writing sub-test - آکادمی دایِلو · 2019. 4. 14. · writing sub-test dentistry sample...

Writing sub-testDentistrySample Test

Please print in BLOCK LETTERS

Candidate number

Family name

Other name(s)

City

Date of test

Candidate’s signature

YOU MUST NOT REMOVE OET MATERIAL FROM THE TEST ROOM

– –

© Cambridge Boxhill Language Assessment – Sample Test (2010)

The OET CentreGPO Box 372Melbourne VIC 3001 Australia

Telephone: +613 8656 4000Facsimile: +613 8656 4020www.occupationalenglishtest.org

ABN 51 988 559 414

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: DENTISTRY

TIME ALLOWED: READING TIME: 5 MINUTES

WRITING TIME: 40 MINUTES

Read the case notes and complete the writing task which follows.

TURN OVER 2

Notes:

Patient: Mrs Joyce Williams

56 Oak Lane

Stillwater

Ph 9751 1234

DOB: 9.5.66

Reason for Presenting: Further Endo required on 37

Dental History: Extractions

Fillings

Scale and clean, regularly

Radiographs

RCTs

Medical History: Myocardial infarction 1.6.2007

Allergic to penicillin

Current Medication: Aspirin 100mg every day

Family & Social History: Married, 2 children

Social worker

Smoker

TURN OVER 3 3

Examination: Missing 18, 28, 48

Porcelain crowns 15, 24

RCTs 15, 24

DO amalgam 23

MO amalgam 16, 17, 25, 26, 27

Occ amalgam 38, 47

MOD amalgam 45, 46

Treatment Record:

2.5.06 37 DO tunnel from occlusal v. deep 60% possibility RCT Fuji IX used

19.3.07 Scale and clean prophylaxis 32 mesio-incisal chip; no LA; composite

9.9.07 37 DB tunnel IRM temp Will need RCT

25.11.07 37IstRCTDff25,Mff20x2,canonlyfindone. LAdifficult.Ledermix+cavit

15.12.07 37 3 root canals converge in one. Cannot get further. Obstruction at ff 30 x 3 to 21mm.IfOK,finishorifnot,gofurther

20.12.07 36o, 37o; Fuji IX; no LA

25.2.08 Crown prep 37

17.3.08 Insert crown VMK 37

17.9.08 Patient complains: pain 37 region since insertion of VMK crown Examined occlusion - nil loading 38 DOB Fuji composite

18.12.08 Pain 37 region persists Remove VMK crown; re-insert IRM temp crown

6.3.10 Pain resolved with IRM crown; however, symptoms now returned; not tender to percussion X-ray: RCT 4mm short of apex; no periapical pathology

Refer to endodontist

4

Writing task:

Using the information in the case notes, write a letter of referral to the endodontist, Dr Patrick O’Malley, 17 Longview Road, Newtown.

In your answer:

• expandtherelevantnotesintocompletesentences

• donotusenoteform

• useletterformat

Thebodyofthelettershouldbeapproximately180-200words.

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: DENTISTRYSAMPLE RESPONSE: LETTER

1

Dr Patrick O’Malley17 Longview RoadNewtown

(Today’s date)

Dear Dr O’Malley

Re: Mrs Joyce Williams, DOB 9 May 1966

Thank you for seeing Mrs Joyce Williams, who is experiencing symptoms of pain associated with 37. On examination, the tooth is not tender to percussion. Root canal treatment was performed on the tooth in November 2007. The RCT was difficult due to the three roots converging into one, and an obstruction was encountered. As a result the root fillings are approximately 4mm short of the apex.

The tooth now has a temporary crown. A VMK crown was inserted in March 2008, but the patient reported symptoms of pain from this time, which were not resolved by subsequent attention to cavities in the adjacent tooth, 38. The occlusion of 37 was also examined but was not found to be under any occlusal loading. Subsequently, the VMK crown was removed and the IRM temporary crown re-inserted in December 2008. This appeared to resolve the problem.

However, the patient is now complaining that the symptoms have returned. Another radiograph has been taken, but no periapical pathology was found.

I would appreciate it if you could manage this case. Please do not hesitate to contact me if you require any further information. I enclose the periapical radiograph of tooth 37.

Yours sincerely

Dentist

Writing sub-testDieteticsSample Test


Candidate number

Family name

Other name(s)

City

Date of test



– –




ABN 51 988 559 414

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: DIETETICS




TURN OVER 2

Notes:

Tim Langham was referred to you by his GP for dietary advice.

Patient: Mr Tim LanghamDOB: 1.8.1987

Presenting Complaint: B12deficiency2o to pernicious anaemia diagnosed by referring GP

History of Presenting Complaint: Moody, irritable, withdrawn, mild depression, lethargy Weight loss Mother complains of his aggressive outbursts

Past Medical History: Asthma, childhood onset Chickenpox, 1992 Measles, 1996 Anthropometric Data: Height: 180cm Weight: 66kg BMI: 20.4

Biochemical Data: FBE Hb* 118g/L (Ref range: 130-180g/L) Serum iron 12µmol/L (Ref range: 10-30µmol/L) Ferritin 30g/L (Ref range: 30-300g/L) MCV 120fL (N: <98fL) B12* 100µmol/L (Ref range: 120-680µmol/L) RBC folate 980nmol/L (Ref range: 360-1,400nmol/L) Serum folate 36 nmol/L (Ref range: 7-45nmol/L)

Medication: B12 (1,000µg) IM injection, 2/week Ventolin inhaler

3

SH: Vegetarian for 7 years, doesn’t like eating eggs University student; lives in shared house near university Shares with 3 other students; all share cooking No partner Body-conscious, works out at gym 4-5 hours per day Non-smoker; no recreational drug use Social drinker (weekends – 2-3 drinks/night, wine or spirits) Amino acid supplements

Dietary Information: Breakfast: Special-K cereal with low-fat milk Toast (white bread) with jam, honey, or peanut butter Orange juice Coffee

Morning tea: Wholemeal salad sandwich Cola or sports drink

Lunch: Pasta with vegetarian sauce Cake Tea or coffee

Mid-afternoon: High protein cereal bar or high protein milk shake

Dinner: TV dinners/frozen dinners – soups, pasta with vegetarian sauce, rice, potatoes Ice-cream &/or tinned fruit/mousse

Supper: Dry biscuits with cheese or chocolate bar Coffee

Management:Advice given: vegetarian dietary sources of B12 – eggs, yoghurt, etc. vegetariansourcesofiron–e.g.,legumes,greenleafyvegetables,driedapricots,figs, nuts combine with vitamin C-containing foods ( absorption)

Immediate plan: continue IM injection B12 (at GP surgery) draw up dietary menu plan recommend fresh food especially fruit & vegetables R/v 2/52

Patient wishes to discontinue IM B12 Patient believes his diet is good – reluctant to change

Writing task:

Using the information in the case notes, write a letter back to the referring GP, Dr Bruce Russell, Health First Clinic, 123 High Street, Newtown. In your answer:



• useletterformat


1

(Today’s date)

Dr Bruce RussellHealth First Clinic123 High StreetNewtown

Dear Dr Russell

Re Tim Langham, DOB 1.8.1987

I am writing to you regarding your patient, Mr Tim Langham, who attended today for dietary advice. As you know, he presents with symptoms and test results suggestive of pernicious anaemia, which requires IM B12 treatment.

