Transcript: OET Listening Practice Test – Extra02

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Doctor:	Hello, Mrs. Black, isn’t it? I believe it’s your first time to this clinic.
Mrs Black:	Yes, we’ve just moved to the area so we’re looking for a new GP.
Doctor:	Right then. So how can I help you today?
Mrs Black:	Oh, well, I’m actually a bit worried about our daughter, Mia. She’s fifteen now. She’s always been very healthy, but recently she’s gotten very thin and I’m worried that it might be anorexia.
Doctor:	Okay, I see. Can you tell me a little bit more about Mia?
Mrs Black:	Well, she always used to eat with the family, but lately she says she hasn’t got time to eat with us because she’s too busy, or she takes her plate into her room and eats in there. She skips breakfast a lot as well, or just has a glass of juice, a couple of bites of toast, before she’s out the door and off to school. It all started late last year, but I’m really not sure what triggered the change.
Doctor:	And what about school. How’s that going?
Mrs Black:	She’s a good student, gets high marks in most exams. Her teachers have always said she’s a quiet girl but she works hard. Now that I think of it, her Maths teacher told us at a recent parent-teacher interview that lately she seems to be having trouble concentrating in class. He said that she was never like that before, and he wondered if we could think of any reason why it might be happening now.
Doctor:	I see.
Mrs Black:	She doesn’t have many friends, just one or two girls she’s close with. She’s always been a bit shy & reserved. She doesn’t have a boyfriend, and we wouldn’t allow it at her age anyway. After school she does ballet, which she loves, but apart from that she tends to spend a lot of her time lying around the house, usually in her room.
Doctor:	Hmm, and what about her weight? You said she’d become quite thin.
Mrs Black:	Yes, she really has. I’ve tried talking to her about it, but of course she won’t tell me how much. Her clothes don’t seem to fit her properly anymore, though. They just hang off her like sacks. She seems obsessed about her appearance lately too. I always catch her standing in front of the mirror. I don’t think she’s sleeping very well either. She stays up very late at night, reading or playing around on her phone, and then of course she’ll be tired and moody in the morning.
Doctor:	Anything else you can tell me about Mia?
Mrs Black:	Oh, yes, she seems to have been getting a lot of headaches lately. I can’t remember her really having them before. And I found a box of laxatives – in her room. I even think she’s been throwing up, but she denies it of course, so that’s a big concern for her father and me too. So what do you think doctor? From what I’ve told you, do you think Mia has anorexia?
Doctor:	Well, without meeting Mia and assessing her, which I think I will need to do, it’s hard to make that judgement. However, I can give you some information about anorexia, and then I think we need to arrange for me to see your daughter sooner rather than later.
Mrs Black:	Okay, I understand. Anything you can tell me, any advice you have, would be very helpful. We’ve tried talking to her, to see if she’s all right, but she’s very sensitive about it all. The moment we mention anything she gets very upset.
Doctor:	I know it’s difficult, but there are some options available. If we think it’s necessary, we may even have to consider referral to a psychiatrist.

