OET writing [Steve lecture's]

[04/05/20] !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1) Advice was given to reduce her weight 2) He is now obese with a 99kilos weight and a 170cm height. 3) Today's examination revealed multiple missing teeth, various carious lesions and a periodontal pocket of depth 4-9mm. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!4) He was overweight 85kg with respect to his height 173cm. 5) I gave advices to the patient regarding her medication

1) Advice was given to reduce weight or A reduction of weight was advised => After ther verb reduce, lose, it is not necessary to follow with a pronoun. So her is not required. 2) He is now obese with a weight of 99 kg and a height of 170cm or He weighs 99kg and is 170cm tall or He weighs 99kg and is 170cm in height 3) pockets depth of 4-9mm, pockets with depth of 4-9mm, pockets which are about 4-9mm in depth 4) He was overweight at 85kg with respect to his height of 173cm *depth of, height of, length of, weight of 5) some advice

genre & style [09/05/20] 1) I would really appreciate your attention regarding further management of this patient. 2) He had a habit of thumb sucking til the age of 5. 3) Examination revealed that Robert started smoking about 6 months back 4) He got regular treatment for asthma when he was a kid

1) I would greatly appreciate your attention regarding further management of this patient. 2) He had a habit of thumb sucking until the age of 5. 3) Examination revealed that Robert started smoking approximately 6 months ago (before/previously) 4) He received regular treatment for asthma in his childhood/when he was a child *proximately

Purposes [13/05/20 good] 1) ? 2) [ectopic pregnancy] 3) [early stage of alzheimer's disease] 4) to [surgeon] 5) [endocrinology] 6) [possible tumour] 7) [prostate]

1) follow up care and management, 2) urgent admission and assessment 3) memory assessment 4) provide surgical consultation 5) assessment and management 6) urgent assessment 7) possible biopsy

[16/07/20] 1) I am writing to request an urgent MRI scan for Mr.Benson who [ ] signs and symptoms [ ] subdural hematoma. 3) The same previous signs [ ] left ventricular failure !!!!!!!!![ ][ ].

1) has been demonstrating, suggestive of/ indicative of 2) of, were observed

New expressions [06/05/20] !!!!!!1) Please note that the next injection of Navane is !!!!!!![ ] 16/01/2020 2) Psychotherapy was commenced, although his participation was [ ] because of his !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] in concentration 3) Jack's condition has [ ] improved

1) on 2) inadequate, difficulties 3) generally

How to make compound sentences? [08/06/20 good] !!!!1) Mrs. Martin does not drink alcohol [ ] smoke cigarettes

1) or ============== There is only one type of glue that you can use to form compound sentences: coordinating conjunctions (FANBOYS): for, and, nor, but, or, yet, so - commonly used => and, but, or vs - not commonly used (empathetic) => nor, yet, so e.g They were neither cheap nor convenient *however is not used for making a compound sentence

Since? when? After? Although? [08/06/20 good] 1) Her condition has regularly improved _______ she started taking the medication 2) _______ the patient first attended my clinic, he complained of swelling and pain in his left knee. 3) [ ] Mr. Nation has good support from his family, they have decided to transfer him to an aged care facility due to his high care needs

1) since - "since" convey more meaning than after. If you use "after" you have to remove "has" and it might need to add "however, her condition deteriorated later" 2) When 3) Although

Articles [08/06/20 good] 1) Neither the patient's husband nor her family members [ ] informed about the diagnosis. 2) Neither the patient's family members nor her husband [ ] informed about the diagnosis 3) 10 g of morphine [ ] administered. !!!!!!!!!!!!!!!4) 10 kg of body weight [ ] lost over 3 months

1) were 2) was 3) was 4) was *Multiple subjects joined by "either... or" "Neither... nor" => The verb agrees with the subject nearest it (ie, the noun after'or/'nor')

How to say "history is unremarkable" [05/05/20] !!!!!!!! 1) Please note, Andrew's prenatal and antenatal examinations were normal [ ] unremarkable findings in the 6-week of age checkup including his feeding and sleeping pattern 2) Cardiovascular examination was !!!!!![ ] and her electrocardiogram was normal. 3) A past history is free [ ] infection/something

1) with 2) unremarkable 3) of

[05/05/20 good] including vs such as

Including (slightly more formal than such as & can include more irrelevant things) vs such as (=for example; informal)

How do you write about social information? [07/05/20]

Social information usually can be included if it's not un urgent case and is maximum one sentence e.g Mrs.Attard is a married mother with two school age children aged 9 and 7. She is a mon-smoker and her medical history is UNREMARKABLE apart from a cholecystectomy 2 years ago. His risk factors include: smoking 20 cigarettes per day, lack of exercise and a strong family history of hypertension. He is reluctant to seek treatment. There were no other remarkable findings.

What are these words? [14/07/20 good] • None of these words can be followed by an object pronoun (him/her/us). • Nor can they be followed by an infinitive.

Suggest, Recommend (!!!!!!!!!!!!!!), Explain (to), Discuss (with) e.g I explained the importance of quitting smoking to him

Past vs. past perfect for "scheduled" [09/05/20]

has been scheduled "a change and a new schedule" vs is scheduled "a routine"

How can we use the word "the patient?" [08/06/20 good]

"the patient" in front of sentence is wrong. But in introduction "the patient" is okay under his full name

[17/07/20] in vs on (x) tenderness [ ], vision [ ], e.g She has very little vision in her left eye an ache [ ], decay [ ] tooth [deeper], arthritis [ ], a lesion [ ], a swelling [ ], a sensation [ ], braces [ ] the teeth, a [cambridge] feeling [ ], a fracture [ ], an infection/inflammation [ ], !!!!!!a lump [ ], pain [ ] (!!!!), pin and needles !!!!!![ ] my leg, a plaster cast [ ] *in: internal, *on: external, *sometimes can be both

(x) tenderness in, vision in, e.g She has very little vision in her left eye ache in, decay in tooth [deeper], arthritis in, lesion (both) in, swelling (both) in, sensation in, braces on the teeth, a feeling in, fracture in, infection/inflammation (both), lump (both), pain in (!!!!), pin and needles in my leg, a plaster case on *in: internal, *on: external, *sometimes can be both

What is the meaning of this sentence? [09/05/20 good] I suggested Bill to play piano

*suggest 는 ing 또는 that 이랑 같이 쓰여야한다 - 나는 (Bill 이 아닌 다른 사람에게) Bill 이 피아노를 쳐야한다고 제안했다

When do you put a comma? [11/05/20 good]

- Before the coordinating conjunction in a compound sentence [when the sentence is short, you can exclude it] - IF MORE THAN 3 WORDS, USUALLY WE USE COMMA (e.g accompanied by her daughter) - if you feel a natural pause is warranted, add a comma - No coma: when information is separated by lines or after street number, - Optional: After "today" - Preferred not: After "at that time"

Classify them depending on the form of objectives [13/05/20 bad] encourage (v), attempt (xxx), recommend (v), persuade (x), help, resist (v), quit (v), consider (!!!!!!!!!!!!!!!!!!!!!!!!!), dislike, refused (x), remind, teach, trust (???), appear/seem (vv), suggest, think about, admit (v), miss (v), practice, advise (x), continue (xxxx), require, intend (xxxxx)

- Gerund: admit (v), avoid, give up, discuss, dislike, postpone, recommend, suggest, think about, avoid, difficulty, enjoy, finish, have, mind, miss (v), practice (v), quit (v), resist (v), stop, CONSIDER!!!!!! e.g I considered finishing my research tonight, e.g We don't consider her to be right for the job e.g she has difficulty passing urines e.g I discussed the treatment options with her e.g His wound was reviewed by the wound nurse who recommended a twice weekly dressing change. - Infinitive: encourage (v), persuade (x), help agree, allow, appear (v), convince, forbid/force/warn/permit, order, urge, cause, invite, refuse (x), remind, seem, teach, tell, trust (???), warn e.g quitting smoke will be helpful in improving your health e.g I refused to go there e.g I persuaded the patient to start e.g her situation at work and within family was causing her stress, frequent headaches and insomnia - Both [GERUND FORM IS MORE POLITE] : attempt (x), start, prefer, try, ADVISE (xxx), begin, continue (x), intend (xxxxxx), hate, like, love, try, plan, require e.g I started smoking when I was 14 = I started to smoke when I was 14 e.g I quit smoking forever when I was 32 [only gerund] =/= I quite to smoke when I was 32 e.g I love watching a movie e.g I love to watch a movie e.g She attempted alleviating her pain with over the counter medications * Note: As a general rule, verbs of preference (to like, to love, to hate, to prefer) are followed by a verb in the infinitive if precise actions are being referred to (eg: I hate to end this conversation, but I have to go.), and by a verb in the ing form when permanent tastes are being referred to (eg: I hate ending conversations prematurely.).wa

[19/05/20 good] vDuring the passing [ ] urine vs During urine passage vs while passing urine vs while exercise

- during the passing of urine is preferred (focusing on the action) - while passing urine" is also possible; while + ____ing, during + noun => while exercise is wrong, you should say either while exercising or while doing exercise

Being formal & Rules in OET [15/06/20]

- using gerund (removing you) => when you speak - not using sentences with the imperative form - by using the noun form - avoid informal words ("that" "shifted" "so" should be avoided in written English) - do not use semicolon in OET - do not use "Therefore" when it is obvious (cause & effect - more subjective)

[06/05/20] 0) He has !!!!![ ] of severe headaches and collapsed at home today. 2) The symptoms first appeared two weeks ago when he complained of [ ] frontal headache. 3) I suspected [ ] tension headache 4) Despite my treatment, his symptoms [ ] to worsen. 5) who I visited today !!!!!!!!!!!!!!!!!!!![ ] a collapse at home and [ ] signs and symptoms suggestive of [ ] space-occupying lesion. 6) Today, the thyroid was firm with limited mobility and the presence of some enlarged lymph nodes on the right side

0) He has "a" two-week history of severe headaches and collapsed at home today. 1) He was conscious but he complained of a headache of 3-hour duration 2) The symptoms first appeared two weeks ago when he complained of a frontal headache. 3) I suspected "a" tension headache 4) Despite my treatment, his symptoms continued to worsen. 5) had, experienced, a 6) The thyroid is [because the status will not change] firm with limited mobility with the presence of some enlarged lymph nodes on the right side

Normal range [08/06/20 again] 1) Intermediate cholesterol range 2) An abnormal respiration rate 3) Definition of DB !!!!4) Definition of microalbuminuria

1) total cholesterol 5.2! - 6.2 LDL cholesterol 3.4! - 4.11 triglycerides 1.7! - 2.25 *Total cholesterol: Less than 200 mg/dL = 5.2 *LDL: 70 to 130 mg/dL (=3.4) *HDL: More than 50 mg/dL (the higher the better) *Triglycerides: 10 to 150 mg/dL (=1.7) 2) under 12 or over 25 bpm 3) Diabetes is defined as fasting plasma glucose level > 126 mg/dl or if 2 hours after glucose load is higher than 200 mg/dl or A1C (>=7%) 4) 30 to 300 mg = early kidney disease

Fix the sentences [20/06 again] 1) In addition, urine microalbumin was 45mg. !!!!!2) Furthermore, we are also planning a follow-up appointment with GP in 3 weeks and with a dietician to introduce a balanced diet and healthy lifestyle and increase his physical activity. 3) Today, her examination is normal apart from a smoothly enlarged thyroid gland. she requires an increased dose of vitamin D. 4) Last week, Ruth presented with symptoms of mild hypothyroidism. Her neck swelling has had enlarged.

1) Albumin urine test revealed microalbuminemia. 2) We have planned [for] a follow-up appointment with GP in 3 weeks and support from a dietician to change his diet and lifestyle or a follow-up appointment will be booked with your surgery within the next three weeks. 3) Today, her examination is normal apart from a smooth and enlarged thyroid gland. she requires an increased dose of vitamin D. 4) Last week, Ruth presented with symptoms of mild hypothyroidism. Her neck swelling had enlarged.

Fix sentences [14/05/20] high points !!!!!!!!1) The patient has smoked 40 cigarettes a day for 25-30 years. [ ], he has type 2 diabetes v2) This child was admitted [ ] acute meningoencephalitis [ ] a complication following mumps 3) The dept of periodontal packet was 3.4mm. [ ], he has undergone extensive treatment for carious lesions and oral hygiene maintenance. v4) Mr. Fox's blood pressure [ = elevate] and he was overweight. [ ], the patient was advised to do exercise and !!!!![ ] a healthy diet. 5) A repeat vaginal examination revealed a very tender right vaginal fornix. [ ] her blood pressure pulse is within normal range. 6) [ ], she has mild hypertension and a 12-year history of diverticulitis 7) The carious lesions on 65 are reasonably deep and [ ] the tooth has to be extracted

1) Besides that 2) as a result of, with (?) 3) Consequently 4) was elevated, For this reason [for that reason - that is wrong!!!], follow 5) However, 6) In terms of her medical history 7) hence

!!!Make them more formal [14/06/20] 1) Blood tests ordered -> verify hormone levels (female patient) 2) Pt advised to modify diet. !!!!!!!!!!!3) US result showed enlarged liver !!!4) Cannot tolerate foods, only drinks fruit juice. noticed that the urine is getting darker in color with chills and rigors (male patient) 5) Mr Henry C/0 diarrhea on and off last week. !!!!!6) Kate unable to walk to school -> lower back pain aggravated by walking >15min. 7) Please educate and guide [too direct] the patient on correct feeding techniques for baby. !!!!!!8) Infection evident on CXR (male patient) !!!!!!!!!9) O/E weak R lower limb (female patient) !!!!10) Sutures removed 05/06/19 11) Stopped the pill 2017 (Mircogynon 30) !!!!!!! 12) trying to get pregnant !!!!!!!!!! 13) because his wife passed away 14) The patient was admitted on the 16th of March 15) he has been [ ] our care in the Rehabilitation Ward for two weeks

1) Blood tests were ordered for verification of hormone levels 2) Pt is advised "to make diet (dietary) modification" Diet modification was advised Pt was advised regarding diet modification 3) The ultrasound confirmed a liver enlargement 4) The patient reported food intolerance "in addition to" urine discolouration and "chills and rigours [one word like a fish and chips]" 5) Mr Henry C/o had "intermittent" diarrhoea last week 6) Kate was unable to walk [=found it difficult to walk] to school due to [arrow means due to = as a result of] !!!!!!aggravation of lower back pain !!!!!(after waking !!!!!!more than 15 minutes) 7) Education and guidance is required "regarding" correct feeding techniques. 8) There was evidence [often uncountable] of an infection on his chest CXR or Chest x ray revealed evidence of an enlarged prostate 9) Examination revealed weakness in her right lower limb 10) Suture removal was done on 05/06/19 11) She was taking Mircogynon 30 until 2017 12) trying to become pregnant or trying to conceive 13) due to his wife passing away, due to his wife's death, due to the death of his wife, as his wife passed away 14) The patient was admitted on March 16. 15) under

1) [has difficulty vs have difficulties] [08/06/20 good] 2) has difficulty of vs in

1) Both forms are correct; the difficulties form is a bit more specific. "They had immense difficulties" evokes explicit obstacles they encountered. "They had immense difficulty" connotes just that they found the task very difficult. 2) The two would be used on different occasions. 'The difficulty of remaining objective' states a general principle. 'The difficulty in remaining objective' would be more appropriate in a particular case. It might even apply to a case in which someone had already remained objective, or was on the point of doing so

[10/05/2020 again] 1) [ ] way of introduction, Miss Patel will be !!!!!!!!!!!!!!!!![ ] your care for the ongoing management of the symptoms of her type two diabetes and your assistance with !!!!!!!!![ ] new diet plan. 2) We have been caring [ ] Miss Patel !!!!![ ] her type two diabetes diagnosis six years ago. She has recently visited the practice due to !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] increase of her urine output, which she has been asked to monitor. 3) She has [ ] been !!!!!!!![ ] her condition with !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] combination of increased physical activity, a healthy balanced diet and !!!!!!!!!!![ ] prescription for 500mg of Metformin. 4) By the patient's [ ] admission, she has not been compliant with the initial diet regime !!!!!!!!!!!![ ] for her. However, a new plan has been set to ameliorate her symptoms. 5) Miss Patel is also experiencing changes !!![ ] her behaviour that !!!!!!!!!!![ ] controlled by taking up [to - by translation] 60mg of Fluoxetine on [ ] daily basis. 6) She is making good progress !!!!!![ ], but due to her sporadic tendency to re-experience depressive episodes, she has been advised to visit your clinic if the symptoms reoccur. It would be much appreciated if a dietitian could provide advice on whether an omega-3 fatty acid diet is [ ] for Miss Patel. v7) Thank you for your !!!!!!!!!![ ] management of this patient. Should you have any queries, please do not hesitate to contact me.

