X7-qP2-mN9-v4/MTS_Dialogue-Clinical_Note huggingface dataset:
Doctor: Do you have any orthopedic conditions that run in your family that I should know about? 
Patient: What, like arthritis? 
Doctor: Yeah, does anything like that sound familiar? 
Patient: No, not that I know of.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Guest_clinician: Hi there! Welcome to the clinic.
Patient: Hi! Thank you.
Guest_clinician: I'm going to get a little background information from you today.
Patient: Okay. 
Guest_clinician: What are any of your medical history conditions? Past and present?
Patient: I have Crohn's disease.
Guest_clinician: How long have you had Crohn's?
Patient: Oh, I don't know. A long time twenty five to thirty years.
Guest_clinician: Have you had a colonoscopy recently?
Patient: I had one, four years ago. Do I need to get another one this year?
Guest_clinician: I am not sure. I will ask the doctor what his recommendation is for you would be. I will let him know that you had a colonoscopy four years ago. 
Patient: Sounds good. I am also a diabetic. That has been going on for four years now.
Guest_clinician: Yes, I see you take insulin. I also see that you're on a blood pressure medication, do you have high blood pressure?
Patient: Yes, I have high blood pressure and high cholesterol. I also have heart disease. I had a stent placed in there.
Guest_clinician: Anything else?
Patient: I have arthritis now. They said it's due to my Crohn's.
Guest_clinician: That makes sense.
Patient: I'm being treated for depression now as well.
Guest_clinician: Okay. Any other surgeries other than the stent?
Patient: Oh, I had a kidney stone removed several years ago. Twenty five years ago. That's it. That's all I got for you.
Guest_clinician: Okay, great! Thank you. I will go let the doctor know that you are ready and she will be right in to see you. 
Patient: I'll be here.

Clinical note:
Symptoms: N/A
Diagnosis: Crohn's disease (25-30 years), diabetes (4 years), hypercholesterolemia, colostomy (4 years), arthritis (related to Crohn's), hypertension, coronary artery disease, depression, history of kidney stone removal (25 years ago)
History of Patient: N/A
Plan of Action: N/A
Doctor: Any sugar or B P problem?
Patient: No, it is normal.
Doctor: Okay, how about thyroid or any other hormone related problem? 
Patient: No, everything is fine.
Doctor: Cholesterol?
Patient: No cholesterol problem.

Clinical note:
Symptoms: N/A
Diagnosis: Normal endocrine function; Negative for diabetes, thyroid issues, cholesterol problems, or hormone-related problems.
History of Patient: N/A
Plan of Action: N/A
Guest_clinician: What's her diagnosis? 
Doctor: Refractory anemia.  
Guest_clinician: Gotcha.

Clinical note:
Symptoms: N/A
Diagnosis: Refractory anemia (transfusion dependent)
History of Patient: N/A
Plan of Action: N/A
Doctor: Do you have patient's family history? 
Guest_clinician: At this point of time, we don't have it.
Doctor: Hm, okay.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Hello, miss. How can I help you today? The nurse said the matter was urgent. 
Patient: Yes, I have been having dizzy spells. I have also noticed a new rash on my right calf. 
Doctor: Can you describe what type of dizzy spells you are having? What do they feel like?
Patient: It is general dizziness and vertigo. I am also lightheaded during the spells. 
Doctor: Are you feeling okay right now or are you experiencing symptoms?
Patient: I am having headaches off and on randomly, but nothing right now. The neck pain and muscle aches also are intermittent. 
Doctor: Let me take a look at the rash on your legs. Are the bruises new?
Patient: They are new, I think. I have noticed them more than usual. 
Doctor: In the past couple days have you had a fever or chills?
Patient: No, nothing like that. 
Doctor: What about chest pains?
Patient: I have had some tightness in my chest, but not right now. 
Doctor: Does the dizziness make you nauseous?
Patient: Yes, but I have not had to throw up or anything. 
Doctor: What about diarrhea?
Patient: No, thank goodness. 
Doctor: Are there any parts of your body that are hurting?
Patient: I do have some left shoulder pain. Not so much painful, but it is uncomfortable and tender. 
Doctor: Have you measured your blood sugar at all? I ask because the notes state there is a history of gestational diabetes and when blood sugars are out of the normal limits this can cause some of the symptoms you are having. 
Patient: I measured it today. After lunch it was one fifty five.

Clinical note:
Symptoms: dizzy spells, vertigo, lightheadedness, intermittent headaches, neck pains, generalized myalgias, new rash on right calf, more bruises on legs, slight cough, chest pains (intermittent), nausea, left shoulder tenderness.
Diagnosis: N/A
History of Patient: blood sugar after lunch was 155, history of gestational diabetes
Plan of Action: N/A
Doctor: Does anyone in your family have or have history of any colon cancer or unusual polyps? 
Patient: No. 
Doctor: Any other family history? 
Patient: Yes, my father died of a cancer called mesothelioma and my mother died of Hodgkin's Lymphoma.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Any known medical history in the family? 
Patient: Nope. 
Doctor: How about anyone with high blood pressure or heart disease or diabetes in the family? 
Patient: Nope.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: How are you feeling today?
Patient: I am feeling very tired.
Doctor: According to your chart, you have seen with us for three separate self harm attempts. Have you had any other self harm events that you have not come to see use for? 
Patient: No. I have been seeing Doctor Lin. 
Doctor: I also see that this is your third time in the last two months that you have attempted to harm yourself. Is there anything that is currently going on in your life that could be triggering these resent episode?
Patient: Last month I lost my job. And then this month my boyfriend left me. 
Doctor: I am so sorry. That is a lot to deal with. 
Patient: Yeah, it has been hard. 
Doctor: Have you been diagnosed with any mental health conditions? 
Patient: Doctor Lin just said that I was depressed. 
Doctor: Have you ever been put on any medication for the for your depression? 
Patient: I have taken Lexapro before. 
Doctor: How long ago did you take the Lexapro? 
Patient: I can't remember. 
Doctor: Okay.

