Reading Part A: Expeditious Reading

Reading Part A practice. Four short texts on anaphylaxis. Text 1, a treatment algorithm: "Call for help. Remove the trigger if possible. Lie the patient flat with the legs raised, or sit them up if breathing is difficult. Give adrenaline 500 micrograms (0.5 mL of 1 mg/mL) by intramuscular injection into the anterolateral thigh; repeat after 5 minutes if there is no improvement. Give high-flow oxygen. Consider an intravenous fluid bolus of 500 to 1000 mL for an adult." Text 2, a dosing table: "Intramuscular adrenaline by age. Adult and child over 12 years: 500 micrograms. Child 6 to 12 years: 300 micrograms. Child 6 months to 6 years: 150 micrograms. Child under 6 months: 100 to 150 micrograms." Text 3, a patient leaflet: "After an anaphylactic reaction you will usually be kept under observation for at least 6 hours once your symptoms have settled, and for 12 hours if you needed more than two doses of adrenaline. Before you go home you will usually be given two adrenaline auto-injectors to carry at all times (unless a medicine caused the reaction), shown how to use them, and referred to an allergy clinic." Text 4, an audit summary: "Of 48 anaphylaxis presentations last year, adrenaline was given within 10 minutes of arrival in 31. The commonest documented trigger was food (22 cases), followed by drugs (11) and insect stings (6); no trigger was identified in 9. A serum tryptase sample was taken in 19 cases."

Which text would you consult to find the adrenaline dose for a four-year-old child?

• AText 4, the audit summary, which reports how quickly adrenaline was given
• BText 2, the dosing table, which lists doses by age band✓
• CText 3, the patient leaflet, which explains what happens after a reaction
• DText 1, the treatment algorithm, which gives the adult dose and the route

Answer: Part A tests whether you can locate information quickly: only the dosing table breaks the dose down by age, so a four-year-old's dose (150 micrograms) is found there. The algorithm gives the adult dose, and the leaflet and audit do not give doses at all.

Reading Part A practice. Four short texts on anaphylaxis. Text 1, a treatment algorithm: "Call for help. Remove the trigger if possible. Lie the patient flat with the legs raised, or sit them up if breathing is difficult. Give adrenaline 500 micrograms (0.5 mL of 1 mg/mL) by intramuscular injection into the anterolateral thigh; repeat after 5 minutes if there is no improvement. Give high-flow oxygen. Consider an intravenous fluid bolus of 500 to 1000 mL for an adult." Text 2, a dosing table: "Intramuscular adrenaline by age. Adult and child over 12 years: 500 micrograms. Child 6 to 12 years: 300 micrograms. Child 6 months to 6 years: 150 micrograms. Child under 6 months: 100 to 150 micrograms." Text 3, a patient leaflet: "After an anaphylactic reaction you will usually be kept under observation for at least 6 hours once your symptoms have settled, and for 12 hours if you needed more than two doses of adrenaline. Before you go home you will usually be given two adrenaline auto-injectors to carry at all times (unless a medicine caused the reaction), shown how to use them, and referred to an allergy clinic." Text 4, an audit summary: "Of 48 anaphylaxis presentations last year, adrenaline was given within 10 minutes of arrival in 31. The commonest documented trigger was food (22 cases), followed by drugs (11) and insect stings (6); no trigger was identified in 9. A serum tryptase sample was taken in 19 cases."

According to the texts, when should a second dose of adrenaline be given?

• AAfter 10 minutes, whether or not the patient has improved
• BAs soon as high-flow oxygen has been started
• CAfter 5 minutes, if the patient has not improved✓
• DOnly once the patient has reached hospital and been assessed

Answer: The algorithm in Text 1 says to repeat the injection after 5 minutes if there is no improvement. Part A answers must use the information exactly as the text gives it, so the timing and the condition both matter.

