jshargo/medical-interview-conversations huggingface dataset:
Patient: So I've been having a lot of trouble in the last two weeks of especially this past week of just a lot of shortness of breath. I'm getting a lot of coughing as well and producing a lot of material. And also I think I might have been having a fever this week as well. 

Doctor: OK, uh, the shortness of breath is it happening at rest or exertion and how much exertion?
Patient: Uhm, I think it's happening mostly on exertion. Usually I'm able to walk around the house, no issues, go up and down stairs, but right now I'm pretty limited. I can't really go up and down stairs without getting really short of breath. I can't even walk from the bedroom to the kitchen without becoming shortness of, like short of breath. 

Doctor: OK, um OK, and when did that change happen? 

Patient: So I would say one week ago is when this all kind of started. 

Doctor: OK, and has it been getting any better, worse, or staying the same?
Patient: I would say it's kind of getting worse. I'm coughing a lot more sputum up. I'm getting more and more short of breath. Now, I do have a call for like a very long time now I've I was diagnosed with COPD in my 60s. Probably like 10 years ago and but this seems to be just a much worse than my COPD. 

Doctor: OK, sure it's been a lot worse in the last week it sounds like. OK. Uhm have you, are you able to lie flat? Like on your back without experiencing shorter breath, shortness of breath?
Patient: Yeah, and when I'm resting or lying down or trying to sleep I don't get short of breath. 

Doctor: OK, and have you ever had instances where you woke up in the middle of the night really short of breath and you had to sit up to catch your breath? 

Patient: Uh no, I don't think so. 

Doctor: OK, have you noticed any leg swelling?
Patient: No. 

Doctor: OK, and you said that to you, so you've had a cough for awhile now, but it's gotten worse. This past week in your, are you bringing up sputum?
Patient: Yeah, I'm bringing up a lot of materials. I think every time I cough I'm bringing some sputum up and right now the like usually the color is like clear to whitish but right now it's a bit more yellow. 

Doctor: OK, so a change in the sputum color and also sounds like you're bringing up more sputum as well. 

Patient: Yeah. 

Doctor: OK and have you brought up or coughed up any blood? So have you had any hemoptysis?
Patient: No, nothing like that. 

Doctor: OK, and have you had any wheezing?
Patient: Uhm, I do but when I get short of breath I have some wheezing, but usually I don't. 

Doctor: OK, but but you've had wheezing this past week though.
Patient: Yeah. 

Doctor: Yeah OK. And have you had any chest pain? 

Patient: Just when I'm coughing and getting short of breath, I do have some discomfort in my chest. 

Doctor: OK, uh, do you feel that, or could you describe he the pains character? Like is it sharp, dull, or achy?
Patient: It's more just an ache and it's kind of more of a discomfort than a pain, and it kind of goes away once my episode of coughing and shortness of breath is relieved with some rest. 

Doctor: OK. Uh, and uh, have you been experiencing any fevers or chills?
Patient: Yeah, I've been noticing that I'm getting a lot more chills this past week. They kind of come and go, but even at night I get like these chills that after wrap myself up in at least three blankets. 

Doctor: OK, and have you had a fever?
Patient: Uh, I didn't get a chance to measure any of them, but I might have had a fever just from the chills that I'm expecting that I had a fever. 

Doctor: OK, and have you had any night sweats? 

Patient: No. 

Doctor: OK and have you had any unexpected weight loss over the last several months?
Patient: No, I think my weights been pretty steady. 

Doctor: OK. Have you had any headaches? 

Patient: No. 

Doctor: Have you had any like eye redness or eye discharge?
Patient: No, not that I know of. 

Doctor: OK, have you had a runny nose or a sore throat? 

Patient: No. 

Doctor: OK, have you had a loss of taste or loss of smell?
Patient: No, nothing like that. 

Doctor: OK. Have you had any nausea or vomiting?
Patient: No. 

Doctor: Have you had any abdominal pain? 

Patient: No abdominal pain. 

Doctor: Have you had any diarrhea?
Patient: No. 

Doctor: Have you had any constipation?
Patient: No. 

Doctor: Have you had any skin rashes? 

Patient: No. 

Doctor: Any muscle aches or joint pains?
Patient: No, nothing like that. 

Doctor: OK, and have you had any any fatigue?
Patient: Maybe a little bit more tired just with the shortness of breath and chills and everything like that, but yeah, so a little bit more fatigue. 

Doctor: OK, and have you had any fainting or dizziness? 

Patient: Uh, no. 

Doctor: Or, OK and have you had any heart palpitations?
Patient: Nope. 

Doctor: Alright. And have you been diagnosed with any medical conditions in the past?
Patient: No. Oh sorry, medical conditions in the past? COPD I have. I also do have some high blood pressure and I take some medications for cholesterol as well. 

Doctor: OK, so you take medications for cholesterol and high blood pressure and you use any inhalers? 

Patient: No. Sorry, inhalers I, use, uh, two different kinds of inhalers. So one of them is just when I like need it, uh, like I've been using a lot more recently, like the Ventolin. And then I also have another inhaler called Spiriva that I've been using as well. 

Doctor: OK, and do you have any allergies?
Patient: Uhm I do have an allergy to sulfa drugs. 

Doctor: And what reaction?
Patient: I usually break out into hives. 

Doctor: OK, and any prior surgeries or hospitalizations? 

Patient: So I've had a surgery to remove my appendix when I was really young. Then I've had another surgery for my hips as well, but yeah, other than that, no other issues. 

Doctor: OK. And are your immunizations up to date?
Patient: Yeah, all of my immunizations should be up to date. 

Doctor: OK, excellent and could you tell me a little bit about where you're living currently and who you're living with?
Patient: Yeah, so I, I currently live alone in, in an apartment just in the city. And yeah, I've been living alone for probably the last five years. 

