jshargo/medical-interview-conversations2 huggingface dataset:
user: No, been at home. 

assistant: OK, has anyone around you been sick at all? 

user: No. 

assistant: OK, have you been having any symptoms like nausea or vomiting or any fevers or chills?
user: No nausea or vomiting, but I do feel a little bit hot today. 

assistant: OK, but have you measured your temperature at all?
user: Uh I did and it was 38 degrees. 

assistant: OK, and have you been having any kind of swelling in your legs or feet? 

user: Uh, no swelling in my legs. 

assistant: OK. Have you been feeling tired at all, like increasingly fatigued?
user: No, my energy has been good.  D; Have you been having any kind of thumping or palpitations or feel like your heart has been racing at all?  It uhh it does feel like it's beating faster right now. It usually only feels like this when I'm playing sports. 

assistant: OK. And have you noticed any changes in your skin at all? Any rashes?
user: No rashes. 

assistant: OK, have you had any cough or runny nose or sore throat? Any kind of those symptoms and in the past month?
user: Uh few weeks ago I was a little runny, but that went away on its own. I haven't had any cough. 

assistant: OK, and have you been feeling dizzy at all or have you fainted? 

user: No dizziness and uh no I haven't fainted at all. 

assistant: OK. Just a few more questions. Have you had any diagnosis made by any physician or any anything like diabetes or high blood pressure?
user: Yeah, I've been told I have high cholesterol and high blood pressure. 

assistant: OK, and do you take any medications for the these things? 

user: Um, I do take medications for both blood pressure and cholesterol, Rosuvastatin and um Lisinopril and I take a multi vitamin. 

assistant: OK, and do you have any allergies to any medications at all?
user: No allergies. 

assistant: OK, have you at all in the past been hospitalized for any reason?
user: No hospitalizations. 

assistant: Any previous surgeries?
user: No. 

assistant: OK, and within your family, has anyone passed away from a heart attack or any cancers that run in the family? 

user: No. 

assistant: OK, and currently right now, do you live alone? Do you live with someone? And where do you live, like an apartment or house?
user: I I live in a house with um, my parents. 

assistant: OK, and do you currently work? 

user: Yeah, I I drive a bus for the city. 

assistant: OK. And in your daily routine, would you say you get enough exercise throughout the week?
user: Uhh yeah, usually on Sundays I'll go for a run. 

assistant: OK, and how about your diet? Well, how's your diet like, just regularly?
user: Uhh, usually I feel like it's fairly balanced overall, I might I eat out a little bit too often, but try to eat as many vegetables as I can. 

assistant: OK. And do you smoke cigarettes at all? 

user: I do yes. Been smoking for the last 20 years roughly. 

assistant: OK, how much do you smoke on an average day?
user: About a half a pack to a pack a day. 

assistant: OK. And do you drink?
user: No alcohol. 

assistant: OK, and any recreational drugs like marijuana? 

user: Um, no marijuana, but I have used crystal meth in the past. 

assistant: OK, and when was the last time that you used crystal meth?
user: Um, six days ago. 

assistant: Six days ago, OK, and how often do you use crystal meth? 

user: Um, I would say a couple of times a month. 

assistant: A couple of times a month, OK. Alright, and for how long have you been using crystal meth?
user: Essentially, when he, so today is Friday, when he got home from school on Wednesday, he seemed fine, but he, I don't know that night he started to have a bit of like a cough. It just seemed like a little dry cough, but obviously I just wanted to keep him home, keep him safe and not like spread anything if he was sick, so he stayed at home on Thursday and he was like having a bit of a cough. Um and then, yesterday it seemed to get a little bit worse and he was really tired, or sorry it's today, today is Friday, um, he was like his cough is like getting a bit worse and I've been taking his temp the whole time and it got like a little high today. What was it? My thermometer says it was high. I'm just like trying to remember. It was it was, it was like over 100 though. 

assistant: Oh OK. 

user: 101 or something or maybe 100.1. But anyways, it was, so I I just thought I should probably bring him in 'cause I was really worried about him and you know thought he could have maybe got COVID and get school or something. 

assistant: Yeah for sure. Um, OK, so just to clarify, he's had this cough and fever for the past five 5 days.
user: Mhmm. 

assistant: OK. OK, so let's focus on the cough.
user: Sorry, it's been more like 3 three days like Wednesday is when he came home and then, and then today's Friday, so yeah, sorry. 

assistant: Today is Friday, OK. Um, OK, yeah sure. So, is this cough a productive cough, or is it kind of a dry cough? 

user: Ah I think it's dry. I haven't noticed him like spitting up anything. Umm, yeah, he yeah, it's just been like little coughs. 

assistant: OK, and he, is he, he's not bringing up any sputum or blood?
user: No. 

assistant: No OK good. OK, and does he sound wheezy at all to you? 

user: No, no, not that I've noticed. 

assistant: OK, how about short of breath?
user: Um, I don't think so like he, usually he's a really active kid and he has, he hasn't been running a lot outside in the past couple days, so maybe he maybe he could have been having a harder time breathing but also I think he's just been tired in general. 

assistant: OK, yeah. OK, and is his coughing getting worse with certain times of the day? Like is it worse at night in the morning?
user: I think it kinda just there the whole day. 

assistant: OK um. And does it, how does it sound? Does this sound like a barky cough? Does it sound? Um, like harsh, what is, what would you say the quality of it, of the sound of the cough is? 

user: Uh, I just sounds kind of dry. It's not like super loud. 

