D: What brings you in? 

P: Yeah, so I just came in today uh a bit concerned. Uh I've been just having this nasty cough for like the last week and then today morning uh, like I thought the cough would just go away, but today morning I also noticed I'm coughing up some blood. 

D: Oh, OK.

P: Yeah.

D: So when did you first start coughing?

P: Um, so let me think uh I just returned from a mission trip uh to the Philippines 2 weeks ago. This cough started uh just last week, so I would say around six to seven days.

D: OK. And that and the blood in your cough, um that was about yesterday, you said? Or?

P: Yeah today, uh. 

D: Today, OK. OK. Um are you bringing up any phlegm at all, besides the blood?

P: Uh no it's just uh like I saw it on my hand, like there wasn't anything, like my cough is like pretty dry.

D: OK, are you short of breath at all?

P: No, I'm not short of breath. Um just, it's just the cough. 

D: OK, and are you having any wheeziness?

P: Uh no wheeziness.

D: OK. Um any runny nose or stuffy nose?

P: No, no uh runny or stuffy nose.

D: Changes in vision, hearing, smell, or taste?

P: Nope. 

D: Uh weight loss?

P: Um I have noticed uh weight loss over the last uh, I would say few months. So I've been I've been doing like like I I came back from Philippines last week, but um, I had gone earlier, like during this year or two and I've kind of noticed this weight change, probably lost around 15 pounds within the last few months.

D: 15 pounds OK. Wow, that's a lot, yeah. Um any night sweats?

P: Um no, I don't think so, no.

D: Any fevers or chills?

P: I did have a, I did have some chills over the last week, um but I didn't really think too much of it.

D: OK, we'll take your temperature today just to make sure. Um any rashes?

P: No. 

D: Any chest pain?

P: No chest pain. 

D: Uh swelling in your limbs?

P: No. 

D: Fainting spells or dizziness? 

P: No, nothing like that.

D: Confusion or memory loss?

P: No. 

D: Headaches?

P: No headaches.

D: Uh, joint pain?

P: No. 

D: Fatigue?

P: Uh, no. 

D: Um, changes in your bowel movements?

P: Uh, no. Not at all.

D: No, changes in your urine? 

P: Nope. 

D: Uh, nausea or vomiting?

P: No nausea or vomiting.

D: OK, how about abdominal pain?

P: No, nothing like that.

D: OK, are you otherwise healthy? Do you have any longstanding medical conditions?

P: Yeah no, I'm otherwise I um I don't, I'm really healthy. I don't take any medications so this was something that happened out of the blue.

D: OK, any um hospitalizations or surgeries in the past? 

P: No.

D: No, um medications, are you on any?

P: No, I haven't um tried any medications.

D: OK. Um are you up to date with all your immunizations? 

P: Uh I I've been yeah, pretty up to date with all my immunizations.

D: OK, uh, allergies, do you have any? 

P: No.

D: Sorry, forgot to ask, immunizations. Did you get the flu shot this year?

P: Yeah I did. 

D: OK, good. Any family history of lung conditions?

P: No, not at all. 

D: No, any lung cancers?

P: No. 

D: No, OK. Do you smoke?

P: No, I have never smoked a day in my life.

D: OK, recreational drugs?

P: No I would never take drugs.

D: OK. Do you drink alcohol?

P: No, no, not at all. 

D: OK. Um where do you live right now?

P: So I I just live in a small apartment by myself, uh just been moving around a lot.

D: OK, for sure. Um any like asbestos, mold, or like old carpets, dust, anything like that at your apartment? 

P: No, I don't think so.

D: No, any sick contacts recently?

P: Um not uh, I don't think so like we um, maybe in the Philippines, we do provide a, so I go on like these mission trips with the Church and um we do sometimes go to the hospital as well.

D: OK.

P: Sometimes yeah, we we do see some sick people. 

D: Mhmm, OK.

P: But other than that, not since I've been here, no.

D: Any travel outside the Philippines recently?

P: Uhm, so I think. So this year has just been the Philippines, before I used to go to India as well. Um but recently nothing outside of the Philippines. 

D: OK. OK, um those were all the questions that I had for you. Do you have any questions for me?

P: Yeah, I I was very worried um uh about the blood. I was just reading some things up and uh, about tuberculosis, so I was really stressed out today.

D: Yeah so um, that's definitely high on our differential. So, we'll do a couple of things. We'll do a Covid swab on you um just to rule that in or out, you should hear back for, about those results, in 24 to 48 hours. While you're here in the hospital, we're also going to do a chest X-Ray and or like an AFB smear to see if you have active TB or latent TB. If those come back positive um we will require you to isolate because this uh, because TB is highly infectious and it's airborne. Um so we have a couple of uh, we have like a regimen that we'd put you on. It's called the RIPE medications that we keep you on for two months and then we continue a couple of those for another four months. Um but we will uh keep you here until we have more answers on um like from this TB standpoint. How does that sound?

P: Yeah, that sounds good. Um yeah I'm really worried, but hopefully it's not TB.

D: Yeah, hopefully it's not, um but if it is, it's it's OK, like um we'll get infectious disease involved. Uh we'll get the isolation going and we'll get you on the correct treatment.

P: OK, thank you so much.

D: Yeah, no problem.