Writing Task 1 and 2

Mr. Bill Allan Surgical Outpatient Clinic Newton Hospital

Date: 22/02/2008

Dear Dr.

Re: Mrs. Cynthia Attard

I am writing to refer my patient Mrs. Cynthia Attard to you. She is 47 years old, a mother of two, diagnoses case of varicose vein whom I believe is suffering from varicose vein with superimposed acute thrombophlebitis.

Initially she presented on 24/02/2008 with gradually worsening pain and swelling of both lower limbs, specially during walking. After her pregnancies she noticed few areas of redness over the varicosities infrequently. Examination revealed multiple varicose veins, unhealthy skin and positive cough impulse in both iliac fossae. She was advised to use support stocking and discussed about possible future surgery if condition further deteriorate.

Mrs. Attard again visited on 20/02/2008 in a distressed condition, complaining of increased in severity of pain in right lower legs for two days and analgesics were not helpful. Examination showed that her temperature was 38.2C, Pulse 100bpm and BP 135/85. Veins of the right calf were infected up-to knee and no new change in left leg. So I prescribed her Flucloxacillin (500mg) for 10 days, Panadeine Forte and to review after 48 hours or earlier depending on her conditions. On 22/02/2008 her condition was improved, examination revealed no abnormality and redness over the infected area was also reduced.

According to the discussion with Mrs. Attard I am referring her to you for surgical removal of varicose vein to prevent possible future attacks.

Thank you for your ongoing assessment and management of this woman. Please do not hesitate to contact me if you require any further information.

Yours Sincerely

Dr. Rumana Ali Anee General Practitioner

Neurologist Emergency Department Royal Adelaide Hospital

Date: 29/09/2007

Dear Dr. Re: Mr. George Whitecroft

I am writing to refer my patient 22 years old Mr. Whitecroft, to you. I believe he has some intracranial pathology.

Mr. Whitecroft initially presented on 13/09/2009 with six hours history of severe frontal headache, nausea and blurring of vision. He had no photophobia, neck stiffness and had no significant past or family history. Nothing abnormality was detected and I advised him to took paracetamol 4 hourly.

He again came to me on 26-09-2007 with distressing left sided throbbing frontal headache associated with blurring of vision, three times vomiting and right sided paraesthesia. Examination showed that pulse 110bpm, BP 155/95 and no neurological abnormality. A stat dose of pethidine and maxlon injection was given and advised to review after 24 hours if there was no improvement.

On 29-09-2007 after three hours of distressing headache he was found in a collapsed state on urgent home visit, complaining of weakness in right arm and leg, impaired level of consciousness and slurring of speech. On examination pulse 100 bpm, BP 155/90, increased knee jerk on the right knee and reflexes were normal.

I believe he has been suffering from intracranial space occupying lesion and needs emergency hospital admission. I would appreciate your assessment and management of this young man.

Please do not hesitate to contact me if you require any further information.

Yours sincerely

Dr. Rumana Ali Anee General Practitioner