Lipoprotein (a), commonly abbreviated as Lp(a), has become a subject of considerable attention in cardiovascular research. However, many experts argue that its dangers are overstated. Three main reasons are usually given to support this claim.
First, Lp(a) is largely determined by genetics and remains relatively stable throughout life. Because it cannot be significantly altered by diet or lifestyle, it should not be treated as a major health concern in the same way cholesterol or blood pressure are.
Second, large-scale studies have shown inconsistent results regarding the association between elevated Lp(a) and cardiovascular disease. Some investigations suggest only a weak correlation, indicating that it may not play a decisive role in heart attacks or strokes.
Third, there are currently no widely available or proven therapies that specifically reduce Lp(a) levels. Since neither standard statins nor common treatments are effective, screening for Lp(a) is often seen as unnecessary and impractical for most patients.
Step 2. Listen to part of a lecture below and take notes.
Genetic researchers emphasize that lipoprotein (a) is actually one of the most reliable markers of cardiovascular risk. Because Lp(a) levels are almost entirely inherited and remain stable across a lifetime, a single blood test can identify individuals at elevated risk decades before symptoms appear. Unlike cholesterol, which may fluctuate with diet or exercise, Lp(a) provides a consistent predictor of disease
Moreover, recent epidemiological studies, such as those published in the European Heart Journal and the New England Journal of Medicine, demonstrate a strong and independent link between high Lp(a) and cardiovascular disease. Elevated levels have been shown to significantly increase the likelihood of premature heart attacks, strokes, and even calcification of the aortic valve. These findings are not isolated but have been replicated in diverse populations worldwide.
Finally, while older therapies had little impact, modern clinical trials are yielding promising results. For example, antisense oligonucleotide therapies have reduced Lp(a) concentrations by more than 80 percent in phase II trials, and monoclonal antibodies are showing similar effectiveness. Cardiologists argue that identifying high-risk patients now is critical, since these individuals may soon be eligible for targeted treatment once these drugs are approved
Summarize the key claims in the passage about Lp(a) and explain how points from the lecture challenge each claim using specific evidence (e.g., findings from epidemiological and genetic studies, and emerging therapies in clinical trials).
[Overview] The passage presents three reasons to downplay Lp(a). The lecture presents evidence that challenges each reason.
[Body 1] Genetics & stability → single measurement as a stable lifetime risk indicator.
[Body 2] “Inconsistent” studies → recent large genetic/epidemiological studies show strong independent association with CVD and aortic stenosis.
[Body 3] “No treatment” → new therapies in trials (e.g., antisense oligonucleotides) substantially reduce Lp(a); screening is useful.
[Conclusion] Therefore, the lecture undermines the passage’s minimization of Lp(a).
TOEFL New — Build a Sentence
Move the words in the boxes to create grammatical sentences.
A clock will show you how much time you have to complete this task.
appx. 45 sec per question!
1.PATIENT: Why is the hospital waiting area so crowded today?
NURSE: The doctors are patients now.
emergency
examining
several
2.PATIENT: Why are you going to the dentist this afternoon?
FRIEND: I am going replaced.
have
filling
to
a
3.PATIENT: Why are you calling the insurance company?
FRIEND: I am having difficulty my claim.
to
approve
getting
them
4.PATIENT: The clinic sent me a bill that seems too high.
RECEPTIONIST: We are checking correctly.
was
whether
procedure
billed
the
5.PARENT: My son keeps coughing at night.
GRANDMOTHER: I wish and rest for a while.
stop
around
would
he
running
6.PATIENT: I feel worse after taking those antibiotics.
FRIEND: I wish you the treatment.
continuing
called
before
had
doctor
the
7.PATIENT: Are my blood test results ready?
NURSE: The doctor is tests are needed.
further
them
whether
reviewing
decide
to
8.FRIEND: How can people reduce the risk of cardiovascular disease?
YOU: protect the heart.
helps
Avoiding
exercising
to
regularly
smoking
and
9.PATIENT: I do not understand why the clinic charged me twice for one scan.
FRIEND: I wish online.
bill
before
it
you
paying
had
checked
the
10.DOCTOR: What lifestyle changes matter most if someone wants to avoid premature cardiovascular disease?
PATIENT: essential.
pressure
manage
while
under
to
keeping
is
control
Learning
stress
blood
Total Questions: 0
Incorrect Answers: 0
<========================Writing an Email===============================>
2. Write an Email
You will read some information and use it to write an email.
You will have 7 minutes to write the email.
Read the Task: 1:00
You recently visited a local hospital outpatient department because you had severe throat pain and a high fever. After a very short examination, the doctor prescribed medication without asking about your allergies or previous reactions to medicine.
After taking the medicine, you developed a rash and dizziness, and your symptoms became worse. You later found out from another doctor that the medicine may not have been suitable for you.
You decide to write to the hospital administration to report the problem and request clarification.