Tim is a vegetarian of seven years duration who has been suffering from weight loss, mood changes such as irritability and depression, and aggressive behaviour. Blood tests reveal B12 deficiency. His haemoglobin and B12 are low, red cells show an increased mean cell volume, and ferritin and serum iron are at the low end of normal. His BMI is still within the normal range, despite his recent weight loss.

As his diet is deficient in vitamin B12 and obviously contains inadequate iron, I have advised Tim of the need for continuing with IM injections of B12 to correct this problem, and given him advice on the vegetarian dietary sources of B12 and iron. I suggested combining his iron-containing foods with vitamin C-containing foods to enhance iron absorption. However, Tim is reluctant to make any alterations to his diet, which he believes is good.

I will review him in two weeks, and have advised him to contact you regarding the B12 injections.

Thank you for your ongoing management of this patient.

Yours sincerely

Dietitian

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: DIETITIAN

SAMPLE RESPONSE: LETTER

Writing sub-testMedicineSample Test


Candidate number

Family name

Other name(s)

City

Date of test



– –




ABN 51 988 559 414

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: MEDICINE




TURN OVER 2

Notes:

Patient: Anne Hall (Ms)

DOB: 19.9.1965

Height: 163cm Weight: 75kg BMI: 28.2 (18/6/10)

Social History: Teacher (Secondary – History, English)

Divorced, 2 children at home (born 1994, 1996)

Non-smoker (since children born)

Social drinker – mainly spirits

Substance Intake: Nil

Allergies: Codeine; dust mites; sulphur dioxide

FHx: Mother – hypertension; asthmatic; Father – peptic ulcer

Maternal grandmother – died heart attack, aged 80

Maternal grandfather – died asthma attack

Paternal grandmother – unknown

Paternal grandfather – died ‘old age’ 94

PMHx: Childhood asthma; chickenpox; measles

1975 tonsillectomy

1982 hepatitis A (whole family infected)

1984 sebaceous cyst removed

1987 whiplash injury

1998depression(separationfromhusband);SSRI–fluoxetine11/12

2000 overweight – sought weight reduction

3 3

2002 URTI

2004 dyspepsia

2006 dermatitis; Rx oral & topical corticosteroids

18/6/10 PC: dysphagia (solids), onset 2/52 ago post viral(?) URTI

URTI self-medicated with OTC Chinese herbal product – contents unknown

No relapse/remittent course

No sensation of lump

No obvious anxiety

Concomitant epigastric pain radiating to back, level T12

Weight loss: 1-2kg

Recent increase in coffee consumption

Takes aspirin occasionally (2-3 times/month); no other NSAIDs

Provisionaldiagnosis:gastro-oesophagealreflux+/-stricture

Plan: Refer gastroenterologist for opinion and endoscopy if required

Writing task:

Usingtheinformationinthecasenotes,writealetterofreferralforfurtherinvestigationanddefinitivediagnosistothegastroenterologist, Dr Jason Roberts, at Newtown Hospital, 111 High Street, Newtown.

In your answer:



• useletterformat


1

Dr Jason RobertsNewtown Hospital111 High StreetNewtown

(Today’s date)

Dear Dr Roberts

Re: Ms Anne Hall, DOB 19.9.1965

Thank you for seeing Ms Hall, a 44-year-old secondary school teacher, who is presenting with a two-week history of symptoms of dysphagia for solids, epigastric pain radiating posteriorly to T12 level, and concomitant weight loss. The symptoms follow a constant course.

Ms Hall believes the problem commenced after an upper respiratory tract infection two weeks ago for which she self-prescribed an over-the-counter Chinese herbal product with unknown ingredients. However, she has also recently increased her coffee consumption and takes aspirin 2-3 times a month. She has a history of dyspepsia (2004), and dermatitis for which she was prescribed oral and topical cortisone. There are no apparent signs of anxiety. She has not smoked for the last 15 years. She drinks socially (mainly spirits), has a family history of peptic ulcer disease and is allergic to codeine. Her BMI is currently 28.2.

My provisional diagnosis at this point is gastro-oesophageal reflux with possible stricture. I am therefore referring Ms Hall to you for further investigation.

Thank you for assessment and ongoing management of this woman. If you require any further information, please do not hesitate to contact me.

Yours sincerely

Doctor

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: MEDICINE


Ms Samantha Bruin, Senior nurse, Greywalls Nursing Home, 27 Station Road, Greywalls (Today’s date) Dear Ms Bruin, RE: Mr Gerald Baker, aged 79 Mr Baker will be discharged back into your care on the 7/9 after undergoing a total left hip replacement. He can bear his own weight, and with the help of a wheelie walker can walk short distances. After the operation, Mr Baker suffered from some disorientation, possibly caused by the anaesthetic, which will require your ongoing observation. In addition, his haemoglobin dropped temporarily, so please monitor him for any signs of anaemia. We have lent Mr Baker a wheelie walker as well as a wedge pillow and a toilet raiser, the latter of which will need to be returned in two weeks. He will need to continue his exercise program with an OT including a range of stretching and strengthening exercises. With regards to ongoing management, Mr Baker’s incision site requires daily dressings, and the staples will need to be removed on the 21/9 at the City Hospital Clinic where he should also undergo FBE and UEC tests. His current medications include Aspirin 100mg post-operatively as well as Panadeine Forte (max. 8 per day). If you have any questions, please do not hesitate to contact me. Yours sincerely, Charge Nurse

Writing sub-testNursingSample Test


Candidate number

Family name

Other name(s)

City

Date of test



– –




ABN 51 988 559 414

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: NURSING




Notes:

TURN OVER 2

Mr Gerald Baker is a 79-year-old patient on the ward of a hospital in which you are Charge Nurse.

