jshargo/medical-interview-conversations2 huggingface dataset:
user: Uh I'm pretty much always bringing up like this uh white material. 

assistant: White, OK. Um and is it constant throughout the day or do you find it comes and goes? 

user: It's pretty much there all the time, but uh it's definitely getting worse. Um it is, I think, the worst in the morning um when I wake up and I just feel like there's just a bunch of gunk stuck in the back of my throat. 

assistant: OK. Um and if you were to describe the quality of this cough, would you say it's harsh, barky, muffled?
user: I would say it's harsh. 

assistant: Harsh, OK. And has the quality of your cough changed at all in the past few years? Like does it sound different than it used to? 

user: Um I don't know if it sounds different, but uh especially for the last month I would say I'm bringing up more of the material, and it's usually white over the five years, but um I noticed uh in the last week-ish, it's had a yellowish tinge to it as well. 

assistant: OK, OK, so it's changed a little bit. Um and are you experiencing any shortness of breath with this?
user: No I I don't think so, like I sometimes when I'm walking around uh doing more stuff, uh working in the garden like I feel like I might have to breathe a little bit harder, but uh not regularly. 

assistant: OK, OK, that's good. Um and any wheezing?
user: Uh, yeah. It's like usually I start coughing a lot more when I'm starting to do any kind of activities and sometimes when I start coughing more, I also start wheezing. Um but uh right now, I'm fine. 

assistant: You're fine now, OK, uh, alright. And sorry, forgot to ask you earlier, do you see any blood in your phlegm? 

user: No, no, I haven't noticed any blood. 

assistant: OK, any uh changes to your hair or on your skin, like rashes?
user: Not that I've noticed, no. 

assistant: OK, any weight loss? 

user: Um, I don't think so. 

assistant: OK, fevers?
user: No. 

assistant: OK, exhaustion?
user: Um yeah, I would say like for the last few months I am a bit more tired. 

assistant: Mhmm OK, how about changes in your vision or hearing?
user: No, I haven't experienced that. 

assistant: How about a stuffy nose? Runny nose?
user: Uh no, not really. 

assistant: No, OK. How about changes to your smell or taste?
user: Uh nope. 

assistant: No, OK. Uh chest pain?
user: Not chest pain, but when I get into those coughing fits, sometimes it feels just really tight in my chest. 

assistant: Oh, yeah.
user: But it tends to go away with uh just some rest. 

assistant: Oh OK, OK. Um how about palpitations? Like feeling like your heart is racing?
user: Uh no, I don't think so. 

assistant: No, OK. How about some swelling in your limbs?
user: I I did notice, like uh a little bit of swelling in my uh both my, like right by my ankles. My shoes, like like even when I wear my socks, it like leaves little marks and then uh I just feel my like my shoes are tighter. 

assistant: OK, OK and how long has that been going on? 

user: Probably, uh, I've had this issue for like a pretty long time um, probably I would say the last year at least. 

assistant: OK, OK, last year. Um any uh dizziness or fainting spells?
user: No. 

assistant: No, OK, any memory issues, uh confusion?
user: No. 

assistant: Numbness or tingling? 

user: No, nothing like that. 

assistant: No headaches?
user: Uh no, no headaches. 

assistant: Changes to your bowel movements? 

user: No, I tend to go like once a day. And yeah, it's pretty normal. 

assistant: OK, uh nausea or vomiting?
user: No. 

assistant: No, OK. And are you otherwise healthy? Do you have any longstanding conditions? I know you said you have COPD, anything else? 

user: I do have high blood pressure. 

assistant: OK. Do you have something called congestive heart failure?
user: Uh no, what's that? 

assistant: OK, it's when um your heart's not pumping as much as it should be, um so you get some backup of fluid. I ask because you you mentioned that you um were having some swelling in your legs.
user: Oh I yeah, I I yeah, I didn't know anything about that. I just thought that was uh, it's been going on for a while now and didn't really bother me too much. 

assistant: OK. Um alright, and are you taking any medications? 

user: Yeah, I have this medication uh right now I'm taking it, it's called lisinopril. 

assistant: OK, so that's for your blood pressure?
user: Yeah. 

assistant: OK. Are you on any puffers? Sorry, go ahead. 

user: Yes I'm on, no worries, I'm on um uh two puffers right now. One of them is like just one that I use when I really need it. And then um there's another one, so I think that's like the Ventolin puffer. 

assistant: Yeah.
user: And then the other one is called, I think it's called Spiriva. 

assistant: OK, OK perfect. And are your puff puffers giving you any relief at all from the coughing fits? 

user: Yeah, I've been using the Ventolin uh more and it it does seem to help. 