Doctor: OK, and have you been around anybody who's been sick? 

Patient: Uhm, not recently. I think I just I just go out to get groceries and stuff. I haven't really been going out too much. 

Doctor: Alright, So have you traveled anywhere?
Patient: No. 

Doctor: OK uhm, do you drink alcohol? 

Patient: Maybe a couple of years a week. 

Doctor: OK, and do you smoke cigarettes?
Patient: Yeah, I still smoke cigarettes. Even though I have COPD, I just yeah, I can't really quit. I smoke probably half a pack a day. 

Doctor: OK, how long have you smoked for approximately?
Patient: Uh, probably at least 45 years. 

Doctor: OK and uhm, if you wanted to talk about quitting, we can discuss that further at a later time if you'd like. Uhm, and so do you use any recreational drugs?
Patient: No, no no no drugs at all. 

Doctor: OK. Uhm, and have you had a family history of heart disease or any lung conditions? 

Patient: Uhm, not, I mean like no lung conditions, but I have a family history like my both my grandather and father both had heart attacks in their 60s. 

Doctor: OK, and any lung cancer in the family?
Patient: No, not that I know of. 

Doctor: OK. So I think that was all the questions that I I wanted to ask today. Was there anything else that I maybe forgot about that you wanted to mention?
Patient: Uhm no, I think that those are all the questions I had and everything was covered. 

Doctor: OK, uhm so uh, the next steps for now, I think, will be to, uh start, we'll get a physical exam in and your vital signs and get some investigations. It is sounding like a COPD exacerbation with the increasing and the change changing sputum. The increasing frequency of cough and the exertional shortness of breath as well, along with wheezing and kind of this chest discomfort that you're experiencing. And so, uh, this will require some antibiotics as well and depending on the severity of symptoms, possibly some steroids as well to help with the inflammation.
Patient: Hi I just want to talk about these, these times when I feel like I'm just I'm suffocating and I just can't breathe. It's pretty scary and I don't know what's going on. 

Doctor: Yeah, certainly, um, feeling short of breath like that can be quite scary for sure. When, when do these episodes kind of happen? Are they spontaneous? Or can you think of things that you're doing when they when they come on. 

Patient: Uhm? I, I don't know, it's just like. Uhm? Sometimes, like before interviews, sometimes just kind of random. Uhm, yeah. I can kind of tell when they're about to come on. Uhm? Yeah, I think. It's mostly like job interviews. 

Doctor: OK, have you had many of those recently?
Patient: Job interviews? 

Doctor: Yeah. 

Patient: I got I got laid off because of the pandemic and now I've been looking for jobs and it's just like it's kind of nerve wracking. But also like I don't know, I'm just worried it could be something else like it's just, yeah, it's like I really just can't breathe, it's so weird. 

Doctor: OK, yeah, it's certainly. It sounds like there's been a lot of stress recently. Certainly plenty for with the pandemic as well. And so when you get short of breath, you you said you have this, you could feel that it's coming on and how long does it last for?
Patient: Like 15 minutes 15, 20 minutes. 

Doctor: Is there anything you do to help it go away? 

Patient: I'll just say go and lie down and close my eyes. 

Doctor: OK. And do you get shorter breath if you walk far distances or exert yourself?
Patient: Oh no, no. I go out for a run every single day. Nothing happens at that time. 

Doctor: OK. And. Have you had a cough?
Patient: No. 

Doctor: Any wheezing?
Patient: No. 

Doctor: OK. And have you had any any chest pain?
Patient: Yeah, I kind of feel like this pressure at that time is just like yeah, someone's like pressing my chest inwards, kind of. It's hard to explain. 

Doctor: I see do you it is it um like, do you feel it in any one particular spot or?
Patient: No. 

Doctor: OK.
Patient: I just feel like my chest is really tight and it's just it's like I can't like expand my lungs. 

Doctor: I see and does this last around 15 minutes as well?
Patient: Yeah. 

Doctor: OK. And similarly you like going for runs and stuff like that you on't ever get any chest pain? 

Patient: No, no, no. 

Doctor: OK. And and I know you mentioned you didn't have a cough, but have you brought up any phlegm or brought up any any blood?
Patient: No, no, I have not had a cough. 

Doctor: Oh no, OK, I'm sorry.
Patient: That's OK. 

Doctor: And have you otherwise been well? Or if you had any infectious symptoms, like a runny or red eyes, runny nose or sore throat? 

Patient: No. None of those. 

Doctor: Alright, have you had any headaches?
Patient: No. 

Doctor: How about any fevers or chills?
Patient: No. 

Doctor: Have you had any night sweats? 

Patient: No, but I get really sweaty when these episodes happen. Just like yeah, my face is like sweating, and my neck. 

Doctor: OK. Yeah, Um, OK, and How is your weight been recently? Any weight gain or loss?
Patient: Yeah, I've gained quite a bit of weight since the pandemic started. Yeah, gained about 10 pounds. 

Doctor: OK, any changes to your diet or appetite?
Patient: Oh yeah, I've been eating quite a bit, been baking a lot at home. 

Doctor: OK. And, and have you had any abdominal pains?
Patient: No. 

Doctor: Any diarrhea? 

Patient: Uhm? No. 

Doctor: OK. Any nausea or vomiting?
Patient: No. 

Doctor: Alright, and any urinary problems like pain or frequency?
Patient: No. 

Doctor: Any rashes or skin changes?
Patient: No. 

Doctor: And, any muscle aches, body pains or joint pains or swelling? 

Patient: Nothing like that, no. 

Doctor: OK and how's your energy been?
Patient: Um. Well, I've been feeling a little low. Since I've been laid off just like worried about my finances and I kind of sleep all day. I'm not feeling very energetic. 

