OCCUPATIONAL ENGLISH TEST

WRITING SUB-TEST: MEDICINE

TIME ALLOWED: READING TIME : 5 MINUTES
WRITING TIME : 45 MINUTES
Read the case notes below and complete the writing task which follows.
Notes:
You are a plastic surgeon at Newtown Hospital. Doris White a 64 years woman.

Patient: Doris White

Adress: 5 Woods St, Stillwater, Newtown city
D.O.B. 01.04.1955
Social history: lives alone with her cat
Independent use frame
On social service registry ( for laundry and cleaning ) Good mental health
Past medical history: type 2 diabetes
Chronic renal failure on regular haemodialysis Ischaemic heart disease ,
hypertension
Peripheral vascular disease , hyperpigmented skin area
Medications: Aspirin 75 mg once
Atorvastatin 40 mg once
Insulin 50 iu 2 times
Beta blockers 5mg 2 times
Linezolid 600mg
Nitroglycrin 4mg PND

Calcium 300 mg 2 times

Multivitamins 2 tablets

25/03/2019
Hospital admission, neglected traumatic leg injury (slip in bathroom)
Treated with analgesics (paracetamol), antibiotic (amoxicillin) and topical
pressure therapy

10/04/2019
Unhealed wound , so surgical debridement done Ankle Brachial index = 60

17/04/2019
No improvement
Skin graft with flap under general anaesthesia. 25/04/2019
Graft healing 40% ( with epithelium growth ) Wound is hyperbaric oxygen.
ABI = 70

03/05/2019
Graft healing 50%
Negative pressure dressings used.

18/05/2019
Graft healing 70% ,so plan for discharge. ABI = 70
Plan : discharge
Attach list of meds

Writing task
Using the information in the case notes, write a letter to Mrs Lucy Walters ,
a Community Nurse , requesting for wound dressing. Address the letter to
Mrs Lucy Walters, Newtown Nurse Clinic, 10 Stillwater St, Newtown.
OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST MEDICINE
TIME : READING: 5 MINUTES
WRITING : 40 MINUTES

Read the case notes below and complete the writing task which follows.
Notes:
You are a GP and Ms. Topp has been following with you for 20 years.
Patient name:. Katherine Topp
Age: 59
Social History: unmarried, no partner, lives with mother
Librarian
2011- left work to care for mother

Family history: Mother died ovarian cancer (August 2017 )

Past medical history: Depression since early 20s (not on medication
Suffers from migraines, Reynaud's syndrome and IBS.
Takes OTC medications for them(Migraleve, ginkgo
biloba, Buscopan)- not effect anymore
Menopause at 52- heavy bleeding one year before
2017- citalopram 20mg daily for depression- effective
Presenting complaints:
Generalized fatigue, joint pain, abdominal distress

15/6/2019:
Subjective: generalised weakness, bone pain, sleeping disturbance (due
to pain), bloating & constipation
Morning stiffness, cold intolerance in feet and hands.
Weakness more on right side

Objective: joint tenderness, no joint swelling, loss of balance.

Diagnosis : ? fibromyalgia

Blood tests (2014, 2017, 2019) NAD Colonoscopy (2016) NAD

Plan: refer to Rheumatologist, attach lab results

Writing Task
Using the information in the case notes , write a letter of a referral to Dr
Gloves , a rheumatologist , Bayview Private Hospital , 81 Canyon Road ,
Bayview

Task: refer Ms. Topp to Dr....., A Rheumatologist at...... For diagnosis and
treatment
OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST MEDICINE
TIME : READING: 5 MINUTES
WRITING : 40 MINUTES

Read the case notes below and complete the writing task which follows.
Notes:
You are a physician at the Emergency Department.
Patient name: Mr Peter Sullivne
DOB: 15/08/1963
Age : 56

Social History: single – no children

lives with elderly parent
Mother and father main carer
Livestock farmer , works long hours in the sun
Past medical history: 2006- excision malignant melanoma
2011- excision compound naevus- confirm by histology examination - no
action taken
2015- two ribs fracture
2016- forearm fracture
Medications: nil

Family history : moderate dementia – mother

07/07/2019
Presenting complaint:
He came to emergency department - severe right arm pain - by kick from
horse in farm
Subjective : bruise , swelling
Ulnar fracture confirmed by x-ray
Medications : Paracetamol
Arm sling - splint
Objective: large mole on his right shoulder - 6mm x 7mm - irregular edges -
variable colours - light brown to dark. Some irritation
Other Large raised mole on his neck - 5mm x 7mm - dark red - no oozing or
bleeding.

Plan : urgent referral to a dermatologist – biopsy.

Review after 2 weeks for his ulnar fracture
Writing Task
Using the information in the case notes , write a letter of a referral to Dr
Patrick Silvester . Address the letter to Dr Patrick Silvester , Consultant
Dermatologist ,Newtown Hospital , 81 Canyon Road , Newtown.

