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# Erythropoietin, known also as EPO, is a glycoprotein hormone that cont

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Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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Updated on: 13 Aug 2019, 22:29
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Erythropoietin, known also as EPO, is a glycoprotein hormone that controls the production of red blood cells in a process called erythropoiesis. When the kidneys detect a lack of oxygen flowing through the bloodstream, they secrete this glycoprotein, increasing the production of red blood cells, the body’s primary method of transporting oxygen to tissues and muscles. Typically a human’s hematocrit level, the percentage of red blood cells in the bloodstream, is between 40 and 45. For most adult males, a hematocrit level of less than 42 is said to be anemic, meaning that red blood cells are in dangerously low supply; this number is substantially less for women.

Synthetic EPO is used to boost low hematocrit levels in chemotherapy patients and those suffering from kidney disease, who are unable to maintain the necessary levels without frequent EPO injections. Perhaps more famously, it is also used illicitly by many endurance athletes seeking to gain a competitive advantage by artificially increasing their red blood cell count. Traditionally, athletes have trained at high altitude to achieve a similar natural effect, but today more and more have chosen to artificially boost red blood cell activity through the use of synthetic EPO.

For all its negative publicity, synthetic EPO remains a positive medical advancement to treat anemia and prevent hypoxia, the condition in which tissues are deprived of oxygen. Researchers continue to improve the effectiveness of synthetic EPO and even to develop a new glycoprotein—called novel erythropoiesis-stimulating protein (NESP) —which eliminates several drawbacks of EPO in its current form. NESP not only requires smaller doses, but also lasts longer, eliminating the need for frequent and often-painful IV administration, which can have complications. Still, unlike the natural stimulus that occurs with the release of EPO, any artificial stimulus of red blood cell production has potential risks, as it raises hemoglobin to the desired levels above 15 grams per deciliter far too quickly. The body cannot properly adjust to the quick change in blood viscosity and substantial cardiac risk results. Given that risk, synthetic EPO must be highly regulated by the FDA so that its use is limited to medical necessity, not athletic performance enhancement.

1. According to the passage, which one of the following is a challenge in using synthetic EPO to treat patients?

(A) It has to be administered more frequently and in larger doses than is ideal.
(B) It does not increase hematocrit levels as quickly as naturally occurring EPO does.
(C) It has more cardiovascular risk than other treatments.
(D) It is frequently stolen by those seeking performance enhancement.
(E) It can result in dangerously low hematocrit levels.

2. Which of the following can be inferred about training at high altitude?

(A) It is not as effective as synthetic EPO at increasing red blood cells in an athlete.
(B) It does not allow athletes to reach levels of hemoglobin above 15 grams per deciliter.
(C) It increases hemoglobin levels in an athlete more slowly than synthetic EPO does.
(D) It poses no health risks to the athlete.
(E) It does not increase the viscosity of blood to a dangerous level.

3. All of the following are potential risks of synthetic EPO except that it ______ .

(A) can raise hemoglobin levels too quickly.
(B) increases hemoglobin to levels above 15 grams per deciliter.
(C) abruptly increases blood viscosity.
(D) increases the likelihood of cardiac problems.
(E) needs to be administered frequently.

4. Which of the following can properly be inferred from the passage?

(A) Training at high altitude is safer than using synthetic EPO.
(B) A higher percentage of athletes are using performance enhancing drugs than in the past.
(C) NESP is a more effective treatment for raising hematocrit levels than synthetic EPO.
(D) NESP carries fewer risks than synthetic EPO.
(E) Kidneys have some mechanism for monitoring oxygen levels.