Doctor: OK. How is your interest in activities been? 

Patient: I don't know, I just feel like staying at home and just being in bed all the time. 

Doctor: OK, so you're um, have you had a low mood?
Patient: Yeah. 

Doctor: Alright and are you sleeping more than usual?
Patient: Yeah. 

Doctor: OK, is there anything that you're feeling particularly guilty about right now?
Patient: No. 

Doctor: OK. How is your concentration been?
Patient: Uhm, not great. 

Doctor: OK. You haven't been able to focus and have you felt like things are moving in slow motion? 

Patient: No. 

Doctor: Alright, so have you had any thoughts of hurting or harming yourself?
Patient: No. 

Doctor: OK. And have you had depression or anxiety in the past?
Patient: Um I've been diagnosed with depression. 

Doctor: OK. And have you had panic attacks before? 

Patient: No, but do you think that's what's going on? 

Doctor: Potentially, it certainly can't rule out. Inorganic cause meaning something going on, otherwise just yet we might need to do some physical exam and some investigations first, but it certainly could be related to that. With all of the stressors that are going on. And so you had a low mood. Have you had any periods in your life where you felt really energetic, like you didn't need any sleep, you're really talkative, you had all the energy in the world.
Patient: I wish, no, I've never really felt that way, 

Doctor: OK. And have you had any concerns with eating disorders in the past?
Patient: No. 

Doctor: Alright. And then you mentioned, even diagnosed with depression, if you had, are you have you been diagnosed with any other medical conditions? 

Patient: No. 

Doctor: OK, are you on any medications right now?
Patient: No, I was doing pretty well. I used to have these episodes of depression when I was younger as a teenager and they kind of went away. I was on meds at that time, but I think I think it's coming back now. 

Doctor: OK, so you haven't been on medication now for for quite awhile for years. 

Patient: For like 12 years 13 years. 

Doctor: OK, what did you use that, if you can remember?
Patient: Prozac? 

Doctor: OK, and did you find it helped? 

Patient: Yeah, yeah it was very helpful, was very good. 

Doctor: OK. That's good. Any allergies to medications?
Patient: No. 

Doctor: Alright and any hospitalizations or surgeries?
Patient: No. 

Doctor: OK, and can you tell me a little bit about where you're living and who you're living with? 

Patient: I I live, I live with my girlfriend. 

Doctor: OK. And. Has there been anybody around that that has been sick that they have been around?
Patient: No. 

Doctor: OK, have you traveled anywhere?
Patient: No no. 

Doctor: And do you smoke cigarettes? 

Patient: Oh no, I don't. 

Doctor: OK, do you drink alcohol?
Patient: I don't. 

Doctor: OK. And. Are you currently sexually active? 

Patient: Yeah. 

Doctor: OK, and any chance that you could be pregnant currently?
Patient: No. 

Doctor: And have you been pregnant in the past?
Patient: No. 

Doctor: OK. And do you smoke cigarettes?
Patient: I don't. 

Doctor: Do you drink alcohol? 

Patient: No. 

Doctor: And do you use any recreational drugs?
Patient: No. 

Doctor: OK, and any family history of heart or lung problems?
Patient: My grandfather had lung cancer. But that's about it. 

Doctor: Did he smoke for a long time? 

Patient: Oh yeah, he was a big smoker. 

Doctor: OK, and anybody in the family have problems with mental illness?
Patient: My mom has uh depression too. 

Doctor: OK. Anybody in in the family have problems with substance, substance use? 

Patient: no. 

Doctor: OK. Um, and  I think that's everything that I I wanted to ask on history today. So you been having these episodes where you get really short of breath and you get chest pain, you'll get sweaty and have what sounds like what sounds like an impending sense of doom where you kind of feel like it's coming on and it lasts for 15 minutes and not related to exercise. Were there any other symptoms or things that you've been experiencing recently?
Patient: Yeah, it's also,  I also feel like my heart's like breathing really fast. 

Doctor: Oh, OK. And I does that, how long does it last for? 

Patient: Same time. Like everything is just sort of comes on at the same time. Just kind of goes away together. 

Doctor: OK, would you say that it comes on like kind of like at the snap of your fingers sort of thing like really quickly and then?
Patient: I can kind of tell it's gonna come on like I have a sense of it and then it just like starts. It suddenly just happens. 

Doctor: OK. So you you have the heart racing, are there any other symptoms as well? 

Patient: I don't think so. 

Doctor: OK, so, uh, we will get an ECG and  I will look at that, but I've been concerned now thinking that this might be related to anxiety or panic attacks and so, I guess that would be something that we could discuss more about in regards to like I guess previous traumas and things that and the stresses that you might be dealing with currently to help manage manage stress better.
Patient: Hi there, I, I've had this cough that started um, three days ago, and over these past couple of days, I've just been really achy all over and so, I've had a headache as well. 

Doctor: Okay, well I'm sorry to hear that you're not feeling well. Um, the cough, when did that start?
Patient: Yeah, so that, about three or four days ago um, it started to come on, yeah. 

Doctor: Okay, and then how about the headache?
Patient: That's been more in the last two days. 

Doctor: Two days, okay, and then the uh, muscle ache?
Patient: Yeah, it's been there for about two, yeah about two or three days. I wake up in the morning and I've been feeling like really fatigued and achy. 

Doctor: Um, the cough, is it dry or you're bringing up phlegm? 

Patient: It's, it's dry, but it's gotten a little bit worse since it started. It's just been happening more often. 

Doctor: Okay, and does it sound harsh?
Patient: Uh, maybe a little bit, yeah. 

Doctor: Okay. Is it getting worse do you think? 

