Benchmark Listeninig Tests

1 2 3 4 5 b
Practice Test 1 : Part A – Extract 1 Q(1-12)

You hear a cardiologist talking to a patient referred for dizziness. For questions 1-12,
complete the notes with a word or short phrase.
 Patient Jack Thatch
Reason for Referral Dizzy spells
History of Condition
Onset of symptoms: (1)
Effect on daily life: Prone to falls
 Some episodes caused loss of (2)
 Early episodes triggered by physical exertion (3)
 Change in episodic trigger pattern: Patient started to have symptoms

while (4)
Takes about 10 – 15 minutes to recover
 Severity: Enough to warrant intervention by way of calling an (5)
 Third person account: Jack appeared (6) during an episode
 A& E check for (7) came back negative
 Diagnosis and Treatment
Suspected condition: (8)
 (9) detected from most recent ECG
 Stokes-Adams attacks due to (10) heartbeat – cause of blackouts

Electrical impulses telling the heart when to beat are delayed or blocked
 (11) needed (to monitor and control heartbeat)
 Surgery required – although it’s not (12)
Discharge: Usually within 24 hours of the procedure
Practice Test 1 : Part A – Extract 2 Q(13-24)

You hear a GP talking with a patient complaining of lack of energy.
 Patient Mrs Halloway
Reason for Appointment: Lack of energy
History
Occupation: Solicitor
Growing fatigue over the (13)
Affecting professional life: fell (14) at work a few times
Affecting social life: gave up weekly tennis game

Affecting personal life: sleep patterns disrupted
 Suffered depression (15) years ago (marriage breakdown)
 Physical symptoms: constipation and (16) gain
 Family history of (17)
 Possible Diagnosis
Normal (18) levels (diabetes ruled out)
 Skin: dry and (19)

Anaemic
 Lipid level: (20) (indicating hypercholesterolaemia)
 Early diagnosis: (21)
 (22) interfering with sleep
 Condition ismore prevalent in (23)

Patient’s age is an added risk factor
 Next Steps
Requires (24) tests to be sure of diagnosis
Practice Test 1 : Part B – Q(25-30)

For questions 25 to 30, choose the answer (A, B or C) which fits best
according to what you hear. You’ll have time to read each question before you
listen. Complete your answers as you listen.
 25
You hear a conversation between a GP and a patient about recurring
diarrhoea.
What does the GP ask the patient to confirm?
o AWhether she caught the disease in St Petersburgh, Russia.
o BWhether she was in the vicinity of a place with the disease

recently.
o CWhether she had been to the tropics recently as the disease is

common there.
 26
You hear a physician in the A&E department talking with a patient
presenting with abdominal pain.
The physician wants to deal with the patient’s dehydration by...
o AOrdering an x-ray of the patient’s abdomen.
o BHaving blood drawn in order to run tests.
o CHaving an IV put in while other tests are run.
 27
You hear a ward briefing about a newly admitted patient.
What does the doctor conducting the briefing want to confirm?
o AThe reason the patient is in pain.
o BThe reason the condition was triggered.
o CThe reason the patient’s eyes are sore.
 28
You hear part of a training on communication between providers.
What will be the priority of the new role discussed?
o ATo improve communication between doctors and patients
o BTo improve communication between patients and nurses
o CTo improve communication between doctors and nurses.
 29
You hear a trainee doctor discussing stress with a senior GP.
What does the senior doctor identify as the cause of the problem in
general practice?
o AThe unwillingness of younger GPs to work locally or full time.
o BThe number of doctors opting to go into general practice.
o CThe difficulty with balancing the long days with family life.
 30
You hear a conversation between a nurse and a doctor about
scheduling appointments.
Why did the nurse mention that she had already spent an hour on the
task?
o ATo show that she had already put in reasonable effort before
asking for help.
o BTo show that she does not have enough information to complete
the task quickly.
o CTo show that she is also feeling the effect of the hospital being
short-handed at the moment.
o
Practice Test 1 : Part C – Extract 1 Q(31-36)
You hear part of a presentation about a recent report on podiatry education.
 31
The speaker points out that many of the foot conditions people suffer
from…
o AAre more common among the elderly.
o BDo not necessitate medical intervention.
o CCan be dangerous if handled by someone without skill or knowledge.
 32
What is the main purpose of the project?
o ATo save money by empowering patients with minor conditions
o BTo discharge as many patients as possible for the podiatry service
o CTo focus all of the podiatry service’s efforts on high risk conditions
 33
What types of patients were deemed suitable for self-care?
o AThose with high risk medical or podiatric needs
o BThose able to take care of low risk conditions
o CThose with a medically-trained family member
 34
What was offered to patients considered to be low risk?
o ASmall group educational sessions
o BOne-to-one assessment appointments
o CSmall group assessment sessions
 35
How did the project result in cost savings?
o ABy reducing the total number of patients seen by podiatrists
o BBy reducing the number of podiatrists seeing patients
o CBy reducing the number of appointments involving low risk patients
 36
According to the speaker, the primary benefit to patients was…
o AThe quality of care that podiatry patients received
o BThe amount of time patients had to wait to be seen
o CThe level of satisfaction of all podiatry patients
Practice Test 1 : Part C – Extract 2 Q(37-42)

You hear an interview with a nurse about common problems in hospitals
 37
What is the current role of the interviewee?
o AA leader of an organization that works to promote nursing
o BA nurse with experience working with elderly patients
o CA health practitioner with a background in emergency medicine
 38
According to the interviewee, what is causing the lack of physician
integration?
o AThe poor communications systems in place
o BThe lack of permanent physicians at hospitals
o CThe integrated care model recently adopted
 39
Why was the interviewer surprised by the interviewee’s initial response

about challenges?
o ABecause he does not agree with what she has said.
o BBecause he has information that contradicts what she said.
o CBecause he has heard information about another problem.
 40
According to the interviewee, what is the most serious result of short-
staffing?
o AJob satisfaction and burnout of nurses
o BSignificant turnover in health systems
o CIncreased risks to patient safety
 41
The interviewee notes that long hours can negatively affect…

o AThe mental abilities of nurses
o BThe physical abilities of nurses
o CThe family and social life of nurses
 42
What challenge does the interviewee say might be surprising to many?
o ADomestic violence
o BBullying by physicians
o CBullying by patients
o
Practice Test 2 : Part A – Extract 1 Q(1-12) Answersheet
You hear a physiotherapist talking to a new patient called Alice Jackson. For
questions 1-12, complete the notes with a word or short phrase.
 Patient Alice Jackson
Referral from GP
Initial diagnosis: Tennis elbow of the 1) arm
Patient Description of Condition
No specific injury
Onset: 5 months ago
 Initial pain was 2)
Patient thought she had bumped into something
 Pain increased after 3)
Daily activities disrupted
Turning point was decreasing inability to hold a saucepan of boiling

water
 Recommendations of GP
Patient refused the 4)
 Instead, patient opted for 5) (ineffective)
Referral to a physiotherapist
 Pain Management Options

 Injection (not helpful as patient has had the pain for more
than 6)
 Acupuncture (to be done 7) and in conjunction with
physiotherapy)
 Physiotherapy (needs time to take 8) )
Pain Management Options
Exercises done at home
 Pain Management Options
Targets the 9) )
Increases strength
 Start with low 10)
 Signs of overdoing it: More 11)
6 weeks before noticeable improvement
12 weeks for full resolution
Recurrence Rate of Condition
Can include short-term flare-ups or long-term recurrence
Varies between patients
 Generally quite low (if physiotherapy is adhered to and

correct 12) is used)

You hear a gastroenterologist talking to a new patient called Luke
Thomlinson. For questions 13-24, complete the notes with a word or short
phrase.
 Patient Luke Thomlinson
Reason for Appointment
Extended bout of diarrhea
Background
Severe diarrhea: visited the Emergency Department
Symptoms have been ongoing for 13)
Drastic weight loss (14kg) in 16 days
BMI below healthy range
 Texture of faeces: 14) (without 15) or mucus)
 Patient initially dismissed the symptoms as unimportant
Symptoms intensified (diarrhea up to 10 times per day)
 Notes from the Emergency Department
On admission: Dehydrated and had 16) respiratory rate
 First line of treatment - 17)
 Change of diet to cut out 18) and lactose
Reinforced with thiamine and added B complex
Ruled out overseas infection (no recent travels abroad)
 Negative result for 19)
 Next Steps
Need to rule out 20) (related to 21) in the small
intestine)
 Initial testing will be painless
To start with a blood test
 To 22) with usual eating habits (to prevent a 23) in

the test results
 A 24) is also advised
 May require endoscopy to get biopsy samples of lining of the small

intestine
Patient informed that all results may return as negatives due to rarity
of suspected condition
Practice Test 2 : Part B – Q(25-30) Answersheet

For questions 25 to 30, choose the answer (A, B or C) which fits best according to
what you hear. You’ll have time to read each question before you listen. Complete
your answers as you listen.
 25
You hear a doctor briefing a colleague about a patient.
How does the doctor correct his initial diagnosis?
o ABy looking at the patient’s appearance
o BBy getting images of the problem area
o CBy consulting with another doctor

 26
You hear a nurse asking a doctor for help with a patient.
What does the doctor suggest be done with the patient?
o ATo let him rest and see if the pain continues
o BTo perform an ultrasound to rule out a fracture
o CTo quickly eliminate a more serious possibility
 27
You hear part of a morning briefing in a hospital ward. Now read the question.
What is the plan for the patient today?
o AShe will be given medication to treat her condition
o BShe will be given medication to help deal with a symptom
o CShe will be given a diagnosis based on lab results
 28
You hear a nurse asking a colleague for advice.
What does the colleague recommend?
o ATo refer the patient and his family to a specialist for support
o BTo get the patient long-term follow-up and support immediately
o CTo get the family of the patient involved in his care
 29
You hear a podiatrist presenting a course of treatment.
What type of intervention was chosen?
o ARemoving the problem by cutting back the nail under local anesthetic
o BUsing a chemical to prevent a recurrence ofin-grown toenail
o COpting for a combination of surgery and topical medication
 30
You hear a patient asking a physiotherapist about his current treatment.
What does the physiotherapist clarify for the patient?
o AThat the injury is more severe than originally thought
o BThat the therapy needs to be continued for now

o CThat a new injury might have recently occurred
Practice Test 2 : Part C – Extract 1 Q(31-36) Answersheet

You hear an interview with an expert on Angelman syndrome, a rare genetic
disease.
 31
Why did Dr Terry leave her career in public health?
o AShe was interested to earn a master’s degree in the US
o BShe was not fulfilled by her work in public health
o CShe was influenced by the diagnosis of her child
 32
How did Dr Terry react to her son’s condition?
o AShe looked for information about the disease
o BShe decided to become more educated about it
o CShe became involved in patient advocacy groups
 33
Why does Dr Terry mention Huntington’s?
o ABecause it is a disorder related to Angelman
o BBecause it is a more familiar disorder
o CBecause she is also interested in researching it
 34
What assumptions about Angelman syndrome have recently changed?
o AWhether doctors know how to properly diagnose the syndrome
o BWhether the disease occurs only in certain places or populations
o CWhether children with the syndrome can attend school
 35
What caused Dr Terry to seek out a diagnosis for her child?
o AHer child was too cheerful and enthusiastic
o BHer child couldn’t communicate or do other common tasks
o CHer child was given a referral to a geneticist
 36
What happened as a result of the conference Dr Terry attended?
o AShe met the person who found a cure for Angelman
o BShe learned about the gene that is responsible for Angelman
o CShe developed an idea for treatment of Angelman

You hear a speech pathologist Kevin Drews giving a presentation to a group of
trainees.
 37
Kevin says that this training will be particularly valuable for
o AThose interested in becoming a speech pathologist
o BThose interested in a medical career treating children
o CThose interested in a medical career as a general practitioner
 38
Kevin says that children with expressive language delays
o AHave difficulty understanding language directed at them
o BHave difficulty producing oral language
o CHave difficulty constructing sentences
 39
Kevin says that most children with LLE will eventually
o ANever develop language skills similar to other children their age
o BGo on to develop normal language skills by the age of about 5
o CDemonstrate language delays until they reach the age of 7
 40
According to Kevin, which is an example of a child-related risk factor?
o AThe development of motor skills
o BThe number of siblings
o CThe access to learning opportunities
 41
According to Kevin, initial treatment for LLE involves
o ADirect intervention alongside other specialists
o BGiving access to learning opportunities
o CMonitoring development and indirect intervention
 42
What is key for a successful intervention plan?
o AInvolving other specialists
o BWorking closely with the family
o CTaking into consideration culture

You hear an optometrist talking to a patient called Austin Jacobs. For
 Patient: Austin Jacobs
Reason for visit:Eye problem
Background
Onset: 4 days ago
Condition started with the 1) eye.
Described as itchy and irritated
Condition affected both eyes a day later
Presence of yellow discharge in 2) eye.
Difficulty in opening eyes
 Absence of 3) in the eyes
 4) is normal
 Can rule out 5) (no relatives with this condition)
Not using eye drops
Does not wear contact lenses
 Patient takes reasonable 6) of eyes
 Diagnosis
A type of 7)
 Various types but most likely type in this case is 8)
Inflammatory response to infection of the eyes
May also involve upper respiratory infection
 Most likely contracted from: 9)
 Recommendations
10) will not be prescribed
Disease expected to clear up on its own in a couple of weeks
 Can apply 11)
Cool compresses recommended (but cautioned not to rub eyes with

them)
Extra precautions need to be taken with hygiene
Disinfectant techniques advised
 Avoid 12) to others