assistant: OK. OK, and has he ever experienced anything like this in the past?
user: I don't like he's had colds before, but I haven't like, I haven't like you, this time he kind of had the fever, which is different than you know, having a regular cold. 

assistant: OK. And are his symptoms getting worse? 

user: I think so. Because yeah, he first day he just seemed like little dry and then yesterday is coughing and today he actually has a fever. 

assistant: OK, and um, is he complaining of anything like chest pain? Or feeling like his heart's racing?
user: No, I don't think so. 

assistant: No OK. Does he have a sore throat? 

user: I don't think so. 

assistant: OK, and is he having any issues swallowing food or fluids?
user: I don't know if he's having trouble swallowing, but he doesn't seem to have a big appetite right now. 

assistant: OK, um, and is he, does he have a blocked nose or runny nose?
user: Maybe a bit of like a runny nose. 

assistant: OK, and does he have any issues with smell or taste? 

user: Ah, this morning he really seemed like he wasn't like into his breakfast and I wonder if he's losing his sense of taste a little bit. 

assistant: OK, how about vision or hearing?
user: I think those are fine. 

assistant: OK, and is he complaining of any chills or night sweats? 

user: No. 

assistant: OK, any changes in his hair, nails or skin like rashes?
user: No, I haven't noticed anything like that. 

assistant: OK, any changes in his bowel movements? 

user: Uh, no. 

assistant: Pardon?
user: I'm sorry, no changes. 

assistant: OK, no diarrhea, no constipation, no blood in the stool.
user: No. 

assistant: OK, any nausea or vomiting? 

user: No. 

assistant: OK, any changes in his urine?
user: Really been looking, but I don't think so. 

assistant: Any dizziness or fainting spells?
user: No, just like fatigue. 

assistant: OK, any confusion or memory loss? 

user: No. 

assistant: And is he an, is he an otherwise healthy child?
user: Yeah, absolutely, he hasn't like decide to like vaccines, he hasn't had to go to the doctor like ever. I mean, he broke his arm once but that was it. 

assistant: OK, so no past illnesses and I guess no hospitalizations or surgeries except for the broken arm? 

user: Exactly, like nothing. 

assistant: OK and were things normal with your pregnancy with him?
user: Yeah totally 

assistant: OK. Ah, and then how about as a newborn, any complications after birth?
user: No, no, like everything was things really good. 

assistant: OK and then did he hit all his milestones? Up till now?
user: Yeah totally 

assistant: OK. And does he have any allergies?
user: Uhm, no, no, I don't think so. I mean like he hasn't really taken a lot of medicine, so it's hard to say, but like nothing, so far. 

assistant: Is he up to date with all his immunizations? 

user: Yep. 

assistant: Yeah, OK. And in terms of family history, are there any lung conditions or heart conditions?
user: Uh, no, everyone is really healthy. 

assistant: OK, and um, are there, and who does he live with and where does he live? 

user: He lives with me and my husband, and he has a little sister like just in town here. 

assistant: OK, and is she healthy?
user: Yeah I like she, yeah she's healthy. 

assistant: OK an any concerns for old carpets, mold, asbestos or any environmental issues like that in the home that you're in?
user: No. 

assistant: No OK, um has he been around any sick contacts recently? 

user: Not not like outside of school. I like we know for sure, not outside of school but he goes to school right now so kind of hard to say. They haven't like contacted us about anything. 

assistant: OK, sure. And has he traveled anywhere recently?
user: No. 

assistant: No, OK. OK, well those are all the questions I had for you today. Were, was there anything that I missed that you wanted to chat about today? 

user: I don't think so. Like I realized that I can often times like we don't really do much for kids when you know, when it's just like a virus or something. But we do, I guess, need to have a COVID test to go back to school, even if you know either way 'cause they want us to be able to say it's like the other kids have had uh an exposure. 

assistant: Mhmm.
user: So yeah yeah, like. Sorry, go ahead. 

assistant: No go ahead.
user: So I just wanted to basically see if it was that and I mean he does receive you're so scared. That's kind of what made me come in, like it's scaring me a little bit. 

assistant: Right, yeah, OK, so first thing is, first we need to do a COVID swab just to make sure that he either has it or it doesn't have it and those results will come back in 24 to 48 hours. Umm we do suggest because his symptoms overlap with symptoms of COVID that he isolate for 14 days and that includes from his his younger sister if possible. And then if the swap comes back negative, there is a chance for false negatives. But also it could be another viral illness that's going around nowadays. If his symptoms get worse, so if he has a really high temperature, if he has any neurological symptoms like seizures or if he's feeling weak, dizzy, if he has any fainting spells, please do take him to the ER and uhm, so for now I'll just wait for those COVID swabs to come back. How does that sound? 

user: Yeah, sounds good. 

assistant: OK great.
user: Thank you. 

assistant: Yeah, no worries. Uhm and I should have mentioned if it was just the cough or if he was just short of breath or something like that and he didn't have the fever, we would add everything's like asthma to the list of things
user: So I've just been having this cough that I feel has just been getting worse, and I've also been feeling a bit short of breath for the last few months. 

assistant: OK, could you tell me when the cough started?
user: So I would say it started around two months ago. 

assistant: OK, and has the cough been dry or have you been bringing up sputum?
user: Uh, it's usually always, uh, produces like the sputum, and it's usually white or yellowish in colour. 

assistant: OK, and how much sputum are you producing each day? Some, sometimes it's useful to think about like teaspoons or tablespoons. 

