galgantar/MTS-Dialog-cleaned huggingface dataset:
Clinical note section (ROS): MSK: Negative myalgia, negative joint pain, negative stiffness, negative weakness, negative back pain.

Dialogue:
Doctor: Any pain in your muscles? 
Patient: No, no pain.
Doctor: How about joint pain? 
Patient: Um no, I don't feel any joint pain.
Doctor: Okay, good.
Doctor: Do you feel any stiffness or weakness in your muscle? 
Patient: Um, nothing like that.
Doctor: Do you have any back pain? 
Patient: No.
Doctor: Okay.
Clinical note section (GENHX): The patient is a 77-year-old female who is unable to give any information.  She has been sedated with Ativan and came into the emergency room obtunded and unable to give any history.  On a chest x-ray for what appeared to be shortness of breath she was found to have what was thought to be free air under the right diaphragm.

Dialogue:
Guest_clinician: How old is the patient? 
Doctor: Seventy seven. 
Guest_clinician: She was sedated with Ativan, correct? 
Doctor: Yeah, we had to sedate her. She wasn't doing so well upon arrival and appeared short of breath. She couldn't give us a history and we immediately had Xray come in to scan her lungs. 
Guest_clinician: Did they find anything? 
Doctor: The report showed what we believe to be free air under her right diaphragm.
Clinical note section (FAM/SOCHX): He is retired from the social security administration x 20 years.  He travels a lot and is extremely active.  He does not smoke.  He consumes alcohol socially only.  He does not use illicit drugs.  He is married.

Dialogue:
Doctor: Are you still working, sir? 
Patient: No, I am retired now. I worked for twenty years in social security administration. 
Patient: Now I just enjoy my life with my wife, we travel a lot. I like to be extremely active. 
Doctor: That's awesome. 
Doctor: Do you drink?
Patient: Yes, but only socially. 
Doctor: How about smoking or any drugs?
Patient: No, I don't smoke or do any kind of drugs or anything. 
Doctor: Okay.
Clinical note section (ALLERGY): No known drug allergies.

Dialogue:
Doctor: Do you know about any allergies from any medications?
Patient: No.
Clinical note section (ROS): Non-contributory. The patient denied fever, chills, ulcers, liver disease or history of gallstones. Vaccines: The patient was vaccinated with BCG before starting elementary school in the Philippines.

Dialogue:
Doctor: Did he get his B C G vaccine?
Guest_family: Yes, he did back in the Philippines before starting his elementary school. 
Doctor: Okay, did you have his immunization records?
Guest_family_2: Yes, we submitted it at the front desk.
Doctor: Okay, how long has he been complaining of uneasiness in his stomach?
Guest_family_2: For a few days.
Doctor: Any history of liver problems or gallbladder stones?
Guest_family: No, he had his physical and blood tests and everything came out normal.
Doctor: Okay, good. Any fever or chills?
Guest_family: No.
Doctor: Any history of ulcers?
Guest_family_2: No.
Clinical note section (ASSESSMENT): 1.  Hypertension. 2.  Hypercholesterolemia. 3.  Osteoarthritis. 4.  Fatigue.

Dialogue:
Patient: I am always tired, I don't know what to do.
Doctor: Yeah, your fatigue can be due to so many reasons. You have many underlying conditions. You have hypertension, high cholesterol, and osteoarthritis. All this can add up and lead to fatigue. I think you need to really take care of your health.
Clinical note section (FAM/SOCHX): Remarkable for being married, retired, quit smoking in 1997, rare use of alcohol, lives locally with his wife.

Dialogue:
Doctor: And how long have you been married?
Patient: I have been happily married for forty five years.
Doctor: Wow, that's remarkable. 
Patient: Yes, we have a small house by the bay just two miles away from your office. This is my dream house. I always dreamt of living in a house with a waterfront and when I retired, I moved here with my wife. It's nice and peaceful. 
Doctor: That's amazing! Okay so tell me something do you drink or smoke?
Patient: Oh, I quit smoking long time ago. Was it ninety six or ninety seven? Hm I think I quit smoking in nineteen ninety seven. I do enjoy a glass of wine or beer but very occasionally. 
Doctor: Okay.
Clinical note section (ALLERGY): The patient has sinus and CVA.  He is a nonsmoker.  No known drug allergies.

Dialogue:
Guest_clinician: Hello, my name is Mary. I will ask you a few questions about your medical and family history and then Doctor Smith will come and check you. Okay?
Patient: Okay. 
Guest_clinician: Do you have any other previously diagnosed medical issues?
Patient: I have sinus. I also had a stroke around two years ago.
Guest_clinician: Do you smoke or drink?
Patient: Nope, never did any of those.
Guest_clinician: Do you have any kind of allergies?
Patient: No, no known allergies.
Guest_clinician: Thank you for answering all my questions, I will let Doctor Smith know that you are ready.
Clinical note section (PLAN): To follow a low-salt diet.

Dialogue:
Doctor: Do you know what foods have a high level of salt?
Patient: Do you mean like chips and junk food?
Doctor: Yes mostly. And pickles.. I want you to avoid them.
Patient: Okay. Why?
Doctor: Because it is harmful for your current condition. 
Patient: Okay I will cut it.
Doctor: Yes, so follow a low salt diet.
Patient: Okay.
Clinical note section (CC): Nausea, vomiting, diarrhea, and fever.

Dialogue:
Doctor: Any nausea, vomiting diarrhea, or fever?
Patient: Yes, all of the above. 
Doctor: Okay.
Clinical note section (DISPOSITION): The patient is discharged home.

Dialogue:
Doctor: So, Doctor Pai how is your patient that you told me about?
Guest_clinician: Oh, we discharged her, she went home.
Doctor: That's great!
Guest_clinician: Yeah.
Clinical note section (EDCOURSE): I discussed the case with Poison Control and apparently this is actually relatively small quantity and it is likely to be a nontoxic ingestion if she even ingested, which should does not appear likely to be the case.