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Physiotherapist:	Ryan Henderson? Please come in and take a seat. My name’s Cathy. I understand from your GP that you’ve got a problem with your knee.
Ryan:	Hi. Yes, that’s right. It’s the left knee, just below the kneecap. It started about four weeks ago. I first noticed it when I’d go for a run. I’d get this sort of niggling pain which would get increasingly worse. It’s gotten to the point now where sometimes I even have to cut my run short.
Physiotherapist:	Hmm, does anything else seem aggravated?
Ryan:	Yeah, actually going from when I’m sitting and then standing, or when I’m sitting at a desk with my knee bent, I really feel the pain then. It isn’t very sore at the moment, but it seems to be getting worse as the day goes on. It doesn’t wake me up when I’m sleeping or anything like that. But, It seems to go away during the night, and I suppose that’s why it feels better in the morning.
Physiotherapist:	Okay, do you have any other symptoms like pins and needles or numbness on your knee?
Ryan:	No, nothing like that.
Physiotherapist:	Do you have any history of injuries or accidents that might account for the pain?
Ryan:	Well, I cut my left knee pretty badly climbing over a concrete wall when I was younger, but that was 15 years ago or more, so I don’t think that’d have anything to do with this. Gave me this pretty crazy scar though.
Physiotherapist:	I see.
Ryan:	Other than that, I’ve just had your typical sorts of injuries. I broke the little toe on my left foot playing football when I was about 10. Ever since then I’ve had to wear shoes a size larger. Then when I was about 25 I twisted my right ankle playing squash and ended up broking the small bone, the ah, what’s it called…ah, the fibula, [Ah yes, that’s right. ] but it’s been fine, haven’t had any problems with it since. Then just last year I broke the little finger on my right hand playing rugby. Totally unexpected that was. And, I ah, I almost forget – I got this bursitis in my left hip.
Physiotherapist:	And, when was that?
Ryan:	Last year, I saw one of your colleagues actually, for some physio treatment, and they said to take a break from running for six months, which I did. I did a lot of stretching and I started doing yoga twice a week. It seemed to help, so I was able to start running again after Christmas.
Physiotherapist:	And is the bursitis better now?
Ryan:	Yep, there’s no pain in the hip. Now it’s the darn knee that’s giving me grief.
Physiotherapist:	Yes, well, can I just get you to stand for me and put your full weight on your left leg? [Yeah, sure.] Tell me, how does that feel? Any pain or discomfort?
Ryan:	Yes, I can feel it is a bit niggly just at the front of the knee cap, and I do feel a bit of pain.
Physiotherapist:	And if you do like a little half squat, bend your knees and come back up, what’s that like?
Ryan:	Ooh. Ow. I can feel a bit of pain in both knees actually. More in my left knee, like a sharp pain, but there’s definitely a little ache in that right knee now as well. I’ll just try standing on my left leg again and see what that’s like. Ow! That really hurts.
Physiotherapist:	A lot worse?
Ryan:	Definitely.
Physiotherapist:	Okay. Can you sit on the side of the bed? And I’m just going to test the muscle strength. I want you to push your right leg out against me as hard as you can go. Is that okay?
Ryan:	Yep okay. It’s hard to do with my left leg, though. Like it’s weaker or something. Like I can’t get enough power through it. That’s really strange. I hadn’t realised it was that weak before.
Physiotherapist:	Well Ryan, I think I know what’s going on with your knee. It appears your kneecap is a little bit out of alignment.
Ryan:	Wow, okay. And how does that happen?
Physiotherapist:	It can occur because the ligament, which we call the iliotibial band, it’s gotten a bit too tight on the outside of your thigh. And in your case I can see that there is some minor swelling on the outside of your left knee, which means there’s some underlying inflammation there.
Ryan:	I guess that explains the pain then. Seems like my days of pounding the pavement might be over. Am I to find some other ways of getting my exercise? It was really disappointing. I’ve been into running since I was in secondary school, used to be in a cross-country team or everything. But now, it seems like everytime my leg is up I get problems.

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Question 25

Doctor:	You can get dressed now…Well, Mr. Hartley, I think your problem is due to the fact that the kidneys are not working as well as they should be. Have you ever had trouble with your water before?
Patient:	Yes. A couple of years ago I had burning when I passed water. The GP said I had high blood pressure and he put me on tablets and it cleared up for a while. So what now?
Doctor:	Well, I want you to have some blood tests, X-rays and kidney function tests. I want you to collect your urine for twenty-four hours. Nurse will tell you exactly how to do it. Then we’ll ask you to come in for an ultrasound examination of the kidneys. This is a very simple procedure to make sure there is no obstruction.