Clinical note:
Symptoms: feeling very tired
Diagnosis: N/A
History of Patient: third suicide attempt in the last two months, remote history of being on Lexapro for depression
Plan of Action: N/A
Doctor: Do you have any drug allergies? 
Patient: No. None that I know of.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: So, if you see here Doctor Patrick there are multiple areas with hypergranulation tissue on the left leg posteriorly and I get a sense that it's associated with the trauma to the back of his right leg. 
Guest_clinician: Yeah, I agree.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Okay, so your psych evaluation came out unremarkable. Do you have any other problems?
Patient: I have this acne. I hate it. I am not feeling comfortable in my own skin.

Clinical note:
Symptoms: acne, discomfort in own skin.
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Hello there, how are you?
Guest_family: I am little scared. 
Doctor: I understand, so how old is she? 
Guest_family: She is ten days old today. 
Doctor: And just wanted to confirm the ethnicity is Caucasian, right?
Guest_family: Yes. 
Doctor: Okay, so tell me what's going on with her?
Guest_family: I was feeding her and then I suddenly noticed this unusual jerky movement in both her arms and legs. 
Guest_family: It lasted about a minute. 
Doctor: When did you first notice it? 
Guest_family: The first day when I was feeding her, she was barely a day old.
Doctor: Okay, and how many times till now?
Guest_family: About six times. 
Doctor: Did you notice any interrupted breathing or bluish color around her mouth? 
Guest_family: No.
Doctor: While the episode occurs do you notice any color changes in the baby? 
Guest_family: No.
Doctor: Did you happened to notice any arching of the back or eyes rolling back?
Guest_family: No, it usually happens while she is sleeping, so I didn't notice her eye movements. But I am able to wake her up and stop the hand and leg movements. 
Doctor: Okay. Otherwise, is she feeding well and is active? 
Guest_family: Yes, absolutely! Although she falls asleep a lot during breast feeding but other than that everything is fine.
Doctor: And how often are you feeding her and for how long? 
Guest_family: I breast feed her every two to three hours for about fifteen to twenty minutes. 
Doctor: Okay, and how many dirty diapers? 
Guest_family: Well, her pee diapers have increased to up to eight and I would say about six to seven poopy diapers a day.
Doctor: And did you notice the color of her poop? 
Guest_family: Yeah, it's like dirty yellowish color. 
Doctor: Okay.

Clinical note:
Symptoms: 1-minute bilateral arm and leg jerks, started at day of life 1, occurred 6 times since then, increased wet diapers (up to 8) and dirty-yellow stools (6-7 per day).
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Has anyone in your family had heart diseases? 
Patient: Yes my father. They did his heart bypass surgery when he was sixty. 
Doctor: Is he alright now?
Patient: Yes I know what you mean.
Patient: Yes by God's grace, both my parents are alive.
Doctor: What exactly was the heart disease named? Do you know?
Patient: Yeah they said it was something called coronary artery disease and he had many strokes due to that.
Doctor: How old is he now?
Patient: My father is in his eighties. My mother is eighty years old too and she has dementia. My father has dementia too. 
Doctor: Okay. Do you smoke or drink alcohol? And how much?
Patient: No I do not drink or smoke.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Are you on steroids? 
Patient: No.
Doctor: Any history of cancer, chemotherapy or anything related? 
Patient: No.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: How have you both been doing? 
Guest_family: We are good. 
Doctor: I see she has been gaining weight since she has been home. Have you been following the meal plan that we discussed? 
Guest_family: Yes. It has been helping. 
Doctor: Great!

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: Stable disposition to home with her mother.
Guest_clinician: I don't see any past medical history here in this report.
Doctor: We don't have any record of P M H for this patient.
Guest_clinician: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Oh, dear God! What happened? 
Guest_family: Hi Doctor, I am his mom.
Doctor: Hello, so what happened?
Guest_family: He was trying to climb a tree, slipped from there and got a deep cut on his thigh. 
Doctor: So, you fell from the tree? 
Patient: Yes.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: What is up with your teeth man? It's been giving you problems huh?
Patient: Yes, yes, many, many problems. Firstly, they pulled out so many teeth and now I have this bad tooth problem. 
Doctor: Oh, so this is new? 
Patient: Yes, it's a new pain. Right now it has been going on for three days on left side's upper and lower teeth. 
Doctor: Then why didn't you go and visit your regular dentist?
Patient: I would have but I have missed so many appointments that they now do not allow me to schedule regular appointments. So they put me on a standby appointment now.
Doctor: Oh I am sorry.
Patient: It is okay.
Doctor: Okay any other problems or any other complaints?
Patient: No.
Doctor:  How about any recent illnesses or injuries?
Patient: No, no illness whatsoever.
Doctor: Do you have any medicine at home for pain?
Patient: Yes I have  OxyContin and Vicodin at home. I use it for my knee pain. But I want more pain medicines. I do not want to use up that medicine for my toothache.
Doctor: Okay I understand. How old are you again?
Patient: I am twenty nine.

