OET writing samples with answers

21 October 2026

Ms Jane Ellis
Nurse Unit Manager
Northside Community Nursing Service
17 Station Road
Northside

Dear Ms Ellis,

Re: Mr Harold Bates, DOB 04/02/1952

I am writing to request daily community nursing from 22 October for Mr Bates, a 74-year-old man being discharged today after treatment for an infected right foot ulcer with cellulitis.

Mr Bates has type 2 diabetes with retinopathy and peripheral neuropathy. As he cannot read his insulin pen and his wife is unable to assist, please administer or supervise his insulin glargine, 14 units at 08:00 daily, and check his blood glucose, aiming for 6–10 mmol/L before meals. Readings below 4 mmol/L should be treated according to the hypoglycaemia protocol, rechecked after 15 minutes and reported to his GP. Please also report readings above 15 mmol/L.

The ulcer under his first metatarsal head measures 1.5 × 1.0 × 0.3 cm and is granulating. Please clean it with 0.9% sodium chloride and apply a non-adherent foam dressing daily, reporting any signs of infection to his GP. He continues cefalexin 500 mg four times daily until 28 October and must wear his offloading shoe when walking.

He will see his GP on 28 October, the high-risk foot clinic on 29 October and the diabetes educator on 4 November.

Yours sincerely,
Registered Nurse
Medical Ward, Lakeside Hospital

Body: 186 words

21 October 2026

Ms Teresa Russo
31 Olive Grove
Riverbend

Dear Ms Russo,

Re: Mr Vincent Russo, DOB 12/12/1946

I am writing, with your father's consent, to advise you how to help him manage his newly diagnosed heart failure at home.

Each morning, please encourage him to weigh himself after using the toilet and before breakfast, using the same scales and similar clothing, and to record the result in a diary. Please telephone our clinic on 5550 1234 if his weight increases by more than 2 kg in two days, if his breathlessness or ankle swelling worsens, or if he needs more pillows to sleep. Outside clinic hours, contact the GP after-hours service. Call an ambulance if he has chest pain, severe breathlessness at rest or faints.

He should have no more than 1.5 litres of fluid daily, including tea, soup and ice cream, and should avoid added salt and processed foods. His fluid tablet is best taken in the morning. He may feel dizzy, so he should stand up slowly. He must also avoid ibuprofen; his GP will advise on gout treatment. Gentle daily walking is encouraged.

He needs a blood test in one week. Please bring his weight diary to the clinic on 3 November.

Yours sincerely,
Heart Failure Nurse
Riverbend Heart Clinic

Body: 188 words

22 October 2026

Ms Eleanor Holroyd
Community Mental Health Nurse
Community Mental Health Service
14 Park Street

Dear Ms Holroyd,

Re: Ms Caroline Gledhill, DOB 14/03/2004

I am referring Ms Gledhill, a 22-year-old law student being discharged today after an intentional paracetamol overdose, for a home visit by 24 October, ongoing support and risk review.

She was admitted on 19 October after taking approximately 30 paracetamol 500 mg tablets with alcohol following an argument with her ex-partner. She completed intravenous acetylcysteine, and her liver function and INR were normal. Psychiatric assessment diagnosed a moderate depressive episode. She regrets the overdose and denies current suicidal intent or plan, although she has intermittent passive thoughts. She self-harmed at 15–16 and binge drinks most weekends.

Sertraline 50 mg each morning was commenced on 21 October. As she is under 25, please monitor for increased agitation or suicidal thoughts, as well as her mood and response to treatment.

A written safety plan has been completed, and she has agreed to avoid alcohol. Her mother will stay for one week and will hold and give her sertraline, and no over-the-counter medicines will be kept at the flat. She has consented to this referral and to information sharing with her mother. Her GP will review her on 29 October.

Yours sincerely,
Registered Nurse
Medical Ward

Body: 187 words

21 October 2026

Dr Anna Lindqvist
Gastroenterologist
Riverside Endoscopy Centre
140 Harbour Road
Northbridge

Dear Dr Lindqvist,

Re: Mr Kevin Doherty, DOB 14/03/1965

I am writing to request urgent assessment and colonoscopy for Mr Doherty, a 61-year-old man with iron-deficiency anaemia and rectal bleeding.