Question 26

Nurse:

Our sickest patient is AJ. AJ is a 6-year-old boy who was admitted with hypoxia and respiratory distress secondary to a left lower lobe pneumonia. He presented with cough and high fevers for 2 days before admission, and on the day he presented to the emergency department he had worsening respiratory distress. In the emergency department he was found to have a sodium level of 130, likely secondary to volume depletion versus syndrome of inappropriate secretion of antidiuretic hormone. He received a fluid bolus and was started on O2 at 2.5 L. He’s on Ceftriaxone. Please look in on him at approximately midnight and make sure his vitals are unchanged and his oxygen saturation is stable. Also check to determine if his blood culture is positive tonight. If his respiratory status worsens, please get another chest radiograph to determine if he is developing an effusion.

Question 27

GP:	Well Brian, at the Belmont Private Hospital they have a CBT programme, which stands for cognitive behavioural therapy. It focuses on changing your thinking patterns and the way you respond to challenging situations.
Brian:	I see.
GP:	It will give you the skills and knowledge to help you achieve more control of your emotions and to feel better about yourself and your life.
Brian:	That sounds like it could be a good thing for me.
GP:	Other topics CBT deals with include anger management, coping with change, as well as things like setting goals and assertiveness training.
Brian:	Sounds okay.
GP:	All right, Brian, I’ll book you in. It’s a 3-week course every day from 9am until 3pm. Now, I would like you to take the antidepressant medication one at night an hour before you go to bed. You can still take the normison if you are having trouble sleeping.
Brian:	Ok. I will do that.
GP:	The most important thing is to talk about how you’re feeling and don’t hesitate to call me if you have any problems with the medication.

Question 28

Nurse:

Hi Doctor Jones, this is Helen from the PA Hospital. I’m calling about your patient, Mrs Singh, in room 231. She’s a 70-year-old, second day post-op hip patient and she’s been complaining of intense pain tonight. She received all her scheduled antibiotics but started running a fever of 38.3 degrees at midnight. Her incision is also quite red and I noted some new purulent drainage. I’m concerned she may have an infection and I’d like you to see Mrs Singh as soon as possible, but in the meantime, I’m wondering what course of action you’d like me to take. Whether or not you’d like me to draw a CBC or blood cultures?

Question 29

Principal:

I wanted to finish up by talking to you about osteoporosis. The age of a lot of our residents means that they are at risk of developing the disease. Genetics and lifestyle factors play a part, but not getting enough calcium and vitamin D can make the condition worse, so I’d like you to ensure that the needs of our residents are being met in this regard. Also, and this may be a significant factor for some of our residents, corticosteroids may contribute to the onset of the disease. For residents who already have osteoporosis, there are medications available to help, including Fosamax, Boniva, Actonel and Reclast. These drugs work by increasing bone density, so they can help reduce the risk of fractures. Now, there are also treatments available specifically for men, which wasn’t the case in the past, and as you know some of our male residents can be resistant to taking medication, so I’d really like you to mention this to them.

Question 30

Nurse 1:	Hey Carlie, can I talk to you for a minute about Mrs Robbins in room 225?
Nurse 2:	Sure. What’s happening?
Nurse 1:	Well, as you know, she’s Doctor Liu’s patient, and his notes state that she needs to start mobilising today and that her discharge is planned for the day after tomorrow. So, I checked in on her and asked how she was feeling and let her know that I’d take her for a shower. She’s been getting a sponge bath up till now.
Nurse 2:	Okay.
Nurse 1:	The thing is, the moment I mentioned the shower to her she started getting really upset and said that she just wanted to rest. I tried explaining how important it was for her to mobilise. And that it was the doctor who had ordered it and that it would help speed-up her recovery, but she wasn’t hasn’t any of it. She told me she’d speak to Doctor Liu herself, and that she wouldn’t listen to me because I was only the nurse. I didn’t want to make her any more upset than she already was, so I just left it, but now I don’t know what to do.