Dialogue:
Doctor: I spoke with Poison Control regarding the possible ingestion of the liquid. They let me know that it is actually a relatively small amount and is likely to be a nontoxic ingestion of the liquid, if she did end up ingesting it. It is not likely to be the case as she is behaving as if she did not ingest any of the liquid.
Guest_family: Thank god! Thank you.
Clinical note section (FAM/SOCHX): The patient does not smoke nor drink alcohol.

Dialogue:
Doctor: Do you smoke cigarettes?
Patient: No, I do not.
Doctor: Good, no one should.
Patient: Yeah, it's a bad habit.
Doctor: Okay. How about alcohol?
Patient: No, I don't drink either.
Doctor: Okay.
Patient: Yeah.
Clinical note section (ALLERGY): Bactrim, which causes nausea and vomiting, and adhesive tape.

Dialogue:
Doctor: And how about any allergies? Are you allergic to any drug or anything?
Patient: Ah, yes I am very allergic to Bactrim. 
Doctor: It causes you side effects?
Patient: Yes, It causes me nausea and vomiting. 
Doctor: I see. 
Patient: I think I am also allergic to adhesive tape. I get this skin rash almost immediately if I use adhesive tapes. 
Doctor: Interesting.
Clinical note section (FAM/SOCHX): polysubstance abuse. smoked 1 pack per day for 15years.

Dialogue:
Doctor: Have you ever smoked? 
Patient: Yes, I've been smoking around one pack. 
Doctor: Each day, is it? 
Patient: Yes.
Doctor: For how long? 
Patient: Around fifteen years. 
Doctor: Do you take any other drug or consume alcohol? 
Patient: Yeah, I'm an addict. I take oxy and a few more narco stuff, which I get from the street, and I drink a lot. I need help.
Clinical note section (GENHX): This is a 36-year-old white female who presents to the office today with a complaint of left knee pain.  She is approximately five days after a third Synvisc injection.  She states that the knee is 35% to 40 % better, but continues to have a constant pinching pain when she full weight bears, cannot handle having her knee in flexion, has decreased range of motion with extension.  Rates her pain in her knee as a 10/10.  She does alternate ice and heat.  She is using Tylenol No. 3 p.r.n. and ibuprofen OTC p.r.n. with minimal relief.

Dialogue:
Doctor: Good morning, ma'am. Did you have a good thirty-sixth birthday?
Patient: Yes, thank you. It was a nice day, despite the knee pain. 
Doctor: That's good, we'll get back to that knee in a moment. Just to confirm, you identify as white, correct? 
Patient: Yes, I do. 
Doctor: Thank you. I just needed to make sure my chart was correct. So, is this left knee still bothering you? 
Patient: Yes, unfortunately, it still is.
Doctor: You've had three Synvisc injections, correct? When was your last one?
Patient: Yes, that was about five days ago, right before my birthday. 
Doctor: Did that provide any relief at all?  
Patient: Well, I'd say there's been, um, thirty-five or forty percent improvement. 
Doctor: Are you still having the pinching pain?
Patient: Yes, it's so bad when I try to put my full weight onto this knee. 
Doctor: Can you bend this knee at all?
Patient: Ow, no, please stop. I can't handle that bending, doctor. 
Doctor: Can you straighten the knee out for me, please? 
Patient: No, not all the way, look. 
Doctor: Yes, that's not out all the way. 
Patient: It hurts really bad, doctor. 
Doctor: With ten being the worst pain ever, how would you rate your pain today out of ten?
Patient: Oh, it's easily a ten out of ten. 
Doctor: Have you used ice or heat? 
Patient: Yes, I use both. I alternate the two. 
Doctor: What medicines are you taking?
Patient: I'm using that Tylenol with codeine you gave me and then some ibuprofen I got from the grocery store. 
Doctor: Have those helped at all?
Patient: I'd say they helped pretty minimally.
Clinical note section (PASTMEDICALHX): Hypertension, hyperlipidemia, recent C. diff colitis, which had resolved based on speaking to Dr. X.  Two weeks ago, he had seen the patient and she was clinically well.

Dialogue:
Doctor: So I talked to Doctor X about your problems.
Patient: And?
Doctor: And he said your recent intestine infction is resolved. Which is C Diff colitis. You saw him two weeks back right?
Patient: Oh Thank God! Yes thanks, recently i saw him.
Doctor: Yeah.
Patient: Ok alright. 
Doctor: And we have Hypertension and high Cholesterol as well which we talked about.
Patient: Thanks doc.
Clinical note section (ASSESSMENT): No intra-abdominal pathology.

Dialogue:
Guest_clinician: Is there any notable intra abdominal pathology? 
Doctor: None whatsoever. 
Guest_clinician: Well, that's good news.
Clinical note section (CC): A 2-month-old female with 1-week history of congestion and fever x2 days.

Dialogue:
Doctor: I hear she hasn't been doing so well. 
Guest_family: My poor two-month-old baby girl has been congested for a whole week. I'm so worried about her. 
Doctor: I completely understand. It's never easy to see your baby sick. Have you taken her temperature recently? 
Guest_family: Yes, I've been using an anal thermometer. She's been running a fever for the past two days. 
Doctor: I'm glad you brought her in today. I'll go ahead and take her temperature again. Is she experiencing any other symptoms, such as difficulty breathing or wheezing at all? 
Guest_family: Not that we've noticed. 
Doctor: Is she taking down milk? 
Guest_family: Barely. Not as much as she used to the week before she started to feel bad. 
Doctor: How often have you been changing her diapers? 
Guest_family: Hm three or four times. I should've kept better track.
Clinical note section (MEDICATIONS): None.

Dialogue:
Doctor: So, just to confirm, no current medications? 
Patient: Yes, that's right.
Clinical note section (ALLERGY): He has no known drug allergies.