He presented on 8 October with a three-month history of fatigue and breathlessness on stairs and an unintentional 6 kg weight loss over four months. For six weeks he has had looser stools two to three times daily, with occasional dark red blood mixed with the stool. His father was diagnosed with colorectal cancer at 68, and Mr Doherty has never had a colonoscopy.

On examination, he had pale conjunctivae and a heart rate of 92. His abdomen was soft without masses, and rectal examination revealed dark red blood but no palpable mass. Investigations showed haemoglobin 98 g/L, MCV 72 fL and ferritin 6 µg/L, with a positive iFOBT. Coeliac serology and renal and liver function were normal.

He has hypertension treated with perindopril and is allergic to penicillin. I have ceased his ibuprofen and commenced oral iron and regular paracetamol. He is anxious about the possibility of cancer. I will repeat his blood count and ferritin in four weeks.

Thank you for seeing him urgently.

Yours sincerely,
General Practitioner

Body: 187 words

21 October 2026

Dr Raj Menon
Rheumatologist
Westside Specialist Suites
Level 3, 210 Victoria Street
Westside

Dear Dr Menon,

Re: Mrs Rania Haddad, DOB 17/08/1982

I am writing to request urgent assessment and DMARD initiation for Mrs Haddad, a 44-year-old dental hygienist with suspected rheumatoid arthritis.

She presented on 14 October with an 11-week history of symmetrical pain and swelling in her hands and wrists, now also affecting the balls of both feet, with approximately 90 minutes of morning stiffness. Difficulty gripping instruments has caused one week off work. A maternal aunt has rheumatoid arthritis.

Examination revealed bilateral synovitis of the second and third MCP and PIP joints and wrists, with tender MTP joints and a positive squeeze test. Rheumatoid factor was 85 IU/mL, anti-CCP above 300 U/mL, CRP 24 mg/L and ESR 42 mm/hr. X-rays showed periarticular osteopenia without erosions. Blood count, renal and liver function, hepatitis B and C serology and chest X-ray were normal.

She is taking naproxen 500 mg twice daily with esomeprazole, with partial relief. I have not started corticosteroids, pending your review. Relevant to your treatment choice, she plans a second pregnancy within the next year and smokes approximately five cigarettes daily. She also takes turmeric capsules and has no known allergies.

Yours sincerely,
General Practitioner

Body: 183 words

3 November 2026

Dr Heba Makhlouf
Consultant Nephrologist
Renal Outpatient Clinic
26 Clinic Road
SW1A 2AA

Dear Dr Makhlouf,

Re: Mr Riad Shammas, DOB 18/02/1970

I am writing to refer Mr Shammas, a 56-year-old office administrator with chronic kidney disease and unexplained persistent albuminuria, to establish the cause and for advice on further investigations and renal protective treatment.

His eGFR has fallen from 58 in April to 54 in July and 51 mL/min/1.73 m² on 26 October. His urine ACR was 78 mg/mmol in July and 86 mg/mmol on an early-morning sample in October. Microscopy showed no haematuria, and cultures were negative.

He reports three months of foamy urine but has no oedema, dyspnoea, dysuria, visible haematuria, rash, joint symptoms or recent illness. Today his blood pressure was 128/78 mmHg. Ultrasound on 29 October showed normal-sized kidneys without hydronephrosis or cysts and no significant post-void residual. HbA1c was 36 mmol/mol, potassium 4.5 mmol/L and albumin 39 g/L.

He has no known diabetes, hypertension, family history of renal disease or drug allergies. He takes no regular medication and denies using NSAIDs, herbal remedies or bodybuilding supplements.

Serial results and the ultrasound report are enclosed. I will continue monitoring his renal function and blood pressure pending your review.

Yours sincerely,
General Practitioner

Body: 181 words

22 October 2026

Dr Omar Mansour
Specialist Orthodontist
Specialist Orthodontic Practice
Suite 4, 210 Harbour Road

Dear Dr Mansour,

Re: Miss Felicity Pickering, DOB 03/05/2014

I am writing to refer Felicity, a 12-year-old patient here since 2018, for assessment and treatment planning of her increased overjet.

On examination on 16 October 2026, she had an early permanent dentition. She has a Class II division 1 incisor relationship with an overjet of 9 mm, incompetent lips at rest and proclined upper central incisors. Her molars are Class II bilaterally, and her overbite is increased and complete. She has mild lower labial crowding and no crossbites. Her profile is convex with a retrusive mandible. An OPG shows all permanent teeth present, including developing third molars, with no pathology.