Patient Details:

Marital Status: Widower (8 years)

Admission Date: 3 September 2010 (City Hospital)

Discharge Date: 7 September 2010

Diagnosis: Left Total Hip Replacement (THR)

Ongoing high blood pressure

Social Background: Lives at Greywalls Nursing Home (GNH) (4 years)

No children

Employed as a radio engineer until retirement aged 65

Now aged-pensioner

Hobbies: chess, ham radio operator

Sister, Dawn Mason (66), visits regularly; v supportive

– plays chess with Mr Baker on her visits

No signs of dementia observed

Medical Background: 2008 – Osteoarthritis requiring total hip replacement surgery

1989 – Hypertension (ongoing management)

1985 – Colles fracture, ORIF

3

Medications: Aspirin 100mg mane (recommenced post-operatively)

Ramipril 5mg mane

Panadeine Forte (co-codamol) 2 qid prn

Nursing Management and Progress:

daily dressings surgery incision site

Range of motion, stretching and strengthening exercises

Occupational therapy

Staples to be removed in two wks (21/9)

Also, follow-up FBE and UEC tests at City Hospital Clinic

Assessment: Good mobility post-operation

Weight-bearingwithuseofwheelie-walker;walkslengthofwardwithoutdifficulty

Post-operative disoriention re time and place during recovery, possibly relating to anaesthetic – continued observation recommended

Dropped Hb post-operatively (to 72) requiring transfusion of 3 units packed red blood cells; Hb stable (112) on discharge – ongoing monitoring required for anaemia

Discharge Plan: Monitor medications (Panadeine Forte)

Preserve skin integrity

Continue exercise program

Equipment required: wheelie-walker, wedge pillow, toilet raiser. Hospital to provide walker and pillow. Hospital social worker organised 2-wk hire of raiser from local medical supplier.

Writing task:

Using the information in the case notes, write a letter to Ms Samantha Bruin, Senior Nurse at Greywalls Nursing Home, 27 Station Road, Greywalls, who will be responsible for Mr Baker’s continued care at the Nursing Home.

In your answer:


• donot use note form

• useletterformat


1

Ms Samantha BruinSenior NurseGreywalls Nursing Home27 Station RoadGreywalls

(Today’s date)

Re: Mr Gerald Baker, aged 79

Dear Ms Bruin

Mr Baker is being discharged from City Hospital back into your care today. He underwent a left total hip replacement. He has good mobility and can walk along the ward using a wheelie-walker without difficulty.

Mr Baker was recommenced on 100mg Aspirin daily post-operatively. In addition to his usual treatment for hypertension, he requires pain relief (Panadeine Forte, max 8 tablets/day) and daily dressing changes. He is to undergo a series of range-of-motion, stretching and strengthening exercises, and occupational therapy, to ensure a full recovery. We are sending a walker and wedge pillow with the patient. Our social worker has organised hire of a toilet raiser for two weeks.

During post-operative recovery Mr Baker appeared disoriented. As there is no record of dementia, this may relate to the anaesthetic; continued observation is nevertheless recommended. His sister may be able to comment. Mr Baker’s haemoglobin dropped post-operatively. He was transfused three units of packed red blood cells, without complication, and his Hb on discharge is stable (112). Please monitor for signs of anaemia.

Mr Baker will have his staples removed at City Hospital Clinic on 21 September. Follow-up blood tests (UEC, FBE) will also be conducted.

Please contact me with any queries.

Yours sincerely

Charge Nurse

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: NURSINGSAMPLE RESPONSE: LETTER

Writing sub-testOccupational TherapySample Test


Candidate number

Family name

Other name(s)

City

Date of test



– –




ABN 51 988 559 414

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: OCCUPATIONAL THERAPY




TURN OVER 2

Notes:

You are an occupational therapist in Newtown. You have assessed and prepared a treatment plan with this patient on referral from Dr Carol Smith.

Patient Details

Name: Melissa Godfrey (Ms)

DOB: 15/03/1972

Address: Flat 5, 18 Pine Street, Centreville

Marital Status: Separated from spouse

Occupation: Financial planner

Treating Doctor: Dr Carol Smith, Newtown

Moving to: Dr Simone Hadley, Centreville

Case Notes

Medical History:

Ms G has been off work (3 mths) with ongoing stress, anxiety & depression resulting from inability to ‘switch off’ after work. This caused absenteeism & tardiness, frequent sick leave, friction with colleagues, mistakes in work (picked up by clerk; no long-term repercussions with clients).

Response to stress: short temper, lethargy, overeating (unhealthy diet).

Has had some counselling – achieved limited success. Still struggling to deal with stress & anxiety, but now wishes to return to work.

Occupational Performance:

Self Care: Independent

Domestic: Independent but not cooking much; eating a lot of takeaway food.

3

Leisure: Has worked long hours in past. Few hobbies. Watches TV, occasionally meets friends for drinks.

Ms G used to play guitar; likes reading, but has had little time; enjoys cycling, but not since splitting permanently last year with husband of 6 yrs. Has been on dates several times but has no steady relationship currently.

Since moving to Newtown, away from her usual support networks in Centreville, Ms G less involved with leisure activities.

Plan:

Develop coping strategies:

- workonsetofaffirmations/meditationstodoatworkwhenitbecomesstressful

- re-engage with social network; return to hobbies & external interests

- encourage healthier diet

- liaise with employer to develop a return-to-work plan: start part-time, adjust workload, etc. to make return easier

Schedule weekly visits to check progress.

Ms G has been staying with parents in Newtown during her leave from work, but is now returning home to own apartment in Centreville. Would like to make more progress & get back to work.

Writing task:

The patient is transferring from Newtown back to Centreville. Write a letter to the patient’s new doctor in Centreville. Use the information given in the case notes to outline for the doctor your plan for the patient’s treatment and ongoing management of work and domestic issues. Address your letter to Dr Simone Hadley, 77 Main Street, Centreville.

In your answer:

• expandtherelevantcasenotesintocompletesentences

• donot use note form

• useletterformat


1

Dr Simone Hadley 77 Main StreetCentreville

(Today’s date)

Re: Ms Melissa Godfrey (DOB 15/03/1972) Dear Dr Hadley,

As Melissa Godfrey is transferring to your care from her currrent treating doctor in Newtown, Dr Carol Smith, I have assessed Ms Godfrey in Newtown and set out a plan for her to support a return to work.

