Listening Part A

Michael Fraser Listening Sub-Test: Part A

In this part of the test, you will hear Doctor Jean Mathews interviewing Michael Fraser a patient with a recent problem. While listening, make notes on your answer sheet about the consultation under the headings given. Give as much information as you can. There will be a short space between each question and you will hear the interview once only Do not write full sentences, use note form. You now have one minute to read through the headings.

1. Reason for Presenting _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________

2. Personal Details _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________

Family History _____________________________________________________ _____________________________________________________ _____________________________________________________

3. Examination
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Listening Part A

Observations _____________________________________________________ _____________________________________________________ Diagnosis _____________________________________________________ Possible causes _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________

Precautions taken by patient

Tests 4. Prognosis & Management

Preventing infection of family _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________

Doctors advice regarding Michaels work situation

5. Tests/results and other relevant advice ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________

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Listening Part A

Now check your results and add up your score with on the answer sheet. Your Score________ To pass the listening test you need to get at least 65%, so for this exam you need to get at least 28/43.
1. Michael Fraser Answer Sheet Note: Underlined words are necessary you will receive 1 mark for each correct answer Reason for presenting Not feeling well Fever Nauseous No medication Not hungry/unable to complete meals Vomited twice Tired/ pains in joints Wife noticed yellowish ski colour Urine darker Personal Details 38 married 2 children carpenter/ works on building sites worked in east Timor/ Nuigini Fine/ No complaints Smoker (10 per day) Drinks in moderation Family History Father retired/good health Mother fine. High BP, takes medication 3 sisters, all well Observations BP excellent Weight & Height okay Diagnosis Possible Hepatitis A Possible causes Fecal and oral transmission Picked up on Overseas Travel Touched something contaminated Precautions taken by patient Careful what he ate/didnt eat at the market Drank bottled water Prognosis & Management Not chronic Viral infection No treatment /Antibiotics dont work Rest Fluid intake Avoid alcohol Preventing infection of family Wash hands thoroughly Avoid sharing food/ crockery/utensils Doctors advice regarding work situation Take leave from work/ medical certificate Dont travel overseas Coworkers at risk Tests/results and other relevant advice Pathology test should be done tomorrow Monitor family members Test results in 24 hours Call if any concerns

2.

3.

4.

5.

Maximum score: 43

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Listening Part A

Transcript Listening Sub-Test: Part A

Michael Fraser In this part of the test, you will hear Doctor Jean Mathews interviewing Michael Fraser a patient with a recent problem. While listening, make notes on your answer sheet about the consultation under the headings given. Give as much information as you can. There will be a short space between each question and you will hear the interview once only Do not write full sentences, use note form. You now have one minute to read through the headings.
Now look at question 1 and take notes on the patients symptoms Pause 10 seconds GP: Good morning Michael, come on in and take a seat. My name is Jean Mathews. MF:Oh hello doctor GP: Well, can you tell me whats brought you here today. MP: Well, to be honest I havent been feeling well for the past week or so GP: Thats no good, what sort of symptoms have you had? MP:I have had a fever for a few days. It comes on worse in the afternoons as well GP: m hm MP:I have been feeling a little bit nauseous as well GP: And are you taking anything for that?....panadolthings like that MP: No I havent , I've just been trying to tough it out GP: Okay and what about your eating habits? Have you noticed any change to your appetite? MP: YeahwellI dont seem to be as hungry.I havent been able to complete my meals without feeling a bit sick GP: and with the nausea, has sort of ended up with vomiting? MP: yeah I did vomit actually, both yesterday morning and this morningthats one of the reasons I thought I d better come and see you. GP: and what about any other aches or pains generally MP: I am feeling a little bit tired and Ive had a few pains in my joints. I've been a little bit stiff in the mornings GP: Have you noticed any other sort of changes, such as yellowish skin or in the whites of your eyes MP: well, I didnt but my wife commented this morning that she thought my skin had turned a bit yellowish GP: What about the colour of your urine. Any changes there? MP: now you mention it I do think its become darker in colour PAUSE 20 seconds Now look at question 2. Take notes on the Michaels personal history Pause 10 seconds GP: Now, Michael, I d just like to get some background details before we go any further. Could we just start with your age please. MF: I m 38 GP: Are you married? MF: yes I am GP: and any children MF: Yes Ive got 2 children GP: and how old are they? MF: Ive got a daughter who is 9 and son who is 11 GP: oh lovely. And what about your employmentwhat sort of work do you do? MF: Im a carpenter by trade GP: I see and you work mainly on building sites and places like that? MF: Well, I do work on building sites , but the company Im currently work for now has quite a few overseas projects so I do go overseas quite a bit with my work GP: and whereabouts have you worked recently? MF: Well, this year I've been to East Timor and Ive just came from Nuigini about 10 days ago GP: I see. and just tell me a little more about your general health MF: Pretty fine I think, I eat healthily I havent had any complaints GP: and do you smoke at all? MF: ah yes I do smoke but Im trying to keep it under controlbut suppose I smoke about 10 cigarettes a day. GP: ..mmm and what about alcohol? MF: I have a couple of beers most days my wife and I are trying to be responsible and have a couple of alcohol free days each week GP: Thats an excellent idea to ..thats very good Pause 5 seconds Now take notes on the family history Pause 5 seconds GP: and now just to go on to your family history..what about your parents? Are they in good health? MF: Yes theyre both in quite good health, ..my father he retired a couple of years ago but hes fine and my mothershes well she does have high blood pressure and she does take some medication for that I believe GP: I see..and do you have any brothers or sisters? MF: yeah Ive got 3 sisters.and theyre all well GP: Pause 15 seconds Now look at question 3. Take notes on the examination Pause 10 seconds GP: Well Michael, your blood pressure is certainly excellent and youre not overweight? MF: Oh, I m pleased to hear that GP: But what I do think, based on your symptoms and the jaundice and everything youve told me..I am little concerned that you might have hepatitis A MF: really GP: Now this not something to be greatly alarmed about.but it may be connected with your travel overseasit is spread through fecal/oral.transmission and it may be that youve touched something and thats been contaminated for example MF: So you think I might have picked this up on one of my overseas trips GP: its very possible yesWhen you travel, do you eat local foods? MF: Well actually because I do travel a lot I am aware of the risks and I am very careful with what I eat. I try to only eat food from the hotel. And on this particular trip I didnt eat out in the market place..and I always drank bottled water GP: well I am sure you took proper precautions but ah even when we do this it is still possibleyou know sometimes ah.the hotel staff may not have practiced the level of hygiene requiredand they mightve touched utensils or food that you have eaten..and thats how this can be picked up. so MF: I see well that is a real nuisance for me doctor..if got this hepatitis..what can I expect to happen now GP: Well the first thing we need to do is confirm this diagnosisand for that youll need to take a liver function test MF: I see Pause 15 seconds Now look at question 4. Take