Dialogue:
Doctor: Any allergies to medicine he might have? 
Guest_family: No, no allergies that we know of.
Doctor: Okay.
Clinical note section (ROS): EYES: Negative visual changes, negative diplopia, negative scotomata, negative impaired vision.

Dialogue:
Doctor: Any problems with your eyesight? Like blur or double vision?
Patient: Um, no.
Doctor: Any partial loss of vision or blind spot?
Patient: Um, no.
Doctor: So, no loss vision, right?
Patient: Right.
Clinical note section (FAM/SOCHX): Mother and 2 maternal aunts with asthma. No history of renal or rheumatologic diseases.

Dialogue:
Doctor: Anyone have asthma at home?
Patient: Yes, my mother and her two sisters have long term asthma.
Doctor: Okay.
Patient: Yes.
Doctor: Any other diseases like kidney problems?
Patient: No kidney problems.
Doctor: Any rheumatological disorders?
Patient: Oh, no, no. Nothing like that.
Clinical note section (LABS): EKG is within normal limits, good sinus rhythm.  His axis is somewhat leftward.  CBC and BMP were normal and cardiac enzymes were negative x1.

Dialogue:
Doctor: Your E K G looks good. Rhythm is normal. Your axis is somewhat leftward, but this is a normal variation. It is not an abnormal finding and in most cases does not need any further treatment.
Patient: How about blood tests?
Doctor: Your CBC and BMP came back normal and your cardiac enzymes were negative x1.
Doctor: Do you know what they are?
Patient: Yes, I can understand.
Clinical note section (MEDICATIONS): None except the Amoxil and Aldex started on Monday.

Dialogue:
Doctor: What are your current medications?
Patient: None, except the Amoxil and Aldex that I started on Monday.
Clinical note section (GENHX): The patient is a 17-year-old female, who presents to the emergency room with foreign body and airway compromise and was taken to the operating room.  She was intubated and fishbone.

Dialogue:
Guest_clinician: How old is the patient? 
Doctor: She's seventeen years old. 
Guest_clinician: Did they determine what was obstructing her airways? 
Doctor: Yes, they found a two millimeter fishbone lodged in her throat. She had to be intubated and taken straight to the O R.
Clinical note section (GENHX): This is a followup dietary consultation for hyperlipidemia, hypertension, and possible metabolic syndrome.  The patient reports that she has worked hard for a number of weeks following the meal plan prescribed, but felt like she was gaining weight and not losing weight on it.  She is not sure that she was following it accurately.  She is trying to walk 1-1/2 to 2 miles every other day, but is increasing her time in the garden and doing other yard work as well.  Once she started experiencing some weight gain, she went back to her old South Beach Diet and felt like she was able to take some of that weight off.  However she realizes that the South Beach Diet is not a healthy diet for her and so is coming back for better instruction on safe weight loss and low-fat eating.

Dialogue:
Doctor: Hello there, how are you doing? 
Patient: I'm doing good. Thank you. How about you? 
Doctor: Yeah, same old, same old. 
Doctor: So, looks like we're here to discuss your diet. Is that right? 
Patient: Yep. That's right. 
Doctor: Okay, let me look through your chart. It looks like you have high lipid levels, high blood pressure and a possibility for a metabolic syndrome. 
Patient: That looks like my chart. I'm kind of struggling here and I need your help. 
Doctor: Yeah, tell me did you follow the meal plan that we gave to you? 
Patient: I tried for many weeks to follow that meal plan that you gave me. 
Doctor: Okay, did it help? 
Patient: I don't know. I felt like I was still gaining weight instead of losing it. 
Doctor: Did you follow it exactly as you are, as you were asked to do?
Patient: I tried my best. But I feel like I am not doing it correctly or something. 
Doctor: Okay, tell me what kind of activities are you doing? How much physical activity are you doing on a regular basis? 
Patient: I try to walk around one and a half to two miles like every other day, but I'm spending more time in my garden and doing the yard work by myself. 
Doctor: That's good. Gardening gets-- can get hard and it helps you keep active. 
Patient: Oh yes, picking up all those pots from here to there and knowing that backyard of mine, it's a hard job. 
Doctor: Tell me what brings you here today? Like how can I help you? 
Patient: So, I think the meal plan that you gave was not working for me and there was definitely some weight gain, so I went back to my old South Beach Diet. 
Doctor: Okay. What were the results with your South Beach Diet then? Was it effective? 
Patient: I was able to get some pounds off. I felt pretty good about it. 
Doctor: That's good. Then what's the issue? 
Patient: Well, you see, deep in my heart I know this South Beach Diet is not a healthy diet for me and that's why I'm back to you. 
Doctor: I appreciate your honesty. You don't know how happy you made me by saying that. 
Patient: Yeah. You know, I'm here. So, tell me what to do to lose all this extra weight and how to enforce a low fat diet? What are your recommendations for that? 
Doctor: Let's set a plan for you.
Clinical note section (PASTSURGICAL): None.

Dialogue:
Doctor: Have you ever had surgery, ma'am? 
Patient: What, like a joint replacement? 
Doctor: Well, it could be anything from a joint replacement to a C section.
Doctor: Oh, no. I've never had surgery. I had all of my children naturally.
Clinical note section (EXAM): GENERAL: Well developed, well nourished, in no acute distress.

Dialogue:
Guest_clinician: Did you see that patient today? His general appearance looked good.
Doctor: Yeah, the patient was well developed and well nourished.
Guest_clinician: Was he in any acute distress?
Doctor: No.
Clinical note section (FAM/SOCHX): noncontributory

Dialogue:
Doctor: Do you have any family medical history? 
Patient: No. I don't know of any family health problems.
Clinical note section (ROS): Positive for right upper quadrant pain.  He has occasional nausea, but no vomiting.  His appetite has decreased.  No joint pain, TIA, seizure or syncope.  Other review of systems is unremarkable. I reviewed his past medical history, past surgical history, and family history.