On 18 September 2026, a hockey ball fractured the mesio-incisal enamel and dentine of tooth 21. I restored it with composite the same day, and it was asymptomatic with a positive cold test on 16 October. Because of her large overjet, I advised a mouthguard for all contact sport. A custom mouthguard was fitted on 2 October 2026, which she wears for hockey but not netball.

Felicity and her mother are very motivated and understand that treatment may involve appliances and long-term retention. I am sending her photographs and OPG with this letter.

Yours sincerely,
Dr Victoria Greenhalgh
General Dental Practitioner

Body: 194 words

12 November 2026

Dr Lindiwe Khoury
General Dental Practitioner
Family Dental Practice
22 Market Street

Dear Dr Khoury,

Re: Mr Emre Celik, DOB 03/05/1979

I am writing to update you on Mr Celik's emergency treatment today and to request a full periodontal assessment and ongoing management. He is working temporarily here and returns home on 20 November 2026.

He presented with three days of lower right posterior pain and swelling and feverishness since yesterday. His temperature was 38.1°C, and his right submandibular lymph nodes were tender and enlarged. Tooth 46 had a localised fluctuant swelling with pus on probing, an 8 mm distobuccal probing depth and grade I mobility. A radiograph showed vertical bone loss at the distal root of about half the root length. He also has generalised plaque and calculus, widespread bleeding on probing and probing depths of 5–7 mm at several posterior sites.

I diagnosed a periodontal abscess of tooth 46 with systemic signs and drained it. I prescribed amoxicillin 500 mg three times daily for five days and chlorhexidine 0.2% mouthrinse twice daily for one week. His type 2 diabetes is poorly controlled, with an HbA1c of 9.6%, and he smokes 15 cigarettes daily. I will review him on 15 November.

Please perform a full periodontal assessment, provide non-surgical therapy, assess the prognosis of tooth 46 and arrange regular recalls.

Yours sincerely,
Dentist
Public Emergency Dental Clinic

Body: 200 words

10 November 2026

Dr Maricel Fischer
General Practitioner
Main Road Medical Practice
25 Main Road

Dear Dr Fischer,

Re: Mr Dinesh Lealaiauloto, DOB 03/05/1958

I am writing to update you on Mr Lealaiauloto's progress after eight weeks of dietetic care for weight loss with severe COPD, and to ask you to change his supplement prescription.

At his first appointment on 15 September 2026 he weighed 61.2 kg, having lost 12.6% of his usual weight. He ate about two small meals a day because of poor appetite and breathlessness. We introduced food fortification, small frequent meals and two 200 mL supplement drinks daily.

Today he weighs 64.0 kg, a gain of 2.8 kg. His appetite has improved, and he now eats three meals and two to three snacks daily, with his wife continuing fortification. He takes both supplements consistently, and food alone now provides about 85% of his requirements.

Please amend his prescription to one 200 mL drink daily and weigh him monthly at your practice. He will take one drink daily from today until his dietetic review on 8 December 2026, when I will consider stopping it only if his food intake is adequate and his nutritional recovery is sustained. If he loses weight or has a COPD exacerbation, please restart two drinks daily and refer him back to me.

Yours sincerely,
Dietitian
Outpatient Dietetics Department

Body: 196 words

22 October 2026

Ms Thandiwe Nikolaidis
Dietitian
Antenatal Clinic
Maternity Outpatients Department
40 Riverside Road
Brisbane QLD 4000

Dear Ms Nikolaidis,

Re: Ms Hana Pappas, DOB 03/05/1997

I am referring Ms Pappas, who moves to Brisbane on 31 October 2026, and I ask you to continue her dietary management and review her blood glucose levels.

She is 29 years old and 28 weeks pregnant today, with an expected delivery date of 14 January 2027. Her 75 g glucose tolerance test at 26 weeks gave a fasting level of 5.4, one-hour level of 10.4 and two-hour level of 8.1 mmol/L, confirming gestational diabetes, which is diet-controlled. She is lacto-ovo vegetarian. I saw her on 9, 16 and 22 October 2026 and advised three small meals and three snacks daily, evenly spread carbohydrate and protein at each meal. Her post-breakfast levels are now within target.