assistant: OK, OK. Uh do you find they're not working as much as they used to though?
user: Yeah, I feel like uh before, I didn't really like, it, just last year I didn't really have to take it too much. Um like even when I use the puffer, I start getting coughing like maybe half an hour later and so it's not, I don't think it's as effective. 

assistant: OK, yeah. Um OK. And have you had any recent blood work done?
user: Uh, no, I haven't been to the doctor for a while. 

assistant: OK. And do you have any allergies?
user: Um I think I have allergies to uh like um amoxicillin, I got like a rash once. 

assistant: OK. Have you had any, uh, amoxicillin, or like penicillin type antibiotics recently?
user: No. 

assistant: No, OK. Um are you up to date with all your immunizations? 

user: Yep. 

assistant: OK. Um, you're not quite at this age range yet, but uh we do recommend the pneumococcal vaccine when you turn 65. And um did you get the flu vaccine this year?
user: Uh yeah I did, with the pandemic going on, I usually don't get it, but I got it this year. 

assistant: OK, good good. Um any family history of lung conditions or heart conditions?
user: Uhm, lung conditions I don't think so. Heart conditions, uh my father did have a heart attack in his 60s, but he's fine. He's he's living right now. 

assistant: OK OK, any cancers? 

user: Cancers, I think my uncle from my father's side um had uh bladder cancer. 

assistant: OK, OK. Um do you smoke?
user: I used to smoke. Um I just quit a few years ago. 

assistant: OK, congrats. Um how much did you used to smoke? 

user: Uhm, I don't know, probably I went through a like a whole pack every day, I would say for at least 30 years of my life. 

assistant: OK, OK um so it's good that you stopped. Um do you take any other recreational drugs?
user: Uh no, nothing like that. 

assistant: No, OK. How about alcohol? Do you drink? 

user: Uh I drink every like, maybe a beer a day. 

assistant: OK. Um are you um living with anyone right now?
user: Yeah, it's just uh me and my wife. 

assistant: OK, where do you guys live?
user: Uh we just live uh outside of the city in in a condominium. 

assistant: OK, any uh old carpets? Mold, dust, asbestos, anything like that in the condo?
user: No, it's pretty well maintained. 

assistant: OK, good. And have you been in contact with any anyone sick recently? 

user: No, I've mainly just been trying to stay inside. I work from home too, so haven't really been seeing anyone. 

assistant: OK, that's good. And um travel to anywhere recently? Outside the province?
user: Uhm, outside of the province, no, not not for like the last year at least. 

assistant: OK, OK. Um so those were kind of all the questions that I had for you. Did you have any questions for me? 

user: Um yeah, I was just wondering like what you think it might be. 

assistant: Yeah, so it definitely sounds like a COPD exacerbation, but because your symptoms overlap with those of Covid, we will take a swab and you should hear back in about 24 to 48 hours. Um and you can you can self isolate for 14 days um and if it's positive, public health will be in touch with you to um do some contact tracing, but in the meantime we'll also do a work up for the COPD exacerbation. Um it seems like you have taken the correct steps so far in like stopping like stopping your smoking and um taking your puffers as needed. Um so right now we will continue using the puffers that you have, and if you don't already have a long acting beta agonist, we'll give you that as well as, if it's like if it gets really severe, we'll also give you some inhaled corticosteroids um and we'll also check your oxygen saturation to make sure it's over uh 88% um and we'll give you oxygen if you need it. Um as well, some antibiotics to consider, you mentioned that you were allergic to amoxicillin, so we might give you like a macrolide like azithromycin for now. Um and hopefully your symptoms subside and we can get you home. How does that sound?
user: OK, that sounds good. Thank you so much. 

assistant: Yeah, no problem. And I forgot, sorry we'll also probably do like a chest X Ray and a pulmonary function test.
user: Hi yes I'm just coming in, uh over the last week, I've been having um like a cough, runny nose and a lot of congestion as well. So I just wanted to come in here to make sure nothing's wrong. 

assistant: I see, alright, and when did the uh cough start? Was it 7 days ago? 

user: A bit less than that, I would say it's been probably like five or six days. 

assistant: OK, um and has the cough been getting any better or any worse or staying the same?
user: Um it's kind of the same. 

assistant: OK, and are you bringing up any uh sputum with the cough?
user: No, it's mainly like a dry cough, but I am getting like a lot of drainage and uh just congestion in my nose. 

assistant: OK, so you're, you are, are you feeling um like mucus drain from your nose like into the back of your uh mouth?
user: Uh yeah, sometimes I feel like that over the last week. 

assistant: OK. And you you haven't caught up any any sputum, but have you brought up any any blood?
user: Uh no, no blood. 

assistant: OK, have you had any wheezing? 

user: No, no wheezing. 

assistant: OK, and how about um any chest pain?
user: Um no chest pain. 