You hear a GP talking to a patient called George Babsy.
 Patient George Babsy
Sudden onset of severe pain
Symptoms
Sudden sharp pain (while putting away tools)
Waited to see if pain would go away
Accompanied by vomiting (13) times)
 Pain started just below the 14)
Pain then radiates towards the back
 Shift in pain level with different body positions (pain 15)

when sitting forward)
 Medical History
Does not drink alcohol
Patient is a 16)
 Had a problem with 17) in the past
Not on any medication at the moment
BMI within normal range
 Initial Diagnosis and Recommendation
Not likely caused by previous night’s 18)
Pulse elevated and epigastrium tender, so hospital admission required
 Initial tests: Abdominal 19) and 20)
 Possibly gallstones causing inflammation (condition is

called 21) ) inflammation often because of gallstones
 Symptoms only partly consistent with tentative diagnosis (risk factors

include being a 22) , which is not the case
 Requires a further test to determine level of patient’s 23)
 Accuracy is increased the 24) the test is done to the start of

the pain

your answers as you listen
 25
You hear an A&E doctor briefing a colleague about a patient.
The A&E doctor
o Athinks that the cough medication is causing the patient’s rash
o Bthinks that the absence of other symptoms is unusual
o Cthinks that further investigation is necessary
 26
You hear a dermatologist in a training session with an intern.
Why does the dermatologist ask about the next step?
o ABecause the patient is in pain due to his condition
o BBecause he wants to hear the intern’s recommendation

o CBecause he wants to hear the intern’s diagnosis
 27
You hear an intern asking a senior doctor about the diagnosis of a patient.
How does the senior doctor deal with the intern’s concern?
o ABy telling her that she is looking at the wrong symptoms
o BBy helping her to reexamine the patient’s symptoms
o CBy telling her to be sure of what the symptoms of Parkinson’s are
 28
You hear a morning briefing in a ward.
What does the doctor prioritise for the patient’s care?
o AHelping the patient with his balance problems
o BGetting a neurologist to confirm a diagnosis
o CLearning more about the patient’s background
 29
You hear two radiologists discussing the possible diagnosis of a patient.
What does the female doctor describe?
o AA plain radiograph showing the patient’s skull
o BA CT scan showing an abnormality
o CA patient with a rare disease
 30
You hear a patient expressing a concern to an occupational therapist.
What does the patient wish to be able to do?
o AWalk up the stairs without using a hand rail
o BSupport herself using her right arm
o CBe able to take a shower by herself

You hear a presentation by a dietitian about a diet recommended for people
with a certain gastrointestinal condition.
 31
Why does the speaker mention the rate of incidence of IBS?
o AShe wants to show the audience that it is an important condition.
o BShe wants to show that Australians are more likely to have the
condition.
o CShe wants to show that women are more likely to develop the
condition.
 32
Why are potential IBS sufferers tested for other diseases?
o ABecause there are other diseases more common than IBS.
o BBecause there is no direct way to test for IBS.
o CBecause there are diseases that generally co-present with IBS.
 33
Why does the speaker say IBS is a difficult disease to manage?
o AIt is not possible to know which symptoms will occur or when.
o BIt is not possible to diagnose patients with the condition.
o CIt is not possible to lessen the negative impact it has on patients.
 34
What warning does the speaker give about a low-FODMAP diet?
o AIt can be dangerous for some patients with gastrointestinal
problems.
o BIt includes foods that most people do not enjoy eating.
o CIt may not be effective for all patients suffering from IBS.
 35
Why is it difficult to stick to a low-FODMAP diet?
o AThere are many popular foods which are high-FODMAPs.
o BThere are no low-FODMAP products available.

o CThere are few places to buy low-FODMAP foods.
 36
According to the speaker, what effect can high-FODMAP foods have on
the digestive system?
o AThey cause the gut to attract water, release gas and stretch the
intestines.
o BThey cause the gut to process the food slower than usual and
breed bacteria.
o CThey cause the gut to expand due to high levels of water and gas.

You hear a dermatologist, Derek Evans, give a presentation about the
challenges facing his speciality.
 37
According to the speaker, the most important challenge facing
dermatology is…
o AThe financial aspect of seeking treatment
o BThe low priority placed on the specialty
o CThe lack of contributions made by the specialty
 38
Why does the speaker mention skin cancer and women’s health?
o ATo give examples of priorities in dermatology
o BTo give examples of failures in dermatology
o CTo give examples of the importance of dermatology
 39
According to the speaker, what is needed to increase the number of
dermatology residents?
o AA way to increase the number of residency positions available
o BA way to fund more residency positions in the specialty
o CA way to train new dermatologists more efficiently than currently

 40
According to the speaker, how is dermatology perceived by
policymakers?
o AThere is a perception that the specialty is only for the rich and
famous.
o BThere is an old-fashioned perception of the specialty.
o CThere is a perception that the specialty lacks diversity.
 41
Other physicians have responded to the shortage of dermatologists...
o ABy treating dermatological disorders themselves
o BBy not referring their patients to dermatologists
o CBy recognizing the need for more dermatologists
 42
According to the speaker, who or what is overly involved in
dermatological research?
o APharmaceutical industry
o BResearch funders
o CDoctors of other specialities

You hear a GP talking to a patient called Seth Kelly. For questions 1-12,
 Patient: Seth Kelly
Reason for visit: Routine check up
Medical History
Stage five 1) (diagnosed 2 years ago)
Being treated at specialized clinic for renal problems
 Began haemodialysis 2)
 Also suffers from 3)
No reports of breathing problems
 Current Condition
Feeling 4) and weary (impacting social life)
 5) is not affected
 Shuns 6) meals
 In retrospect, negative feelings can be traced to the

patient’s 7)
 Reports past episodes of emotional and 8) abuse
Had trouble fitting in at school

 Potential Diagnosis and Treatment Plan
Likely suffering from 9)
 Requires a 10)
Referral to the clinic where he is currently being treated
 11) therapy - to help with negative thoughts
 Caution to be taken before prescribing an 12) , due potential

side effects of mixing medications
GP to remain in contact with kidney clinic

You hear a dermatologist talking to a patient called Karen Patch. For
 Patient Karen Patch
Referral for skin problem
Symptoms
Skin at back of neck has become 13) and heavily lined
Unsure when it started
 14) changes recently to the main area affected
 Cheeks and ears show 15) of excessive solar exposure
 Rough and patchy skin on hands are areas of solar 16)

 Parts where the skin is unaffected by sun damage: 17)
and 18)
 Diagnosis
The 19) of the skin has thickened
 20) has solar elastosis
 Cutis rhomboidalis nuchae (also known as farmer’s or 21)

skin)
Damage to collagen and elasticity
 Condition is unlikely to turn 22)
Patient at higher risk of skin cancers
 Recommendation
Not to leave it alone
Should be monitored 23) by a dermatologist
 Wear protective clothing when outdoors

 Use sunscreen, particularly on damaged areas
To ensure better 24) , early detection of skin cancer is crucial

 25
You hear an intern in radiology talking with a senior doctor.
How does the intern decide on the diagnosis?
o ABy looking at the patient’s account of events
o BBy taking into account the physical exam in the A&E
o CBy examining the radiograph of the patient’s injury
 26
You hear a GP ask a colleague for advice about a patient.
What does the female doctor confirm?
o AThat the doctor should help the patient get screened for cancer
o BThat the doctor should give more information to the pati
o CThat the doctor should get more information about the guidelines
 27
You hear an intern asking a senior doctor a question after a training
session.
What does the senior doctor clarify for the intern?
o AThe recommendations he made for the patient
o BThe reason for the recommendations he made
o CAlternative recommendations for the patient
 28
You hear a GP discuss a patient with a radiologist.
How does the radiologist respond to the GP’s plan?
o ABy agreeing with the GP’s next steps for the patient
o BBy suggesting an alternative to the GP’s plan
o CBy asking the GP how he came up with his plan
 29
You hear two nurses discussing a patient referred by his GP.
What does the female nurse identify as a cause?
o AThe patient’s recent travels
o BThe patient’s medical history
o CThe patient’s oxygen levels
 30
You hear a patient’s family member expressing concerns to a nurse
What does the nurse say to prioritize in this case?
o AFinding a nursing home close to the patient’s house
o BTaking the patient home for treatment
o CRespecting the patient’s desires

You hear a presentation by a GP talking about group appointments.
 31
Why does the speaker mention the increase in the demand for GP
appointments?
o AShe wanted to show that more and more people need to see their
GP.
o BShe wanted to show the need for looking for a new type of
appointment.
o CShe wanted to show that increasing need for more GPs to be

trained.
 32
Why is the traditional appointment less effective than it used to be?
o ABecause it isn’t enough time for the types of problems patients
have.
o BBecause it isn’t enough time for the GP to get to know the patient.
o CBecause it isn’t enough time for the GP to see older patients.
 33
Why does the facilitator make certain information visible for patients
during the appointment?
o ASo that the patients can remember the main topic of the
conversation.
o BSo that the doctor can use the information in the group
discussion.
o CSo that the patients can use the information to ask the GP
questions.
 34
What is the main aim of the group appointment?
o ATo dedicate less time to each patient
o BTo give patients an opportunity to learn
o CTo have patients ask the GP questions
 35
What was the patient’s perception of the group appointment?
o AIt took a long time for the group to get going.
o BNot everyone shared a lot of information.
o CThe group felt connected during the session
 36
It is still best to use a traditional appointment with a patient when..
o Athe patient has a diagnosed, long term illness.
o Bthe patient wants the support of a peer network.
o Cthe patient does not have any particular diagnosis.

You hear a researcher being interviewed about a new class of cancer drugs.
 37
Why is the researcher excited to share the news at this moment?
o ABecause they have just completed trials with the new drug.
o BBecause they have just gotten permission to use the drug.
o CBecause they have just started to review the results of studies.
 38
How are the new drugs different from previous approaches to treatment?
o AThey target genetic abnormalities in the body.
o BThey target a particular area of the body to treat
o CThey target cancer in various parts of the body.
 39
According to the speaker, what is needed to be able to offer the treatment
to patients in the UK?
o AThe approval from European regulators
o BA certain kind of genomic testing
o CAn agreement between NHS and European authorities
 40
According to the speaker, what is the cause of Charlotte’s tumour?
o AThe tumour genes take over and replace the DNA present in the
patient
o BPatient DNA comes together with another and creates an

alteration
o CPatient DNA is altered for a reason that doctors do not

understand
 41
According to the speaker, researchers originally feared that Charlotte’s
type of cancer...
o ACouldn’t be treated because of the way the genes were linked to
neurological cells
o BCouldn’t be treated because of the possibility of causing other

cancers
o CCouldn’t be treated because of the importance of the genes in

development
 42
What is the difference in the way children and adults respond to the
treatment?
o AChildren respond better to the treatment.
o BThere is no difference in the way children and adults respond to
the treatment.
o CAdults respond 94% better than children

You hear a pediatrician talking to a mother about her baby. For questions 1-
12, complete the notes with a word or short phrase.
 Patient:Alex Johnson
Patient’s age:1 month old
Background
Second child
Full term baby
Mother’s pregnancy: without 1)
 Weight at birth: Below 2) kilos
 Family history: 3) and diabetes
 Current Condition of of Patient
Irregular sleep pattern
Yellow eyes: prolonged jaundice
Condition is getting 4)
 Need to be checked for 5)
 Suspected that 6) remains in the liver
 Needs to check for direct bilirubin concentration
Possibly idiopathic neonatal 7) or biliary atresia
 8) was broken - not due to a 9) but mother’s action

in diaper change
 Patient is irritable
Normal for temperature, respirations and heart rate
Has 10) spleen and liver
 Next Steps
Liver biopsy
11) of the liver
 Specialist required: 12)
Check Vitamin D concentration

You hear an occupational therapist conducting an assessment of a patient
named Josh Edwards.
 Patient:Josh Edwards
Reason for Asessment:
OT assessment of home 13)
 Background
Injuries caused by 14)
 15) ankle significantly injured
 On-going treatment: 16)
Reduced mobility
Reliant on crutches
Affected leg remains 17)
 18) visible on affected ankle
 Necessity of keeping the leg19)
 Existing home furniture not supportive of transfers
Dependent on others for physical help
Pain reported in other parts: spine and 20)
 Equipment Recommendations
Requires special chair
Sit-to-stand transfer essential
21) in new equipment is necessary
 22) can help with alignment
 For social health, place new equipment in 23)
 Consider personal tastes when choosing equipment
 Equipment must also meet 24) requirements

 25
You hear a morning briefing on a ward
How does the doctor decide on the next steps?
o ABy looking at the patient’s medical history
o BBy looking at patient’s symptoms and exam
o CBy looking at a scan of patient’s abdomen
 26
You hear a trainee nurse asking a mentor for advice.
Why does the trainee ask his mentor for advice?
o ATo confirm and support possible diagnoses
o BTo help him consider other possibilities like HIV
o CTo explain to him what he should do next
 27
You hear a nurse talking to another nurse about the discharge of a
patient.
What does the female nurse tell the male nurse to prioritize?
o AThe right of the patient to receive non-hostile service
o BThe right of the patient to not be judged
o CThe right of the patient to receive care
 28
You hear a nurse talking about a new education program for parents.
Why is the nurse giving information about the new program?
o ATo get ideas on how to improve the areas of focus
o BTo explain why they are developing this program
o CTo invite members of the staff to join in its development
 29
You hear a doctor in the A&E discussing a case with a nurse.
What does the nurse confirm to the doctor?
o AThe patient’s lack of knowledge about his condition
o BThe patient’s response to the current treatment plan
o CThe patient’s continued refusal to contact a family member
 30
You hear a hospice nurse explaining intake protocol for new patients.
The protocol is designed to
o AHelp the patient make decisions about his/her own health care
o BSupport the family of a patient to make decisions about care
o CGive information about the purpose of hospice and palliative care

You hear an interview about career development in occupational therapy.
 31
What does the speaker say has changed in career development in
occupational therapy?
o AThe number of opportunities available to therapists
o BThe quality of the opportunities available to therapists
o CThe number of new therapists entering the field
 32
According to the speaker, therapists have used their strengths to...
o AImprove the opportunities available in traditional sectors
o BCreate new businesses related to occupational therapy
o CTake the profession into areas outside of traditional sectors
 33
Why is the change in the curriculum particularly important at this time?
o ABecause the field is currently experiencing significant changes
o BBecause there is less stability in employment and careers
o CBecause more and more people are entering the field.

 34
What advice does the speaker give to new practitioners?
o ATo wait for the perfect post to come along
o BTo take posts to gain experience in the field
o CTo first pursue further education in the field
 35
According to the speaker, what career path do the majority of therapists
decide to take?
o AA career that is focused on the clinical
o BA career that combines areas of the field
o CA career that combines different sectors
 36
According to the speaker, continuing professional development can...
o AHelp a therapist to learn about new research developments
o BHelp a therapist to actively contribute to the future of the field
o CHelp a therapist to get from a current post to their ideal post

You hear a radiologists talk about the latest trends in her field.
 37
According to the speaker, the main reason for the increased influence of
technology is...
o ARelated to bigger trends that are currently happening.
o BRelated to the pace at which progress is taking place.
o CRelated to the demand for new solutions to problems.
 38
What example does the speaker give of the current impact of Artificial
Intelligence?
o AThe improvement of various types of imaging
o BThe ability to detect changes in images over time
o CThe detection of biomarkers in stroke patients
 39
According to the speaker, how can Big Data contribute to the field of
radiology?
o AFaster analysis of information, leading to better treatments.
o BMore collection of information, leading to better databases.
o CBetter organization of information, leading to better research.
 40
According to the speaker, how does technology change the role that
radiologists can play?
o AIt reduces the amount of time that radiologists can spend with
patients.
o BIt increases the importance of the radiologist in the care of

patients.
o CIt makes it more difficult to devote enough time to the care of

patients
 41
Interventional radiology is growing due to...
o AThe spread of its techniques to other areas of medicine.
o BThe reduction in the number of diagnostic radiology residents.
o CThe change in the way that radiology residents are trained.
 42
Radiologists face challenges because…
o AOther providers don’t trust radiologists with imaging.
o BOther providers prefer to hand over all communication.
o COther providers are reluctant to hand over control.