Patient: Yeah, I think so. 

Doctor: Okay, are you experiencing any shortness of breath along with the cough?
Patient: Uh, a little bit after, um, if I have like a coughing fit that's bad enough, but um, for the most part, I've been okay. 

Doctor: Okay, any wheeziness?
Patient: Um, no. 

Doctor: No. Chest pain? 

Patient: No. 

Doctor: Okay. Do you ever feel like your heart's racing?
Patient: No, I haven't felt like that. 

Doctor: Okay. Um, any dizziness or fainting spells? 

Patient: No. 

Doctor: Uh, numbness or tingling?
Patient: No. 

Doctor: Uh confusion or memory loss? 

Patient: No. 

Doctor: This headache, is it always there?
Patient: These past couple of days, yeah, it's kind of, it, it's been there. It's been a little bit more mild after using some Tylenol or Advil to help settle it down, but I just have this, yeah, achiness in the front, front of my forehead and kind of sides of my head. 

Doctor: Yeah um, sides of your head, okay. And 1 to 10, 10 being the worst pain you've ever felt, how, how would you rate it?
Patient: A 4. 

Doctor: A 4 okay, so it's not the worst headache you've ever had in your life? 

Patient: No, it's not that bad, it's just been pretty annoying. 

Doctor: Yeah um, okay. And have you like, do you usually get headaches?
Patient: Not really it, yeah I don't get them that often. I guess they come when I, I, well, get sick. 

Doctor: Okay yeah, that makes sense. Um, have you had any fevers recently? 

Patient: Um, I have felt a bit hot um, and, but I, I didn't check my temperature and um, yeah. 

Doctor: Okay. How about weight loss, have you experienced any weight loss recently?
Patient: No, I've been, my weight's been pretty stable. 

Doctor: Okay. Um, any rashes? 

Patient: No, I haven't noticed any rashes. 

Doctor: Okay, um, and any changes in your hearing or vision?
Patient: No. 

Doctor: Runny nose or stuffy nose? 

Patient: No. 

Doctor: Sore throat?
Patient: Um, yeah, now that you mention it, I have had a little bit of a sore throat as well. Hasn't been too painful with um, like swallowing uh, foods or anything like that. It's kind of worse in the morning and it's not so bad later on. 

Doctor: Okay um, alright. How about changes in your smell or taste?
Patient: No, nothing like that. 

Doctor: Um, changes in your bowel movements? 

Patient: No, I've been uh, regular. 

Doctor: Okay um, and then nausea or vomiting?
Patient: Nope, I haven't had anything like that. 

Doctor: Okay um, changes in your urine? 

Patient: No, I've had UTIs, like one or two in the past, um, so I know what that's like. So yeah, everything's been normal. 

Doctor: Okay, good. And are you otherwise healthy or do you have any longstanding medical conditions?
Patient: Uh, I have asthma, which I will like, asthma and allergies, and I'll use um, just Ventolin for that every like once in awhile, but it hasn't bugged me too frequently. 

Doctor: Okay. Um, do you also take anything else for that asthma or is it just the Ventolin that use?
Patient: Yeah just Ventolin. 

Doctor: Okay. Have you had any hospitalizations or surgeries in the past? 

Patient: No, well I, I've had my, my wisdom teeth taken out and, actually yeah I had my tonsils out as well when I was 12. 

Doctor: Okay. Um, are you on any medications besides Ventolin?
Patient: Yeah I, I currently, I think a birth control. 

Doctor: Okay, how long have you been on that for?
Patient: Uh, since high school, so I, yeah since I was 18 so eight years. 

Doctor: Okay, and um, are you up to date with all your immunizations?
Patient: I am, yeah. I get the flu shot every year. 

Doctor: Okay, okay, good. Any allergies? 

Patient: Uh yeah, to cats and um, like, I think environmental triggers. No medicines. 

Doctor: No medicines, okay. Any family history of lung or heart diseases?
Patient: Um, my grandfather had, had a stroke when he was in his 70s and um, but he was like, a smoker and a drinker, and didn't really look after himself very well unfortunately, and uh, but that's about it. 

Doctor: Okay, um and do you smoke? 

Patient: No, I don't 

Doctor: No, okay. Any other recreational drugs like marijuana, cocaine, heroin or anything like that?
Patient: No, I don't use anything like that. 

Doctor: Okay. How about um, alcohol, do you drink? 

Patient: Yeah, sometimes, I'll have a or maybe a cocktail on the weekend, or um, a glass of wine with dinners. 

Doctor: Okay. Are you currently sexually active?
Patient: I am, yeah with uh, with my boyfriend. Um, we use uh, condoms as well. 

Doctor: Okay, so you use both condoms and you're on birth control so, okay good, that's a lot of protection. Um, how long have you two been together? 

Patient: Um, uh six months. 

Doctor: Okay, okay, good. And um, any sick contacts recently?
Patient: Um, not that I'm aware of. 

Doctor: No, okay. Any travel recently?
Patient: Nope, just been um, going to, or just been doing online uh, classes. I'm finishing up my masters right now. 

Doctor: Okay, okay wow, congrats.
Patient: Thank you. 

Doctor: Um, and where do you live and who do you live with? 

Patient: Yeah, so I live in an apartment downtown here um, just with uh one of, one of my friends who's a roommate. 

Doctor: Okay, and is everyone at home healthy?
Patient: Yeah, she hasn't had any any symptoms, any symptoms either. 

Doctor: Okay. Okay, well those were all the questions that I had for you. Did you have any questions um, or anything that you wanted to bring up that I haven't covered? 

Patient: No, that's it. I was just uh, I mean concerned about COVID. I've been hearing about this new variant and stuff on the news so, a little bit worried. 

