Vitamin C Deficiency: Texts: Text A

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Vitamin C Deficiency: Texts

Text A

Scurvy is a life-threatening condition due to dietary vitamin C deficiency.


Those affected are mostly refugees or victims of famine, alcoholics, older
people, fad dieters, or children with autism or idiosyncratic behavioural
abnormalities. Diagnosis is often delayed due to incomplete review of dietary
history.

Vitamin C deficiency may result from a diet deficient in fresh fruits and
vegetables. Also, cooking can destroy some of the vitamin C in food.

The following conditions can significantly increase the body’s requirements for
vitamin C and the risk of vitamin C deficiency:

Pregnancy
Breastfeeding
Disorders that cause a high fever or inflammation
Diarrhoea that lasts a long time
Surgery
Burns
Smoking, which increases the vitamin C requirement by 30%

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Vitamin C Deficiency: Texts

Text B

The recommended daily intake of vitamin C varies by age, gender, pregnancy,


lactation, and smoking status.

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Vitamin C Deficiency: Texts
Text C

Symptoms

The symptoms of scurvy develop only after a few months of deficiency.

Adults feel tired, weak, and irritable. They may lose weight and have vague muscle and
joint aches.

Bleeding may occur under the skin (particularly around hair follicles or as bruises), around
the gums, and into the joints. The gums become swollen, purple, and spongy. The teeth
eventually loosen. The hair becomes dry and brittle, and the skin becomes dry, rough, and
scaly. Fluid may accumulate in the legs. Anaemia may develop. Infections may develop, and
wounds do not heal.

Infants may be irritable, have pain when they move, and lose their appetite. Infants do not
gain weight as they normally do. In infants and children, bone growth is impaired, and
bleeding and anaemia may occur.

Normal examination has also been reported, presumably when symptoms have
developed in the setting of very low but not critical body stores.

Examination

Although no consistent order of presenting signs is established, the earliest signs of scurvy
are often gingival abnormalities, and a comprehensive examination of the mouth when
scurvy is recommended in patients presenting relatively early.

If the test is available, measuring the vitamin C level in blood can help establish diagnosis.

Blood tests to check for anaemia.

In children, x-rays to check for impaired bone growth.

Treatment

For scurvy in adults, ascorbic acid 100 to 500 mg orally twice daily must be given for 1 to
2 weeks, until signs disappear, followed by a nutritious diet supplying 1 to 2 times the daily
recommended intake of fresh fruits and vegetables.

In scurvy, therapeutic doses of ascorbic acid restore the functions of vitamin C in a few days.
The symptoms and signs usually disappear over 1 to 2 weeks. Chronic gingivitis with
extensive subcutaneous haemorrhage persists longer.

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Vitamin C Deficiency: Texts

Text D

VITAMIN C EXCESS AND TOXICITY

High doses of vitamin C are usually not toxic to healthy adults. Occasionally, higher doses
cause nausea or diarrhoea and interfere with the interpretation of some blood test results.

Some people take high doses of vitamin C because it is an antioxidant, which protects cells
against damage by free radicals. Free radicals are thought to contribute to many disorders,
such as atherosclerosis, cancer, lung disorders, the common cold, eye cataracts, and
memory loss. Whether taking high doses of vitamin C protects against or has any beneficial
effect on these disorders is unclear. Evidence of a protective effect against cataracts is
strongest.

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OET ONLINE – READING
TEST 5
A5
Part A
TIME: 15 minutes

Vitamin C Deficiency: Questions

Questions 1 - 7
For each of the questions, 1 - 7, decide which text (A, B, C, or D) the information comes from. You may use any
letter more than once.

In which text can you find information about

1) the types of people usually affected by scurvy? _______


2) the physical effects of scurvy? _______
3) tests that can be conducted to check for scurvy? _______
4) adequate intake totals for vitamin C each day? _______
5) the effects of taking high doses of vitamin C? _______
6) conditions that increase a person’s need for vitamin C? _______
7) recovery time for a patient suffering from scurvy? _______

Information text
Questions 8 - 13
Complete each of the sentences, 8 - 13, with a word or short phrase from one of the texts.
Each answer may include words, numbers, or both.

8- Scurvy takes only a _________________of deficiency to develop.


9- In infants and children, _________________and anaemia may be present.
10- Incomplete review of dietary history frequently results in diagnosis
being _________________.
11- RDA sufficiently meets the vitamin C requirements in _________________of patients.
12- 75mg of vitamin C daily is recommended for women who are_________________.
13- It takes only a few days' worth of _________________ for the normal functions of vitamin
C to return.

