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Review Request for Mr. James Smith

Dr G Stark, I am writing to request your review of 17-year-old James Smith, who has cystic fibrosis and was recently admitted with respiratory symptoms. He presented with shortness of breath, coughing, low oxygen levels, chest pain and fever. Imaging showed pneumonia and a lung infection, which responded well to antibiotic treatment. While his condition has improved, his lung function remains compromised due to cystic fibrosis. Given his history and the risks of future exacerbations, we recommend exploring whether he may be a candidate for a double lung transplant to improve his long-term prognosis. Please advise on next steps for evaluation of his transplant suitability.

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dr.alice
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712 views4 pages

Review Request for Mr. James Smith

Dr G Stark, I am writing to request your review of 17-year-old James Smith, who has cystic fibrosis and was recently admitted with respiratory symptoms. He presented with shortness of breath, coughing, low oxygen levels, chest pain and fever. Imaging showed pneumonia and a lung infection, which responded well to antibiotic treatment. While his condition has improved, his lung function remains compromised due to cystic fibrosis. Given his history and the risks of future exacerbations, we recommend exploring whether he may be a candidate for a double lung transplant to improve his long-term prognosis. Please advise on next steps for evaluation of his transplant suitability.

Uploaded by

dr.alice
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Instructions to Candidates
  • Patient Details
  • Writing Task
  • Treatment Record

MEDSAMPLE05

WRITING SUB-TEST – TEST BOOKLET

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INSTRUCTIONS TO CANDIDATES
You must write your answer for the Writing sub-test in the Writing Answer Booklet.
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You must NOT remove OET material from the test room.
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©Cambridge Boxhill Language Assessment Pty Ltd 2020


Occupational English Test PPP MEDSAMPLE05

WRITING SUB-TEST: MEDICINE


TIME ALLOWED: READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES

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

Notes:

You are a doctor working in the Respiratory Unit at Bridgeford General Hospital. A patient, Mr James Smith, has
been sent from the ED with acute respiratory symptoms.

PATIENT DETAILS:

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Name: James Smith
DOB: 26.10.2004
Next of kin: Mother, Bridget (56 y/o)

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Social background:
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High school student. Sedentary - no sports, spends many hours at computer.

Family history: Mother: hypothyroidism, rhinitis


Father: deceased (lung cancer 54 y/o)
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Medical history: Symptomatic focal epilepsy


Chronic sinus infections
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Cystic fibrosis (2006) – poor growth


Healthy diet but overweight (BMI 28.5)
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No allergies

Current medications:
Phenytoin 100 mg 3 x daily (anti-seizure)
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Panadol Rapid (paracetamol 500 mg)/ 6h


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Pulmozyme (dornase alfa), 2.5 mg b.i.d (breaks down sputum)


Creon (Lipase-Protease-Amylase), 4 x caps with food (pancreatic enzymes)

Admission: 02.02.2019

Presenting factors:
Severe dyspnoea (SOB), coughing, hypoxia (lack of oxygen), hemoptysis (coughing up blood),
fever, headache, facial pain.

©Cambridge Boxhill Language Assessment Pty Ltd 2020


PPP MEDSAMPLE05

Treatment record:
02.02.2019 VS: BP: 116/78 mmHg, HR: 82, RR: 18, T: 36.5 C
hydrated; O2 sats = 80%
Erythematous oropharynx (red tongue &throat)
Ó breathing rate (30 breaths/minute)
Sonorous wheeze (indicates lung blockage) & bibasilar crackles (sound at base of lung –
indicates mucus/fluid)
Treatment: Ampicillin sulbactam (antibiotic) – Lower respiratory tract infection (LRTI)?
bacterial sinusitis?, and supplemental oxygen.

03.02.2019 Pt. stable


Chest x-ray: pleural effusion & pneumonia

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CT scan: chronic sinusitis (paranasal sinus)
Treatment: azithromycin (500 mg p.o., q.d. (reduce to 250 mg)) (antibiotic), ciprofloxacin (500
mg p.o., 12 hourly) (antibiotic).

17.02.2019

io e Satisfactory clinical recovery


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Antibiotics finished
Ó likelihood lung infections & Ó frequency
Discussion regarding Ô time in school, Ó hospital visits: home-schooling?
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Discharge plan: Physio – airway clearance technique (q.d./prn)


Dietitian - Ó exercise, improve/discuss diet
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Double lung transplant suitability - explore with surgeon


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Writing Task:

Using the information in the case notes, write a letter to Dr Stark for review of Mr James Smith. Address the letter to
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Dr G Stark, Surgeon, Department of Thoracic Medicine, Smithtown Hospital, Smithtown.


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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.

©Cambridge Boxhill Language Assessment Pty Ltd 2020


PPP MEDSAMPLE05

Any answers recorded here will not be marked.

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B
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©Cambridge Boxhill Language Assessment Pty Ltd 2020

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