She tests four times daily. Over the last seven days her post-meal levels were 6.1–7.2 mmol/L, all within target. However, her fasting levels were 5.2–5.6 mmol/L on four days, above the target of 5.0 mmol/L or less, despite a supper snack. She is anxious about possibly needing insulin. A review on 24 October will consider metformin or insulin.

Please see her within one week of arrival. She has a copy of her glucose and food diary.

Yours sincerely,
Dietitian
Antenatal Clinic, Melbourne

Body: 192 words

23 October 2026

Ms Fang Bitar
Community Occupational Therapist
Community Occupational Therapy Service
Community Health Centre
42 High Street

Dear Ms Bitar,

Re: Mrs Lucia Paredes, DOB 14/03/1945

I am writing to refer Mrs Paredes, an 81-year-old widow who lives alone and is being discharged home today, and to request a home visit within one week for a home assessment, installation of rails and a review of her daily living skills.

She fell at about 02:00 on 19 October 2026 after tripping on a loose bath mat in the dark on the way to the toilet, sustaining an undisplaced right distal radius fracture. She is right-handed and has a below-elbow cast for six weeks. She cannot manage buttons, cut food or open jars, but she prepares simple meals with adapted cutlery.

Her shower is over the bath, and she cannot step over the edge safely, so she will wash seated at the basin until a bath board or rails are fitted. Her toilet is low with nothing to hold, so I supplied a toilet frame with a raised seat, which she used safely on the ward. Please assess for grab rails in the bathroom and toilet and a rail at her front steps, and consider a bath board and night lighting.

A carer will visit each morning from 24 October.

Yours sincerely,
Occupational Therapist
Orthopaedic Ward

Body: 192 words

23 October 2026

Dr Vikram Srivastava
General Practitioner
The Medical Centre
42 High Street

Dear Dr Srivastava,

Re: Mrs Lakshmi Bukhari, DOB 14/03/1968

I am writing to update you on the outcome of Mrs Bukhari's occupational therapy and to ask you to review her medical management, as she now has signs of a rheumatoid arthritis flare.

She completed six sessions between 26 August and 21 October 2026. She applies joint protection and energy conservation principles at work, wears custom resting splints most nights and uses adapted tools. She can now complete a cut and blow-dry without a rest break, whereas she previously needed two. She rates her work performance 7 out of 10, up from 4.

However, on 21 October 2026 her morning stiffness had increased over four weeks, from about 20 minutes to about 90 minutes. She has swelling and tenderness in both wrists and the second and third metacarpophalangeal joints, worse on the right, with warmth over the right wrist. Her end-of-day pain is 6 out of 10, previously 3. She reports more fatigue, no fever, no missed methotrexate doses and ibuprofen use most days for three weeks. She cannot start clients before 10:00.

Please review her medical management and consider requesting an earlier rheumatology review, as her next appointment is in February.

Yours sincerely,
Occupational Therapist
Outpatient Hand Therapy Clinic

Body: 192 words

22 October 2026

Dr Nomsa Aitken
Consultant Ophthalmologist
Eye Surgery Clinic
22 Market Street

Dear Dr Aitken,

Re: Mr Dean Lockyer, DOB 14/03/1963

I am writing to refer Mr Lockyer, a 63-year-old carpenter, for routine assessment for left cataract surgery. He is keen to proceed and has private health insurance.

He reports gradual left vision loss over 12 months, with glare and difficulty reading a tape measure. He has turned down two jobs in the past three months and now avoids driving at night.

Two years ago his best corrected visual acuity was 6/6 on the right and 6/9 on the left. Today it is 6/6 and 6/24, with no pinhole improvement on the left. Refraction shows a left myopic shift of approximately −1.50 D, while the right is stable. Slit lamp examination shows a dense nuclear cataract on the left and mild nuclear sclerosis on the right. Intraocular pressures are 15 and 16 mmHg. Both pupils dilated poorly with tropicamide, so the left fundus view was hazy, with no retinopathy seen and the macula not clearly visualised. The right fundus is normal.

He takes tamsulosin 400 microg daily and has type 2 diabetes and hypertension. I have not prescribed spectacles, and I will review his right eye in 12 months. His GP will receive a copy.