assistant: OK, and you've had a, and did you, have you had a cough before or is this a new cough?
user: Um no, this is like fairly new. 

assistant: OK. And um could you, is your nose uh like, could you describe the discharge from your nose?
user: Yeah, it's more like kind of a clear to maybe whitish discharge. 

assistant: And these symptoms start about a week ago as well or about five days ago?
user: Um yeah, around the same time. 

assistant: I see, OK. And have you had any uh like facial pain like over your over your cheeks or or forehead?
user: Uh no, nothing like that. 

assistant: OK, and have you felt like your nose um is obstructed, like you're not able to breathe in through either one of your nostrils? 

user: Yeah, that happens and sometimes the nostrils keep switching. 

assistant: OK, and have you had a loss or a change in your sense of smell?
user: Um just when I'm congested like I feel like I can't really smell. 

assistant: I see, alright. Have you had a loss or a change in your sense of taste? 

user: No. 

assistant: OK. Um and have you had any shortness of breath with the cough?
user: Uh no. 

assistant: OK, um and have you had any eye redness or um eye discharge? 

user: No, I don't think so. 

assistant: Alright, and how about a sore throat?
user: Uhm, maybe a little bit of a tickle in my throat, but not sore. 

assistant: I see, OK, so have you had any pain with swallowing food or liquids?
user: No. 

assistant: OK, and um have you had any headaches?
user: No. 

assistant: Any fevers or chills?
user: No, nothing like that. 

assistant: Any uh night sweats?
user: No. 

assistant: And how was your weight been recently? Any changes?
user: No, no changes. 

assistant: OK, um and have you had any nausea or vomiting?
user: Uhm no, nothing like that. 

assistant: Have you had any diarrhea? 

user: Uh no, no diarrhea. 

assistant: OK, and have you had any urinary problems like painful urination or or frequency?
user: Nope. 

assistant: OK, and then any skin changes or or rashes? 

user: Uh nope, nothing like that. 

assistant: Alright, any muscle aches or body pains?
user: Uhm no, nothing like that. 

assistant: Alright, and how has your energy been over this past week? Have you had fatigue? 

user: Uh no, I've been, I haven't been tired or like, it's just been like these symptoms that don't seem to go away. 

assistant: I see, OK. Um and uh, have you had any changes to your um to your voice?
user: No. 

assistant: Or any any neck swelling? 

user: No. 

assistant: Alright, um so it sounds like over the past uh week you've been having this dry cough uh as well as some nasal discharge and some congestion with um a little bit of a scratchy throat. Um any other symptoms?
user: Uh no, that's pretty much it. 

assistant: I see, alright, and in the past have you been diagnosed with any medical conditions? 

user: Uh no, I've been pretty healthy. 

assistant: OK, that's good. And, uh, any uh prior hospitalizations or surgeries?
user: Uhm no, nothing like that. 

assistant: Alright. And do you take any medications regularly, prescribed or over the counter? 

user: Um I've just been taking like Tylenol cold, but it's not really been helping too much. 

assistant: OK, um do you have any allergies?
user: Uh no. 

assistant: OK, uhm and, uh currently are you, could you just tell me a little bit about your living situation, um like who you're living with and uh and whereabouts? 

user: Um yeah, so I just live in an apartment with my boyfriend and uh live like just within the city. 

assistant: OK, and are you going to school right now or are you working?
user: Yeah, I'm working uh currently um just at a grocery store. 

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

user: Uh not that I know of, yeah, I haven't seen anyone like have symptoms or anything. 

assistant: OK, have you traveled anywhere?
user: No, I've been in the province. 

assistant: OK, um and you mentioned um that you have a boyfriend. Are you currently uh sexually active? 

user: Yep. 

assistant: And do you use condoms or any form of birth control?
user: Uh yeah, usually like just condoms. 

assistant: I see, OK, and is there any chance that uh you could be pregnant currently?
user: Uh, no, I don't think so. 

assistant: OK, uh, and I just want um, are you currently smoking?
user: Uh no, I have haven't, haven't smoked ever. 

assistant: OK, and that includes cigarettes and marijuana? 

user: Uh Yeah, no no marijuana either. 

assistant: OK, do you drink alcohol?
user: Uh just like once or twice in a week. 

assistant: And is it like one or two drinks? 

user: Yeah, so I would say, like it would usually be wine. 

assistant: I see alright, and do you use any other uh recreational drugs?
user: Uh no, nothing else. 

assistant: OK, um and in the family, um are there any history of heart or lung problems? 

user: Um not that I know of, no. 

assistant: Alright, and how about any uh any cancers?
user: No. 

assistant: Alright, um so uhm that was everything I wanted to ask today on on history, was there anything else that maybe I forgot to ask about, you wanted to mention? 