Part C Extract 1

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Transcript

Interviewer:	Today we’re speaking to Dr Kyle Munro, a critical care physician from the United States who’s recently returned from Liberia where she volunteered to treat Ebola patients. Can you tell us a little about Ebola, and explain your reasons behind volunteering?
Dr Munro:	Sure. Ebola virus is a severe, often fatal illness and without treatment nine out of 10 people who contract the virus die, many from dehydration, hypovolemia from excessive vomiting, loss of nutrients due to diarrhea, internal and external bleeding, and sometimes kidney and liver failure. Aggressive medical care is really simple by modern medical standards. Saving lives might require as little as clean IV needles, fluids and basic lab tests – things that are readily available in resource-rich parts of the world – and we have them at our disposal all the time, they’re not considered fancy where we come from. That isn’t always the case in remote parts of Africa, where supplies can be scarce.
Interviewer:	And how did the patients you were treating respond to your presence?
Dr Munro:	To give you some sort of idea of what we were dealing with, the first two patients I treated were a brother and sister. Both had developed Ebola symptoms, which often presents like flu, with fever and pain, and straight away they fled to the bush because they were fearful of what might happen to them if they were treated. They were found quite quickly because they were too weak to run, but even with treatment, both later died. We need to be conscious that nine out of ten people we treated, never saw their loved ones again. So the distrust about what we were doing wasn’t entirely unfounded.
Interviewer:	And is it true you had to wear a lot of specialised clothing while treating patients with Ebola?
Dr Munro:	Yes, that’s correct. It’s a little beyond the traditional white coat a lot of patient’s associate with doctors in a hospital setting. I would wear my scrubs and then I would put on a pair of thick rubber boots that came right up to my knees. After that, I had to get dressed in a bodysuit, then two pairs of gloves, a face mask, a hood that covered my neck and, finally, goggles.The overall impression is similar to that of a spacesuit. You can imagine in the tropical heat and humidity, it was suffocating. You lose about three to five litres of sweat, then spend the next two hours hydrating before you can go back in. It does limit the level of care you’re able to provide because it prevents you from physically contacting your patients, and that reduces the amount of sensory input we usually get as part of our jobs as physicians. But it also saves your life.
Interviewer:	Can you tell us about one of the patients you treated while you were there?
Dr Munro:	One particular case involved a young girl who was part of a small cohort of patients we had to deal with where someone in the family would be positive and someone else would be negative. And once a person was negative, they had to leave the unit. The little girl was 6-years-old and she had contracted the virus, but her mother had not, so I had no option but to escort her away. Both the child and her mother were terrified about what lay ahead for them. The girl died four days after they were separated. I think, in some ways, this example encapsulates just how awful things could be during this outbreak, and the kind of personal tragedies that people had to live through.
Interviewer:	You’re back home now in Manchester. When treating patients in the UK, do you think you approach your job in a different way because of your work in Liberia?
Dr Munro:	I do think it’s made me sensitive to the limitations that are imposed on us. Making sure that you’ve made a connection with your patient. One of the things we had to do for our patients in Liberia, in addition to just witnessing their illness and doing what doctors do around the world, which is try to use medicines to blunt the worst effects of an illness, is also to try and help manage their own anxieties and fears. I would like to think that I had been aware of it before, but now I think I understand the principle in an entirely new way.
Interviewer:	And do you believe Ebola is something for the rest of the world to be concerned about?
Dr Munro:	Well, I know the disease has spread further, and I’m not surprised. In a recent case in Nigeria, a man infected with Ebola collapsed at a crowded airport in Lagos, its busiest city. He later died and now authorities are closely monitoring up to 59 people he might have come in contact with. The majority of people think that Ebola is a dramatic disease that kills people in no time. The reality is that the incubation period is 21 days, and because the disease can spread from an infected person to another person via direct contact with blood or body fluids via the nose, mouth, eyes, or even from open wounds like cuts and abrasions, the potential for spread outside of Africa is there.
