jshargo/medical-interview-conversations huggingface dataset:
Patient: Uh I would say it's the same, it's like I'm in as much pain as I was earlier. 

Doctor: OK. OK and um so yeah, OK, um do you know how you felt like on the floor? Like did you uh go like leg first or was it, did your um, kind of like the mechanism of your fall, did you break the fall at all with your arms? 

Patient: Uh no, I didn't break, it kind of, so I was kind of uh, I feel like when I was slipping it was at first my leg was hyper extended but it kind of just felt like it snapped and it went straight down, so there was some kind of twisting as well as some hyperextension. Um but it just kind of slipping on my dress and then just straight down. 

Doctor: OK, OK. Um otherwise, do you have any pain elsewhere in your body?
Patient: No. 

Doctor: How about any numbness or tingling in the area? 

Patient: Um I do feel some numbness, tingling just below where it happened, um but it like comes and goes. 

Doctor: OK um and then how about how about any um like feelings of like losing sensation or feeling cold in that area?
Patient: Um no, I I can feel everything in that area. 

Doctor: OK.
Patient: But it's hard to tell like it's just very painful right now. 

Doctor: OK, yeah, that's understandable. Um how about headaches?
Patient: No, no headaches. 

Doctor: Uh any fainting or dizziness. 

Patient: No. 

Doctor: Um confusion or memory loss?
Patient: No. 

Doctor: Um weight loss recently.
Patient: No. 

Doctor: Fevers or chills? 

Patient: No. 

Doctor: Uh changes to your hair, nails, or skin, like rashes?
Patient: No, nothing that I've noticed. 

Doctor: No, any changes to your vision, hearing, smell, or taste? 

Patient: No. 

Doctor: Um how about coughing, shortness of breath, or wheezing?
Patient: No, no, nothing like that. 

Doctor: No, OK, um how about chest pain or palpitations? 

Patient: No. 

Doctor: No, any changes to your bowel movements?
Patient: Uh no, not that I've noticed. 

Doctor: Uh nausea or vomiting? 

Patient: Nope. 

Doctor: Abdominal pain?
Patient: No. 

Doctor: Changes to urinary habits? 

Patient: No, nothing like that. 

Doctor: No, OK, um and are you otherwise healthy?
Patient: Yeah, I've been pretty healthy, I um don't take any medications regularly, I don't have any medical conditions. 

Doctor: OK, that's good. Any hospitalizations or surgeries in the past?
Patient: No, um just just for like my pregnancies, I had two pregnancies, both of them delivered vaginally, but no issues with that, just after that no hospitalizations or surgeries. 

Doctor: OK, OK. Um and then um are you up to date with all your immunizations? 

Patient: Yep. 

Doctor: OK, that's good. Um do you have any allergies?
Patient: No, not that I know of. 

Doctor: OK, um and then is there any family history of like musculoskeletal issues? 

Patient: Um so my mother has something called osteoporosis. 

Doctor: OK, yep.
Patient: Um but that's that's all that I can think of. 

Doctor: How old was she when she was diagnosed with that?
Patient: Um probably in her fifties. 

Doctor: In her fifties, OK. 

Patient: Late fifties I would say. 

Doctor: Um have you been, have you ever like been tested for that?
Patient: No, I've never, I've never had testing. 

Doctor: OK, all right. Um and then any family history of lung or heart conditions?
Patient: No. 

Doctor: Uh how about autoimmune conditions? 

Patient: Uh no, not that I know of. 

Doctor: Any cancers?
Patient: Uh, I think one of my aunts has uh ovarian cancer. 

Doctor: OK, OK, um how old was she when she was diagnosed with that? 

Patient: Um like pretty uh recently, so probably like in her sixties. 

Doctor: OK, OK, um and then have you been in touch with anyone sick recently?
Patient: No. 

Doctor: No, OK, have you done any travel recently?
Patient: No. 

Doctor: OK. Um those are all the questions I had for you. Did you have any questions of your own or anything you wanted to add before we move to the physical exam component?
Patient: No, I just want to get this fixed as soon as possible. 

Doctor: OK, that sounds good, yeah we'll, we'll try our best. 

Patient: Thank you. 

Doctor: Um OK, so now looking at your legs like side by side, do you notice any uh redness or swelling in your right leg compared to your left?
Patient: Yeah, it's all, it's all swollen and red and just looks so much different than my other leg. 

Doctor: OK, yeah, um do you notice any obvious like breaks in the skin?
Patient: No, there's no breaks in the skin but like when I fell like I, I can definitely see like the bend, there is like a bend in the bone, so I definitely do think it's broken. 

Doctor: OK, and do you notice any like bony pieces that are pushing on the skin? 

Patient: No. 

Doctor: No, OK. Uh any bruises in the area?
Patient: Yeah, the whole area seems bruised up and angry. 

Doctor: OK. Um does uh, besides the bruising and the misalignment, do you notice any other obvious deformities, any muscle atrophy in the area?
Patient: No. 

Doctor: No, OK, and then uh placing your hand on one leg compared to the other, does it seem warmer?
Patient: Yeah, I feel like it's it's warmer. 

Doctor: OK um and then I'm gonna try to get you to do some movements, um can you move your right leg at all, like can you flex and extend your knees?
Patient: No, not not at all like I I'm I'm too scared to try. 

Doctor: OK, and how about weight bearing, are you able to stand up at all on that leg? 

Patient: No, I just I just got time to call the ambulance, I knew I knew it was just not possible. 