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Originally posted by souvik101990 on 03 Aug 2014, 09:50.
Last edited by SajjadAhmad on 13 Aug 2019, 22:29, edited 2 times in total.
Updated - Complete topic (132).
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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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04 Aug 2014, 07:36
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1
OAs posted. Thanks for participating. Here are the OEs

Q1

1. As for all detail-oriented questions, you must go back and find the necessary information to answer the question. Synthetic EPO is introduced in the second paragraph, but most of the details about how it is used come in the third paragraph. In the second and third sentences of the third paragraph, you learn that NESP eliminates several drawbacks of EPO by requiring smaller doses and less-frequent injections. Therefore, it must be true that large doses and frequent administration are challenges in using EPO (synonymous with drawbacks), so answer choice A is correct. It is easy, however, to miss this information and fall for one of the other choices. For answer choice B, the passage suggests naturally occurring EPO raises levels more slowly, not more quickly, so answer choice B is incorrect. For answer choice C, the common incorrect choice, you know that synthetic EPO has cardiovascular risk, but you do not know how that risk compares to other treatments. The statement in answer choice C may or may not be true, because this inference is far outside the scope of the passage. For answer choice D, while you know that synthetic EPO is used by athletes seeking performance enhancement, you do not know how they obtain that EPO. (Do they steal it or just get it from doctors?) For answer choice E, it is suggested that synthetic EPO helps increase low hematocrit levels, so it would be illogical to conclude that it can result in dangerously low hematocrit levels.

Q2

suspicious of any answer choice that is so categorical; it is unlikely that you could ever prove such a statement. For answer choice E, you know that the rapid increase of viscosity caused by synthetic EPO is dangerous, but you do not know anything about the risk of high viscosity on its own and whether high training raises the blood viscosity to dangerous levels. NOTE: Most difficult incorrect answer choices in Reading Comp reference something discussed in the passage but go just beyond what is inferable.

Q3

While not as difficult as the last two, this question still has its pitfalls. Most of the risks of synthetic EPO are in the third paragraph, but you may have to look in the second. Answer choice A is clearly defined as a risk of synthetic EPO, as you can see from this section: “any artificial stimulus of red blood cell production has potential risks, as it raises hemoglobin to the desired levels above 15 grams per deciliter far too quickly.” Answer choice B is the correct answer, as it is not a risk of synthetic EPO. As you can see from the italicized section above, levels above 15 are “desired,” so this is not a risk. Answer choice C addresses the same issue as answer choice A and is a well-defined risk. The cardiac risk in answer choice D is well defined in the third paragraph. However, the risk associated with answer choice E is harder to find; therefore answer choice E is the common incorrect answer choice on this problem. From the section in the second paragraph “who are unable to maintain the necessary levels without frequent EPO injections” and the section in the third paragraph that references the frequency of injections as a drawback of EPO, it is logical to infer the frequency required is a risk: If patients cannot get injections frequently their health will be compromised.

Q4

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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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01 Apr 2020, 00:12
2
varotkorn First, notice that the sentence you're citing mentions nothing about risks at all, just drawbacks, so it provides zero support for D. The subsequent sentence mentions exactly one risk--the potential for complications due to frequent IV administration. So apparently NESP reduces this one risk, but that's all we really know about it. There could be many other new risks. Perhaps it works faster and therefore raises the cardiac risk even higher. Perhaps it can interact poorly with other drugs. For all we know, it may make you burst into flame or feel a compulsive urge to insult boxing champions. My point is that we simply know nothing about the overall risks.

In general, we can never say "X is more/less than Y" just because one aspect of that difference has been addressed. If jelly beans are lower in fat than almonds, and we know that fat is bad for us, that doesn't allow us to infer that jelly beans are healthier for us than almonds.
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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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03 Aug 2014, 22:17
1
my take of the above RC is as follows :
1) A :It has to be administered more frequently and in larger doses than is ideal
2) C : It increases hemoglobin levels in an athlete more slowly than synthetic EPO does.
3) C abruptly increases blood viscosity.
4) E: Kidneys have some mechanism for monitoring oxygen levels.