James Tredellow:	Hello. I’m James Tredellow, a sleep physician who specialises in upper airway physiology. While snoring can be frustrating for those who have to listen to it, it is also known to contribute to a range of health problems. There’s now also an emerging line of research that suggests snoring may directly contribute to serious cardiovascular health problems. When we go to sleep, the muscles of the upper airway relax, causing it to become “floppy” and partially collapse. This occurs to some extent in all of us. However, in some people the airway is excessively narrowed, particularly at the level of the tongue and uvula, or soft palate. As we breathe in, we produce suction pressure to draw air into the lungs. This further narrows the airway – similar to when a person sucks too hard on a straw – and can cause upper airway tissues such as the soft palate to vibrate or flutter, similar to a flag in the wind. This movement creates the noise of snoring.
	There are many triggers for snoring. If a person doesn’t normally snore, alcohol can be a key trigger as it blocks the nose and can contribute to relaxing of the airway muscles. And if a person already snores, alcohol is likely to make their snoring a lot louder. Being overweight increases fat around the neck, compressing and narrowing the throat. But thin people do snore too, and many who are overweight do not. A blocked nose – due to a cold, allergies, polyps or anatomical abnormality – creates the need for greater suction pressure to draw air into the lungs when breathing, which further narrows the airway. Mouth opening often occurs when the nose is blocked during sleep, which itself can cause snoring, via airway anatomy and pressure changes. Sleeping on the back contributes to collapse of the airway, as gravity pushes the tongue and soft palate towards the back of the throat. Enlarged tonsils narrow the airway, and are a primary cause of snoring in children.
	In terms of the effects that snoring can have on a person’s well-being, it can create a dry mouth, sore throat or headache, and can leave a person feeling tired. It can place significant strains on personal relationships, particularly a person’s bed partner, but also those sleeping in an adjacent room or even sometimes on the other side of the house! Snoring forces many couples to sleep in separate bedrooms, disrupting intimate bonds. Snorers are often embarrassed to sleep among others, promoting anxiety and hindering their social relationships. Sleep disruption caused by snoring can make someone, and others, cranky and irritable during the day, but also may lead to impaired memory, concentration and learning difficulties, and obesity and reduced immunity.
	More serious consequences include snoring as a possible marker for obstructive sleep apnoea, a disorder where the upper airway repeatedly closes during sleep, and breathing stops for at least ten seconds at a time. Obstructions to breathing can sometimes last for more than a minute and occur over 100 times an hour, starving the body of oxygen and fragmenting sleep. Obstructive sleep apnoea sufferers are often excessively sleepy and at greater risk of car and industrial accidents, and cardiovascular diseases like high blood pressure, heart attack and stroke.
	Over the last decade, research has suggested heavy snoring itself may be a direct cause of cardiovascular complications, particularly a condition known as carotid artery atherosclerosis. When affected by atherosclerosis, fatty deposits known as plaques form in the wall of the artery. Over time these can cause the blood vessel to narrow and limit blood flow to the brain. One study has shown that snoring vibrations are transmitted to the carotid artery, which can damage its wall and lead to the development of atherosclerosis. Subsequently, snoring may rupture a formed plaque, resulting in pieces of the plaque moving through the bloodstream and blocking small vessels in the brain. However, additional research is required to bring further clarity to this hypothesis.
	Given the multiple causes of snoring, there are numerous potential treatments available that work for some people but not others. Recommended lifestyle changes that work for some patients may include: avoiding alcohol before bed and avoiding sleep deprivation; losing excess weight; and, stopping smoking. There are several medical treatments for snoring that require professional advice. If you treat patients that snore regularly, it is highly recommended they see a sleep and respiratory doctor for diagnosis, and to determine the right kind of treatment.