Dialogue:
Doctor: Hi, how are you? 
Patient: I am okay, but I have this pain on my right side of the chest which is troubling me. 
Doctor: Where exactly do you have pain?
Patient: Ah, um it's kind of on the upper right side of my chest.
Doctor: Hm, do you have any nausea vomiting? 
Patient: Yeah, I have nausea sometimes but no vomiting.
Doctor: How is your appetite are you having a proper diet?
Patient: No not really. I don't feel hungry that much, my appetite has reduced a lot.
Doctor: Okay.
Doctor: Any fever, diarrhea headache or joint pain? 
Patient: No sir.
Doctor: Did you ever have any seizure or have loss consciousness or any stroke like symptoms?
Patient: Nothing of that sort.
Doctor: So, I just reviewed your past medical and surgical history. Tell me something, does anyone else in your family have this kind of chest pain? 
Patient: No, it's just me!
Doctor: Hm, okay.
Clinical note section (EXAM): BREASTS: Normal male breast tissue.

Dialogue:
Doctor: That is just normal male breast tissue, nothing to worry about.
Patient: Oh okay.
Clinical note section (EXAM): GENERAL: This is a well-developed and well-nourished, ??

Dialogue:
Doctor: You look good? What are you eating these days? 
Patient: I've just started a protein rich diet. I am taking whey protein and have added a lot of greens as well. 
Doctor: You look great! Keep doing whatever you're doing. It's working for you.
Clinical note section (PASTMEDICALHX): Positive for prostate cancer, intermittent urinary incontinence and left hip replacement.

Dialogue:
Doctor: Did you have any medical issues in the past? 
Patient: I was found positive for prostate cancer. 
Doctor: Anything else? 
Patient: I also had on and off trouble holding my urine. 
Doctor: Any surgery in the past? 
Patient: I had my hip replaced on the left side.
Clinical note section (EDCOURSE): RESTRAINTS: None.  She does have a palm protector in her right hand.

Dialogue:
Guest_clinician: Is the patient restrained? 
Doctor: No, but she does have a palm protector in her right hand.
Clinical note section (FAM/SOCHX): The patient lives with his wife.  He was an IT software developer, but he has been out of work for several months.  He smokes less than a pack of cigarettes daily. He denies alcohol or illicit drug use.

Dialogue:
Doctor: Welcome to the clinic, sir! 
Patient: Thank you. 
Doctor: Do you use tobacco product, alcohol, or recreational drugs? 
Patient: I don't drink or do drugs. I do smoke cigarettes. 
Doctor: How much do you smoke per day? 
Patient: I probably smoke less then a pack a day. 
Doctor: Do you live at home with anyone? 
Patient: I live at home with my wife. 
Doctor: What do you do for work? 
Patient: I am currently unemployed. I have been out of work for several months now. I was working as an I T software developer. 
Doctor: I am sorry to hear that.
Clinical note section (ROS): Review of systems is otherwise negative.

Dialogue:
Guest_clinician: I took her R O S, and everything looks normal except for mild soreness in her arm due to the vaccine.
Patient: In my left arm.
Doctor: Okay, thank you for updating the notes.
Guest_clinician: Sure, no problem.
Clinical note section (PASTSURGICAL): None.

Dialogue:
Doctor: Did you ever have had any surgery? 
Patient: Not that I remember.
Clinical note section (FAM/SOCHX): There were possible illicit drugs.  Her family is present, and I have discussed her case with her mother and sister.

Dialogue:
Doctor: Hi, how are you all?
Guest_family: We're good. Thank you. 
Doctor: How are you related to the patient? 
Guest_family: We are family. I am her mother and this is her sister.  
Doctor: Do you suspect any abuse of drugs?
Guest_family: we are not sure, but I guess she used to smoke or consume weed.
Doctor: I suspect there was some use of drugs as well. We can't tell which drug she was taking, but It looks like she was taking something.
Doctor: I hope you have understood her case very well and if there are any questions, please reach out to me.
Clinical note section (OTHER_HISTORY): None.

Dialogue:
Doctor: Have you ever been hospitalized for anything? 
Patient: No, thankfully. I was close to being hospitalized once, but it never actually happened. 
Doctor: And when was this? 
Patient: About two years ago. I got into a pretty brutal skateboarding accident.  
Doctor: Oh gosh. How long have you been skateboarding? 
Patient: Since I was a kid. Bout eight or nine years old. 
Doctor: Do you skate in your neighborhood or at a skatepark? 
Patient: Skatepark. I'll go with my friends every now and again.  
Doctor: Nice. I've never been skateboarding, but I've always been in awe of kids like you who know how to do cool skateboard tricks.
Clinical note section (PASTSURGICAL): Includes a repair of a right intertrochanteric femur fracture.

Dialogue:
Doctor: Any past surgeries I should know of? 
Patient: Uh yes. I had a femur fracture repaired. 
Doctor: Do you remember which side? 
Patient: It was on the right. 
Doctor: Let me pull up your records. 
Doctor: Okay, I see. It looks like you had a repair of the right intertrochanteric femur.
Clinical note section (GENHX): This is a return visit to the renal clinic for this patient.  She is an 85-year-old woman with history as noted above.  Her last visit was approximately four months ago.  Since that time, the patient has been considerably more compliant with her antihypertensive medications and actually had a better blood pressure reading today than she had had for many visits previously.  She is not reporting any untoward side effect.  She is not having weakness, dizziness, lightheadedness, nausea, vomiting, constipation, diarrhea, abdominal pain, chest pain, shortness of breath or difficulty breathing.  She has no orthopnea.  Her exercise capacity is about the same.  The only problem she has is musculoskeletal and that pain in the right buttock, she thinks originating from her spine.  No history of extremity pain.

