Questions 1-7
Choose NO MORE THAN THREE WORDS from the passage to fill the blanks in the following questions.
Questions 8-13
Answer the following questions and mention the passage numbers in blanks like 1 2 3 4 5 6 7 8 9 10.
Thalidomide’s Return
1. Bundled in a stark white hospital blanket, Rafael looks like any other month-old baby. But when his mother, Lucienc Das Dores, unwraps the snug cover, the sight is shocking: Rafael has no arms or legs. “I got very upset and started to cry when I first saw him,” says Das Dores, 23, a part-time cleaning woman who lives in Belo Horizonte, Brazil. “When I saw him with only a head and a torso. I was devastated. I wanted to kill myself.” She could not help feeling guilty: unaware that she might hurt her baby, she had taken the powerful sedative thalidomide during her pregnancy.
2. Her story is a flashback to an old nightmare. Yes, Das Dores took the some medication that made headlines 33 years ago when it produced 12,000 severely deformed children around the world. But while the word thalidomide became synonymous with tragedy and its use as a sleeping pill was banned, the drug did not disappear. In fact, it has benefits that have made it an increasingly valuable medicine when used carefully. Misuse, however, has caused a grim side-effect: the reappearance of “thalidomide babies.”
3. Trouble strikes when patients don’t know about thalidomide’s dark side — and when those selling and dispensing the drug don’t give adequate warning. Although the US has strict rules governing thalidomide’s use, controls are much laxer in some other parts of the world. The consequences are now apparent in Brazil, which has at least 46 new instances of birth defects caused by thalidomide. If there are cases in other countries, they haven’t received the same publicity, but given the increasing use of the drug, health officials fear that the problem will be widespread.
4. A few years after the initial thalidomide disaster, researchers discovered that the drug has an almost miraculous ability to treat complications of leprosy. Then they learned they could use it against some of the potentially fatal side-effects of bone-marrow surgery. The past year has brought reports that the drug may help fight tuberculosis, a common cause of blindness called macular degeneration and even AIDS.
5. Brazil is one of the largest producers of thalidomide because it is home to perhaps 300,000 people who suffer from leprosy. About 30,000 of them take the drug to soothe the excruciating pain and eradicate the lesions that occur in severe cases of the infection. The only alternative treatment, corticosteroids, does not work as quickly or as completely. “The pain was so great that I couldn’t walk,” says Irani, 24, a former patient at the Santa Isabel leper colony. “I almost died. Thalidomide was my salvation."
6. Irani was lucky to have a doctor who cared enough to take precautions. They administered the drug only after putting her in a hospital, where they could make sure she did not become pregnant. But some doctors give out prescriptions without telling patients of the danger, much less keeping them under observation. In other cases, the patients who are often poor and barely literate, ignore or misunderstand what they are being told.
7. Greed also comes into play. Although only two companies are authorized to produce the drug in Brazil, several underground laboratories reportedly sell it to people without a prescription. Health authorities shut down on illicit operation last year, after a TV-news crew showed how easy it was to buy the pills.
8. The resurgence of birth defects is especially painful for members of Brazil’s first thalidomide generation, born around 1960. They believe the government has not done enough to warn women and have started their own education campaign. “People still believe this kind of thing is God’s punishment or even a side-effect of leprosy," says Rosangela Nascimento, head of the Thalidomide Victims Association.
9. In the meantime, US scientists are trying to find out more about how thalidomide works. They have learned that the drug, besides having sedative effects, blocks two important processes in the body. The first involves the production of a substance called tumor necrosis factor, or TNF, which fights both malignant cells and infections. But if too much TNF is produced, as apparently happens in leprosy, AIDS and tuberculosis, the body makes itself sicker. The second process stymied by thalidomide is the creation of new blood vessels, which is crucial to the development of arms and legs in the fetus. The eventual goal of researchers is to alter thalidomide somehow so that it continues to inhibit TNF without harming nascent arteries and veins.
10. Such efforts will be of little comfort to the families of children like Rafael. Until thalidomide is made safe, governments will have no choice but to regulate the drug tightly and publicize its perils.
Another kind of medicine used to treat leprosy is .
Brazil is one of the largest producers of thalidomide because there is a large number of cases.
Thalidomide can lead to severe .
Thalidomide was originally used for its effects.
Too much TNF in a patient's body makes him/her feel .
Lepers take thalidomide to .
Thalidomide stymies the of new blood vessels.
Which paragraph says that thalidomide is a multi-function drug?
Which paragraph explains how thalidomide works?
Which two paragraphs mention how some Brazilians may obtain thalidomide?
Which two paragraphs indicate that it is governments' responsibility to let people realize how serious the side-effects of thalidomide can be?
AI explanationShows the answer. Tap to open.
Question Focus: Finding an alternative treatment for leprosy mentioned in the passage
Correct Answer: corticosteroids
Why this is correct: The note says "Another kind of medicine used to treat leprosy", and the passage clearly states "The only alternative treatment, corticosteroids". You must copy this exact word from the passage.