user: I would say every time I cough like a teaspoon I probably have like. I don't know. Maybe 5 to 10 teaspoons a day. 

assistant: Uh OK, and is there any particular time of day that the cough is worse?
user: Um, not really. It's pretty, pretty much the same. Sometimes it is worse in the morning. Yeah, and sometimes it gets better when I go out for a smoke. 

assistant: OK um. And have you noticed any blood?
user: No, um I haven't noticed any blood. 

assistant: OK, and have you had, so you had shortness of breath, when did that start? 

user: It's around two months ago, around the same time. 

assistant: OK, And. Is this? Do you have shortness of breath at rest or is it when you exert yourself?
user: Uh, it's it can happen like at anytime, but worse when I am exerting myself. 

assistant: OK and then have you had a cough before? 

user: Uh. Not as frequently. I would say not really, it just started in the last two to three months. 

assistant: OK, and have you had shortness of breath like this before?
user: Just throughout my life I've had asthma so when I am exercising too much or get exposed to like dust, sometimes get shortness of breath. 

assistant: OK. Has there been anything, um besides exerting yourself, that's made that either the cough or or shortness of breath worse? 

user: Uh, over the last year like I've had a couple of chest infections. After going to the ER, they gave me some antibiotics. But yeah, when that happens it usually gets worse. The shortness of breath and the cough. 

assistant: OK, and uh, do your symptoms feel like any of those times right now?
user: No, I I don't feel like I have a fever and no other symptoms, just the shortness of breath and cough. 

assistant: OK, and have you been doing anything that's made it better? 

user: I've been taking some Tylenol Cold, hasn't really helped too much. I've tried my inhalers, they sometimes help, but I've never had have this frequent of coughing and shortness of breath before. 

assistant: OK, um, and how has your energy been? Have you been experiencing fatigue?
user: Um, when it gets really bad then I can't really step out of the house, but other than that I feel like my energy's still there. 

assistant: OK and you have it, have you had any fevers or chills?
user: No. 

assistant: OK, how about at a loss of smell? 

user: No. 

assistant: Um a loss of taste?
user: Nope. 

assistant: OK, and have you had any chest pain?
user: No, just sometimes when I'm like coughing a lot it gets a little bit uncomfortable. But other than that, no. 

assistant: OK, um have you had any instances where you felt like your heart was racing?
user: No. 

assistant: OK, how about being lightheaded or or like you were going to pass out?
user: Nope. 

assistant: OK, and how about headaches? 

user: No headaches. 

assistant: Alright, and have you had any wheezing?
user: Um, sometimes I've noticed it, but I had it before. Like with asthma as well, but not not that much. 

assistant: OK, and how about abdominal pain?
user: No abdominal pain. 

assistant: Alright, then any urinary problems? 

user: Nope. 

assistant: Any bowel problems?
user: No. 

assistant: Any rashes?
user: Nope. 

assistant: OK, and then how about any muscle aches or or joint aches or or body aches? 

user: No, nothing like that. 

assistant: Alright. And you mentioned asthma, but have you been diagnosed with any other medical conditions?
user: No, just asthma. 

assistant: OK, and do you use inhalers? Are there any other medications you're currently using? 

user: Oh no, just the salbutamol and like the steroid inhaler. 

assistant: OK, yeah, and how often are you using both of those?
user: So the steroid one I am using pretty much every day but the salbutamol I found I've been using a lot more recently. I would say probably at least six to 10 times in a week. 

assistant: OK, um that reminded me I I forgot to ask. Have you notice any changes to your voice?
user: Um no, not really. 

assistant: OK um. And I was wondering if you had any allergies to medications? 

user: No, not that I know of. 

assistant: Alright, and have you been in the hospital recently?
user: No. 

assistant: Alright, so when was the last time that you had antibiotics?
user: I would say like six months ago. 

assistant: OK and any surgeries? 

user: Nope. 

assistant: OK, and did you get the flu shot this year?
user: Yep. 

assistant: OK, great um and I was wondering if you could tell me a little bit about your living situation. 

user: So I live in London um in a small apartment with my wife. 

assistant: OK, do you have any pets around?
user: No, no pets. 

assistant: Alright, and um, any exposures at work too, like dust or any types of like chemicals like that.
user: No, not really. My work is pretty much a desk job, so nothing like that. 

assistant: OK, and do you smoke cigarettes?
user: Yeah yeah, I smoke a lot of cigarettes just like I would say 30 cigarettes a day. 

assistant: OK, and how long have you smoked for? 

user: I'd say, probably at least 25 years. 

assistant: OK and sorry, could you remind me of your your age again?
user: So I am 60 years old now. 

assistant: OK, so you started smoking um around 35. 

user: Yeah yeah. 

assistant: OK. Have you tried to quit?
user: Yeah, tried to quit. I've even quite a couple times but then just got back onto it. Yeah, not not really ready to quit. 

assistant: OK. That's fair enough. If there's something that you wanted to talk about quitting smoking at another appointment, we can arrange follow up for that. 

user: Alright 

assistant: Do you drink alcohol?
user: Not much, just out say one or two beers on the weekend. 

assistant: Alright, and you use any recreational drugs like cocaine, crystal meth, or IV drugs. 

user: No, nothing like that. 

assistant: Alright, and has anything similar like this happened in your family before?
user: Uh, I think my um sister has a COPD, like she smokes a lot too. But that's that's about, I don't know if that's genetic. 

assistant: Oh OK, um I. So I mean anybody in the family have cancers?
user: Um no, not that I know of. 