Dialogue:
Doctor: Hello there!
Patient: Hi, how are you? 
Doctor: I am good. Do ypu mind stating your age and waht brings you in today? 
Patient: Oh, yes, I am 85 years old and I am having this weird muscle pain in my rightbuttocks region that I think it's radiating from my lower back or spine area I am not sure.
Doctor: Hm, what kind of pain is it? Like sharp pain or dull? 
Patient: It's kind of difficult to explain, but it's very irritating. 
Doctor: Okay! So, it's on the right side?
Patient: Yes.
Doctor: And when was your last visit to renal clinic? 
Patient: About four months back.
Doctor: Hm and you mentioned you are doing much better than before in terms of managing your high blood pressure with the current medication? 
Patient: Oh yes, absolutely I am doing so much better. I think earlier the nurse mentioned she has never seen my blood pressure this good. 
Doctor: Yes, it is much better than any of your previous visits. And no side effects, right?
Patient: No.
Doctor: Hm, and any other problem or any uneasiness?
Patient: Not really.
Doctor: Any nausea, vomiting or diarrhea?
Patient: No.
Doctor: Any weakness, dizziness or lightheadedness?
Patient: Nope.
Doctor: Any constipation or stomach pain?
Patient: No, I think just the hip pain.
Doctor: Any shortness of breath, chest pain or difficulty breathing?
Patient: I am fine no issues there.
Doctor: How bout any breathing issues while you sleep or when you lay down?
Patient: No.
Doctor: And do you exercise?
Patient: It is same as before not much difference.
Doctor: Okay.
Patient: Right now, it is just this hip pain which is bothering me.
Doctor: And you mention it is kind of radiating from your lower back.
Patient: Yeah, kind of like from my spine maybe, I am not sure.
Doctor: And no pain in your toes or lower legs?
Patient: No.
Doctor: Okay, did you try any medicines?
Patient: Yes, I did try some Tylenol but that's it. It does help a bit.
Doctor: Okay, let's try something stronger, I will write you a prescription for it. You can take it for a week and if your pain does not improve, we will take some x rays.
Doctor: How old are you again eighty-five? 
Patient: Yes.
Doctor: Okay. Overall, you do look better today and these medicines should take care of the pain. 
Patient: Thank you!
Doctor: Take care.
Clinical note section (ALLERGY): No known drug allergies.

Dialogue:
Doctor: Do you have any known drug allergies? 
Patient: No.  None that I know of.
Clinical note section (FAM/SOCHX): She drinks alcohol occasionally.

Dialogue:
Doctor: Hello, miss. How was your weekend? 
Patient: It was fun. I went to a party, but now my back hurts. 
Doctor: I see. Did you drink alcohol at the party? 
Patient: Just a little. I only drink when I go to special occasions. 
Doctor: Would you say you drink occasionally then? 
Patient: I do.
Clinical note section (ROS): Negative.

Dialogue:
Doctor: Are you experiencing any symptoms? 
Patient: Nope.
Clinical note section (GENHX): The patient is a previously healthy 2-month-old female, who has had a cough and congestion for the past week.  The mother has also reported irregular breathing, which she describes as being rapid breathing associated with retractions.  The mother states that the cough is at times paroxysmal and associated with posttussive emesis.  The patient has had short respiratory pauses following the coughing events.  The patient's temperature has ranged between 102 and 104.  She has had a decreased oral intake and decreased wet diapers.  The brother is also sick with URI symptoms, and the patient has had no diarrhea.  The mother reports that she has begun to regurgitate after her feedings.  She did not do this previously.

Dialogue:
Doctor: I'm sorry to see that she's not doing well.  
Guest_family: I can't even begin to tell you how hard this past week has been for us. She has had so much congestion. She's also coughed more than she ever has before. She is only two months old and it breaks my heart to see her like this.
Doctor: Oh wow. We'll see what we can do for her. How's her breathing been? 
Guest_family: She's had some irregular breathing where she would breathe very quickly and retract.  
Doctor: Has she been running a fever? 
Guest_family: She's been running in the hundreds between one O two and one O four. 
Doctor: Has she been feeding well? 
Guest_family: No, not at all. She's been feeding less and I notice she hasn't had as many wet diapers as a result. 
Doctor: Is anyone else in the family sick? 
Guest_family: My son has an upper respiratory infection.  
Doctor: How long has he been sick? 
Guest_family: A day or two before our two month old. 
Doctor: You mentioned that she's been coughing a lot. Is she bringing anything up with her coughs?  
Guest_family: Yeah, I think her coughs trigger some sort of reflex response, causing her to spit up or throw up a few times. It comes on so suddenly, it takes me by surprise. 
Doctor: Does she happen to experience similar symptoms after her feedings? 
Guest_family: Yeah, that's new too. 
Doctor: Any diarrhea? 
Guest_family: None.
Clinical note section (MEDICATIONS): Multivitamins and calcium.

Dialogue:
Doctor: Are you taking any medication? 
Patient: Just multivitamins and calcium.
Clinical note section (CC): Buttock abscess.

Dialogue:
Doctor: Hey what you got there?
Patient: I got this boil type of situation going on on my butt.
Doctor: Oops!
Patient: I know.
.
Clinical note section (ALLERGY): She has no known drug allergies.

Dialogue:
Doctor: Do you have any known drug allergies? 
Patient: No.
Clinical note section (ASSESSMENT): Ongoing purulent rhinitis.  Probable sinusitis and serous otitis.

Dialogue:
Doctor: How's she doing today? 
Guest_family: She's been blowing up green snot and complaing of ear pain. 
Doctor: Both ears? 
Guest_family: Both the right and left. 
Doctor: How long has she been bringing up green snot? 
Guest_family: Maybe six or so days? 
Doctor: Let's see. It looks like she may have sinusitis. After checking both ears, I noticed fluid buildup in the right middle ear. I'll go ahead and prescribe her some antibiotics and hopefully she'll be as good as new in a few days. I'd like her to come back for a follow up to make sure all the fluid in her ear is gone.
Clinical note section (ALLERGY): None.