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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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04 Aug 2014, 01:54
1
8 mins

1. A - It has to be administered more frequently and in larger doses than is ideal.
2. E - It does not increase the viscosity of blood to a dangerous level.
3. E - needs to be administered frequently.
4. E - Kidneys have some mechanism for monitoring oxygen levels.
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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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04 Aug 2014, 02:15
1
A, C , B and A.
1. (A) It has to be administered more frequently and in larger doses than is ideal. << In treating patients, it's an issue mentioned in last paragraph.
2. (C) It increases hemoglobin levels in an athlete more slowly than synthetic EPO does. << both provided similar effect(para 2), but artificial method quickly increases the level(para 3).
3. (B) increases hemoglobin to levels above 15 grams per deciliter. << above 15 too quickly is the cause not above 15.
4. (A) Training at high altitude is safer than using synthetic EPO. << both provides similar effect(para 2), but natural methods do not increases level above 15 as quickly. Thus training at high altitude is safer.
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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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26 Aug 2014, 06:52
1
souvik101990 wrote:
OAs posted. Thanks for participating. Here are the OEs

Q1

1. As for all detail-oriented questions, you must go back and find the necessary information to answer the question. Synthetic EPO is introduced in the second paragraph, but most of the details about how it is used come in the third paragraph. In the second and third sentences of the third paragraph, you learn that NESP eliminates several drawbacks of EPO by requiring smaller doses and less-frequent injections. Therefore, it must be true that large doses and frequent administration are challenges in using EPO (synonymous with drawbacks), so answer choice A is correct. It is easy, however, to miss this information and fall for one of the other choices. For answer choice B, the passage suggests naturally occurring EPO raises levels more slowly, not more quickly, so answer choice B is incorrect. For answer choice C, the common incorrect choice, you know that synthetic EPO has cardiovascular risk, but you do not know how that risk compares to other treatments. The statement in answer choice C may or may not be true, because this inference is far outside the scope of the passage. For answer choice D, while you know that synthetic EPO is used by athletes seeking performance enhancement, you do not know how they obtain that EPO. (Do they steal it or just get it from doctors?) For answer choice E, it is suggested that synthetic EPO helps increase low hematocrit levels, so it would be illogical to conclude that it can result in dangerously low hematocrit levels.

Q2

suspicious of any answer choice that is so categorical; it is unlikely that you could ever prove such a statement. For answer choice E, you know that the rapid increase of viscosity caused by synthetic EPO is dangerous, but you do not know anything about the risk of high viscosity on its own and whether high training raises the blood viscosity to dangerous levels. NOTE: Most difficult incorrect answer choices in Reading Comp reference something discussed in the passage but go just beyond what is inferable.

Q3

While not as difficult as the last two, this question still has its pitfalls. Most of the risks of synthetic EPO are in the third paragraph, but you may have to look in the second. Answer choice A is clearly defined as a risk of synthetic EPO, as you can see from this section: “any artificial stimulus of red blood cell production has potential risks, as it raises hemoglobin to the desired levels above 15 grams per deciliter far too quickly.” Answer choice B is the correct answer, as it is not a risk of synthetic EPO. As you can see from the italicized section above, levels above 15 are “desired,” so this is not a risk. Answer choice C addresses the same issue as answer choice A and is a well-defined risk. The cardiac risk in answer choice D is well defined in the third paragraph. However, the risk associated with answer choice E is harder to find; therefore answer choice E is the common incorrect answer choice on this problem. From the section in the second paragraph “who are unable to maintain the necessary levels without frequent EPO injections” and the section in the third paragraph that references the frequency of injections as a drawback of EPO, it is logical to infer the frequency required is a risk: If patients cannot get injections frequently their health will be compromised.

Q4

I have a question regarding Q4.
In CR we are told that inference is only things that are not explicitly written.
In this question, it's explicitly written that kidneys can detect a lack of oxygen in the bloodstream...
So I chose A.
I would appreciate if someone can address my concern.
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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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09 Aug 2014, 06:50
My pick D, C, E, E

1. According to the passage, which one of the following is a challenge in using synthetic EPO to treat patients?

(A) It has to be administered more frequently and in larger doses than is ideal.
(B) It does not increase hematocrit levels as quickly as naturally occurring EPO does.
(C) It has more cardiovascular risk than other treatments.
(D) It is frequently stolen by those seeking performance enhancement.
(E) It can result in dangerously low hematocrit levels.