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Listening Part A notes on the prognosis and management Pause 10 seconds MF: So if this blood test does confirm that I do have hepatitis Awhat can I expect GP: Well the good news is that Hepatitis A never causes chronic long term infection MF: oh thats good GP: But it is a viral infection and there is no medical treatment available but there are a number of things we can do to relieve your symptoms MP: excuse me doctor but is there no antibiotics or anything else like that I can take GP: ahhantibiotics dont work for viral infections but it can be relieved by rest, by adequate fluid intake. and the other thing is you really should avoid alcohol as this can be detrimental to your liver. Pause 5 seconds Now take notes on preventing infection Pause 5 seconds MF: Doctor I am a little bit concerned about my family and spreading the condition to them GP: Yes, well basically you are considered infectious for a week after the onset of jaundice, so youll need to take for at least the next week MF: oh..that worries me doctor, as Ive told you I've got 2 young children and dont want to pass it on to them, or my wife for that matter GP: Well you can manage that, Michael as Hepatitis is mainly transmitted through what we call the fecal oral route, so if your always wash your hands thoroughly after going to the toilet and also before preparing any food, then that will definitely limit the likelihood of spreading the virus. The other thing is at this stage I would avoid sharing any food or crockery, Pause 5 seconds Now take notes on Michaels work situation Pause 5 seconds MF: doctor, how long will I feel sick for.. GP: There isnt a definite time period but certainly I would be thinking at this stage that you take some leave from work. Id be happy to give you a medical certificate. And what you really need now is rest and plenty of fluids MF: well that could be quite difficult as I am quite busy at work and Im supposed to be going overseas in 10 days time to complete a construction project in Nuigini. GP: Well I certainly couldnt advise that you do that because not only would you be putting the people you work with at risk but it could also have negative effects to your own health.. Pause 5 seconds Now look at question 5 Take notes on tests, advice, follow up Pause 10 seconds GP: Now Michael, this is your referral for the pathology test I want to have done. There is a collection centre near you and theyre open 7.30~9.30 and Id like you to get that done tomorrow morningso that we can the results as quickly as possible MF: Okay, Ill definitely go and do that. ..Doctor, I did have one more question GP: yes whats that MF: well what if my wife or kids have already picked up this infection? GP: Well Michael, have they shown any of the symptoms that youve such as the fever, loss of appetite, nausea..and so on MF: ..no not really, theyve been okay GP: What I think we should do at this stage is monitor themand if do display any signs or symptoms , then please bring them up to the clinic immediately MF: Okay..and when do you think youll get my results GP: oh ..in 24 hours I would think, well give you a call and let you know MF: Okay GP: Now please do follow my advice and take some rest, and dont return to work until youre feeling better. MF: Okay doctor, thank you. GP: Well see you soon. Pause 30 seconds That is the end of Part A

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