Passage Reference: The only alternative treatment, corticosteroids, does not work as quickly or as completely.
Common Mistake: Students may write medicine or alternative treatment, but these are not the specific word used in the passage. You must copy the exact term. This is a synonym trap.
Paraphrasing: Passage: "alternative treatment" = Summary: "another kind of medicine"
Tips: When the question asks for a name, copy the exact medical term from the passage.
Key Vocabulary:
- alternative = another option
- treatment = medical care
Question Focus: Identifying the disease connected to thalidomide production in Brazil
Correct Answer: leprosy
Passage Reference: Brazil is one of the largest producers of thalidomide because it is home to perhaps 300,000 people who suffer from leprosy.
Why this is correct: The passage explains that Brazil produces a lot of thalidomide because many people "suffer from leprosy". This matches the note about a large number of cases.
Common Mistake: Some students write patients or illness, but the question asks what kind of cases. This is a partial truth trap.
Paraphrasing: Passage: "people who suffer from leprosy" = Summary: "leprosy cases"
Tips: Look for repeated ideas across sentences. Numbers often point to the key noun you need.
Key Vocabulary:
- suffer from = have
- cases = instances
Question Focus: Identifying the serious consequence of thalidomide misuse
Correct Answer: birth defects
Passage Reference: The consequences are now apparent in Brazil, which has at least 46 new instances of birth defects caused by thalidomide.
Why this is correct: The passage repeatedly mentions "birth defects" as the result of thalidomide misuse. This directly completes the sentence in the notes.
Common Mistake: Students may write side-effects or deformities, but these are not the exact words used here. This is a synonym trap.
Paraphrasing: Passage: "instances of birth defects" = Summary: "lead to severe birth defects"
Tips: If a phrase appears many times in the passage, it is often the answer.
Key Vocabulary:
- severe = very serious
- defects = physical problems
Question Focus: Original purpose of thalidomide
Correct Answer: sedative
Passage Reference: while the word thalidomide became synonymous with tragedy and its use as a sleeping pill was banned, the drug did not disappear.
Why this is correct: A sleeping pill is a sedative, and later the passage clearly says "besides having sedative effects". This shows its original use.
Common Mistake: Students may write sleeping pill, but the summary requires the adjective describing the effect. This is a grammar fit trap.
Paraphrasing: Passage: "sedative effects" = Summary: "sedative effects"
Tips: Check the words after the gap to decide the word form you need.
Key Vocabulary:
- sedative = calming
- effect = result
Question Focus: Effect of too much TNF on the body
Correct Answer: sicker
Passage Reference: . But if too much TNF is produced, as apparently happens in leprosy, AIDS and tuberculosis, the body makes itself sicker.
Why this is correct: The passage explains that when there is too much TNF, "the body makes itself sicker". The note sentence paraphrases this idea.
Common Mistake: Some students misunderstand and write weaker or ill, but you must copy the exact comparative word. This is a synonym trap.
Paraphrasing: Passage: "makes itself sicker" = Summary: "feel sicker"
Tips: Comparative words like -er are often important. Copy them exactly.
Key Vocabulary:
- sicker = more ill
- TNF = immune substance
Question Focus: Reason leprosy patients take thalidomide
Correct Answer: soothe the excruciating pain
Passage Reference: About 30,000 of them take the drug to soothe the excruciating pain and eradicate the lesions that occur in severe cases of the infection.
Why this is correct: The passage says patients take thalidomide to "soothe the excruciating pain" and also to "eradicate the lesions". Either reason is accepted.
Common Mistake: Students may write reduce pain, which changes the wording. This is a synonym trap.
Paraphrasing: Passage: "soothe the excruciating pain" = Summary: "take thalidomide to soothe pain"
Tips: If two purposes are listed, check which one best fits the word limit.
Key Vocabulary:
- soothe = calm
- excruciating = extremely painful
Question Focus: Biological process blocked by thalidomide
Correct Answer: creation
Passage Reference: . The second process stymied by thalidomide is the creation of new blood vesse
Why this is correct: The passage states that thalidomide blocks "the creation of new blood vessels". The summary copies this structure.
Common Mistake: Students may write growth or development, but these are not the exact word used. This is a synonym trap.
Paraphrasing: Passage: "creation of new blood vessels" = Summary: "stymies the creation of new blood vessels"
Tips: Abstract nouns like creation, development, production are common in FIB questions.
Key Vocabulary:
- stymies = stops
- creation = making
General Tips:
- Summary completion questions follow passage order. Use the previous answer to help you locate the next one.
- Always copy the exact word or phrase from the passage. Do not use your own synonyms.
- Check the grammar around the gap. Articles, prepositions, and "to" give strong clues.
- Keep an eye on the word limit. Extra words make the answer wrong even if the idea is correct.
- Spend about 90 seconds per question. Do not get stuck on one gap.
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