2. Which of the following can be inferred about training at high altitude?

(A) It is not as effective as synthetic EPO at increasing red blood cells in an athlete.
(B) It does not allow athletes to reach levels of hemoglobin above 15 grams per deciliter.
(C) It increases hemoglobin levels in an athlete more slowly than synthetic EPO does.
(D) It poses no health risks to the athlete.
(E) It does not increase the viscosity of blood to a dangerous level.

3. All of the following are potential risks of synthetic EPO except that it ______ .

(A) can raise hemoglobin levels too quickly.
(B) increases hemoglobin to levels above 15 grams per deciliter.
(C) abruptly increases blood viscosity.
(D) increases the likelihood of cardiac problems.
(E) needs to be administered frequently.

4. Which of the following can properly be inferred from the passage?

(A) Training at high altitude is safer than using synthetic EPO.
(B) A higher percentage of athletes are using performance enhancing drugs than in the past.
(C) NESP is a more effective treatment for raising hematocrit levels than synthetic EPO.
(D) NESP carries fewer risks than synthetic EPO.
(E) Kidneys have some mechanism for monitoring oxygen levels.
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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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10 Apr 2016, 06:14
Quote:
3. All of the following are potential risks of synthetic EPO except that it ______ .

(A) can raise hemoglobin levels too quickly.
(B) increases hemoglobin to levels above 15 grams per deciliter.
(C) abruptly increases blood viscosity.
(D) increases the likelihood of cardiac problems.
(E) needs to be administered frequently.

I have a doubt regarding the option C, which explains that risk associated with Synthetic EPO is quick change in viscosity and substantial cardiac risk results. The change in viscosity gives us no information as to whether it results in increase or decrease in viscosity. How can we say C is a risk?
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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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01 Nov 2016, 01:45
souvik101990

3.
"The body cannot properly adjust to the quick change in blood viscosity". This change doesn't indicate any direction. So, how can we say it is increasing?

4.
"Researchers continue to improve the effectiveness of synthetic EPO and even to develop a new glycoprotein—called novel erythropoiesis-stimulating protein (NESP)" doesn't it mean that NESP is more effective than synthetic EPO?
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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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19 Dec 2016, 00:12
Mahmud6 wrote:
souvik101990

3.
"The body cannot properly adjust to the quick change in blood viscosity". This change doesn't indicate any direction. So, how can we say it is increasing?

4.
"Researchers continue to improve the effectiveness of synthetic EPO and even to develop a new glycoprotein—called novel erythropoiesis-stimulating protein (NESP)" doesn't it mean that NESP is more effective than synthetic EPO?

3. It can be increasing or decreasing. But we can infer that when the RBCs increase there will be an increase in viscosity not decrease. Hence we can safely infer that the viscosity increases. Even then if you have a doubt option 2 for the 3rd question only says that the Rbc levels increase by a certain number which is no where stated as risk but how fast one's body reaches that level is . Hence the correct answer will be 2.

4. As you have quoted effectiveness of the EPO is increased but no where it is stated that NESP is more effective in raising RBC levels than EPO. The author only states the advantages which includes longer effect of the injected RBCs and less frequent admission of the NESP.
When we effective it means that the drug has to perform better in increasing the RBCs and this is nowhere implied or mentioned. Hence for these reasons option 3 cannot be inferred.
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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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06 Jun 2018, 03:59
Having queries reagarding question 3 and 4 -
for question 3- ' The body cannot properly adjust to the quick change in blood viscosity ' --It does not explictly mention whether it decreses or increses the viscsity level , So C may be the ans.
' Still, unlike the natural stimulus that occurs with the release of EPO, any artificial stimulus of red blood cell production has potential risks, as it raises hemoglobin to the desired levels above 15 grams per deciliter far too quickly. ' --Does it give a notion that Synthetic EPO does not do that ?

for question 4 - Why is the answer not D ( need POE )