assistant: Alright um so, that that was all the questions that I wanted to ask on history. Was there any, uh, any other questions that you had? 

user: No, not really. Just wanted to get to the bottom of this. 

assistant: OK for sure so um we will run some investigations and likely get a chest X Ray because it's been a couple of months that these symptoms have been going on for. But I think it could be related to your smoking and most likely um Bronc, chronic bronchitis, but we can definitely will be looking into this, and then also with possibly some pulmonary function tests as well.
user: Um yeah, so I brought my 7 year old daughter here um because she's been coughing uh a lot over the past two weeks. Um she's she sounds wheezy and I'm not too sure what's going on with her so, she's been off school um 'cause they think it's Covid. Uh we got her swab, but because she still has symptoms she can't go back to school, so here she is. 

assistant: OK, um and when did the cough start?
user: It started two weeks ago. 

assistant: OK, and when did the wheezing start?
user: Um that started about the same time like I should I should mention she does have like episodes like this. Um she's had episodes like this for the past like 2 years uh but they usually go away in a couple of days. But this time it's it's taking a lot like a lot longer to go away. 

assistant: OK, so it's been uh has been more than a week, you said?
user: Yeah, it's been close to two weeks now. 

assistant: Two weeks, OK. And uh were these symptoms brought on by, are they usually brought on by any kind of like activities or can they come up just by themselves?
user: I find it's usually worse in the winter um and if she's like doing some sort of uh like extensive physical activity, so if she's like playing tag and she's running around a lot. Um or if she's like at her gym class and they're running. 

assistant: OK, and the cough that she's having is it like a wet cough or is it a is it a dry cough?
user: It's a dry cough. 

assistant: OK, and at all, is she bringing up any yellowish or white uh or green material or any blood at all?
user: Uhm, it's, no nothing like that. 

assistant: OK, and are her symptoms uh constant or do they come and go? 

user: Her symptoms I guess come and go, um yeah, they come and go. 

assistant: OK, and how many days of school has she had to miss?
user: She's missed almost two weeks now. 

assistant: Wow, OK um and when she's at home, is she is she like very tired, is she um? 

user: Yeah, yeah, she's pretty tired out um, yeah, she's pretty tired out, she's been doing a lot of like resting and uh you know watching TV. She's not really very active right now. 

assistant: OK, uhm and have her symptom symptoms been getting worse over the last two weeks, or are they getting better at all?
user: Uh I can't, you know, I can't tell, it comes and goes so in that sense, it's been pretty constant. Um there hasn't been a day when she hasn't had these symptoms. 

assistant: OK, and do they get worse at night at all or are they um the same throughout the day?
user: Uh yeah, now that I think about it, when she's laying down she does have a hard time. 

assistant: OK. And is she having any other symptoms at all, like uh shortness of breath, um or sore throat?Anything like that?
user: Uh, no sore throat. She sounds wheezy, so she might have like some difficulty breathing, but she doesn't sound short of breath. 

assistant: OK, and any kind of uh runny nose or any other symptoms at all? 

user: No. 

assistant: No, OK. Uh anything that helps her or makes her symptoms better?
user: Um no, nothing that we've tried. 

assistant: Any recent uh travel at all? 

user: No. 

assistant: No, any fainting or dizziness spells?
user: No. 

assistant: OK. Um, any uh fevers or chills? 

user: No. 

assistant: Any um changes in her bowel movements like any constipation, diarrhea?
user: No. 

assistant: Any urinary problems? 

user: No. 

assistant: And any uh any kind of, do these symptoms wake her up at night at all?
user: Um no, no it doesn't wake her up at night. It just makes it hard for her to fall asleep. 

assistant: I see. Is she getting enough sleep? Like how, how, how many hours would you say on average she's getting per day? 

user: I'd say she's getting about 6 to 7 hours. She used to sleep about 8 hours before. 

assistant: OK, um and is she having any changes in her appetite at all?
user: Um I don't think so, no. 

assistant: No? 

user: No. 

assistant: Um any kind of changes in her weight at all over the past few months?
user: I haven't checked over the past month, but before that no, no changes. 

assistant: No changes, OK. And um has she been, she had like a cold or anything like that recently? 

user: No, not that I can think of. 

assistant: OK, has she been around anyone that's been sick recently?
user: No. 

assistant: OK. Um does she have any past history of any medical conditions at all? 

user: Uh no, no, nothing like that. 

assistant: OK and um does she have any uh allergies to any medications or any environmental allergies?
user: I think she might have some environmental allergies. We haven't gotten her officially tested though. 

assistant: OK. And um has she had any previous hospitalizations or surgeries?
user: When she was a baby, when she was first born, she was hospitalized um for something about having like uh not fully developed lungs. 

assistant: OK and uhm, was she premature at all? Or was she born after uh, at term?
user: She was slightly premature, I believe she's 34 weeks. 

assistant: 34 weeks, OK. And um was it a vaginal delivery or was it a C-section? 

user: Uh it was vaginal. 

assistant: Vaginal, OK. Were there any uh complications during the pregnancy or after she was born? C
user: Um no complications after besides the hospitalization for the small lungs. 

assistant: OK. And is there any family history of any lung conditions, heart conditions, or cancers? 

user: Uh nope, nothing like that. 

assistant: Has anyone in the family have, had any kind of asthma, eczema, anything like that?
user: Um no. 

assistant: No, OK. Um so, and in terms of like at school, are there any kind of complaints uh and any um issues with her development over the last last few years?
user: No, nothing like that. 