Doctor: OK, alright, um I guess those were all the questions that I had for you. Um I think you may have a tibial fracture. So we'll start with some X Rays um to be sure and to try to take a look at like where the fracture is and how we can approach that. Um because everything is swollen and angry down there, we'll probably try and um apply a splint um until the swelling goes down. And then um we can uh refer you to an orthopaedic surgeon for a surgic, for the surgery itself. So that could um involve, like uh  you know them doing like and intramedullary nail, plates and screws, and um like some sort of fixation. Um but after the surgery, your fracture will probably take about four to six months to heal completely, uh so in that period um we can talk about like pain management and physiotherapy as well, just to keep the muscles in that area strong and to increase your range of motion. Does that sound OK?
Patient: I've had uh a new cough that started um this week, it's been going on the last like three or four days and um I've had a headache and um but yesterday I just noticed that I haven't been able to to smell, so I wanted to come in this morning. 

Doctor: OK, yeah, so it's been going on for the last uh four days. Is it kind of like a dry cough or a wet cough?
Patient: It's dry. 

Doctor: It's dry, OK. Are you at all bringing up any kind of sputum or blood at all? 

Patient: No, I haven't been. 

Doctor: OK and um have you been experiencing any kind of uh fevers or chills?
Patient: Yeah, I feel, uh, I have felt feverish. Uh and I think that yeah, that's kind of started uh like within the last day. 

Doctor: OK, and did you um get a temperature at all? 

Patient: No, I've just been really feeling, yeah feverish and feeling really hot. 

Doctor: OK and um besides the um cough, are you having any other symptoms like muscle aches or headaches?
Patient: Uh yeah, I've been having a headache like I dont know, on and off for this past three or four days as well, and I have had muscle aches, my whole body kind of aches. 

Doctor: OK, um and when did this start?
Patient: That's been over the past um like 3 days or so, yeah, I woke up and I've just been feeling uh yeah achy and just not feeling good. 

Doctor: OK. Yeah, so it all just kind of started in the last four days. Uh are you having any kind of fainting or dizziness episodes at all?
Patient: Uh no, I haven't had anything like that. 

Doctor: OK and any uh, are your symptoms getting worse at all? 

Patient: No, they, well I, initially they did but um they've kind of stayed the same. 

Doctor: OK, and have you had any loss of sense of taste or smell?
Patient: Yeah I had, I have, I've had a loss of um smell and taste now that you mention it, yeah. 

Doctor: And when did that happen?
Patient: Um within the last uh two days. 

Doctor: OK, and are you having any runny nose, congestion, sore throat, any of those symptoms?
Patient: Uh no, not really. Nothing like that. 

Doctor: OK, have you traveled at all recently? 

Patient: No, I I haven't traveled um, haven't traveled anywhere. But I I've just been going to work and and being at at home. 

Doctor: OK and um, where do you go for work?
Patient: Um I'm a nurse actually at the at a um a walk in clinic. 

Doctor: OK, and have you uh at all been exposed to anyone who's been sick? Uh anyone who has tested positive for Covid?
Patient: Uh no, nobody that I'm aware of that's that's tested positive, but there has been people uh recently um that within the past week, that we've seen come in with with cough and um things like like that so. 

Doctor: OK. Um are you having any nausea or vomiting?
Patient: Um no, I haven't had anything like that. 

Doctor: OK, any um night sweats?
Patient: No. 

Doctor: Any chest pain or shortness of breath?
Patient: No. 

Doctor: OK, any changes in your bowel movements, any diarrhea, constipation? 

Patient: No. 

Doctor: Any um changes in your urination?
Patient: No, nothing like that. 

Doctor: Um no burning sensation or pain at all? 

Patient: No, nothing like that. 

Doctor: OK, any changes in your sleep or appetite recently?
Patient: Uh yeah, just these past couple of days, I haven't really felt like eating much. Um my sleep has been OK, but I think that's just because I haven't been feeling well so just haven't really wanted to eat. 

Doctor: OK, any weight changes recently?
Patient: No I, I wish. 

Doctor: OK. And have you been diagnosed with any medical conditions in the past at all?
Patient: No, I've been. I've been, I've been healthy. 

Doctor: OK. And do you take any medications on a regular basis? 

Patient: Um just the uh the multi vitamin and then a like a greens supplement. 

Doctor: A green green supplement?
Patient: Yeah, it's just sort of like a like a green um powder. It's supposed to replace uh I don't know one of your servings of vegetables for the day. 

Doctor: OK, um and have you been hospitalized or had any surgeries in the past?
Patient: I I had like a scope on my knee when I was um like a teenager, I injured it playing soccer, but that's it. 

Doctor: OK, any family history of any heart or lung conditions? 

Patient: Um my my grandfather had had lung cancer, um but he smoked his whole life 

Doctor: OK. Um and currently, so you work as a nurse, uh what's your living situation like? Do you live with anyone, do you live in house or apartment?
Patient: Yeah, so I live in a house with my wife um we we have a a young um a daughter. 

Doctor: OK, has anyone in the house had similar symptoms or been feeling sick lately?
Patient: No, it's just been me. Yeah my wife and daughter have been both uh staying home. I've been the one, only one really kind of leaving the house for well going to work and then uh getting most of the groceries and that that sort of thing, since I'm already out. 

Doctor: OK. OK, and currently do you smoke at all?
Patient: Uh no cigarettes, um well I uh smoke weed every once in awhile. 

Doctor: OK, and how often would you say you smoke weed?
Patient: Uh probably like, uh probably once a week. Just yeah, just on the weekend, maybe once. 

Doctor: OK, and uh, do you drink alcohol?
Patient: Um I had some like a couple of beers on the weekend, like one or two. 

Doctor: OK, um OK, so those are all the questions I had for you today. Do you have any questions or concerns?
Patient: Um just a bit concerned possibly about uh Covid. 