Clinical note:
Symptoms: tooth pain on left side (upper and lower), ongoing for three days
Diagnosis: N/A
History of Patient: extensive dental disease, multiple teeth pulled, missed dental appointments leading to standby appointments only, has OxyContin and Vicodin at home for knee pain
Plan of Action: N/A
Doctor: How's your jaw doing? 
Patient: The pain seems to have gotten worse. 
Doctor: Do you mind if I take a look? 
Patient: Sure. Ow, ow, ow. That's the spot that hurts the most. What's causing it? 
Doctor: It's hard to say, but I'm thinking it could be T M J. I'd like to get you in to see a T M J specialist.

Clinical note:
Symptoms: worsening jaw pain, specific spot of pain.
Diagnosis: N/A
History of Patient: N/A
Plan of Action: refer to TMJ specialist.
Doctor: Are you taking Citalopram for depression?
Patient: Yes, I take it once a day.
Patient: It is ten M G tablet.
Doctor: Is that so?
Patient: Yes.
Doctor: What do you take for pain?
Patient: Just Tramadol as needed.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: What is your family health history? 
Patient: My mom and dad are both diabetics. My mom has high blood pressure. My brother is having some issues with his liver.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Can you tell me about your family?
Patient: I have or had two sons both born normally without any complications. 
Doctor: Why did you say had?
Patient: One of my sons was a heavy smoker, he uses to smoke a whole packet or more in a day. We tried everything possible, but he just couldn't quit. He died of clots. 
Doctor: Does anyone in your family like parents or siblings had any medical issues?
Patient: Yes, my father had heart related issues, he died in his sixties, my mother died of colon cancer. I also have a sister but I don't think she has any issues.c

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Do you smoke cigarettes? 
Patient: Yes.
Doctor: How about alcohol? 
Patient: No, I don't consume alcohol. 
Doctor: Okay. And any history of using drugs like marijuana or stuff like that for fun?
Patient: No.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: N/A
Doctor: Are you married, sir?
Patient: No divorced. I live a lone.
Doctor: What work do you do?
Patient: I am a retired postal worker.
Doctor: Do you have kids?
Patient: Yes, I have three of my own and seven grandkids.
Doctor: Do you smoke cigarettes?
Patient: Yes I do.
Doctor: How much and what kind?
Patient: I keep changing the brands but Newport, one pack a day.
Doctor: Okay. How about alcohol or drugs like substance abuse?
Patient: No drugs but I drink occasionally depending on the company.
Doctor: How long have you smoked?
Patient: Thirty years now.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: Divorced and lives alone, retired postal worker, has 3 children and 7 grandchildren
Plan of Action: Smokes 1 pack of Newport cigarettes daily for 30 years, social drinker, denies illicit drug use
Doctor: Hello! How are you doing?
Patient: Hello Doctor! I am good. 
Patient: I am here today for my follow-up, as suggested. 
Doctor: Has it been a month already? 
Patient: Yes, seeing you after a month.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: One-month follow-up.
Plan of Action: N/A
Doctor: Do you have any allergies?
Patient: I am allergic to IV contrast.
Doctor: Are you sure?
Patient: Yes.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: Allergic to IV contrast.
Doctor: Just to debrief, we will rule out angina related heart problems while evaluating your jaw pain. 
Patient: Oh can that be related to each other?
Doctor: Yes they might be.
Patient: What else?
Doctor: Pardon?
Patient: I am asking anything else?
Doctor: We have discussed this before, but keep track of your high cholesterol and hypothyroid.

Clinical note:
Symptoms: Jaw pain, musculoskeletal; angina equivalent
Diagnosis: Hypercholesterolemia, hypothyroidism
History of Patient: N/A
Plan of Action: Rule out angina-related heart problems, monitor high cholesterol and hypothyroidism
Doctor: Hello, sir. How are you feeling today? 
Patient: Very itchy. I just keep scratching myself. 
Doctor: Oh, wow. I can see the rashes all over your arms. Are there rashes anywhere else? 
Patient: Yeah, it's all over my back and stomach. 
Doctor: I see it on your torso. When did this all start? 
Patient: I woke up this morning and started itching my back. After a few minutes, I noticed the rash was on my arms, chest, back, and stomach areas. 
Doctor: I'm going to take a look at the rashes and the rest of your body. 
Patient: Sounds good. 
Doctor: It looks like your face and lips are not swollen. Could you say ah for me? 
Patient: Ah. 
Doctor: It looks like your tongue isn't swollen either. 
Patient: That's good to hear. 
Doctor: Have you been feeling a shortness of breath, wheezing, or other related symptoms?
Patient: Not that I know of. 
Doctor: Sounds good. I wonder why this happened. Did you do anything the night before? 
Patient: Uh. A few days ago, I was working and had to remove some insulation. Other than that, I don't know what else could have given me these rashes. 
Doctor: I see. Do you remember being itchy after that? Did you try any new foods? 
Patient: Nope I was not itchy. Also, my diet has been the same. 
Doctor: Are you taking any new medications? 
Patient: I haven't. 
Doctor: You don't recall being exposed to any other substances? 
Patient: Not that I know of.