assistant: OK, so she's been growing well?
user: Yeah, she's been growing well. She's been gaining weight like a normal amount um and she's doing well, she was doing well at school. 

assistant: OK. And um at home, uh what is the environment like? 

user: Um she lives at home with both of us like um her mom and her dad, and uh she has a younger sibling who is 4 years old. 

assistant: OK. And um does anyone smoke in the house at all?
user: Um no, not anymore. 

assistant: OK, um how long ago uh did someone smoke?
user: Um it was, um so her dad used to smoke um and he stopped when she was like 3. 

assistant: OK, that's good. Um any kind of uh dust or mold or animals, uh anything in the household?
user: No, we don't have any pets and um the place is just renovated so nothing like that. 

assistant: OK. Alright, so yeah, those were just some of the questions that I had for her today. Do you have any questions or concerns? 

user: Um yeah, so what can we do for her right now to make these symptoms go away? 

assistant: Yeah, so what we should do for her right now is, she's seven years old, um what I'm thinking right now with her symptoms especially coming on after uh exertion, being worse in the winter, she may have asthma.
user: OK. 

assistant: And although she doesn't have any family history of it, it can happen without family history as well. Um so we would like to uh try and do uh what's called a pulmonary function test. That will help us kind of understand uh if she has um asthma or not and then we can try her on um, it's called a short acting beta agonist, so it's a puffer.
user: OK. 

assistant: And uh usually when she gets these types of symptoms, she can use the puffer to help her. Uh and if it um helps her then it's most likely that she does have asthma and she will need um that puffer and then she might also need another puffer, which is an inhaled corticosteroid, um for the future to decrease um the likelihood that this asthma gets worse in the future. 

user: OK, OK yeah thank you. 

assistant: Yeah, no worries. So yeah, so yeah we'll get those tests done and then go from there.
user: It my name is Scott. It's nice to meet you too. 

assistant: Alright, um so Scott. How old are you?
user: 15. 

assistant: OK, What brings you in today? 

user: Um, I've had a sore throat now for a couple of weeks and it's just not going away. 

assistant: Couple of weeks. OK, so about two weeks, three weeks?
user: Yeah, about two to three weeks. 

assistant: OK, um what does it feel like is it, is it kind of like a burning feeling? Is it more like an itchy feeling? What does it feel like?
user: Uh I would say it's kinda yeah like burnin' or burning or scratchy. 

assistant: OK, and does it hurt when you swallow? 

user: It does, yeah, uh, If my throat hurts when I'm eating or Um uh or swallowing like liquid's as well, but cold stuff seems to make it feel a little bit better. 

assistant: OK, good, and does your neck hurt too?
user: Um. A little tender, I've noticed the um some lumps at the front of front of my neck that have been a bit sore. 

assistant: OK, and is it mostly sore, kind of like midline? Or is it more sorta one side versus the other?
user: Um I'd say, maybe the, uh, the right side is a little bit more sore, but I think I can feel it on both sides of my neck. 

assistant: OK, and how bad would you say your discomfort is 1 to 10, 10 being the worst.
user: Um. I would say maybe a two or three if I move my neck I I can feel it more, but otherwise I can just barely notice that it's there. 

assistant: OK, so it's not preventing you from sleeping, going to school, playing, things like that? 

user: No, it's more so the sore throat when swallowing. 

assistant: OK. OK. Um, have you noticed a fever at all?
user: Um, I have. Yeah I felt hot and Um I checked my temperature this morning and it was 38.7 I think it was. Is that a fever? 

assistant: Yeah, I'd say that's a fever. We can also do another temperature check today.
user: OK 

assistant: Um yeah, but that definitely sounds like a fever. Um, have you noticed rashes anywhere? 

user: Um Yeah, I've had this, uh this, like red I guess pink rash that I have noticed it's come over my chest and and belly area. 

assistant: OK, how big is it? Is it more than a centimeter?
user: Uh huh. Yeah, it's pretty well, I mean, it's kind of, um spread out over over an area like it's not all continuous I guess. You can kind of see patches or blotches. 

assistant: OK and, is it raised?
user: No, it's it's not raised. 

assistant: OK. OK, is it itchy? 

user: Uh, no, it's not itchy. 

assistant: Painful?
user: No, not painful. 

assistant: OK and is it bleeding or oozing anything like pus? 

user: Um no it's not, nothing like that, it's just pink and red and it's just kind of shown up over the last little while. I've noticed it on my um like hands a little bit too. 

assistant: OK, and you said this started when like was this before the sore throat or after?
user: Oh I can't like remember the onset. I I think that the sore throat started first and maybe a rash came a little bit later. 

assistant: OK, OK and have you noticed that your that your glands are swollen? 

user: I think so, um maybe that's what's swollen in my neck. 

assistant: OK, OK. Um how about coughing?
user: No, I haven't had a cough no. 

assistant: And how about a stuffy nose or or a runny nose?
user: Nothing like that. 

assistant: OK, body aches? 

user: Yeah, I felt so some muscle aches for sure. 

assistant: OK, upper limbs or lower limbs?
user: I say I got a whole body, I just feel like my muscles and joints are sore. 

assistant: OK, yeah, and or do you have any headaches? 

user: Uh. No, I haven't really had any headaches. 

assistant: No OK. And how's your appetite? Are you still eating well?
user: Um. It might be a little ah might have been a little bit down. I just kind of haven't been feeling so great, so I'm I've probably eating less the last few weeks, yeah. 