1) By, transferring into, a 2) for, since, an, 3) since, managing, a [Ludwig - especially it's specific], a [by translation] 4) own, a [ludwig], set 5) in, seem to be, a [Ludwig] 6) overall, suitable, 7) continued

What is right location? [14/05/20] !!!!!!!!1) He attempted [ ] suicide [ ] deep cuts !!!!!!!!!!!!!!![ ] his both wrists 2) We treated his infection with antibiotics 3) I presented due to concern of a heart attack to hospital

1) He attempted [x] suicide [with] deep cuts [to] both his wrists [both first] 2) correct 3) I presented to hospital due to concern of a heart attack

[11/05/20] !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1) He has had fair oral hygiene but pockets with depth of 4-5mm in his both lower second molars 2) a couple of (informal) bridges 3) an indication of performing surgical flap was discussed with him 4) Mr Flip's examination showed poor dental hygiene with plaque build-up. Mr Flip stated that he had used to floss his teeth 5) He has been suffering from Addison's disease 6) It would be greatly appreciated if you could provide your professional adjustment for my patient's medication as you feel appropriate 7) He had falls on multiple occasion 3 days ago 8) She stated that she might be pregnant which was confirmed by a home pregnancy test 9) the 10th of March 2020

1) He has fair oral hygiene, a depth of 4-5mm in both his [keep the personal pronoun next to body part] 2) a couple of (informal) -> two bridges 3) the possibility of 4) He used to floss his teeth!!!!!!!!! 5) suffering from -> you wouldn't lose a mark 6) good 7) occasions 8) good 9) on March 10

!!Write down prepositions [16/07/20] 1) He is admitted to [ ] hospital ICU !!!!!!!!!!!!!2) He is admitted [ ] assessment of a nasty rash, 2-2) I would appreciate your assessment and management !!!!!!!![ ] Sally's case 3) She had a rash [ ] her body !!!!!!!!!!!!!!!!!!!!!!!4) If you could provide an assessment [ ] Mr. Jones, !!!!!!!!5) Marry attended [ ] the clinic 6) He was advised to attend [ ] quit smoking program 7) Mr. Cochrane attended my clinic complaining [ ] nausea, headache and fever. 8) Today(,) Mrs Snowdon presented with complaints of intense right-sided headaches [ ] the past 3 days. 9) He presented [ ] my clinic on 23/03/2019 complaining [ ] severe pain associated with lower left first molar !!!!!10) I would appreciate your ongoing care [ ] Mrs Green. 11) She was admitted to our hospital [ ] a collapse at home [ ] symptoms [ ] dehydration, nausea and severe pain. 12) I am writing [ ] response to your memo [ ] 20/11/18 to urgently request a preoperative CT head scan [ ] Mr. Leek. !!!!!!!!!!!!!!!12-1) The patient made a request [ ] a painkiller 13) In view of the above, I would appreciate it if you could assess his suitability !!!!!!!!!!!!!![ ] !!!!!!![ ] double lung transplant 14) On examination, Mr Beat has "a" blood pressure [ ] 160/90 mmHg [ ] a regular pulse of 70 beats per minute 16) The patient has lost 6kg [ ] weight !!!!!!!!!![ ] 3 months. !!!!!!!!!!!!!!!!17) An appointment has been !!!!!!!!![ ] at the Trauma Clinic on 13/04/15 18) She is overweight [ ] a body mass index [ ] 31 19) Apart [ ] bruises to her body, x-rays revealed that she has [ ] fracture of the right ankle. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!20) The patient presented !!!!!!!!![ ] a regular check-up on 12/02/16 21) Physical examination revealed a weight loss [ ] 5kg over the past 22) She is overweight [ ] a BMI 28 23) She has a BMI [ ] 28.4 24) She insisted [ ] taking the medication due to addiction !!!!!!!!!!!!!!!!!!!25) Examination revealed dysuria which was !!!!!!![ ] [ ] a urinary tract infection !!!!!!!!![ ] positive nitrate, for which cefalexin was prescribed 26) The patient has lack of confidence !!!!!!!!!!!!!!!!!!!!![ ] breastfeeding !!!27) Please monitor [ ] signs of PTSD 29) [ ] review two weeks later, Ms Marcus reported no change 30) [ ] the next visit, she reported worsening of symptoms 31) Due to [ ] provisional diagnosis of depression and/or schizophrenia, diazepam 10mg [ ] was prescribed 32) Furthermore, !!!!![ ] erythematous area has reduced [ ] size. 33) [ ] today's visit, My John's blood pressure was 140/90 34) Education and guidance !!!!!!![ ] required "regarding" correct feeding techniques. 35) During hospitalization, IV fluids were !!!!![ ] in order to improve hydration and a transdermal patch was used !!!!![ ] her pain.

1) He is admitted to the hopsital ICU 2) He is admitted for assessment of a nasty rash 2-2) of 3) She had a rash all over her body, 4) for 5) x 6) a 7) Mr. Cochrane presented complaining of* (written & formal)/about (spoken) nausea, headache and fever. 8) Today, Mrs Snowdon presented with complaints of intense right-sided headaches over the past 3 days. 9) He presented to/at my clinic on 23/03/2019 complaining of severe pain associated with lower left first molar "to" more focusing on the behaviour "at" is more focusing on the clinic "in" too descript. you don't need this level of detail about more general vs of more personal signs & symptoms 10) I would appreciate for your ongoing care [for/of] Mrs Green 11) following, with symptoms of 12) in response to your memo dated 20/11/18, for [vs a CT head scan of her head]. 12-1) for 13) for, a 14) of, with 16) of, in 17) arranged 18) with, of 19) apart from = except, a 20) for [presented for strabimus surgery] 21) of 22) She is overweight "with" a BMI 28 23) of 24) on 25) confirmed as, by 26) with/in 27) x [correct] 29) On 30) On 31) a, at night 32) the, in 33) On 34) is 35) commenced, for *[attend vs attend to: address, provide care]

Fix sentences [15/06/20] 1) He was admitted on 19/02/2019 to hospital 2) The patient was recently admitted to hospital on 15/03/18 due to head trauma 3) Also, he was admitted on 19/02/2019 [ ] hospital. 4) Where is the location of an adverb? 5) who has been recently diagnosed with the right breast cancer

1) He was admitted to hospital on 19/02/2019 We usually say the place before the time 2) That's correct 3) Never start with "also", to 4) who -> what -> where -> when -> why 5) who has recently been diagnosed with right breast cancer

Fix the sentence [15/06/20] 1) He was [ ] [ ] three units of blood and was commenced on iron supplements 2) He has been having hypothyroidism since 2006 3) During hospitalisation, he complained of upper body pain following his fracture which he was treated with regular analgesic including: Endone 5mg if he needed 4) he was advised to rest and walk daily with gradual increasing in time and distance 5) I am writing to inform you [ ] the recall [ ] your anticoagulant medication = providing information regarding the recall of 6) She had quit smoking while pregnant, but started to smoke again after her children were born.

1) He was transfused with...... *There is no need to repeat "was" in the past passive. 2) He has had hypothyroidism since 2006 3) following a fracture (the first time mentioned) which was treated with regular analgesic (not countable) including Endone 5mg if needed 4) he was advised to rest and walk daily with a gradual increase in time and distance 5) about, of 6) She had quit smoking while pregnant, but started again after her children were born.

Conciseness and Preciseness [14/05/20] !!!!!!!!!!!!!!!!!!1) Referral to psychiatrist arranged along with weekly group psychotherapy but attendance in group psychotherapy was irregular + Mother believes he stopped taking medications 2) He was first admitted to our hospital on 14/05/18 with confusion, lack of concentration on his studies along with frequent mood swings. At that time, he was diagnosed with schizophrenia associated with paranoid disorders. Jack was readmitted on 25/08/18 following an attempted suicide by self-harm with deep cuts in both wrists, possibly prompted by stress over his mother's plan to remarry. He was discharged after three days to his mother's care/under the care of his mother. However, his symptoms worsened and he was brought back to the hospital by his mother two months later. At that time he was irritable and suspicious and had been experiencing auditory hallucinations for the past week.

1) His compliance has been poor "for" medications and [structured work projects!!!!!!!] 2) He is first diagnosed with schizophrenia associated with paranoid disorders 18 months ago and has a history of hospital admissions due to recurrent episodes of psychosis including "an" attempted suicide [or he has had frequent admissions due to...]. *He attempted [x] suicide vs including an attempted suicide or a suicide attempt [compound noun; YOU CANNOT SAY A SUICIDAL ATTEMPT; just because] vs the patient is suicidal

States verb [17/07/20] 1) I am concerning about/regarding osteoporosis due to the extraction without medication arrangement

1) I am concerned or I have concerns state verbs: liking or disliking or mental status (e.g concern): agree, appear, believe, belong, consist, contain, depend, deserve, disagree, dislike, doubt, feel, fit, hate, hear, imaging, impress, include, involve, know, want, wish, weigh, understand, surprise, promise both: be, have (e.g I have a headache, I am having a problem/party), see (e.g I have been seeing my boyfriend for three years), taste, think

Fix the sentences [07/05/20] 1) I am writing to request a fluid replacement therapy 2) There was a wheeze and bibasilar crackles 3) Today, he presents with 4) Examination revealed clinical signs of dehydration. In addition, the result of chest x-ray .... v5) The symptoms first appeared 2 days ago when Andrew has had a 2-day history of vomiting which was associated with crying spells !!!!!!!!6) Andrew has lost 50 grams of his weight and currently weighted 3 kilogram 7) Upon that, an abdominal ultrasound study was requested 8) I would appreciate if you could take over [ ] ongoing care and provide the patient with the appropriate treatment 9) Today(,) Mr Hobble had a limp and is anxious about his ability to work v10) Initially, Mr Cribb presented complaining of right lower abdominal pain radiated to the groin associated with nausea

1) I am writing to request fluid replacement therapy 2) There was/were [I think both] a wheeze and bibasilar crackles 3) Today, he presented/has presented with 4) Examination revealed clinical signs of dehydration and the result of chest X ray ....[in addition is old style] 5) The symptoms first appeared 2 days ago when Andrew presented with a 2-day history of vomiting which was associated with crying spells 6) Andrew has lost 50 grams of weight and currently weighs 3 kilogram 7) For this reason/therefore/consequently, an abdominal ultrasound study was requested 8) his 9) Today Mr Hobble has a limp and is anxious about his ability to work [Use present tense for symptoms that are unlikely to change quickly!!!!!!!!!!!!] 10) Initially, Mr Cribb presented complaining of right lower abdominal pain radiating to the groin and [needed because the pain is already described by radiating] associated with nausea

Fix the sentences below [14/05/20] 1) I suggested her to return in the morning as she required for further blood test and assessment 2) I explained them about the necessity of further investigation including semen analysis. 3) I have already explained the couple the importance of timing with regard to conception. !!!!!4) I have discussed him the benefits of quitting smoking.

1) I suggested returning in the morning as she required further blood test and assessment 2) I explained to them the necessity of further investigation including semen analysis. 3) I have already explained to the couple the importance of timing with regard to conception. 4) I have discussed with him the benefits of quitting smoking [you should not put "about"] e.g explain vs explain about (?) - you usually don't use "about" because explain already included the meaning of about - in some syntaxes it's acceptable "Let me explain about my family (e.g how it works) - To explain about your family would be to explain - Both are grammatical, but have different meanings. 'Explain a word' probably means 'give the meaning of a word', whereas 'explain about a word' might include that, but might also include why a word has been used.

When you suspect a disease, how do you experess it? [06/05/20]

1) I suspected ??? 2) I believed he may be suffering from ??? 3) I informed him of my provisional diagnosis, ???, and 4) Due to my provisional/preliminary/tentative diagnosis of ??? 5) experiencing signs and symptoms suggestive of ???? 6) who I suspect may be suffering from ???? 7) due to possible osteoarthritis 8) Provisional diagnosis suggests of prostate cancer 9) a suspected hip fracture, with suspicions of a hip fracture, due to possible hip fracture

Flow [08/06/20] 1) Initially, Mrs Lewis presented to me on 11/08/2019 with fatigue, and a low grade fever. The general examination was unremarkable. Therefore, I advised her to do regular exercise and maintain a temperature chard. 2) Initial examination revealed that tooth 54 had a temporary filling with a cavity extending through the furcation. Furthermore, I advised extraction for 54 and 65 a long with the construction... Moreover, I advised the filling of carious 55. As far as I am concern, the patinet requires a reconstruction 3) Initially, I saw Mr. Jones on 12/06/19 when he came for check-up. at this time his blood pressure showed a mild elevation (165/90). Also, his weight as above the normal limit (85 kg for a height of 173 cm). Furthermore, the cardiovascular examination and the urinalysis were normal. Therefore, I advised him to lose weight, to stop smoking cigarettes and to come for a review visit within one months. In addition, a prostate specific antigen test was requested before next visit.

1) Initially, Mrs Lewis presented to me on 11/08/2019 with fatigue, and a low grade fever. The general examination was unremarkable. Therefore, I advised her to do regular exercise and maintain a temperature chard. 2) -> no furthermore -> I also advised -> I believe (as far as I am concern is too strong) 3) -> at that time, -> His weight also as above the normal limit -> However (contrast) -> no Therefore (the flow is strange) -> within one month -> the next visit

[verb] Fix the sentences [07/05/20] 1) Mrs Fatt's appetite has been increased 2) Mrs Atrophy's health has been deteriorated 3) Mr Glum's mood has been improved 4) His symptoms have worsened !!!5) Her PT and aPTT has prolonged and calcium levels were low. v6) She is being discharged to a Woman's shelter as her condition has been stabilised 7) We implemented some measures for you to follow

1) Mrs Fatt's appetite has increased vs Mrs Fatt's appetite has been increased [=increased by someone] 2) Mrs Atrophy's health has deteriorated [change over time] 3) Mr Glum's mood has improved [change over time] vs Mr Glum's mood has been improved by "some drugs" has not fully healed 4) Correct 5) were prolonged 6) has stabilised 7) we have implemented some measures for you to follow

Change verbs/tenses [07/05/2020] 1) Ms Lingo has an ulcer on the right lower lateral border of the tongue which is present for more than one year. 2) Mrs Atrophy's health/condition has been deteriorated with occasional disorientation 3) Mrs Fatt's appetite has been increased 4) The cancer metastasised to her liver and left lung !!!!5) Santosh has made steady progress and was able to ambulate independently 6) The patient [ ] hypothyroidism since 2007 7) Today she was very anxious and depressed as she [ ] some blood in her motions [ ] two separate occasions 8) Mr Smith's activities were restricted since last year by grinding pain in the left hip and had difficulty in climbing and descending stairs !!!9) The patient [ ] osteoarthritis for 3 years before he underwent hip surgery in 2016 10) The patient has had osteoarthritis vs Tom has had (=has lived with) epilepsy since 2017 !!!!!!!!!!!!!!!11) Home modifications have completed and GP appointment has been scheduled for 07/06/19

1) Ms Lingo has an ulcer on the right lower lateral border of the tongue which has been present [not presented!!] for more than one year 2) Mrs Atrophy's health has deteriorated 3) Mrs Fatt's appetite has increased 4) The cancer has metastasised to her liver and left lung [unfinished action] 5) Santosh has made steady progress and is able to ambulate independently 6) has had = has lived with 7) had noted, on 8) Mr Smith's activities have been restricted since last year and "he" had difficulty in climbing and descending stairs *no change in "had difficulty" (I think "has had difficulty" is also possible) 9) had been living with = had had 10) The first sentence means he doesn't have osteoarthritis anymore so the meaning is different from the second one 11) been completed *I have completed" is active (I did something.), but it's not a complete sentence. You need an object after "completed". I have completed the report. "I have been completed" is passive (Something has been done to me.), but it's not a good sentence

11/05/20 again 1) I am writing to refer Kate, a 16-year-old girl, who has been suffering from chronic low back pain and requiring hydrotherapy treatment. She is playing water polo at an elite level every day after school for two hours and compete on Saturday !!!!2) On the 10/06/2019, Kate presented....On examination, her spine range of motion was restricted in every directions. In addition, flexion, right rotation and extension was painful. Her lumbar spine's right side and muscles were tender on palpation. 3) Since her initial assessment, Kate has followed a classic low back pain protocol consisting of ultrasound, heat therapy, posture correction, abdominal muscle exercises and stretching. Therefore, her GP requested a CT scan which had shown no abnormality. Unfortunately, the treatment had little to no effect on her condition. On today's visit, the compression test of her lumbar spine was positive.

