OET Writing practice · Medicine
Discharge after alcohol-related acute pancreatitis – GP
An original practice task written by LetterScore AI. Read the case notes in 5 minutes, then write your discharge letter in 40 minutes, about 180–200 words in the body.
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Case notes
MEDICINE — WRITING TASK (practice) Time allowed: Reading time 5 minutes, Writing time 40 minutes Read the case notes below and complete the writing task which follows. Notes: Today's date: 14/07/2026 You are a surgical registrar on Ward 7 (General Surgery), Ashby Royal Infirmary, Ashby. Patient: Mr Dmitri Volkov, DOB 11/11/1979 (46 yrs) Admission date: 05/07/2026 Discharge date: 14/07/2026 Social background: - Head chef in hotel restaurant, evening shifts, high work stress - Married, 2 children (12 and 9). Wife supportive, attended ward meeting - Alcohol approx. 60–70 units/week (vodka and beer) for 5+ years; drinks after shifts - Smoker, 15 cigarettes/day Medical history: - Gastro-oesophageal reflux, omeprazole 20 mg daily - Ingrown toenail L great toe, surgically treated 2024 - No previous pancreatitis. NKDA Clinical notes: 05/07 ED: 12 hrs severe epigastric pain radiating to back, vomiting × 6. Last alcohol 04/07 evening (heavy drinking weekend). O/E: T 37.9°C, HR 112, BP 138/86, RR 20, SpO2 96% on air. Epigastric tenderness and guarding. No jaundice. Ix: lipase 2,340 U/L (<60), CRP 36 mg/L, WCC 14.2 ×10^9/L, glucose 9.8 mmol/L, calcium 2.31 mmol/L (normal), triglycerides 2.1 mmol/L, ALT 88 U/L, GGT 412 U/L, bilirubin 18 µmol/L. Glasgow score 1. US abdomen: no gallstones, normal bile duct; fatty liver. Tx: IV fluids, IV paracetamol and morphine PCA, antiemetics, nil by mouth, IV thiamine (Pabrinex). 06/07 CIWA-Ar score 16: tremor, sweating, anxiety. Chlordiazepoxide reducing regime commenced. 08/07 CRP 188 mg/L. CT pancreas: acute oedematous pancreatitis, no necrosis or collections. 09/07 Pain improving; light diet tolerated. Morphine stopped. 10/07 Chlordiazepoxide course completed; no withdrawal symptoms since. 11/07 Alcohol liaison nurse review: AUDIT score 27. Pt motivated to stop drinking completely; referred to Ashby Community Alcohol Team (appointment 21/07/2026). Nicotine patch started. 12/07 CRP 42 mg/L. Glucose 5.4–7.2 mmol/L. HbA1c 45 mmol/mol. 13/07 Pt asks about returning to work; advised 2 weeks off. Mild L knee pain after slipping in bathroom; examination normal, no treatment needed. Medications on discharge: - Thiamine 100 mg TDS - Vitamin B compound strong 1 tablet TDS - Nicotine patch 21 mg/24 hrs - Omeprazole 20 mg daily (unchanged) - Paracetamol 1 g QID PRN - No benzodiazepines prescribed Plan: - Complete abstinence from alcohol; community alcohol team 21/07 - GP: repeat LFTs in 4 weeks; repeat HbA1c in 3 months - GP to support abstinence and smoking cessation; avoid further benzodiazepine prescribing - Surgical outpatient clinic in 6 weeks - Return if severe abdominal pain, vomiting or jaundice - Sick note for 2 weeks provided Writing Task: Using the information in the case notes, write a letter to Dr Priya Nair, General Practitioner, Elmwood Health Centre, 3 Cotton Lane, Ashby, who will be responsible for Mr Volkov's care after discharge. 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.
How to approach this discharge letter
- The reader takes over care after discharge. Open with who the patient is, why they were in hospital and that they are going home, then say what you need the reader to do.
- Give the current condition, medication changes and the follow-up plan. Summarise the hospital stay instead of retelling it day by day.
- Leave out resolved problems and background that does not change care at home.
Members also get the model answer, the note-selection table and task-specific tips for this task.