Clinical note:
Symptoms: Very itchy, rashes all over arms, back, stomach, torso; no facial, tongue, or lip swelling; no shortness of breath or wheezing
Diagnosis: Itchy rash, cause unknown.
History of Patient: Itchiness started this morning, rash appeared on arms, chest, back, and stomach areas; no changes in foods, medications, or exposures; worked on insulation a few days ago but didn't feel itchy that day.
Plan of Action: Examine rashes, investigate potential triggers, monitor for any additional Symptoms.
Doctor: Do you have any family medical history of migraines? 
Patient: I know that my brother has them too. Mom, do you know if anyone else gets them? 
Guest_family: Your grandfather had migraines. 
Doctor: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: Family history of migraines affecting patient's brother and maternal grandfather.
Doctor: What do you do for work? 
Patient: I am retired now. I was a school teacher. 
Doctor: Are you a smoker? 
Patient: Yes. 
Doctor: How much do you smoke per day? 
Patient: I would say about a half to a full pack a day. 
Doctor: How long have you been a smoker. 
Patient: Probably sixty years.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: Retired school teacher, smokes 0.5-1.0 pack of cigarettes per day for 60 years
Doctor: Are you allergic to anything?
Patient: No, I am not.
Doctor: Are you sure? Penicillin or sulfa?
Patient: Nope nothing.
Doctor: That's good.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: Denies any drug allergies
Doctor: Hi there, sir! How are you doing today? 
Patient: I feel out of it. 
Doctor: Have you been using any substances? 
Patient: I did a little heroin and some coke earlier today. I still feel high. 
Doctor: Okay. Any shortness of breath, chest pain, abdominal pain or back pain?
Patient: No. 
Doctor: Are you having any headaches, hallucinations or visual disturbances? 
Patient: No. 
Doctor: Do you have any open sores or wounds? 
Patient: No.

Clinical note:
Symptoms: Feels "out of it" after using heroin and cocaine, no headache or visual complaints, no hallucinations, no chest pain, shortness of breath, abdominal pain, back pain, or open sores/wounds
Diagnosis: Substance use (heroin, cocaine)
History of Patient: N/A
Plan of Action: Monitor for any changes or complications related to substance use
Doctor: Have you had any surgical procedures done? 
Patient: Yes, in fact I had a hysterectomy back in March of ninety nine. I believe it was done on the twentieth of the month. 
Doctor: Got it.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: Hysterectomy on March 20, 1999
Plan of Action: N/A
Patient: You know Doctor, I am widowed for eighteen years now. Never remarried, I live by myself in my house.
Doctor: Oh okay, are your still working?
Patient: No, I use to run a restaurant, but now retired. 
Doctor: Hm. And you smoke cigarettes? 
Patient: No, I don't!  Never liked the smell.
Doctor: How about alcohol?
Patient: No, I don't drink either.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: Nonsmoker, nondrinker; widowed for 18 years; retired from running a restaurant; lives alone at home
Plan of Action: N/A
Doctor: How old are you, sir? 
Patient: I'm sixty five years old. 
Doctor: Are you right handed or left handed? 
Patient: I'm right handed. 
Doctor: When was your last stroke? 
Patient: Well, it was on January seventeenth. I had these episodes where I was like always so confused and looks like I lost everything. All my memory and everything. And then they did a scan. It was verified that I was having a stroke on the same day. 
Doctor: Did they put you on some medications? 
Patient: They gave me an anticonvulsant and aspirin. 
Doctor: Are you taking them regularly? 
Patient: There have a few times like one or two days that I forgot to take my, uh, dyphenhydramine, but even when I'm taking it regularly, I'm still having all those symptoms or forgetfulness, confusion, and everything. 
Doctor: Do you feel anything else along with these episodes like a urine urgency, tendency to bite your tongue, headaches, any visual change, or your heart is beating very fast? Any kind of weakness or numbness or shortness of breath? 
Patient: No nothing else, just the confusion and forgetfulness. 
Doctor: How frequent are these episodes? 
Patient: Well, they occur like two or three times in a week. Each one of the episodes lasts for like one or two minutes.

Clinical note:
Symptoms: Episodic confusion and memory loss lasting several minutes, forgetfulness, confusion, no other associated Symptoms
Diagnosis: Stroke on January 17, 1992, anticonvulsant and aspirin medication, episodes occur 2-3 times per week
History of Patient: N/A
Plan of Action: Monitor medication adherence, evaluate for potential underlying causes of ongoing Symptoms
Doctor: Any medical disorders in the family? 
Patient: Yeah, my father had a special kind of tumor, which doctors said is very rare. 
Doctor: Do you know the name of the tumor? 
Patient: I don't remember the exact name of the disease, but it was a big name and it started with something with V.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: Father had Von Hippel-Lindau Disease (VHL)
Plan of Action: N/A
Doctor: Do you have any major medical conditions that I should know about? 
Patient: Actually, I have a whole list of conditions. I have them written down here. 
Doctor: Thank you, so I see congestive heart failure, chronic renal insufficiency, azotemia, hyperglycemia, coronary artery disease, and a history of paroxysmal atrial fibrillation. Oh, and azotemia.
Patient: Yes, I told you I have a lot going on. 
Doctor: Are you taking any medications? 
Patient: Well, they wanted me to take Coumadin but I had, um, a subdural hematoma so they would let me. 
Doctor: I see, what about any neurological or psychological conditions? 
Patient: Well, I have depression, and I've had panic attacks while taking Doxepin before. 
Doctor: I see here that you also have perioperative anemia, does that sound familiar? 
Patient: Yes, another doctor told me about that. 
Doctor: Do you have any other symptoms you'd like to report today? 
Patient: Um, I'm having some difficulty swallowing.