You hear an obstetrician talking to a woman about her pregnancy. For
questions 1-12, complete the notes with a word or short phrase
 Patient:Alison Jackson
Reason for Appointment:
1)
 Prior to Pregnancy
Menstrual cycles were 2)
 Pregnancy
Uneventful so far
Minor complications: some tiredness and 3)
 Patient reports absence of 4)
 Examination shows 5) are unremarkable
 Patients reports baby’s gestational age as 6)
 Unusual observation: fundal height does not correspond to baby’s

gestational age – should not be the case after 7) of
pregnancy
 Conception date was not 8)
 Patient’s uterus size warrants a 9)
 Possible Explanations
Amniotic fluid is more than usual - possibility baby may be
born 10)
 Baby’s size could be 11) than expected
 Accuracy of 12) could be affected by position of baby
Hereditary reasons
Other possibilities, which are more serious

You hear a sports podiatrist meeting with a patient referred by his GP.
 Patient:Vance Godfrey
Ongoing complex 13) in right foot
 Medical History
Plantar fasciitis: 14) case
Diagnosed 2 years prior
Pain under the 15) of his heel, in centre
 Heel pain usually dissipates within 16) after touching the

ground
Added pain on the side that continues throughout the day
 Recently had three 17) in a short time period

 Previous Treatment Plan
Consulted another podiatrist before this
Application of 18) was advised
Roll the heel on a hard object
 Prescribed 19)
Treatment was unsuccessful
 Further investigation - 20) was also unremarkable
 Assessment & Treatment Plan
Possibly two separate conditions present
Heel pain is consistent with diagnosis
Possible pathology causing pain around 21) of heel
 Affecting the 22) of abductor digiti minimus or the sural nerve
Another ultrasound required for further investigation
Start treatment of existing condition
 23) to be used to allow heel to rest and recover
 To block sural nerve, can opt to inject 24) of xylocaine
Pain monitoring for 24 hours after injection

 25
You hear a training for optometrists.
What does the instructor clarify about the training ?
o AThat it is for optometrists seeking a specialty in the field
o BThat it is for optometrists wanting a review of primary eye care
o CThat it is for optometrists currently still completing their training
 26
You hear a nurse explaining a new protocol for patient handover. .
The new protocol for patient handover prioritises
o Acommunication between the nurses on the case
o Bcommunication between nurses and patients
o Ccommunication between the nurses and the doctors
 27
You hear a nurse talking to a patient about his upcoming hospital stay. .
What does she describe to the patient?
o AA written document about eight main areas of care after surgery
o BA written document about how families can help the patient during
recovery
o CA written document about what patients can do to be safe
 28
You hear a surgeon talking about an optional training. .
What does the surgeon explain about the medical problem?
o AIts prognosis is more complicated than that of similar cancers
o BIts prognosis is comparable to that of similar cancers
o CIts prognosis is not as promising as that of similar cancers
 29
You hear a doctor explaining the side effects of a treatment to a patient. .
What does the doctor suggest the patient do?
o APurchase a thermometer to keep track of his temperature
o BTake the prescribed treatment every four weeks
o CAvoid any infections as much as possible during treatment
 30
You hear an intern ask a senior doctor about a patient’s treatment. .
The senior doctor explains to the intern
o AA series of reasons why this particular treatment is being used
o BA series of ways in which the patient is not responding well
o CA series of ways that a patient could respond to the treatment

You hear a presentation about research on allergies in children.
 31
What does the speaker say has changed in terms of allergies and
children?
o AMore children are presenting with food allergies.
o BMore children are presenting with allergies in general.
o CMore children are presenting with an allergy to peanuts.
 32
According to the speaker, children with this allergy initially
o APresent with a less severe reaction
o BPresent with a more severe reaction
o CPresent with other allergies or conditions
 33
What is the objective of the first treatment approach being researched?
o ATo have children build up tolerance by starting to eat a wider
variety of foods
o BTo have children build up tolerance by starting to eat small
amounts of the allergen
o CTo have children build up tolerance by starting to eat large

amounts of the allergen
 34
How will researchers know how children have reacted to the treatment?
o AThrough observing them for a few hours at the hospital
o BThrough recording them for a few hours at a time
o CThrough phone calls and having them visit the clinic
 35
According to the speaker, why is the current treatment for this condition
difficult for patients?
o ABecause it requires persistent watchfulness
o BBecause many people like to eat foods with the allergen
o CBecause many people are unaware of the condition
 36
What is one reason for the treatment method used in the second study?
o ABecause many patients do not have the time to add the allergen
to their diet
o BBecause many patients have a strong reaction to the taste or

smell of the allergen
o CBecause many patients prefer not to make any changes to their

current diets

You hear a doctor specialising in kidney transplants being interviewed about a
new procedure.
 37
According to the interviewee, what problem was the research trying to
address?
o AThe damage done to the transplanted organ during surgery
o BThe amount of time required to complete the transplant
o CThe loss of blood supply to the transplanted organ during surgery
 38
What factor did the researcher take into account when choosing which
tool to use?
o AThe cost of overall procedure
o BThe cost of the tool itself
o CThe ease of access to the tool
 39
How did the placebo procedure differ from the experimental one?
o AThe blood pressure cuff was tightened more
o BThe blood pressure cuff was not tightened
o CThe blood pressure cuff was not used
 40
According to the researcher, why was the research done over a number of
years?
o ABecause the effectiveness of the kidney declines gradually
o BBecause there were many patients involved in the study
o CBecause it took a long time to analyze all of the information
 41
The interviewer says that the procedure has the potential to…
o AExtend the lifespan of all patients by years
o BIncrease the cost to the NHS by quite a lot
o CMake the lives of transplant patients better
 42
The research would like to figure out why the procedure...
o AHas not always received positive results
o BHas not been thoroughly researched
o CHas not received a lot of attention by doctors

You hear a GP talking to a patient named Alex Summers about a skin
problem. For questions 1-12, complete the notes with a word or short phrase.
 Patient:Alex Summers
Hand:1)
History of Condition
Recurring condition
 Current outbreak began 2) ago
 Current outbreak possibly related to 3) ingested less than 24

hours prior
First outbreak was also related to the same medication (taken three
days before)
 First outbreak left residual 4) after healing
 Patient describes pain as a slight 5)
Fixed drug 6) (immune-mediated

mucocutaneous 7) to medication)
 Complicates diagnosis when patients do not report taking OTC drugs
Essential to keep record of all drugs taken

 Possible to confirm diagnosis with a 8) (invasive)
 Another option to confirm diagnosis is a 9) (less invasive)
 Recommendations
10) therapy can be used on non-mucosal areas
 11) to reduce pain
Change fever medication
Monitor reaction to any new medications
 12) the condition to any other medical professional

prescribing medication
You hear a physician in the A&E talking to a patient experiencing abdominal
pain. For questions 13-24, complete the notes with a word or short phrase.
 Patient:Mrs Haverson
Medical History
Abdominal pain lasting for 13)
 Prescribed ranitidine - not effective
Pain has been constant
Accompanied by nausea and has started vomiting
Also reports feeling 14)
Pain not associated with food

 Underlying condition: 15) (on medication: glyburide)
Past GP observation: mild 16) in the mid epigastrium and

right upper/lower 17)
 Blood test: Glucose level the only remarkable result of test
 Radiography: 18) ileus (type of mechanical 19)

obstruction)
 Chronic cholecystitis could have caused an 20) fistula
 Gallstone could have been 21) in a narrow area of the

intestine (size of patient’s gallstone - about 3 milimetres in diameter)
 Quite a rare condition, likely related to patient’s 22)
 Treatment
Recommendation: Surgery
Control fluid and 23) imbalances prior to surgery
 Removal of gallbladder to prevent organ 24)



 25
You hear a conversation between a physician and patient about pain
management.
What does the physician want to confirm with the patient?
o AThe management of the underlying condition
o BThe continued management of the patient’s pain
o CThe communication with the patient’s family
 26
You hear a trainee doctor asking a senior doctor about a radiography.
The senior doctor explains to the trainee that
o AThere are a wide variety of systems to classify ankle fractures
o BThere is a classification system related to how the fracture occurs
o CThere is a classification system related to how to treat the fracture
 27
You hear a nurse talking to another nurse about a patient’s treatment.
What does the female nurse want the male nurse to correct?
o AHow accurate he is in updating the patient’s file
o BHow often he checks on the patient’s condition
o CHow compliant he is in following instructions
 28
You hear part of a training on infection prevention and control.
Why is the training being given at this time?
o ABecause of the volume of patients presenting with symptoms
o BBecause most of the staff have not gone through the training
o CBecause there are new guidelines that everyone needs to know
 29
You hear a trainee nursing asking a senior nurse for advice.
What does the senior nurse say should be prioritized?
o AThe staffing needs of the ward and hospital
o BThe needs of the patients you are caring for

o CThe needs and safety of each individual nurse
 30
You hear a conversation between a patient and a dietitian.
The patient made the appointment with the dietitian because
o AOf the recommendation of her GP
o BOf her lack of success in losing weight
o COf her lack of success in eating better

You hear part of a training about the use of radiology in patients with
headaches.
 31
Who is the target audience of this training session?
o ATrainees hoping to specialise in diagnostic radiology
o BTrainees currently training in emergency medicine
o CA&E physicians looking to specialise in radiology
 32
According to the speaker, the first step that should be taken is…
o ATo compare the different sides of the brain for a shift
o BTo determine if emergency surgery needs to take place
o CTo decide on the course of treatment for the patient
 33
Which of the following is a symptom of the type of stroke mentioned?
o AA bleeding into the space around the brain
o BA sudden onset of a severe headach
o CA ruptured aneurysm
 34
According to the speaker, how might a patient with ventricular
enlargement feel?
o AThe patient may have a headache and see double.
o BThe patient may have a blockage of fluid in the brain
o CThe patient may have a condition like meningitis.
 35
According to the speaker, why is it generally not necessary to order a CT?
o ABecause most headaches cannot be diagnosed with imaging.
o BBecause most headaches are not severe enough to require a CT.
o CBecause most headaches can be diagnosed without a CT.
 36
According to the speaker, it is necessary to order a CT when…
o AIt is requested by a patient.
o BA GP is not able to make a diagnosis.
o CA patient reports a change in symptoms.

You hear an interview with a dietitian about malnutrition in the elderly.
 37
According to the interviewee, what is the approach taken by the project?
o ATo involve the family members of the patient
o BTo involve other healthcare professionals in care
o CTo involve the general physician of the patient
 38
How did the project come to know about the case that the interviewee
mentions?
o AThrough the social worker assigned to the patient
o BThrough the care agency of the patient
o CThrough the speech language therapist of the patient

 39
What social barrier prevented the patient from getting enough nutrition?
o AShe eats very slowly.
o BShe doesn’t like to eat alone.
o CShe doesn’t like to prepare food.
 40
What changes were made to the patient’s diet?
o ATo add full fat milk to food and drink
o BTo replace meals with milky puddings
o CTo add butter to the soft texture meals
 41
Which new service did the plan get started for the patient?
o ASpeech therapy
o BSocial service
o CBefriending
 42
Which part of the plan has been the most successful?
o AHaving the patient eat with someone else
o BChanging the texture of the meals
o CMaking the food cheaper for the patient

You hear a general practitioner talking to a new patient called Doug Jones.
For questions 1-12, complete the notes with a word or short phrase.
 Patient Doug Jones
Occupation: 1) (retired)
Having trouble sleeping
 Information Given
Ignored the sleep problem initially – now experiences it 2-3 times a

week
Described as 2) by the patient
 Coupled with concentration problem
Recounted an incident: Could not immediately recognize 3)

from previous workplace
 Cannot cope with 4) resulting in irritation and frustration)
Has memory problems as well - forgetting simple words and phrases
 5) of physical activity (due to self-isolation)
Hypertension – on medication s
 Initial Diagnosis: Dementia
Potential due to presence of 6)
 Not the same as general forgetfulness but is a 7) brain

disorder
Long-term result: death
 Affects thinking, behavior, and daily 8)
 More work needed to identify 9) type of dementia
 Initial Recommendations
Improve general health
Increase 10) of physical activity
 Improve quality of sleep (to eliminate 11) from the brain)
Refrain from using sleeping pills
 Intervene to prevent breathing problems while sleeping, because lack

of 12)
will have a negative impact on memory
Referral
to a sleep specialists

You hear an addiction specialist talking to a new patient called Cheryl Tyson.
 Patient: Cheryl Tyson
Reason for Referral:
Addiction to painkillers
Chronology of events
Onset of 13) pain due to physical work in a warehouse

 Had 14) - disrupted daily activities
Initially relied on OTC pain relievers
 Resorted to microdistecomysurgery after 15) did not help
 Only prescribed opioids post-surgery, including 16) and

opiate mix
Developed reliance on the painkillerss
 Led to overdosing on painkillers up to 17) the recommended

dosage
Developed breakthrough pain
 Also started taking up to three 18) a day
 Complications of Medication
Severe constipation
Nausea
19) swingsto the point of being suicidal
Fuzziness
 Memory loss (as a result of 20) years of taking painkillers)
 Treatment Plan
First phase: Learn 21) ways to manage pain

Second phase: Progress to 22) therapy to learn how to
handle stress
 Third phase: Learn to slowly reduce painkillers through private session

with a 23)
 Ultimate goal: to no longer see opioids as a 24) (instead, to

use other pain management techniques)

