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Writing Sub-Test - Test Booklet: Physample04

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32 views

Writing Sub-Test - Test Booklet: Physample04

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ABCL COMMUNITY
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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PHYSAMPLE04

WRITING SUB-TEST – TEST BOOKLET

INSTRUCTIONS TO CANDIDATES
You must write your answer for the Writing sub-test in the Writing Answer Booklet.

You must NOT remove OET material from the test room.

www.occupationalenglishtest.org
© Cambridge Boxhill Language Assessment – ABN 51 988 559 414 (2020)
Occupational English Test
WRITING SUB-TEST: PHYSIOTHERAPY
TIME ALLOWED: READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES

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

Notes:

Assume that today's date is 30 August 2019.

Your patient, Sophie Bennett, is about to go on vacation and requires transfer to a local physiotherapist.

PATIENT DETAILS:

Patient: Ms Sophie Bennett


DOB: 14 Nov 1969 (49 y.o.)
Occupation: Nurse
Current history: Lifting heavy object at work, sharp pain (P) for one hour
Kept going but by end day P++. P now radiating into R leg
Couldn’t sit; tried to get up at 2am, couldn’t move, took ½ hr to
urinate
Unable to sit, even on toilet
Cuada equina syndrome (CES) red flag questions checked. No
onward ED referral was required
 To Dr – Dr Greta Langley. Panadeine Forte, meloxicam NSAID
(Mobic), benzodiazepine (Valium) prescribed
P easing, continuing medications, avoiding sitting
28 Aug 2019
Presenting complaint:
R
 buttock/posterior thigh pain – constant and gripping. Intermittent numbness in
sole of R foot, on outer border of ankle and great toe

Aggravating factors: Sitting, coughing/sneezing, putting on shoes/socks


R
 leg/buttock pain is 8/10 at worst and subsides to 4/10 at best, Óin P as day
progresses
Night: Can’t turn, woken x3 night
Day: Worse as day progresses

Relieving factors: Heat (hot water bottle)


Medication (as per prescription)
Standing up (if sitting)
Lying down (especially prone)

Observation: R knee flexed, limping, scared to turn, unable to weight bear (WB)

AROM lumbar spine:


Flexion: 50cm from floor (P) Extension: No active extension (P)
Palpation: R low lumbar paravertebral tenderness and spasm
R buttock tenderness and spasm
L5 central posterior/anterior (PA): ÓP +++
L3 and L4 central PA: ÓP +
Straight leg raise: R 35° P Óback/leg (positive ankle dorsiflexion)
L 80° (limited by L post thigh tightness)

Reflexes: R=L=NAD ankle, knee

Sensation: ÔLight touch over R little toe; remainder NAD

Power: L2 to S1 NAD

Action taken: Education


 re diagnosis of disc injury probable L4/5. No serious neurological signs
but numbness (intermittent)
Prone lying: repeated extension push up on elbows – improved lumbar flexion
and reduction in leg pain
Nil manual techniques performed due to irritability

Recommendations: Limit sitting – to use a lumbar roll


Lie prone with extension routine hourly x10 when awake over next 2 days
See Dr – change medication to tramadol (morphine-like narcotic) Review
in 2 days

30/08/19 Review appointment


50% Óin mobility, 50% Ôin P
Straight leg raise (SLR) R 50° P limits
Able to lie prone with comfort. Able to open bowels OK

Recommendations: Continue prone extension exercises x10 every hr


Pelvic floor exercises & transversus abdominis exercises x5 every hr
To see physio in 2 wks
Dr has reviewed medication. Off Pandeine Forte, onto tramadol
Pt taking vacation (4 wks) to spend at beach house in Sandy Beach
Requests transfer to physio nearby

Writing Task:

Using the information in the case notes, write a letter of referral to a fellow physiotherapist, Dr White, outlining the
presenting complaint and treatment to date. Address the letter to Dr Maggie White, Golden Sands Physiotherapy, 987
Main Rd, Sandy Beach.

In your answer:
●● Expand the relevant notes into complete sentences
●● Do not use note form
●● Use letter format
The body of the letter should be approximately 180–200 words.
Any answers recorded here will not be marked.

N K
L A
B
PHYSAMPLE04
Occupational English Test

WRITING SUB-TEST: PHYSIOTHERAPY


SAMPLE RESPONSE: LETTER OF REFERRAL

Dr Maggie White
Golden Sands Physiotherapy
987 Main Road
Sandy Beach

30 August 2019

Dear Dr White

Re: Ms Sophie Bennett (DOB: 14.11.69)

I am writing to refer Ms Sophie Bennett, a 49-year-old nurse, who I suspect has a disc injury at L4/5.

Ms Bennett presented on 28/08/19 following a work-related injury incurred while lifting a heavy object. On initial
examination, there were no obvious neurological signs, but the patient reported intermittent numbness in the right
foot. Symptoms included buttock/posterior thigh pain, exacerbated by sitting as the day progressed. Upon further
questioning, there were no cauda equina syndrome symptoms. The symptoms were relieved by analgesics (initially
Panadeine Forte, subsequently changed to tramadol), benzodiazepines and anti-inflammatory medication prescribed
by her doctor.

The most significant findings on initial examination were limited lumbar flexion (to 50cm from floor) and no active
extension range. Straight leg raise was limited to 35° on the right by pain in the buttock/thigh, with further pain
increase with dorsiflexion. After two days of repeated extension in lying, her pain is now settling (50% improvement)
and I have now prescribed additional pelvic floor and lower abdominal exercises, with ongoing physiotherapy for
review in two weeks’ time.

Ms Bennett has requested transfer to a physiotherapist at Sandy Beach, where she is taking a four-week vacation. I
would appreciate your assistance in managing her recovery.

Yours sincerely

Physiotherapist

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