OCCUPATIONAL ENGLISH TEST

WRITING SUB-TEST: MEDICINE

TIME ALLOWED: READING TIME: 5 MINUTES

WRITING TIME: 40 MINUTES

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

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Mr Daniel Mccrae is a patient in your general practice.

History:

DOB: 17 October 1962

Height: 180cm
Weight: 91kg
BMI: 28.1

Social background: Smoker

Married, 4 children (23, 20, 10, 8yrs)
Barrister

Hobbies: Reading, cooking, art, music

19/09/13: Pt fever, sore throat, cough, headache, body aching

Wants antibiotics so no need for time off work - v busy

0/E: BP 120/75
Heart rate 76bpm
Chest clear
Wt 91kg
BMI 28.1
Temp 38.9 ° C

Tests: None

Assessment: Viral infection

Plan: Rest 1-3 days until fever subsides, symptoms weaken

Paracetamol
Riv if symptoms persist >5 days

2
 I

08/02/14: Pt feeling tired, 'off-colour', as if never fully recovered from infection (Sep 2013).
Complains of 'unsettled system' for several weeks - abdominal discomfort, gas,
diarrhoea/constipation; feels fatigued. Still under some stress from workload.
No family history of colorectal carcinoma, colonic polyps or inflammatory
bowel disease.

0/E: BP 115/80
Heart rate 77bpm
Wt 92kg
BMI 28.4
Temp 37.1° c
Abdomen soft, lax, no masses, no guarding or rebound
Normal bowel sounds

Assessment: ? Irritable bowel syndrome

? Crohn's disease, ulcerative colitis, inflammatory bowel disease
? Unfit, overweight

Plan: Investigations: CBC

Faecal occult blood test (FOBT)
Colonoscopy
Riv in 2 weeks for test results

22/02/14: Pt still feeling unwell

0/E: BP 120/85
Heart rate 74bpm
Chest clear
Temp 37 °C
No abdominal mass

Results: CBC: normal, WBC (8.5), !- Hb (91), t Hct (34%)

FOBT: positive
Colonoscopy: abnormal. Malignancy detected in ascending colon; biopsy
taken and adenocarcinoma diagnosed

Assessment: Adenocarcinoma of the ascending colon

Plan: Refer to colorectal surgeon for assessment ASAP

Writing Task:

Using the information given in the case notes, write a letter of referral to: Associate Professor Simon
Anderson, Surgeon, Suite 65, City Hospital, 25-29 Main Road, Centreville.

In your answer:
• Expand the relevant notes into complete sentences
• Do not use note form
• Use letter format

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