assistant: Have you been around anyone who may have been sick recently? 

user: Yeah, actually I think a few of my friends or there was somebody in my gym class knew that I sounded like they had similar symptoms. 

assistant: OK, OK, and when was this?
user: Um, Uh, now that I think about it, probably about three or four weeks ago. 

assistant: OK, and were they ever treated for that? Did they see a doctor? 

user: Um I'm not sure. 

assistant: No, OK. No worries.
user: I just remember them being off for school 'cause they were they were sick. 

assistant: OK yeah, any issues with your eyes?
user: No. 

assistant: No, nothing like crusting or pus coming out of your eyes? Red eye, anything like that? 

user: Um. No, that well, did they might have looked maybe a little bit more more red, red then usual but I haven't noticed any anything in terms of itchiness or um discharge. 

assistant: OK. Any nausea or vomiting?
user: Um, no nausea or vomiting. 

assistant: OK, how how about your stools? Have they been normal? Have you had diarrhea, constipation, anything like that? 

user: No changes to bowel habits. 

assistant: OK how about urine?
user: Um, that's been OK. 

assistant: OK, OK. Um, have you ever had these symptoms before?
user: Um, I mean I've had sore throats in the past, but not while feeling like this though. 

assistant: Yeah. OK, when was the last time you had a sore throat? 

user: Um, I don't know maybe when I was a kid. 

assistant: OK.
user: It's been awhile. 

assistant: Yeah, like a strep throat kind of thing, or or more viral?
user: Yeah, I do remember getting antibiotics when I was younger. 

assistant: OK, OK, and are you otherwise healthy? Do you have any medical conditions? 

user: I was diagnosed with uh with asthma. 

assistant: OK, and are you on any medications for that?
user: Um yeah, so I, I just use ah Ventolin as needed, but otherwise oh and then I take Flovent daily so um. 

assistant: OK.
user: I think that's the one, there's there's a couple inhalers that that I take. 

assistant: OK, OK, and any other medications? 

user: Uh, sometimes I'll take um like Reactine or some other type of allergy pill, but that's it. 

assistant: OK, What are you allergic too?
user: Um mostly seasonal allergies, bug me like um yeah, like seasonal allergies and dust, maybe. 

assistant: OK. And are you up to date with all your immunizations?
user: Yeah, my mom makes me get the flu shot every year. 

assistant: OK, good. And it's, OK, have you seen another doctor for the symptoms at all? Have you been worked up for that? Any blood work testing done for it already?
user: No, I thought I would have felt better by now and so I haven't seen anybody but it's kind of just been going on now, not seeming to get better. So wanna come see somebody. 

assistant: Yeah for sure. Have you tried anything for your symptoms? Any medications, anything over the counter? 

user: Um yeah, I've tried some Tylenol and it's, I I think what is it Advil? And that definitely is helped with some of the kind of aches and pains, but they've come right back. 

assistant: OK, um any family history of Lung issues, heart issues?
user: Um, No. nothing like that, um no. 

assistant: Yeah, OK. How about cancers?
user: I, I think my Grandfather had a like pancreatic cancer. 

assistant: OK, OK. Um, alright, so do you live at home correct? 

user: Yeah, I live with my parents and my younger sister. She's 12. 

assistant: She's 12, Is she healthy?
user: Yeah she is. 

assistant: OK, good and have you guys traveled recently?
user: Um no we've been, we've been at home. 

assistant: OK, OK, Um, and do you smoke?
user: No, I don't smoke. 

assistant: No, How about marijuana? 

user: I I've tried it once or twice but it was just those couple times, nothing that I do or used regularly. 

assistant: OK, And how about alcohol?
user: No, no alcohol. 

assistant: No alcohol. OK, are you sexually active?
user: No, I'm not. 

assistant: No, OK um. Is there a possibility that? Or actually sorry I should rephrase that. Have you kissed anyone recently?
user: Um I. Well, I I guess I kinda have a girlfriend now. Um that we, that I started hanging out with about two months ago. 

assistant: OK, OK.
user: And so I guess yes. 

assistant: OK, alright, well that's good. Um have, has she had any of these symptoms?
user: Uh, well she she was, wasn't feeling well for awhile back, but, I don't think it was this bad for her. 

assistant: OK. Actually, and she's better now?
user: Yeah, she's better now. 

assistant: OK. Alright, so you mentioned you're not sexually active. If you were to be, make sure you use protection. Um and OK. So everything at home is OK then? No ones, no ones sick at home you mentioned, right? 

user: Yeah, no ones, no ones sick at home. 

assistant: OK. And school is going OK?
user: Um yeah, schools been been going OK for the most part it's been tough these last few weeks feeling like this though. 

assistant: Yeah for sure. And are you and your girlfriend in an exclusive relationship? 

user: Uh. I I think so yeah. 

assistant: OK, I ask because there's something called what you may be familiar with um it's called the kissing disease. In medical terminology, it's called mono, as caused by a virus called EBV, and so it could be that so we're covering all our bases.
user: Oh, I've heard of mono before. 

assistant: Yeah, 

user: OK. 

assistant: It's it's likely it could be up there in terms of what you have, so I think those were all the questions I had for you. Did you have any questions for me? Anything you wanted to add?
user: Um, no, I think that's you covered everything. 

assistant: OK alright so I will will go off a few, we'll try to cover our basis and get you tested for mono which I would have to do like a monospot test and we can do rapid strep test as well to see if he has something called strep throat. But yeah, we'll see what those results come back as. And we'll go from there. Does that sound good?
user: Hi, this morning I read after I woke up by I coughed up some phlegm and there was some blood in it and it it totally scared me. 