Ms Godfrey is a financial planner who experienced difficulty switching off after work, leading to stress, anxiety and depression. This affected her work and caused problems including absenteeism, sick leave and conflict with colleagues and led to problems with temper, lethargy and overeating. The patient has been off work for three months and staying with her parents in Newtown. She is permanently separated from her husband of six years (since last year).

Coping strategies will help deal with her anxiety. She can resume activities she previously enjoyed, such as guitar playing, reading and cycling. Group activities should help her to rebuild her social networks in Centreville. Ms Godfrey needs support to address her diet and general health issues.

In relation to Ms Godfrey’s desire to return to work, I suggest working on a set of affirmations and meditations, so that when she begins to feel anxious at work, she can break her stress response and stay calm. Liaison with her employer is required to establish a return-to-work plan, starting with limited hours and a lighter workload.

I suggest weekly visits with an occupational therapist in Centreville to monitor her progress.

Please contact me if you require any further information.

Yours sincerely,

Occupational Therapist

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: OCCUPATIONAL THERAPY


Writing sub-testOptometrySample Test


Candidate number

Family name

Other name(s)

City

Date of test



– –




ABN 51 988 559 414

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: OPTOMETRY




Notes:

TURN OVER 2

Presentation: 31 September 2010

Patient history: Mr Andew Johnson: 46 y.o. taxi driver.

Double vision after about 11 hrs of driving, for 12 months.

Blurring of R eye, 8 months, becoming worse.

Lately, 1st letter of street signs absent.

No pain or headache.

General health: Good. No medication.

Family history: Father – cataracts for some yrs.

Vision: R 6/60+, L6/6

Refraction: R +0.25/-0.50 x 90, L +0.25 DS. No correction needed.

VA: R 6/60+, L 6/6, no improvement w. pinhole.

Phorias: Distance – 1Δ exophoria.

Near – 4Δ exophoria.

Stereopsis: Gross(Titmusfly).

Colour vision (D-15): R – red-green loss. L – normal.

External examination: Normal ocular appearance.

Eye movements: Full but jerky.

Convergence: Near point – 15cm.

Slit-lamp: Cornea and media – normal.

3

IOP (Goldmann): R 18.5mmHg; L 14mmHg at 10.00am.

Confrontation fields: R – constricted.

L – temporal hemianopia.

Humphrey fields: R – temporal hemianopia w. some inferior nasal loss.

L – temporal hemianopia without macular sparing.

Diagnosis: Probable chiasmal lesion, possible pituitary tumour.

Plan: Referral to ophthalmologist.

Writing task:

Using the information given in the case notes, write a letter of referral to Dr R Taylor, an ophthalmologist at Newtown Hospital.

In your answer:

• expandtherelevantcasenotesintocompletesentences


• useletterformat

Thebodyofthelettershouldbeapproximately180–200words.

1

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: OPTOMETRY


(Today’s date)

Dr R Taylor OphthalmologistNewtown HospitalNewtown

Dear Dr Taylor,

Re: Mr A Johnson, aged 46 years

Mr Johnson presented on 31 September 2010 because of blurred vision in the right eye. This was first noticed eight months ago and has become progressively worse since then. For the last 12 months, Mr Johnson has been aware of double vision occurring after about 11 hours of driving. He is a taxi driver and recently, the first letter of the name on street signs appears to him to be missing.

Mr Johnson vision is R 6/60+ and L 6/6, with no significant improvement with either spectacles or pinholes. Near point of convergence is 15cm, eye movements are full but jerky and the right pupil is sluggish to a near stimulus. Stereopsis is reduced to gross as measured with the Titmus fly. Colour vision assessed using the D-15 indicates a red-green loss in the right eye only.

The cornea and media are clear. Intraocular pressures were R 18.5mmHg and L 14mmHg using Goldmann tonometry at 10.00am, and the anterior chamber angles are wide (van Herick). The ocular fundi appear normal, except that the right optic disc is paler than the left. Visual fields indicate a bitemporal hemianopic field loss without macular sparing, with some additional loss in the inferior nasal field of the right eye (Humphrey charts enclosed).

The reduced acuity, the other neurological signs, and particularly the bitemporal visual field loss may indicate chiasmal involvement. Therefore, I am referring Mr Johnson to you for further assessment and management.

Yours sincerely

Optometrist

Writing sub-testPharmacySample Test


Candidate number

Family name

Other name(s)

City

Date of test



– –




ABN 51 988 559 414

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: PHARMACY




TURN OVER 2

Notes:

You are a pharmacist at Newtown Hospital. An elderly patient who has been treated for a fractured femur is being discharged. You are writing a letter to her carer (her daughter) to ensure the medication regime is followed when she returns home.

Patient History

Name: Mrs Alice Ramsey

Date of Birth: 4 January 1925

Allergies: Nil

Current Medication:

On Admission: Zantac (ranitidine) (for GORD): 150mg bd Lipitor (atorvastatin): 20mg mane (on empty stomach)

On Discharge: Zantac (ranitidine) (for GORD): 150mg bd Lipitor (atorvastatin): 20mg mane Heparin low molecular weight (LMWH) (anti-coagulant): 7500 bd – to be continued until mobile Panadeine Forte (paracetamol & codeine for pain relief): 500mg 4-hourly/prn Durolax (to prevent constipation): 10mg nocte Maxolon (metoclopramide) (for side effects of codeine): 10mg tds/prn Penicillin (prophylactic: ↓ risk of post-op infection): 250mg qid 2/52

Drug Information: Adverse Drug Reactions

Ranitidine Adverse: headache; GI upset; rash; CNS disturbances (rare)

Atorvastatin Adverse: Serious: rhabdomyolysis, myopathy, myalgia (0.2%); GI upset (1%); headache (2%); rash (2.5%); flu-likesymptoms(1.5%);raisedLFTs(1.3%)

Heparin Adverse: haemorrhage, easy bruising, nausea, vomiting

Codeine/Paracetamol Adverse: constipation, stomach-aches, nausea, vomiting; Rare: dependence, tolerance; CNS disturbances incl. impaired alertness

Metoclopramide Adverse: CNS disturbances incl. impaired alertness (rare); tardive dyskinesia (rare)

Penicillin Adverse: Rare: sensitivity reactions; haematological effects; nausea, vomiting, mild diarrhoea; allergic skin rash or hives

Social History:

Pt normally lives alone. On discharge, staying with daughter. Pt non-driver. Public transport.