 25
You hear a dermatologist talking to a patient about their skin health.
What is the cause of the patient’s problem?
o Aher recent change in diet
o Ba change in medication
o Ca new treatment plan
 26
You hear a nurse talking about a new program to be introduced on her ward.
What will be the programme’s main objective?
o AThe programme will provide support for nurses dealing with
addiction.
o BThe programme will provide support for patients dealing with

addiction
o CThe programme will provide support for community outreach.
 27
You hear an intern asking a senior colleague about a patient’s treatment plan.
What recommendation has the senior colleague made?
o ATo treat Mr Harris’ balance issues
o BTo have Mr Harris do light physical activity
o CTo get Mr Harris out of bed as soon as possible
 28
You hear a surgeon and an internist discuss the treatment plan for a patient.
The female doctor suggests that the patient could
o Ahave internal injuries not detected by the tests done
o Bhave further damage as a result of the fracture
o Cwait for further tests and scans to be run
 29
You hear members of a hospital discussing a problem in the A&E department.
.
What problem is the department experiencing?
o AThere are more patients with mental health disorders.
o BThere is no mechanism to get patients into treatment.
o CThere are no staff in the hospital who can help the patients.
 30
You hear a GP talking about opening and managing her own practice.
What does she consider to be the biggest challenge?
o ACreating close relationships with patients
o BBalancing time with patients with other responsibilities
o CMaintaining healthy finances

You hear a presentation by a radiologist, Allen Jackson, who’s talking about
his own work with artificial intelligence
 31
Why does Allen Jackson give information about how the current system
works?
o ATo emphasize how the research can improve upon the current
system
o BTo give information that few people are likely aware of
o CTo explain why he decided to take part in this research project
 32
How does artificial intelligence compare to the current system?
o AAI is slightly less accurate than the current system.
o BAI compares favorably to the current system.
o CAI results in more women being diagnosed with cancer.
 33
How did patients feel about the study?
o AThey were not informed about their participation.
o BThey were not concerned about any aspect of the study.
o CThey were worried about the security of their records.
 34
Allen Jackson believes that the results of the research study mean that
o Adoctors can specialize in other areas of medicine
o Bdoctors can spend less time specializing in radiology
o Cdoctors can devote less of their time to diagnosis
 35
How might future patients be affected by the research?
o AThey will not notice any difference as a result of the research.
o BTheir stress levels may decrease because of speedier results.
o CFewer patients will likely be diagnosed with breast cancer.
 36
Allen Jackson believes that international collaboration is important
because
o Ait will help improve the accuracy of diagnosis for women in the UK
o Bit will help to eradicate the disease around the world

o Cit will help to increase positive outcomes for patients

You hear a presentation by a specialist thoracic called Sally Grasslake, who’s
talking about her work with a patient, John Blake, with a rare condition that
affects his ability to breathe normally.
 37
How did Sally come to take John on as a patient?
o AHe was referred by his regular GP.
o BHe was not helped by a series of GPs.
o CHis GP told him to seek a specialist.
 38
How does John’s condition affect his everyday life?
o AHe experiences pain in all areas of his body.
o BHe cannot do common exercises.
o CHe is not able to stand on his own.
 39
Why was John frustrated by his diagnosis?
o ABecause he felt it was not accurate
o BBecause his symptoms did not match the diagnosis.
o CBecause he was not able to receive medical care.
 40
What was John’s reaction to the response of the GPs he saw?
o AHis outlook on life was negatively affected.
o BHe immediately sought out a specialist for help.
o CHe started to self-medicate for his condition.
 41
How did Sally react to John’s condition?
o AShe believed his symptoms were caused by something else.
o BShe felt that surgical intervention was necessary.
o CShe thought that more research was necessary.
 42
What does Sally suggest about the success of the surgery?
o AThe earlier it is done the more likely it will result in a positive
outcome.
o BIt is very difficult to reduce the amount of pain it will cause

patients.
o CThe severity of the problem will determine the outcome.

You hear a neurologist talking to a patient who has had a traumatic incident.
For questions 1-12, complete the notes with a word or short phrase. You now
have thirty seconds to look at the notes.
 Patient :Jack
Reason for Assessment
Was hit in the head while playing football
Injury
Sustained 6 hours ago
Impact on 1) of patient’s head (by another player’s knee)
 Patient cannot recall incident
Loss of consciousness for 2) after impact
Patient reports feeling fine after regaining consciousness
 First-line Treatment and Effect
Brought to medical facility
Prescribed 3) due to generalized motor seizure
 Imaging test done: CT scan (with 4) results)
 Currently has nausea and a 5)
 Next steps and probable diagnosis
Another CT scan, in particular of the 6)

Close observation to prevent rapid deterioration
 Initial diagnosis: 7) (indicated by lucent period prior to

seizure)
 Essentially an 8) of blood between the skull and outer dural

membrane
 Cause by head trauma with a 9) object
 Common result: skull 10)
 Differential diagnoses: subarachnoid 11) and subdural

hematoma
 Prognosis
Damage is not 12) due to minimal injury to the brain)
Needs aggressive treatment
Better prognosis if treatment commenced early

You hear a doctor in the A&E talking to a patient with chest pain. For
 Patient: Mrs Frank
Reason for Coming to A&E:
Acute chest pain
History
Patient reports recurring 13) chest pain over the last 2 years
Previous episodes usually lasted 1-2 seconds
 Previous position of chest pain: Usually on the left but

sometimes 14)
 Current episode
Pain has lasted for 15) hours
 Position of pain: 16) of chest
No shortness of breath
No heart palpitations
 Pain lessens when patient sits up or leans forward
Medication taken: two 17) (ineffective)
 Family History and Recent Illness
Father had 18) in early 50s
Father has high cholesterol level
 Patient’s recent illness: 19) infection
Started 2 weeks ago
Lasted 4 -5 days
 Symptoms: sore throat, blocked nose, sneezing and a

severe 20)
 Diagnosis & Treatment

Likely that the pain is originating in the 21)
Tentative diagnosis: pericarditis with a viral aetiology
 Swelling and inflammation of the 22) surrounding the heart
Commonly viral
 Possible causes: Cold or 23)
Hospital admission not required
 Treatment: Rest and 24)
Run additional electrocardiogram in 4 days

 25
You hear a conversation between a GP and an office manager about staff
burnout.
What does the GP identify as a negative effect on the practice’s patients?
o AThe quality of care they are receiving.
o BThe amount of time they have to wait.
o CThe level of stress they are feeling.
 26
You hear a trainee doctor asking a senior doctor about a patient’s chest X-ray.
The senior doctor points out the importance of…

o AThe markings and tubular shadows in the upper lobes on the
chest X-ray.
o BThe prominence of the pulmonary arteries on the chest X-ray.
o CThe repeated chest infections that the patient has had.

 27
You hear part of a training about sports nutrition.
Who is the audience for the training?
o AThe training is for professional athletes training for competitive
sports.
o BThe training is for general practitioners involved in helping

athletes recover from sports injuries.
o CThe training is for dietitians who may be referred by a general

practitioner.
 28
You hear a morning briefing on a ward.
The doctor explains that a head CT will help…
o ATo eliminate another possible diagnosis.
o BTo assess the neurological deficiencies.
o CTo determine the next diagnostic step.
 29
You hear part of a training on handovers between nurses.
What does the doctor demonstrate with the example?
o AHow to link two parts of the patient handover.
o BHow to give all necessary information.
o CHow to decide which type of information to include.
 30
You hear a conversation between a GP and a neurologist.
The GP has contacted the neurologist primarily because…
o AThere was some information left out of the patient’s file.
o BShe is very worried about the prognosis of the patient.
o CShe was concerned that the notes contradict the patient’s

symptoms.
You hear an interview about extended roles in dietetics.
 31
The interviewee says it is important to talk about her profession in order
to...
o AMake people aware of what the profession includes because it is
a small profession.
o BEncourage future professionals in this small field of medicine.
o CEstablish a clear career path in the profession for the next

generation of dietitians.
 32
According to the interviewee, what types of roles do dietitians now have?
o AThey have maintained the same roles in healthcare that they have
always had.
o BThey have fluid and indeterminate roles in modern healthcare

now.
o CThey have added roles traditionally held by other healthcare

professionals.
 33
According to the interviewee, what big changes in health care have
affected dietitians?
o AEfforts to reduce the cost of healthcare
o BEfforts to make healthcare more modern
o CEfforts to increase job satisfaction
 34
Why does the interviewee discuss the case of a patient?
o ATo demonstrate the increased complexity of dietitian’s cases
o BTo demonstrate the potential of the profession of dietetics
o CTo demonstrate the need for additional training for dietitians
 35
What is the purpose of four pillars of practice?
o ATo guide the career development of advanced practitioners
o BTo help new dietitians in the field to start their career
o CTo guide the profession of dietetics as practice changes
 36
According to the interviewee, what is holding back the profession?
o AThe lack of new professionals in the field
o BThe lack of funding for the extended roles
o CThe lack of funding for basic dietitian services

You hear a presentation about the role of general practitioners in the care of
older adults.
 37
What is the main topic of the research described by the presenter?
o AThe variety of challenges facing general practitioners
o BA particular challenge facing general practitioners
o CA challenge facing the future of general practitioners
 38
According to the presenter, why is it a challenge for GPs to diagnose older
adults with infection?
o ABecause they often don’t go to their GP for diagnosis
o BBecause they often don’t have this condition
o CBecause they often display unusual symptoms
 39
How did the research project gather data?
o AIt invited GPs to a group session to talk about their work.
o BIt invited GPs to individual sessions to talk about their work
o CIt analysed previous comments by GPs about their work

 40
According to the presenter, what is the role of medications in challenges
leading to diagnostic uncertainty?
o AIt can make it easier to diagnose infections in older patients.
o BIt can make it more complicated to diagnose infections in older

patients.
o CIt has no measurable effect in diagnosing infections in older

patients.
 41
Why have GPs lost their ability to follow up with patients?
o ABecause most GPs change practices frequently.
o BBecause most GPs work less hours than before.
o CBecause of the increased workload of GPs.
 42
What limits the use of investigations to diagnose infection in older
patients?
o AThe amount of time that GPs have to wait for results.
o BThe lack of available tests for this population of patients.
o CThe pre-existing conditions of the older patients.

You hear a GP talking to a patient about recent weight loss. For questions 1-
 Patient:Mrs Jacobs
Recent weight loss
Current Condition
Primary cause: Loss of appetite
No intentional effort to lose weight
Total weight reduction 1) kg in four months
 Associated problem: 2) (interval after food consumption)
No reports of stomach pain
 Also reports that 3) going up stairs or hill
 History
Diagnosed with 4) two years ago
 4 months ago: Stopped taking prescribed 5)
 High level of urea indicates 6)
Low sodium levels
 Low potassium levels (likely causing the reported 7) )
 Examination, Diagnosis and Next Steps

Suspected: Presence of 8) preventing food leaving the
stomach
 Stomach has retained 9)
 Further tests: 10) and biopsy
 Possible causes: 11) or cancer in 12)
 Need to wash out the stomach for clarity

You hear a doctor in the A&E talking with a patient with persistent headaches.
 Patient:Nathan Saunders
Current Symptoms
Failing vision (described as blurry)
Reduced urinary output
Swollen 13)
 Headaches
Never used to have them
On-going for past 14) months
Description of pain: 15)
Simple analgesics not working
Previous Treatment
Two months ago: GP diagnosed 16)

Prescribed codeine (not effective)
Prescription changed three weeks ago - patient unsure of medication name

(not effective either)
17) : At crisis level
 Also has 18)
Also has papilloedema
Possible renal failure
 Probable diagnosis: 19)
 Next steps
Reduce blood pressure over next 24 hours (Note: 20) : reduction

to prevent arterial thrombosis)
Control fluid intake

Observe for 21)
 Diuretics may not work, possibly start 22)
 Measure kidneys through 23)
 Vision expected to 24)

listen. Complete your answers as you listen
 25
You hear part of a training about patients in ICU wards.
What is the effect of the problem that the doctor describes?
o AAn increase in the number of patients in the ICU.
o BPatients are not admitted at all to the ICU.
o CPatients spending more time in the ICU.
 26
You hear a trainee doctor asking a senior doctor about next diagnostic steps.
Why does the trainee doctor refer to the chest X-ray?
o AIn order to explain a probable cause of the patient’s condition.
o BIn order to explain an unlikely cause of the patient’s condition.
o CIn order to explain what has already been done with this case.
 27
You hear part of a training about eating disorders.
Why does the speaker say the training is necessary?
o ABecause there are very few professionals to give this type of
training.
o BBecause very few medical programs incorporate this type of

training.
o CBecause this type of training has been completely overlooked for

many medical professionals.
 28
You hear part of a training on safety briefings.
What does the speaker say the medical community has learned from
outsiders?
o AThe importance of conducting regular safety briefings
o BThe importance of responding to staff feedback
o CThe importance of changing how often briefings are held
 29
You hear part of a handover between two nurses.
The male nurses asks to go to a different place because…
o AHe doesn’t want to be interrupted during the handover.
o BHe doesn’t want to have problems hearing the other nurse.
o CHe doesn’t want to discuss the case in front of the patient.
 30
You hear a conversation between a GP and a psychiatrist.
How does the psychiatrist feel about the GPs’ call?
o AHe is relieved because the patient’s file does not talk about the
next steps.
o BHe appreciates the call because it will help him to understand the
patient better.
o CHe was expecting the call because context has not been included
in the file.
00:00
1.0X

You hear part of a presentation on training opportunities in dentistry.
 31
What does the presenter say is his primary motivation?
o AHe wants to inspire dentists to be mentors.
o BHe wants to inspire dentists to do research.
o CHe wants to inspire future practitioners in the field.
 32
According to the presenter, his approach to dentistry is different
because…
o AIt is more focused on the materials than the structure of the tooth.
o BIt is more focused on maintaining the structure of the tooth.
o CIt is more focused on maintaining a strong bond with the tooth.

 33
According to the presenter, what is a benefit of his approach?
o AFewer severe complications for patients
o BMore advanced training for dentists
o CFewer dental procedures for patients
 34
The restorative materials used in the approach try to…
o ADecrease the amount of tooth that remains
o BReplicate the bond that natural materials have
o CMimic the natural structures and look of a real tooth
 35
What is the objective of the second course that the presenter described?
o ATo go over the basic concepts related to the approach described
o BTo review scientific literature related to advanced techniques
o CTo apply basic concepts and techniques previously learned
 36
How are the two types of dentistry described related to one another?
o AThey both require years of advanced training.
o BThey both focus on preserving the natural tooth.
o CThey both focus on applying traditional methods.