assistant: OK, and was this the first time that happened?
user: Uhm, yeah, I've never I never noticed blood in my sputum before. 

assistant: OK, but have you been coughing recently? 

user: Uh yeah, I have, uh, had a cough recently leading up to this. 

assistant: OK, and how long have you had the cough for?
user: Uhm, I've had it for uhm, yeah, about about four weeks. 

assistant: Wow, four weeks. OK. Do you know if you did anything prior to that, any new exposures or being around someone ill like anything like that that might have caused your cough?
user: Yeah, I was just down in a, I went to Haiti on a on a trip for a, for a volunteer program with my school and I don't know I definitely notice there is a lot of people down there coughing. 

assistant: OK, and were you at all living like close quarters or were you crammed into like like smaller spaces at all when you were there? 

user: Yeah, we were kind of like living with the locals while we while we were there. It was part of the experience for volunteering. I was there for almost two months as part of, part of my my summer break through University. 

assistant: OK, and did you notice, uh, at all any potential exposures to tuberculosis? Anyone there that had tuberculosis? Or found out later?
user: Yeah, there were definitely some people around that I heard of who who mentioned tuberculosis, but I don't know if anybody specifically who had it. 

assistant: OK. And the cough that you've been having for the last four weeks at, is it like a wet cough? Are you producing any sputum or phlegm, or is it more of a dry cough?
user: Uh, I have been producing some phlegm, um, but it's been just kind of white, yellowish. 

assistant: Up until this morning?
user: Yeah or moreso clear actually, up until today where I saw some blood. 

assistant: OK. And how much blood was in the phlegm? Was it like a significant amount it filled the whole production or just little streaks? 

user: Um it was pretty red. It, ah, yeah it was bright red and it was covering the, the issue. 

assistant: OK and have you had any similar episodes before?
user: I've never brought up blood before. 

assistant: And after this morning, was that the only time you had that or did you did it recur at all? 

user: Um, it was just that time just this morning on the tissue and then a little bit in the toilet and it looked like a lot in the in the water. 

assistant: OK, I see and how often are you coughing in like an average day? Are you coughing throughout the day or does it come and go?
user: Uhm, it's been pretty severe through throughout the day. I've been just coughing or coughing a ton. 

assistant: OK, anything that makes your coughing go away or makes it worse at all? 

user: Not-nothing seems to help. I've tried various over the counter medications and and stuff for, for cough and nothing has seemed to help it. 

assistant: OK, and are you having any other symptoms at all, like shortness of breath, sore throat, runny nose, anything like that?
user: Uhm, nothing like like that. I mean the back of my throat, might feel a little itchy from the coughing, but not really sure. 

assistant: OK. Are you having any headaches or nausea or vomiting? 

user: Nothing like, well, a little bit of nausea maybe, but no vomiting. 

assistant: OK. How often you getting nausea?
user: Uh, it's coming after like if I'm having a really big cough, coughing fit I could feel a little nauseous after but it doesn't last very long. 

assistant: OK, are you having any fevers or chills? 

user: Yeah, I've been having ah, so fevers throughout the day, but feeling really hot, and and really sweaty at night. 

assistant: OK, how often are you getting night sweats?
user: Uhm, also a few times this past week, I've what woke up soaked. 

assistant: OK. And have you at all measured when you felt, measured your temperature when you felt like these chills and night sweats?
user: No, I haven't measured my temperature yet. 

assistant: OK. Have you noticed at all, uh, any increased fatigue throughout the day?
user: Yeah, but I've definitely been more more tired. I haven't been able to concentrate on, umm, on my schoolwork. 

assistant: OK. And, um, have you been having any shortness of breath?
user: Just after the, like coughing really, but otherwise, ah, no. 

assistant: Any chest pain?
user: No chest pain. 

assistant: Any feeling that your heart is racing?
user: No, nothing like that. 

assistant: OK, any swelling in your limbs at all? 

user: No. 

assistant: Ok. Any loss of sense of taste or smell?
user: Uh, no, nothing like that. 

assistant: OK, any changes in your bowel movements? 

user: Um, no. 

assistant: OK, any changes in your urination?
user: No. 

assistant: OK, any changes at all in your sleep? 

user: Uhm, just been, well, I haven't been sleeping as well, waking up all sweaty and the cough is kept me up a little bit too. 

assistant: OK, any changes in your appetite?
user: Uh, no, I've been eating OK. 

assistant: Have you noticed at all any weight loss over the last few months?
user: Yeah, I think I'm down like 15 pounds since the summer time, which is great. 

assistant: OK, have you tried to lose weight at all or is it just been completely unintentional? 

user: Uh, well I, I mean my, my appendix was taken out a few months ago and so I guess after that I, well, maybe wasn't eating and eating as much, but I mean I wasn't really trying to lose weight. 

assistant: OK, and have you had any recent exposure to any fumes or dust or animals?
user: Uh, no, my my parents have a dog at home, but I've been away at school, so. 

assistant: OK. OK, uh, in terms of your overall health, have you been diagnosed with any medical conditions before? 

user: Uh, no, I'm uh, healthy. 

assistant: So like no asthma or anything like that?
user: No, nothing like that. 

assistant: OK, are you on any medications currently?
user: Uh. Yeah, I take an oral contraceptive pill. 

assistant: OK um, and when did you start that? 

user: Probably about five years ago. 