Dialogue:
Doctor: Do you have any allergies? 
Patient: I am not allergic to anything as far as I know.
Clinical note section (GENHX): The patient is a 2-1/2-year-old female with a history of known febrile seizures, who was placed on Keppra oral solution at 150 mg b.i.d. to help prevent febrile seizures.  Although this has been a very successful treatment in terms of her febrile seizure control, she is now having occasional brief periods of pauses and staring, where she becomes unresponsive, but does not lose her postural tone.  The typical spell according to dad last anywhere from 10 to 15 seconds, mom says 3 to 4 minutes, which likely means probably somewhere in the 30- to 40-second period of time.  Mom did note that an episode had happened outside of a store recently, was associated with some perioral cyanosis, but there has never been a convulsive activity noted.  There have been no recent changes in her Keppra dosing and she is currently only at 20 mg/kg per day, which is overall a low dose for her.

Dialogue:
Doctor: How old is the baby girl? 
Guest_family: She is two and a half years old. 
Doctor: And you both are her parents?
Guest_family: Yes. 
Doctor: Tell me what happened in detail.
Guest_family: She has a history of seizures. She used to have shakes and lose consciousness. 
Doctor: Was she taking any medications for that? 
Guest_family: Yeah, she was placed on Keppra solution one hundred and fifty M G for two times a day. It helped a lot and she was doing fine. Her seizures were improving a lot but recently we have noticed something similar again. 
Doctor: What kind of symptoms are showing now? 
Guest_family: She will just stop doing everything and stare blankly. We tried to shake her but during that period she just does not respond.
Doctor: Does she becomes floppy like can't control her body during that phase? 
Guest_family: No, we didn't notice that. 
Doctor: How long is that period? 
Guest_family2: I think it lasts somewhere around ten to fifteen seconds. 
Doctor: What are your thoughts on this? As a mother you might be spending more time with her. 
Guest_family: Yeah, I have noticed this too, but I think it stays for like three to four minutes. 
Doctor: So, it is somewhere around thirty to forty seconds.
Guest_family: One day I was outside the store and then I noticed that she had a similar event. Her skin around her mouth turned blue. 
Doctor: Was she having any kind of jerky motions?
Guest_family: No. 
Doctor: Have you changed her medications like the amount you are giving or anything like that? 
Guest_family: No, we haven't changed anything. She's still on the same dose. 
Doctor: I'm looking at the record and it says that she is supposed to take twenty M G per kilogram every day. It looks like a very low dose for her.
Clinical note section (MEDICATIONS): unknown anxiolytic, estrogen.

Dialogue:
Doctor: Is she taking any medications? 
Guest_family: Um uh I wrote them down. Let me find the Post-it note. I had it right here. 
Doctor: Take your time. 
Guest_family: Ok uh found it. 
Guest_family: It looks like she's taking some type of anxiety medication and estrogen.
Clinical note section (FAM/SOCHX): Reviewed and unchanged.

Dialogue:
Doctor: And we did review your family history last time. No one else suffers from heart problems in your family, right? 
Patient: Yeah, it's just me.
Clinical note section (GENHX): The patient has had no help with the headaches from over-the-counter analgesics.

Dialogue:
Doctor: Have you ever taken any prescribed drug for your headaches. 
Patient: No. 
Doctor: What do you take when you get headaches. 
Patient: I try not to take to much medication but when they get really bad, I take Excedrin or ibuprofen. 
Doctor: So only over the counter medications? Do they work in providing you relief?
Patient: Yes, I have been using over the counter medications and they have been no help with my headaches . 
Doctor: Okay.
Clinical note section (GYNHX): This is her first pregnancy.

Dialogue:
Doctor: Is this your first pregnancy? 
Patient: Yes. I'm so excited for the baby to arrive!
Clinical note section (FAM/SOCHX): Divorced. Lives with boyfriend. 3 children alive and well. Denied tobacco/illicit drug use. Rarely consumes ETOH.

Dialogue:
Doctor: How many kids do you have? 
Patient: I have three kids, and I'm blessed to say that they're all healthy and well. 
Doctor: That's great to hear. Do they live with you or your ex husband? 
Patient: They live with my boyfriend and me. 
Doctor: Wonderful.  
Patient: It's a full house for sure. 
Doctor: Do you drink or smoke? 
Patient: I don't touch tobacco or any other drugs. I sometimes drink, but only on rare occasions. 
Doctor: Gotcha.
Clinical note section (PASTMEDICALHX): She has an intolerance to Prevacid.

Dialogue:
Doctor: Are you still take Prevacid? 
Patient: No. I had to stop taking it.  It gave me diarrhea.
Clinical note section (EDCOURSE): He also had a P-Bag placed, but did not have any urine.  Therefore, a straight catheter was done, which was done with ease without complication and there was no leukocytes noted within the urine.  There was a little bit of blood from catheterization but otherwise normal urine.  X-ray noted some stool within the vault.  Child is acting normally.  He is jumping up and down on the bed without any significant findings.

Dialogue:
Guest_family: They just changed his P bag, that's why there is no pee in it.
Doctor: Okay. Yes, it looks empty. I think they did a straight cath.
Guest_family: Yeah, and they took out the urine to send it to the lab.
Doctor: Okay. Yes, there were no leukocyte seen. That means no infection.
Guest_family: But they said there was blood?
Doctor: Yes, during catheterization but the urine is normal.
Guest_family: Okay.
Doctor: In your x ray there was stool seen in the colon.
Guest_family: Okay.
Guest_family_2: He is fine?
Doctor: Yeah, he is fine. I can see that he is very active. Jumping up and down.
Doctor: Hi champ!
Patient: Hi.
Clinical note section (ROS): Unobtainable secondary to the patient's condition.