1) She plays water polo at an elite level every day after school for two hours and competes on Saturdays 2) On 10/06/2019, Kate presented....On examination, the range of motion in her spine was restricted in all directions or every direction. In addition, flexion, right rotation and extension were painful (all different things). Her lumbar spine on the right side... 3) [Since her initial assessment, Kate has followed a classic low back pain protocol consisting of ultrasound, heat therapy, posture correction, abdominal muscle exercises and stretching => A level] => had shown - past perfect is better here than past => both no abnormalities and no abnormality is correct => had little effect on her condition

Fix sentences [09/05/20] 1) Should you have any enquires, do not hesitate to contact me 2) John has been having difficult in caring for his partner !!!!!!!!!!!!!!!3) Mr Vale was admitted to hospital due to/[ ] a suicidal attempt !!!!!!!!!!!!!!! 4) On examination today, his condition had gotten worse !!!!!!!!!!!!!!! 5) It would be greatly appreciated if you could arrange him for a CT scan and further assessment 6) The patient had no any screening for diabetes previously !!!!7) Mr Thompson requires to take his medication every day. !!!!!!!!!!!!!!8) The size of the lesion was 10mm x 10mm x 5mm, which had an even border, and brown base. !!!9) The baby was delivered by emergency caesarean section at 32 weeks who weighed 2.1 kg 10) She [ ] riding a bicycle when she was hit by a car

1) Should you have any queries, please do not hesitate to contact me 2) John has been having difficulties (in/with) caring for his partner 3) Mr Vale was admitted to hospital due to/following a suicide attempt => we have to use a compound noun in this case. <-> He had had suicidal thoughts for the previous 3 weeks [becuase suicidal thought is not a compound noun] 4) On examination today, his condition had deteriorated 5) It would be greatly appreciated if you arrange a CT scan (for him) and provide further assessment [if you use right verbs for right objects, sounds better] 6) The patient had no screening for diabetes previously 7) Mr thompson needs to take his medication every day ["is required to" is possible but a bit awkward. "need" is nicer because focusing on thompson] 8) The size of the lesion was 10mm x 10mm x 5mm, and it had an even border and brown base. 9) The baby, who weighed 2.1kg, was delivered by an emergency cesarean section at 32 weeks 10) had been riding *ALWAYS USE HISTORY WITH PRESENT SIMPLE

Fix sentences [14/06/20] 1) Socially, her son is her next of kin who is very supportive. 2) The patient has a history of depression [ ] she takes medication 3) She grazed both palms of her hands [ ] antiseptic was applied !!!!!!4) His wound was reviewed by the wound nurse and recommended for a twice weekly dressing change.

1) Socially, her son, who is very supportive, is her next of kin. 2) for which 3) for which 4) His wound was reviewed by the wound nurse who recommended a twice weekly dressing change.

[08/06/2020] 1) Thank you for seeing Mrs Welshman, an 85-year-widow who _________ today due to her family's _________ about her ________________. 2) I am writing to refer this elderly widow, ________________ at my clinic with symptoms _________ dementia possibly _________ early Alzheimer's disease. She _________ a full memory assessment _________ the diagnosis.

1) Thank you for seeing Mrs Welshman, an 85-year-widow who presented today due to her family's concern about her failing memory. 2) presented, suggestive of, due to, requires, to confirm

[04/04/20] 1) When should we put dosages of medication? 2) How to write the dosage of medication 3) When should we put information of medications? 4) Should medication names have a capital letter?

1) We don't know when we should put dosages of medication. Treat every case differently. 2) On the benchmark, it's written that better off not use abbreviation but I think sometimes it's fine. e.g 50mg b.d, 5mg x 2 mane e.g mmol/L 3) in case of chronic disease or complication 4) This is a frequently asked question about capital letters. If you are studying for the test, the simple answer is to copy the medication as it is written in the case notes. a. Generic drug names do not need a capital letter aspirin: !!!!!metformin [controvertial - OET online says opposite thing], metoprolol, diazepam, fluconazole b. Brand names for drugs do need a capital letter Panadol, Zyrtec, Tylenol, Claritin, Eurax

[09/05/20 again] !!!!1) Refers to a woman whose husband has died and who has not remarried. !!!!!2) Refers to a man whose wife has died and who has not remarried. !!!!!3) This is the adjective form of both widow and widower.

1) Widow (noun) 2) Widower (noun) 3) Widowed (adjective) e.g I am writing this letter to refer MaryGreen, a 68-year-old widow woman to your community care service for ongoing care and support *widow is not judgemental; devorce is judgemental

Summary of expressions [19/05/20] 1) [ ] satisfactory recovery 2) Vitamin D [ ] have been [ ] 3) [Fix this] Sally initially presented alone to my clinic on 27/12/07 with a 3-month history of constipation and associated using laxatives 4) On today's consultation, [ ] included shortness of breath along with chest pain and anxiety 5) Blood tests have been ordered. [ ], the patient has been placed in isolation

1) a 2) levels, normalized 3) associated use of laxatives 4) his symptoms 5) In the interim - attended my clinic, presented with, reattended (the clinic), returned - Describing symptoms: with complaints of, (has) a two-week history of, a headache of 3-hour duration, with symptoms of, experienced, reported, complained of, stated, showed, noticed, the symptoms appeared/initiated/were observed, his symptoms included - Examination/initial assessment results: revealed, confirmed, showed, indicated/suggested, obtained, are found - Change: has made progress/"a" satisfactory recovery, has improved, has returned to normal, has been within normal range, has fallen to, have been normalized, has continued to worsen with a symptom of, has worsened!!!!!, has deteriorated, has improved, have returned to - Time: On the next visit, On review 2 weeks later (=while reviewing 2 weeks later), On the following day, at that time, On reassessment today, He is suffering from [symptom] and reports that he is [details of drug abuse], Since that time, after the first consultation, on the second visit, While reviewing [Time Period] later, [his/her] [symptom] was persistent all the time, especially at [time of a day], however, it resolves by [type of treatment]. - Treatment: included (=consisted of), were prescribed, were given, he was treated with, a one-week course of, has been on, I recommend___ ing, There are several methods which can be implemented including... - Category: in terms of medication, in terms of "a" mood state, in terms of mobility, regarding (=with regard to=concertning), due to/for which, With regard to her medication, Based on the blood test results, Her dental history shows, The risk factors include, treatment to date includes - Contrast: despite my treatment, - Adding information: Apart from this [beside is too informal], along with, associated with!, as well as (=in addition to), together with - Location: at my practice, a patient of mine, During hospitalization - Emphasis: please note, Please ensure that, my main concern is..., what concerns me most is.... - Emotion: Unfortunately, Regrettably (only when significant deterioration or bad prognosis are excepted) - Frequency: On a regular basis - Conclusion: in view (light) of the above,

11/05/20 good 1) [ ] fever, 2) "a" [ ]/[ ]/[ ]/[ ] pulse 3) "an" elevated/normal/mild temperature 4) [ ] slightly elevated/high blood pressure

1) a low-grade/mild fever, 2) an elevated/rapid/irregular/weak pulse 3) an elevated [normal, mild] temperature 4) (a) slightly high blood pressure

[Article] When do you put "the", "a"? [07/05/20 good] 1) [ ] swollen joint, [ ] damaged cartilage 2) [ ] left/lower joint 3) [ ] spot 4) raising [ ] head at the end of [ ] bed !!!!5) [ ] weight loss of 5 kg 6) [ ] aged care facility 7) The patient requested [ ] early discharge 8) In [ ] brain, on [ ] tongue,

1) a, a 2) the left/lower joint 3) a spot 4) the, the 5) x 6) an 7) an [The patient requested to be discharged early] 8) the, the *use his/her, if you don't know the or a *the pill = contraceptive pill *pills mean aspirin and so on...

[16/06/20] 1) Thank you for seeing Mrs Priya Sharma, [ ] type 2 [ ], [ ] further management !!!!!!!![ ] her blood sugar levels. 2) Mrs Sharma was diagnosed with NIDDM in 1999. She has been monitoring her BP and sugar levels at home [ ] then. She has [ ] family history of diabetes and is allergic [ ] penicillin. Her weight is !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] (BMI [ ] 24) and !!!![ ] eye examination in October !!!!!!!![ ] 2017 !!!![ ] no issues. 3) She initially presented on 29/12/18 !!!!!![ ] that her blood sugar levels were [ ] well controlled. Her BP !!!!!!!!!![ ] was 155/100 and her recent sugar levels were [ ] between 6 and 18mmol/L. 3) Her medication [ ] Metformin 500mg b.d. and Glipizide 5mg x2 mane. I !!!!!!!!!!!!!!!!!!!!!!!![ ] Atacand 4mg x1 mane. !!!!!4) [ ] pathology report [ ] on 05/01/2019 showed HbA1c levels !!!![ ] 10% and GFR greater than 60ml/min. Her cholesterol was high (6.2). 5) On 12/01/19, I prescribed Lipitor 20mg mane. I also increased her Metformin regime [ ] 750mg b.d. !!!!!!!!!![ ], her [ ] BP has been [ ] range and her cholesterol has fallen to 3.2. Her non-fasting blood sugars are 7-8mmol/L, but her fasting blood sugar levels are usually in the 16+ range, which is high. Therefore, I am referring her to you [ ] your specialist [ ].

1) a, diabetic, for, of, 2) since, a strong, to, "steady", of, an, x, indicated 3) concerned, no longer, "that day", ranging, 4) included, instituted [=commenced], 5) A, received, of, 6) to, Since then, home-monitored, within, for, advice

[11/05/20] 1) I am referring Mr.Cochrane, a 56-year-old retired patient [ ] who is suffering from !!!!!!!!!!!!!!!!!![ ] acute left ventricular failure. He requires urgent admission to your !!!!!!!!!!!!!![ ] in order to stabilize his condition. 2) The symptoms first appeared on 12/08/2019, when he presented with [ ] night cough, [ ] chest tightness and [ ] shortness of breath which was worse when lying down but improved !!!!!!!!!!!!!!!!![ ] raising [ ] head at the end of [ ] bed. 3) Examination revealed dyspnoea, bilateral leg edema, [ ] high jugular vein pressure, [ ] laterally deviated apex beat which was located in the 6th intercostal space and basal crepitation [ ] lung auscultation 4) These symptoms were !!!!!!!![ ] left ventricular failure. Electrocardiography revealed cardiomegaly and [ ] chest x-ray showed features of infection. I prescribed antibiotics, frusemide and digoxin. 5) Two weeks later, the patient's condition had [ ] improved. !!!!!![ ], he was advised to continue his medications and to rest for one week. 6) Today, Mr Cochrane presented with severe shortness of breath, chest pain and sweating for [ ] last 2 hours. On examination, he was anxious and !!!!!!!!!!![ ]. His blood pressure was 120/80 and his pulse was 66. The same [ ] signs of left ventricular failure were observed. I would appreciate your urgent assessment of this patient. Yours sincerely, Doctor

1) at my practice, an, Cardiology Unit 2) a, x, x, on 3) x, a, on 4) indicative of, the, 5) partially, Therefore 6) the, dyspnoeic, previous

[09/05/20] 1) 0-1 2) 2-7 3) 7-12 4) 13-19 !!!!5) 45-65 6) over 75 7) a moderate smoker 8) a heavy smoker 9) UK guideline

1) baby [0-2m newborn, 2m-1 infant, 1-4 toddler] 2) young children 3) school-aged children 4) teenagers 5) middle-aged woman/man 6) elderly 7) 1-2 packs of cigarette daily 8) He consumes 2 packs of cigarette daily 9) He consumes 10 units of alcohol per day

Procedures, Medication, X-ray, Ultrasound, Investigations, Treatment [23 words] [12/05/20] 1) He ___________ his asthma with a bronchodilator. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!2) Doctor ________ an improvement [ ] the patient's condition !!!!!!!!!!!!!!!!!!!!!!!!3) I _____________ to see them again when your assessments _____________. V4) I ___________ appreciate it if you _____________ a full memory assessment to _____________ this _____________ diagnosis. 5) Serum TSH test should be followed up periodically to [ ] any rise in TSH or cholesterol levels !!!!!!!!!!!!!!!!!!!!!!6) The validity of the test result may be affected if the patient is currently being treated with antibiotics or a proton-pump inhibitor or [ ] a course of treatment with these medicinal products !!!!!!!!7) A colonoscopy [ ] 3 years ago. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!11!!8) I have [ ] the radiography for your convenience 9) The patient had his wisdom teeth [ ]

1) controls/manages 2) detected, in 3) have arranged, are complete 4) would, could provide, confirm, provisional 5) detect 6) has completed* [refer complete card] 7) was done 8) enclosed 9) removed 10) did not detect [Ludwig] administer! alleviate cancel commence! confirm! complete! control! delay detect! ease enclose! indicate! introduce maintain minimise obtain! order! postpone prevent remove! repeat! reveal! show! start! suggest! treat!

[13/04/20 good] 1) When [ ] is mentioned for the first time, the infinite article "a/an" is required. This also signifies to the reader that it hasn't been mentioned before and is non-specific. 2) When an uncountable noun is mentioned for the first time, [ ] is required (known as the zero article). This also signifies to the reader that it hasn't been mentioned before and is non-specific. 3) [ ] is used when referring to something specific [either you have mentioned it before or the word is unique and special] with both countable and uncountable nouns.

1) countable noun 2) no article 3) The definite article

Timeline [13/06/2020] 1) Mr Hall is [ ] overweight (BMI 28.2) 2) Thank you for seeing Ms Hall, a 45-year-old secondary school teacher, who presented today with !!!!!!!![ ] of gastro-oesophageal reflux with [ ] stricture

1) currently 2) a two-week history, possible

[06/05/20] 1) [ ], James !!!![ ] a satisfactory recovery and he has completed his course of antibiotics. His !!!!!!![ ] includes chest physiotherapy and support [ ] a dietitian. 2) He has made a routine recovery and his wounds appear to be !!!!!!![ ] well.

1) during hospitalization, has made, follow up plan, from 2) healing

[05/05/20 again] 1) I am writing to refer Andre, a-two-month old boy, for urgent admission. He is the [ ] child in his family and has been diagnosed with infantile hypertrophic pyloric stenosis (IHPS). 2) v[ ], he v[ ] normally with !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!v[ ] birth weight of 2750 gm. Andre initially presented !!!!!!!!!!!!!!!![ ] 6 weeks [ ] age on 26/7/18 for !!!![ ] general check up. No abnormality was seen [ ] examination and his weight was 3050 gm. 3) He !!!!!!!!!!!!!![ ] on 05/11/18 suffering from vomiting !!!![ ] two !!!!!!!!!!![ ] duration associated with crying spells. Examination showed a well hydrated child. [ ], visible peristalsis was seen [ ] his abdomen and [ ] palpable olive-like mass was felt. He [ ]!!!!!!!!!!!!!!!!!!!!!!!! 50 g of weight, and [ ] abdominal ultrasonography was ordered. 4) !!!!![ ], no improvement [ ] his condition was noticed. He vomits after each meal and looks mildly dehydrated. [ ] has revealed thickening in [ ] pyloric muscle. 5) [ ], I believe Andrew has IHPS and he needs urgent admission [ ] control his hydration status as well as [ ] surgical management. I will telephone later to check !!!![ ] his condition.

1) first 2) In terms of his birth history, delivered, a, at, of, a, on 3) returned, of, days, However, on, a, had lost, an [me] 4) Despite management, in, The ultrasonography, the 5) In view of the above (=Given this history), to, x, on

[09/05/20 again] Thank you for seeing Goerge Whitecroft, a 22-year-old patient of mine, 1) who I visited today [ ] a collapse at home. He was conscious but he complained of [ ] headache [ ] 3-hour duration. Examination revealed an elevated pulse of 100 and a BP of 155/90 along with reduced power in his right arm and leg associated with [ ] exaggerated knee reflex. I believe an urgent admission is required due to !!!!!!!!!!!![ ] possible space-occupying lesion or intracranial pathology. 2) The symptoms first appeared two weeks ago when he complained of [ ] frontal headache which was associated with mild nausea and slightly blurred vision !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] without aura or vomiting. There v[ ] no symptoms of photophobia or neck stiffness. He reattended 3 days later [ ] similar symptoms and complained that his headaches were severe and associated with blurred vision and slight paraesthesia on the right side. Examination at that time only found a fast pulse rate (110) and BP (150/95). 3) Treatment !!!!!!!!!!!!!!!!!1!!![ ] rest and paracetamol [ ] the first consultation and intramuscular pethidine and maxalon [ ] the second visit Please note, there is no family history of migraine. If you require further information, do not hesitate to contact me.