Doctor: OK, yeah, so that's definitely uh with you working in the in the hospital clinical setting, um there is definitely a possibility, and a lot of the symptoms that you're having overlap with Covid symptoms. Uh, so we will definitely get a Covid swab test done for you today. It usually comes back in the next 24 to 48 hours and until then uh I would recommend that you isolate either in a room separately, wear a mask around your family members, um isolate to the best of your abilities, not go outside, see if someone else can get groceries for you guys uh as well. And then um depending on the test, public health will contact you with further instructions. 

Patient: OK, yeah, that sounds good. Thank you. 

Doctor: You're welcome. Take care.
Patient: Um, I just I've had a cough and I've had a sore throat for the past two days and I was just worried that I might have COVID so I thought I'd come in. Just to make sure that everything's OK. 

Doctor: OK, well that's a good idea that you came in, so it's been happening for the last two days. Did you start having the cough first or the sore throat or both around the same time? 

Patient: It started with a sore throat two nights ago and then it got worse in the morning when I woke up and then I developed the cough, like about a day ago, a day and a half. 

Doctor: OK and can you describe your cough? Is it a wet cough or a dry cough?
Patient: It's a dry cough. 

Doctor: OK, are you having any kind of? Are you bringing up any blood or sputum at all? 

Patient: No. 

Doctor: No OK. And, uh. So this started 2 days ago. Is it constant, are your symptoms constant? Or they come and go?
Patient: No, they're not constant. They kind of come and go. 

Doctor: OK, and do they occur when you're exerting yourself at all or it can happen it? Or do they happen at some point during the day in the morning or night, or just randomly?
Patient: It's pretty random. 

Doctor: Okay. Are you symptom getting any better or worse? 

Patient: Uhm? Maybe a little worse. I kind of feel like I'm also, um, I'm now having like a, a runny nose. 

Doctor: A runny nose as well? OK, when did that start?
Patient: Uhm, maybe like I don't know just now even, like an hour or two ago. 

Doctor: OK, uhm have you had any recent exposure to anyone that's been sick recently at all?
Patient: Uhm? Maybe. I, I work at a hospital. Um, but I'm always maintaining, social distancing and I try to be very careful. 

Doctor: OK, and uh. Do you have you tried any medications over the counter to help with these symptoms? 

Patient: No. 

Doctor: OK. Do you have any other symptoms like. Shortness of breath, chest pain, dizziness, or anything like that?
Patient: No. 

Doctor: No. Okay. And the sore throat are you having trouble or pain while swallowing any food?
Patient: It's not that bad. 

Doctor: Not that bad.
Patient: It's just irritation in my throat. 

Doctor: OK. Any hoarseness in your voice at all? 

Patient: No. 

Doctor: Well, OK. Have you traveled at all recently utside of the province?
Patient: No. 

Doctor: Any headaches? 

Patient: No. 

Doctor: Any nausea, vomiting?
Patient: Now I know. 

Doctor: No OK. Any fatigue or malaise?
Patient: Maybe a little bit. It's not too bad. 

Doctor: OK, any muscle aches at all?
Patient: Uhm? Yeah, little bit. 

Doctor: Okay, and when did that start?
Patient: Maybe two days ago? 

Doctor: OK, and is it just all over your body or in certain locations? 

Patient: It's all over. 

Doctor: Have you tried any pain medications?
Patient: Uhm no, no I haven't. 

Doctor: OK. Any changes in your bowel movement at all like Constipation or diarrhea? 

Patient: No. 

Doctor: Um, any changes in your appetite?
Patient: No. 

Doctor: OK, have you lost any significant weight recently? 

Patient: Uh, no. 

Doctor: OK. Do you have any past medical conditions that you've been diagnosed with?
Patient: Um, no, I'm pretty healthy. 

Doctor: OK. Any allergies to medication?
Patient: No. 

Doctor: Any environmental allergy? 

Patient: No. 

Doctor: OK, any previous, so sorry? Are you taking any medications at all right now?
Patient: Uhm? Um, I'm not, no. 

Doctor: Any past hospitalizations or surgeries?
Patient: Um, no. 

Doctor: No. OK, and any family history of any lung or heart condition. 

Patient: Just high blood pressure. My mom has it. 

Doctor: OK. Uhm, and currently, are you working?
Patient: I was working before the symptoms started. 

Doctor: OK, and what do you do for work? 

Patient: I work as a custodian at the hospital. 

Doctor: OK, and so you've been isolating and have you gotten COVID swab test yet?
Patient: Uhm no I haven't. 

Doctor: OK, so yeah we can do that for you today after a physical, physical examination. 

Patient: Sure. 

Doctor: Currently, right now, what's your living situation like?
Patient: I live alone. 

Doctor: OK, and do you live in like an apartment or house?
Patient: Apartment. 

Doctor: OK, and any new exposures at all in your house to dust, new, carpets, animals, anything like that? 

Patient: No. 

Doctor: No, OK. And do you smoke?
Patient: I used to, I don't anymore. I I smoked when I was in high school. Maybe a couple times. 

Doctor: And do you smoke marijuana? 

Patient: No. 

Doctor: Uh, any alcohol?
Patient: Um, once once a day, maybe one class of wine at night. 

Doctor: Yeah, so that's all the questions I had for you today. Do you have any questions or concerns?
Patient: No. 

Doctor: OK, so yeah, it seems like you've been having these symptoms for the last few days. They seem kind of like viral in nature with your dry cough and runny nose, sore throat. And sometimes with these viral illnesses, it may take some time for the symptoms to go away, especially the cough. So today we will do a COVID swab test for you today, as a lot of the symptoms overlap and you will receive the result in the next one to two days and be contacted by public health for further instructions. As for management, I think you can take over the counter medications like Tylenol cold, drink lots of fluids and stay hydrated. And if those if your symptoms worsen at all, you can contact us again.
Patient: Sure, thank you. 