Doctor: Yeah for sure. We will definitely um, take a swab from you today and we'll see um, what the results are. You should hear back in about 24 to 48 hours, but in the meantime you should self isolate for 14 days um, and if it's not COVID, if that comes back negative, and um yeah, some of your symptoms also sound like other typical viral symptoms, so you could have one of the common strains that's going around this time of year. So for that just, it's um, you should just um, do some supportive care, you know, staying hydrated, eating well. And if your symptoms become worse, uh, you're running a really high fever, you have any neurological symptoms like weakness or seizures, then you should seek help from the ER. How does that sound?
Patient: Yeah, so I'm I'm George, the father, my daughter is 5 years old and I noticed just a few days ago that she was walking a little bit funny and kind of having a limp when she came back from school. And since since that then, she's been saying that it just hurts too much to put any weight on on that leg, on the right leg. And since then I've been like carrying her around. It's been very painful for her. So I just wanted to come in and check what might be going on. 

Doctor: OK and so so. And this, when did this exactly start? 

Patient: So just two days ago. 

Doctor: OK, an um did she have any trauma to her right hip or or to hurt your right leg like a fall or any injuries?
Patient: Sorry um no. Not that I know of at least and she hasn't told me anything like that. She does do some activities, some sports, but I haven't seen her fall anywhere. 

Doctor: OK. Um. Alright, and uh, has she has she not not been able to walk then?
Patient: Yeah, so I've I've been carrying around for at least like she's missed school too, but been carrying her around for the last 1 1/2 to two days. As soon as I had like ask her to walk she starts kind of a hopping and saying that there's a lot of pain near the top of her leg and by your hips whenever she puts her foot like a foot down. So yeah, she's in pain crying, so I kind of have to carry her. 

Doctor: OK. And, uh, how has her behaviour been recently like her mood and things like that?
Patient: She's definitely been more just, a bit anxious about the pain. Very scared about putting her foot down and just overall, I think also more irritable crying more because of the pain so but I I guess I understand if there's something going on it must be very painful. 

Doctor: OK, and. Alright, has she had any fevers or chills?
Patient: Uhm I. Did notice a couple of days ago she felt a bit warm but we didn't really measure her temperature. Over the last few weeks, though, she has had a. Kind of a runny nose and a cough and I think she might have had a fever last week as well so she has been sick recently. 

Doctor: OK, so it sounds like she might have had a cold last week and did like the runny nose and cough go away? 

Patient: Yeah, the runny nose and cough are gone. Fever was gone too, but she did feel a little bit warm yesterday so I'm not sure about that. 

Doctor: OK, so she's at a a bit warm now still OK.
Patient: Yup. 

Doctor: Has she had any any headaches? 

Patient: No, no headaches. 

Doctor: Any sensory changes like things to her vision or hearing or taste or smell?
Patient: No. 

Doctor: OK. Any um sore throat or cough? 

Patient: No. 

Doctor: Alright, any shortness of breath?
Patient: No. 

Doctor: Any chest pain?
Patient: No. 

Doctor: Has she had a loss of appetite?
Patient: No. 

Doctor: OK, and has she had any unexpected weight loss? 

Patient: Oh no, nothing like that. 

Doctor: Any night sweats?
Patient: No. 

Doctor: Any nausea or vomiting?
Patient: No. 

Doctor: Any abdominal pain? 

Patient: No abdominal pain. 

Doctor: OK, any diarrhea or constipation or blood in the stool?
Patient: No, nothing like that. 

Doctor: Alright, and any problems with urination like pain or frequency? 

Patient: No, not that she's mentioned, no. 

Doctor: OK. And any skin rashes or changes?
Patient: No. 

Doctor: OK, and any muscle aches or body pains or any other pains anywhere else?
Patient: No, it's mainly just her upper right leg and hip. 

Doctor: OK, I have she had any numbness or tingling?
Patient: No, not that she's mentioned no. 

Doctor: OK and and, how about a muscle weakness?
Patient: No. 

Doctor: No OK. And any confusion or or memory loss? 

Patient: Um no. 

Doctor: OK, I'm and in the past has she been diagnosed with any medical conditions?
Patient: She did have this condition with her hips. Dysplasia, like developmental dysplasia of the hip. So when she was born she she was getting like this clicking noise and her, in her hips and so she was in this splint for probably almost two months at the start, like after she was born. 

Doctor: OK, and did her hips, did like was she able to walk afterwards? 

Patient: Yeah, yeah. And we were seeing a specialist, an orthopedic surgeon and they were managing her and after one year they stopped following her. She was well like she was walking, no issues. 

Doctor: OK, so she's walking around one year.
Patient: Mmm 

Doctor: Have you had any other concerns about her, either social or physical development? 

Patient: No, she's been really great. She's good with people, she's has great social skills. She has grown well, met all her milestones, she's doing really well at school and gets along well with her peers as well. 

Doctor: OK, excellent. And were there any concerns throughout pregnancy, such as gestational diabetes or hypertension or any exposures to infections?
Patient: No, her mom's pregnancy was perfectly normal. She was born, like she was delivered vaginally at 39 weeks. She was breech at that time, which the DOCTOR: said might have to do with her clicking hips. But yeah, but since then or during pregnancy, no other complications. 

Doctor: OK, that's great. And. Uh, in regards to, you mentioned her hurt hip any other past medical history? 

Patient: Um no other than that she's been healthy. 

Doctor: OK, and does she take any medications regularly over the counter or prescribed?
Patient: No no, no medications. 

Doctor: OK, any allergies to medications?
Patient: No, not that I know. 

Doctor: And sorry has she taking anything for the, the pain?
Patient: No, I haven't really given her anything, I didn't know what to give. 