Relevant History for Surgical Procedure:

Height 168cm; Weight 75kg; BMI 26.8

Non-smoker

Dentures – upper & lower

Gastro-oesophagealrefluxdisease(GORD)–controlledbymedication

Hypercholesterolaemia – controlled by medication

11 July 2010

2:45pm: Pt brought to A&E by ambulance. Knocked down by car in Garden Nursery car park (buying plants) – landed on bitumen. Driver failed to see her in rear-view mirror → reversed into her. Not run over. Fell on R side on femur.

Presentingsymptoms:pain–postfall&difficultystandingorwalking

3.00pm: Pt seen by Dr Hogarth. Pain relief: pethidine (opiate)

X-rays of affected femur – anterior-posterior & lateral views Repeatfilmswithhipat15-20°internalrotation→ MRI

5:30pm: Transferred to ward

Pt booked for surgery 12 July am – nil by mouth from midnight

Full pre-operative general investigation: LFTs, platelet count, WBC count, WBC types, RBC count, RBC indices, Hg, haematocrit, blood smear, ECG & chest X-ray

12 July 2010

Openreduction&internalfixation(ORIF)performed

GAgiven:induction–propofol;sevoflurane,fentanyl,midazolam,suxamethonium, ondansetron

Heparin – thrombus prevention

IV antibiotics – penicillin – continued for 24/24 post surgery

Immobilised with spica cast

Post-Op

TURN OVER 3

• pressuresoreprevention&careofpressureareas;woundcare

• painrelief

• fluidbalance&bloodlossmonitoring:IVfluids+penicillin

• nutritionalmanagement:oralproteinsupplementation

• thrombusprevention:lowdose,lowmolecularweightheparin,&mechanisedcompression stockings

• lowerlimbcirculation&sensation

• earlymobilisation&weightbearingoninjuredleg

24 July 2010 Transferred to Rehab Unit

8 August 2010

Due for discharge home – appointment made for 22 August 2010 for removal of cast Letter to carer/daughter (NB: heparin to be continued only until mobile)

The patient is being discharged to the care of her daughter.

Writing task:

Using the information in the case notes, write a letter to the daughter, Mrs Holly Kerr, 3 Rose Avenue, Springbank, outlining her mother’s medication regime, any potential adverse effects to be aware of, and when to seek medical advice.

In your answer:



• useletterformat


4

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: PHARMACY


1

Mrs Holly Kerr 3 Rose AvenueSpringbank

(Today’s date)

Dear Mrs Kerr

Your mother, Mrs Alice Ramsey, is now being transferred into your care following her operation and it is important that you ensure her medications are taken correctly.

On admission, she was already using an anti-ulcer drug, ranitidine (Zantac), twice daily to control her acid reflux, and a cholesterol-lowering medication, Lipitor, one tablet on an empty stomach. The main side effects to be aware of with Zantac are stomach upsets, headaches and skin rash. The most serious reaction to Lipitor is muscle pain; any occurrence should be reported to her doctor.

Since hospitalisation, she has been prescribed several additional medications. Panadeine Forte for pain relief, is to be taken as required (not more than every four hours). It can cause stomach-ache, constipation, nausea and vomiting and drowsiness/sedation. To counteract any nausea, Maxolon (metoclopramide) can be taken up to three times daily as needed. The penicillin (four times daily) is to prevent any infections, while a blood-thinning medication called heparin will prevent clot formation due to the surgery or immobility. This is to be continued while your mother is immobile, and you will need to be alert for possible bleeding or bruising. If this occurs, you should seek medical advice from your doctor or community nurse.

I hope you find this information helpful. Please feel free to contact me if you have any questions.

Yours sincerely

Hospital Pharmacist

Writing sub-testPhysiotherapySample Test


Candidate number

Family name

Other name(s)

City

Date of test



– –




ABN 51 988 559 414

TURN OVER 2

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: PHYSIOTHERAPY




Notes:

You are a physiotherapist in private practice. Max Wolff has been referred to you by his GP, Dr William Stacey, for review and a treatment plan after presenting with chronic back pain.

Physiotherapy Notes – from initial consultation 1 May 2010

Personal Details:

Name: Max Wolff (Mr)Age: 35Profession: Full-time musician: orchestral double bass player Lives with spouse, also a musician No dependants

Family/Patient History:

Father (70) has mild osteoarthritis; mother (67) healthy Younger brother & sister healthy

Tonsillectomy/adenoidectomy (1979) Myopic (corrective lenses since age 14)

Non-smoker; ‘social’ drinker (8-10 units/week)

Mild idiopathic scoliosis (<20º, untreated) since teenage years: slouching at desk while studying at school & music college

Minor, ongoing postural problems from music college to present: daily work routine (practising, attending rehearsals & performing with orchestra); pain not a problem until recently

Little formal exercise (no sports, no gym); busy schedule, with frequent evening work

Subjective: Pt complains of ongoing upper back pain – feels stiff, ‘frozen’, ‘locked’ between shoulders; also dull pain in lumbar region

Agg: prolonged performance on instrument (>2 hrs); ease: rest

Symptoms developing over last 6-10 months; pt too busy at work to attend GP; has been using non- prescription analgesics lately for relief (to help with sleep, esp. after evening performances)

3

Bass playing requires particular body posture – pt normally sits on high stool with body weight mainly on R leg; L arm is bent & raised up to near pt’s ear on instrument, R arm reaches forward to produce sound with bow. Unbalanced posture.

Pt concerned that current symptoms may prevent participation in important international tour with orchestra (for 1 month, leaving in 3 weeks) – this was trigger to attend GP.

Also aware, however, of need to find & treat cause of current symptoms to maintain long- term health & continued capacity to perform (= earn).

Physical Examination Findings:

Standing posture – mild thoracic kyphosis with protraction of both scapulae & forward head posture. Average build with lax abdominal muscles.

Flexion in standing – fingertips 10cm below knees, mild scoliosis convex on right.

Extension in standing – stiff ++

Side flexion in standing – fingertips to knee on left – complains of right lumbar tightness; fingertips 5cm above knee on right with stiff segment T3-T8.

Spinal rotation in sitting – stiff end of range to left but range normal. Pain reproduced with overpressure; ¾ range to right – stiff segment T3-T8.

Palpation – increased tone & tenderness left erector spinae T6-T8 & right erector spinae L2-L4. Stiff PA central & right unilateral T3-T8.