1) following, a, of, an, a *I think "an elevated pulse of 100" is better 2) a, but, were*, with *There were no palpable lymph nodes 3) has included, after, on *3-hour [adjective] duration => Steve thinks this is more appropriate but 3 hours duration is used everywhere so it is acceptable vs 3 hours' duration

[12/05/2020] reason 1) Brad broke his left femur in a car accident on 12/05/19, ___________ screws______ inserted 2) Mrs. Fischer suffers from allergic asthma, [ ] since 2007 [ ] Serevent

1) for which, were 2) controlled, with

Patient focus verbs [35 words] [12/05/20 bad] 1) Brad ______ his left femur in a car accident !!!2) He [ ] ampicillin sulbactam and supplemental oxygen due to a provisional diagnosis of LRTI or bacterial sinusitis !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!3) Patient [ ] [ ] endoscopy 2 days ago. !!!4) She ___________ her knee on the corner of the table. 5) They ___________ my big toe to remove the nail 6) The girl ___________ her hand on a hot frying pan. !!!7) A healthy body can _______ some infections 8) She was recovering from severe injuries [ ] in a car accident !!!!9) who [ ] features !!!!!!!!![ ] the early stage of dementia !!10) Ms Marcus, who [ ] may be suffering from thyroid cancer v!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!111) Today, her vital signs [ ] normal and the pain level has decreased. Furthermore, the erythematous area has [ ] in size. 12) The patient [ ] that he had experienced lower back pain !!!!13) I !!![ ] a fall and !!!!!![ ] bruising and a fractured arm from a fall 14) The patient !!!!!!!!!!!![ ] vomiting and she was vague reporting [ ] laxatives !!!!!!!!!!!!!!!!!!!!!!!15) The patient is advised to [ ] a low fat diet v16) This condition is !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] [ ] prednisolone medication but the pruritus !!!!!!!!!!!!!!!!!!!!!!![ ] when the medication is withdrawn 17) She !!!!!!!!!!!!!!!!!!!!!!!!!!![ ] alleviating her pain with over the counter medications !!!!!!!!!!18) American influence has [ ].

1) fracture 2) was commenced on 3) underwent an 4) bruised 5) froze 6) burned 7) resist 8) received, sustained 9) has been demonstrating, consistent with/suggestive of 10) I suspect 11) have returned to = within normal range, reduced 12) stated 13) had, sustained 14) denied, about 15) follow 16) responsive to, returns 17) attempted 18) declined agree arrive attend! attempt!!!!!!!!! avoid! become consume! complain! decline/default! demonstrate! deny! display experience! express follow! [new] has hospitalise injure participate present! receive! recover refuse respond! return! report! require suffer [noun = suffering] from state! stop take! use quit walk weigh! cure [noun = cure]

Explain the difference between infinite and gerund [14/05/20 good] 1) Giving up smoking will be beneficial to your health vs I plan to give up smoking before I have children? 2) I advise reducing your salt intake vs I advised the patient to reduce his salt intake vs She has been advised to stop the OTC product

1) giving factual information vs describe a future action 2) one object (more focusing on the action) vs two objects (more focusing on the person) vs passive [to patient, it sounds more natural by Steve] >>> I advised stopping the OTC product *infinite = action, future, to describe a future action, two objects (more focusing on the person) *gerund = fact, past, to provide factual information, one object (more focusing on the action, so more formal when you talk to a doctor); Using gerunds can help you to "soften" instructions" by changing the focus of the sentence and removing the pronoun i.e . "you"

[20 words] which change over time and often take perfect tense [12/05/20 again]: !!!!!!!!!!!!!!!!!!!!!!!!!!!!1) The nurse noted that the patient [ ] an irregular pulse 2) He [ ] a pressure ulcer, a chest infection, a wound infection and reduced cardiac output. !!!!!!!!!!!!!!!!3) Nobody noticed that the patient's blood pressure [ ]. 4) Symptoms have [ ] !!!!!!!!!!!!!!!!!!5) Antenatal screening for Down's began in the 1970s, and in the 1980s blood tests !!!!!!!!!!!!!!!!!!!!!![ ] to predict expectant mothers' chances of having a baby with Down's. 6) While reviewing [Time Period] later, [his/her] [symptom] was persistent all the time, especially at [time of a day], however, it [ ] [type of treatment].

1) had developed 2) has developed 3) had dropped 4) developed 5) were developed 6) resolves by aggravate change continue! decrease deteriorate! develop! drop! gain/regain! heal! increase improve lose! metastasise! progress radiate reduce relieve (vs resolve) spread worsen!

[09/05/20 again] During hospitalisation, Isobel ___________ good progress physically and the amputation incision site !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!___________ intact with no signs of infection and the sutures !!!!!!!!!!!!!!!!!!!![ ].

1) has made, is, have been removed

Useful expressions giving extra points [16/07/2020] 1) [ ] Mary's rehabilitation, 2) As you may be aware = has a known history of 3) [ ] the possibility of pain, a local anaesthetic was used to numb the region. !!!!4) [ ] experiencing pain, the patient was suffering from nausea and had vomited twice. 5) !!!![ ] the treatment, he had intermittent pain [ ] swollen joints 6) He has mild depression and is reluctant to mobilize as well as [ ] full assistance. 7) Her urine dipstick test revealed increased levels of protein and nitrate [ ] slight "blood". 9) He has a history of limited attention [ ] and is easily distracted 10) [ ] Chloe's lack of confidence !!!!!![ ] breastfeeding, education [ ] reparenting skills is required 11) Mr Drinkwater [ ] 2 episodes of chest pain for the last 4 months !!!!!12) Ms Crook reported [ ] lack of energy and has stopped exercising and [ ] enjoys !!!!!![ ] such as gardening 13) Ms Almond's symptoms [ ] "a" lack of interest "in work" and home activities. 14) Mrs black has a history of 3 falls [ ] the past week and [ ] dizziness. She [ ] a loss of balance and was unstable !!!!!!!!!!!! [ ] her feet. !!!!!!!15) I am writing to refer this patient, an 18-year old student who ___________ from significant injuries ___________ !!!!!!![ ] a traffic accident one month ago. 16) Isobel !!!!!!!!____________ to hospital via ambulance after a traffic accident on 08/04/19, which !!!!!!!!___________ an emergency above knee amputation due to an open tibial-fibular fracture. 17) [ ] her mental state, she ___________ phantom limb pain, insomnia [ ] signs of anxiety, silent rumination and decreased interest in social activities. [ ], please ___________ (for-remove it by Mike) signs of PTSD and !!!!!!!!!!!___________ a trauma focussed CBT programme if ___________ 18) At/on discharge, Isobel is able to ___________ her medication which ___________ Neurontin, paracetamol, tramadol and amitriptyline. 19) [ ], a follow-up visit at [ ] trauma clinic ___________ for 17/05/19. 20) Examination revealed an elevated pulse ( ) and BP ( ) along with reduced power in his right arm associated with an exaggerated knee reflex 21) Physical examination findings are !!!!!!!!!!!![ = in line with] the patient's symptoms

1) in terms of Mary's rehabilitation, 3) due to the possibility of pain, a local anesthetic was used to numb the region. 4) As well as experiencing pain, the patient was suffering from nausea and had vomited twice 5) Despite the treatment, he had intermittent pain "as well as" swollen joint"s" 6) He has mild depression and is reluctant to mobilize as well as requiring [we need gerund] full assistance. He has mild depression and is reluctant to mobilize. As well as this, he requires full assistance. 7) increased levels of protein and nitrate along with slight blood. 9) span *has a history of [more formal] >>> has suffered from 10) due to, with/in, regarding 11) has experienced *His recovery was complicated by 2 episodes of chest pain 12) a, no longer, physical activities 13) include 14) over, has been experiencing, reported, on *complained of 15) is recovering, sustained/received, "in (Ludwig)" 16) was initially admitted, led to 17) With regard to, has experienced, with, therefore, monitor, arrange, warranted 18) is able to self administer, include 19) please note, the, has been scheduled 20) using a bracket is no problem [by Steve] 21) congruent - only if you wanna get A and not sure it's medical and in OET exam no need to be fancy. Just precise and clear.

Put the right word [05/05/20] 1) The physiotherapist !!!!!!!!![ ] the patient to do leg strengthening [ ] (repetition e.g 10 sets) = Different exercises were provided. Not just one. 2) Regular [ ] (not related to repetition, not in sets, but in general meaning) was advised in order to lose weight (not repetitions)

1) instructed, exercises 2) exercise *exercise vs walking, physical activity (in general, but you can say activities)

[13/05/20] v1) Over recent decades, thanks to better vaccines and strategic [ ], the world [ ] incredible progress !!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] reducing child mortality and tackling infectious diseases. v2) !!!!!!!!!!!!!!!![ ] the continual emergence of new pathogens, the increasing risk of [ ] bioterror attack, and [ ] ever-increasing connectedness of our world, there is !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] significant probability that [ ] large and lethal modern-day pandemic will occur in our lifetime. v3) Several events in the past decade have !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] close attention to the risk of future pandemics. The H1N1 influenza outbreak revealed a weakness [=a flaw] [ ] our ability to monitor the !!!!!!!!![ ] of an epidemic as it grows 4) Although the seasonal influenza vaccine isn't always !!!!!!![ ] effective, and must be [ ] each year, it represents an enormous step forward. 5) [ ] thirty-three million people worldwide would die in just 6 months. 6) The writer uses statistical information to !!!!!!![ ] present-day vulnerability to infectious diseases.

1) interventions, has seen, in 2) Given (=considering=knowing), a, the, a, a 3) warranted, in, extent 4) fully, taken, represents 5) Nearly 5) stress/underline/demonstrate/show from reading class 3 on 24/03/20

Write down prepositions II [05/05/20] 1) For both children, advice [ ] recommended vaccines will be necessary v2) She is not [ ] any medication and has no !!!!!![ ] allergies 3) The patient arrived [ ] my surgery in [ ] depressed state 4) She lacks confidence !!!!!!!!!!!!!!!!!!!!![ ] caring her baby in terms of breastfeeding and bathing 5) I have made an appointment !!!![ ] her !!!!![ ] your receptionist 6) Mr Robinson complains of being tired and dispirited and is concerned about [ ] impact her condition is having [ ] her work 7) Mr. Jones has been a patient of mine since 1999 and has attended my clinic [ ] a regular basis [ ] scaling and cleaning !!!!!!!!!!!!!!!8) Intervention takes place !!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] consultation !!!!!!!!!!!!!!!!!!!![ ] doctors, nursing staff and, where necessary, the Speech Therapy department. 9) He has been prescribed [ ] Metformin v10) As a divorced elderly lady, who lives alone !!!!!![ ] no one to take care !!!![ ] her, I believe that she needs to be visited two times a week to [ ] her compliance [ ] the diet plan and medication (Amitriptyline - 25 mg, 3 times a day) 11) Regarding her social history, she works as an accountant and is married [ ] three children. v12) he had gained 5 kg [ ] weight vs he also reported a weight gain [ ] 5kg vs his weight had increased [ ] 5kg

1) on 2) on, known 3) at, a 4) in/with 5) for, through 6) the, on 7) on, for 8) in, with 9) (with) 10) with, after, monitor, on/with 11) with 12) of, of, by

[06/05/2020] 1) an unfounded mistrust of others 2) seeing something that is not there 3) hearing one or more talking voices 4) speech that does not rise or fall in pitch !!!!!!!!!!!!!!5) speech that is quiet, blurred and difficult to understand 6) does not initiate conversation or express one's opinions frankly and publicly 7) having the head and shoulders habitually bent forward 8) not wanting to communicate with others 9) it was not chewed properly !!!!10) almost amputated v11) a feeling of being confused about where you are, where you are going, or what is happening !!!!!12) suspicion, irritability, excessive sensitivity 13) stop passing waterly bowel actions 14) acne on the face 15) group psychotherapy 16) irritability, lack of humour, untidiness, occasional resentment

1) paranoia 2) visual hallucination 3) auditory hallucination 4) monotonous speech 5) incomprehensive speech/murmurs 6) reduced speak output 7) a stooped posture [vs facial droop] 8) withdrawn [e.g she was withdrawn] 9) incomplete chewing 10) a near-complete amputation v11) occasional disorientation 12) suspiciousness, irritable mood, oversensitivity 13) stop diarrhea 14) facial acne 15) structured work projects 16) behaviour changes

Acronyms & expression? [08/06/20 again] !!!!1) PCA 2) silent rumination 3) ACE bandage v4) PRN (pro re nata) 5) nocte 6) sid vs bd/bid vs tds/tid vs qid 7) q8h !!!!8) q.4 weeks 9) referred to an OT !!!!!!!!!!10) A wound dressing change is required 3/7 vs 3/12 11) R hemicolectomy 12) borderline 13) dyspepsia 14) relapse 15) remittent = intermittent 16) +/- 17) ? 18) types of diagnosis 19) spirits 20) substances 22) Navane 1.5mg IM q. 4 weeks !!!!!!!!!!!!!!!23) FTA !!!!!!!!!!24) NAD 25) -> !!!!!!!!!!!!!!!26) P/PR !!!!!!!!!!!!!!!!!!!!!!!!27) PMH !!!!!!!!28) 6/h !!!!!!!!!!!!29) 1t 30) bpm !!!!!!!!!!!!!31) 57/m 32) surgical tx !!!!!!!!!!!!!!!!33) comm. !!!!!34) ferrous sulphate for < 6 months

1) patient-controlled analgesia (pca) 2) repetitively going over thoughts [my life will suck] 3) compression bandage 4) when required = as required [do not say when he requires] 5) at night 6) once a day = a daily dose vs two times a day vs three times per day vs four times a day 7) every 8h 8) every 4 weeks 9) referred to an OT = an occupational therapist 10) 3/7 = every 3 days or 3 days a week vs 3 months 11) a right hemicolectomy 12) She was noted to be overweight and has borderline hypertension 13) indigestion e.g bloating, discomfort, burping 14) deteriorate after a period of improvement comes and goes of symptoms 16) with possible, associated with 17) possibility of something 18) Definitive Dx = Accurate Dx, Provisional Dx = Preemptive Dx = Preliminary Dx Differential Dx 19) rum, vodka, scotch, gin, bourbon, brandy 20) illicit drugs 22) Navane 1.5mg every 4 weeks intramuscularly 23) failed to attend 24) No abnormality detected 25) in order to 26) pulse/pulse rate 27) past medical history 28) 6 hourly 29) tablet = tab 30) beats per minutes 31) a 57-year-old man 32) surgical treatment 33) commenced 34) for a maximum of = for up to

[07/05/2020] Health professional focus verbs [42 words] 1) I would appreciate it if you !!!!!!![ ] urgent attention to her condition. 2) I [ ] that you drink [ ] !!!!!!!!!3) I ______ Ms Marcus [ ] my _______ diagnosis, multi-nodular goitre, and advised !!!!!![ ] surgical review to rule out ___________ malignancy. !!!!!!!!!!!4) Improvement [ ] [ ] [ ] the vitamin D levels as well as the lipid profile. 5) Therefore, please monitor [ ] signs of PTSD and arrange a CBT program focused [ ] trauma if warranted 6) I educated them [ ] dementia and Alzheimer's disease 7) As Mrs Welshman has been !!!!!!!![ ] my care since 2020, I [ ] their concerns. !!!!8) He manages his condition !!!!!![ ] [ ] salbutamol inhaler

1) provide 2) recommend, in moderation 3) informed, of, provisional, a, the possibility of 4) was noticed in 5) x, on 6) about 7) under, share 8) with, a adjust admit advise apply assess bathe boost cleanse (?) commence! conduct cover diagnose discharge discuss dispense(?) educate! enrol ensure explain find! give! insert! inform! manage! monitor notice! observe! offer organise perform! prescribe proceed provide recommend refer remind request schedule start see train transfer share

[05/05/20] 1) Thank you for seeing Ms Hall, a 45-year-old [ ] teacher, who presented today with a two-week history of gastro-oesophageal reflux with [ ] stricture. [You can put this sentence to the conclusion] I am referring Ms Hall to you for further investigation and [ ] endoscopy [ ]. 2) Ms Hall's symptoms !!!!!!!!!!!!!!!!!!!!!![ ] a constant !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] and include dysphagia [ ] solids, [ ] epigastric pain radiating posteriorly to !!!!![ ] T12 level, and !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] 1-2kg weight loss. The problem [ ] after an upper respiratory tract infection two weeks ago for which she !!!!!!![ ] an over-the-counter Chinese herbal product with unknown ingredients. There are no !!!!!!!!!!!![ ] signs of anxiety, and no !!!!!!!![ ] of a lump. 3) Ms Hall has [ ] increased !!!!!!!![ ] coffee consumption and takes aspirin 2-3 times a month. She has a history of dyspepsia (2012) and dermatitis for which she was prescribed oral and topical cortisone. She [ ] smoking 15 years ago. She drinks socially (mainly spirits), has a (positive) family history of peptic ulcer disease and is allergic to codeine. Her BMI is !!!!!![ ] 28.2. v4) I have recommended that Ms Hall reduces !!!!!!!![ ] coffee and alcohol intake and immediately stops !!!!![ ] the over-the-counter product. [ ] I have prescribed Pantoprazole 40mg daily. v5) I would be grateful if you could provide Ms Hall !!!!!![ ] a definitive diagnosis. If you require any further information, please do not hesitate to contact me. Yours sincerely,

1) secondary school, possible, an, if required *I am writing to refer MsHall, a 45-year-old female teacher, whose features are suggestive of gastroesophageal reflux disease with a possibility of stricture. Her condition requires your specialist advice and an endoscopy. *Thank you for seeing Mss Hall, a 45-year-old secondary school teacher, who has been complaining of possible symptoms of gastroesophageal reflux and requires a definitive diagnosis and an endoscopy if warranted. 2) follow, course, for, x (it is specific pain but we usually do not use "the" in front of pain), x/(the by Steve), concomitant, commenced, self- prescribed, apparent, sensation 3) recently, her, ceased, currently 4) her, taking, In addition, 5) with

[10/05/20] Fix sentences 1) He needs your assistance on the issues of his accommodation, visa renew as well as referring to programs for stop smoking and weight loss. 2) During hospitalization, his vital signs have been monitored and he has been assisted [ ] his showers 3) Currently, her pain is !!!![ ] control with medication and she is tolerating fluids. 4) Since the stroke, Mr Grants condition [ progress] slowly. He has mild depression and is reluctant to mobilise. [ ], he requires full assistance with activities of daily living.