Doctor: Welcome, take care.
Patient: I'm just having this really sharp pain in my chest and I'm scared. I think I'm having a heart attack. 

Doctor: Oh wow, yeah um that must be really scary. When did this, when did this pain start?
Patient: So about 3 days ago. 

Doctor: Three days ago, OK, and where exactly in your chest do you feel it? 

Patient: It's kind of right here, right over my heart I think, that's where it's the worst. 

Doctor: OK, and is it, what kind of pain is it? Is it more like a dull pressure pain, or is it a sharp pain? How would you describe it?
Patient: I would say it's a sharp pain. 

Doctor: A sharp pain, OK. Um, so it started three days ago, has it been coming and going or has it been constant?
Patient: It just lasts for a few seconds and then it goes away. 

Doctor: OK, does the pain come on when you're doing any activities or When does the pain usually come on? 

Patient: Oh, it's usually worse when I'm coughing or laying down. Yeah, yeah. 

Doctor: OK, and um, does it improve with any positional changes at all, or anything that you do that does it help?
Patient: When I when I lean forward, it actually does get better. I think about it, yeah. 

Doctor: OK, and has this ever happened to you before? 

Patient: No, no it hasn't. 

Doctor: OK and on a scale of 1 to 10, one being the least amount of pain felt and 10 being the worst, how much would you rate it?
Patient: I would say a 6 out of 10. 

Doctor: OK, and does the pain move anywhere in your chest or does it stay in the same spot? 

Patient: Yeah, I think it kind of goes to my neck sometimes. 

Doctor: OK, and do you have any other symptoms, like do you have any shortness of breath, dizziness, anything like that?
Patient: No, I don't. 

Doctor: OK any any palpitations?
Patient: No. 

Doctor: OK. Alright, and other than that, have you been having any other symptoms at all besides the pain?
Patient: No, no, nothing else, that's it, just have these sharp episodes of pain that last a couple of seconds. 

Doctor: OK, um have you have you tried like any medications that has helped the pain? 

Patient: Yeah, I took some um, I took some Tylenol and that did help. 

Doctor: OK.
Patient: I took it once yesterday. 

Doctor: Alright, um, any recent injuries to the area like did you have any falls or anything like that?
Patient: No, no I haven't. 

Doctor: Any headaches, nausea or vomiting, fevers, or chills? Any of those symptoms? 

Patient: No. 

Doctor: OK, any cough, runny nose, any viral symptoms?
Patient: No, well not right now, but I did have a, I did have a flu last week. I had a fever, had a runny nose. I did have a bit of a cough and I was feeling super tired, but not anymore. I'm OK now. 

Doctor: OK, and have you at all had any dizziness or have you fainted at all?
Patient: No. 

Doctor: OK. Have you been noticing any kind of weakness or numbness? 

Patient: No. 

Doctor: No, OK, and in terms of your past medical history, do you have any medical conditions like diabetes, high blood pressure, any other diagnosis?
Patient: No. I'm a pretty healthy 25 year old. 

Doctor: OK. Um, do you take any medications? 

Patient: I sometimes take Tylenol. 

Doctor: OK, and any allergies at all?
Patient: No. 

Doctor: OK, and any previous surgeries?
Patient: No no, no surgeries. 

Doctor: Do you have any family history of any heart conditions or any cancers or anything like that?
Patient: Yeah, my father, he he had a heart attack two weeks ago and he and he passed away. And I'm worried I am having a heart attack too. 

Doctor: It was just two weeks ago? 

Patient: Yeah. 

Doctor: I'm so sorry to hear that. Yeah, it must be really difficult time for you right now. OK, so you're worried you might be having a heart attack as well?
Patient: Yeah. 

Doctor: OK, so we can definitely do some tests and see what was going on. I just have a few more questions and then I'll just get to some of the management and what we will be doing for you in the future. So currently right now do you work at all?
Patient: No, I'm a student. I, well as a part time job, I do work as a post man. 

Doctor: OK, and where are you a student? What do you do? 

Patient: I'm studying engineering at Western. 

Doctor: Alright, and currently where do you live? Do you live in student housing, an apartment or a house?
Patient: I live with my parents, well my mom now, in a house. 

Doctor: Right, and you drink at all any alcohol? 

Patient: I drink occasionally, maybe one or two drinks on the weekends. 

Doctor: OK, and any recreational drug use like marijuana or cocaine?
Patient: No. 

Doctor: And do you smoke?
Patient: No. 

Doctor: Alright, so those are all the questions we had for you today. And yeah, it must be really difficult and scary for you right now, but we'll make sure to get to the bottom of this to see what's going on. So what we can do is get you an ECG to see how your heart is functioning and then see getting the blood work if we need it for the future. But yeah, right now I would say try not to worry too much about it right now and see um what some of those tests come back. 

Patient: Thank you. 

Doctor: So yeah, you're welcome.
Patient: Um hi, yeah I've had the stuffy nose um that's been on and off, as well as a runny nose for the past week and it doesn't seem to be getting any better, so I thought I should come in and get it checked out in case I have covid. 

Doctor: OK, yeah I know for sure that's a good idea. So how long have you had this for? 

Patient: A week now. 

Doctor: A week. And did. So what started first? Was it the runny nose? Or like the stuffiness?
Patient: It felt pretty stuffy at first, but now it's mostly running. 

Doctor: OK, and are you coughing at all? 

Patient: No. 