Dialogue:
Guest_clinician: How's the patient doing? 
Doctor: In stable condition, but I'm not yet able to obtain a history from them. 
Guest_clinician: Please page me when they're awake and able to answer questions. I'll be on the eighth floor if you need me. 
Doctor: Will do.
Clinical note section (GENHX): The patient has NG tube in place for decompression.  She says she is feeling a bit better.

Dialogue:
Doctor: We have placed this nasogastric tube for decompression.
Guest_family: Okay.
Doctor: How are you feeling now?
Patient: Um.
Guest_family: She said that she feels better now.
Clinical note section (GENHX): This is a 78-year-old male who has prostate cancer with metastatic disease to his bladder and in several locations throughout the skeletal system including the spine and shoulder.  The patient has had problems with hematuria in the past, but the patient noted that this episode began yesterday, and today he has been passing principally blood with very little urine.  The patient states that there is no change in his chronic lower back pain and denies any incontinence of urine or stool.  The patient has not had any fever.  There is no abdominal pain and the patient is still able to pass urine.  The patient has not had any melena or hematochezia.  There is no nausea or vomiting.  The patient has already completed chemotherapy and is beyond treatment for his cancer at this time.  The patient is receiving radiation therapy, but it is targeted to the bones and intended to give symptomatic relief of his skeletal pain and not intended to treat and cure the cancer.  The patient is not enlisted in hospice, but the principle around the patient's current treatment management is focusing on comfort care measures.

Dialogue:
Doctor: We are following up with you for your prostate cancer which has metastasized to your bladder and in several locations throughout your body including the spine and shoulder.
Patient: Yes, you remember I had blood in my urine in the past, but I think it is coming back. I started noticing that from yesterday, and today I saw a lot of blood with very little urine.
Doctor: Oh okay, we will have to evaluate that then. Let me ask you few other questions to get this out of the way. How about your back pain, how's it? Also any incontinence?
Patient:  Okay sure. No, there is no change in my chronic lower back pain, and no, no incontinence, urinary or stool. 
Doctor: All right. How about fever, belly pain, nausea or vomiting?
Patient: No to everything.
Doctor: Are you able to pee noramally and pass urine, you aren't retaining? How about blood in stools?
Patient: Yes, I am passing everything well. No blood in stools.
Doctor: Okay. Can you tell me if you have finished your chemo?
Patient: Yes, I have already completed chemo. Now they started me with radiation therapy, but it is only targeted to the bones. They told me I will feel well as in there won't be any pain. It's not supposed to treat or cure the cancer, but just to make me comfortable.
Doctor: Yes, we are looking at that at this point.
Patient: Okay. 
Doctor: Do you have any hospice care facility listed?
Patient:  No, I haven't looked at it yet, but I would love to look at hospice facilities.
Doctor: That treatment management we are focusing on-
Patient: I know only comfort ha!
Clinical note section (DIAGNOSIS): Foreign body OS.

Dialogue:
Doctor: Looks like he has a foreign body in his left eye. 
Guest_family: Does he need to see an eye doctor after this?
Clinical note section (ASSESSMENT): I feel that this patient has a febrile seizure.

Dialogue:
Doctor: His fever is running very high, I think he is having a febrile seizure.
Guest_clinician: Yeah, I think so too.
Guest_family: Is he going to be okay? 
Doctor: Ma'am, let us have a look.
Clinical note section (FAM/SOCHX): No tobacco, alcohol, or drug abuse.

Dialogue:
Doctor: Do you have any history of tobacco, alcohol, or drug use? 
Patient: I have a glass of wine with dinner every once in a while, but no other than that.
Clinical note section (FAM/SOCHX): No history of any smoking, alcohol or drug abuse.

Dialogue:
Doctor: Do you have a history of alcohol or drug abuse? 
Patient: I have had a drink on special occasions, but I don't drink. And I have never ever done drugs. 
Doctor: Okay. Do you smoke or have you ever in the past? 
Patient: No! 
Doctor: Excellent!
Clinical note section (MEDICATIONS): He is currently on several medications, a list of which is attached to the chart, and was reviewed.  He is not on any blood thinners.

Dialogue:
Doctor: What are you taking? 
Patient: You mean meds?
Doctor: Yes, sir.
Patient: Actually, that nurse asked me already and reviewed it with me. Do you want me to tell you again?
Doctor: No let me check the chart then.
Patient: Okay.
Doctor: You are not on any blood thinners right?
Patient: No I am not.
Doctor: Okay great.
Patient: Yeah.
Clinical note section (GENHX): School reports continuing difficulties with repetitive questioning, obsession with cleanness on a daily basis, concerned about his inability to relate this well in the classroom.  He appears confused and depressed at times.  Mother also indicates that preservative questioning had come down, but he started collecting old little toys that he did in the past.  He will attend social skills program in the summer.  ABCD indicated to me that they have identified two psychologists to refer him to for functional behavioral analysis.  There is lessening of tremoring in both hands since discontinuation of Zoloft.  He is now currently taking Abilify at 7.5 mg.