1) smoking cessation 2) with 3) under 4) has been progressing, As well as this

[10/05/20; The content is bullshit - anyway check grammar & expressions] 1) His personal medical history largely consists of !!![ ] injuries and his family history is also unremarkable. 2) !!!![ ], his blood pressure was 110/73 and his temperature was 36.3 with a heart rate of 75 and a respiration rate of 19 breaths per minute. 3) [ ], however, he developed a fever that [ ] his blood pressure [ ] elevate to 180/105, and his body temperature to rise to 40 degrees. His heart rate was 85 and his respiration was 25 breaths per minute !!!!!!!!!!![ ] severe wheezing. 4) [ ] that he is experiencing [ ] type of obstructive lung disease that may explain these symptoms as well as his raised level of inflammatory markers. 5) Mr Tyler was provided with his [ ] combination [ ] inhaler which, when accompanied by a short rest, alleviated the patient's symptoms slightly. It would, however, be [ ] appreciated if he could be admitted and kept !!!!![ ] observation [ ] deterioration. Should you have any queries, please do not hesitate to contact me.

1) sport-related, 2) On arrival, 3) During his visit, caused, to, accompanied by 4) It appears, a 5) prescribed, therapy, much, for, in case of

Tenses - finish sentences [13/05/20] 1) She [ ] smoking after her children were born 2) She quit smoking [ ] her children were born 3) She [ ] smoking after the birth of her first child 4) She !!!!!!!![ ] smoking while pregnant, but started to smoke again after her children were born

1) stopped 2) when 3) quit 4) had quit

11/05/20 again Steve grammar class 2 (20.04.20) !!!1) I am writing to refer this couple, who have been suffering from infertility for 18 months. Initially, Mrs Conway attended the clinic on 10/04/20 2) She used to take Microgynon 30 for 5 years but it has been stopped since May. 3) She [!!!!!!!dinied any history of = Steve likes it] gynecological problems or sexually transmitted disease. Her period is regular. Her examination was normal [apart from = Seve likes it] being overweight. [At that time = Seve likes it], blood tests and cervical smear were ordered, and I discussed [ ] her the importance of investigating her husband. 4) [Today, Mrs Conway came to the clinic with her husband who stated that he works away from home about 2 weeks out of 4, and he thinks that they have not tried long enough = Steve likes it]. Therefore, he refused to be examined at first, but I persuaded him to do semen analysis. The ovulation-prediction test revealed normal ovulation and the cervical smear was negative. !!!!!!!!!!!!!!5) Mrs Conway [ ] to be referred for IVF treatment and her husband reluctantly agreed. I advised them on the suitable timing of intercourse. [ ], losing weight was suggested and folic acid 400 microgram daily was commenced [ ] Mrs Conway v[fix this sentences] 6) Please note, Mrs Conway has a history of previous pregnancy 10 years ago, but Mr Conway does not know about. Mr Conway is alcohol drinker, while Mrs Conway reported he drinks heavily

1) suffering from headache, or back pain => who has been trying to conceive for 18 months => who has been unable to conceive for 18 months *Using the word "couple" is good (better than Mrs Conway), have -> has 2) [stop/start cannot be continuous!!!!!! or she has not taken the pill since May 2016] 3) with 4) a semen analysis 5) asked, Additionally, she has been advised to lose weight or weight loss was advised, for 6) Mrs Conway has a history of a previous pregnancy 10 years ago, of which Mr Conway is unaware . an alcohol drinker

[10/05/20 bad] 1) This letter is to [ ] you !!!!!!!!!!!!![ ] Mr Schofield's progress following his brief stay at our hospital. He was admitted due to anxiety regarding sudden, recent weight gain and has !!!![ ] made good progress. He will be discharged today and your follow-up in three weeks would be !!!!![ ] appreciated. 2) Mr Schofield was admitted on 16th September, 2019 !!!!![ ] gained 22lbs within approximately eight weeks. He was diagnosed with type two diabetes earlier this year, and has since !!!!!!!!!!!!!!!!![ ] himself unable to lose more than two to three pounds each month. Mr Schofield was [ ] !!!!!!!!!!!!!!!!!!!![ ] observations and all vital signs were !!!!!!!!!!!!![ ] within normal range. !!!!!!!!!!!!!!!!!!v[ ] Mr Schofield !!!!!!!!![ ] to lead !!!!!!!!!!!!!!!!!!!!!!!![ ] sedentary lifestyle and his BMI is 32.6, [ ] that he is obese. !!!!!!!!!!!!!!!!!!!!!![ ] a dietician's !!![ ] has been requested. 3) !!!!!!![ ] treatment, Mr Schofield was initially prescribed with Avandia !!!!!!!![ ] mouth !!!!!!!![ ] once a day. However, due to increased weight gain, the Avandia was stopped and !!!!!![ ] with 500mg of Metformin. !!!!!!!4) He made good progress [ ] our care and a follow-up appointment will be booked !!!!!!!!!!!![ ] your surgery within [ ] next three weeks.

1) update, on, since, much, 2) having gained, found, kept for, recorded, As you may be aware, appears, a, indicating, As such, intervention 3) In terms of, to be taken by, either, substituted 4) in, with, the, please

[13/05/20 again] 1) Thank you for seeing Mrs Welshman, an elderly [ ], who I [ ] today due to concerns about her [ ] memory. *They showed their concerns regarding decline !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] her memory recently 2) Mrs Welshman presented [ ] her daughter who reported !!!!!!!!!!!!![ ] of memory loss which has been !!!!![ ] her routine activities, social life and !!!!!![ ] skills. This has been associated with !!!![ ] such as irritability and lack of humour. 3) On mini-memory assessment, there was !!!!!!!!!!!!!![ ] poor short term memory !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] days, dates and months. I reassured them and explained that more assessments !!!!!!!!!!!!!!![ ] necessary !!![ ] a diagnosis could be !!![ ]. However, I [ ] their concerns as Mrs Welshman's doctor has been a patient of mine for many years and I have observed other symptoms which may !!!!!!![ ] early-stage Alzheimer's disease, vv[ ] lack of adherence[=unintended non-compliance=being intermittent in compliance] to her medication regime. 4) Other !!!!!!!!!!![ ] of her medical history include hypertension which is now well [ ] and her !!!!![ ] results have improved. Her vitamin D is now !!!!!!!!!!!!!!!!!!!within [ ] normal range so can be [ ] as a major cause of symptoms. Please note, she uses [ ] Webster pack to manage her medication. 4) I would appreciate a full memory assessment to confirm this provisional diagnosis. I have !!!!!!!!!!!!!!!!!!!![] to see them again when your assessments [ ]. Please do not hesitate to contact me if you have any questions [] this [].

1) widow, assessed, failing, in 2) with, recent symptoms, affecting, decision making, behavioural changes (=personality), 3) x, with/for, were, before, made [you can say form a diagnosis in case diagnosis is not clear], share, indicate, such as 4) significant/relevent aspects, managed, pathology, within [x/a/the], excluded, a, arranged, are complete [or have been completed], regarding, referral *By student - Mrs Welshman presented today with her daughter concerned about her failing memory. Her daughter mentioned that Mrs Welshman had forgotten important events. She also noticed behaviour changes and problems in making decisions. In her memory tests, she had trouble remembering the day and month

[09/05/20] 1) On 24/02/18, he attended my clinic [ ] a month history of [ ] lack of energy and [ ] attacks of dizziness. He also complained of sore eyes and [ ] vision 2) Blood tests revealed elevated random glucose and fasting glucose levels [ ] HbA1c [ ] 8.5% 3) [ ] are elevated and he has !!!![ ] BMI [ ] 28.4 4) In the case of DB patient, where should be the lifestyle paragraph located?

1) with, (a), intermittent, deteriorating [=reduced] 2) together with, of 3) His lipid profiles, a, of 4) After introduction or second [top of other paragraphs]

Write down articles [10/05/20] 1) The patient has reduced speech output and [ ] little eye contact 2) I ordered !!!!![ ] x-ray and [ ] MRI 3) I ordered [ ] urine test v4) Examination revealed elevated pulse and BP of 155/90 along with reduced power in his right arm associated with exaggerated knee reflex 5) Jacinta was involved in a car accident last night. Accident has caused multiple injuries. 6) Mr Gates presented at my clinic yesterday at 7pm with [ ] complaint of lower back pain. 7) Today she was accompanied by her husband with complaints of impaired vision in both eyes and !!!!![ ] inability to read books or watch television 8) On her next visit, she presented with !!!!!!!![ ] low blood pressure, [ ] pale and thin skin and her weight had dropped !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] 6kg in 3 months. She [ ] vomiting and she was anxious.

1) x 2) an, an (e 사운드) 3) a [like a university (유, not 우; vowel)] 4) Examination revealed an elevated pulse and (a - because of "an elevated pulse" in front of BP) BP of 155/90 along with reduced power in his right arm associated with an exaggerated knee reflex 5) The 6) a 7) an 8) x, x, by [not frequent], has a history of

Absolute rules of articles [made by me] [07/05/20 good]

1. Strongest rule: If it's mentioned before [or if you're talking about the unique things], you must use "the" - the previous 5 years, in the left ankle, the same, the whole, the possibility of surgery 2. You don't use article - when you refer general things e.g to hospital, require urgent admission, pain (general pain) - non-countable noun - the name of people or disease or so on e.g tooth 54 3. You use a/an - if countable - Some non-countable nouns become countable when they convey different meaning (e.g when it's used in a more specific situation, it needs to be counted) e.g an acute pain in a specific area *Article errors should be less than 2, otherwise, it will reduce your score

How to get extra points by using good structures? Make examples [06/05/20 again] 1. Using clauses of contrast 2. Using clauses of purpose 3. Using clauses of reason 4. Timeline 1) Six months ago, Mr. Roberts twisted his right ankle while playing golf. During [ ] following months, the patient !!!![ ] intermittent [ ] of pain which [ ] his ability to work effectively. On review [ ] three months, [ ] right ankle joint was x-rayed and the result !!!![ ] to be satisfactory. 2) [ ], when the swelling, pain and imapired improvement !!!!!!!![ ], !!!!![ ] MRI was ordered which revealed [ ] detached cartilage. !!!!!![ ], Mrs. Roberts does not have full mobility and is !!!!!![ ] capable of full-time employment [ ] which, financially, his family depends. 3) Treatment!!!!!!!!!!!!!!!!!!!!!!!!!!!![ ] has included transferring from bed to chair, mobilization with gutter frame, and !!!!!!!!!!![ ] active range of motion exercises. 5. Considering=knowing

1. Using clauses of contrast: Although (>however), but, despite, despite the fact, however, inspite of, even though e.g Despite the fact there has been an improvement in her condition, she is still very weak e.g Even though her condition has improved, she is still weak 2. Using clauses of purpose: in order to, so that, e.g In order to alleviate pain, paracetamol is prescribed 3. Using clauses of reason: for this [x that] reason, due to, because of, due to the fact, since/as/seeing that e.g Due to a low fat diet, the patient's health improved 4. Timeline 1) the, experienced, attacks, hindered, after, the, x-rayed, appeared, 2) However, impaired, persisted, an, a, Currently, no longer, on 3) to date (=until now), an 5. Given his age, Mr X is in excellent physical condition

writing criteria

1. content - are you selecting right information [no important information is missing], 2. conciseness & clarity [length, no irrevent information, 200 words without conclusion], e.g [concise sentence] Cleo was presented to the clinic by her owner due to one-week history of vomiting, listlessness, lethargy and loss of appetite. e.g don't put too much information 3. organization: highlighting information 1) time-line: initially, during hospitalization (!!!), over 3 months, on/after examination, please note 2) put the most important information first 3) using a passive sentence 4. purpose: for this, we have a tendency to put more introduction than the last part [introduction is to introduce a patient]. 5. language: countable nouns, tense, informal words use (e.g shifted, deteriorating memory issue - not professional)

[04/05/20] 18/01/18 Dr David Torpy Endocrinologist Royal Adelaide Hospital Adelaide SA Australia Dear Dr Torpy RE: Mrs Monica Fischer, DOB: 12/04/1965 I am writing this letter to refer Mrs Fischer, a 52-year-old obese female with a BMI of 34.04, who has been experiencing signs and symptoms suggestive of cushing syndrome for further assessment and management of her condition. Today, Mrs Fischer presented with the red face, hirsutism and non-healing wounds in the left leg and right forearm. She also reported a weight gain of 10kg over the last three months associated with abdominal obesity, severe tiredness and frequent episodes of sudden mood swings and depression. In terms of Mrs Fischer's past medical history, she has lived with asthma since 2007 for which a Serevent and Pulmicort tubuhaler has been used. In 2014, her allergic rhinitis was worsened due to frequent contact with allergens and consequently, immunotherapy was performed without any success. She has also suffered from chronic insomnia since august 2017. Please note, Mrs Fischer has a family history of diabetes, hypercholesterolemia and stroke. Regarding her social history, she works as an accountant and is married with three children. Mrs Fischer stated that she is a vegetarian and social drinker. In view of the above, I believe Mrs Fischer requires specialist advice and care regarding her condition. Should you have any queries, please do not hesitate to contact me. Yours sincerely, Doctor

18/01/18 Dr David Torpy Endocrinologist Royal Adelaide Hospital Adelaide SA Australia Dear Dr Torpy[,] RE: Mrs Monica Fischer, DOB: 12/04/1965 I am writing this letter to refer Mrs Fischer, a 52-year-old obese female (BMI 34), experiencing signs and symptoms suggestive of [Cushing] syndrome for further assessment and management of her condition. Today, Mrs Fischer presented with [x] red face, hirsutism, abdominal obesity and non-healing wounds in the left leg and right forearm. She reported [a 3-month weight gain] of 10kg, severe tiredness and frequent mood swings and episodes of depression. Mrs Fischer suffers from allergic asthma, !!![controlled] since 2007 [with] Serevent and Pulmicort [Turbuhaler]. In 2014, her allergic rhinitis [worsened] due to frequent allergen contact and immunotherapy was performed without [success]. She has also suffered from chronic insomnia since [August] 2017. Her family history includes diabetes and hypercholesterolemia in her mother and stroke and hypertension in her father; and stroke in her maternal grandfather. [Optional: Mrs Fischer works as an accountant and is married with three children. She is a vegetarian and social drinker]. In view of the above, I believe Mrs Fischer requires specialist advice and care regarding her condition. Should you have any queries, please do not hesitate to contact me. Yours sincerely, Doctor

ago vs previously [18/07/20 good] previous vs last 1) When the patient first presented 3 months ago, he stated he had had headaches for [ ] 3 days

6/4/20 [today's date] - [time point: today's date] The patient first presented on 12/01/20 after having injured his ankle 6 months ago in a football game (occurred Oct 19) - [time point: the accident] The patient first presented on 12/01/20 after having injury 6 months previously (July 19) - Ms. Marcus presented complaining of a painless neck swelling, which she had noticed two months previously. 1) the previous last is from today previous is from the moment in the article

Explanation related to discharge [04/06/20] *Regarding a discharge letter, you can also start with "I refer this patient"

As she is planned to be discharged tomorrow As she is scheduled to be discharged As she is expected to be discharged

What is tense of reported speach? [21/06/20]

Back shifting [when reported speach]: Presence simple -> past simple, Present perfect -> past perfect, Past simple -> past perfect e.g I have had headaches for 3 days -> the patient complained that he had had headaches for 3 days If the situation is still current, back shifting is optional and it may be preferable not to backshift in order to create a sense of now (e.g I had a temperature of 38.4 yesterday -> Mj Jones stated that he had had a temperature of 38.4 yesterday -> Mj Jones stated that he had a temperature of 38.4 yesterday (=> Steve prefers this) e.g She reported that she had noticed a lump in her left breast, we discussed the possibility of surgery if the condition deteriorated ["deteriorates" is possible] e.g She said that she was a mother [OK because she was a mother when she was reporting this to you] e.g She said she is a mother [OK if she is still a mother when you report it to you] *in previous visit we use simple past *on today's visit we use present perfect or simple pres

Enlargement [ ] the right kidney? [14/05/20 good]

Both are right - an enlargement of the right kidney [diagnosis] - enlargement in the right kidney [explanation] *in tells us the location *of tells us the findings

Using brackets [07/05/20 good]

Brackets or parentheses are fairly neutral but are most regularly seen in informal writing as a means of adding extra ideas to the main point. They can often be replaced by commas. - Miss Wang is prescribed Amoxicillin, 1g twice daily, and Omeprazole, 20mg twice daily. - Alternatively, as the frequency of the dose is the same, the sentence could be improved further to: Miss Wang is prescribed Amoxicillin, 1g, and Omeprazole, 20mg, both to be taken twice daily However, Steve says that using bracket is totally okay because he has seen many OET centre referral letters with bracket. Mike also uses it quite often.

