Read the passage and mark the letter A, B, C or D on your answer sheet to indicate the best answer to each of the following questions from 2...

Read the passage and mark the letter A, B, C or D on your answer sheet to indicate the best answer to each of the following questions from 27 to 34.

        In UVA’s labyrinthine labs, researchers probe how the gut’s microbial makeup modulates cancer trajectories. By perturbing mice with antibiotics to induce dysbiosis, they observe shifts in immune signaling and metastatic behavior. The team treats the microbiome as a barometer of environment, diet, and stressors, arguing that clinical insight must account for these contextual textures. Although many variables complicate causality, the aim is pragmatic: translate basic findings into preventive strategies and gentler therapeutics that attenuate metastasis while respecting patient-specific physiology.

        Personalized medicine marries genetic, environmental, and lifestyle data to steer prevention and care. In oncology, targeted therapies and immunotherapy have sharpened efficacy and spared patients blunt, exhausting regimens. Over recent decades, clinicians have moved away from a monolithic template toward treatments calibrated to a patient’s molecular profile. Teams now stratify tumors by driver mutations to forecast prognosis and select interventions with greater precision, helping explain steep mortality declines in certain cancers such as melanoma, and advancing beyond the “one-size-fits-all” orthodoxy in clinical decision-making.

        Pharmacogenomics extends personalization beyond cancer by aligning drug choice and dose with inherited variation in metabolism, transport, and immune response. A simple swab can reveal markers indicating toxicity risks or likely nonresponse, guiding safer dosing or alternatives. Crucially, pharmacogenomic testing – it primarily concerns genes mediating drug handling rather than predicting untreatable diseases – now has guideline support for 26 gene–drug pairs. While broadly nascent outside academic centers, the approach reduces adverse events when small dosing errors would otherwise prove perilous.

        The research frontier is lively but uneven. The FDA has authorized a genetic test (Dec 2023) to flag elevated risk of opioid use disorder after surgery, and large initiatives – such as Mount Sinai’s plan to sequence one million diverse patients – promise richer datasets. Yet gaps persist: most genomic studies over-sample people of European ancestry, blunting generalizability, and health systems struggle with equitable delivery of high-end technologies at scale. Progress thus hinges on diversity, infrastructure, and pragmatic pathways to access.

(Adapted from AAMC, “Making medicine personal: Moving away from a one-size-fits-all approach to health care,” Feb 22, 2024)

Question 27. The word nascent in paragraph 3 is OPPOSITE in meaning to ______.

A. budding                B. incipient                        C. mature                        D. embryonic

Question 28. Which of the following is TRUE according to paragraph 1?

A. The researchers proved that diet alone eliminates metastasis in human patients.

B. The microbiome is treated as irrelevant noise rather than a clinical clue.

C. Antibiotics are used in mice to disturb gut bacteria and observe metastatic changes.

D. The team avoids translating basic science into preventive strategies.

Question 29. The word it in paragraph 3 refers to ______.

A. inherited variation                                        B. pharmacogenomic testing

C. drug toxicity                                        D. a dosing error

Question 30. Which of the following best paraphrases the underlined sentence in paragraph 2?
A. In recent years, medical practice has transitioned from standardized protocols toward more individualized therapeutic approaches.

B. Medicine has pivoted from uniform regimens to precisely adjusted therapies based on each patient’s biology.

C. Physicians increasingly abandon one-size-fits-all strategies in favor of treatments tailored to genetic and biological factors.

D. Recent decades have witnessed a shift from generalized treatment models to precision therapies guided by patient-specific data.

Question 31. The word orthodoxy in paragraph 2 can be best replaced by ______?

A. innovation                B. doctrine                        C. deviation                        D. anomaly

Question 32. Which of the following is NOT mentioned in paragraph 4 as a challenge to advancing personalized medicine?

A. Privacy concerns about storing whole-genome data in electronic records across institutions

B. Over-representation of European-ancestry cohorts limiting generalizability of findings

C. Difficulty delivering sophisticated technologies equitably at a broad health-system scale

D. The need for more diverse, large-scale sequencing initiatives to enrich datasets

Question 33. Which paragraph mentions guideline support for a specific number of gene–drug interactions?
A. Paragraph 1        B. Paragraph 3                C. Paragraph 2                D. Paragraph 4

Question 34. Which paragraph mentions the role of immunotherapy and targeted therapy in improved outcomes?

A. Paragraph 2        B. Paragraph 1                C. Paragraph 3                D. Paragraph 4