You hear an interview about recent innovations in physiotherapy.
 37
According to the interviewee, what is the role of physiotherapy in health
and wellbeing?
o AIt is primarily a way to help three out of five people in the UK with
their overall health.
o BIt is primarily a way to address the whole person to manage

health long-term.
o CIt is the primary treatment for certain long-term conditions like
Parkinson’s, asthma, cystic fibrosis, and chronic obstructive
pulmonary disease.
 38
Why does the interviewer ask about the use of therapy for a particular
disease?
o ABecause he was not aware of the use of therapy for this disease.
o BBecause he wants to hear more about an unusual use of therapy.
o CBecause he wants the audience to learn more about the topic.
 39
What does the interviewee say physiotherapy can build in all patients?
o AIt helps to aid the clearance of airways and improve lung function.
o BIt helps to increase patients’ abilities to bounce back from a

disease.
o CIt helps to avoid the need to use health care resources in the
long-term.
 40
What is mentioned as a change in the role that some physiotherapists
play?
o AThey are working more independently to deliver care to patients.
o BThey are working as part of a team to deliver integrated care.
o CThey are working to eliminate the need for other types of care.
 41
The interviewee says that robot-assisted therapy is used...
o AMostly independently of therapists.
o BIn conjunction with a trained therapist.
o CMostly outside of healthcare settings.
 42
What is the main purpose of the second type of robot-assisted therapy
discussed?
o ATo help patients regain the movement of their upper limbs.
o BTo help patients regain the ability to move their fingers.
o CTo help patients regain the use of their lower limbs.

You hear a GP talking to a patient about an ongoing problem. For questions
1-12, complete the notes with a word or short phrase.
 Patient :Stephanie
Background
Chief complaint: Battling 1)
Duration of symptoms: Last few months
Effect: Stopped going to the gym
 Diet/Exercise
Exercise: Regular
Smoking: 2)
Drinking: Occasional
 Diet: 3) , but eats dairy and fish
 Recent Symptoms
Reports no pain in the abdomen
Reports no change in 4) as well
 5) is frequent and large
 Possible condition: 6)
 Family History
Deceased grandmother: died 7)

From Ireland
Reported abdominal issues (but no specifics available)
 Next Steps
To check white blood cell count
To check 8) level
 (as low levels may cause) 9)
To check platelet level
Diagnosis: based on family history and symptoms
Possible disease: 10)
 Ireland has 11) more cases than the rest of UK
Genetic link
Routine blood test is not sufficient to confirm diagnosis
 Extended investigation via 12) required
Biopsy needs to be carried out

You hear a doctor in the A&E talking to a patient presenting with pneumonia.
 Patient :Mr. Jacobs
Reason for Admission
Admitted with pneumonia

Presence of other health problems
Medical History
Symptoms in A&E: Episodes of persistent 13) (past 6 months)
 Also had episodes of stabbing pain on the right side of

the 14)
 Pain is exacerbated by coughing, sneezing or taking a 15)
 Has additional issue with 16) (ongoing for 5 years)
 Food sometimes gets lodged in 17)
 Has had 18) done (results unremarkable but symptoms

worsened)
 Recently, 19) and vomiting have started after eating
 No relevant 20)
None smoker, and light drinker
 Observations from Chest X-Ray
Taken upon admission
No gastric air bubble
Oesophagus is dilated and 21)
Sign of food spilling into the lung
Possibly located source of respiratory infection

Next Steps
Possible diagnosis: Achalasia of the cardia
Problem is 22) in nature
 Affects the 23) at bottom of oesophagus
 Other possible causes: acid reflux, malignant structures or an

oesophageal 24)

 25
You hear part of an announcement in a ward.
Why is the announcement being given at this time?
o AIt is a routine announcement given before every briefing.
o BIt is being given because of an accident in the hospital.
o CIt is being because of the rise of a certain infectious disease.
 26
You hear part of a training for nurses on medication errors.
What is the overall topic of the training?
o ABeing able to explain the causes of most medication errors
o BBeing able to acquire knowledge and skill in managing errors
o CBeing able to demonstrate how to investigate medication errors
 27
You hear two nurses discussing a training they took on vaccinations.
What do the two nurses agree on about the training?
o AThe usefulness of a review on certain issues
o BThat it was not necessary to include some topics
o CThat not everyone needed to take the training
 28
You hear part of a conversation between a trainee doctor and a senior doctor.
How does the senior doctor help the trainee doctor to interpret the ECG?
o ABy showing her the different parts of the ECG recording
o BBy asking her to explain the different parts of the ECG recording
o CBy asking her to show him the different parts of the ECG recording
 29
You hear part of a conversation between two dentists.
What do the dentists disagree about in terms of the training?
o AThe need for more medical training for dentists
o BThe need for more safety training for dentists
o CThe need for more legal training for dentists
 30
You hear a handover between doctors in the A&E.
Who is most affected by the problems with handovers?
o AThe ambulance drivers who are working overtime
o BThe patients in the community and in the ambulances
o CThe doctors who are treating the patients coming in

You hear part of a training for midwives.
 31
What is the main topic of the training?
o AThe role of probiotics in the gutmicrobiome
o BThe role of probiotics pre- and post-partum
o CThe role of probiotics in functional medicine nutrition

 32
Why does the speaker say professional development is important?
o ABecause there are so many things to learn about the topic.
o BBecause it is necessary to review topics from initial training.
o CBecause new areas of study are constantly emerging.
 33
What is the focus of the first topic?
o AThe makeup of the microbiome of human breast milk
o BHarmful species of bacteria found in human breast milk
o CThe supply of beneficial bacteria to the infant gut
 34
The species of microorganisms mentioned have been shown to…
o AHave positive effects on both mother and infant health
o BHave potentially negative effects on infant health
o CHave overwhelmingly positive effects on infant health
 35
During the next phase of the training, participants will…
o ADiscuss their thoughts on the training topics
o BReview articles on topics related to the training
o CReview what they already know about the topics
 36
According to the speaker, what is the role of antibiotics in dysbiosis?
o AThe use of antibiotics can be a cure for dysbiosis.
o BAntibiotics are not generally used for this condition.
o CThe use of antibiotics can be a cause of dysbiosis.

You hear an interview with a doctor specializing in youth mental health.
 37
Why does the interviewer give statistics about the topic?
o ABecause she wants to show under-diagnosed the topic is.
o BBecause she wants to show how it relates to suicide in young

people.
o CBecause she wants the audience to the gravity of the topic.
 38
According to the interviewee, teenagers are vulnerable to mental disease
because…
o AThey are not equipped to handle the unique challenges they are
facing
o BThey are facing an onslaught of changes in their lives
o CThey are facing peer pressure for greater autonomy
 39
According to the interviewee, how does technology affect teenagers’
mental health?
o AThey are confused between real life and virtual life.
o BThey compare their lives to how they think others are living.
o CThey have more opportunities to bully and be bullied online.
 40
The interviewee says that teenagers with diagnosed mental health
conditions are often…
o ATreated early for their mental health conditions.
o BTreating others poorly because of their condition.
o CTreated poorly by peers because of their condition.
 41
According to the interviewee, what can be done to prevent mental health
conditions in adolescents?
o ABuild healthy habits and supportive communities to support teens
o BLet teens work individually to build resilience

o CInvolve teens in activities in the community and school
 42
What is important in treating teens with mental health conditions?
o AIt is important to look for approaches that do not involve
medication.
o BIt is important to involve mental health institutions in the

treatment.
o CIt is important to define the mental health condition correctly.

You hear a GP talking to a patient about an ongoing problem. For questions
1-12, complete the notes with a word or short phrase. You now have thirty
seconds to look at the notes.
 Patient:Jake Edwards
Recent Symptoms
Ongoing symptoms for a week
Overall feelings of 1)
 Reduced appetite but has 2) once
 Reports slight fever during this time
Reports 3) in joints
 Joints not visibly swollen
4) volume is normal
Bowel movements are unremarkable
 Medical History
Diagnosed with 5) (5 years ago)
 Is a 6) smoker
 Is a heavy drinker
Is a recreational drug user - marijuana and 7)
 Source of drugs recreational drugs: 8)

Not using IV drugs
Signs of liver problem
Tenderness in right upper quadrant of abdomen
Elevated 9)
 Pallor is a bit 10)
 Possible Diagnosis & Treatment
Preliminary diagnosis: 11)
 Blood tests required
Treatment depends on levels indicated in investigations
Recommended to not consume alcohol or drugs
Referral to a 12)

You hear a doctor in the A&E talking to a patient presenting with back pain.
 Patient:Chelsea
Reason for Admission
Pain across the back
Symptoms
Feeling unwell for past two days

First symptoms: 13) and backache
 Pain has gotten more severe
Frequency of vomiting: 14) in past six hours
 Abdomen tender, particularly in 15)
Symptoms indicate presence of 16)
 Likely condition: acute pyelonephritis
Caused by ascent of bacteria into the 17)
 Organ affected: 18)
 Likely related to the 19) patient was diagnosed with 2 months

ago
 Next Steps
Hospital admission required
Blood and urine 20) will be taken
 Will start patient on 21) and medication
 Medication to be monitored depending on the 22) causing the

infection
 23) ultrasound required

 24) of the urinary tract could be present

 25
You hear part of a conversation between two doctors.
Why is the male doctor asking the female doctor for her opinion?
o ABecause he wants to tell her about a diagnosis he has made
o BBecause he wants to know what she thinks the problem is
o CBecause he wants to ask her what his next steps should be
 26
You hear part of a training for ward leaders.
Why are the people attending this training?
o ABecause they are interested in taking a course on becoming a
ward leader.
o BBecause they are experienced ward leaders looking to train other

leaders.
o CBecause they are in a training course to become a ward leader.
 27
You hear a ward briefing on safety.
What does the person say is the purpose of the reporting system?
o ATo know who is making the most mistakes
o BTo know where the team needs improvement
o CTo know who on the team needs improvement
 28
You hear part of a conversation between two doctors in the A&E.
What do the two doctors agree about?
o AHow busy the A&E has been recently
o BThe number of patients waiting for treatment
o CHow the system is handling mental health
 29
You hear part of a conversation between a GP and a physiotherapist.
What does the physiotherapist ask the doctor to do?
o AShow the patient how to do the exercises
o BTell the patient how important the exercises are
o CTell the patient how important exercising is
 30
You hear part of a training for GPs.
What kind of course is being described?
o AA blended course for GPs interested in dermatology
o BA traditional face-to-face general education course for GPs
o CA blended, general education course for GPs

You hear part of a lecture about an inner ear condition.
 31
What is the main topic of the lecture?
o AAn overview of a disease commonly affecting menopausal women
in the UK.
o BAn overview of a rather uncommon disease in the UK.
o CAn overview of a rare disease affecting geriatric women in the

UK.
 32
How is this lecture related to the lectures that came before?
o APrevious lectures talked about the anatomy of the head.
o BPrevious lectures talked about different parts of the ear.

o CPrevious lectures talked about disorders of the outer and middle
ear.
 33
Which is a common symptom of the disease?
o AA feeling that the world is rotating quickly around you.
o BA feeling that you are going to fall to the ground.
o CA feeling that something is blocking you from hearing.
 34
What type of hearing loss is not associated with the disease?
o ANerve damage related to abnormalities
o BA blockage of the transfer of sound waves
o CNerve damage related to an injury
 35
What is the most common cause of the disease?
o ALess than adequate of taking in of endolymph
o BOveractivity of the sympathetic nervous system
o CA hypersensitivity to something in the environment
 36
What is often seen with hearing loss associated with this disease?
o AIt is sudden in nature and happens in both ears.
o BIt is gradual and it happens in one ear, not both.
o CIt is gradual in nature and happens in both ears.

You hear an interview about early detection of breast cancer.
 37
How does the interviewer feel about the topic of the interview?
o AHe is very enthusiastic about the topic because of its widespread
impact.
o BHe is very enthusiastic about the topic because the breakthrough

amazes him.
o CHe is very enthusiastic about the topic because the researcher is

going to be famous soon.
 38
According to the interviewer, the topic of the research…
o AHas not been made public
o BIs well known to the public
o CIs unbelievable to the public
 39
According to the interviewee, how was the blood test developed?
o ABy developing sets of antigens associated with breast cancer
o BBy developing sets of antigens found in healthy people’s blood
o CBy developing sets of antigens associated with all cancers
 40
What did the researchers notice about the accuracy of their results?
o AThey were unreliable due to differing results with different panels
of antigens used.
o BThey increased in accuracy when the number of antigens

increased.
o CThey increased in accuracy when the number of antigens

decreased.
 41
What is being done to further develop the blood test the interviewer is
working on?
o AA new study with a larger sample size is being done
o BA new study with other types of antigens is being done
o CA new study with other types of cancers is being done.

 42
What concern does the interviewer raise about the use of these tests?
o AHow quickly they can become available to the public
o BHow much the tests will cost patients around the world
o CHow patients will deal with the results of the tests

You hear a GP talking to a patient about bruising. For questions 1-12,
complete the notes with a word or short phrase. You now have thirty seconds
to look at the notes.
 Patient:Mrs. Spivey
Background
Bruising that started (1) prior
 Patient initially thought bruises were sustained as she (2)
 Bruises sustained did not(3)
 Started getting (4) bruises
 Recent Symptoms
Patient described bad menstrual cycle
Previous two periods were (5)
 Unexpected (6) while at work
 Family History/Lifestyle
No recent lifestyle changes
No family history of (7)
Non-smoker
Consumes alcohol occasionally (social drinker)
 Physical Examination
Multiple areas of purpura

Affected areas: mainly legs and fewer on(8)
Varying in color from black-purple to yellow
Two mouth bullae detected
 Patient confirms occasional gum bleeding when brushing teeth

 Gum bleeding does not (9) as expected
 Results of Investigations
Blood test results received
(10) level: lower than normal
Platelets are far below normal
Suspected: spontaneous purpura
 Next Steps
Immediate referral to haemotology unit
Urgent for (11) required
 Need to reduce possibility of (12)

You hear a GP talking to a patient complaining of increasing tiredness. For
 Patient :Sally Helm
Age: (13)
 Symptoms
Tiredness for the past (14)

Also reports loss of (15)
Weight loss: 7 kilos since last check up
Some nausea at times
 Cramping in muscles: on and off since 3 weeks ago
Some (16) of muscles as well
 Medical History
On (17) for high blood pressure (20 years)
Hypertensive controls proving ineffective (BP: 190/110)
Patient compliant with medication.
 Eyes: (18) on occasion
 Sometimes feels (19)
 Next Steps
Further (20) are needed (to check urea and creatinine levels)
 Symptoms indicate (21)
 (22) also needed to check for causes
 May need to commence (23) if kidneys are damaged
 Treatment for damaged kidneys can be in the hospital or

at (24)
 25
You hear part of a ward briefing.
What does the person giving the brief explain is governed by a specific
law?
o AWho you can share confidential information with and how
o BWhen and how it is necessary to ask for patient consent
o CWhen it is more important to give data than protect it
 26
You hear two nurses having a conversation.
What do the nurses agree about?
o AThe value of making patients feel at ease with treatment
o BThat nurses spend a lot of their time talking to patients
o CThat failures in communication are easily overcome
 27
You hear part of a conversation between a GP and a nurse.
What issue does the nurse want to address?
o AHow patients can confirm their appointments through email
o BHow patients can get more out of their consultation time
o CHow patients can use videos to know more about their condition
before their appointment
 28
You hear part of a training on an addiction treatment program.
Why does the speaker talk about the program?
o ATo show the main objective of the initiative
o BTo show the type of research being done

o CTo show the advances that have been made
 29
You hear part of a conversation between a junior and senior doctor.
What is the senior doctor explaining to the junior doctor?
o AHow the night and day teams share their work load
o BHow information about patients is shared within the unit
o CHow to the nurse and consultant divide handover duties
 30
What does the senior doctor point out?
o AAnother possible diagnosis for the patient
o BAnother area of concern on the X-ray
o CAnother possible explanation for the X-ray

You hear part of an interview about the use of technology in medicine.
 31
According to the interviewee, why is this research needed?
o ATo better inform how to treat and diagnose patients
o BTo use new methods to do research in medicine
o CTo help broaden the number of treatments available
 32
What is the main focus of the interviewee’s research?
o AUsing diagnostic systems to predict patient response to
medication
o BUsing new ways of analyzing data to predict patient response to

medication
o CUsing a combination of methods to predict patient response to

medication
 33
How did previous investigation inform the current research?
o AIt brought in learning from fields outside of medicine.
o BIt linked brain activity to a person’s reaction to medication.
o CIt helped to measure brain activity using resting state

electroencephalography
 34
In what context was the research conducted?
o AIn a small trial with a variety of medications
o BIn a large trial with a variety of medications
o CIn a large trial with one type of medication
 35
How did the method of analysis compare to other methods?
o AIt performed as well as other methods.
o BIt performed better than other methods.
o CIt performed worse than other methods.
 36
According to the interviewer, what are future implications for this
method of analysis?
o AIt is can be used to predict advanced depression in patients.
o BIt can make treatment for depression more personal.
o CIt can be used to make treatment better for all patients.