user: Uh no, I just yeah, I was just wondering if like I should be worried at all about Covid. 

assistant: Yeah, certainly um something that we'll be testing for today with some of the symptoms that you're having like um cough and some nonspecific symptoms like that can show up in Covid, um for sure so it will be important to get a test for that today, which will require a nasal swab. Um that being said, it could be uhm another type of viral illness like the common cold, which is causing your your symptoms here today, um and so it will be just be important to be diligent and if your symptoms, diligent with the testing I mean, with the Covid, and if your symptoms get any worse we, it might be important to go to the hospital or or the emergency department.
user: Um yeah hi, I brought I brought my 8 year old daughter here um because I've noticed that she's been quite wheezy um for the past four five days and now she has a slight cough, um sounds like she's a little short of breath, so I just wanted to get things checked out. 

assistant: OK, so for the, when it first presented, about four to five days ago, what did you notice, notice first?
user: Um I noticed that she was wheezy um and it's it seemed like she was having some difficulty taking in deep breaths. 

assistant: OK, now was this with any type of activity or just at rest?
user: Yeah, she was playing tag with one of her cousins and she she was quite out of breath after. 

assistant: OK, has she ever had anything like this before? 

user: No. 

assistant: Nothing like that, OK, and has it been fairly steady since then? Or has it been fluctuating?
user: It's been fluctuating. 

assistant: OK, but it hasn't really gone away in the sense that you're still concerned coming now four days later? 

user: Yeah, it's just it would, she would have these these uh episodes, but it would resolve on its own and then she would, you know go back to doing some sort of activity and then she would have all these symptoms all over again, but when she rests um then it goes away, so I wasn't really sure, too sure what to think of it. But now I think it's important to get it checked out, so here we are. 

assistant: Has she had any fevers at home?
user: No. 

assistant: Has she had a runny nose at all at home? 

user: No. 

assistant: Has she seemed well otherwise, does she look sick?
user: Yeah, she looks fine otherwise. 

assistant: OK. And has she had any sick contacts recently? Anyone around her or her friends been sick?
user: No, not that I've noticed. 

assistant: OK. Any recent travel anywhere? 

user: Uhm, no, no, we didn't go anywhere because of covid. 

assistant: OK, but she's still been going to school I suppose, playing with her friends?
user: Yes. 

assistant: OK. Have you noticed any rashes? Any skin changes anywhere on her body?
user: Uh not that I've noticed, no. 

assistant: OK, nothing like that, has she complained of any pain anywhere? 

user: No. 

assistant: OK, and has she had any recent infections?
user: Uh she had, actually she had a couple of infections over the past two years. Uh they would come and go uh and we took her to the doctor each time and it just ended up being some sort of viral infection. 

assistant: OK, so nothing really needing antibiotics in the last couple of years? 

user: No. 

assistant: And in terms of how she's been doing, has she been keeping up with her peers in terms of education, and how she moves, how she acts?
user: Uh yeah, she's been yeah, she's been on par with her peers. 

assistant: OK, so does she have a family physician?
user: Um yes. 

assistant: OK, so they haven't brought up any concerns about how she's growing, how she's developing? 

user: No. 

assistant: So her weight, her height, they've been good for her age?
user: Yeah, yeah. 

assistant: Excellent. And has she gotten, has she been keeping up to date for immunizations?
user: Yes, she's fully up to date. 

assistant: Excellent. In regards to how she's doing, otherwise health, in terms of her health, has, did she see a family physician for any other medical issues that she might be having? 

user: Uh no, she's otherwise pretty healthy. 

assistant: OK. How was the birth? Was there any complications when she was born?
user: No, she was a vaginal delivery, full term, no complications. 

assistant: OK, so nothing when you were pregnant with her, no toxic congestions? By that I mean um did you drink any alcohol, smoke at all when you were pregnant with her?
user: No. 

assistant: No, OK. And you just had antenatal care, so you saw doctor for ultrasounds and just for checkups?
user: Yep, everything was fine. 

assistant: OK. And when she was born, she didn't have to stay in the hospital at all?
user: No, no. 

assistant: And was she born, uh what weight was she when she was born? 

user: Uh, she was, how much was she? I think she was about 8 kilos. 

assistant: 8 kilos?
user: Sorry 8 pounds, 8 pounds. 

assistant: Yeah, no worries. And then otherwise she is, so she's been healthy otherwise, been doing well, uh just in terms of how she's been doing uh with other systems of her body, have you noticed any concerns for her bowel movements? 

user: Uh no, she's been pretty regular. 

assistant: OK, any concerns for peeing?
user: Uh no, she's been going pretty frequently and she's, yeah no changes there. 

assistant: And we already talked, she hasn't had any fevers, when she coughs does she ever bring anything up?
user: Uh no, I haven't noticed any phlegm, no. 

