Reading Comprehension Questions and Answers

Direction for [ Question No: 611 To 612 ] :

A fundamental principle of pharmacology is that all drugs have multiple actions. Actions that are desirable in the treatment of disease are considered therapeutic, while those that are undesirable or pose risks to the patient are called "effects." Adverse drug effects range from the trivial, e.g., nausea or dry mouth, to the serious, e.g., massive gastrointestinal bleeding or thromboembolism; and some drugs can be lethal. Therefore, an effective system for the detection of adverse drug effects is an important component of the health care system of any advanced nation. Much of the research conducted on new drugs aims at identifying the conditions of use that maximize beneficial effects and minimize the risk of adverse effects.

The intent of drug labeling is to reflect this body of knowledge accurately so that physicians can properly prescribe the drug; or, if it is to be sold without prescription, so that consumers can properly use the drug.

The current system of drug investigation in the United States has proved very useful and accurate in identifying the common side effects associated with new prescription drugs. By the time a new drug is approved by the Food and Drug Administration, its side effects are usually well described in the package insert for physicians. The investigational process, however, cannot be counted on to detect all adverse effects because of the relatively small number of patients involved in premarketing studies and the relatively short duration of the studies.

Animal toxicology studies are, of course, done prior to marketing in an attempt to identify any potential for toxicity, but negative results do not guarantee the safety of a drug in humans, as evidenced by such well known examples as the birth deformities due to thalidomide.

This recognition prompted the establishment in many countries of programs to which physicians report adverse drug effects. The United States and other countries also send reports to an international program operated by the World Health Organization. These programs, however, are voluntary reporting programs and are intended to serve a limited goal: alerting a government or private agency to adverse drug effects detected by physicians in the course of practice. Other approaches must be used to confirm suspected drug reactions and to estimate incidence rates. These other approaches include conducting retrospective control studies; for example, the studies associating endometrial cancer with estrogen use, and systematic monitoring of hospitalized patients to determine the incidence of acute common side effects, as typified by the Boston Collaborative Drug Surveillance Program.

Thus, the overall drug surveillance system of the United States is composed of a set of information bases, special studies, and monitoring programs, each contributing in its own way to our knowledge about marketed drugs. The system is decentralized among a number of governmental units and is not administered as a coordinated function. Still, it would be inappropriate at this time to attempt to unite all of the disparate elements into a comprehensive surveillance program. Instead, the challenge is to improve each segment of the system and to take advantage of new computer strategies to improve coordination and communication.

Direction for [ Question No: 613 To 616 ] :

The classical realist theory of international relations has long dominated both academic institutions and the American government. Even at the birth of the nation, early political thinkers, such as Alexander Hamilton, promoted a realist view of international relations and sought to influence the actions of the government based on this perspective. While the classical realist school of international relations is not entirely homogeneous in nature, there are certain premises that all classical realists share. 

The primary principle underlying classical realism is a concern with issues of war and peace. Specifically, classical realists ask, what are the causes of war and what are the conditions of peace? The members of the classical realist school mainly attribute war and conflict to what is termed the security dilemma. In the absence of any prevailing global authority, each nation is required to address its own security needs. However, each nation’s quest for security-through military buildups, alliances, or territorial defenses-necessarily unsettles other nations. These nations react to feelings of insecurity by engaging in their own aggressive actions, which leads other nations to react similarly, perpetuating the cycle.

It is important to note that for realists, unlike idealists or liberal internationalists, international conflict is a necessary consequence of the structural anarchy that nations find themselves in. Whereas other schools may see international conflict as the result of evil dictators, historical chance, flawed socio political systems, or ignorance of world affairs, classical realists see war as the logical result of a system that by its nature lacks a true central authority.

Hand in hand with this view of conflict as an inevitable condition of the global power structure is the realists’ view of the nation as a unitary actor. Because classical realists see international relations as a continuing struggle for dominance, the nation can not be viewed as a collection of individuals with disparate wants, goals, and ideologies. The realist view requires the formulation of a national interest, which in its simplest terms refers to the nation’s ability to survive, maintain its security, and achieve some level of power relative to its competitors.

Realism is not without its critics, many of whom challenge the premise that war is the natural condition of international relations or that there can be a truly national interest. However, the realist school of international relations continues to shape foreign policy because of the successes it has had in describing real world interactions between nations.

Direction for [ Question No: 617 To 620 ] :

On the surface, the conquest of the Aztec empire by Herman Cortes is one of the most amazing military accomplishments in history. With a small fighting force numbering in the hundreds, Cortes led the Spanish explorers into victory against an Aztec population that many believe topped 21 million. In light of such a seemingly impossible victory, the obvious question is: how did a small group of foreign fighters manage to topple one of the world's strongest, wealthiest, and most successful military empires?

Several factors led to Cortes' success. First, the Spanish exploited animosity toward the Aztecs among rival groups and convinced thousands of locals to fight. In one account of a battle, it is recorded that at least 200,000 natives fought with Cortes. Next, the Spanish possessed superior military equipment in the form of European cannons, guns, and crossbows, leading to effective and efficient disposal of Aztec defenses. For example, Spanish cannons quickly defeated large Aztec walls that had protected the empire against big and less technically advanced armies.

Despite the Spanish advantages, the Aztecs probably could have succeeded in defending their capital city of Tenochtitlan had they leveraged their incredible population base to increase their army's size and ensured that no rogue cities would ally with Cortes. In order to accomplish this later goal, Aztec leader Motecuhzoma needed to send envoys to neighboring cities telling their inhabitants about the horrors of Spanish conquest and the inevitability of Spanish betrayal.

In addition, the Aztecs should have exploited the fact that the battle was taking place on their territory. No reason existed for the Aztecs to consent to a conventional battle, which heavily favored the Spanish. Motecuhzoma's forces should have thought outside the box and allowed Cortes into the city, only to subsequently use hundreds of thousands of fighters to prevent escape and proceed in surprise "door-to-door" combat. With this type of battle, the Aztecs would have largely thwarted Spanish technological supremacy. However, in the end, the superior weaponry of the Spanish, the pent-up resentment of Aztec rivals, the failure of Aztec diplomacy, and the lack of an unconventional Aztec war plan led to one of the most surprising military outcomes in the past one thousand years.