When do you use capital? [07/05/2020] Sort them out! emergency room, penicillin (!!!!!!!!!!!!!!!!), furosemide (!!!!!!), x-ray, caesarian section, parkinson's disease, panadol, pantoprazole (!!!!!!!!!!!!!), navane, the lactation consultant, the director of nursing, paracetamol (!!!!!!!!!), tramadol (!!!!!!!!!!!!!!!!!)

Capital : Job Title (e.g The Lactation Consultant, the Director of Nursing - otherwise disrespectful), name of an institution, organization (e.g Spirit Hospital), internal departments (e.g Emergency Department - especially in the letter because you are talking about specific emergency department), Some medical conditions after person's name (Parkinson's disease, Bell's palsy, Alzheimer's disease, Cushing's syndrome), Brand names of drugs (Zocter, Voltaran, Panadol!!!, Pantoprazole!!!, Navane, Ritalin, Metformin!!!, Glipizide, Atacand), places including addresses (e.g 82 Monash road) Non capital: the others (x-ray, caesarian section, furosemide, penicillin, amoxicillin, paracetamol, tramadol, schizophrenia), common nouns & profession (a general practitioner, a university student, a pharmacist) * According to James, you can say ER, Emergency Room, emergency room but not Emergency room or emergency Room

Types of orders [07/05/20]

Chronology - Discharge is very good for chronology *If the report is to be back to GP - you might need to reduce identification of the patient - order can help you to understand what's happening to the patient now Subjective order - first paragraph 1: this is the subjective history over 3 months: symptoms... - first paragraph 2: object findings - exams... - first paragraph 3: treatment of medications *You can put two ideas in one paragraph by using linking words (e.g in terms of medications) *allows the writer to focus on relevant aspects of the history (e.g !!!progression, !!!!compliance, medication, social, history) *used for any type - referral, discharge *Once you master it, it's satisfying. Subjects base has an element of chronology & order of importance Order of importance - order of importance is good for urgent cases - it can be final or middle consultations [depending on the case] - key point: when you write the second paragraph, you should start like "the symptoms first appeared 18 months ago, not on 12/10/19....." because we need to write history that leads to that situation

Distinguish between countable and uncountable nouns [10/06/20] saliva, tension headache, diabetic, nurse, dentist, cough, !!!!!!!!!!!!runny nose, assessment, cartilage (????), increase, attention, doctor, staff, couple (!!!!!!!!!), bruise, cut (????), heart attack, dust, dirt, condition [illness], sand, appetite, cancer, joint, tooth, toe, finger, research, study (???????????????), investigation(?), intervention (?????????), status (??????????????), state (??????????????), operation (?????????????), blood test, result (?), sensation(?????????????), asthmatic, ultrasound/ultrasonography, MRI, pneumonia, influenza, education, progress (???), health, medication (both), replacement (???????) information, news, passing of urine, walking, sleeping, vaccination, program, transplant (?), visit, distance, stricture, surgery, therapy, deterioration (????), degeneration (????), deficiency (?), enlargement, dependence, check-up, elderly, sleep, concentration, inability (????????), improvement (???), fiber (?????), level (???), wheezling sound (!!!!!!), asthma attack, condition, analgesic (?????????) support/assistance

Countable Nouns - Professions: a nurse, a dentist, a doctor, a veterinarian, a social worker, - Nouns which describe someone: a smoker, a diabetic, a non-drinker, an asthmatic, a moderate drinker - Group: a couple (!!!!!!!!) - Body Parts: a joint, a tooth, a toe, a finger, two tonsils, the gum, a lip, a liver, a stump, a sore tongue/throat - Injuries: a bruise, a cut, a limp, a cavity, an incision, - Symptoms: a cough, a runny nose, a headache, a heart attack, an appetite [except pain], a loss of weight [Steve says "weight loss" needs "a"], an allergy [e.g He is known "to be" allergic vs He has a known allergy to nuts] - Signs: a temperature/a fever, a pulse rate, blood pressure [both - but frequently without it], a liver enlargement (!!!!!), a (tingling) sensation, an infection, a halo, calcifications [also without is okay], a dependence (!!!!!), in a depressed state, a wheezling sound, an asthma attack *Her pulse and blood pressure "are" stable/normal - Size/Space: a short distance, an area - change (if it is specific, you put the article): (a) deterioration, (a) degeneration of his condition, (a) deficiency, an increase, an improvement - Tests/Examinations: a blood test, an ultrasound, an MRI, a family history, a level - Admissions: a "GP/follow up" appointment, an admission (can be used without any article), a complaint, a condition [medical conditions => countable e.g a heart condition vs general health/condition!!!!!!! => uncountable; especially in conclusion], a situation, an episode, (an) investigation, a check-up, a (hospital) visit - Treatments [both]: a (near) amputation, an operation (!!!!!!!!!!!!!!!!!!!!!!) [except: surgery because it's related to procedure!!!!!!!!!!!!!!!!!!!!!!!!], a dose, a modification, a graft, a side effect, a result, a review (!!!!!!!), a program, a suture, a transplant, movements, an inhaler *when you don't want to specify the noun you don't put article: to hospital, school *when you list things, you can skip the article e.g a pulse and blood pressure, paresthesia and sore tongue Uncountable Nouns - Fluids: blood, water, saliva - Gases: oxygen, nitrogen, smoke - Particles: dust, dirt, sand, fiber - organ: the thyroid gland, the Achilles tendon, the sclera, the scalp, the upper back, the gums, the skin, the hair, the cartilage (but if it's torn or damaged or medial you can put "a") - Symptom: pain [generally uncountable but if it's pain in the specific location & type, countable e.g an acute pain], shortness of breath, general swelling [both], neck stiffness, patient's behaviour, sleep, concentration, discomfort, lack [but quite often used together with "a" due to normalization e.g a lack of energy, a lack of confidence], damage, - Sign: general fatigue, stricture - Group of something: staff, tissue, (a pair) of glasses, the elderly - Place: accommodation, - Names of diseases: cancer(!!), diabetes, pneumonia, influenza [vs a heart attack!!!!!!!!!!!, a stroke] - Abstractions: research [!!!!!!!!!!!!!!!!!!!!!!!vs a study], education, progress, health, information, screening - Management: ADVICE, urgent attention, (palliative/child) care,(physical) & PROGRESS (!!!!!), rehabilitation, surgery(!!!!!)/treatment (!!!!)/therapy (!!!!!!!!), nutritional status (vs a mood state, a depressed state), vaccination, good support/assistance, analgesic (uncountable) - Activities: walking, sleeping, and other gerunds (e.g the passing of urine) [if it is both => we prefer to consider as uncountable] -Assessment (Steve prefers it to be an uncountable noun but both are possible) e.g Thank you for looking after Ms Weston's wrist splint and arranging an(type of assessment) ergonomic assessment for her -Investigation, -Intervention (if you are specific use "a"), -Medication, -Replacement, -request, - medications/medication

Fix sentences [06/05/2020 good] Dear Dr Allen RE: Mrs Cynthia Attard DOB 14/01/74 I would be appreciated, if you can assess Mr. Frasers case and treat him as you feel appropriated. Your's sincerely Dr Jiri Pavlu Consultant Haematologist Hammersmith Hospital

Dear Dr Allen, RE: Mrs Cynthia Attard DOB 14/01/74 I would appreciate it, if you could assess Mr. Fraser's case and treat him as you feel appropriate. Yours sincerely, Dr Jiri Pavlu Consultant Haematologist Hammersmith Hospital

consider/imagine + ing vs to [07/05/20]

Different meanings: I am considering working abroad. (I am thinking of working abroad.) Everybody considers him to be the best person for the job. (Everybody thinks that he is the best person for the job.) Imagine living at 2,000 metres above sea level! (Imagine what it would be like to live at 2,000 metres above sea level.) I imagined him to be much taller. (I expected that he would be much taller.)

20/05/19 Dr Emma Smiley Brest Cancer Oncologist Spirit Breast Clinic Suite 303 Bullhead St Bulla NSW 2898 Dear Dr Smiley, RE: Mrs Elizabeth Miro, DOB: 23/10/70 I am writing to refer Mrs Miro, a 48-year-old laboratory technician, who has been recently diagnosed with inflammatory breast cancer and requires further assessment and treatment.[LA1] Mrs Miro initially presented one month ago with a 3-week history of worsening pain, swelling, redness and warmth in her right breast. Brest examination revealed the[LA2] mildly enlarged right breast with periareolar erythema which[LA3] was warm, firm and tender to touch. Several palpable non-tender lymph nodes were also found in the right axilla. A review was scheduled in one week [LA4] and I prescribed [LA5] a week's duration of oral flucloxacillin. Mrs Miro defaulted the next appointment and reattended yesterday. There was no improvement in her signs and symptoms and I observed [LA6] new findings such as pitted skin and nipple retraction on physical examination. Mammogram and ultrasound results showed increased thickening and density in her right breast together with a deep mass (4mm) in the centre of the breast and enlarged right axillary lymph nodes. Additionally, a biopsy result received today confirmed infiltrating ductal carcinoma. [LA7] Please note, Mrs Miro is currently suffering from depression, for which fluoxetine 20mg daily and a referral to a psychiatrist has been made have been recommended. She has a family history of ovarian cancer in her mother and her aunt died of breast cancer at the age of 73. In view of the above, I believe Mrs Miro requires urgent specialist assessment and care regarding her condition. Should you have any queries, please do not hesitate to contact me.

Dr Emma Smiley Brest Cancer Oncologist Spirit Breast Clinic Suite 303 Bullhead St Bulla NSW 2898 [LA1]Clear intro. 😊 [LA2] a = Temporary changes to body parts need 'a/an'. [LA3] mildly enlarged right breast which was warm, firm and tender to touch with periareolar erythema [LA4] for the following; In one week means one week after "today". [LA5]Using the passive would be better: A week's.. was prescribed => a week's supply of oral flucloxacillin [LA6]Passive better here too. [LA7]for which fluoxetine 20mg daily has been prescribed and a referral to a psychiatrist has been made

[10/05/20] Kr Karin Schacinger Healthclic Concierge Medicine 57 Berkelry square London UK I am writing this letter to refer Mrs Johnson, a 69-year-old retired teacher living alone, [experiencing] signs and symptoms suggestive of multiple myeloma for diet and medicine management at her home. Mrs Johnson initially presented a month ago with a 6-week history of myalgia, for which ibuprofen was prescribed and she was advised to cease Simvastatin which she had been on since 2012 to control hypercholesterolemia. On review after one week, she reported persistent pain[,] severe at night and v[relieved by] warm bath[,] and a weight loss of 6kg for the last 2 months. Today, her severe pain has continued and caused her to [consume] high level of alcohol to relieve the pain. Imaging revealed multiple destructive lytic lesions in skeleton and urinanalysis confirmed positive positive Bence-Jones protein. Examination at that time demonstrated high blood pressure of 160/90 bpm. Please note, Mrs Johnson has suffered from depression since 2012 and has been taking amitriptyline 25mg twice a day for this reason. She has been divorced without any children and has been a heavy drinker [for 18 years]. In view of the above, I believe Mrs Johnson requires frequent home visits to help with her diet and medication. Should you have any queries, please do not hesitate to contact me. Yours sincerely, doctor

Dr Karin Schachinger Gerneral practitioner Healthclic Concierge Medicine 57 Berkelry square London,UK (Today's date) Dear Dr Schachinger, Re: Mrs. Rachel Johnson, 70 yrs I am pleased to refer Mrs. Johnson, who is suffering from multiple myloma, for monitoring her diet plan and medication. She first attended my clinic on 18.03.2018 complaining of generalised muscle aches and pain for six weeks. She was given [Ibuprofen] (3 times a day) and advised to stop taking Simvastatin. [While reviewing one week later], her pain was persistent all the time, especially at night, however, it [resolves] by warm bath. In addition, she reported loss of 6 kg over two months and was depressed about life. On reassessment today, Mrs. Johnson is suffering from severe pain and reports that she is drinking more alcohol. After examination, her BP was 160/90 and her pulse was 86. Skeletal survey and urinanalysis test were ordered and these confirmed the diagnosis of multiple myeloma. As a divorced elderly lady, who lives alone with no one to take care after her, I believe that she needs to be visited two times a week to monitor her compliance with the diet plan and medication (Amitriptyline - 25 mg, 3 times a day). Therefore, I would be grateful if you could visit her at home to monitor her compliance with the diet plan and medication. Please do not hesitate to contact me for any further information. Yours sincerely, Dr Jiri Pavlu Consultant Haematologist Hammersmith Hospital

[04/05/20] Dr. David Torpy Royal Adelaide Hospital Adelaide SA Australia (Today's date) Dear Dr. Torpy, Re: Monica Fisher, DOB: 12/04/1965 I am referring Mrs. Fisher, who is suffering from Cushing's syndrome, for assessment and ongoing management. The patient has a history of hay fever and colds and has been attending our hospital for various !!!![ ] since July 2007. She was prescribed vitamin B12 injection [ ] low Hb level due to [ ] strict vegetarian diet. Two weeks [ ], her symptoms were unchanged and work-related stress was suspected. In addition, she was treated with Ventolin [ ] mild asthma. On review five months [ ], Serevent and Pulmicort turbuhaler were [ ] due to the side effects of Ventolin. After returning from overseas in 2014, she experienced features [ ] allergic rhinitis, which was aggravated [ ] close contact with domestic cats. [ ], she was prescribed Zyrtex and also referred to v[ ] Allergy specialist. Two weeks later, she was commenced on !!!!!!!!!!!!!!!!!!!![ ] course of Immunotherapy for her allergic reaction to cat fur. Four months [ - from now], she complained of failed immunotherapy. Her symptoms have not resolved even though she followed [ ] strict hygiene and avoidance of trigger factors [ ] allergy. Moreover, Stilnox was !!!!!!!!![ ]* to help her sleep for one month. Today, her sleeping problem, poor wound healing, obesity and depressive mood change are suggestive of Cushing's syndrome. I would be grateful if you take over further management of Mrs. Fisher. Please do not hesitate to contact me if you require any further information. Yours sincerely, Dr. Josephine Peters General practice *to test something in a formal way to discover how effective or suitable it is:

Dr. David Torpy Royal Adelaide Hospital Adelaide SA Australia (Today's date) Dear Dr. Torpy, Re: Monica Fisher, DOB: 12/04/1965 I am referring Mrs. Fisher, who is suffering from Cushing's syndrome, for assessment and ongoing management. The patient has a history of hay fever and colds and has been attending our hospital for various [ailments] since July 2007. She was prescribed vitamin B12 injection [for] low Hb level due to [a] strict vegetarian diet. Two weeks [later], her symptoms were unchanged and work-related stress was suspected. In addition, she was treated with Ventolin [for] mild asthma. On review five months [later], Serevent and Pulmicort turbuhaler were [commenced] due to the side effects of Ventolin. After returning from overseas in 2014, she experienced features [of] allergic rhinitis, which was aggravated [by] close contact with domestic cats. [Subsequently], she was prescribed Zyrtex and also referred to [an] Allergy specialist. Two weeks later, she was commenced on [a] course of Immunotherapy for her allergic reaction to cat fur. Four months [ago], she complained of failed immunotherapy. Her symptoms have not resolved even though she followed [x] strict hygiene and avoidance of trigger factors [for] allergy. Moreover, Stilnox was [trialed] to help her sleep for one month. Today, her sleeping problem, poor wound healing, obesity and depressive mood change are suggestive of Cushing's syndrome. I would be grateful if you take over further management of Mrs. Fisher. Please do not hesitate to contact me if you require any further information. Yours sincerely, Dr. Josephine Peters General practice

[04/04/20 again] [ ] a suspected urinary infection, cefalexim 250 mg hourly daily for [ ] 5 days was prescribed and a mid-stream urine test [ ]. Please note, I !!!!!!!!!!!!!!![ ] Mrs. Maclntyre [ ] folic acid 400 microgram daily and have advised a nuchal translucency scan [ ] rule out Down's syndrome. I am happy to [ ] her antenatal care with you !!!!![ ] you think appropriate

Due to a suspected urinary infection, cefalexim 250 mg hourly daily for [x] 5 days was prescribed and a mid-stream urine test was ordered. Please note, I have commenced Mrs. Maclntyre on folic acid 400 microgram daily and have advised a nuchal translucency scan in order to rule out Down's syndrome. I am happy to share her antenatal care with you as you think appropriate.