Part C Extract 2

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Transcript

James Tredellow:	Hello. I’m James Tredellow, a sleep physician who specialises in upper airway physiology. While snoring can be frustrating for those who have to listen to it, it is also known to contribute to a range of health problems. There’s now also an emerging line of research that suggests snoring may directly contribute to serious cardiovascular health problems. When we go to sleep, the muscles of the upper airway relax, causing it to become “floppy” and partially collapse. This occurs to some extent in all of us. However, in some people the airway is excessively narrowed, particularly at the level of the tongue and uvula, or soft palate. As we breathe in, we produce suction pressure to draw air into the lungs. This further narrows the airway – similar to when a person sucks too hard on a straw – and can cause upper airway tissues such as the soft palate to vibrate or flutter, similar to a flag in the wind. This movement creates the noise of snoring.
	There are many triggers for snoring. If a person doesn’t normally snore, alcohol can be a key trigger as it blocks the nose and can contribute to relaxing of the airway muscles. And if a person already snores, alcohol is likely to make their snoring a lot louder. Being overweight increases fat around the neck, compressing and narrowing the throat. But thin people do snore too, and many who are overweight do not. A blocked nose – due to a cold, allergies, polyps or anatomical abnormality – creates the need for greater suction pressure to draw air into the lungs when breathing, which further narrows the airway. Mouth opening often occurs when the nose is blocked during sleep, which itself can cause snoring, via airway anatomy and pressure changes. Sleeping on the back contributes to collapse of the airway, as gravity pushes the tongue and soft palate towards the back of the throat. Enlarged tonsils narrow the airway, and are a primary cause of snoring in children.
	In terms of the effects that snoring can have on a person’s well-being, it can create a dry mouth, sore throat or headache, and can leave a person feeling tired. It can place significant strains on personal relationships, particularly a person’s bed partner, but also those sleeping in an adjacent room or even sometimes on the other side of the house! Snoring forces many couples to sleep in separate bedrooms, disrupting intimate bonds. Snorers are often embarrassed to sleep among others, promoting anxiety and hindering their social relationships. Sleep disruption caused by snoring can make someone, and others, cranky and irritable during the day, but also may lead to impaired memory, concentration and learning difficulties, and obesity and reduced immunity.
	More serious consequences include snoring as a possible marker for obstructive sleep apnoea, a disorder where the upper airway repeatedly closes during sleep, and breathing stops for at least ten seconds at a time. Obstructions to breathing can sometimes last for more than a minute and occur over 100 times an hour, starving the body of oxygen and fragmenting sleep. Obstructive sleep apnoea sufferers are often excessively sleepy and at greater risk of car and industrial accidents, and cardiovascular diseases like high blood pressure, heart attack and stroke.
	Over the last decade, research has suggested heavy snoring itself may be a direct cause of cardiovascular complications, particularly a condition known as carotid artery atherosclerosis. When affected by atherosclerosis, fatty deposits known as plaques form in the wall of the artery. Over time these can cause the blood vessel to narrow and limit blood flow to the brain. One study has shown that snoring vibrations are transmitted to the carotid artery, which can damage its wall and lead to the development of atherosclerosis. Subsequently, snoring may rupture a formed plaque, resulting in pieces of the plaque moving through the bloodstream and blocking small vessels in the brain. However, additional research is required to bring further clarity to this hypothesis.
	Given the multiple causes of snoring, there are numerous potential treatments available that work for some people but not others. Recommended lifestyle changes that work for some patients may include: avoiding alcohol before bed and avoiding sleep deprivation; losing excess weight; and, stopping smoking. There are several medical treatments for snoring that require professional advice. If you treat patients that snore regularly, it is highly recommended they see a sleep and respiratory doctor for diagnosis, and to determine the right kind of treatment.

Curriculum

Transcript: OET Listening Practice Test – Extra02

Part A Extract 1

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Transcript

Part A Extract 2

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Transcript

Part B

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Transcript

Question 25

Question 26

Question 27

Question 28

Question 29

Question 30

Part C Extract 1

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Transcript

Part C Extract 2

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Transcript