Writing Sub-test (Medicine) Sample Four

(Medicine)

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.

Writing Task:

Using the information in the case notes, write a letter of referral for urgent assessment and management to the ER Physician at City General Hospital, 123 Main Street, Metropolis.

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.

Note: You Can Highlight Keywords In the Reading Text

Notes:
Assume that today’s date is 15 August 2024.
You are a general practitioner examining the following male patient, who has been diagnosed with AMI.

PATIENT DETAILS:

Patient: Mr. John Martin

Date of Birth: 05/03/1965 (59 years old)

Medical History:

  • Hypertension (2014)
  • Hyperlipidemia (2019)
  • Gastroesophageal reflux disease (GERD) (2021)
  • Appendectomy at age 25
  • No known allergies

Current Medications:

  • Amlodipine 5mg daily (for hypertension)
  • Atorvastatin 20mg daily (for hyperlipidemia)
  • Omeprazole 20mg daily (for GERD)
  • Aspirin 81mg daily

Social History:

  • Lives with his wife in a suburban home
  • Works as an office manager
  • Enjoys gardening and walking
  • Previous smoker (quit 5 years ago), occasionally consumes alcohol

Date of Visit: 15 Aug 2024Chief complaints:Acute chest pain (L side)

Assessment:

Vital Signs:BP: 150/95 mmHg, Pulse: 100 bpm, Respiratory Rate: 24 breaths/minute, Temp: 36.8°C

Physical Examination:

  • Appears anxious & diaphoretic
  • Severe central chest pain radiating to left arm and jaw
  • Shortness of breath
  • Pale &clammy skin
  • Mild epigastric tenderness

Investigations:

  • ECG: ST-segment elevation in leads II, III, and aVF suggestive of acute myocardial infarction
  • Blood tests: Elevated troponin levels
  • Chest X-ray: Normal

Diagnosis: Acute Myocardial Infarction (AMI)

Treatment Received:

  • Aspirin 300mg immediately
  • Sublingual nitroglycerin 0.4mg
  • Oxygen via nasal cannula at 2L/min
  • Attached to cardiac monitor
  • IV access established

Plan:

  • Immediate referral to the emergency room for urgent assessment and intervention
  • Paramedic transfer for continuous monitoring and support will be arranged

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