Fix sentences [09/05/2020 good] Dr jane thompson Medical practitioner Fitzroy medical centre 12, Raeburn st, Fitzroy Qld 4165

Fix sentences Dr Jane Thompson Medical Practitioner Fitzroy Medical Centre 12 Raeburn St. Fitzroy Qld, 4165

[14/05/20 again] He was administered pantoprazole and kept in observation for two hours. [ ] was scheduled after two days or earlier depending on his progress. Mr Miller [ ] diabetes and hypertension controlled by an insulin pen and amlodipine 5mg respectively since 2012. His BMI is currently 24.8 vs The patient [ ] to review in 2 weeks. vs She presented complaining of an accidentally discovered breast lump, which had not increased in size. A follow up visit [ ] scheduled for [date]

He was administered Pantoprazole and kept in observation for two hours. [A review] was scheduled !!!!!!for two days or earlier, depending on his progress. Mr Miller [has lived with] diabetes and hypertension controlled by an insulin pen and Amlodipine (5mg), respectively, since 2012. His BMI is currently 24.8. vs The patient was asked to review in 2 weeks. vs had been

[08/06/20] I am writing this letter to refer Rosemary, a 15-year-old high school student, who is discharging today after being diagnosed by celiac disease [for] further management of her gluten-free diet. She first admitted to [ ] two days ago presenting with persistent greasy [diarrha], abdominal pain and !!!![ ] blistering rash over her elbows, knees and buttocks. She reported easy bruising and !!!!![ ] weight loss of 2.5 kg over the past 2 weeks. Examinations that day revealed anemia, low WBC and platelets. Her PT and aPTT !!!!!!!!![ ] prolonged and calcium levels were low. Stool exam showed steatorrhea and all antibody tests were positive for [celiac disease]. A small bowel biopsy result today confirmed typical features of flattened villi and lymphocytic infiltration without presence of lymphoma. In terms of treatment, she is currently on !!!!![ ] gluten-free diet and has been prescribed ferrous sulphate for [ =최대] of 6 months. She has been recommended to repeat antibody, CBC and calcium tests in 6 weeks' time. Please note, she has a positive family history of diabetes type 2 in her mother and Crohn's disease in her father.

I am writing this letter to refer Rosemary, a 15-year-old high school student, who is discharging today after being diagnosed by celiac disease [and requires] further management of her gluten-free diet. She first admitted to the emergency room two days ago presenting with persistent greasy [diarrhoea], abdominal pain and [a] blistering rash over her elbows, knees and buttocks. She reported easy bruising and [a] weight loss of 2.5 kg over the past 2 weeks. [Investigations] that day revealed anemia, low WBC and platelets. Her PT and aPTT [were] prolonged and calcium levels were low. Stool exam showed steatorrhea and all antibody tests were positive for [coeliac disease]. A biopsy is performed and confirmed the diagnosis of coeliac disease. During hospitalization, Rosemary has made good progress. She has been prescribed Ferrous Sulphate for [a maximum] of 6 months and [a] repeat of antibody titres is due in 6 months along with CBC and calcium levels. She requires [a] gluten free diet to help alleviate her symptoms Her family history is positive for diabetes mellitus type 2 and hypertension in her mother and Crohn's disease in her father.

[09/05/20] vThank you seeing Mr Dave Cochrane, a 56-year-old retired man, who has been experiencing signs and symptoms suggestive of acute left ventricular failure. I believe Mr Cochrane needs admission to [ ] cardiology unit for further stabilization. Today, Mr Cochrane presented with severe dyspnea, chest pain and a 2-hour history of sweating. Examination revealed bilateral ankle edema, elevated jugular vein pressure, a laterally deviated apex beat in the 6th ICS and bilateral basal lung crepitations. Her blood pressure was 120/60 (mmHg) and pulse was 66bpm without any murmurs. Mr Cochrane initially attended my clinic on 12/08/2019 with complaints of shortness of breath, which was worse when lying down and improved when raising head at the end of his bed, tightness in chest and coughing at night. ECG showed cardiomegaly and chest x-ray detected features of an infection. Therefore, I informed my diagnosis of left venticular failure and prescribed digoxin 0.25mg daily and frusemide 40mg daily, and a 7-day course of antibiotics. On review 14 days later, Mr Cochrane's condition had improved and I reduced consupmption of cigarete (10/day) and alcohol (10 units/week). I continued frusemide and digoxin. In view of the above, I believe Mr Cochrane needs urgent assessment and management of this acute episode. Should you have any further queries, do not hesitate to contact me.

I am writing to refer Mr Dave Cochrane, a 56-year-old retired man, to your attention for urgent assessment of signs and symptoms suggestive of acute exacerbation of established left ventricular failure. I believe Mr Cochrane will require admission to the cardiology unit for further stabilization. Today, Mr Cochrane presented anxiously with a 2-hour history of severe dyspnea, chest pain and sweating. Examination revealed bilateral ankle edema, elevated JVP*, bilateral basal lung crepitations and a laterally deviated apex beat in the 6th intercostal space*, but no cardiac murmurs. Her blood pressure was 120/60 (mmHg) and pulse was 66bpm. Mr Cochrane initially attended my clinic on 12/08/2019 experiencing [a similar acute episode]: chest tightness, a nocturnal cough, dyspnea with orthopnea and physical findings [identical to today's]. ECG demonstrated cardiomegaly and chest x-ray detected features of an infection. In view of all these findings, I diagnosed left ventricular failure and prescribed digoxin 0.25mg daily and frusemide 40mg daily and a 7-day course of antibiotics. On review 14 days later, Mr Cochrane's condition had partially improved and I continued frusemide and digoxin. I would appreciate your assessment and management of this acute episode. Should you have any further queries, do not hesitate to contact me.

Fix the sentences below [06/05/2020] Dear Doctor, Re: Mr. David Taylor DOB 14/4/80 I am writing to refer this patient, 39-year-old married male who is suffering from damaged medial cartilage on left knee, for further management and possible surgery I am writing this letter to refer Rosemary McQueen, a 15-year-old high school student, who is discharging today after being diagnosed by celiac disease for further management of her gluten-free diet I am wiriting to refer Rosemary, a 15-year-old high school student who was diagnosed with coeliac disase and she requires further dietary advice

I request further management and possible surgery for this patient, a 39-year-old landscape gardener who is suffering from "a" damaged medial cartilage in "the" left knee I am writing this letter to refer Rosemary McQueen, a 15-year-old high school student, who is discharging today after being diagnosed by celiac disease and requires further management of her gluten-free diet [Steve says it is too long] I am writing to refer Rosemary, a 15-year-old high school student who was diagnosed with coeliac disease [for which - more formal] she requires further dietary advice

[09/05/20] ______________, I saw Mrs. Martin ______________ when she complained of poor health, tiredness and lack of motivation at work. !!!!!______________, she reported worsening of [ ] symptoms and her situation at work and family was [ ] her stress, frequent headaches and insomnia. ____________ a provisional/preliminary diagnosis of depression and/or schizophrenia, diazepam 10mg ____________ was prescribed. (61 words)

Initially, 4 weeks ago, On the next visit (!!!), her, causing, due to, at night

[16/06/20] Kate was unable to walk to school due to lower back pain aggravated by walking for more than fifteen minutes.

Kate was unable to walk to school, due to lower back pain that is aggravated by walking for more than fifteen minutes.

[13/05/20 again] Grade: lower B I am writing this letter to refer Brian, a 23-year-old university student, experiencing signs and symptoms suggestive of acute appendicitis and requires urgent surgical assessment and management if warranted. [v] Brian has presented to my clinic twice since yesterday with a 2-day history of abdominal pain associated with several vomitings. On examination, his abdomen was slightly flushed with the right-sided tenderness and mild guarding and there was no rebound tenderness or rigidity. His vital signs were unremarkable. [He has been advised to increase his fluid intake and prescribed Naxolon 10mg every 4 hours for his nausea. When Brain returned [in the afternoon], he was suffering from severe and constant pain localized in the right Iliac Fossa. He was flushed and restless. [Examination revealed localized tenderness in the right Iliac Fossa with guarding and rebound tenderness and reduced bowel sounds]. I observed an elevated pulse (100), blood pressure (140/90) and temperature (38.8) and his blood test results showed increased white cell count (18,000). [In view of the progress of his condition and findings, I have decided to send him to hospital for further specialist assessment and management due to suspition of potential acute appendicitis. Please keep me updated regarding his progress]. Should you have any queries, please do not hesitate to contact me. Yours sincerely, GP

Model letter I am referring [Mr. Morgan] for an urgent surgical assessment due to probable acute appendicitis. [Mr. Morgan] first presented yesterday complaining of a cramp and central abdominal pain, which was associated with nausea and several loose bowel motions. Abdominal examination revealed generalised central abdominal tenderness. Increased fluid intake, rest and analgesia were advised for possible viral gastroenteritis. [He has been advised to increase his fluid intake, and he has been prescribed Naxolon 10mg every 4 hours]. Despite the conservative measures, Mr. Morgan returned this morning with worsening abdominal pain. On examination, his temperature continued to be slightly elevated and right-sided abdominal tenderness with mild guarding was noticed. Therefore, blood tests, fluid maintenance and Maxalon 10 mg tablets 4 hourly [were organised] for probable viral gastroenteritis or early appendicitis. Mr. Morgan returned [this afternoon] with severe and constant, localised right iliac fossa pain. [He appeared] flushed and restless. His temperature was 38.8 C. [On abdominal examination, localised right iliac fossa pain with guarding and rebound tenderness were observed and his bowel sounds were diminished]. The blood tests results revealed elevated [white cell counts (18,000mm3)*]. *James says white blood cell count if it is total, white blood cell counts if it is differential. I would greatly appreciate it if you could provide urgent attention to his condition and [keep me informed of the outcome]. [Due to concerns of probable acute appendicitis, I have decided to send him to hospital for further specialist assessment. I would appreciate if you keep me informed of his progress] Yours sincerely, Doctor

[13/05/20 again] Mr Romeo initially attended my clinic last month for a general check up. He reported he had high blood pressure in the past and his father died at age of 48 of acute myocardial infarction

Mr Romeo initially attended my clinic last month for a general check up. He reported a past history of hypertension and a positive family history of heart disease in his father who died of acute myocardial infarction at the age of 48 *at the age of vs at age of: The only difference is in register: they're both equally valid in professional writing. Writing "at the age of five" is more formal, while "at age five" is more technical or direct. Modern and effective language tends towards brevity, so the second wins in that sense.

[13/05/20] Mr Jones initially presented with back pain of 4 days duration which initiated while lifting a heavy box at his work. X-ray revealed no signs of disc problems and he was diagnosed with severe lower back strain. I referred him to a physiotherapist and issued a certificate for thirty days off at work.

Mr. Jones initially presented with back pain of [four] days duration, which initiated while [he was] lifting a heavy box at his !!!!!!!!![place of] work. The X-ray revealed no signs of disc problems and he was diagnosed with severe lower back strain. I referred him to a physiotherapist and issued a certificate for thirty days off at work.

[14/05 again] Please note [May I remind you that Mrs X has an allergy to E (it is more advanced & can be last sentence)], Mr Tyler does not have a particular medical and family history related to asthma. He is currently in university rugby team and has a history of injuries received in playing rugby.

Please note, Mr Tyler does not have a particular medical and family history related to asthma. He is currently "on" "the" university rugby team, and has a history of injuries received "through" playing rugby.

[21/06/20 again] QAD 4543 Dear Nurse 1) I am writing to request an ongoing care for Ms. Green, a 69-year-old widow, who is recovering from low grade adenocarcinoma 2) Postoperatively, Ms Green had immediate complication in regard to acidosis after five hours of anesthesia, but currently the patient is progressing well. 3) She had spent one week in the intensive care unit and was shifted to our care on 30/01/2019. 4) She only needs minimal assistance with ADL but needs oxygen support of 2 liter during showers. She walks with single point stick and had good appetitie. Her home modification has had been done by occupational therapist. !!!!!!!!5) She is happy about it. Importantly, she needs to be monitored for anxiety and oxygen usage. She has a history of COPD and asthma since 2014 and 2015 respectively. !!!!!6) Please note, the abdominal dressing need to be changed every third day for early recovery. As she is planned to be discharged tomorrow, her sister will be escorting her to home via taxi.

QAD, 4543 Dear Nurse, 1) request ongoing care (second comma is optional) *Rule 1: care is uncountable so no article *Rule 2: If it's type of care, so something specific, you use "a"] 2) remove postoperatively, complication is countable 3) shifted (less formal) -> transferred nasal prong -> nasal prongs (two) 4) 2 liters, a stick, has a good appetitie, has been done (but Stev prefers this), an occupatioinal therapist 5) She is happy to do so. Importantly -> after discharge 6) needs, escorting her home

[10/05/20 again] Sally initially presented with her mother who was concerned about Sally's lack of appetite and weight loss. [ ] frequent arguments on her habits between her mother and her, she denied the problem and reported she felt well. On examination, I noticed Sally had lost 6 kg over the one and a half month. When Sally was interviewed alone one week later, she stated her mother was overreacting and her ideal weight was 40kg which was 7kg less than the current weight.

Sally initially presented with her mother[,] who was concerned about Sally's lack of appetite and weight loss. [Despite] frequent arguments between Sally and her mother [regarding] her habits, she denied the problem and reported she felt well. On examination, I noticed Sally had lost 6kg over the !!!!!!![a month and a half]. When Sally was interviewed alone one week later, she stated that her mother was overreacting, and her ideal weight was 40kg, which was 7kg less than the current weight.

[06/06/20 again] Examples of good conclusions that give you more points 1) Due to ____________of malignancy, I would be ____________if you could !!!!!!!!!!!!!!!!!!!!!!!!!!________________further assessment !!!!!!!!!!!!!!![ ] this patient. 2) In _____________ the above, I would appreciate your ____________attention to her condition. Please do !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!______________ of her outcome. 3) I would appreciate your assessment of this girl to find out !!!![ ] he has any [ ] psychological problems. Other examples regarding conclusions - I would appreciate your urgent attention to her condition - I [less formal] would appreciate your urgent assessment of this patient or if you could take over his care and provide appropriate management in order to prevent osteoporosis - to confirm this provisionary diagnosis, - Please do not hesitate to contact me if you have any queries regarding Mr Smith's condition - I am happy to share her antenatal care with you as you think appropriate. I would be happy to share her clinical management.