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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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07 Jun 2018, 10:11
soumya170293 wrote:
Having queries reagarding question 3 and 4 -
for question 3- ' The body cannot properly adjust to the quick change in blood viscosity ' --It does not explictly mention whether it decreses or increses the viscsity level , So C may be the ans.
' Still, unlike the natural stimulus that occurs with the release of EPO, any artificial stimulus of red blood cell production has potential risks, as it raises hemoglobin to the desired levels above 15 grams per deciliter far too quickly. ' --Does it give a notion that Synthetic EPO does not do that ?

for question 4 - Why is the answer not D ( need POE )

Souvik101990 posted the OEs:

Q3:

While not as difficult as the last two, this question still has its pitfalls. Most of the risks of synthetic EPO are in the third paragraph, but you may have to look in the second. Answer choice A is clearly defined as a risk of synthetic EPO, as you can see from this section: “any artificial stimulus of red blood cell production has potential risks, as it raises hemoglobin to the desired levels above 15 grams per deciliter far too quickly.” Answer choice B is the correct answer, as it is not a risk of synthetic EPO. As you can see from the italicized section above, levels above 15 are “desired,” so this is not a risk. Answer choice C addresses the same issue as answer choice A and is a well-defined risk. The cardiac risk in answer choice D is well defined in the third paragraph. However, the risk associated with answer choice E is harder to find; therefore answer choice E is the common incorrect answer choice on this problem. From the section in the second paragraph “who are unable to maintain the necessary levels without frequent EPO injections” and the section in the third paragraph that references the frequency of injections as a drawback of EPO, it is logical to infer the frequency required is a risk: If patients cannot get injections frequently their health will be compromised.

Q4:

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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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31 Jul 2018, 06:49
1. According to the passage, which one of the following is a challenge in using synthetic EPO to treat patients?

(A) It has to be administered more frequently and in larger doses than is ideal. "Researchers continue to improve the effectiveness of synthetic EPO and even to develop a new glycoprotein—called novel erythropoiesis-stimulating protein (NESP) —which eliminates several drawbacks of EPO in its current form. NESP not only requires smaller doses, but also lasts longer, eliminating the need for frequent and often-painful IV administration" - sums up the point
(B) It does not increase hematocrit levels as quickly as naturally occurring EPO does. the reverse is true: "it raises hemoglobin to the desired levels above 15 grams per deciliter far too quickly"
(C) It has more cardiovascular risk than other treatments. while it does have some drawbacks, we can't compare it all other treatments, about which we don't know from the passage
(D) It is frequently stolen by those seeking performance enhancement. "stolen"? I think this is a stretch
(E) It can result in dangerously low hematocrit levels. "Synthetic EPO is used to boost low hematocrit levels <...>"

2. Which of the following can be inferred about training at high altitude?

(A) It is not as effective as synthetic EPO at increasing red blood cells in an athlete. " Traditionally, athletes have trained at high altitude to achieve a similar natural effect <...>"
(B) It does not allow athletes to reach levels of hemoglobin above 15 grams per deciliter. "EPO raises hemoglobin to the desired levels above 15 grams per deciliter" and "athletes have trained at high altitude to achieve a similar natural effect" let us infer this
(C) It increases hemoglobin levels in an athlete more slowly than synthetic EPO does. "EPO raises hemoglobin to the desired levels above 15 grams per deciliter far too quickly", but increasing it naturally takes time
(D) It poses no health risks to the athlete. too extreme, maybe you can fall off a cliff or something as we're talking about "training at high altitudes" in general terms
(E) It does not increase the viscosity of blood to a dangerous level. not given, maybe it does in some circumstances

3. All of the following are potential risks of synthetic EPO except that it ______ .

(A) can raise hemoglobin levels too quickly. "it raises hemoglobin to the desired levels above 15 grams per deciliter far too quickly <...>"
(B) increases hemoglobin to levels above 15 grams per deciliter. "it raises hemoglobin to the desired levels above 15 grams per deciliter"
(C) abruptly increases blood viscosity. "The body cannot properly adjust to the quick change in blood viscosity <...>"
(D) increases the likelihood of cardiac problems. "<...> substantial cardiac risk results."
(E) needs to be administered frequently. "<...>, eliminating the need for frequent <...>, which can have complications"