Write an email to the hospital administration. In your email, do the following:
Describe the treatment you received and the health problems that followed.
Explain that the doctor did not ask about your allergies or medical history.
Ask the hospital to review your case and explain whether the treatment was appropriate.
Request information about follow-up care or corrective treatment.
Ask how you can obtain a copy of your medical records.
Write as much as you can in complete sentences.
Your email should be polite, clear, and serious in tone.
I am writing to express my concern about the treatment I received at your hospital.
Я пишу, чтобы выразить обеспокоенность по поводу лечения, которое я получил(а) в вашей больнице.
I am contacting you regarding a recent visit to your outpatient department.
Я обращаюсь к вам по поводу недавнего посещения вашего амбулаторного отделения.
I would like to report a problem that occurred after my recent medical appointment.
Я хотел(а) бы сообщить о проблеме, которая возникла после моего недавнего медицинского приёма.
I am writing to request a review of my recent case.
Я пишу, чтобы попросить пересмотреть мой недавний случай.
Transition and linking phrases
First of all, — прежде всего
After the appointment, — после приёма
Shortly after taking the medication, — вскоре после приёма лекарства
As a result, — в результате
In addition, — кроме того
Moreover, — более того
For this reason, — по этой причине
Given these circumstances, — учитывая эти обстоятельства
Useful introductory words and reporting phrases
Unfortunately, — к сожалению
To my concern, — к моему беспокойству
I was surprised to find that... — я был(а) удивлён(а), обнаружив, что...
I am concerned that... — я обеспокоен(а), что...
It appears that... — похоже, что...
I understand that medical decisions can be complex; however,...
Я понимаю, что медицинские решения могут быть сложными; однако...
Polite call-to-action / demand phrases
I would appreciate it if you could review my case.
Я был(а) бы признателен/признательна, если бы вы могли пересмотреть мой случай.
Could you please explain whether the prescribed treatment was appropriate?
Не могли бы вы объяснить, было ли назначенное лечение подходящим?
I would be grateful if you could advise me on the next steps.
Я был(а) бы благодарен/благодарна, если бы вы могли посоветовать мне дальнейшие шаги.
Please let me know how I can obtain a copy of my medical records.
Пожалуйста, сообщите мне, как я могу получить копию своей медицинской документации.
I kindly request information about possible follow-up care.
Я вежливо прошу предоставить информацию о возможном последующем лечении.
I would also like to know whether corrective treatment is available.
Я также хотел(а) бы узнать, доступно ли корректирующее лечение.
Conclusion and wrap-up phrases
I hope this matter can be reviewed promptly.
Надеюсь, этот вопрос может быть рассмотрен в ближайшее время.
Thank you in advance for your attention to this matter.
Заранее благодарю вас за внимание к этому вопросу.
I look forward to your response.
С нетерпением жду вашего ответа.
I would appreciate your prompt reply.
Буду признателен/признательна за ваш скорый ответ.
Yours faithfully,
С уважением,
3. Writing for an academic discussion
Reading time – 2 minutes, writing time – 8 minutes
Step 1. Read the academic discussion
Read the post carefully: 2:00
Professor Elena’s Post (Public Health Policy):
This week, let’s debate whether governments should subsidize routine lipid screening (total cholesterol, LDL/HDL, and lipoprotein(a)) for adolescents and young adults. Advocates argue that early detection—especially of inherited risks like elevated Lp(a)—can prevent heart disease, reduce long-term costs, and improve equity by giving every young person access to testing. Critics counter that screening healthy youth diverts limited funds, risks overdiagnosis and anxiety, and that resources should focus on school-based nutrition, exercise programs, and media literacy. Where should policy draw the line?
Student 1 — Arman (Skeptical)
I think subsidizing lipid panels for youth is a poor use of public money. Most teenagers are healthy, so screening millions to find a few high-risk cases isn’t efficient. False positives can create anxiety and trigger unnecessary follow-ups. If the aim is prevention, invest in lifestyle education: better school lunches, safe sports spaces, and campaigns that fight junk-food marketing. These interventions help everyone, not just the tiny fraction flagged by tests. Clinics are already overloaded—adding routine labs for low-risk groups will crowd out those who actually need care.
Student 2 — Naya (Supportive)
I support broadly subsidized screening, at least once in late adolescence. Some risks—like high Lp(a)—are genetic and not solved by lifestyle alone; early identification lets families plan with a clinician. Subsidies promote equity: without them, only wealthier families screen early. One affordable panel per student (with clear follow-up rules) is unlikely to strain budgets and could prevent costly events later. We should pair screening with the same lifestyle programs Arman wants—this isn’t either/or.
Step 2. Write a response
Tip: Write at least 120 words
State your own view clearly.
Refer to both Arman’s and Naya’s points.
Use specific reasons/examples (cost, equity, overdiagnosis, genetics, prevention).