Some degree of originality will impress the assessors. Therefore, where possible try to ensure that your conclusion is related to your task and not simply a memorised ending. Here are some examples. 1) concerns, grateful, arrange, of 2) view of, urgent, keep me informed [neurosurgeon]. 3) whether, underlying

[09/05/20] Thank you for [ ] this 39-year-old mother [ ] 2, [ ] home pregnancy test [ ] she is [ ] her 8th week of pregnancy. She has a strong [ ] severe pre-eclampsia in her first pregnancy which [ ] an emergency caesarean section at [ ] 32 weeks [ ] gestation. Her second pregnancy and delivery was [ ] but she !!!!!!!!!![ ] two miscarriages. In view of her age and history, I believe Mrs. Maclntyre needs urgent [ ] assessment and care. vs I am writing to refer Mrs. Haze, a 47-year-old married nurse [ ] 4 children who has been diagnosed with left breast cancer vs She is [ ] single mother of [ ] 7 year old child

Thank you for accepting this 39-year-old mother of 2*, whose home pregnancy test indicates she is in her 8th week of pregnancy. She has a strong history of severe pre-eclampsia in her first pregnancy which resulted in an emergency caesarean section at 32 weeks of gestation. Her second pregnancy and delivery was [uneventful] but she has had two miscarriages. In view of her age and history, I believe Mrs. Maclntyre needs urgent specialist assessment and care vs with vs She is a single mother of a 7 year old child

Improves sentences [18/05/20 - again] The patient presented with multiples acnes located on the face as well as back, shoulders and neck. She reattend to my clinic due to worsening of the acnes and complaints with vaginal candidiasis and sore tongue. The acnes were cyst like and left scars. She has stopped taking her OCP since January 2013 and she requested referral to endocrinologist.

The patient suffers from facial acne, as well as [acne - no plural form] on the upper back, shoulders and neck. She reattended/returned complaining of vaginal candidiasis and !!!!!!!![a] sore tongue. Symptoms were of four-weeks' duration. Upon examination, we observed cystic acne with residual scars. Please note, she had taken the pill until January 2013 and => You can't use "has stopped" with since. The patient has requested [a] referral to an endocrinologist.

lack of vs a lack of?

The use of the indefinite article indicates singularity. "A lack of"indicates " a particular lack of"(Thefreedictionary.com).If you use "lack of"you refer to "lack or absence in a general way. Your examples require "a".

complete vs completed [09/05]

The word "complete" is both an adjective and a transitive verb.As an adjective, "complete" means fully constituted of all of its parts or steps, fully carried out, or thorough. e.g The Starship Enterprise made out of Lego blocks is finally complete. Mary is planning a complete renovation of her kitchen. As a transitive verb, "complete" means to bring to an end or a perfected status. Examples:The contractor completed the foundation work on Tuesday.The football quarterback completed a 75-yard pass for the touchdown. Therefore, something is complete, or something has been or was completed. Therefore, Action Item A is complete (adjective), or Action Item A was completed (past tense verb). Action Item A "is completed" is wrong, although "is being completed" or "is going to be completed" are proper verb forms.

[14/05/2020] 1) These days, less money is spent on the development of new drug. 2) A baby requires adequate nutrition in order to meet the developmental guideline. 3) A wound will heal more quickly if proper hygiene practice is followed. !!!!!!!!4) The patient who has allergy to food or drugs is at higher risk of having side effects to the medication 5) During those check-ups, no problem was detected in his primary dentition. !!!6) Sally presented with a 3-month history of constipation despite having fibers in her breakfast

When you talk about things in general, use plural form 1) These days, less money is spent on the development of new drugs. 2) Babies require adequate nutrition in order to meet the developmental guidelines. 3) Wounds will heal more quickly if proper hygiene practices (practice is also fine) are followed 4) The patients who have allergies to food or drugs are at higher risk of having side effects to the medication 5) During those check-ups, no problems were detected in his primary dentition [any+countable noun+s] 6) fiber

Writing criteria [09/05/20] !!!!!!!!!!!1) Not Judgmental: Mr Rose is divorced, she is a housewife 2) Emphatic with negative connotations: - Mr Smith has a bad diet, eats lots of junk food and is obese - It is important to note that the patient is allergic to penicillin. 3) Old fashioned - The medication needs to be taken thrice a day 4) Informal expression - A pulse was elevated !!!!!![ ] 88. So I recommended she return today for reassessment - Osteoarthritis is a common condition among old people

Writing criteria 1) You cannot use divorce or also housewife; say "she lives on her own" 2) - Mr Smith diet is not nutritionally balanced or a poor diet or take away food or Mr Smith has an unhealthy diet and is overweight among old people -> among the elderly - Please note, the patient is allergic to penicillin. 3) - The medication needs to be taken 3 times a day - using a lot of "in addition", "therefore" 4) - A pulse was elevated [at; not optimal but used] 88. Therefore I recommended she return today for reassessment - Osteoarthritis is a common condition among the elderly

Top 7 Mistakes In OET Writing Sub Test [14/05/20: 15m - 25m - 5m]

Writing sub-test is OET is not going to be a piece of cake for you especially, if you're someone who is not good at writing or someone who is not aware of what is required to get through it. The way you structure your write-up matters a lot. Here, we have covered top seven mistakes which you shall avoid. 1) Not paying attention to reading before writing Before you begin writing, it really makes sense that you read properly read the test content. Yes, you need to spend some time on it to understand it and then structure your approach. 2) Not focusing more on grammar and punctuation Grammar is the backbone of the language and punctuation is the beautification required to make your write-up look more beautiful or meaningful. Here, you need to focus on writing grammatically correct and at the same time, you need to make sure that you punctuate your write- up well. Remember, a small error can bring in lot of trouble for you. 3) Not picking the right words There are some candidates who feel that by making use of high-sounding words, they can impress the examiner. But, in reality such is not the case. Yes, you are required to make use of simple words. In fact, us of the complex or difficult-to-understand words can make the letter look a bit awkward. Your examiner may not like it and you will not be able to get the score you wish to. 4) Not rewriting or revamping The content you find in the question shall be revamped or rewritten. Yes, you can't just make use of the same words or the phrases for your answer. You need to change the structures or convey the information in much simple form. Remember, if you copy exactly the same phrases or the sentences which you find in your question then you will get very low score. 5) Including not-so-clear views, suggestions, recommendations Be away from being vague. You need to understand and present the concept in the right way. You can't just write something that is vague in nature. If you are to conclude the letter then it is important that you shall provide right suggestions, recommendations as needed. 6) No coherence You need to check the answer for coherence. Yes, it matters a lot. You need to focus on whether each and every sentence has good connectivity or not. Use of irrelevant sentences or beating around the bush just in order to fill out the empty space is not enough. The main concept of the task shall be intact and shall not be broken up into pieces. 7) Not proofreading Before submitting your answer, it is always quintessential that it shall be proofread. Who knows there can be some mistakes! By effectively proofreading, you can find out those mistakes and correct them as needed. By focusing on all essentials rules of writing, you can get the best score in your OET Writing Sub-Test

Which one is correct? [18/07/20 good] 1) On abdominal examination, localised guarding and rebound tenderness was observed in the right iliac fossa. 2) On abdominal examination, localised guarding and rebound tenderness were observed in the right iliac fossa

You can use a singular verb if you are referring to something as a "whole". In the example, the guarding and tenderness can be considered as one overall symptom. However, plural form here would also be accepted.

Fix Introductions [05/04/20] 1) I am writing to introduce Mr. Roache, a 53-year-old independent aboriginal pensioner for your assistance. He was admitted to the hospital ICU on 05/02/2019 for the treatment of intrathoracic haemorrhage and multiple skeletal injuries by a motor vehicle accident with a car !!!!!!!2) I am writing to discharge Mrs Mills, a 20-year-old smoker and drinker, who has schizophrenia and paranoid disorder 3) I am writing to refer James, who has been demonstrating features suggestive of post-streptococcal nephritis with early renal failure [ ] he requires evaluation and management. 4) I am writing to request an urgent admission !!!![ ] Emma, who [ ] today with acute exacerbations of asthma triggered by viral upper respiratory tract infection. She requires further evaluation and management. 5) Thank you for seeing Mr K, a 68-year-old retired management consultant, who requires urgent investigation due to possible pancreatic malignancy

You should use less than 30 words for introductioin! 1) following a motor vehicle accident. He is due for discharge into your care today / caused by a motor vehicle accident / due to/resulting from/received in 2) You can't define someone by their habit - judgemental => a 20-year-old university student who has a history Mrs Jones has suffered from diabetes since childhood 3) for which 4) for, has presented

[10/05/20 bad] vThank you for seeing Jack Mills, a 20-year-old man who is recovering from symptoms of schizophrenia. His parents divorced 4 years ago and he is a heavy smoker and drinker with a history of binge drinking. 1) Jack was first admitted to Spirit Hospital Psychiatric ward on 14/04/18 due to a 6-month history of confusion, lack of concentration on his studies along with frequent mood swings. He also quit attending his university and had no friends. At that time, Jack was diagnosed with Schizophrenia with possible paranoid disorders and nicotine dependence, for which haldol 20mg and sodium and valproate 125mg daily were prescribed. 2) Jack was readmitted on 25/08/18 following an attempted suicide with self-harm through deep cuts in both wrists, possibly due to his mother's plan to remarry. He was discharged after three days. However, his symptoms worsened and he was brought up to the hospital by his mother two months later. At that time, he reported irritability, suspicion, and auditory hallucinations for the past week and he had not adherent to his medication. During hospitalization, sodium valproate and Navane (IM, qid) were given and psychotherapy was commenced but his participation rate was low. On today's discharge, his finance-managing skill and judgment ability have improved. 3) A follow up plan includes continuing sodium valproate 250mg twice a daily and Navane 1.5mg every 4 weeks intramuscularly (the next dose on January 16, 2020) and one-to-one psychotherapy, absence from alcohol and smoking cessation and vocational rehabilitation and day programs. Please note, an improvement in treatment compliance and social stability is necessary.

[Mike] 1) Ward, along with -> and, also quit -> had also stopped university, !!!!!!!!reported having no friends, !!!!!!Schizo -> schizophrenia, haldol -> Haldol 2) !!!!!!!![by] self-harm [with] deep cuts in both wrists, !!!!!!!!!!!!!!![prompted by stress over]. He was discharged after three days [to his mother's care], he was brought [back] to the hospital, At that time[x] he was irritable and suspicious and he had been experiencing auditory hallucinations for the past week and had not been adherent to his medication. During hospitalization, psychotherapy was commenced but his participation rate was poor. On today's discharge, his skill in managing finance and his judgment have improved, though they are not ideal 3) "The" follow-up plan is to continue sodium valproate twice a day, Navane 1.5 mg IM every 4 weeks, psychotherapy, alcohol absence and smoking cessation. Furthermore, we have planned for vocational rehabilitation and day programs to improve his quality of life, treatment compliance and social stability.

Which one is more correct? [12/05/20 good] [between nurses] - Please change the wound dressing every 3 days after discharge vs The patient's wound dressing requires changing every 3 days after discharge [Medication advice to a doctor] - I recommend that you stop medication X due to its possible side effects vs I recommend stopping medication X due to its possible side effects. - I advise you to prescribe Frusamide in the morning to reduce its diuretic effect vs I suggest prescribing Frusamide in the morning to reduce its diuretic effect. [Advice to a patient] - Take your medication regularly to help control your blood pressure vs Taking your medication regularly will help control your blood pressure

[to nurses: the second one] [to doctor: the sentence without you] [to patient: both are fine]

[12/05/20 good] Mrs Martin attended today, _________________ her husband who was _________________about her ____________ condition. She was ____________ and ____________, showing little eye contact. Her speech was ____________ and incomprehensible !!!! ____________. _________ my management, her symptoms have ____________ worsen [ ] a 1-week history of ____________ and ____________ and ____________ hallucinations along with _______- _____ behaviour at work and !!!!!!!!!!!! ____________ planning ability. Mr Martin ____________episodes of anger and ____________ speech output. ____________ the above, I believe Mrs. Martin is experiencing schizophrenia, !!!!!!!!!!!!!!!!!!!!!!____________she requires !!____________ care. I would be happy to ____________ her ____________management and please do not hesitate to contact me if you require any additional information.

accompanied by, very CONCERNED, RECENT, depressed, withdrawn, monotonous (disorganized), at times (=occasionally=sometimes but formal than sometimes), despite, continued to, with[when you want to add "with" the content you want to add should be related to the previous content], paranoia, visual, auditory, inappropriate, IMPAIRED!!!!, reported, reduced, in view of, for which, SPECIALIST/SPECIALIZED, SHARE, CLINICAL

Preposition III composed [ ] different [ ] important [ ] work hard important [ ] everyone to selfisolate agree [ ] do agree [ ] somebody/somthing apologize [ ] being late he is known [ ] responsible [ ] disagree [ ] something/ disagree [ ] somebody application [ ] application [ ] do work [ ] experience [ ] pandemics increase [ ] number increase [ ] 1 % I have an excuse [ ] being late we have demand [ ] I will request [ ] penicillin a problem [ ] the procedure disagree [ ] work [ ] [ ] sale [ ] time = correct time [ ] time [ ] pressure [ ] reference [ ] my job application

composed of different from you/to do important to work hard important for everyone to selfisolate agree to do agree with sombody/somthing apologize for being late he is known for responsible for disagree about something/ disagree with somebody application for application to do work on experience with pandemics increase in number increase of 1 % I have an excuse for being late we have demand for I will request for penicillin a problem with the procedure disagree about/with work on for/on sale on time = correct time in time under pressure with reference to my job application

Distinguish the difference between 2 types of relative clauses [15/06/20 good] 1) Ms Smith is a 19-year-old woman who recently tested positive for chlamydia. vs Ms Smith, who is a 19-year-old woman, recently tested positive for chlamydia. 2) I am writing to refer Ms Smith, a 19-year-old woman who recently tested positive for chlamydia. vs Ms Smith, who recently tested positive for chlamydia, is a 19-year-old woman. vs I am writing to refer Ms Smith, who recently tested positive for chlamydia.

depending on your intention 1) Defining (Essential info) - Ms Smith is a 19-year-old woman who recently tested positive for chlamydia. => She is being defined by her positive test result. - I am writing to refer Ms Smith, a 19-year-old woman who recently tested positive for chlamydia. => She is being defined by her age and positive test result. (There are other Ms Smiths.) 2) Non-Defining (Extra info) - Ms Smith, who is a 19-year-old woman, recently tested positive for chlamydia. => Extra information is being added about Ms Smith, but it is non-essential. - I am writing to refer Ms Smith, who recently tested positive for chlamydia. => The referral is for Ms Smith. The positive test is extra information.

The location of "also" [08/06/20] 1) the patient also has been advised on the....

exercise 1) the patient has also been advised on the importance of regular check ups ================ 1) (before simple past tense) The well may have produced 258 b/d of heavy oil, but it also produced a lot of sand. 2) (before simple present tense) This downhole tool not only measures temperature, but it also measures pressure. 3) (after verb "to be") She may be a lawyer, but she is also a registered petroleum engineer. (after an auxiliary verb) If we exceed our production target by 20%, each of you will also receive a new car. *If the word "also" refers to an entire sentence, then it goes at the beginning of the sentence with a comma after it [but I think it's colloquial]. Example:Turn in your expense account. Also, your timesheet needs to be filled out.

The rule of plurals

https://www.quickanddirtytips.com/education/grammar/compound-nouns?page=1 https://english.stackexchange.com/questions/138273/list-of-items-is-correct-is-items-list-correct?rq=1

on, at, without? [09/05/20] [ ] admission, [ ] birth, [ ] discharge, [ ] death, [ ] examination, last year or [ ] last year [duration], last April !!![ ] midnight, next year, !!!!![ ] puberty, [ ] night,

on admission, at birth, at/on discharge, at death, on examination, last year or the last year [duration], at midnight, next year, at/in puberty, at night,

[07/05/20 good] can we write the word "patient" or better "her name?"

put Name at the beginning, I don't like overusing the patient, especially at the start of each paragraph - patient's name, in the remaining paragraph - use pronoun

Fix sentences 20/07/20 1) Mr X needs to reduce his weight by 5kg. 2) Mr X requires reducing his weight.

require + noun 1) Mr X needs to reduce his weight 2) Weight reduction is required

[06/05/20] Please note, she [ ] asthma and has a positive family history of cancer [ ] her mother who died [ ] colon cancer at 62 years !!!!![ ]

suffers from, in, of, of age *if the condition causes real pain, you can use "suffer", but not for an ongoing condition like "DB"

[10/05/20 good] On review 2 weeks later, [ ] dosage of Metformin increased from 500mg to 750mg and atorvastatin (20mg) was added to Glipizide (5mg)

the - "a dosage" means one particular dosage among multiple dosages

5-Minute Reading Time [09/05/2020]: Understand the case Ask yourself the following questions when reading the case notes and analyze the repetitive pattern of symptoms and put a number (e.g 1,2,3):

• What is my role? • Who am I writing to? • What is the chief complaint/diagnosis/main point? • Is the communication urgent or not? • Is patient's condition improving or deteriorating? • What is the current situation? • What supporting information is useful? • What information is not related to the current condition?