Clinical note:
Symptoms: Difficulty swallowing
Diagnosis: Congestive heart failure, chronic renal insufficiency, azotemia, hyperglycemia, coronary artery disease, paroxysmal atrial fibrillation, remote history of subdural hematoma precluding the use of Coumadin, depression, panic attacks on Doxepin, perioperative anemia, swallowing difficulties
History of Patient: N/A
Plan of Action: Evaluate difficulty swallowing and address underlying medical conditions
Doctor: Doctor Shami, can you please take down the notes as I examine the patient? 
Guest_clinician: Sure. 
Doctor: Can you put the heading as cervical lymph nodes. 
Guest_clinician: Okay.
Doctor: I am going to check for any swelling in your neck okay? Can you look down?
Patient: Okay. 
Doctor: Alright, I do not feel anything here. Can you look up?
Patient: Sure.
Doctor: No palpable nodes here. None of the lymph nodes are enlarged or have any swellings. 
Guest_clinician: So, no lymph adenopathy?
Doctor: Yeah.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: N/A
Plan of Action: No lymphadenopathy
Doctor: You have chronic pain? 
Patient: Yes I do.
Doctor: You use tobacco also?
Patient: Yes.
Doctor: And you have a history of hepatitis C, right?
Patient: That sounds right.
Doctor: Okay.
Patient: Yeah.

Clinical note:
Symptoms: Chronic pain
Diagnosis: N/A
History of Patient: Tobacco use, History of hepatitis C
Plan of Action: N/A
Doctor: Have you had any surgeries in the past? 
Patient: No, none.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: No surgeries in the past
Plan of Action: N/A
Doctor: Do you live close to the office, or did you have to drive a long way here? 
Patient: I live right around here, I'm a local girl. 
Doctor: Good, are you working right now?
Patient: Yes, doctor, I work full time. 
Doctor: That's good, sometimes it's nice to stay busy. Is there any history of drug or alcohol abuse I should know about? 
Patient: No, absolutely not, doctor.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Patient: Patient lives locally, works full time, no history of significant alcohol or illicit drug use
Plan of Action: N/A
Doctor: How are you, Mary? 
Patient: I am okay, I have got this ulcer on my right hip again. 
Doctor: Oh, is it like the one you got last time?
Patient: Pretty much.
Doctor: Oh, I remember that one. It took almost three treatment cycles to get resolved.
Patient: Yeah. They keep saying I have some hidden split in my spine still. 
Doctor: Yeah, it looks like you have residual spina bifida.
Patient: I am just so frustrated sitting in my wheelchair. I am spending around sixteen hours a day in this wheelchair. 
Doctor: I think, that is the reason you developed this pressure ulcer. It appears to be on the right trochanter area. In simple terms you have developed a pressure sore on the outer part of your hip. 
Patient: Yeah, I recently celebrated my thirtieth birthday just sitting in my wheelchair the whole day.
Doctor: Oh, I am sorry dear. So, how long since you have had this ulcer?
Patient: It's been several weeks, so I thought I should get it checked.
Doctor: Yeah, good thing you came. We need to treat it. Did you experience any chills or fever? 
Patient: No.
Doctor: Any other symptoms?
Patient: No.

Clinical note:
Symptoms: Ulcer on right hip, spending around sixteen hours a day in wheelchair
Diagnosis: Residual spina bifida, pressure sore on outer part of hip (trochanter area)
History of Patient: History of similar problem last year, spending most of time in wheelchair, developed pressure ulcer on right trochanter area several weeks ago
Plan of Action: Presenting for evaluation and management of pressure ulcer, denies chills or fever, no other Symptoms reported
Doctor: Do you have any history of heart disease that you know of?
Patient: Nope, nothing like that. 
Doctor: How about diabetes?
Patient: No, there's no sugar here that I know of. 
Doctor: Good, and how about your lungs? Do they work well. 
Patient: Absolutely, they're in great shape. There's nothing like that here.

Clinical note:
Symptoms: N/A.
Diagnosis: N/A.
History of Patient: Denies history of diabetes, cardiovascular disease, or pulmonary disease.
Plan of Action: N/A.
Doctor: How about allergies to medications? 
Patient: Nope.

Clinical note:
Symptoms: N/A.
Diagnosis: N/A.
History of Patient: No known drug allergies.
Plan of Action: N/A.
Doctor: Your chest x ray showed diffuse pulmonary edema. This means that you have fluid in your lungs. That would explain your chest pain and the difficulies with your breathing. I would like to start you off with a course of antibiotics to prevent any possible infection. I will also send in a prescription for Furosemide. It will reduce the fluid accumulation in your lungs. Do you have any questions? 
Patient: When should I start to feel better? 
Doctor: You should start to feel better within three to five days.

Clinical note:
Symptoms: Chest pain, difficulties with breathing.
Diagnosis: Diffuse pulmonary edema (fluid in lungs).
History of Patient: N/A.
Plan of Action: Prescribed antibiotics to prevent infection and Furosemide to reduce fluid accumulation in lungs. Patient should start feeling better within three to five days.
Doctor: Any headaches?
Patient: No.
Doctor: Any history of seizures or epilepsy?
Patient: No.
Doctor: Any sudden loss of consciousness or have you blacked out?
Patient: Um, no.
Doctor: Any weakness? Feeling any tremors in your body?
Patient: No, nothing like that.
Doctor: Any history of stroke or any brain related condition? 
Patient: No, no such history.

Clinical note:
Symptoms: N/A.
Diagnosis: N/A.
History of Patient: Denies headaches, seizures, loss of consciousness, weakness, tremors, strokes, or other neurological conditions.
Plan of Action: N/A.
Doctor: Are there any known disease running in your family?
Patient: My dad has high blood pressure, and he takes medication for it. He is now eighty two years old. He had a stroke around two years ago. This was his second stroke. First one he had when he was forty five. 
Doctor: What about your mom? How old is she?
Patient: My mom is eighty years old. She does have sugar issues.

