes even why. But then there are the other cases: patients with complicated stories or medical histories; cases where the symptoms are less suggestive, the physical exam unrevealing, the tests misleading. Cases in which the narrative of disease strays off the expected path, where the usual suspects all seem to have alibis, and the diagnosis is elusive. For these, the doctor must don his/her deerstalker cap and unravel the mystery. It is in these instances where medicine can rise once again to the level of an art and the doctor-detective must pick apart the tangled strands of illness, understand which questions to ask, recognize the subtle physical findings, and identify which tests might lead, finally, to the right diagnosis.
The phrase “bread and butter” in paragraph 4 is closest in meaning to _______.
- A negotiation
- B foundation
- C resolution
- D plantation
- E annexation
思路引導 VIP
請觀察這句話前面提到的三個具體例子：感冒引起肺炎、胸痛代表心臟病、腿腫對應肺栓塞。作者形容這些案例的特點是「因果關係緊密連結」且醫生能「立即解釋」。你認為這類案例在醫生的日常工作中，是屬於「罕見的特例」，還是「最尋常、最支撐日常運作的基本內容」呢？這種性質最接近哪一個抽象名詞？
🤖
AI 詳解
AI 專屬家教
太棒了！你能準確捕捉到 "bread and butter" 在這段醫學敘述中的引申義，代表你對文章脈絡與慣用語的掌握非常敏銳。
語境中的慣用語解析
在第四段中，作者列舉了肺炎、心臟病發作和肺栓塞等典型案例，這些病例的共同點是「病因與結果緊密相連，診斷迅速」。雖然 "bread and butter" 字面意義是奶油麵包，但在英文慣用語中，它常用來指代「基本生計」或「最核心、最基本的組成部分」。在本文脈絡下，作者是用它來形容那些標準、典型的病例，它們構成了醫療診斷中最基礎 (foundation) 且最常見的日常工作，與後段提到的「神祕且複雜」的案例形成鮮明對比。
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