Treatment Plan:

Posture training including cross-tape to mid thoracic spine to promote postural awareness & self- correction of forward posture.

Soft tissue releases left erector spinae T6-T8 & right erector spinae L2-L4.

Spinal mobilisation T3-T8 to increase extension & right rotation.

Home exercises: Right side flexion in sitting bringing left arm over head; right rotation in sitting with hands behind neck, elbows forward – eight repetitions of each exercise with 10 second stretch at end of range – repeat four times each day.

Review twice each week until departure – introduce strength exercises & self-massage using tennis ball at next session. Advised patient that problem is not acute – should be able to participate in tour but will need to exercise, do self massage & use tape for posture while away.

Writing task:

Using the information in the notes, write a letter back to the referring GP detailing your findings and suggested treatment plan. Address your letter to Dr William Stacey, Greywalls Clinic, 23 Station Road, Greywalls.

In your answer:

• expandtherelevantnotesintocompletesentences • donot use note form • useletterformat

The body of the letter should be approximately 180-200 words.

1

Dr William StaceyGreywalls Clinic23 Station RoadGreywalls

(Today’s date)

Dear Dr Stacey,

Re: Max Wolff – aged 35

Thank you for referring your patient, Mr Max Wolff, to me for review and a treatment plan. He attended my office yesterday.

As you know, Mr Wolff is an orchestral double bass player by profession. He reports upper back pain between his shoulders that is aggravated by prolonged performance on the instrument (over two hours) and eased by rest. He also has dull pain in his lumbar spine. The symptoms have been developing for 6-10 months and Mr Wolff has recently been using low-strength analgesics to help him sleep.

On examination, there is mild thoracic kyphosis with protraction of both scapulae and forward head posture. Mild scoliosis is evident on the patient’s right side with lumbar tightness (stiff segment T3-T8) and 3/4 range spinal rotation.

I initiated posture training and spinal mobilisation and have started the patient on home exercises involving rotation and stretching. Mr Wolff will have twice-weekly sessions for three weeks until the start of the concert tour and I will introduce strength exercises and self massage at our next session.

Mr Wolff will need to continue his treatment routine while away, but will be able to participate in the tour.

Please contact me for any further information.

Yours sincerely

Physiotherapist

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: PHYSIOTHERAPYSAMPLE RESPONSE: LETTER

Writing sub-testPodiatrySample Test


Candidate number

Family name

Other name(s)

City

Date of test



– –




ABN 51 988 559 414

TURN OVER 2

Notes:

You are attending to a dancer’s toe nails after a number of recurring attempts to relieve trouble from an ingrown toe nail.

Clinic: Podiatry Clinic

Name: Jennifer Dupont

Marital status: Single

Residence: 14 Powell Drive

Newtown

Date of Birth: January 10, 1990

Examination date: September 4, 2010

Diagnosis: Recurring onychocryptosis (ingrown toenail) R/ hallux

Past Medical History: Appendicectomy 1998

Father - ingrown toe nail problems for yrs.

Ingrown toe nail – treated with success 2005

L sore - not ingrown 2006

Infected R toe given anti-biotic powder 2007

R toe nail still sore, purulent discharge – resting from dance 2008

Toebeengoodformorethan1yrnowveryred,inflamed&green discharge 2010.

Social background: Migrated France -> Australia 1999 with parents.

Elite dancer. Lives at home with parents between travelling on dance tours.

Medical History ChronicbadlyinfectedRhalluxfor5yrs.Attendedmanytimes& treated with betadine antiseptic liquid and oral antibiotics.

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: PODIATRY




3

Treatment record/Case notes:

1/08/09 Presented for routine nail treatment

Strongly recommended that podiatrist attends nail care as the patient has an involuted nail shape and poor cutting techniques has lead to recurring problems.

6/12/09 L / hallux - good. Hypergranulation of R /hallux red - no evidence of infection.

Cutowntoenailsinahurrybeforeadancerecently.Superficialskindamage ~8mm to R/1

Busy schedule over next month - cannot rest.

4/09/10

On examination: R/1 Extremely painful with exudate

Daily soaks in Epsom salts and dressings by district nurse /family memberwithbetadineandmefix/hypafix

Currently resting. Reviewed by doctor whilst on tour recently. Oral antibioticscephalexin(Keflex)(1rpt)

R/1 treated, nail spike removed and dressing applied

To attend clinic once/week.

Wants something done about the recurring problem.

Discussed options including wedge resection with phenolisation, though not during infective stage. Need plenty of time off from dancing. Explained healing post procedure.

For referral to Local GP.

Writing task:

Using the information given in the case notes, write a letter of referral to the local doctor, Dr Ray Brooks, 3 Brougham Road, Lakeside suggesting that Jennifer be reviewed for possible wedge resection of her right large toe.

In your answer:

• Expand the relevant notes into complete sentences

• Do not use note form

• Use letter format

The body of the letter should be approximately 180 - 200 words.

1

Dr Ray Brooks 3 Brougham RoadLakeside

(Today’s date)

Dear Dr Brooks,

RE: Ms Jennifer Dupont14 Powell DriveNewton

DOB 10/1/1990

Thank you for reviewing Jennifer Dupont, an elite dancer with chronic onychocryptosis in her right hallux. Her left toe is less problematic. Jennifer’s medical history is uneventful but her father has had numerous ingrown toe nails. Jennifer has attended this clinic since 2005 with varied success for infections.

Her attendance to the clinic has been irregular, despite my advice. Due to heavy schedules she recently cut her own nails and caused further superficial soft tissue damage (~8mm). I have seen her three times since August 2009. Her current regime includes daily soaks in Epsom salts, regular dressings with betadine liquid and mefix. Recently, whilst on tour she required oral Keflex (cephalexin) from a local doctor.

I explained that due to her ongoing problems and infrequency of visits for regular treatment, the best treatment option is a wedge resection. With proper phenolisation she should be problem free in the future. I also explained that the infection must first be treated with antiobiotics before the procedure can be undertaken. Jennifer is likely to require 2-3 weeks of rest for the toe to heal.

I would appreciate an assessment of Jennifer to determine if further antiobiotics are required and if a wedge resection would be an appropriate treatment path.

Sincerely,

Podiatrist.

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: PODIATRY


Writing sub-testRadiographySample Test


Candidate number

Family name

Other name(s)

City

Date of test



– –




ABN 51 988 559 414

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: RADIOGRAPHY




TURN OVER 2

6/9/10

Radiographer in ChargeCity HospitalNewtown

Dear Radiographer

I am writing to express my concern at a patient of mine not having a chest X-ray prior to surgery.