Clinical note:
Symptoms: N/A.
Diagnosis: N/A.
History of Patient: Father has a history of high blood pressure and experienced two strokes, one at age 45 and another around 2 years ago at age 80. Mother has sugar issues.
Plan of Action: N/A.
Doctor: Are you currently living alone? 
Patient: Yep. Just me, myself, and I. 
Doctor: What do you do for a living? 
Patient: I've been working as a plumber for the last five years. 
Doctor: Nice. Where do you work? 
Patient: Mostly in the city. 
Doctor: Do you drink, smoke, or do injection drugs? 
Patient: I drink and smoke here and there, but I've never tried hard drugs. 
Doctor: Any recent travel? 
Patient: I was in Mexico earlier this year. 
Doctor: That sounds nice. How was your trip? 
Patient: Relaxing. Much needed. 
Doctor: Great to hear. I have a few more questions I need to ask so bear with me. How is your sexual history? Are you sexually active? 
Patient: I'm sexually active with women, but my sex life isn't as good as it was in Japan. Over there, I would mix and mingle with prostitutes. 
Doctor: Did you use protection? 
Patient: I don't really remember. 
Doctor: Have you been tested for S T D's? 
Patient: Yep. I'm negative for right now. 
Doctor: Have you ever been incarcerated? 
Patient: Nope. 
Doctor: One last question. Have you ever been in need of a blood transfusion? 
Patient: No, thank God.

Clinical note:
Symptoms: N/A.
Diagnosis: N/A.
History of Patient: Patient is single and lives alone. He works as a plumber. He smokes and drinks occasionally, denies IV drug use, and has a history of sexual encounters with prostitutes in Japan. He recently traveled to Mexico. Denies history of blood transfusion or incarceration.
Plan of Action: N/A.
Doctor: Good afternoon, champ, how you holding up?
Patient: Good afternoon, Doctor, I have a lot of lower back pain. 
Doctor: Oh no, before we begin, how old are you, sir and which hand do you write with?
Patient: I'm seventy five now. Right.
Doctor: Great, so tell me, how long have you had this lower back pain? 
Patient: It's been about ten days now. 
Doctor: Have your symptoms improved at all since they began? 
Patient: No, they keep getting worse. 
Doctor: Does the pain radiate into your legs? 
Patient: Yes, it started radiating down my right leg three days after the lower back pain began, and then the left leg three days after the right. The next day I could barely walk, the pain was so severe. 
Doctor: Do you remember the initial date of the beginning of your low back pain? 
Patient: Um, it was on December third nineteen ninety five. 
Doctor: Have you seen another doctor for this pain? 
Patient: Yes, I saw my local physician, um, it was on December eleventh, but he wasn't able to pinpoint what was going on. 
Doctor: What kind of treatments did he recommend? 
Patient: He gave me some antiinflammatories and sent me on my way. 
Doctor: Did you drive yourself? 
Patient: Yes, I did. 
Doctor: How did the antiinflammatories work? 
Patient: Um, by the time I got home, I could hardly walk due to the back pain, and I had weakness in my legs. I was, however, able to feed my dogs, and I fixed myself some dinner. 
Doctor: Was there any leg numbness? 
Patient: Yes. Since December eleventh. 
Doctor:  Have you seen an orthopedist for this pain? 
Patient: Yes, I saw one the day after my primary care physician, but my legs gave out and I fell while walking to my car because of the leg weakness and back pain.  
Doctor: What kind of imaging studies did that orthopedist do? 
Patient: He did a C T and x rays of my lower back, but he didn't see anything wrong. He recommended I follow up at U I H C. The imaging was on my L S Spine.

Clinical note:
Symptoms: Lower back pain, radiating pain into right leg and then left leg, leg weakness, leg numbness.
Diagnosis: N/A.
History of Patient: 75-year-old male presenting with progressively worsening lower back pain starting on December 3, 1995. Pain began radiating down right leg on December 6, 1995, then down left leg on December 9, 1995. Developed difficulty walking by December 10, 1995. Saw local physician on December 11, 1995, who prescribed NSAIDs. Experienced leg weakness and numbness since December 11, 1995. Saw local orthopedist on December 12, 1995, who conducted CT scan and X-rays of L-S Spine, which were negative. Referred to UIHC.
Plan of Action: N/A.
Doctor: Alright. So this is going to be a complex case. Your wound is complicated by methicillin-resistant staphylococcus aureus cellulitis. 
Patient: Is there a treatment for my right leg?
Doctor: There is. It will be more aggressive, but we can do it.

Clinical note:
Symptoms: N/A.
Diagnosis: Complex open wound right lower extremity complicated by methicillin-resistant Staphylococcus aureus cellulitis.
History of Patient: N/A.
Plan of Action: Aggressive treatment for the wound.
Doctor: What is going on with him?
Guest_family: He is complaining of chest pain.