Reading Part A practice. Four short texts on anaphylaxis. Text 1, a treatment algorithm: "Call for help. Remove the trigger if possible. Lie the patient flat with the legs raised, or sit them up if breathing is difficult. Give adrenaline 500 micrograms (0.5 mL of 1 mg/mL) by intramuscular injection into the anterolateral thigh; repeat after 5 minutes if there is no improvement. Give high-flow oxygen. Consider an intravenous fluid bolus of 500 to 1000 mL for an adult." Text 2, a dosing table: "Intramuscular adrenaline by age. Adult and child over 12 years: 500 micrograms. Child 6 to 12 years: 300 micrograms. Child 6 months to 6 years: 150 micrograms. Child under 6 months: 100 to 150 micrograms." Text 3, a patient leaflet: "After an anaphylactic reaction you will usually be kept under observation for at least 6 hours once your symptoms have settled, and for 12 hours if you needed more than two doses of adrenaline. Before you go home you will usually be given two adrenaline auto-injectors to carry at all times (unless a medicine caused the reaction), shown how to use them, and referred to an allergy clinic." Text 4, an audit summary: "Of 48 anaphylaxis presentations last year, adrenaline was given within 10 minutes of arrival in 31. The commonest documented trigger was food (22 cases), followed by drugs (11) and insect stings (6); no trigger was identified in 9. A serum tryptase sample was taken in 19 cases."

Complete the sentence using words from the texts: 'Adrenaline is injected into the ____.'

• Aanterolateral thigh✓
• Bupper outer buttock
• Cfront of the lower leg
• Ddeltoid muscle of the arm

Answer: Text 1 specifies the anterolateral thigh. In the real Part A you write the exact words that appear in the text — a paraphrase such as 'front of the thigh' would not score, and neither would a site that is not mentioned.

Reading Part A practice. Four short texts on anaphylaxis. Text 1, a treatment algorithm: "Call for help. Remove the trigger if possible. Lie the patient flat with the legs raised, or sit them up if breathing is difficult. Give adrenaline 500 micrograms (0.5 mL of 1 mg/mL) by intramuscular injection into the anterolateral thigh; repeat after 5 minutes if there is no improvement. Give high-flow oxygen. Consider an intravenous fluid bolus of 500 to 1000 mL for an adult." Text 2, a dosing table: "Intramuscular adrenaline by age. Adult and child over 12 years: 500 micrograms. Child 6 to 12 years: 300 micrograms. Child 6 months to 6 years: 150 micrograms. Child under 6 months: 100 to 150 micrograms." Text 3, a patient leaflet: "After an anaphylactic reaction you will usually be kept under observation for at least 6 hours once your symptoms have settled, and for 12 hours if you needed more than two doses of adrenaline. Before you go home you will usually be given two adrenaline auto-injectors to carry at all times (unless a medicine caused the reaction), shown how to use them, and referred to an allergy clinic." Text 4, an audit summary: "Of 48 anaphylaxis presentations last year, adrenaline was given within 10 minutes of arrival in 31. The commonest documented trigger was food (22 cases), followed by drugs (11) and insect stings (6); no trigger was identified in 9. A serum tryptase sample was taken in 19 cases."

What dose of adrenaline does the table give for a child aged eight?

• A150 micrograms
• B500 micrograms
• C100 to 150 micrograms
• D300 micrograms✓

Answer: An eight-year-old falls in the 6-to-12-year band, which is 300 micrograms. 500 micrograms is for anyone over 12, 150 micrograms for 6 months to 6 years, and 100 to 150 micrograms for babies under 6 months; scanning the age bands quickly and accurately is the whole skill being tested.

Reading Part A practice. Four short texts on anaphylaxis. Text 1, a treatment algorithm: "Call for help. Remove the trigger if possible. Lie the patient flat with the legs raised, or sit them up if breathing is difficult. Give adrenaline 500 micrograms (0.5 mL of 1 mg/mL) by intramuscular injection into the anterolateral thigh; repeat after 5 minutes if there is no improvement. Give high-flow oxygen. Consider an intravenous fluid bolus of 500 to 1000 mL for an adult." Text 2, a dosing table: "Intramuscular adrenaline by age. Adult and child over 12 years: 500 micrograms. Child 6 to 12 years: 300 micrograms. Child 6 months to 6 years: 150 micrograms. Child under 6 months: 100 to 150 micrograms." Text 3, a patient leaflet: "After an anaphylactic reaction you will usually be kept under observation for at least 6 hours once your symptoms have settled, and for 12 hours if you needed more than two doses of adrenaline. Before you go home you will usually be given two adrenaline auto-injectors to carry at all times (unless a medicine caused the reaction), shown how to use them, and referred to an allergy clinic." Text 4, an audit summary: "Of 48 anaphylaxis presentations last year, adrenaline was given within 10 minutes of arrival in 31. The commonest documented trigger was food (22 cases), followed by drugs (11) and insect stings (6); no trigger was identified in 9. A serum tryptase sample was taken in 19 cases."