assistant: OK, and when she's having these wheezy episodes, do you ever notice that she looks like she's really straining to breathe, really struggling?
user: Uh yeah, so she, it's not like she turns blue or anything like that, um she just slightly slightly has a hard time catching her breath. 

assistant: OK, so these usually recover on their own? 

user: Yeah. 

assistant: You don't give her anything for it?
user: No. 

assistant: OK, uh does she have any allergies?
user: Um no, well she has some seasonal allergies, but nothing that she's been tested for. 

assistant: OK, do you give her anything for seasonal allergies?
user: Sometimes she takes like Reactine or like over the counter stuff, but um no, no prescribed medications. 

assistant: OK, so she doesn't have any allergies where her face swells up or she has trouble breathing?
user: No. 

assistant: OK, and this, these episodes mainly happen when she's playing with friends, so do they happen in a certain environment? Like for example, is this in a friends house or is this outdoors or has it been across different settings?
user: It's been across different settings but I will say it's worse when um when when there's colder weather. 

assistant: OK. 

user: Yeah. 

assistant: And do these episodes ever happen in your home?
user: Yeah. 

assistant: And what's the context from them happening in your home? 

user: Um usually when she is out and about running around in the backyard with her friends um is when I've mostly noticed it, yeah. 

assistant: OK, so she doesn't have any symptoms at rest?
user: Oh, no. 

assistant: And she doesn't have any symptoms at night?
user: Uh at night, so there was one one one night when she had some issues um with like wheeziness but it did resolve on its own. 

assistant: OK. And did she wake up at night with that or just? 

user: Just trouble falling asleep, I think yeah. 

assistant: OK. Alright, so we already talked about, so she doesn't really have any past medical issues that she's seen a doctor for, uh any surgeries?
user: No surgeries. 

assistant: OK. Is she taking medications right now? 

user: Um no, no medications. 

assistant: Aside from the occasional Reactine?
user: Uh yeah, aside from that, nothing, no regular medications. 

assistant: And she's in school? 

user: Um yeah, she's uh she's in Grade 3 now. 

assistant: OK, and does she live with you?
user: Uh yeah she lives with me and my husband. 

assistant: OK, do you two live in a house in town? 

user: Um yep, in a townhouse 

assistant: OK, and what do you two do for work?
user: Um so my husband is an ultrasound technician and I am a uh kindergarten teacher. 

assistant: OK, excellent, and this is a question we just ask everyone, has there ever been any CC CAS involvement in the family?
user: No. 

assistant: And does anyone smoke in the household? 

user: Uh, no no. 

assistant: OK, uh do you keep any carpets or pets in the household?
user: We have carpets, but they're new carpets. We just got them, uh maybe six months ago, and nothing else. 

assistant: So no pets, no dogs?
user: No. 

assistant: OK. Any wood burning fireplaces, stoves in the household?
user: No. 

assistant: And changed your air filters? 

user: Yeah. 

assistant: Alright, excellent, so I think I have all the information I need, we're just going to do a physical exam and then I'm going to go talk to the physician and I'll come in and see your daughter and we'll talk about next steps from there. Do you have any questions that you'd like me to direct to him before that happens?
user: No, thank you so much. 

assistant: Alright, have a good one
user: Hi I'm, I have been having this nasal obstruction and discharge for the past week and it doesn't seem to be going away and it's bothering me so I thought I would get it checked out by you. 

assistant: OK, for sure. Uhm, could you describe the discharge?
user: Yeah, it's a. It's mostly clear, it doesn't, it doesn't have a color to it. 

assistant: OK, so no yellow, green or or red to indicate any blood?
user: No. 

assistant: OK, and you mentioned, so with the obstruction, have you had difficulties breathing?
user: Um a little bit, I just need to, and is mostly at night. I just need to shift to one side or the other to like unblock my airways. 

assistant: I see OK and have you been having any pain on your face? Like I like kind of over your cheeks or over your forehead? 

user: No. 

assistant: OK, how about any headaches?
user: No headaches. 

assistant: All right, have you had any changes or to your sense of smell or any loss of smell? 

user: Uhm no, maybe a little bit, but no, not really. I can still eat. I can still smell like candles and things like that so, maybe go with no. 

assistant: OK. Have you had any changes to your sense of taste?
user: No. 

assistant: OK. Have you had any eye redness or or any eye pain?
user: No. 

assistant: Any ear pain or ear discharge? 

user: No. 

assistant: Any changes to the vision or hearing?
user: Uh, no. 

assistant: OK, have you had a sore throat? 

user: No. 

assistant: Have you had a cough?
user: No. 

assistant: Have you had any shortness of breath
user: Uh, no. 

assistant: Have you had any wheezing?
user: No. 

assistant: OK. And have you coughed up any blood? 

user: No. 

assistant: OK, and have you had any chest pain?
user: No. 

assistant: Have you had any lightheadedness or dizziness? 

user: Uh, no. 

assistant: Have you felt like your hearts beating really fast or racing?
user: No. 