You hear a presentation about a way to reduce the risk of tooth decay.
 37
Why does the presenter give statistics about tooth decay?
o ATo help the audience understand the scope of the problem
o BTo help the audience understand the cost of the problem

o CTo help the audience understand possible short-term solutions
 38
Why does the presenter introduce the topic of tooth extractions?
o ABecause many people are not aware they take place in a hospital
o BBecause it sets the stage for the presenter’s research project
o CBecause it helps to explain why the research was undertaken
 39
What kind of intervention was developed for the research project?
o AA planned conversation with parents on prevention strategies
o BA planned program to change bad habits in children’s dental

health
o CA planned training for dental nurses involved in baby teeth

extraction
 40
How was the intervention different from the conventional approach?
o AIt focused on parental responsibility over their children’s dental
health.
o BIt focused on helping parents set reasonable targets for their

children’s dental health.
o CIt focused on informing parents on how to measure the success of

their goals related to their children’s dental health.
 41
Did the intervention improve health outcomes?
o AIt did not improve health outcomes because children in both
groups went back to the dentist.
o BIt improved health outcomes because children needed less dental

treatment for cavities.
o CIt improved health outcomes because children did not need

fillings as they had less tooth decay.
 42
According to the speaker, the most important aspect of the intervention
was…
o AThe way it empowered parents to be in charge of their children’s
dental health.
o BThe way it involved trained dental nurses in educating parents

about their children’s dental health.
o CThe way it made dental health care more pleasant for nurses,
parents and children.
You hear a nephrologist talking to a patient. For questions 1-12, complete the
notes with a word or short phrase. You now have thirty seconds to look at the
notes.
 Patient Mr. Jakey
Background
Microscopic haematuria
Condition detected (1) months ago
Condition detected through urine sample
Condition assessed by a GP
 No previous symptoms/medical issues
Patient describes general health as (2)
 No family history of (3)
 Results of Investigations
(4) test was ordered by GP
 Haemoglobin, platelets, and (5) :Normal
 Blood pressure reading: High at (6)
Urea: High
 Creatinine: High
Gamma-glutamyltranspeptidase: Very high (linked to patient’s alcohol

consumption of more than (7) units per week

Immediate action: Patient to (8) from alcohol
High blood pressure and (9) indicate chronic glomerulonephritis
 (10) of the kidney are likely inflamed
 If unchecked, like to progress to (11) renal failure
 Also requires ultrasound to assess the (12) (biopsy may be

needed as well)

You hear a specialist talking to a patient referred by her GP. For questions 13-
 Patient Sheila, final year university student
Background
Chief complaint: (13)
Symptoms started 10 days prior
Triggered by climbing stairs
 Symptoms got progressively worse
Patient reports having a (14) illness before symptoms started
 Reported illness had accompanying symptoms: (15)

(recovered in 1-2 days)
 Other symptoms: tiredness, (16) and chest pain

 Lifestyle
Reduced exercise due to university demands
Runs 2-3 times a week
Denies any (17)
Normal (18)
 and ECG with (19)
 Tentative diagnosis: (20)
Diagnosis fits symptoms and test results
 Viral causes: Coxsackie A and B, echovirus and chicken pox.
(21) to confirm and investigations
 Predicted severity of suspected condition: (22)
 Immediate management (23)
 Prognosis: (24) expected to return to normal

 25
You hear part of a conversation about a patient’s upcoming discharge.
What is the patient’s concern?
o AHe is concerned about whether he has enough medication at
home
o BHe is concerned that his daughter only has one day off to help
him
o CHe is concerned about travel arrangements to see his doctor
 26
You hear a nurse doing a pre-admission assessment.
What has the nurse covered prior to this conversation?
o AThe patient’s concerns about the surgery
o BThe patient’s previous and current condition
o CThe patient’s medication and changes to it
 27
You hear part of an information session for the public about when to go to the
A&E.
Why is the A&E not a replacement for a person’s GP?
o ABecause the GP has more resources and time for the patient.
o BBecause the GP is aware of a patient's prior conditions.
o CBecause the GP can make referrals for specialised care.
 28
You hear part of a training for dentists about easing dental fear.
According to the speaker, what should be the priority of the dentist?
o ATo make a patient feel comfortable and in control
o BTo help a patient get access to treatment quickly
o CTo work with patients with a variety of needs
 29
You hear part of a training for junior doctors.
The series of training sessions will develop...
o ASkills that are important for successful meeting management.
o BSkills that are not typically included in their previous training.
o CSkills that are typically developed later in a doctor’s career.
 30
You hear part of a ward briefing on a mental health unit.
What is the reason for the changes on the ward?
o AThe mismatch between the number of mental health patients and
the current capacity
o BThe increasing number of mental health patients visiting the A&E
o CThe shortage of nurses available who are able to work in other

ward areas

You hear part of an interview about problems that junior doctors face.
 31
According to the interviewee, what is one of the symptoms of the problem
being discussed?
o AThe number of people who chose not to become a doctor
o BThe number of doctors choosing not to practice medicine
o CThe number ofdoctors who do not progress in their career
 32
According to the interviewee, what is a solution to the high rate of
suicide?
o ARecognize that junior doctors are at an increased risk of low
morale, stress and suicide
o BReduce the work-related pressure on junior doctors so that they

have room to learn and reflect
o CEducate junior doctors so that they know they should not be

ashamed if they are stressed
 33
What is the reason mentioned for junior doctor resignations?
o ALack of engagement between junior doctors and the rest of
people in the system
o BLack of experience by junior doctors on how to work within the

system
o CLack of acknowledgement for the passion and contribution of

junior doctors
 34
Why are junior doctors not becoming involved in research and
leadership?
o ABecause junior doctorsdo not have enough experience to lead
research.
o BBecause other more senior doctors are reluctant to release

leadership roles.
o CBecause the skills of junior doctors are diverted to meeting the

need of providing care.
 35
What is an example of a positive change being made?
o AJunior doctors becoming more involved in problem solving.
o BJunior doctors becoming more involved in focus groups.
o CJunior doctors becoming more involved in trainings.
 36
How could current educational requirements be improved?
o AThey could be made more easily available online.
o BThey could be standardized for all junior doctors.
o CThey could be made less rigid and more practical.

You hear a presentation about a new infectious disease.
 37
According to the presenter, what is the original transmission pattern for
this type of virus?
o AIt is transmitted from humans to animals.
o BIt is transmitted from animals to humans.
o CIt is transmitted from human to human.
 38
What was a common initial symptom of the first disease discussed?
o AA dry cough
o BPneumonia
o CHigh fever
 39
What was the origin of the second disease discussed?
o AThe origin is unknown at this time.
o BThe origin is a large mammal.
o CThe origin is a small mammal.
 40
How has the spread of the disease changed?
o AIt is currently being spread between humans who had contact with
animals.
o BIt is currently being spread between humans who have traveled to

the affected region
o CIt is currently being spread between people who are not sure how
they were infected.
 41
How is the new disease different from the other disease discussed?
o AIts mortality rate is much lower than those diseases.
o BMost people do not need special treatment to recover.
o CIts infectiousness is much lower than those diseases.

 42
How is the new disease similar to one of the other diseases mentioned?
o AThere is no vaccine available.
o BThere is no treatment available.
o CThere are few new cases.

You hear a GP talking to a patient about her pregnancy. For questions 1-12,
 Patient:Maria
Routine pregnancy check at (1)
 Medical History
Previously (2) male child (8 years ago)
No other pregnancies
 No history of (3)
 Family History
Type 2 diabetes
First degree relative with condition: (4)
 Examination
Pregnancy weight gain
Urine dipstick test
Detected: (5) (high sugar level)
 No evidence of (6)
 At risk for (7)
 Next Steps and possible treatment

Requires (8)
 Self-monitoring of (9)
Dietary & insulin therapy
 Potential effects on Baby & Mother Baby
Possibly (10) than normal
 Increased chance of (11)
Future development of types 2 diabetes mother
 May get (12)
Diabetes may not go away after delivery

You hear a GP talking to a woman about heavy menstrual bleeding.
 Patient:Mrs Peters
Menorrhagia, heavy periods
Interrupting her daily life
Worried about absence from (13)
 Medical History
Menstruation began at (14) (regular cycles)
 (15) started 7 days prior

 No issues with (16)
No spotting
 Married over last 3 years (17) with one partner since)
No history of STI
 Stopped (18) (the pill) 6 months ago
 Normal result for last (19) (2.5 years ago)
No recent changes in health
 Not on any (20)
 Diagnosis
Likely condition: (21)
 Possible cause: (22) (although unlikely due to patient’s age)
 Investigations
Pregnancy test
Blood tests
(23) to eliminate common causes
 Suggested Treatment
Reason for suggestion: Patient is trying to conceive
Treatment option: Tranexamic acid (because it is a treatment) (24)

 25
You hear a nurse briefing her colleague about a patient.
What does she warn her colleague about?
o AThe patient may later need additional assistance in breathing.
o BThe patient may have something more than community-acquired

pneumonia.
o CThe patient may have been put on the wrong medication since
test results are not out.
 26
You hear a ward leader talking to the nursing staff
He says that not reporting errors make?
o AEfforts to study errors more difficult
o BEfforts to identify errors less voluntary
o CEfforts to reduce errors less effective
 27
You hear part of a morning briefing on a hospital ward.
What is the plan for the patient today?
o AHer diagnosis is still waiting to be confirmed.
o BShe will be transferred to a less specialised unit.
o CA social worker will come to talk with her family.
 28
You hear part of a post-surgery follow-up at a GP practice.
What does the patient want to know about?
o AThe cause of the pain in his belly.
o BThe time period before resuming activity.

o CThe reason he still needs to be taking it slow.
 29
You hear a trainee doctor telling his supervisor about a problem he had with a
patient.
The trainee feels that the cause of the problem was…
o AThe patient’s negative reaction to the procedure.
o BA lack of familiarity with the procedure being done.
o CThe amount of treatment the patient has received.
 30
You hear a doctor talking to an athlete with a painful arm.
What is the patient concerned about?
o AThe pain getting worse if he doesn’t warm up.
o BThe pain not caused by a triggering event.
o CThe pain interfering with his bowling.

You hear part of an interview with a doctor called Dr Ellen Samuels, an expert
on Lyme disease.
 31
Why does Dr Samuels say the rate of Lyme disease has increased?
o ABecause more patients and doctors are reporting infections
o BBecause of changes in human behavior and the environment
o CBecause of more ticks in different regions of the country
 32
Dr Samuels says that transmission of the disease to humans requires...
o AAny type of body fluids from human beings
o BA tick infected with the bacterial pathogen
o CAn animal host to infect other animal hosts

 33
Dr Samuels says that Lyme disease is a challenge to detect because…
o AThere are no tests to detect the bacteria responsible for the
disease
o BThe bacteria responsible for the disease only attacks lymph

nodes
o CEvidence of the disease disappears from the bloodstream quickly
 34
What does Dr Samuels say a person should do if they find a tick?
o AThe person will need antibiotics to prevent the disease if the tick
is attached.
o BThey may need antibiotics, depending on the amount of time that

has passed.
o CThey will need to get a diagnosis before seeking treatment for the
disease.
 35
What problem does Dr Samuels identify with current diagnostic tests?
o AThey are not accurate for Lyme disease that is detected early
o BThey are not accurate for all types of antibody responses
o CThey are not accurate for certain types of individuals
 36
What is Dr Samuel’s place of work doing about the problem?
o AThey are working to improve existing diagnostic tests to detect
Lyme disease.
o BThey are working to understand how a person’s DNA responds to

the disease.
o CThey are working to improve the effectiveness of current

treatment of the disease.
You hear a psychiatrist called Dr Matthew Andrews giving a presentation to a
group of GPs.
 37
Matthew Andrews says that GPs are not providing mental health services
because
o AAdolescents do not visit GPs on a regular basis
o BAdolescents with mental illnesses visit specialists
o CGPs do not have the required training in the area
 38
What does Matthew Andrews say is the most effective way to train GPs?
o AProgrammes focused on educational theories
o BProgrammes involving GPs working with specialists
o CProgrammes set in psychiatry or paediatric settings
 39
How were the joint appointments set up?
o APer the request of the patient and family
o BPer the request of the attending GP
o CPer the request of the consultant
 40
What was the objective of the joint appointments?
o ATo come to a diagnosis for the patient
o BTo initiate contact with the parents of the patient
o CTo decide on next steps for the patient
 41
Matthew Andrews says that GPs now report feeling…
o AMore comfortable dealing with certain mental issues
o BMore comfortable working with outside consultants

o CMore comfortable talking to parents about these issues
 42
Matthew Andrews says that child psychiatry specialists describe…
o ALearning more about another area of medicine outside their
specialty
o BLearning more about children and adolescents with psychological

problems
o CLearning more about how to handle consultations in a clinical

setting
You hear a doctor in the A&E talking to a man who collapsed on the beach.
 Patient:Mr Phelps
Taken to the hospital by ambulance
Fell on the beach, while walking dog
Did not display (1)
 (2) for about half a minute
 Witness account: Patient was not confused once recovered
Possible trigger: Ran up (3) before collapsing
 Injuries sustained: (4) on right shoulder from hitting rock but

no
injury to the (5)
 Overall Health
Reduced: (6) of exercise due to lack of 7)
 Previous similar episode: Happened after a (8)
 Resting heart rate: (9) bpm
 Blood pressure elevated despite being on (10)
Does not drink or smoke