Yours sincerely,
Optometrist
Private Practice

Body: 194 words

22 October 2026

Dr Suresh Trivedi
General Practitioner
45 King Street

Dear Dr Trivedi,

Re: Mrs Orla Bhatia, DOB 14/03/1977

I am writing to update you on Mrs Bhatia's diabetic eye examination today, which showed new mild non-proliferative diabetic retinopathy in both eyes, and to recommend a review of her glycaemic and blood pressure management.

Her last examination in October 2025 showed no retinopathy. Dilated fundus examination today shows scattered microaneurysms only, with no retinal haemorrhages, and OCT shows no macular oedema or maculopathy in either eye. Visual acuity with her spectacles is 6/6 in each eye. A copy of her retinal photographs is available for you.

She has had occasional blurred distance vision for two months, which varies from day to day. This is likely to be fluctuating refraction from hyperglycaemia rather than retinopathy, so I have not prescribed new spectacles. Her home blood glucose readings are often in the teens, and she admits that her control is poor. She is unsure of her latest HbA1c and has missed her last two appointments with you.

I advised her to report any sudden loss of vision, new floaters or distortion promptly. I will review her in 12 months, or sooner if symptoms develop. She intends to book an appointment with you this week.

Yours sincerely,
Optometrist
Community Optometry Practice

Body: 193 words

22 October 2026

Dr Mette Schreiber
General Practitioner
The Medical Centre
45 Main Street

Dear Dr Schreiber,

Re: Mr Rodrigo Vargas, DOB 14/03/1992

I am writing to update you on Mr Vargas's asthma medication use, symptoms and inhaler technique, and to request an expedited review as soon as possible rather than a routine appointment.

He stopped his fluticasone propionate 125 microg preventer about two months ago when it ran out, because he felt fine and feared steroids cause weight gain. It was last dispensed on 20 June 2026. Six salbutamol inhalers were dispensed between 22 July and 20 October, and he uses his reliever most days, including before football. Over the past four weeks he has woken with cough and wheeze three to four nights a week. He has had no emergency department visits and has no written asthma action plan.

His technique was poor: he did not shake the inhaler, finished inhaling before actuating, did not hold his breath and used no spacer. I explained preventer and reliever use, addressed his concerns, supplied a spacer and dispensed his fluticasone today. He then demonstrated correct technique.

Please review his asthma control and treatment and provide a written asthma action plan. He has booked a routine appointment with you on 28 October, which he should keep as a follow-up.

Yours sincerely,
Pharmacist
Community Pharmacy

Body: 195 words

23 October 2026

Mr Prakash Raghavan
Principal
Primary School Office
45 Railway Parade

Dear Mr Raghavan,

Re: Huong Huynh, DOB 14/03/2019

Thank you for your letter of 19 October 2026. With her mother's consent, I am replying with advice on how staff should store and use Huong's adrenaline autoinjector.

Please store the device at room temperature, below 25°C, and do not refrigerate it. Keep it away from heat and direct sunlight. Keep it with her Action Plan in a labelled, unlocked, easily accessible place known to all staff, and send it with her on excursions, sport and camps. Please check monthly that it has not expired and that the viewing window solution is clear. If not, ask her mother for a replacement.

If Huong shows any sign of anaphylaxis, such as difficult or noisy breathing, a swollen tongue or collapse, give the autoinjector immediately, even if you are in doubt. Lay her flat and do not let her stand. Pull off the blue safety release, place the orange end against her outer mid-thigh and push down hard until it clicks. Hold it in place for 3 seconds. Then call an ambulance on 000 and phone her mother.

I recommend that all staff complete the free ASCIA online anaphylaxis training. I can visit the school to demonstrate the device if you wish.

Yours sincerely,
Pharmacist
Community Pharmacy

Body: 200 words

22 October 2026

Dr Arun Juneja
General Practitioner
General Practice
42 Park Road

Dear Dr Juneja,

Re: Mrs Jocelyn Sethi, DOB 14/03/1971

I am writing to update you on Mrs Sethi's progress with physiotherapy for her right frozen shoulder and to ask you to consider further management.

Mrs Sethi attended eight weekly sessions between 3 September and 22 October 2026, which included education, gentle range-of-motion exercises and a home exercise program that she has followed twice daily. Her passive external rotation improved from 10° to 20° during the first four weeks, but it has not improved further in the last four weeks. Her passive range on the right is now flexion 100° (left 170°), abduction 80° (left 165°) and external rotation 20° (left 70°). Night pain remains 7/10, she wakes three to four times each night, and she has difficulty dressing and reaching overhead. Paracetamol gives limited relief, and ibuprofen was stopped in September because of indigestion.