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Questions 14 - 20
Answer each of the questions, 14 - 20, with a word or short phrase from one of the texts.
Each answer may include words, numbers or both.

14- What is frequently seen as an early indication of scurvy?


________________________________________________
15- What can occur in the gums, joints and under the skin of a patient with scurvy?
________________________________________________
16- How many extra milligrams each day of vitamin C does a smoker require?
________________________________________________
17- What increases the need for vitamin C by 30%?
________________________________________________
18- What is the maximum amount of vitamin C per day that should be given to infants?
________________________________________________
19- What do high levels of vitamin C protect cells from?
________________________________________________
20- Which condition is most likely to benefit from higher levels of vitamin C?
________________________________________________

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B5

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C5.1

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C5.2

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OET ONLINE TEST 5
ANSWER
----------------------------------------------------
Part A
1. A
2. C
3. C
4. B
5. D
6. A
7. C

-----------------------------------------------------------------------
8-few months
9-Bleeding
10-Delayed
11-97% to 98%
12-not pregnant
13-ascorbic acid

-----------------------------------------------------------------------------
14-gingival abnormalities
15-bleeding
16-35 mg
17- smoking
18-not determined
19-free radicals
20-cataracts

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Part B
1. C
2. B
3. B
4. A
5. B
6. A

Part C.1
1. B
2. C
3. A
4. B
5. C
6. D
7. C
8. B

Part C.2
1. A
2. D
3. A
4. B
5. D
6. C
7. B
8. A
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20

OET Online Test 6

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Dengue Fever: Texts

Text A

Dengue: virus, fever and mosquitoes

Dengue fever is a viral disease spread only by certain mosquitoes – mostly Aedes aegypti or
“dengue mosquitoes” which are common in tropical areas around the world.

There are four types of the dengue virus that cause dengue fever – Dengue Type 1, 2, 3 and 4. People
become immune to a particular type of dengue virus once they’ve had it, but can still get sick from the
other types of dengue if exposed. Catching different types of dengue, even years apart, increases the
risk of developing severe dengue. Severe dengue causes bleeding and shock, and can be life
threatening.

Dengue mosquitoes only live and breed around humans and buildings, and not in bush or rural areas.
They bite during the day – mainly mornings and evenings. Dengue mosquitoes are not born with
dengue virus in them, but if one bites a sick person having the virus in their blood, that mosquito can
pass it on to another human after about a week. This time gap for the virus to multiply in the mosquito
means that only elderly female mosquitoes transmit dengue fever. The mosquitoes remain infectious for
life, and can infect several people. Dengue does not spread directly from person to person.

Text B

Signs and Symptoms

Classic dengue fever, or “break bone fever,” is characterised by acute onset of high fever 3–14 days after
the bite of an infected mosquito. Symptoms include frontal headache, retro-orbital pain, myalgias,
arthralgias, hemorrhagic manifestations, rash, and low white blood cell count. The patient also may
complain of weight loss and nausea. Acute symptoms, when present, usually last about 1 week, but
weakness, malaise, and weight loss may persist for several weeks. A high proportion of dengue infections
produce no symptoms or minimal symptoms, especially in children and those with no previous history of
having a dengue infection.

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Dengue Fever: Texts

Text C

Steps to take when seeing a suspected case of dengue fever

Step 1: Notify your nearest Public Health Unit immediately upon clinical
suspicion.

Step 2: Take a comprehensive travel history and determine whether the


case was acquired overseas or locally.

Step 3: Note the date of onset of symptoms to identify the correct


diagnostic test, as suitable laboratory tests depend on when the blood
sample is collected during the illness.

• Another useful test is full blood count. Cases often have leukopenia
and/or thrombocytopenia.

The table below shows which test to order at which stage of illness:

TEST TYPE PCR NSI IgM IgG


ELISA

Days after
onset of 0-5 days 0-9 days From day 5 From day 8
symptoms onwards onwards

Step 4: Provide personal protection advice.

• The patient should stay in screened accommodation and have someone


stay home to look after them.

• The patient should use personal insect repellent particularly during


daylight hours to avoid mosquito bites.

• All household members should use personal insect repellent during


daylight hours.

• Advise family members or associates of the case who develop a fever


to present immediately for diagnosis.

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