Denies being on (11)
 Further tests
ECG and (12)

You hear a GP talking to a man about back pain. For questions 13-24,
complete the notes with a word or short phrase. You now have thirty seconds
to look at the notes.
 Patient:Thomas
Incident causing sudden back pain: (13)
Patient heard a click before the pain started
Initial pain was sharp
 Now pain is described as a (14)
 Pain will become sharp when patient attempts to (15)
 Self-medicated for pain and also applied (16) but little relief
so far
No other symptoms reported
 Medical History
Takes (17) for high blood pressure
 No (18) for last several years

 Clinical Examination
Observation: Gait is a bit (19)
 Tenderness in (20)
Limited range of movement
 No(21)
 Recommendations/Next Steps
Observe condition for a spell
Medical leave for one week to rest
Patient to totally refrain from(22)
 Requires (23) assessment
Pain medication: Codeine
 Appointment in two weeks if condition (24)

according to what you hear. You’ll have time to read each question before
you listen. Complete your answers as you listen.
 25
You hear part of a training about prescribing for junior doctors
What does the presenter clarify about certain types of medication?
o AThat the same system is used for medical and legal guidance.
o BThat a different system is used for medical and legal guidance.

o CThat a similar system is used for medical and legal guidance.
 26
You hear a junior doctor asking about how to write a discharge summary
The senior doctor advises the junior doctor to prioritise
o ABeing very thorough and technical in the summary
o BUsing patient friendly language in the summary
o CFocusing on next steps and consequences in the summary
 27
You hear part of a conversation between nurses about a patient with dementia
The male nurse suggests that the female nurse...
o ALearn about communicating with all types of patients.
o BAcknowledge how the patient is feeling and why
o CHelp the patient to understand the facts of the situation
 28
You hear part of a ward briefing on patient interactions
It is important to try to identify how a patient is feeling because...
o APatients may not be able to identify emotions for themselves.
o BIt gives the patient a way to get the negative energy out.
o CIt gives more information about how to direct the conversation.
 29
You hear a senior doctor discussing with a junior doctor how to interpret a test
What aspects of the test does the junior doctor describe

o AThe purpose of the test and its primary elements
o BThe reason for doing the test and potential problems
o CThe types of pathologies that can be identified
 30
You hear a doctor in the A&E talking to a medic about a patient with opioid
overdose.
What does the medic explain to the doctor?
o ARelevant aspects of the patient’s medical history
o BPatient’s current condition and treatment administered
o CPatient’s unexpected reaction to treatment administered

You hear part of a training for junior doctors about explaining immunisations.
.
 31
The presenter warns the audience about…
o AFeeling overwhelmed by the number of topics covered.
o BFeeling uninformed about the topic being covered.
o CFeeling unprepared because of high expectations.
 32
Why is it important to be open to parent’s concerns during the
consultation?
o ATo make sure parents understand the importance of the topic.
o BTo make sure parents do not feel irritated and disengaged.
o CTo make sure parents will keep an open mind and be

cooperative.
 33
What kind of information should be provided about individual vaccines?
o AThe number of patients who have received it so far.
o BThe low incidence of side effects of the vaccines.
o CThe main disease that it prevents.
 34
It is important to explain to parents about what happens before the
vaccination because…
o AIt will allow them to have more confidence in their health
practitioner.
o BIt will allow them to feel more at ease during the appointment.
o CIt will allow them to feel more at ease with possible side effects.
 35
When giving information about side effects, the doctor should also…
o ATell parents how to contact their health care professional.
o BTell parents what to do to make the child feel better
o CTell parents about research related to different side effects
 36
How should doctors deal with incorrect information related to
vaccinations?
o AThey should assure parents that the vaccination programme is
very safe.
o BThey should thoroughly explain the source of the misinformation.
o CThey should give basic information about the source of the

misinformation.

You hear an interview with Dr. Laura Sanders, an Alzheimer’s researcher.
 37
Dr. Sanders says that the research into the drug had been stopped
because…
o AOf poor results in the early stages of trials.
o BOf problems with data analysis during the trials.
o COf problems with how the trials were conducted.
 38
Dr. Sanders points out that research for the drug was…
o AAt a very early stage in development.
o BAt an advanced stage in development.
o CNear the end of development.
 39
Newly examined results showed that…
o APatients on all doses experienced a decrease in decline.
o BPatients on elevated doses experienced a decrease in decline.
o CPatients on elevated doses experienced an increase in decline.
 40
Dr. Sanders states that this research supports the theory that…
o AThe presence in certain proteins is indicative of Alzheimer’s.
o BThe decrease in certain proteins is indicative of Alzheimer’s.
o CThe removal of certain proteins can reverse Alzheimer’s.
 41
Analysis of the data from the trials has been complicated by…
o ANew data from other studies into Alzheimer’s
o BThe attitudes of researchers toward the trial
o CAdjustments made during the clinical trials
 42
How does the scientific community feel about the research?
o AThere is overwhelming enthusiasm about the results.
o BThere is a general lack of interest in the results.
o CThere is some concern about the latest round of results.

You hear a doctor in a hospital talking to a patient presenting with jaundice.
 Patient:Marie Stevens
Reason for Referral:
Jaundice lasting approximately (1)
Other Symptoms
Stool: (2) in colour
 (3) Normal in amount
Darker in colour
 Stomach pain
Right (4)
 Intermittent but has lasted(5)
 Sharp pain increasing in(6)
 (7) large meals
 Medical History
Two pregnancies
Surgery on (8)
 No(9)
Medication for blood pressure
 Not a candidate for (10)
 Investigations
Full blood count
Liver Function
Serum lipase & amylase (to eliminate (11)
 Coagulation Screen
(12) after results

You hear a doctor in the A&E talking to a man with blood in his urine. For
questions 13-24, complete the notes with a word or short phrase. You now
 Patient:Mr Andrew Yates, 55
Blood in urine
Symptoms
(13) haematuria
 Turned from (14) to dark red in last 24 hours
 Difficulty (15)
 (16) in urine
 No (17) or similar feeling
No back pain
 Family History
No (18) bladder or renal cancer
 Medical & Social History
(19) on medication
 Heavy (20)
At increased risk for (21)
 Next Steps
Bladder washout and (22)
 by way of a (23)
 Urine culture to be collected: To check for (24) cause
Blood test: To check haemoglobin levels (may require transfusion
Bladder scan: To check for clot retention

 25
What is the senior doctor’s stand on painkillers in this case?
o ATriptans can sometimes be ineffective for severe headaches.
o BThey can sometimes be sufficient in the management of the

condition.
o CA variety of painkillers can be used to as prophylactic options.
 26
You hear part of a training on the classifications of strokes.
What does the presenter clarify about how diagnosis is determined?
o AThere is a reliance on the results from investigations.
o BThere is a reliance on the patient’s clinical history.
o CThere is a reliance on observation of the patient.
 27
You hear part of a ward briefing about documentation of results.
What does the ward leader warn the team not to forget?
o AThe duration of the last therapy.
o BThe absence of abnormalities.
o CThe details related to treatment.
 28
You hear part of ward briefing on history taking and information giving.
What does the speaker say to prioritize during this type of patient
interaction?
o AGiving the patient the opportunity to express themselves.
o BGiving the patient the opportunity to discuss medical decisions.
o CGiving the patient the opportunity to ask for medical advice.

 29
You hear a dermatologist reporting results to a GP.
What does the dermatologist explain to the GP?
o AA possible diagnosis for the patient’s lesion.
o BThe risk factors presented by the patient.
o CThe aspects checked during the appointment.
 30
You hear two nurses discussing handwashing.
The nurses agree that...
o APeople have improved how they wash their hands.
o BPeople are better at training others to wash their hands.
o CPeople know what type of cleaning liquid to use.

You hear part of a training for A&E doctors about a type of suture.
 31
Why does Dr Paduh refer to the previous training?
o ASo that the trainees know that he is not repeating similar content
from a previous training.
o BSo that the trainees can use their previous knowledge to good
use in the current training.
o CSo that the trainees can concentrate on the new information and
worry less about what they already know.
 32
Dr Paduh says that the vertical mattress stitch is often used when…
o AA wound is located in a place where scarring is noticeable
o BA wound is located where skin is particularly tense
o CA wound is located where skin tends to turn outwards
 33
What is a reason not to use the vertical mattress stitch?
o AIt is difficult for doctors to learn to do it well.
o BSuccess depends on the ability of the doctor.
o CIt requires a lot of time to set up the procedure.
 34
Dr Paduh warns that a wound cannot be closed until…
o AA booster of necessary vaccines is administered
o BAn X ray is performed to check for fractures
o CThe limits of the wound are thoroughly cleaned
 35
Dr Paduh says the symmetry of loops is key because...
o AIt will decrease the chances of excessive scarring
o BIt will result in alignment of the edges of the wound
o CIt will decrease the amount of swelling that occurs
 36
Dr Paduh says pulling on the knot excessively will result in…
o AA higher risk of scarring near the edges wound
o BA turning out of the edges of the wound
o CA lack of opposition of the edges of the wound

You hear an interview with Youyou Tu, a researcher specialising in malaria.
 37
The interviewer mentions Tu’s background in order to…
o AEmphasise the significance of Tu’s achievement.
o BEnsure that the audience have clear expectations of the interview.

o CPrepare the audience for Tu’s lack of official medical credentials.
 38
Tu says that she was motivated to study medicine because…
o ATuberculosis took away two fruitful years of her life.
o BTuberculosis helped her empathise with others.
o CTuberculosis gave her time to think about her future.
 39
What was the focus of Tu’s medical education?
o AFinding a cure for bacterial infections such as tuberculosis.
o BUnderstanding the use of naturally-found compounds.
o CClassifying different types of traditional medicine.
 40
What was a turning point in Tu’s professional career?
o AWhen a war in a neighboring country started.
o BWhen a new drug was developed for malaria.
o CWhen her government started a new project.
 41
Why did Tu’s team start doing research into old texts?
o ABecause the texts had been useful in the past.
o BBecause they had run out of other options.
o CBecause malaria had been previously cured in China.
 42
Tu mentions language as an obstacle to…
o AThe identification of the active component.
o BThe development of an effective treatment.
o CThe spread of theTu’s team’s research findings.

You hear a doctor in the A&E talking to a patient named Alice Knowles who
has come in because of haematemesis. For questions 1-12, complete the
notes with a word or short phrase. You now have thirty seconds to look at the
notes.
 Patient:Alice Knowles
Started to feel sick and (1)
Vomited blood
Colour of blood: Described as fresh and red
 Volume: Approximately a (2)
Passed out
First known episode
 Other Symptoms
No changes in (3)
 Medical History
Ongoing (4)
 Takes (5) daily
 Treatment & Investigations
Not (6) stable
 Blood test & (7)

 (8) fluids via IV
 Purpose of blood test: To check
(9) & urea levels ECG
 Clinical Assessment
Blood pressure/low
(10) /high
 Possible Diagnosis & Recommendations
Gastrointestinal bleeding
Possible causes - (11) & oesophageal erosions
 (12) use /risk factor

You hear a physician in the A&E talking to a patient who woke up with
one side of her face drooping. For questions 13-24, complete the notes
with a word or short phrase. You now have thirty seconds to look at the notes.
 Patient:Mrs Shepherds
Current Symptoms
Weakness on (13) side of face
 (14) normal, no numbness

 Is able to see, and swallow both (15)
 Clear speech, no (16) or problems with words
 No balance issues or (17)
 Recent History
No recent (18)
 Medication for (19)
 Likely Diagnosis
Other symptoms & (20)
 indicate (21)
 A type of paralysis caused by (22)
 Prognosis & Management
Most patients recover in less than (23)
 Important to keep eye lubricated as condition impacts (24)

 25
You hear part of a conversation between a junior and senior doctor on how to
interpret the results of an investigation.
What does the senior doctor clarify about the results of the investigation?
o AThat the results clearly point to portal hypertension
o BThat the results are not sufficient to come to a definite diagnosis

yet
o CThat the medical history allows them to rule out cirrhosis
 26
You hear part of a training about smoking cessation counselling.
The speaker points out that this approach is better than…
o AOne not focused specifically on this behavior
o BOne used by other types of specialties
o COne focused on patient´s worries and desires
 27
You hear a doctor going over an upcoming procedure with a patient.
What does the doctor explain to the patient?
o AWhen they can insert the implant
o BHow they will insert the implant
o CWhy they will insert the implant
 28
You hear part of a conversation between a nurse and a doctor about a patient’s
medication.
What does the nurse point out about the patient’s medication?
o AHe took an analgesic before he was admitted to the hospital.
o BHe depends on his wife to get painkillers from the doctors in the
hospital.
o CHe is mixing over-the-counter and prescribed medications.