I would be grateful if you would consider an intra-articular corticosteroid injection for pain relief, and she is willing. Because she has type 2 diabetes, she will monitor her blood glucose closely after any injection. Alternatively, or if there is no improvement, please consider referral to an orthopaedic shoulder clinic. Meanwhile, I will continue physiotherapy fortnightly, with her next appointment on 5 November 2026.

Yours sincerely,
Physiotherapist
Outpatient Physiotherapy Clinic

Body: 199 words

21 October 2026

Ms Morag Sinclair
Sports Physiotherapist
Sports and Exercise Physiotherapy
Level 1, 88 River Road
Toowong QLD 4066

Dear Ms Sinclair,

Re: Ms Natalie Mellor, DOB 03/08/1992

I am writing to refer Ms Mellor, who moves to Brisbane on 1 November 2026, so that you can continue her staged rehabilitation after right ACL reconstruction.

She underwent reconstruction with a hamstring autograft and partial lateral meniscectomy on 15 July 2026. At 14 weeks after surgery, she has no effusion, pain of 0–1/10 after exercise, full extension and flexion of 135° (left 145°). Quadriceps strength is 72% of the left and hamstring strength is 78%, and she has mild dynamic knee valgus on single-leg squat. She has jogged in a straight line since 12 weeks, but further running and impact progression are paused pending readiness reassessment.

Please first improve quadriceps and hamstring strength and valgus control, then reassess her readiness before graded running or further jumping. Staged single-leg plyometrics and agility work should follow only when appropriate criteria are met. A return to netball is not planned before nine months after surgery (mid-April 2027), and it depends on individual sports-team clearance after hop testing and a clinician-reviewed ACL-RSI. She understands that she will miss the start of the March season. Her new address is Unit 5, 30 Park Road, Milton. The operation report and strength test results are enclosed.

Yours sincerely,
Sports Physiotherapist
Outpatient Sports Physiotherapy Clinic, Melbourne

Body: 200 words

22 October 2026

Mr Kofi Wishart
Senior Podiatrist
Podiatry Department
Community Health Centre
40 Ocean Road

Dear Mr Wishart,

Re: Mrs Carys Menzies, DOB 03/05/1965

I am writing to refer Mrs Menzies, who has been my patient since 2021 and moves interstate on 14 November 2026 to Unit 5, 28 Harbour Street, for ongoing callus care, orthosis review and footwear advice.

Mrs Menzies has seropositive rheumatoid arthritis and takes methotrexate and hydroxychloroquine, so she is immunosuppressed. On 15 October 2026 she had bilateral hallux valgus, subluxed second to fourth metatarsophalangeal joints and clawed lesser toes, with painful plantar callus under the second and third metatarsal heads, right worse than left. A superficial ulcer under the right second metatarsal head healed with offloading and has not recurred. Her pulses, protective sensation and skin are intact, and she is allergic to zinc oxide adhesive tape.

Scalpel debridement every six weeks reduces her pain from 6/10 to 2/10, and the next is due in late November. Her custom orthoses, issued in April 2025, have compressed cushioning and worn top covers, although the domes remain correctly positioned, so they need re-covering or replacement. Slip-on flats recently increased her forefoot pain. I have advised her to report any skin break, heat, swelling or discharge promptly and to avoid medicated corn plasters. A copy of the orthosis prescription is enclosed.

Yours sincerely,
Podiatrist
Private Podiatry Practice

Body: 199 words

22 October 2026

Dr William Maalouf
General Practitioner
High Street Medical Centre
28 High Street

Dear Dr Maalouf,

Re: Mrs Haruka Seo, DOB 14/03/1948

Thank you for referring Mrs Seo, whom I assessed this morning after her two falls in the last three months. I am writing to update you on my findings and treatment and to request a review of possible postural hypotension and her medication.

Both falls occurred on standing, once from an armchair and once from bed at night, and she felt light-headed just before each fall. She reports that her dizziness on standing has increased since furosemide was started six weeks ago. She also takes perindopril for hypertension.