In your answer:
 Expand the relevant notes into complete sentences.
 Do not use note form.
 Use the letter form.
The body of the letter should be approximately 180 – 200 words.
OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST MEDICINE
TIME : READING: 5 MINUTES
WRITING : 40 MINUTES

Read the case notes below and complete the writing task which follows.
Notes:
You are a cardiothoracic surgeon.
Patient name: Ms Janet Pristiely
DOB: 19/07/1947
Age : 72
Social History:
widow - retired accountant care of 5 grand children

non alcoholic – smokes 35 cigarrates/d

Past medical history:

Hypertension – DM II
Depression , Nephropathy Ischemic heart disease
Acute myocardial infarction (2018) Medications
Aspirin 75 mg
Beta blockers 10 mg
Citalopram 10 gm
Insulin 50 IU
Statins 40 mg
02/08/2019
Non-critical coronary artery bypass cancelled
Procedure not done due to smoking prior admission
On admission BP was 180/100 , Betablockers
BP fall to 140/80
Psychiatrist Counselling:
smoking cessation.
social and financial status including grand children
diagnosed as moderate depression
03/08/2019
Discharge Plan:
Lisinopril 8 mg , monitor BP& electrolyte 1w
Nicotine patches 25 mg
Citalopram 20 mg
Aspirin 150 mg , stop on re-admission
Re-admission advice on 19/10 :
Respite care for grand children
Contact me if SOB , chest pain
Writing Task
Using the information in the case notes , write a letter of a discharge to the
patient’s GP including history ,medication and advice . Address the letter to

Dr Peter Harvey ,Newtown Clinic , 62 Ville Road , Newtown.

In your answer:
• Expand the relevant notes into complete sentences.
• Do not use note form.
• Use the letter form.
The body of the letter should be approximately 180 – 200 words.
OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST MEDICINE
TIME : READING: 5 MINUTES
WRITING : 40 MINUTES

Read the case notes below and complete the writing task which follows.
Notes:
Patient name: Mr Jane Browne
DOB: 25/08/2001
Age : 18
History:
Student
Facial eczema as baby
Flexular eczema as child
Allergic rhinitis to pollens , cat hair
History of asthma (mother)
01/09/2019
Tender ,weepy, crusty nipple
Surrounding inflammation from plaster dressing
Treatment plan:
Hydrocortisone
Soap substitute
Ellomite e.g Edomin 5
stop using plaster , replace it with mepor dressing and keep uncovered
except during sport
On 10/9/2019
Showed improvement
Feels happy with the mepor
Advised to return in case of symptoms worsening
On 21/9/2019
Nipple never healed
Increased friction with T-shirts during sport , so cover with mepor
Feels embarrassed after sports dressings room , need complete resolution
Reported use hydrocortisone intermittently
On examination
Nipple was tender , no crustations , change in appearance and become
warty
Diagnosis: ? Seborrheic keratosis
: ? Eczema
: ? Others
Plan : refer to a dermatologist for assessment and diagnosis
Writing Task
Using the information in the case notes , write a letter of a referral to Dr
Elizabeth Macnor ,Consultant Dermatologist ,Newtown Hospital , 81
Canyon Road , Newtown.
November 2018 (Writing Case note)

Allen Mathis

61 yo retired cabinet maker.

Personal History:

Married, lives with family

Ex-smoker (smoked for 35 yrs, quitted 7yrs ago)

Mother and grandmother had DM.

Medical history:

Poorly controlled DM

Mild-Moderate HTN

Ischemic Heart disease

2011: had coronary artery angioplasty after acute MI

2012: cataract surgery

Fungal infection on foot. Went po—— therapy

FBG - > 5-25mmol

HbA1c -10%

Presenting complaints:

Worsening of Dysponea, decreased exercise tolarence, ankle edema for 2 months.

Can’t sleep lie down (orthopnoea) for past few days.

No chest pain .

Medications:

Inj. Novorapid

Inj. Lantus

Metformin

Metoprolol

Aspirin

Rosuvastatin

Nifedipine

Hydrochlorothiazide
3.11.18

Objectives:

Temp : 36.8

BMI : obese>30

BP 148/98

Chest : apex beat shifted laterally with ejection systolic murmur. Bibasal crepitations .

Bilateral Ankle edema

ECG: T inversion in antero-lateral leads. No Q wave, no ST elevation ( changed from 6 months ago)

Assessment : Biventricular heart failure with possible silent ischemia with sustained HTN and poorly
controlled DM

Plan: refer to emergency cardiologist for urgent assessment and advice on management of acute
heart failure and possible silent myocardial Ischemia.

Referral letter to

Cardiologist,

Emergency department

Central hospital

Stillwater.

For urgent assessment and advice on Mx.