Doctor: OK all right, we'll talk more about that. Has she had any prior surgeries or hospitalizations?
Patient: No. 

Doctor: Can you tell me about who she's living with and whereabouts she's living? 

Patient: Yeah, so she's currently living at home with me, my wife, and she has an older brother. We live in a small house just near near the city. 

Doctor: OK, and what do you guys do for work?
Patient: Yeah, so I'm a lawyer and my wife is a music teacher. 

Doctor: OK, is there anybody who smokes in the home? 

Patient: No, none of us smoke. 

Doctor: OK um, OK, And any family history of heart or lung conditions?
Patient: Uhm, no, no family history our family is pretty healthy. 

Doctor: OK, how about any family history of any autoimmune conditions such as hypothyroidism?
Patient: No nothing like that. 

Doctor: OK. And then any musculoskeletal or neurological conditions in the family? 

Patient: No. 

Doctor: OK, so next on um just the exam. Um when you're looking at the right hip are you seeing any swelling, redness?
Patient: Uh, no, not that I see anything. 

Doctor: No OK, and is there any like muscle atrophy around the hip?
Patient: No, not that I see at all. 

Doctor: OK and then is there any misalignment or deformity of the joints that you can see?
Patient: No, I can't. Yeah, I don't see anything in the hips or legs that really points out to me. 

Doctor: OK um and is there any pain to palpation over the hip or or knee?
Patient: Uh, if I if I press on it, I don't think she's in that much pain. It's mainly just when she's trying to walk or put put weight on it. 

Doctor: OK, and is she able to move the hip in a full range of motion of like flexion, and extension, abduction, adduction?
Patient: Uhm, so she does. She is able to move it if she really tries. But it's mainly just the putting her weight on it and anytime she puts her weight on it is is when it really hurts. 

Doctor: OK, so more about the weight on it, and is she able to move that her knee with a full range of motion? 

Patient: Yeah. 

Doctor: OK, and any any muscle weakness when testing around the joint?
Patient: No. 

Doctor: No, OK. So I think that was everything that I wanted to ask on history and check was there anything I maybe forgot about you thought would be more important today,
Patient: I've, uh, had a runny nose over the last few days and I've started to have a sore throat as well. 

Doctor: Hmm, Uhm, when did this start?
Patient: I would, so the runny nose started, uh, about five days ago and, and the sore throat, uhm, about the same. 

Doctor: OK. Have you, uh, with the, the runny nose, do you have any, what's the discharge like?
Patient: Uh, it's been kind of watery, it's clear. 

Doctor: OK. Alright and has your sore throat gotten better or worse over the past five days?
Patient: Uh, it did get a little bit worse initially and since then it's been kind of stable. 

Doctor: Have you, uhm, had any difficulties swallowing? 

Patient: No, it, it is a bit sore, uhm, to swallow so it takes me a little bit longer to eat, but I've been able to still, still eat. 

Doctor: Have you changed, noticed any changes in your voice? Any hoarseness in your voice?
Patient: No. 

Doctor: No, OK. And do you have any nasal congestion? Does your nose feel stuffy? 

Patient: Yeah it does, yes. 

Doctor: OK, uhm, any fevers or chills?
Patient: No, I don't think so. 

Doctor: OK. Any difficulties breathing? 

Patient: No. 

Doctor: Any cough?
Patient: No. 

Doctor: OK, uhm any, uh, pain in your chest? 

Patient: No. 

Doctor: Any other symptoms, anything related to your belly,  say, diarrhea or Constipation or any changes in your urinary, any urinary symptoms?
Patient: No, nothing like that. 

Doctor: OK, OK, are you feeling fatigued, tired? Have any muscle aches? 

Patient: I, I have felt a little bit more drowsy these last few days and, uhm, yeah my, uhm, I have had some muscle aches as well. 

Doctor: Have you taken anything to help yourself, anything over the counter or any pills?
Patient: I did use, uh, some uhm, like cold medication to help because I was having a headache as well and a lot of I guess just like pressure from the nose stuffiness. 

Doctor: Did the cold meds help?
Patient: Yeah, it did help a little bit, it did help my nose clear up but it came right back after a few hours. 

Doctor: And how's your headache now?
Patient: It's not too bad. It's pretty mild, but it's there. 

Doctor: Uhm, do you usually get headaches of this sort, or is this very different from what you generally experience, if you usually have headaches. 

Patient: I don't usually get headaches, but I have felt uhm, a headache like this before though. 

Doctor: Oh OK, when was that?
Patient: Maybe the last time I was, I was sick. 

Doctor: Sure. 

Patient: Or if I don't get a good night's sleep. School's pretty early in the morning, so sometimes if I'm not sleeping well. 

Doctor: I see. OK alright, any other symptoms that you've experienced over the past five days that I didn't ask you about?
Patient: No, it's been, yeah mostly the runny nose and sore throat and headache. 

Doctor: I see. OK, alright, and do you have any medical conditions? 

Patient: No, I've been healthy. 

Doctor: All right, good, any medications that you take on a regular basis?
Patient: Uh, I'll use like Reactine or Claritin sometimes for allergies, but that's it. 

Doctor: What allergies do you have?
Patient: I have allergies to dust and some environmental things, like pollen or ragweed I think maybe. 

Doctor: I see. Alright, and, uhm, do you have any family history of any medical conditions? 

Patient: Uh, I think my dad has high blood pressure. He takes a medication for that, uhm nothing serious though that I know of. 

Doctor: OK, alright, and who do you currently live with?
Patient: So I live with both my parents and I have an older sister as well. 

Doctor: Good, OK, and do you smoke? 

Patient: I did try a vape once or twice, but, didn't really like it so, no. 

Doctor: Alright, what about marijuana?
Patient: Uh, no, I haven't tried that. 