Protective sensation is reduced in both feet, but her pulses are palpable and her skin is intact. She has clawed second and third toes with painful corns, causing pain of 6/10 on walking. She wears worn backless slippers indoors all day, and her gait is slow and shuffling. I debrided the corns, which reduced her pain to 1/10, fitted silicone toe protectors and advised enclosed, well-fitting shoes and daily foot checks. I also advised her to rise slowly and referred her to the community falls prevention physiotherapy program, and I will review her in six weeks.

Please review her for postural hypotension and her medication, particularly the recent furosemide.

Yours sincerely,
Podiatrist
Community Podiatry Clinic

Body: 197 words

23 October 2026

Ms Jing Perera
Unit 3
27 Banksia Avenue

Dear Ms Perera,

Re: Benedict Herath, DOB 14/03/2020

Thank you for your letter of 19 October 2026 about Benedict's X-rays. I will explain why each was needed, what the radiation dose means and how we keep it low.

Benedict broke both bones of his left forearm on 25 August 2026. The first X-ray, that day, confirmed the break and showed the bones out of position. The second, after the doctors straightened them, checked that they were in a good position. The third, on 1 September, checked that the position had held in the cast, because straightened breaks can slip in the first weeks. The fourth, on 6 October, showed healing good enough for the cast to be removed. No images were repeated.

A forearm X-ray uses a very low radiation dose. The forearm is far from the organs most sensitive to radiation, so the risk to Benedict is extremely small, and each X-ray's benefit far outweighs it. Children are more sensitive, so we take extra care, using low child settings, limiting the beam to the forearm and using modern digital equipment. No further X-rays are planned unless new symptoms appear, and he should not avoid future X-rays, including dental ones, when a doctor or dentist recommends them.

Yours sincerely,
Joanne Ashby
Senior Radiographer, Medical Imaging Department

Body: 199 words

22 October 2026

Dr Jodie Westerman
General Practitioner
Family Medical Practice
12 Main Street

Dear Dr Westerman,

Re: Mrs Mele Uddin, DOB 11/06/1979

Thank you for your letter of 20 October 2026. I am writing to describe the reaction Mrs Uddin had during her contrast CT of the abdomen and pelvis on 15 October 2026, the treatment given and our recommendations.

About five minutes after injection of iohexol (Omnipaque 350), she developed itch, facial flushing, widespread urticaria on the trunk and arms, and swelling of both eyelids. She had no wheeze, stridor or throat tightness, and her oxygen saturation was 98%. The radiologist, Dr Nitin Wadhwa, graded this as a moderate allergic-like reaction and directed intravenous antihistamine treatment. Adrenaline was not required. The symptoms had resolved by 12:15, and she was discharged at 16:30 without recurrence. On 16 October she reported no delayed reaction.

Please record an allergic-like reaction to iohexol in her record and My Health Record, and state it on all future imaging requests. Please consider non-contrast alternatives where appropriate. If iodinated contrast is essential, radiologist review beforehand, a different agent and a site with resuscitation facilities are advised. Her asthma and atopy increase her risk. Shellfish and iodinated contrast have no specific cross-reactivity, so no additional seafood restriction is needed, although she must still avoid prawns.

Yours sincerely,
Senior Radiographer
Medical Imaging Department

Body: 196 words

20 November 2026

Ms Rebecca Alavi
Senior Paediatric Speech Pathologist
Children's Community Health Service
40 Wharf Street
Brisbane QLD 4000

Dear Ms Alavi,

Re: Toby Javadi, DOB 18/09/2021

I am writing to ask you to continue speech pathology therapy for Toby, aged 5 years 2 months, who has developmental language disorder and moves to 27 Riverside Parade, Brisbane on 12 December 2026. His last session with me is on 4 December 2026.

Toby was assessed in May 2026. His CELF-P3 core language score was well below average, with receptive and expressive language both affected, expressive more than receptive. His speech sounds are age-appropriate. Since May he has attended weekly 45-minute sessions with his mother, using recasting, focused stimulation, visual sentence frames and word mapping. He now uses 'is' plus verb-ing about 80% of the time in structured play, and he uses he and she consistently in structured tasks but is only emerging in conversation. Regular past tense -ed is at about 40%. He now names categories and uses 'thing' less.

Please continue work on past tense -ed and pronouns in conversation, and introduce following multi-step instructions and narrative skills before he starts Prep in late January 2027. Formal reassessment is due in May 2027. I recommend liaison with his new school about classroom supports such as visual instructions. His mother consents to sharing reports, which are enclosed.

