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OET Letter Writing Phrases to achieve Grade B

OPENING SALUTATION

Dear Doctor / Registrar / Dr. Smith / Michael,

Re: Patient … (John Smith) , DOB … (28.6.1985)                       [DOB – Date of birth]

OPENING CLAUSE                                                        [Referral/Admission plus Patient data]

Thank you for (urgently) seeing … (the above patient/ Mrs. Polanski),            [Referral letter]

a 38 year-old … (worker, profession) with … (cholelithiasis)
for further … (management) and possible … (operation)

who is currently | in this hospital recovering from … (a stroke)
                               | suffering from … (severe acute asthma)
                               | bedridden/immobile with possible … following … on … [combination]                                                                                                      (nerve compression) (heavy lifting) (date)
I am writing to refer   |my patient aged 45 and married with 3 children of school age.
I am pleased to refer | this 45-years old lady
                                        | Mrs. Smith
                                        | a 45-years-old worker

(This lady of 45years)…                               was admitted                               [Admission letter ]
to your facility / this hospital/clinic on … (22.6.21)
for further (neurological) assessment and possible treatment of … (headaches)
operation … (of a hernia)
management of … (her drug substance abuse)
for a fracture of his … (femur)
for post-fracture rehabilitation

I am writing to follow up on our conversation earlier today       [Advice letter]
       about … (your son’s management plan)
Further to our earlier conversation … (I am reporting you about …)

REASON FOR REFERRAL
(Mr. Dubois) … presented to me (today) with signs of a (possible) … (pulmonary infection)
                           at my clinic complaining of … (left thorax pain)
                           to emergency

This 5 yo boy initially presented with … (tonsillitis)
                  for which he was treated with … (antibiotics)

He is/has been suffering his first episode of … (post-streptococcal nephritis/chest pain)

He was admitted to this hospital on … for a fracture of …
                                                                       suffering from …
                                                                      with signs for early renal failure / heart attack

PROVISIONAL DIAGNOSIS  (PD)           [NYD – not yet diagnosed]
My provisional diagnosis is … (headaches), possibly … (stress-related)
Today, I diagnosed .. / he is diagnosed with …
The complaints may result from … / caused by …

I believe he has / may have … (a urinary tract infection)
I believe that the cause of his complaints is … (an asthma attack)
and is at risk of developing renal failure

Investigation Diagnosis:
The ECG                                indicated possible … (ischemia)
The liver function tests    showed possible … (mild obstruction)
The X-ray                             detected …

PRESENT ILLNESS

Introduction:

                                                                             in … (Nov 2003)

on … / today / 6 weeks ago

1)                       (He)… first attended my clinic for … (a check-up)

                              complaining of… / suffering from …

with symptoms of … (tonsillitis)

On his first visit to me on …. he was / has been suffering … (a sore throat)

On … Mr Smith presented (at my clinic) complaining of … for the previous 10 days which was not responding to … (simple analgesia)

2) His complaints set in 10 days earlier and were related to … (strong gardening exercise)

SYMPTOMS

The pain occurs … (on exercise)

He was/felt + adjective … (irritable / feverish/ sweaty/ distressed/ nauseated /dehydrated)

                suffers from … irritability

                complained of …

He          presented with … an irritable condition

               showed… no guarding or rebound on abdominal examination

               found it difficult to …

               is unable to … see clearly Apart from this, In addition, noticed                

               progressively worsening sight Furthermore, he experienced a new episode of pain

Moreover, reported no further … (fever)

Otherwise,

And there is

At times,

Occasionally,

He (initially) had … (headaches), but has had none since that time until … (now / 3 weeks ago)

She reported no history of … (abdominal tenderness)

This causes her stress

He had a decreased range of … (movement on his right hip)

PAST HISTORY (PH)  [use simple present tense !]

He has a five year history of … (osteoarthritis)

She has a history of … hypertension (well controlled by medication)

His (medical) history includes (iron deficiency) for which he is given … / treated with …

He also suffers from …

excluding:

She reported no history of dysuria

There has been no history of being overweight/ obesity (98kg at 170cm ht)

He has not suffered from … (epilepsy) or other significant illness/injuries before … (accident)

RISK FACTORS/ALLERGY

His (cardiovascular) risk factors such as … (hypertension)

include … (hypercholesterol, smoking)

being overweight / obesity

lack of regular exercise / having no regular exercise

a strong family history (father died of … aged 48)

Smoking:

She has smoked 15 cig. a day for the past … years

He had cut his smoking to 10 c. a day [past perfect]

Allergy: Please note that she is allergic to … (penicillin)