Doctor: No OK, and the runny nose what kind of content are you producing or draining? Is it mainly like clear or is there any color to it?
Patient: It's mostly clear. 

Doctor: OK. And, is it mainly just congestion and drainage from your nose or are you feeling and go at the back of your throat as well? 

Patient: Uh no it's just mostly for my nose. 

Doctor: OK, any other symptoms like sore throat, shortness of breath, fevers or chills?
Patient: No. 

Doctor: No OK. And is this like something that's constant or does it come and go? 

Patient: Ah, it's it's. Ah It's been pretty constant for the past week. 

Doctor: OK, has this happened to you before at all?
Patient: No, well, actually I've had I've had a cold before but not recently. Maybe like five years ago. 

Doctor: OK, have you tried any over the counter medications at all?
Patient: Um I've tried like decongestants and. That's not. Well, I guess my nose is runny now so that worked a little bit. 

Doctor: OK. OK, and have you been in contact with anyone who's been sick recently? 

Patient: Uhm? No, I don't think so. My I have um a nephew who I live with who goes to daycare. 

Doctor: OK, and has he been sick at all?
Patient: No, he's been fine. 

Doctor: OK, any recent travel at all? 

Patient: No. 

Doctor: No, OK. Any headaches or nausea or vomiting?
Patient: Nope, nothing like that. 

Doctor: OK, any fatigue?
Patient: A little bit. 

Doctor: OK, any loss of sense of taste or smell. 

Patient: Um. No, um not that I've noticed. 

Doctor: OK, any sort of like chest pain or racing sensation of racing of yourbheart or anything like that?
Patient: No. 

Doctor: No OK? Any changes in your bowel movements? 

Patient: No. 

Doctor: How about your any difficulties in urinating?
Patient: Um no. 

Doctor: OK, have you been sleeping and eating well? 

Patient: Yes. 

Doctor: OK, any weight changes like any significant weight loss recently?
Patient: No, no, no, nothing like that. 

Doctor: OK. At home or at work home any exposure to like fumes, dust or animals? 

Patient: No. 

Doctor: OK, and have you been diagnosed with any medical conditions in the past?
Patient: Um I have type one diabetes. 

Doctor: OK, and when were you diagnosed with that?
Patient: When I was like 7. 

Doctor: OK. And so you have your insulin medication and your are you all up to date with that?
Patient: Yes. 

Doctor: OK, and do you see an endocrinologist? 

Patient: I do. 

Doctor: OK, alright. Any medications that you are on besides insulin?
Patient: Uh no . 

Doctor: No, OK. Any allergies at all?
Patient: No. 

Doctor: OK, have you been hospitalized or had any surgeries before? 

Patient: No. 

Doctor: No, OK. Any family history of any medical conditions, in particular with the lungs or the heart.
Patient: No. 

Doctor: No, any autoimmune diseases? 

Patient: No. 

Doctor: OK. And currently right now do you work or do you go to school?
Patient: I’m in school right now. 

Doctor: OK, and so are you living, where are you living right now?
Patient: I live in an apartment by myself. 

Doctor: OK. And currently, do you use any recreational drugs like marijuana or anything?
Patient: Uh no, not OK so not frequently, but maybe like once a month I'll have an edible. 

Doctor: OK, any other recreational drugs like cocaine and heroin? Anything like that?
Patient: Oh no. 

Doctor: No. And you drink alcohol? 

Patient: Uh no. 

Doctor: And do you smoke tobacco?
Patient: No. 

Doctor: Yeah, those were all the questions that I had for you today. Do you have any questions for me? 

Patient: I yeah, how do I get rid of this? And it's really been bugging me. 

Doctor: Yeah, it kind of so just a stuffy nose in the runny nose it seems like it's most likely a viral infection like the common cold. It takes a few weeks for the symptoms to get relieved, but there's not much that we can do besides supportive care, so make sure you get you stay well hydrated. You can use over the counter medications uh like Tylenol cold. now, if you to relieve some of your symptoms, but since right now we're in a pandemic, some of these symptoms can also be seen in covid patients, so we will also get a swab done for you today, and you should have the results back by 48 hours. Um until then, we recommend that you stay isolated in your own home and not see anyone else. And then once the results come back, you'll get further instructions from public health.
Patient: OK, that sounds great. Thank you. 

Doctor: Your welcome. Take care
Patient: Yeah, so I just brought my son, went to the hospital. I've just been getting very concerned because he's making like these, like grunting noises for the last day and, like it's it's really worrying me, I don't know if he's like not breathing and I also just did like a temperature on him just this morning and it came up to like like a high 38, so I don't know what's going on, and then he's just very like irritable and just not himself I think. 

Doctor: OK, so all of this started a day ago, you mentioned?
Patient: Yeah, it started yesterday, but the grunting started today, like, I think he was a bit on the warmer side last night as well, more irritable last night, but the grunting started this morning. 

Doctor: OK, Uhm, and you mentioned his fever was 38, correct?
Patient: Yeah, I think it was like 38, 7 or something like that. 

Doctor: OK is he coughing at all? 

Patient: Uhm, yeah, I would say with the grunting there is some coughing in between as well. 

Doctor: OK, and is he bringing up any phlegm?
Patient: Uhm, he's been having some spit ups as well. They're mainly like clear and whitish, but yeah I don't know if he's bringing anything else up. There's no green or yellow material though. 

Doctor: OK, any blood in there?
Patient: No, I haven't notice any blood. 

Doctor: Does he sound wheezy?
Patient: Uh no, it's mainly just the grunting. 

Doctor: OK, OK, does he look swollen to you? 

Patient: Uh, swollen as in just, uh, like in his. 

Doctor: In his, uh, like uh, legs, arms or belly area.
Patient: No, I don't think so. 