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

assistant: Have you had a night sweats?
user: No. 

assistant: Have you had any unexpected weight loss?
user: No. 

assistant: OK, have you had any loss of appetite?
user: Uh, nope. 

assistant: OK, have you had any nausea or vomiting?
user: No. 

assistant: Have you had any abdominal pain? 

user: No. 

assistant: Have you had any diarrhea or constipation?
user: No. 

assistant: Have you had any painful urination or urinary frequency?
user: No. 

assistant: OK, have you had any skin rashes?
user: No. 

assistant: Have you had any muscle aches or joint pains? 

user: No. 

assistant: Have you had any memory loss or confusion?
user: No. 

assistant: OK, and how has your energy been? Have you had fatigue or malaise? 

user: No, nothing like that. 

assistant: OK. Uhm, and have you had any sneezing?
user: No. 

assistant: OK. Uhm, and, uh, are you healthy? Or, or have you been diagnosed with any medical conditions in the past? 

user: No, I'm actually pretty healthy. 

assistant: OK. Have you had any prior surgeries or hospitalizations?
user: Nope. 

assistant: OK, and any allergies like to any medications or any seasonal allergies? Like do you get symptoms like this that change throughout the year? 

user: No. 

assistant: OK and sorry, no allergies to medications as well?
user: No allergies to medications. 

assistant: OK, and do you take any medications regularly, either prescribed or over the counter?
user: No, I don't take any medications. 

assistant: OK, and can you tell me about where you're living currently and who you're living with? 

user: Uhm, I live by myself right now. I live in an apartment downtown. 

assistant: OK, and are you, got working right now or are you going to school or both?
user: I'm working right now, but I'm working from home. 

assistant: OK, uh, have you been around anybody who's been sick? 

user: No one personally, but I do go to the grocery store and the bank and all the essential things. 

assistant: I see, OK. Uhm, and have you have you traveled anywhere recently?
user: No, I haven't. 

assistant: OK. Are you in a relationship? 

user: I am. 

assistant: Are you sexually active?
user: I am. 

assistant: OK, could you tell me a little bit about your partner or, or partners?
user: Uhm yeah, so we've been together for the past five years. And yeah, he's the only sexual partner I have. 

assistant: OK, and do you use condoms or birth control? 

user: Birth control. 

assistant: OK. Uhm, and any concern for a sexually transmitted infection?
user: No. 

assistant: OK and you smoke cigarettes?
user: I don't. 

assistant: Do you smoke cannabis or use cannabis products? 

user: Uh, nope. 

assistant: OK, how about the use of any recreational drugs?
user: No. 

assistant: OK, do you drink alcohol? 

user: I do, I'll have like a glass of wine every day. 

assistant: OK. And in the family, are there any heart conditions or lung conditions that run in the family?
user: No. 

assistant: How about things like diabetes or or high blood pressure?
user: Uhm, I don't think so. 

assistant: OK, and uh, are there any cancers in the family? 

user: Uhm, there's colon cancer in the family. 

assistant: OK, and who was that and how old were they?
user: Uhm, my grandfather, he was 55. 

assistant: OK. Uhm, alright, and so that was everything that I wanted to ask today on history. Was there anything else that I was maybe forgetting? 

user: Uh, no, I think that was it. 

assistant: OK, so with the prominent symptoms of being nasal discharge and obstruction without fever and without, like changes to smell and also without pain, it's most likely a viral rhinosinusitis. Uhm, however, this could have symptoms that overlap with, with COVID, and so we will still end up doing a swab even though the most likely diagnosis is going to be a viral acute rhinosinusitis.
user: OK. 

assistant: Do you have any other questions?
user: No thank you or yeah, thank you. 

assistant: Thank you.
user: I just bringing my son in today because he's had this cough that's been going on for a few days now and for these past two days, I've noticed that he's been just tugging at his ear more as well. 

assistant: OK, so you said the runny nose started two days ago?
user: Yeah, yeah he had a cough yeah cough and runny nose started about yeah 2-3 days ago 

assistant: Okay, the runny nose, what color is the discharge?
user: Pretty clear and watery 

assistant: OK, and the coughing is it dry, or is it bringing up any phlegm? 

user: It's been dry. 

assistant: It's been dry OK. And does it sound harsh?
user: Not really, 

assistant: No? 

user: I don't know. It sounds kinda like a typical cough. 

assistant: OK, has he lost his sense of taste or smell?
user: He's been a bit more irritable and not eating as much but I'm not sure. 

