James Warden OET Case Notes



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


Today’s Date 25.08.12

Patient History

James Warden

DOB 05.07.32

Regular patient in your General Practice



  • Wants regular check up, has noticed small swelling in right groin.
  • Hypertension diagnosed 5 years ago, non smoker, regularly drinks 2 – 4 glasses of wine nightly and 1
  • – 2 glasses of scotch at weekend.
  • Widower living on his own ,likes cooking and says he eats well.
  • Current medication noten 50 mg daily, ½ aspirin daily, normison 10mg nightly when required, fifty
  • plus multivitamin 1 daily, allergic reaction to penicillin.


  • BP 155/85 P 80 regular
  • Cardiovascular and respiratory examination normal
  • Urinalysis normal
  • Slight swelling in right groin consistent with inguinal hernia.
  • Plan
  • Advised reduction of alcohol to 2 glasses maximum daily and at least one alcohol free day a week.
  • Discussed options re hernia. Patient wants to avoid surgery.
  • Advised to avoid any heavy lifting and review BP and hernia in 3 months



  • Had problem lifting heavy wheelbarrow while gardening. Has a regular dull ache in
  • right groin, noticed swelling has increased.
  • Has reduced alcohol intake as suggested.


  • BP 140/80 P70 regular
  • Marked increase in swelling in right groin and small swelling in left groin.


  • Bilateral inguinal hernia
  • Advise patient you want to refer him to a surgeon. He agrees but says he wants a
  • local anaesthetic as a friend advised him he will have less after effects than with general anaesthetic.

Writing Task:

Write a letter addressed to Dr. Glynn Howard, 249 Wickham Tce, Brisbane, 4001 explaining the patient’s current condition.

In your answer:

● Expand the relevant case notes into complete sentences

● Do not use note form

● Use correct letter format

The body of your letter should be approximately 200 words. Use correct letter format.

Here is a grade B letter on this topic written by one of our students. Need help with OET writing? Get your letters corrected by me.

Sample letter

Dr. Glynn Howard

249 Wickham Tce

Brisbane, 4001

Date: 25/08/2012

Dear Dr. Howard

Re: Mr. James Warden; DOB: 05/07/32

I am writing to refer Mr. Warden who has symptoms indicative of bilateral inguinal hernia. He requires further assessment of his condition and subsequent treatment for hernia.

Mr. Warden first visited my clinic on the 9th of July, 2012 complaining of small swelling in the right groin, a symptom consistent with inguinal hernia. His cardiovascular and respiratory examinations were normal. BP was raised at 155/85 mm Hg. Urine analysis was normal. He was advised to avoid any heavy lifting and review BP and hernia in 3 months. Treatment options were discussed for hernia and the patient was reluctant to undergo surgery.

Mr. Warden visited again on July 25th complaining of regular dull ache in right groin. There was marked increase in swelling in the right groin and development of small swelling in left groin. He was diagnosed with bilateral inguinal hernia and advised to see a surgeon. He agreed; however, he insists that he should be administered a local anesthetic to avoid the side effects of general anesthetic.

Please note that Mr. Warden has been suffering from hypertension for 5 years. His current medication includes noten, aspirin and normison (nightly when required). He is allergic to penicillin.

I would appreciate it if you could further assess his condition and advise him surgical options for the same.

If you require any information, please do not hesitate to contact me.

Yours sincerely


Manjusha Nambiar

Hi, I'm Manjusha. This is my blog where I give IELTS preparation tips.