Doctor: No ok, and uh, does he have a runny nose or a stuffy nose? 

Patient: No, I don't think so. 

Doctor: No, OK, how is his feeding?
Patient: Yeah, it's it's been difficult. So right now, like his mom is at home, but she was having difficulty feeding. He's mainly breastfed right now. 

Doctor: OK. 

Patient: And he's not really been feeding too much either. 

Doctor: OK, and how about like the number of wet diapers he has?
Patient: Just the normal like, that hasn't changed. He has like three or four in a day. 

Doctor: OK, OK, good. Have you noticed any changes to his bowel movements or urine? 

Patient: No, pretty much been the same. 

Doctor: OK, is he throwing up at all?
Patient: Nope, just some spit ups, I don't know if that's, Just because of the coughing or if they're just spit ups, like, but nothing after eating. 

Doctor: OK, OK, have you noticed any rashes on him? 

Patient: No, no rashes. 

Doctor: OK, uhm, has he had any fainting spells or seizures?
Patient: Uh, no, I've been really trying to make sure, like, I was worried if he gets blue or something that we would rush to the emergency department, but I haven't noticed anything like that. 

Doctor: OK, OK good. Has he been in contact with anyone who's been sick recently?
Patient: No, I don't think so. We've been trying to be very careful with the pandemic and everything going on. 

Doctor: For sure, any travel to anywhere recently? 

Patient: No. 

Doctor: OK, and is he an other-wise healthy baby?
Patient: Yeah, so, uh, healthy but he was born premature at 36 weeks. 

Doctor: OK. 

Patient: And no complications really with the pregnancy or after he was born. But yeah, he was premature. 

Doctor: OK, and so he didn't need any hospitalizations right after birth, right?
Patient: No, he was fine after birth. 

Doctor: And no longstanding medical conditions after birth?
Patient: No. 

Doctor: Has he needed hospitalizations for anything in the past, or surgeries?
Patient: No, nothing like that. 

Doctor: OK, and is he up to date with all his immunizations?
Patient: Yeah, the two months vaccinations are all up to date. 

Doctor: OK, good. Medication-wise is he on anything? 

Patient: No, no medications. 

Doctor: OK, any allergies?
Patient: No. 

Doctor: Any family history of lung conditions or heart conditions?
Patient: No, not that we know of. 

Doctor: OK, any cancers in the family?
Patient: Nope. 

Doctor: And who does he live with at home?
Patient: Just me and my wife. 

Doctor: OK, uhm, in a house, apartment? 

Patient: In a house. 

Doctor: OK, any old carpets, mold, dust, asbestos, pets, anything like that at home?
Patient: No, nothing like that. 

Doctor: OK, and does anyone at home smoke? 

Patient: Nope. 

Doctor: OK, well, those were all the questions I had for you. Did you have any questions of your own?
Patient: Yeah, no, I was just really worried like, the grunting is just really scaring us. So do you, I was just wondering if you know what it could be. 

Doctor: Yeah, so the grunting is worrisome. He could have anything from bronchiolitis to pneumonia so what we'll do is, we'll, first get his temperature, we'll get his O2 sat and we will get some imaging done as well to see if it's more in line with bronchiolitis or pneumonia. If it's bronchiolitis, it will be supportive treatment so we can keep him here at the hospital because he is in some distress and we'll keep him hydrated and give him some oxygen. And if it's pneumonia, we'll prescribe him some antibiotics. How does that sound? 

Patient: Yeah, and will he need to stay in the hospital at all? 

Doctor: Yeah so for now, because, if he is in any distress and if he needs oxygen, and IV hydration, he'll need to stay in the hospital until he's better from that standpoint. I should also mention, we should do a covid swab on him as well because his symptoms are in line with covid as well, so we'll have to do that to rule it out.
Patient: Hi there, I've just last night I was, I went for a run and I twisted my ankle. I think I stepped on something and it it really hurts. 

Doctor: OK, and so when did you have the injury? 

Patient: It was just yesterday. 

Doctor: OK.
Patient: Yeah it was just just yesterday that it happened. 

Doctor: OK, and do you remember if you twisted it so you twisted your ankle, like did did it twist inwards or outwards? 

Patient: Inwards yeah, I feel like I inverted my ankle. 

Doctor: OK. And, so since then, were you able to stand up and or were you not able to bear any weight?
Patient: No, I was able to, uh, kind of finish the I I I just finished the walk. I was able to walk home 'cause it didn't hurt that bad immediately. It was a bit painful, but the pain really started a few hours later and has been pretty much constant ever since. 

Doctor: OK, OK so it kind of got worse over time over the last day?
Patient: Yeah. 

Doctor: And do you notice any kind of bruising, redness, swelling, any skin changes? 

Patient: No, I haven't really noticed I uh, really, any swelling or I or or skin changes. Yeah, no skin changes and no swelling. 

Doctor: OK, and how would you describe the pain? Is it like a dull, aching pain or sharp stabbing pain?
Patient: Dull and achy. 

Doctor: OK. OK. And has this happened to you in your ankle before?
Patient: I'm I, I feel like I've maybe I I've done something like this when I was younger, maybe playing basketball or something like this when I was a kid, I twisted my ankle before. 

Doctor: OK, and does this pain just stay, where's the pain exactly on the right side of your ankle or on your left, like interior side?
Patient: It's on the right kind of outside of the ankle. 

Doctor: OK, and which ankle is this just to clarify? 

Patient: On the right ankle. 

Doctor: OK so so it hurts on the right side of the right ankle.
Patient: Yeah, exactly. 