On the morning of 4/9/10, I personally delivered the request form to the X-ray Department and indicated it needed to be done on the same day, as the patient was for theatre on the morning of 5/9/10 (yesterday). However, for some reason, the patient – Mr Peter Billings – did not have the X-ray, and consequently the operation was done without the aid of a recent chest X-ray.

Although Mr Billings has suffered no ill effects from this, I am concerned that the X-ray was not done as requested, particularly as I made an effort to ensure that it was. I would ask that you investigate this matter in the hope that a similar situation does not arise in future.

Yours faithfully,

Dr Tony Milne

Surgical Registrar

RADIOLOGY REQUEST FORM

Pt. Mr Peter Billings No. 124326 Wd. 7 Date 4/9/10

CXR — Pre op. Pt for theatre 5/3. Dr Milne, Surgical Reg

Notes:

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PATIENT TRANSPORT LOG DATE 4/9/10 PM

Time Name Ward Travel Comments

12.00 Estella 9 Trolley

12.15 Nguyen 2 W/chair No films on Wd

12.30 Jones 6 Walk

12.45 Simms 2 W/chair Go to Path. after X-ray

1.00 Billings 7 W/chair Dr with pt – try later

1.15 Syme 8 Trolley O2

1.30 Alrabiah 1 Walk

1.45 Rouse 10 Trolley Too sick to come down

2.00 Courtney 5 Walk

2.30 Lamb 9 W/chair O2

2.45 Aitken 1 Trolley I.V. Films back with patient

3.15 Billings 7 W/chair Pt not on ward – having test

3.30 Singh 2 Bed In traction

4.00 Fry 6 W/chair

4.15 Lui ICU Bed

4.30 Tonkin 1 Walk

5.00 McBean 1 Trolley

5.30 Johnson 5 W/chair I.V.

6.00 Billings 7 W/chair Now needs Trolley – try later!

7.00 Xu 9 Trolley To Wd 6 after X-ray

7.30

8.30 Lee ICU Bed

9.00 Jenson 2 Trolley O2 No films on Wd

9.15

9.30 Billings 7 Trolley Too late – nurses wouldn’t let patient down & said OK to do 5/9 am, as pt for theatre in pm.

END OF SHIFT

Writing task:

Using the information given in the transport log and the request form, write a letter of explanation in response to Dr Milne’s complaint.

Address the letter to Dr Tony Milne, Surgical Registrar, City Hospital, Newtown.

In your answer:



• useletterformat


1

(Today’s date)

Dr Tony MilneSurgical RegistrarCity HospitalNewtown

Dear Dr Milne,

Thank you for your letter regarding Mr Peter Billings’ pre-operative chest X-ray.

It appears that we attempted on four separate occasions to do Mr Billings’ chest X-ray, between 1pm and 9.30pm on 4/9/10, but for a variety of reasons we were unable to get him down from the ward to the X-ray Department. Mr Billings was undergoing tests and consultation when we first attempted to transport him down. On our last attempt, we were sent away as it was too late in the evening. We were informed by the nursing staff that Mr Billings was scheduled for theatre in the afternoon of 5/9/10 and that we could therefore do the chest X-ray in the morning.

Unfortunately, there was no indication on your request form as to what time the operation was to be done; hence, we acted on the information given to us by the ward. Perhaps in future you could be more specific regarding the patient’s operation schedule and also ensure that the ward staff have accurate information.

Yours sincerely

Radiographer

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: RADIOGRAPHY

SAMPLE ANSWER: LETTER

Writing sub-testSpeech TherapySample Test


Candidate number

Family name

Other name(s)

City

Date of test



– –




ABN 51 988 559 414

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: SPEECH PATHOLOGY




Notes:

You are a speech pathologist in private practice. This patient was referred to you by an ENT surgeon, Ms Anne Werrall, for assessment and treatment, and you have now completed three months of regular treatment sessions with the patient.

Name Jana Pelovic (Ms)

DOB 24/11/1975

Diagnosis Intermittent dysphonia caused by vocal fold nodules

Medical Hx

Frequent URTIs (upper respiratory tract infections), especially in winter

Allergic to nuts

Asthmatic (since childhood, 5 yrs old)

Active & fit (plays competitive netball)

Voice has been slowly deteriorating (i.e., becoming increasingly hoarse) over past 2-3 years

Social Hx

Beginning teacher (qualified last year) – full time position; finds work stressful (heavy workload, difficulties with classroom management)

Difficult separation from husband (18 mths ago); now lives with two children

Fit, smoker, good diet, normal weight (BMI 23)

Outgoing personality, sociable, speaks loudly, dominant in conversation (describes self as ‘loud’)

SP Initial Ax Results (2/12/09)

Voice profile indicates moderate roughness & breathiness with mild strain, phonation breaks, mildly low mean pitch, mildly loud volume

Pt reports sensory changes characterised by dryness, fatigue & use of effort required to talk

Pt reports reduced pitch range especially in upper register; pitch & phonation breaks in singing

Videostroboscopic analysis shows thickened epithelium & bilateral thickened superficial lamina propria at the midpoint, which impedes normal voicing; nodules appear soft & benign

Stroboscopic view of moving vocal folds shows motion inhibited by the masses

TURN OVER 2

3

Other influencing factors

Smoking & regular URTIs may exacerbate occupational vocal abuse

Anxiety, stress & conflict relating to marriage breakdown perhaps contribute to development of vocal nodules (through bodily physical tension)

Progress

Voice therapy Tx focus

1. facilitate normal voice production, e.g., reduce volume and effort required, use of optimal pitch, use of diaphragmatic breathing, optimal posture and resonance

2. manage vocal abuse, teach ‘yell well’ technique, reduce/eliminate throat clearing, facilitate cessation of smoking

3. implement vocal hygiene, e.g., increase water intake, steaming, use of vocal rest and reduction of vocal load

Tx duration: regular sessions over estimated 3-6/12

Reassessment recommended at 3/12

After 3 months (6/3/10)

Good compliance by pt; voice normal, no sensory symptoms reported; cessation of smoking; regular use of voice techniques

Review in 3/12

Writing task:

Write a letter to the referring ENT surgeon, Ms Anne Werrall, Ear, Nose and Throat Surgeon, City Hospital, Main Street, Newtown, outlining assessment recommendations, treatment results and recommended follow-up treatment.

