OET Writing practice · Medicine
Crohn's disease flare managed in primary care – gastroenterologist
An original practice task written by LetterScore AI. Read the case notes in 5 minutes, then write your update 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: 03/09/2026 You are a GP at Harbourside Surgery, 41 Pier Street, Northgate. Patient: Mrs Fatima Al-Sayed, DOB 07/09/1991 (34 yrs) Social background: - Primary school teacher (returned from summer holidays 01/09) - Married, no children. Planning pregnancy next year - Smokes 5 cigarettes/day. Alcohol rarely - Sister's wedding abroad 20/09 – pt very keen to travel Medical history: - Ileocolonic Crohn's disease, dx 2019; under Dr Achterberg, Northgate Hospital IBD Service - Flare Nov 2025 → prednisolone course (hospital-prescribed) - Last IBD clinic 03/2026: clinical remission, faecal calprotectin 80 µg/g - Hay fever - Cervical screening due 10/2026 Medications: - Azathioprine 125 mg daily (since 2020) - Cetirizine 10 mg PRN - Allergy: NKDA Consultation notes: 13/08/2026 - 3 weeks: diarrhoea 6–7/day, occasional blood, crampy RIF pain, fatigue. No fever, no vomiting, no perianal symptoms - Took ibuprofen 400 mg TDS × 5 days (July) for toothache; amoxicillin prescribed by dentist - O/E: T 37.2°C, HR 94, BP 116/72. Tender RIF, no mass. Wt 60 kg (03/2026: 62 kg) - Ix: stool culture and C. difficile toxin negative. Faecal calprotectin 640 µg/g. CRP 38 mg/L, Hb 112 g/L, WCC 7.2 ×10^9/L, neutrophils 4.8, platelets 410, albumin 34 g/L, LFTs normal - Discussed with IBD nurse by phone: agreed GP management - Prednisolone 40 mg daily, reducing by 5 mg weekly (8-week course); calcium and vitamin D (Adcal-D3) BD; omeprazole 20 mg daily - Advised to avoid NSAIDs; smoking cessation advice given 20/08/2026 - Improving: stools 4/day, no blood, mild pain. Tolerating steroids; poor sleep - Hay fever symptoms – cetirizine 03/09/2026 - Prednisolone now 30 mg daily. Stools 2–3/day, formed, no blood. Pain resolved - CRP 9 mg/L, Hb 118 g/L, WCC 8.1, albumin 37 g/L. Wt 59.5 kg - BP 124/78. Glucose (random) 6.8 mmol/L - Cut down to 2 cigarettes/day; referred to stop-smoking service - Asks whether azathioprine is safe in pregnancy and whether second steroid course means "treatment not working" Plan: - Continue steroid taper (finish 08/10/2026) - Letter to IBD consultant: 2nd steroid course in 10 months – ?need for treatment escalation; please advise re pregnancy planning - Repeat calprotectin after steroid course - GP review 4 weeks - Travel: fit to attend wedding; carry steroid card Writing Task: Using the information in the case notes, write a letter to Dr Benjamin Achterberg, Consultant Gastroenterologist, IBD Service, Northgate Hospital, 90 Crescent Road, Northgate, who already manages Mrs Al-Sayed's Crohn's disease, to update him on her recent flare and request his advice. 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 update letter
- The reader already knows the patient. Open with what has changed since they last saw them and why you are writing now.
- Report the new findings and current management briefly, then state clearly what you need from the reader.
- Do not repeat background the reader already has.
Members also get the model answer, the note-selection table and task-specific tips for this task.