Clinical note:
Symptoms: Chest pain.  
Diagnosis: N/A.  
History of Patient: N/A.  
Plan of Action: He is maintained on Flonase and denies much in the way of nasal Symptoms.
Doctor: Good morning, young man. You're a patient of Doctor X Y Z, correct? 
Patient: Yes sir, that's right. I've seen him for years. 
Doctor: I just need to confirm some demographic information before we get started today. So, you're a twenty nine year old white male, correct? 
Patient: Yes, doctor. That's all right. 
Doctor: Great, thank you. So, what seems to be the problem today?
Patient: Well, I got stung by a Yellow Jacket Wasp yesterday. 
Doctor: Do you have a lot of swelling? 
Patient: Yes, it's in my right hand and right arm. 
Doctor: Have you every been stung by wasps before?
Patient: Yeah, this wouldn't be the first time. 
Doctor: Have you had similar reactions before? 
Patient: Yeah, I have. I have had one severe reaction. I came because I wanted to make sure it didn't get to that point again. I've never had, um, anaphylaxis, nothing super serious to date. 
Doctor: Okay, that's good. Do you have any shortness of breath or difficulty with your throat?
Patient: No, it's never felt like it was going to close up or anything like that. 
Doctor: Do you have any rapid heartbeat or anxiety?
Patient: No, I don't have anything like that either. 
Doctor: So, it's just the localized swelling where you got stung?
Patient: Yes, that's really all, doctor.

Clinical note:
Symptoms: Chest pain.  
Diagnosis: N/A.  
History of Patient: He was stung by a Yellow Jacket Wasp, experiencing localized swelling in his right hand and arm.  
Plan of Action: N/A.
Doctor: When was your last menstrual period?
Patient: Um, it was around June third of two thousand nine.
Doctor: Okay so it says you have had an abortion recently?
Patient: Yes I have, but I am not sure if it is finished, because I am still bleeding.
Doctor: Okay.
Patient: Do you want me to do a pregnancy test?
Doctor: No I would have you see our Gynecology and Obstetrician.
Patient: Okay.

Clinical note:
Symptoms: N/A.  
Diagnosis: N/A.  
History of Patient: Her last menstrual period was 6/3/2009. The patient is admitting to having a recent abortion done. She is not too sure whether the abortion was completed or not, has not had a followup with her OB/GYN.  
Plan of Action: N/A.
Guest_family: My nipples are cracked, and they are bleeding.
Doctor: Oh, I am so sorry to hear that.
Guest_family: He has some fluid coming out of his belly button as well as his penis.
Doctor: Okay I will look at it. But other than that, everything else looks good? Any other problems related to circumcision?
Guest_family: No, no other issues.

Clinical note:
Symptoms: Cracked and bleeding nipples in mom, umbilical discharge, and penile discharge in the child.
Diagnosis: N/A.
History of Patient: N/A.
Plan of Action: Doctor will examine the umbilical and penile discharge. No other issues related to circumcision reported.
Doctor: Welcome to the clinic, Miss A. 
Patient: Thank you. 
Doctor: Let's start with your medical history. What medical conditions do you have? 
Patient: Okay. I have high blood pressure, asthma and sleep apnea. I had blood clots in my left leg about six months ago. I also have cancer. 
Doctor: What kind of cancer do you have? 
Patient: I have stomach cancer. They also did a total abdominal hysterectomy. 
Doctor: Did they put you on an anticoagulant medication for the blood clotting? 
Patient: Yes. I took it for six months. I stopped taking it and then I had the stroke. 
Doctor: Have you had any other surgeries? 
Patient: Yes. I had a colonic resection to remove benign polyps. I had another benign lump removed from my breast.  
Doctor: How are you feeling today? 
Patient: I am still having weakness in my left leg. That is why I still have to us my walker, but I have been able to get around easier. 
Doctor: Have you been experiencing any daytime fatigue? 
Patient: No. I have been falling asleep at work. I think it is from looking at my computer screen all day. My supervisor caught me snoring one day and forgot where I was at. My supervisor offered to give me a coffee. This has happened more than once. 
Doctor: This could be due to your sleep apnea. Who is treating you for your sleep apnea? 
Patient: Doctor X did a consult and had me do one of those sleep test about two years ago. I only get sleepy when I look at my computer screen. 
Doctor: Did Doctor X recommend a C P A P machine to use at night? 
Patient: Yes, but I never used to use it. I had another follow up visit with her and she told me that I need to use it every night. I have been using it every other night. 
Doctor: How much uninterrupted sleep do you think that you get per night? 
Patient: Maybe two to five hours, on a good night. 
Doctor: That is not enough sleep. No wonder you are falling asleep at work. I recommend following up again with Doctor X regarding your sleep apnea. You are at a much higher risk for obesity and high cholesterol if you continue to not address the issues you have been having with the lack of sleep and sleep apnea. 
Patient: Okay. I will make a follow up visit with her.

Clinical note:
Symptoms: Weakness in left leg, daytime fatigue, falling asleep at work
Diagnosis: Hypertension, asthma, sleep apnea, residual left leg weakness, obesity, hypercholesterolemia
History of Patient: Patient reports continued left leg weakness and improvement in motor functioning. She acknowledges falling asleep at work, which she attributes to looking at a computer screen. She experiences snoring and forgetfulness at work, with a supervisor offering her coffee. Patient receives 2-5 hours of sleep per night.
Plan of Action: Patient to follow up with Dr. X regarding sleep apnea treatment. Advised on risks of untreated sleep apnea, obesity, and hypercholesterolemia.
Doctor: They gave you Procrit for your anemia? 
Patient: Yes I think so. That is how they treated it in the past.
Doctor: Okay. Are you married? Who do you live with?
Patient: Oh I am by myself.
Doctor: Okay, and do you smoke or drink alcohol?
Patient:  No I do not.
Doctor: Great.
Patient: Okay.