According to the leaflet, how long will a patient who needed three doses of adrenaline be observed?

• AFor at least 6 hours
• BFor 5 minutes after the last dose
• CFor 12 hours✓
• DUntil the allergy clinic appointment

Answer: Text 3 gives the general rule (at least 6 hours) and then a longer period, 12 hours, for anyone who needed more than two doses. Three doses is more than two, so the longer period applies; the question tests reading the condition, not just the first number you find.

Reading Part A practice. Four short texts on anaphylaxis. Text 1, a treatment algorithm: "Call for help. Remove the trigger if possible. Lie the patient flat with the legs raised, or sit them up if breathing is difficult. Give adrenaline 500 micrograms (0.5 mL of 1 mg/mL) by intramuscular injection into the anterolateral thigh; repeat after 5 minutes if there is no improvement. Give high-flow oxygen. Consider an intravenous fluid bolus of 500 to 1000 mL for an adult." Text 2, a dosing table: "Intramuscular adrenaline by age. Adult and child over 12 years: 500 micrograms. Child 6 to 12 years: 300 micrograms. Child 6 months to 6 years: 150 micrograms. Child under 6 months: 100 to 150 micrograms." Text 3, a patient leaflet: "After an anaphylactic reaction you will usually be kept under observation for at least 6 hours once your symptoms have settled, and for 12 hours if you needed more than two doses of adrenaline. Before you go home you will usually be given two adrenaline auto-injectors to carry at all times (unless a medicine caused the reaction), shown how to use them, and referred to an allergy clinic." Text 4, an audit summary: "Of 48 anaphylaxis presentations last year, adrenaline was given within 10 minutes of arrival in 31. The commonest documented trigger was food (22 cases), followed by drugs (11) and insect stings (6); no trigger was identified in 9. A serum tryptase sample was taken in 19 cases."

In how many audited cases was the trigger recorded as a drug, and in how many was no trigger identified?

• A48 and 11
• B11 and 9✓
• C22 and 6
• D31 and 19

Answer: Text 4 lists food 22, drugs 11, insect stings 6 and no trigger identified in 9. The other pairs are real numbers from the same text — the food count, the sting count, the number treated within ten minutes and the tryptase samples — placed to catch anyone who matches numbers without checking what they refer to.

Which statement about Reading Part A is correct?

• AIt is worth half of the Reading marks and is the only part in which the four texts are drawn from the candidate's own profession
• BIt is worth 6 of the 42 Reading marks and can be returned to at any point during the 60 minutes
• CIt is worth 20 of the 42 Reading marks, has a strict 15-minute limit, and the papers are collected before Parts B and C begin✓
• DIt is worth 16 of the 42 Reading marks and is answered by shading a circle for each question

Answer: OET's Reading guidance gives Part A 20 marks, Part B 6 and Part C 16. Part A has a strict 15-minute limit after which the Part A materials are collected, so there is no chance to check those answers later. Part A answers are written in the booklet, not shaded.

A candidate answering Reading Part A writes 'BP' where the text says 'blood pressure', and spells 'haemorrhage' as 'hemorrhage'. How are these marked?

• A'BP' scores because it is a standard clinical abbreviation, but 'hemorrhage' loses the mark for a spelling error
• B'BP' does not score unless the abbreviation appears in the texts, but 'hemorrhage' is accepted because British and American spellings are both allowed✓
• CBoth score, because Part A is marked on meaning rather than on the exact form of the words
• DNeither scores, because Part A requires the exact letters used in the text with no variation of any kind

Answer: OET's Reading guidance states that abbreviations are not accepted unless they appear in the texts, that answers must use exactly the same form of the word or phrase as the text, and that spelling must be correct — with British and American variants such as 'foetus' and 'fetus' both accepted.