4. Which of the following can properly be inferred from the passage?

(A) Training at high altitude is safer than using synthetic EPO. yes, in terms of increasing red blood cells, but not generally - we simply don't know
(B) A higher percentage of athletes are using performance enhancing drugs than in the past. "more and more" doesn't give us much information to infer this - too broad
(C) NESP is a more effective treatment for raising hematocrit levels than synthetic EPO. NESP is in the development phase, and the removal of several drawbacks of EPO doesn't translate to greater effectiveness
(D) NESP carries fewer risks than synthetic EPO. no information about its effects on people is discussed
(E) Kidneys have some mechanism for monitoring oxygen levels. correct: "When the kidneys detect a lack of oxygen flowing through the bloodstream, they secrete this glycoprotein, increasing the production of red blood cells <...>"
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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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01 Aug 2018, 18:59
3 correct, 1 wrong in 11 minutes. Feel for below

was totally undecided b/n A and C. Although, it felt like A might be wrong.. But didnt realize that (C) can be clearly inferred from paragraph 3.
In absence of less info vs missing info (didnt lookk for 3rd pgph), i drew less conclusive inference

Which of the following can be inferred about training at high altitude?

A) It is not as effective as synthetic EPO at increasing red blood cells in an athlete.
(B) It does not allow athletes to reach levels of hemoglobin above 15 grams per deciliter.
(C) It increases hemoglobin levels in an athlete more slowly than synthetic EPO does.
(D) It poses no health risks to the athlete.
(E) It does not increase the viscosity of blood to a dangerous level.
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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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01 Aug 2018, 19:00
3 correct, 1 wrong in 11 minutes. Feel for below

was totally undecided b/n A and C. Although, it felt like A might be wrong.. But didnt realize that (C) can be clearly inferred from paragraph 3.
In absence of less info vs missing info (didnt lookk for 3rd pgph), i drew less conclusive inference

Which of the following can be inferred about training at high altitude?

A) It is not as effective as synthetic EPO at increasing red blood cells in an athlete.
(B) It does not allow athletes to reach levels of hemoglobin above 15 grams per deciliter.
(C) It increases hemoglobin levels in an athlete more slowly than synthetic EPO does.
(D) It poses no health risks to the athlete.
(E) It does not increase the viscosity of blood to a dangerous level.
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Re: Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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14 Feb 2019, 04:23
Question 1 - A is wrong. You can not compare the dosages of two different medicines, each having a different mechanism of action. Even if they worked the same way, you still can't compare that. It's like comparing 70 mg of diclofenac to 200 mg of ibuprofen and say that ibuprofen has a higher dosage.

This is just wrong! To infer that EPO is used in higher dosages is just not correct. And again, I notice how GMAT flunks with the answers regarding medicine/pharmacy. The only answer which would work is C.
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Erythropoietin, known also as EPO, is a glycoprotein hormone that cont  [#permalink]

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28 Mar 2020, 23:42

Why is Q.4 choice D. wrong?
Quote:
4. Which of the following can properly be inferred from the passage?

(D) NESP carries fewer risks than synthetic EPO.

According to the passage:
Quote:
Researchers continue to IMPROVE THE EFFECTIVENESS of synthetic EPO and EVEN to develop a new glycoprotein—called novel erythropoiesis-stimulating protein (NESP) —which eliminates several drawbacks of EPO in its current form.

From the above sentence, how could you possibly interpret that the more effective NESP have THE SAME OR MORE OVERALL RISKS than the less effective synthetic EPO?
Could you please give an example for the scenario that fits such interpretation?
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Erythropoietin, known also as EPO, is a glycoprotein hormone that cont   [#permalink] 28 Mar 2020, 23:42