assistant: OK. Do you have any allergies, to any medications or any environmental allergies at all?
user: Uh, yeah, I think Septra, gives me a rash. 

assistant: OK. Um, any previous hospitalizations?
user: No, I've never been in the hospital before. 

assistant: OK, any previous surgery? So you said you had the appendix removed but anything else? 

user: Uh, no the appendix was the only thing. 

assistant: OK. Any family history of asthma or any lung conditions? Any cancers that run in the family?
user: Um, yeah but well, my grandfather had lung cancer, but he smoked for his entire life. And my mom has had diabetes for quite some time, but no, no lung problems. 

assistant: OK, any heart attacks in the family or any autoimmune conditions? 

user: No. 

assistant: OK, and currently what is your living situation like?
user: So I live with uh, four roommates here going to school. 

assistant: OK, and so do you work right now or you just a student right now?
user: Just a student. 

assistant: OK. And currently do you smoke? 

user: Uhm, I'mm smoke maybe maybe socially so, maybe a pack of cigarettes a week at the at the most. 

assistant: OK. And any recreational drug use like marijuana?
user: Uh, yeah I'll smoke one or two joints on on the weekend with friends socially. 

assistant: OK yeah, so yeah. This uh, the smoking marijuana or cigarettes make your symptoms worse at all? 

user: Uhm, it depends. Yeah, sometimes I can. It can bring on some more coughing. 

assistant: Yeah, so yeah, we always recommend cutting down or quitting smoking whenever, whenever we see patients who are smoking, especially like, you're fairly young. And you know your grandfather had history of lung cancer with smoking throughout the year. So as early as we can quit smoking, the better for the long term health of your lungs, but whenever you're thinking of quitting, or if you want any more resources about quitting, just let me know. We can set up a separate appointment for that.
user: OK, that that sounds good. Yeah, maybe maybe next appointment we can talk about that. 

assistant: OK, sounds good. Um. Any, uh, so no recreational, so just besides marijuana. Any other recreational drugs like cocaine or crystal meth, anything of that sort? 

user: Ah, no. Well, sometimes I at parties maybe a few times a year with friends will use ecstasy or something like that, but that's only a few times a year. 

assistant: OK. Uh, and any alcohol?
user: Yeah, I'll have a few drinks on the weekend with with friends usually. Like rum or beer. 

assistant: OK. Yeah, so this is all the questions I had for you today. Any, any questions or concerns or any ideas of what you think this might be?
user: Uhm, I don't know. I'm really concerned about the the blood that I brought up like I mean is this cancer or, uh, uh tuberculosis like one of those tuberculosis infections that I heard about while I was away? 

assistant: Yeah, so definitely, a cancer is pretty unlikely because you're fairly young and you've just recently started smoking, but one of the things that we're concerned about is your recent travel history being in close quarters. So definitely we need to get a chest X-Ray and we can even do a sputum culture to test for tuberculosis. And then based on the results, we might have to start you on like a whole antibiotic regiment if it does come back as tuberculosis. Yeah, we'll, we'll, we'll get those investigations done first and then we'll go from there. 

user: OK, thank you. 

assistant: We'll also get some blood work done as well, so that'll be done before your next appointment.
user: Alright, that sounds good. Thank you. 

assistant: You're welcome.
user: Hi, my son Dave who's 5 years old, who comes to the clinic quite often, has uh, his asthma has been really bad over the past few days. I've tried his puffers, but they're not really helping much, and I'm just worried about him. 

assistant: So what symptom is he experiencing now? 

user: Uhm so, he's just having this wheezing that just doesn't go away, like, I can actually hear it, it's frightening, he's having like he's having difficulties falling asleep, he's just been very irritable, uhm, he didn't go to school yesterday. It's just, yeah, it's just, it seems like, it's just, he's not eating well either. 

assistant: OK, so yeah, it's been affecting, uh, sleep, appetite, his mood, has he been short of breath?
user: If he was like, he said that he was having some difficulty breathing, yeah. 

assistant: OK, has he, uh, able to talk like in full sentences, like, how is he right now?
user: Yeah, he's  able to talk in full sentences but he just gets a little bit breathless when he's eating, which I think is probably why he's not eating much. But yeah, he's able to talk, he's not talking much either, just been like, just been in a mood, you know, he gets a little bit breathless when he's crying. 

assistant: OK, I see, and, has he had a cough? 

user: Yeah he does, he does have a cough, yeah. 

assistant: OK, and when did the cough start?
user: I want to say about two days ago. 

assistant: OK, and has he been bringing up any sputum?
user: No. 

assistant: Or any blood? 

user: No no no. 

assistant: OK, and has the cough been getting any better or any worse?
user: It's been the same. 

assistant: OK, uhm, and has he complained of having a sore throat or painful ears? 

user: No, he hasn't complained of those. 

assistant: OK, and have you noticed any eye redness or or any discharge from his eyes or nose?
user: No. 

assistant: OK, and has he been having any chest pain? 

user: Uh, no. 

assistant: OK, and you mentioned, uh, a wheeze, have you been able to hear a wheeze like this before?
user: It's usually not this bad. 

assistant: OK, has he been having any abdominal pain? 

user: No. 

assistant: Any nausea or vomiting?
user: No. 

assistant: Has he had any urinary problems like, painful when he's going to the bathroom?
user: No, he hasn't complained of anything like that. 

assistant: I see, OK, and has he had any diarrhea or Constipation?
user: No. 

assistant: OK, has he had any skin changes or rashes?