Yours sincerely,
Paediatric Speech Pathologist
Community Health Service, Melbourne

Body: 199 words

22 October 2026

Dr Rahul Fordyce
General Practitioner
Family Medical Practice
22 Main Street

Dear Dr Fordyce,

Re: Mrs Isla Farquhar, DOB 03/05/1947

I am writing to update you on the results of Mrs Farquhar's videofluoroscopic swallow study on 20 October 2026 and to ask you to review her medications urgently with a pharmacist.

The study showed silent aspiration of thin fluids, with delayed swallow initiation. There was no aspiration with mildly thick fluids, and her current soft, bite-sized diet needs no change. A barium test tablet was held in her throat and cleared only after several swallows. All fluids should now be mildly thick (IDDSI Level 2), and her daughter has been trained to prepare them. She should sit fully upright for food, fluids and medications and for at least 30 minutes afterwards, take single small sips without straws, and clean her mouth and dentures twice daily.

Please review metformin, the calcium and vitamin D tablet and the slow-release potassium chloride, which must not be crushed, and consider smaller or alternative forms. Any new form must suit her swallow. I phoned your practice and her community pharmacist today, because a medication-specific plan is needed before further doses of large tablets. Please also monitor her chest and hydration. I will review her at home in four weeks.

Yours sincerely,
Speech Pathologist
Outpatient Speech Pathology Department

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25 October 2026

Dr Wayne Aziz
Veterinary Surgeon
Family Veterinary Practice
5 Market Street

Dear Dr Aziz,

Re: Pepper, Cocker Spaniel, owner Ms Brooke Nassar, 22 Hill Road

I am writing to update you on Pepper, a three-year-old spayed female Cocker Spaniel, who is being discharged this morning after eating grapes, and to ask you to repeat her kidney blood tests.

Pepper was admitted on 22 October 2026 after eating an estimated 300–400 g of red grapes about one hour earlier. She was bright and alert, with normal vital signs, and baseline creatinine, urea and phosphate were normal. We induced emesis with intravenous apomorphine and recovered a large quantity of grape material, then gave a single oral dose of activated charcoal. She received intravenous Hartmann's fluids for 48 hours. Creatinine and urea were normal at 24 and 48 hours, her urine output was normal, and she is eating well.

She is bright and needs no medication. Please repeat creatinine and urea, with urine specific gravity if possible, about 72 hours after ingestion, which is the evening of 25 October. A further check on 27 October may be needed. Ms Nassar has been advised to avoid grapes, raisins, sultanas and currants strictly, to limit her to light exercise until the blood tests are repeated, and to return immediately if she vomits or becomes lethargic. Results are attached.

Yours sincerely,
Attending Veterinarian
Out-of-Hours Emergency Veterinary Clinic

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22 October 2026

Dr Ramesh Talukder
Veterinary Ophthalmologist
Veterinary Eye Referral Service
48 Bridge Street

Dear Dr Talukder,

Re: Bruno, Pug, owner Ms Achieng Sokolova

Thank you for seeing Bruno, a four-year-old neutered male Pug, at 15:00 today. I am referring him for urgent assessment and possible surgical management, such as a conjunctival graft, of a deteriorating right corneal ulcer.

Bruno presented on 12 October 2026 with blepharospasm and epiphora in the right eye, and a superficial central ulcer of about 3 mm without stromal loss. His owner suspects a cat swipe on 11 October. By 20 October the ulcer measured about 5 mm with stromal loss of about one third depth, and cytology showed rod-shaped bacteria and neutrophils. Today the ulcer is about 6 mm and about half depth, with soft, grey, gelatinous stroma, marked corneal oedema, miosis and increased pain. The Seidel test is negative, and no descemetocele is seen. Culture grew Pseudomonas aeruginosa, sensitive to ofloxacin. His left eye is normal.

He is receiving ofloxacin every two hours day and night, as agreed with you by phone, autologous serum drops every two hours since today, atropine and meloxicam once daily, and a collar at all times. His last meloxicam was at 08:00, and he is fasted. Ms Sokolova will bring all eye medications, and the cytology and culture reports are enclosed.

Yours sincerely,
Veterinarian
General Veterinary Practice

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