He has no known allergies

CURRENT MEDICATION

Abbreviations:

stat (latin: statim) – immediately,

BD – twice,

t.d.s./t.i.d. – thrice,

q.d.s./q.i.d. – four times

p.c. – after food, nocte – at night,

s.l. sublingual,

s.c. – subcutaneous

Her current medications include/are…

She also uses … (Mylanta) for … (reflux)

 has(not) has not responded to simple analgesia

(No) effect: The pain was (not) relieved by oral medication, Senna, Zantac was persistent

resistant to Coloxyl, Avapro, Panadol

The was pain resisted to … (Aspirin)

His complaint usually settles with NSAID and rest

Side-effect: But the medication caused significant … (dyspepsia)

TREATMENT

 Prescription: He was treated here with … (diuretics)

Combination Treatment:

He was given … (oxygen) followed by … (hospital admission)

in addition to … (adrenalin)

combined with … (life support)

and advised on … (losing weight)

I prescribed … (Respeace) combined with … (the Pulmipak)

in addition to

Effect:

Initially, his response to … (fentanyl) was … (good), but unfortunately, his pain flared up.

Therefore, I commenced him on … (morphine)

I changed him on … (frusemide)

After discussion with Dr. X, I started her on …

After persistently elevated BP readings around x mmHg,

Doses: he was commenced/started on …(nifedipin), this has recently been increased to … (20mg)

Operation: An arthroplasty was performed. She underwent/had … (an appendicectomy) and recovered well/ will be discharged today.

Recovery:

She has been able to … (shower) with assistance

Since the operation her wounds have healed and sutures have been removed.

Her post-operative recovery was successful/ uncomplicated /uneventful /normal.

Subsequently,

In the following days, he recovered by taking … (Penicillin) for 7 days.

after 7 days treatment with … (Penicillin)

Complications:

While here, she has (extreme) difficulty using a walking frame/ the crutch

 has been able to walk (with extreme difficulty)

to have a shower with assistance

Her short-term memory has worsened while here

Her general condition has deteriorated

EXAMINATION:

neurological he scored … (five) on a short-term memory test

On physical examination this lady showed

cardiovascular I found … no abnormalities

she was overweight with normal vital signs (P80, BP 120/70, T36)

The examination was unremarkable / normal

revealed … (elevated liver enzymes, no abnormalities)

(Bilateral fine crepitations) … were noted on chest auscultation / examination

Otherwise, examination was normal.

Readings:

The (liver function tests) … showed (no) pathological findings

(FBC, MSU, ASOT) significant abnormalities

were consistent with … (hepatic failure)

He had elevated BP readings around 150/1000

The blood test was normal and Urea, Creatinine was slightly elevated

Technical Investigations:

 Tests including … An Xray/ECG/radiograph taken here on … revealed … NSA (no signifcant abnormalities)

indicated … Test for/on … (Mr. Smith) were done and showed …

I had test for … (Mrs. Jones) done which showed …

I ordered the following test for … (Michael):

Results:

All tests, in summary, indicate pathological findings consistent with … (hepatitis)

confirm my provisional diagnosis of … (post-streptococcal nephritis)

(The urine analysis) … showed / confirmed significant … (haematuria)

(Her liver function tests) … showed possible … (mild obstruction)

The … (CT scan) at that time appeared … (unremarkable/ normal)

ACTUAL CONSULTATION                            [Review, follow-up visit]

On review (Today), … (Mr. Romano) reports no further episodes of … (headaches)

presented persisting complaints

reviewed me due to … (brown urine) for 4 days.

On review, investigations showed … and haematuria of renal origin.

One month later, he returned today with the symptoms above.

 

PSYCHOLOGICAL ISSUES /CONCERNS

was anxious

She showed concerns that she may have … (cancer), about which I have reassured her.

 worried

She is most concerned of …

She is a widow and has managed alone until now.

He receives support from … to manage

He needs assistance requires

ADVICE

 He was advised to …(take antibitotics) and return in … (2 days)

on … (losing weight)

Mrs. Smith was given advice on … (quitting smoking)

I advised her (that she may need) to represent to hospital for admission …

if she gets any worse or if she isn’t getting better in 2 days.

To avoid future episodes, he needs … (to carry medical ID at all times stating he is diabetic)

REQUEST/FUTURE MANAGEMENT

Thank you for continuing the care of … (this lady)                                      [discharge letter]

I would appreciate your further assessment and management/treatment

regarding … (his acute worsening condition).

of the possibility of … (cancer)

of the suspected/potential cancer

I would appreciate

I would be grateful

(for) your opinion regarding … (his future management)

if you could please assess this patient

if you could see … (this lady) fairly soon for further management.

if you could arrange an appointment with a physiotherapist/ an occupational therapist /a social worker

I would be interested if he would be a suitable candidate for … (a hip replacement)

I would appreciate if you could keep me informed about his further management.

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