Clinical note:
Symptoms: N/A.
Diagnosis: N/A.
History of Patient: History of anemia treated with Procrit. No smoking or alcohol use, lives alone.
Plan of Action: N/A.
Doctor: Hello. How are you doing? 
Patient: Not doing that good. I'm here so that you can help me. 
Doctor: Tell me how can I do that? What's bothering you? 
Patient: I have gestational diabetes and I'm here for consultation related to my diet. No matter what I eat, I'm kind of scared that it will spike up my numbers. 
Doctor: Hold on, hold on. First, tell me how old are you? 
Patient: Sorry. I am thirty eight. 
Doctor: Okay, now tell me what are you afraid of? 
Patient: No matter what I eat, my number goes up and I just, I'm so afraid of eating anything now. 
Doctor: Do you work? 
Patient: I do, at Walmart. I try not to eat anything whenever I'm on the third shift. 
Doctor: Tell me about the eating habits. Do you prepare meals at home, or do you order from outside? 
Patient: Well, before all this, I mean this gestational diabetes and pregnancy, I used to eat out a lot. Almost like every day. I like to eat rice a lot. It is like the staple food for me. 
Doctor: You said you don't try to eat, so are you facing any symptoms because of not eating? 
Patient: Yeah, whenever I'm on my late shift, I work from ten in the night to seven in the morning. I try to avoid eating. And then I feel very fatigued and tired all the time. I also have young kids at home, so after finishing my duty here at in the morning I go home and then there are young children who keep me busy. 
Doctor: What is your sleeping pattern? How much are you sleeping throughout the day? 
Patient: Around two to four hours at a time. 
Doctor: When do you test for ketones? 
Patient: Normally, it is the first thing that I do when I reach back home from my shift in the morning.

Clinical note:
Symptoms: Fatigue, tiredness.
Diagnosis: Gestational diabetes.
History of Patient: Patient is scared to eat due to fear of blood sugar spikes. Works third shift at Walmart, avoids eating during late shift, leading to fatigue and tiredness. Previously ate out frequently and enjoys rice as staple food. Sleeps two to four hours at a time throughout the day. Tests for ketones upon returning home from work.
Plan of Action: Dietary consultation for gestational diabetes, advice on meal planning and timing to manage blood sugar levels.
Doctor: How old are you? What brings you here today? 
Patient: I am fifty six years old. I am here for this pain in my legs. It hurts mostly in the night. 
Doctor: Does changing positions helps you? 
Patient: Yeah, it helps. Whenever I stand it just goes away. 
Doctor: Is it only in your legs or it starts there and goes somewhere else as well? 
Patient: It normally starts in my hips and then it goes down my leg and sometimes into my ankles as well. 
Doctor: When did you first notice it? 
Patient: It all started after taking that medication. What is it called? Something with L? Yeah, Lipitor. 
Doctor: Have you ever noticed any night sweats? 
Patient: Sometimes I do sweat at night. 
Doctor: Any other issue? Anything else going on? Your body temperature is a little on the higher end. 
Patient: Yeah, I do feel feverish and have nausea as well. 
Doctor: How are your sugar numbers? 
Patient: They have been low for quite some time. You know, I have started going to Genesis in Wichita and I've been doing water aerobics. And you know what? Surprisingly, I have lost thirty pounds. 
Doctor: That's good. How much is your fasting sugar? 
Patient: Anywhere between a hundred to one hundred and twenty. I check them one and a half hours after meals as well. They are, they have been one hundred and eighty five regularly. 
Doctor: Okay. 
Patient: Yeah. I have a request to make. I will be coming for my diabetic checkup in one month. Can we do all the labs before that? 
Doctor: Yeah, sure, that's a great idea. I should tell my assistant and they will call you for labs before your appointment for diabetes checkup. 
Doctor: Anything else going on? How is everything else? 
Patient: I tried to control my cholesterol with diet, but it didn't help. I cannot keep on dieting. It is just not my thing. I have started eating more meat though. I feel full after that.

Clinical note:
Symptoms: Pain in legs at night, radiating from hips to legs and ankles, relieved by changing positions, occasional night sweats, feverish feeling, nausea.
Diagnosis: N/A.
History of Patient: Onset of leg pain after starting Lipitor medication. Low blood sugar levels, weight loss of 30 pounds after starting water aerobics. Fasting blood sugars range from 100 to 120, post-meal blood sugars at 185. Requesting labs before upcoming diabetic checkup. Increased meat consumption due to failed attempts at controlling cholesterol with dieting.
Plan of Action: Further evaluation of leg pain, monitoring blood sugar levels, scheduling labs before diabetic checkup, consideration of cholesterol management alternatives.
Doctor: Are you married? 
Patient: Yes. 
Doctor: Do you have kids? 
Patient: Yes, I do have seven. I have a handful. 
Doctor: Do you work? 
Patient: Yeah, I'm a driver for FedEx. 
Doctor: Did you ever smoke? 
Patient: Nope. 
Doctor: What about alcohol or any other kind of drugs? 
Patient: Nope. None of that.

Clinical note:
Symptoms: N/A.
Diagnosis: N/A.
History of Patient: N/A.
Plan of Action: N/A.
Doctor: Is patient allergic to any medication? 
Guest_clinician: Yes, actually he is allergic to quite a few medicines. I have noted them down, here is the list.
Doctor: Okay, so he is allergic to Lamisil, Equagesic. Oh, he is allergic to Bactrim too. 
Guest_clinician: Yeah, and Dilatrate and cyclobenzaprine.
Doctor: That's quite a lot, we need to be careful while making his treatment plan.
Guest_clinician: Yeah.

Clinical note:
Symptoms: allergic to some medicines-Lamisil, Equagesic, Bactrim, Dilatrate, cyclobenzaprine.
Diagnosis: N/A.
History of Patient: N/A.
Plan of Action: N/A.