 29
You hear two doctors talking about a patient that one is referring to the other.
The doctor referring the patient explains that…
o AThe previous diagnosis was made by a doctor at another practice.
o BThe previous diagnosis was made by a specialist in another field.
o CThe previous diagnosis was made by a doctor who is no longer

working.
 30
You hear a conversation between two ward leaders about administrative
duties.
The ward leaders agree that...
o ATheir job responsibilities have changed over time
o BTheir job has become much more difficult over time
o CTheir satisfaction with their job has changed over time

You hear part of a presentation by Jessica Stokes on a study related to
dietetics.
 31
Why does Jessica Stokes say it is important to focus on coconut oil?
o ABecause of all of the benefits it is known to have
o BBecause of the recent interest in it
o CBecause of the findings of other research studies
 32
Jessica Stokes points out that previous studies show...
o AConsumption of coconut oil likely has no noticeable effect
o BConsumption of coconut oil likely has a beneficial effect
o CConsumption of coconut oil likely has a negative effect

 33
What limitation did previous studies have?
o AThe duration of the study
o BThe methods of analysis
o CThe number of total studies
 34
Who was not selected to be part of the study?
o APeople living outside of the country
o BPeople with no known medical issues
o CPeople living close to one town
 35
Jessica Stokes says that before the study…
o ADaily food consumption was evaluated
o BThe amount of exercise was evaluated
o CThe medication history was taken
 36
Jessica Stokes concluded that future studies should…
o AInclude a larger number of total subjects
o BBe conducted over a longer period of time
o CAllow subjects to choose their own diet

You hear a training by Dr James Coffey about a non-surgical procedure.
 37
Dr Coffey says that the procedure is indicated for patients…
o AWho have any type of severe illness
o BWho are having serious problems with sputum

o CWho are having some respiratory distress
 38
Dr Coffey says extra precautions should be taken with patients…
o AWho have an infectious disease
o BWho are constantly coughing
o CWho have trouble coughing
 39
Why does Dr Coffey give an example of an interaction with a patient?
o AIn order to demonstrate how to explain the procedure
o BIn order to demonstrate how to deal with difficult patients
o CIn order to demonstrate how the patient might feel
 40
What is key to getting accurate results from this investigation?
o AGetting a large specimen from the patient
o BGetting a specimen from deep inside the chest
o CGetting rid of any potential contaminants
 41
Dr Coffey offers several tips in order to help patients…
o ARecover quickly after the procedure is over
o BProduce a quality sample of sputum
o CFeel comfortable with the procedure
 42
Dr Coffey suggests changing the procedure when…
o AA patient is physically not able to cough
o BA patient is taking certain medication
o CA patient does not want to give consent

You hear a doctor in the A&E talking to a patient named Mandy Johnson. For
questions 1-12, complete the notes with a word or short phrase. You now
 Patient:Mandy Johnson
Now feeling more (1) than when first came in
 Description of Episode
During
Holding head & losing consciousness
Whole body started (2)
 Made (3) sounds and unable to open eyes
 Bruising & (4) on face
 Before
Severe (5) just before
No weakness or numbness
 Episode of (6)
 No loss of consciousness recently or (7)
No head trauma
Daily activities resumed as usual
Mild (8) headache & nausea
 Administered (9) for nausea
 No reported (10) disturbances
 (11) neck
 Medical History
No problems or medication
Smokes (12) a day
Does not drink
Next Steps
Head CT

You hear a GP talking to a patient about a diagnosis of Cushing's
syndrome. For questions 13-24, complete the notes with a word or short
phrase. You now have thirty seconds to look at the notes.
 Patient:Mr Thomas
Symptoms
Weight gain, particularly noticeable in the (13) & shoulders
 (14) have spread

Wound healing is slow
 Experiencing (15) & depression
 Frequently feels (16) around other people
 Investigations Results
Urine and blood tests done
24-hour (17) cortisol investigation
 Shows above 3x (18) of normal
 (19) cortisol confirmed Cushing’s syndrome
 Exploration of Causes
Patient not on (20)
 (21) Cushing’s syndrome
 Tumour of the (22)
Problem with adrenal gland
 Investigations to find cause
Test to detect(23)
MRICT
scan
 Treatment Options
Medications to reduce levels temporarily until (24)
Surgery - if tumour found to be present

 25
You hear part of a conversation between a doctor and a patient about the
results of an investigation.
The doctor explains that the results of the investigation show…
o AThe pathogen causing the disease
o BA combination of coryzal symptoms
o CThe type of condition the patient has
 26
You hear part of a conversation between two doctors about an MRI scan.
The male doctor asks the female doctor to confirm…
o AThe severity of the condition
o BThe possible type of condition
o CThe direction of the malformation
 27
You hear part of a training on suture materials.
Which problem does the presenter identify?
o AA lack of options available in relation to this topic
o BA lack of knowledge about this topic
o CA lack of confidence in this topic

 28
You hear part of a conversation between a trainee nurse and a senior nurse.
What does the senior nurse suggest?
o ATo explain the procedure to the patient
o BTo consult with the patient about the procedure
o CTo change the site of the procedure
 29
You hear two doctors talking about breaking bad news to a patient.
What do both doctors agree about?
o AThe lack of information makes the situation more difficult.
o BThe way patients react to news makes the situation more difficult.
o CThe type of diagnosis can make the news more difficult to give
 30
You hear a ward safety briefing about preventing falls.
The ward leader suggests that patients should…
o ABe encouraged to perform exercises in bed first after an
operation.
o BBe accompanied when they need to get out of bed.
o CBe given walkers or canes if they want to walk down the hallway.

You hear part of an interview with Dr Christina Salem about diabetic patients
and respiratory illness.
 31
What do Dr Salem and the interviewer agree about?
o AHow difficult it can be to get the right information
o BHow difficult it can be to find any information
o CHow difficult it can be to understand the information

 32
Dr Salem points out that it is not known if…
o ADiabetics have different outcomes from other patients
o BDiabetics have an increased risk of becoming ill
o CDiabetics will experience different symptoms
 33
According to Dr Salem, what causes diabetics to be at a higher risk of
complications?
o APoor management that increases the infection rate
o BPoor management that affects blood sugar levels
o CPoor management that weakens the immune system
 34
Dr Salem clarifies that the level of risk for different types of diabetes…
o ADepends more on other health problems than anything else
o BDepends more on other factors, such as age, than anything else
o CDepends more on good management than anything else
 35
Dr Salem says that when contacting a doctor, a diabetic should…
o AKnow their most recent blood sugar levels
o BBe able to say how long they have had symptoms
o CAsk for assistance in getting more insulin
 36
Dr Salem prioritises getting insulin to those…
o AWhose supply is being cut off by large manufacturers
o BWho cannot afford to pay due to financial problems
o CWho cannot find it because of distribution networks

You hear a training by Dr Samuel Adams about suicidal risk assessments.
 37
Why does Dr Adams say this training is necessary?
o ABecause many doctors avoid interacting with patients in this way
o BBecause of the impact the lack of training is having on patients
o CBecause of the increased number of patients seeking treatment
 38
Dr Adams prioritises the human connection with patients because…
o AIt will lead to a more-informed evaluation of the patient.
o BIt will allow for a long-term relationship with the patient.
o CIt will give the doctor insight into the patient's thinking.
 39
According to Dr Adams, which aspect is key to determining the level of
impulsivity of the patient?
o AType of self-harm
o BExistence of a trigger
o CEvidence of forethought
 40
Why might part of the interview be modified?
o AIn order to ask more about the method used
o BIn order to ask more about the current mood
o CIn order to ask more about theoretical next steps
 41
Dr Adams explains that risks uncovered while taking the social history
may…
o AResult in further assessments being done
o BResult in other professionals being brought in
o CResult in patients reacting negatively
 42
For the majority of patients, Dr Adams recommends…
o AReferring the patient to specialist
o BPutting together a list of actions points
o CContacting a local support network

You hear a GP talking with a woman, Teresa Young, complaining of
worsening tiredness. For questions 1-12, complete the notes with a word or
short phrase. You now have thirty seconds to look at the notes.
 Patient:Teresa Young
Started to feel tired (1) prior
 Fell asleep during (2) at work
 Symptoms
Sleep
(3) increased number of hours (from 7 to 14 hours)
 (4) of sleep is reported as good
 Appetite
Decreased
No nausea or (5)
 (6) faster than before
 No change in (7)
 Other
No recent colds
Occasional (8)
 Stressed about work
(9) but not taking medication for it
 Areas of (10) on limbs/torso
 Investigations
Symptoms indicate problems with gastrointestinal, (11) &

cardiovascular systems
 Full blood count & (12)
Coagulation studies
You hear a doctor in the A&E talking with a woman, Emily Campbell,
presenting with chest pain. For questions 13-24, complete the notes with a
word or short phrase. You now have thirty seconds to look at the notes.
 Patient:Emily Campbell
Current Symptoms
Chest pain & (13)
 Took (14) for symptoms
 Recent Symptoms
Sharp, constant pain on (15) of chest
 Pain becomes worse after a (16)

Not able to do physical activity
 No coughing, fever or (17)
 Recent Medical History
A (18)
 3 weeks prior with (19)
At risk for (20)
 ECG & CT (21) to confirm
 Treatment Options
Open pulmonary embolectomy (rare)
(22) treatment (common)
 Until confirmation, (23) heparin will be administered
 Goal is to achieve (24)

 25
You hear part of a conversation between two nurses about a blood transfusion.
What does the female nurse tell the male nurse to prioritise?
o ABuilding rapport with the patient
o BFollowing protocols closely
o CReviewing procedures regularly
 26
You hear part of a conversation between a junior doctor and a senior doctor
about how to interpret a cardiotocograph.
The senior doctor confirms the….
o AClassification of the pregnancy
o BAbnormality in the heart rate
o CPresence of contractions
 27
You hear part of a conversation between a nurse and a doctor about an angry
patient.
The nurse explains that the patient likely suspects…
o AThat the staff is avoiding treating him
o BThat his spouse doesn't want to see him
o CThat he is going to wait a long time
 28
You hear part of a training on arterial blood gas interpretation. .
What is the main aim of the training?
o AA review of the basic aspects of a difficult topic
o BAn introduction of a difficult-to-understand topic
o CA way to think about a difficult-to-understand topic
 29
You hear a doctor taking a medication history of a patient.
What is the doctor explaining to the patient?
o AThe action plan developed during the consultation
o BConcerns about the patient's medication regimen
o CThe best way to contact him after the appointment
 30
You hear part of a conversation between a junior doctor asking for assistance
with a recently admitted patient.
The junior doctor is suggesting the other doctor…
o ATell him how to take over the patient's treatment
o BTell him what to do until another doctor arrives
o CTell him if current treatment is appropriate

You hear part of a presentation by Dr Neil Gore about cauda equina
syndrome.
 31
Dr Gore points out that noticing patterns of who is affected is limited
by…
o AThe small number of patients that doctors see
o BThe difficulty in diagnosing patients with the condition
o CThe lack of knowledge of the cause of the condition
 32
Dr Gore recommends first collecting information related to…
o ARecent medical history
o BRelevant symptoms
o CRelevant family history
 33
Dr Gore points out that all known causes of the condition are related to…
o ADamage to a part of the anatomy
o BPrevious medical interventions

o CDamage caused by infection
 34
According to Dr Gore, clinical examination should be done for patients…
o APresenting with certain known symptoms of the condition
o BIn certain groups considered at high risk for the condition
o CPresenting with symptoms or a history related to the condition
 35
The clinical examination is primarily focused on……
o ADetermining characteristics related to the pain
o BDetermining level of feeling and muscle response
o CDetermining the risk of experiencing incontinence
 36
The type of CES a patient is diagnosed with has...
o ANo bearing on the urgency of the situation
o BSome influence on the next steps to take
o CA lot of influence on how urgent the situation is

You hear an interview with Dr Julia Schneider, an expert on Crohn's disease.
 37
What is the nature of Dr Schneider´s work with Crohn's?
o ALeading a new research study
o BWorking with patients as a physician
o CConsulting on cases as a dietitian
 38
What does Dr Schneider clarify about treatment options?
o AThey only serve to manage the disease.
o BThey are focused on the digestive tract.

o CThey are not often very effective.
 39
Dr Schneider explains that genetics plays a role…
o ABut other factors are more influential in the development
o BBut this does not eliminate risk of developing the disease
o CBut not much research has been done on this topic
 40
Dr Schneider explains the potential role of the immune system because…
o AA specific virus has recently been identified
o BNot much is known about how this process works
o COf the primary system affected by this disease.
 41
Why does the interviewer ask Dr Schneider to talk about one of the
diets?
o ABecause it is relatively new compared to the other
o BBecause it is less well-known than the other
o CBecause it has been researched less than the other
 42
Dr Schneider explains that the diet has been used to treat…
o ADiseases with similar symptoms to Crohn's
o BDiseases that affect children and adolescent
o CSensitivities to certain types of ingredients

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1 2 3 4 5 b

Practice Test 1 : Part A – Extract 1 Q(1-12)

 Patient Jack Thatch

Reason for Referral Dizzy spells

Onset of symptoms: (1)

Effect on daily life: Prone to falls

 Some episodes caused loss of (2)

 Early episodes triggered by physical exertion (3)

 Change in episodic trigger pattern: Patient started to have symptoms

Takes about 10 – 15 minutes to recover

 Severity: Enough to warrant intervention by way of calling an (5)

 Third person account: Jack appeared (6) during an episode

 A& E check for (7) came back negative

 Diagnosis and Treatment

Suspected condition: (8)

 (9) detected from most recent ECG

 Stokes-Adams attacks due to (10) heartbeat – cause of blackouts

 (11) needed (to monitor and control heartbeat)

 Surgery required – although it’s not (12)

Discharge: Usually within 24 hours of the procedure

Practice Test 1 : Part A – Extract 2 Q(13-24)

 Patient Mrs Halloway

Reason for Appointment: Lack of energy

Affecting professional life: fell (14) at work a few times

Affecting social life: gave up weekly tennis game

 Suffered depression (15) years ago (marriage breakdown)

 Physical symptoms: constipation and (16) gain

 Family history of (17)

 Skin: dry and (19)

 Lipid level: (20) (indicating hypercholesterolaemia)

 Early diagnosis: (21)

 (22) interfering with sleep

 Condition ismore prevalent in (23)

Requires (24) tests to be sure of diagnosis

Practice Test 1 : Part B – Q(25-30)

o BWhether she was in the vicinity of a place with the disease

o CWhether she had been to the tropics recently as the disease is

o BHaving blood drawn in order to run tests.

o CHaving an IV put in while other tests are run.

o BThe reason the condition was triggered.

o CThe reason the patient’s eyes are sore.

o BTo improve communication between patients and nurses

o CTo improve communication between doctors and nurses.

o BThe number of doctors opting to go into general practice.

o BDo not necessitate medical intervention.

o CCan be dangerous if handled by someone without skill or knowledge.

o BTo discharge as many patients as possible for the podiatry service

o BThose able to take care of low risk conditions

o CThose with a medically-trained family member

o CSmall group assessment sessions

o BBy reducing the number of podiatrists seeing patients

o CBy reducing the number of appointments involving low risk patients

o BThe amount of time patients had to wait to be seen

o CThe level of satisfaction of all podiatry patients

Practice Test 1 : Part C – Extract 2 Q(37-42)

o BA nurse with experience working with elderly patients

o CA health practitioner with a background in emergency medicine

o BThe lack of permanent physicians at hospitals

o CThe integrated care model recently adopted

Why was the interviewer surprised by the interviewee’s initial response

o BBecause he has information that contradicts what she said.

o CBecause he has heard information about another problem.

o BSignificant turnover in health systems

o CIncreased risks to patient safety