Doctor: Any recreational drugs?
Patient: No. 

Doctor: Do you drink alcohol? 

Patient: No. 

Doctor: And have you recently traveled anywhere?
Patient: No, we've been doing classes virtually. 

Doctor: And any contact with anyone who you think might be sick.
Patient: No. 

Doctor: OK alright, well sounds like you have a sore throat and runny nose. You've been a little bit drowsy, had some headaches in the past five days, things were getting a little bit worse early on, but it's been a little bit, it's been more stable now. We'll do a physical exam, see, just listen to your chest, have a look inside your mouth and check your temperature and go from there. It sounds like you probably have a viral infection of some sort that should get, hopefully get better over time. We will also get a covid swab done just in case and if things seem to get worse, we can, you can definitely come back.
Patient: I just came in because I've been having this just just yesterday it started this sudden just pain over the front of my kind of like a shoulder an also elbow and it was right after doing I was just doing some workout and this pain just started and it's just like a stabbing sharp pain that hasn't really gone away since then. 

Doctor: OK, and so what activity were you doing specifically?
Patient: So I was doing so I was just doing weight training and I was kind of flexing my elbows and I was working on my biceps. I was on that machine where you so know I wasn't using weights or doing curls, but I was working on my biceps and I think I did hear, I don't think I heard like any pop or anything, but right after that I just had this sudden sharp pain in my shoulder as well as my elbow. 

Doctor: OK, so you you you think you heard a pop at that time?
Patient: Um I'm not sure if I heard a pop. Actually, I think I might have though. 

Doctor: OK, and did the pain start immediately or or a bit later on? 

Patient: The pain I think it started pretty soon after, like probably within like half an hour of that happening. 

Doctor: OK. And where is the pain located now?
Patient: The pain right now is a. Yeah, just kind of right at the front of my right elbow as well as near my shoulder as well.  D" OK. And. Um I think you mentioned the pain as as being sharp is that how you would describe the character of the pain?  Yeah, it's sharp. Yeah, I just feel like something stabbing in there. 

Doctor: OK, and does the pain radiate anywhere else? 

Patient: No, it's kind of in the same area as they described. 

Doctor: OK, has there been anything you've tried to make the pain better?
Patient: No nothings I tried like Advil nothings really worked. 

Doctor: OK. And, uh, sorry. How long is how many days is the pain been on going on for just just started yesterday? 

Patient: Yesterday. 

Doctor: OK, and since then has the pain getting any better or any worse?
Patient: I think it's the same, probably a bit worse than so it just happened last evening and I I didn't end up coming last night, but I wanted to make sure. I'm just coming this morning since it's just been a really painful night. 

Doctor: OK, have you done anything that's made the pain worse since last night?
Patient: No I just tried to just rest and I tried to use some ice, but nothing. Nothing's been working and I kind of also have like this. It it's weird, it's just like this mass right where my biceps is. It kind of just makes my biceps look really big. 

Doctor: OK, alright, well I skip look at that during the physical exam component thank you and so like are you seeing swell is there like swelling there is as well or is is that part painful? 

Patient: Yeah, it's painful there swelling there as well. 

Doctor: OK. And well, how severe is the pain on a scale of 10 to 1, 10 being the worst pain that you've ever experienced and one being the least.
Patient: Probably at least an 8, maybe a 9. 

Doctor: OK, so the pain is pretty severe then it sounds like. Uh, OK. Have you had any fevers or chills? 

Patient: No. 

Doctor: Have you had any unexpected weight loss?
Patient: No. 

Doctor: OK, and have you had any appetite loss?
Patient: Uhm no. 

Doctor: OK, and have you had any headaches? 

Patient: Uhm no. 

Doctor: How about any sensory changes like changes to vision or hearing?
Patient: No, nothing like that. 

Doctor: Any changes to your sense of smell or sense of taste? 

Patient: Nope. 

Doctor: Have you had a runny nose or a sore throat?
Patient: Uhm no nothing like that. 

Doctor: OK, have you had a cough?
Patient: No. 

Doctor: Any shortness of breath? 

Patient: No. 

Doctor: OK, any wheezing?
Patient: No. 

Doctor: Um have you had any chest pain? 

Patient: No. 

Doctor: Have you had any heart palpitations or feeling like your heart's racing?
Patient: No. 

Doctor: Any lightheadedness or dizziness? 

Patient: Nope. 

Doctor: OK, uh, and have you had any abdominal pain?
Patient: No. 

Doctor: Any nausea or vomiting? 

Patient: No. 

Doctor: Any changes to your bowel movements such as diarrhea or constipation or even blood in the stool.
Patient: No nothing like that. 

Doctor: OK, any urination problems such as pain or frequency?
Patient: Nope. 

Doctor: OK and have you noticed any changes to your skin like rashes or changes to your nails or hair? 

Patient: No. 

Doctor: Alright, and have you had any neurological symptoms such as numbness or tingling?
Patient: No, I don't think so. 

Doctor: OK, and have you had any muscle weakness? 

Patient: Just just in the in that area, I can't really like. I can't really flex an really move my upper upper arm in my elbow. 

Doctor: OK. Do you have any pains in any other joints?
Patient: Um no that's it's only my right upper arm. 

Doctor: OK. Um. And. Have you had any confusion or memory loss?
Patient: No. OK. And in the past, have you been diagnosed with any other medical conditions?  Uhm no I've been pretty healthy, um I they think I do have like pre diabetes but I'm not on any medication. 

Doctor: OK, and have you had any issues with your shoulder before like like a subacromial like impingement syndrome or like a rotator cuff pains or problems in the past?
Patient: A few years ago I did have some pain um with like some, they they told me not to do like overhead work like just things that require like with Physio I need to do some strengthening as well and it was it wasn't the same same shoulder. 