assistant: OK, how about changes in his vision or hearing? 

user: No 

assistant: OK. Any fevers?
user: Uhm, I don't think so. But he, we haven't checked and he's been, yeah, as I said, kinda, a little bit irritable. 

assistant: OK, any weight loss recently?
user: Uhm no, he's been gaining weight. Actually, sorry, I think it. Yeah, he has had a fever. The fever. Yeah the fever started like yesterday. 

assistant: Oh OK, did you take his temperature?
user: Yeah, my my wife just texted me and told me that she checked it, checked it and said it was over 38. 

assistant: Oh OK. Yeah, we'll definitely take a temperature here as well just to make sure. Has he had any rashes?
user: No, 

assistant: No rashes OK. And how about shortness of breath or wheezing? 

user: No, I haven't heard that. 

assistant: No, OK. And then have you actually taken a look into his ears?
user: No, I haven't. He has just been tugging at the right one. 

assistant: Is he itching it at all? 

user: Uh yeah, I guess just kind of like really rubbing it around the outside and pulling on the lobe a little bit. 

assistant: OK, any discharge? Oh sorry go ahead
user: Sorry I'm just gonna say yeah he's been kind of fussy and pointing at it and no discharge from the ear. 

assistant: No discharge, OK. Does it look swollen? 

user: No, the outside of the ear looks normal. 

assistant: OK, OK, and how have his bowel movements been?
user: That's been normal, . 

assistant: Normal. Any changes in his urine? 

user: No, it's been normal. 

assistant: Nausea or vomiting?
user: Nope. 

assistant: uhm headaches?
user: No, I don't think so. 

assistant: OK, how about dizziness or fainting spells?
user: No. 

assistant: No, any confusion or memory loss?
user: No, I don't think so. 

assistant: No OK, is he an otherwise healthy child? 

user: Yeah, he he is. I mean he, uhm about six months ago he had uhm croup I think but he recovered quickly from that and he didn't need to be hospitalized or anything. 

assistant: OK, and his mother's pregnancy with him, was it complicated in any way?
user: She had gestational diabetes, but it was diet controlled and she's healthy now from that perspective. 

assistant: OK, OK, that's good. Uhm and then was he born at term? 

user: He was yeah he was born over like 38 weeks I think 

assistant: Oh OK, good and was it a C-section or a vaginal delivery?
user: Uhh vaginal. 

assistant: OK, any complications during the delivery?
user: Uhh no. 

assistant: No, OK, how about uhm after birth? Was he hospitalized for any reason?
user: No, he wasn't. He was able to go home. 

assistant: OK, that's good. Uhm and has he been developing normally in terms of his motor movements, like behavior wise, social wise, like is he on par with his peers in terms of milestones?
user: Yeah he is. Yeah, everything's been normal that way and he's been growing well too. 

assistant: OK, good. growing while gaining weight well, OK, is he on any medications?
user: No, he's not. 

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

user: He is, yeah, we've been following along with with that. 

assistant: OK, does he have any allergies?
user: I don't think so. 

assistant: No, Ok. Any family history of lung or heart conditions? 

user: Uh, no. 

assistant: No OK. Does anyone at home smoke?
user: Uhm I do but not like in the house or anything like that, usually just well, it will always be either outside or when I'm at work. 

assistant: OK OK, any old carpet, dust, mold, asbestos, anything like that in your home?
user: No. 

assistant: No. OK. Who does he live with? 

user: So yeah, he lives with me. It's just me and my wife. 

assistant: OK. Any pets at home?
user: We have a a dog. 

assistant: OK. Has he been in contact with anyone sick recently?
user: Uh. Not that I can think of. 

assistant: OK is he in like daycare?
user: No, no my wife's been, been looking looking after him at home. She's the primary caregiver, well while I'm at work. 

assistant: OK, any trouble recently? 

user: No no. 

assistant: No, OK. Well, those are all the questions that I had for you today. Did you have any questions of your own?
user: Uhh no, just was wondering what what might be going on? 

assistant: Yeah, for sure, so right now it sounds like a viral picture. It sounds like he has a cold and possibly an ear infection. I'd have to take a look into his ear to be able to tell more uhm because some of his symptoms overlap with those of covid we'll probably do a swab and you should hear back in about 24 to 48 hours. Uhm and so after I take a look into his ears, we can do one of a couple of things, so if his tympanic membrane looks like it's been perforated, or if there's pus in there, then we'll prescribe him a 10 day course of antibiotics, and if I see like middle ear effusion or his tympanic membranes bulging, and he seems really sick like he has a high fever, what she does, I will again prescribe him 10 days of antibiotics. And if he has a middle ear effusion or a bulging tympanic membrane, just one of those two, and he doesn't seem to be too sick, we can reassess him in 24 to 48 hours. Uhm An antibiotic that we usually prescribe is amoxicillin. Uhh how does that sound? 