Doctor: OK, and does the pain radiate or move anywhere in your feet?
Patient: I can kind of feel it around on the the sole of my foot as well, but mostly on the outside though. 

Doctor: OK, and is there anything that makes the pain better or worse?
Patient: Alright, it gets worse really to if if I move my ankle or if I'm standing on it. 

Doctor: OK, and anything that makes it better?
Patient: Alright, just if I rest and avoid moving it. 

Doctor: OK, have you notice any fevers or chills?
Patient: No. 

Doctor: OK, any pain in any other joints besides your ankle?
Patient: No, just my my right ankle. 

Doctor: OK, any appetite or weight changes? 

Patient: No, I've been I've been just training for this race coming up, so I mean I've been just trying to work on my fitness a little bit, but my weight has been relatively stable. 

Doctor: OK, any weakness in your right right extremities or any kind of numbness or tingling sensation?
Patient: No numbness or tingling and no muscle weakness either. 

Doctor: Ok, right. Have you been diagnosed with any medical conditions in the past?
Patient: I'm uh, I had diarrhea a few months ago and I was given a fluoroquinolone as an antibiotic. 

Doctor: OK, that's two months ago. OK. And any medications that you're on currently?
Patient: I I take a Vitamin D and some other vitamins too. Vitamin A as well I guess that just helps my my skin and and then the vitamin D for my my bones. 

Doctor: OK, any allergies to medications or any environmental issues?
Patient: No allergies, no. 

Doctor: OK, any hospitalizations or previous surgeries? 

Patient: No. 

Doctor: OK. Any family history of any musculoskeletal conditions, any rheumatological conditions. Anything that you know of?
Patient: My grandparents have arthritis, so and my like my dad had had gout before. 

Doctor: OK, and do your grandparents have rheumatoid arthritis or osteoarthritis, do you know?
Patient: I think osteo yeah osteoarthritis. 

Doctor: OK, and do you currently work?
Patient: I do, yeah, I work as a software engineer. 

Doctor: OK, and what's your living situation like currently? 

Patient: Right now I'm actually just living alone in a in an apartment. 

Doctor: Ok, and do you smoke at all?
Patient: No, never I can't with the with all this like training for yeah at the race and stuff like that. 

Doctor: OK, that's good. Any recreational drugs like marijuana, cocaine, heroin, anything like that before?
Patient: No, I've never used anything like that in the past. 

Doctor: OK, and how about alcohol?
Patient: Uh rarely I'll have maybe a glass of wine like once every couple of months, but it's pretty infrequent. 

Doctor: OK. Alright, so I just have a few questions. Right now over your right ankle, do you have, so you mentioned you don't have any swelling, but do you notice any kind of redness or warmth at all? 

Patient: No, nothing like that. 

Doctor: OK, and if you press down on your ankle, does it hurt a lot?
Patient: Uh a little bit of pain now that right, uh, like outside, but it's not uh, it doesn't hurt that bad. Yeah, I'll say no. 

Doctor: OK, and if you kind of, uh, are you able to move your ankle at all?
Patient: I can, yeah I can move it around a little bit. I'm trying to avoid that though, just because it it does hurt, but I can move it around. 

Doctor: OK. And are you able to stand up and walk or are you not able to do that right now? 

Patient: I can, yeah, just for short periods of time 'cause it's just 'cause of the pain, but I can walk on it. 

Doctor: Ok, yeah, so definitely what we'll do is we might need to get like a proper physical examination done to make sure there is no fracture. Most likely though, it seems that this may just be an ankle sprain uh, due to you inverting your ankle the other day. Uhm, what we can do is usually we just immobilize the ankle and then recommend applying ice. You can take some NSAIDS like Advil for pain to help you. And it should it should get better on its own, with some physiotherapy later on as well. However, if we find that on physical examination you are having significant pain on palpation or any kind of bony pain, we might also require you to get an X Ray of the right foot and ankle, as well as just your lower leg. So yeah, we'll have you come come in in person and then go from there and see if you need an X Ray.
Patient: I'm I am here because I've had this intense pain in my right foot for the past six hours or so or so, and I thought it was important to come get it checked out by you guys. 

Doctor: OK, so you say it started six hours ago has the pain been getting better or getting worse?
Patient: Uhm, it's been it's been the same since it started. 

Doctor: OK, and was there any trauma to the foot or anything happen within the last day, or in the last six hours? 

Patient: No, not no trauma. 

Doctor: OK and, where is the pain located if you had to try to pinpoint it with one finger?
Patient: It's just below my big toe, kind of like on the medial side. 

Doctor: OK. Do you feel the pain radiating anywhere else, or you just feeling it at that one spot? 

Patient: I'm feeling it just in that one spot. 

Doctor: OK. And how would you describe the pain?
Patient: It's intense, it's sharp. 

Doctor: OK, and and has there been anything that you've tried that's made the pain better? 

Patient: Um no I haven't really tried anything. I've I can't seem to move it so every time I move it, it hurts. I'm trying to keep it pretty still and stationary. I took an ibuprofen, that's not, that doesn't seem to help. 

Doctor: OK. And so like any movement makes it it worse, is there anything else that makes it worse, like putting socks on or even having I don't know clothing touch it or your shoes touch it?
Patient: Yeah, I guess yeah, my shoes, my shoes touching it hurts. 

Doctor: OK, and are you able to walk?
Patient: I'm able to walk on it, it's just very painful and I can't you know, I can't bend that toe. I can't flex it or extend it, but my other toes are OK. 

Doctor: Alright, and how would you describe the severity of this pain. One being the least pain and 10 being the worst pain you've ever felt. 

Patient: I say it's like an 8. 

Doctor: OK, and have you ever had a pain like this before and in your toes or or any of your other joints?
Patient: No, never. 