Doctor: OK. And do you take any medications regularly? 

Patient: Uh, no. 

Doctor: OK, and do you have any allergies?
Patient: No. 

Doctor: Have you had any hospitalizations or prior surgeries?
Patient: I had my tonsils removed when I was probably like 10 or something, but that's about it. 

Doctor: OK, and for the shoulder in the past did you have any imaging done like an ultrasound or or MRI maybe to look at the structures? 

Patient: No, it was just a it kind of went away. I just did some physio they didn't really do any imaging. 

Doctor: I see OK. And can you tell me a little about your living situation right now, like you're living with and where?
Patient: Yeah so I'm living with my wife and um daughter and I'm living just in a condominium in the city. 

Doctor: OK, and are you working right now? 

Patient: Yeah, so I'm an accountant. I'm working from home, so it's not that bad, but I I might just take a few days off depending on what I have to do with this injury. 

Doctor: OK, and um do you and hobby wise you mentioned like weight lifting, are you an active person like bodybuilding and that sort of thing regularly?
Patient: I I just actually probably started this past year. I used to. I used to workout a lot. In University and in my early 30s but then I stopped and this year I've kind of gone back into it. 

Doctor: OK, well it's good that you're staying active. And um do you smoke cigarettes?
Patient: No, I uh, probably tried a couple times and. High School and University, but just it was never my thing. 

Doctor: OK, and how about cannabis, like smoking marijuana or using any of those types of products? 

Patient: No, I I try to stay away from any drugs. 

Doctor: OK, uh, including recreational drugs?
Patient: Yeah. 

Doctor: OK and. Uh, are there any musculoskeletal or neurological problems that that run in the family?
Patient: Not that I know of, no. 

Doctor: OK, now how about any autoimmune diseases?
Patient: Uh, no, I don't think so. 

Doctor: OK, so next I just wanted to ask you to have a look at the at the arm. Compared to the other side, are you noticing any swelling, redness, or?
Patient: Yeah, any swelling or redness, I do see some just like kind of like in the middle of this area, some redness kind of looks like some bruising in in that in that region. Uhm, I also feel like when I like try to flex my biceps kind of have moved upwards. 

Doctor: OK, is this the mass or lump that I you were mentioning earlier that you kinda can notice in the in your right arm?
Patient: Yeah yeah. 

Doctor: OK, is there any temperature change, like does it feel warm on that side? 

Patient: Uhm I can't really tell if it's warm or not. 

Doctor: OK, and you so you mentioned are you able to bend your elbow all the way up so to flex it all the way up, or is a range of motion limited?
Patient: It's pretty limited. It's pretty tough to flex. It's really painful and that I also can't like. I can't turn my arm, I can't supinate. 

Doctor: OK so yeah, so is that so you have reduced supination as well?
Patient: Yeah. 

Doctor: And how are your shoulder movement, are you able to like if you're lifting your arms straight out in front of you, are you able to to lift them all the way up above your head? 

Patient: Out like at the sides or in front of me? 

Doctor: In front of you.
Patient: Yeah, the shoulder seems to be OK. I am able to lift up, but it's just if I try to move my upper arms at all it hurts a lot. 

Doctor: OK, alright so. You'll get some pain at the at the shoulder with the movement. 

Patient: There there is discomfort in the affected side, but I can I can move it much more than I can move my elbows or anything like that. 

Doctor: OK, I see. So I think that was everything that I wanted to ask about and and I look for on on the physical today. Was there anything I may be missed or anything like that?
Patient: Hi, I've just been been so like weak and so tired, I just I can't I can't seem to like get off the couch, like I'll get up from my bed and go lay on the couch and then you know I might be able to get something to eat but I just I get so tired so fast and I don't know I don't know what's wrong. 

Doctor: OK, when did these symptoms start?
Patient: Um, like I've been feeling pretty tired for like a week, but like this bad for like maybe four days. 

Doctor: OK, um and so it sounds like you haven't been going to work or like anything like that because you have been so kind of tired and weak. 

Patient: Yeah, I mean at first I was already kind of working. I'm I'm a truck driver so you know, once you start the job, you kind of have to finish that. I was supposed to go on another another trip like 4 days ago and I just couldn't. I had to call my boss and say that I can't. 

Doctor: OK, um have you had any like specific muscle weakness like in your legs or or in your arms? Or would you say it's overall like a general weakness?
Patient: It's just everywhere. It's it's not like I can't move. I'm just really, really tired. 

Doctor: OK, and how, how have you been sleeping?
Patient: I mean, I've just been sleeping like all the time. I have been sleeping all night and then like I said, I get up and I go to the couch and like just fall back asleep. 

Doctor: OK, uh, have you been having any other symptoms?
Patient: I mean my my throat is maybe a little sore, but nothing nothing else. 

Doctor: OK, uh, when when did the sore throat first start? 

Patient: Probably probably about a week ago. It's not really bad, it's just kinda there. 

Doctor: OK, so it's it started just before uh, the weakness and fatigue?
Patient: Yeah, around the same time. 

Doctor: OK, um, and have you been having any pain with swallowing?
Patient: Uh, I mean maybe a little bit. 

Doctor: OK, like with uh, like solid foods or liquids or both?
Patient: It it's just like it's just like it's a little a little tender. It's not like, really it's not like hard to swallow or anything, it just feels like it's like my throat's kinda tired. 

Doctor: OK, have you had any changes to your voice?
Patient: Uh, no, I don't think so. I mean, I live. I live alone so I can't really ask someone else if I have. 

Doctor: OK, but your voice sounds the same to you? 

Patient: Yeah, I think so. 

Doctor: Alright, um, and so have you been having any fevers or chills?