Dialogue:
Doctor: Can you tell me more about your son, ma'am? 
Guest_family: Well, I have his reports from his school right here.
Doctor: What do they say? 
Guest_family: Well, in summary, he's having a lot of problems at school. 
Doctor: What kind of problems is he having? 
Guest_family: Well, he has been asking an unusual number of questions, and he's been obsessed with cleaning and cleanness. 
Doctor: What about his interactions with his classmates? 
Guest_family: According to the reports from his school, he doesn't relate well in the classroom. 
Doctor: How is his mood? 
Guest_family: Well, he seems to be confused and depressed sometimes. 
Doctor: Is he still asking a lot of questions in class? 
Guest_family: It's come down a little bit recently. 
Doctor: Are there any other unusual behaviors you've seen? 
Guest_family: Um, he used to collect old little toys when he was younger, and he's started doing that again. 
Doctor: I see, what are his plans for the summer, will he be in classes? 
Guest_family: He'll be in a social skills program this summer, doctor. 
Doctor: I see here as well that A B C D has referred him to two psychologists for functional behavioral analysis, is that correct?
Guest_family: Yes, doctor, that's correct. 
Doctor: Good, be sure to follow up with them please. 
Guest_family: Yes, we will, doctor. 
Doctor: Has he been taking his Zoloft? 
Guest_family: No, he's taking, um, seven point five M G of Abilify. 
Doctor: I see, how has he responded to stopping taking the Zoloft? 
Guest_family: Actually, the tremors in his hands have been a little better.
Clinical note section (GENHX): This 1+ year, black female, new patient in dermatology, sent in for consult from ABC Practice for initial evaluation of a lifelong history of atopic eczema.  The patient's mom is from Tanzania.  The patient has been treated with Elidel cream b.i.d. for six months but apparently this has stopped working now and it seems to make her more dry and plus she has been using some Johnson's Baby Oil on her.  The patient is a well-developed baby.  Appears stated age.  Overall health is good.

Dialogue:
Doctor: Hello, ma'am. I see you brought your baby daughter in today. Is she a new patient? 
Guest_family: Hello, I am her mother. She is a new patient. 
Doctor: Before we begin, could you verify her age and ethnicity, please? 
Guest_family: She is a little over one years old, and we identify as black. 
Doctor: Thank you. How did you hear about our dermatology office? 
Guest_family: Well, we just came from Tanzania, my birthplace. I have been seeing this odd skin issue with my baby, so I took her to the A B C Practice. After, they sent me here so that you can check her skin problem. 
Doctor: I see. Do you have a report from the A B C Practice? 
Guest_family: I do. Here you go. 
Doctor: Thank you. It looks like she has a history of this atopic eczema, correct? 
Guest_family: Yes, she has. 
Doctor: Did they provide you with any medication? 
Guest_family: I have the bottle with me. Here you go. 
Doctor: It looks like they gave you an Elidel cream. How often do you apply it to her rashes? 
Guest_family: I've been putting it on my daughter twice a day for six months now. 
Doctor: Is it effective? 
Guest_family: It was, but now it doesn't work. Her skin is just dry now. I've been putting this oil on her now.
Doctor: Do you know the name of the oil? 
Guest_family: No, I don't. It starts with a J. I can find a picture. 
Guest_family: Here it is. It's this oil. 
Doctor: Oh, I see. The Johnson's Baby oil. That's a good brand. Well, your daughter seems to be well-developed and has good health. She looks her age. We can see what else can help with her rashes.
Clinical note section (ALLERGY): No allergies.

Dialogue:
Doctor: Did you have any known allergies?
Patient: Not that I know.
Clinical note section (ASSESSMENT): The patient presents for evaluation after a contaminated needlestick to the index finger. The source patient was tested and found to be negative for HIV. However, he did test positive for hepatitis C. He was described as a carrier without active disease. The patient has been followed with periodic evaluation including blood testing. He has completed a 3 shot series for hepatitis B and had titers drawn that showed protected antibodies. He also was up-to-date on his immunization including tetanus. The patient has been well during this time except for the onset of a intestinal illness being investigated with some squeakiness and vomiting. He had no other symptoms that were suggestive of acute hepatitis. His abdominal exam was normal. He had no generalized lymphadenopathy and no fever. Blood tests were drawn on 02/07/2005. The results of which were reviewed with the patient. His liver function test was normal at 18. His hepatitis C and HIV, both of which were negative. He had no local signs of infection, and otherwise has been doing well except for his acute intestinal illness as described above.

Dialogue:
Patient: So, as you remember I was working with a patient and I accidently jammed that needle inside me.   
Patient: I am coming for regular screening.
Doctor: Yes, thank you for that, sir. Did they screen patient?
Patient: Yes, he got negative H I V but positive hep C, they said he is a carrier only, never will show disease symptoms. 
Doctor: Okay.
Patient: I am scared. 
Doctor: Don't worry, we will do what we can okay. Firstly, let me check if they did some hepatitis B shots on you. Okay looks like you had three shots of hep B and Tetanus is up to date with all others. Antibodies are showing, which is good. 
Patient: They did the tests on February seven two thousand and five. Have you seen my liver test results? And maybe some other?
Doctor: Yes, I can see that your liver function test were normal at eighteen and hepatitis C and H I V, both were negative. We took these labs on February seventh. You do not have any local signs of infection, right?  Except acute intestinal problem?
Patient: Nothing local, but I do have intestinal squeakiness and vomiting.
Doctor: Let me look at your exam.
Patient: Okay.
Doctor: Abdomen is fine, no fever and no swellings. That's great.
Patient: Okay.
Clinical note section (CC): Weak and shaky.

Dialogue:
Doctor: How are you feeling?
Patient: I am feeling very weak and shaky.
Doctor: Oh I am so sorry.
Patient: It's okay.
Clinical note section (FAM/SOCHX): Mother with breast CA, MA with "bone cancer." AODM both sides of family.

Dialogue:
Doctor: Lets talk about your family history, does anyone else in your family have cancer?
Patient: Yes, my mother had metastatic breast cancer and my mother's sister was dealing with bone cancer. 
Doctor: Oh, I am sorry to hear that!
Doctor: Anything else? 
Patient: Yeah, both sides of my family has diabetes.
Doctor: Were your family members young when they were diagnosed, or did they develop it later in life?
Patient: I believe they all were adults when they were diagnosed with diabetes.
Doctor: Ah, yes. They had adult onset diabetes mellitus.
Patient: Yeah.