Doctor: OK. And have you had any neurological symptoms such as like numbness or tingling or sensory loss? 

Patient: No. 

Doctor: OK, how about any muscle weakness?
Patient: No, nothing like that. 

Doctor: Alright, and have you had any any headaches? 

Patient: No, no headaches. 

Doctor: Have you had any memory loss or or or confusion?
Patient: No. 

Doctor: OK. Have you had any fevers or chills?
Patient: No. 

Doctor: Have you had any unexpected weight loss? 

Patient: No. 

Doctor: And have you had any any night sweats?
Patient: No. 

Doctor: OK, and how about any sensory changes like changes to your vision, hearing, sense of smell or sense of taste? 

Patient: No changes there. 

Doctor: Alright and have you had a sore throat or runny nose?
Patient: No. 

Doctor: And how about having a cough or shortness of breath?
Patient: No, nothing like that. 

Doctor: OK, and have you had any chest pain? 

Patient: No. 

Doctor: And how about any heart palpitations or feeling like your heart is racing.
Patient: No. 

Doctor: OK. And have you had any lightheadedness or dizziness? 

Patient: No. 

Doctor: OK. And how about any nausea or vomiting?
Patient: No. 

Doctor: Alright, have any abdominal pain? 

Patient: Nope. 

Doctor: Any changes to your bowel habits like diarrhea or constipation?
Patient: No, I don't think so. 

Doctor: OK, and have you had any changes to urinary patterns like pain frequency or incontinence?
Patient: No. 

Doctor: OK. And have you had any skin changes like rashes or any changes to your nails or hair? 

Patient: No. 

Doctor: OK, and how about your energy, have you had a fatigue or malaise recently?
Patient: Uh no, nothing like that. 

Doctor: Alright, and any muscle aches or body pains or or any joint pains anywhere else? 

Patient: No. 

Doctor: OK, um and have you been diagnosed with any medical conditions in the past?
Patient: Um no, I am. Actually sorry I have um high blood pressure as well as diabetes and I am a little overweight. But other than that, nothing else. 

Doctor: OK, do you take medications for any of those things?
Patient: Um I take ramipril for high blood pressure and I'm on insulin for the diabetes. 

Doctor: OK, have you had any medication changes recently?
Patient: Um no, no medication changes. 

Doctor: OK. And have you had any prior hospitalizations or surgeries? 

Patient: I was recently hospitalised for kidney stones. But that since has resolved. 

Doctor: OK.  Have you had any any surgeries?
Patient: No surgeries, just the lithotripsy for the kidney stone. 

Doctor: OK, and are your immunizations up to date? 

Patient: Yep they are. 

Doctor: Excellent, um OK and do you smoke cigarettes?
Patient: No, I don't. 

Doctor: How about marijuana or using other cannabis products? 

Patient: No. 

Doctor: OK and do you use any recreational drugs?
Patient: Uh no. 

Doctor: OK, and how about alcohol, how many drinks per week would you have usually?
Patient: Um alcohol have about. I usually have about 2 glasses of wine a day. 

Doctor: OK, and has that changed recently for you. 

Patient: No, not really. I've just been I've also been start drinking like a beer every day as well recently. 

Doctor: OK. Alright, and alright could you tell me a little bit about your living situation right now who you're living with and and where?
Patient: I live with my son in a house. 

Doctor: OK, uh, and have you been around anybody who's been sick?
Patient: No. 

Doctor: Alright, and have you traveled anywhere recently?
Patient: Um no no travel recently. 

Doctor: OK, and and can you tell me a little bit about your diet an and like do you eat a lot of red meat and or a lot of seafood like like shell shellfish? 

Patient: I eat a lot of red meats. But not a lot of um seafood. 

Doctor: OK. And. OK, and anybody in the family have a history of musculoskeletal or or neurological conditions?
Patient: Um so. Who OK, so my my father had like arthritis and I don't remember what kind of arthritis he had but he had severe arthritis. He also had high blood pressure and diabetes, and on my mother's side. Um there is some arthritis there as well and as well as gout and kidney stones. 

Doctor: OK.  So that that was everything I wanted to ask all the history. And so, uh, next to ask you to have a look at your feet. And are you seeing any swelling, redness, or discolouration?
Patient: I see some redness and uh, some swelling in that area. 

Doctor: OK, and are you feeling any temperature changes? 

Patient: Yes, and the right one is definitely warmer than the left. 

Doctor: OK, then how about any muscle atrophy in the foot or or lower leg or any joint malalignment or deformities?
Patient: Uh, so in terms of deformity is like it just looks swollen and so there's like a big bump on the right side of my foot, whereas it's completely straight on my left, but other than that, no deformities. 

Doctor: OK, and if you were to a palpate or press on areas of your foot or joints of your toes, are you feeling any any pains along the top of your foot or or in any of your other toes?
Patient: None of my other toes. 

Doctor: OK, and how about any pains at the ankle?
Patient: Um no pain at the ankle. 

Doctor: OK, so the metatarsals are not having any pain and then the joints of the 2nd 5th digits are pain free along with the ankle as well. Um and when it comes to range of motion, are you able to flex your toes downwards and extend them upwards towards your nose?
Patient: Yes, I can do that. 

Doctor: OK, and how about your ankle, are you able to um move your ankle on a full range of motion.
Patient: I can. 

Doctor: OK, and are you having a limping with, walking or otherwise called an antalgic gait? 

Patient: Somewhat because I'm trying not to put too much weight on my right big toe. 

Doctor: OK. Alright, and so I think that was everything that I wanted to ask and check today. So did you have any other questions or anything that I maybe forgot to ask about you wanted to mention today?