In your answer:

• expand the relevant case notes into complete sentences

• do not use note form

• use letter format

The body of the letter should be approximately 180-200 words.

1

(Today’s date)

Ms Anne WerrallEar, Nose and Throat SurgeonCity HospitalMain StreetNewtown

Dear Ms Werrall,

Ms Jana Pelovic DOB 24/11/75

Thank you for referring Ms Jana Pelovic to me for assessment and treatment of intermittent dysphonia due to bilateral vocal nodules.

Initial assessment results on 2/12/09 showed perceptual changes (moderate roughness and breathiness, phonation breaks, mildly low pitch and mildly loud volume) and reported sensory changes. Ms Pelovic is a recently qualified teacher and professional voice use may have contributed to the dysphonia. Another contributing factor might be recent stressful events (a marriage breakdown 18 months ago) and poor management of the associated stress. A history of smoking and frequent URTIs may well also exacerbate the problem.

Speech pathology aimed to facilitate normal voice production, eliminate or reduce vocal abuse, and provide voice education. This included increased fluid intake, reduction of vocal load, cessation of smoking, use of optimal pitch in speech, and stress management techniques.

Ms Pelovic was committed to her three-month program of therapy and has stopped smoking. Her voice is now normal and no sensory abnormalities are reported. A review in three months is recommended to ensure maintenance of Ms Pelovic’s vocal health.

Yours sincerely

Speech Pathologist

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: SPEECH PATHOLOGY


Writing sub-testVeterinary ScienceSample Test


Candidate number

Family name

Other name(s)

City

Date of test



– –




ABN 51 988 559 414

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: VETERINARY SCIENCE




TURN OVER 2

Notes:

Date: 23 July 2010

Owner: Mrs Martina Schmidt

Patient: ‘Lulu’ – 18-year-old poodle cross, spayed female

*Care* unpredictable behaviour – anxious & can bite when frightened

DOB: April 1991

History:18/6/03 Vaccination given (C5). Owner reports dog ‘slowing down’, sleeping more, with moderate cough (getting worse & more frequent), less energy during walks than before (now have to be shorter). Clinical examination – cardiac auscultation suggests provisional diagnosis: congestive heartfailure(CHF).Recommendedteststoconfirm:haemogram,biochemical profile,urinalysis(U/A),thoracicX-rays,ECG.

23/6/03 Haemogram,biochemicalprofile,U/A,thoracicX-rays,ECG.Testresultsconfirm provisional diagnosis: ++CHF. Treatment: medication – benazepril hydrochloride (½ tab daily). Also regular walks, good diet, maintain healthy weight.

25/8/04 Dog well, bright & alert. Coat glossy. Body weight (BW): 10kg. Vaccination given (C5). CHF treatment continuing.

3/8/05 Bright & alert. BW: 9.5kg. Heart rate: 90bpm. Managing 1-hour walk daily. Good muscle tone. Vaccination (C5). Continue CHF treatment regime.

10/7/06 Dog well, responsive. BW 9.5kg. CHF treatment ongoing. Vaccination (C5). Heart rate: 88bpm.

26/5/07 Check-up. Bright & responsive. Heart rate: 85bpm. Lungs clear. Muscle tone good. Heartworm prevention. Vaccination (C5).

24/6/09 Bright & alert. BW: 9.0kg. Vaccination (C5). Heart rate 80bpm. Lungs clear.

3

10/7/10 Owner reports Lulu seems depressed, sleeping more, slow sitting down & reluctant to get up, reduced interaction with family & other dogs, ‘shivering’, periodic retching, urinary incontinence. Coat dull. BW: 8.5kg. Heart rate: 81bpm. Vaccination (C5). Provisionaldiagnosis:chronicrenalinsufficiency/chronicrenalfailure.Recommended tests:U/A,haemogram,biochemicalprofile.Ownerdoesn’twantdogeuthanased.

17/7/10 Tests:U/A,haemogram,biochemicalprofile;observation. Clinicalfindings:provisionaldiagnosisconfirmed:++chronicrenalinsufficiency(CRI); ++CHF;osteoarthritis(OA).

Care Notes For CRI – low protein diet (commercial or homemade – recipes available) to reduce load on kidneys. Fresh water daily. For CHF – daily walk, adequate (varied) diet. For OA – warm bedding & sleeping place, ? dog coat (for warmth), daily exercise (not toolong/difficult).

Medications For CHF: benazepril hydrochloride – ½ tab daily (ongoing). ForOA:carprofeninjection–1xwklyfor4wks,thenmthly(ongoing);chondroitin sulfate (Cosequin DS) – one capsule daily, sprinkled over food. For urinary incontinence: phenylpropanolamine (Propalin Syrup) – 0.25ml 2x daily on food (calibrated syringe provided to measure dosage).

Writing task:

Write a letter to the dog’s owner outlining your diagnosis of Lulu’s illnesses and appropriate instructions for care at home. Address your letter to: Mrs M Schmidt, 21 High Street, Newtown.

In your answer:

•expandtherelevantnotesintocompletesentences

•donotusenoteform

•useletterformat


1

Mrs M Schmidt21 High StreetNewtown

(Today’s date)

Dear Mrs Schmidt,

Re: Lulu – female poodle cross, aged 19

The results of the tests performed on Lulu yesterday confirm that she has chronic renal insufficiency. This is in addition to the heart condition first diagnosed six years ago. Lulu is also suffering from osteoarthritis.

Lulu should have access to fresh water every day, and should be given a diet low in protein to reduce the load on her kidneys. We can recommend suitable commercial food for Lulu or provide recipes for appropriate homemade food. Her urinary incontinence can be treated with phenylpropanolamine (0.25ml twice a day on food).

You should continue to give Lulu benazepril hydrochloride for her heart (half a tablet each day), maintain a varied diet and keep up the daily walks, as this is good for Lulu’s heart. Note, however, that the exercise should not be too long or difficult for her because of the arthritis. Lulu needs a warm place to sleep, appropriate bedding, and possibly a dog coat to help her feel more comfortable, given this condition. A series of carprofen injections (starting weekly for four weeks and thereafter monthly) would help; you could also give chondroitin sulfate (Cosequin DS) for this – one capsule daily sprinkled over food.

Please do not hesitate to call if you have any questions or concerns.

Yours sincerely

Veterinarian

OCCUPATIONAL ENGLISH TESTWRITING SUB-TEST: VETERINARY SCIENCE


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