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Podiatry

Read the following information.

Free OET Writing Sample Test with Answer Subtest Podiatry #19

Case Notes: Elderly Fall Risk – Onychogryphosis

Case Notes:

  • Patient: Mrs. Irene Hall, 82 yrs

  • Living situation: Nursing home resident

  • Presenting issue: Painful, thickened toenails on both feet

  • Exam: Onychogryphosis (severely thickened, curved nails), difficulty with nail care

  • Symptoms: Pain while walking, reduced balance, frequent near-falls

  • Medical history: Osteoarthritis, mild visual impairment

  • Mobility: Walks with a cane

  • Concern: Increased risk of falls and reduced independence

  • Current management: Basic foot hygiene by nursing staff, inadequate due to nail deformity

  • Request: Write to GP recommending a podiatry-led routine foot care plan and fall prevention measures.

To: Dr. Bennett


Dear Dr. Bennett,

I am writing to refer Mrs. Irene Hall, an 82-year-old nursing home resident, who presented with painful, severely thickened toenails consistent with onychogryphosis.

On examination, her nails were markedly hypertrophied and curved, causing discomfort on ambulation. She reports increasing difficulty in walking and has experienced several near-falls in recent months. Her medical history includes osteoarthritis and mild visual impairment, both of which further compromise her mobility.

The nursing staff have been providing basic foot care; however, they are unable to adequately manage the advanced nail deformity. Mrs. Hall ambulates with a cane, but her gait is unsteady, and pain from her toenails exacerbates her risk of falling.

I recommend implementing a podiatry-led routine foot care program, which includes debridement and regular monitoring, alongside fall-prevention strategies. This will enhance her comfort, mobility, and safety within the nursing home setting.

Thank you for your attention to this referral.

Yours sincerely,
[Podiatrist’s Name]

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