OET Nursing Writing Task-2 - Referral Letter for Crohn’s Disease

Sep 4, 2026

OET Nursing Writing Task 2 requires drafting an urgent referral letter to a gastroenterologist for Mrs Briana Curran. The case outlines worsening abdominal cramps, bloating, alternating diarrhoea and constipation, and new red-flag symptoms including rectal bleeding, fever, and night sweats, alongside weight loss and fatigue. Stool testing shows occult blood and elevated calprotectin, with raised CRP, and clinical findings suggest possible Crohn’s disease. The letter communicates history, current medications, examination context, and requests assessment and colonoscopy.

LanguageEnglish

CategoryExam

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Writing Task 2 - Urgent Referral Letter

Case Notes

Writing the Referral Letter

OET NURSING: WRITING TASK-2 Read the case notes below and complete the writing task which follows: Notes: You are a charge nurse in a suburban clinic. Mrs Curran is a new patient in your clinic. PATIENT DETAILS: Name: Mrs Briana Curran DOB: 15/03/1965 (age 58) Social background: Single, lives alone Works as a business analyst Sedentary lifestyle, rarely exercises Smokes occasionally, drinks moderately Family history: Mother has Crohn’s disease Father has hypertension Medical background: Recurrent urinary tract infections 2019: diagnosed with irritable bowel syndrome (IBS) Mild anxiety and insomnia Medication: 2019: started antispasmodic (mebeverine) 2020: started low-dose antidepressant (amitriptyline) 01.07.23 Discussion: Abdominal cramps and bloating – worsened over past 6 months Pt reports frequent episodes of diarrhoea and constipation Pt also complains of mouth ulcers Objective exam: Full exam performed: No positive findings Wt: 58kg Budesonide 9 mg/day for 8wks Ordered stool test and CRP test Review 3 wks 22.07.23 No improvement in abdominal symptoms Pt’s main concern is now weight loss and constant fatigue Wt ↓4kg since last appointment (now 54kg) New symptoms: rectal bleeding, fever, night sweats Abdomen tender and swollen on palpation Bowel sounds increased Pathology report: Stool test positive for occult blood and calprotectin CRP 25 mg/L (high) Discussion: Discussion of examination findings and stool results with Pt Assessment: ?Crohn’s disease – patient aware of possibility Plan: Urgent referral to gastroenterologist for assessment and colonoscopy Writing Task: Using the information given in the case notes, write a letter of referral to Dr Jones, a gastroenterologist at Royal Oak Hospital, for assessment of Mrs Curran. Address the letter to Dr Laura Jones, Gastroenterologist, Royal Oak Hospital, 123 Oak Street, London, SW1A 1AA, UK. SAMPLE LETTER Dr Laura Jones Gastroenterologist Royal Oak Hospital 123 Oak Street London SW1A 1AA UK 22.07.2023 Dear Dr Jones, Re: Mrs Briana Curran DOB: 15.03.1965 I am writing to request your urgent attention for Mrs Curran, who presents with signs and symptoms suggestive of Crohn’s disease. Mrs Curran has also lost 4kg in weight over the last three weeks and has persistent fatigue. Her abdomen is tender and distended on palpation, with increased bowel sounds. Her stool test was positive for occult blood and calprotectin, and her CRP was 25 mg/L (elevated) . Mrs Curran initially presented to clinic on 01.07.2023 with a six-month history of abdominal cramps and bloating, and frequent episodes of diarrhoea, constipation and mouth ulcers. She was prescribed budesonide 9 mg for 8 weeks and asked to return in three weeks. Today she reports having developed rectal bleeding, fever and night sweats. Her abdominal symptoms have not improved. Notably, Mrs Curran has a positive family history of Crohn’s disease in her mother. She was diagnosed with irritable bowel syndrome in 2019 and is taking mebeverine as an antispasmodic. She leads a sedentary lifestyle, smokes occasionally and drinks moderately. I would be grateful if you could see Mrs Curran at your earliest convenience for an assessment and colonoscopy as I am concerned about the possibility of Crohn’s disease. I have discussed this possibility with Mrs Curran. Please do not hesitate to contact me if you have any queries. Yours sincerely, Charge Nurse

FAQs

How does the timeline of events described in the case influence the referral urgency?

Symptoms began around 6 months before 01.07.2023, treatment with budesonide started in July, and despite follow-up there is no improvement by 22.07.2023, followed by rapid deterioration with weight loss and systemic symptoms—prompting urgent referral.

Sep 4, 2026

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