user: That sounds really good. Thank you. 

assistant: OK, no worries. Take care.
user: I've had this cough for over a week now, and it just hasn't gone away. 

assistant: OK, and uh, so this cough has been going on for a week. Can you describe the cough a little bit for me? 

user: Yeah, so I mean sometimes I produce sputum and sometimes I don't. It's uh, white and whiteish clear in color. 

assistant: OK, um, and it's been going on for more than a week.Has it been getting worse?
user: It got a little bit worse at first, but then it's been kind of the same, um, since. 

assistant: OK, have you noticed at all, um, like green or yellow color of your sputum or any blood tinged sputum?
user: Uh, No blood, and maybe a little yellowish. 

assistant: OK, little yellowish, OK. And how much would you say you bring up, um, on an average day? 

user: Uh, a couple of teaspoons. 

assistant: Couple of teaspoons OK.OK, has there been anything that um, makes it worse or better?
user: Nothing that I can think of. 

assistant: OK, and have you had this happen to you previously in the past?
user: No. 

assistant: And is the cough uh, constant or does it come and go?
user: It comes and goes, uh, throughout the day. No particular time of the day it's worse. 

assistant: OK, and, um, are you having any, uh, other symptoms besides the cough, um, like shortness of breath,sore throat, um, runny nose, congestion, anything like that?
user: Uh. yeah, I've had, um, a sore throat, uh, and a headache, as well. 

assistant: OK, and when did the sore throat start?
user: Um, that started about five days ago. 

assistant: Five days ago? And has it been getting worse? 

user: No, that's been about the same. 

assistant: And do you have any difficulty, uh, swallowing at all?
user: It's a little sore, but, uh, it's been OK, to eat and drink. 

assistant: OK, and have you noticed any kind of redness in your throat or any swelling around your neck?
user: No, I took a look in the mirror as best I could with my phone and I couldn't really notice anything that looked red. 

assistant: OK, and how about the headache? When did that start? 

user: So it's been, uh, kind of off and on over the past, uh, week or so. Um, feels like a like a pressure sensation and my head is just really squeezing. 

assistant: OK, and um. So is it on one side of your head or both sides?
user: Both sides. 

assistant: And it's Kind of like a pressure and squeezing. Is it at all pulsating? 

user: No 

assistant: No? OK, Is it constant or does it come and go?
user: It comes and goes. 

assistant: OK, and have you taken any medications to make any of these symptoms better?
user: Yeah, I have used some Advil for the headaches and over the counter medicine at night time to help sleep. 

assistant: OK. Uh,and do you recall doing anything in the last few weeks which you might believe that Uh, caused some of these symptoms? like for example, were you in contact with anyone that was sick at all? 

user: Well, I'm a nursing student and I've been on rotations in the hospital recently. 

assistant: And anyone that you probably saw in the hospital, anyone sick that you were in contact with?
user: I did see some people who had, like, infectious symptoms. 

assistant: OK, and other than that, have you been having any fevers or chills? 

user: Yeah, I've felt chills. 

assistant: OK chills, and when did you feel them?
user: I've been feeling chills throughout the day and at night, I just feel like I can't get warm even with a blanket on. 

assistant: OK, and have you taken your temperature at all?
user: No. 

assistant: OK yeah, we can do that for you today. Uh, other than that any recent travel outside of the province.
user: No, been just at school. 

assistant: OK, and any loss of sense of taste or smell? 

user: No. 

assistant: Any nausea or vomiting?
user: No. 

assistant: Any night sweats? 

user: No, 

assistant: OK, any fatigue?
user: Yes. 

assistant: OK, and When did that start?
user: Just over this past week I've been really tired, I've been been needing naps and not feeling rested in the morning. 

assistant: OK, any chest pain at all? 

user: Yeah, It does feel sore, kind of, uh, the center of my chest. 

assistant: OK, so any coughing at all?
user: Yeah, I feel it, like more, like it does hurt when when I'm coughing, that's kind of what I'm feeling it. I think it's being caused by how much I'm coughing.I kind of feel it there in the center. 

assistant: And besides, when you're coughing, do you have any pain in your chest when you're breathing in or out?
user: No, 

assistant: No? OK. Alright, any changes to your bowel movements, like any Constipation or diarrhea?
user: No. 

assistant: Any urinary issues?
user: No. 

assistant: OK, any changes with your sleeping or your appetite? 

user: No. 

assistant: Have you noticed any significant weight loss in the last few weeks?
user: No, it's been the same. 

assistant: OK. And have you recently, prior to your coughing, have you had any infections like a viral illness or like a cold for example, anything like that? 

user: Yeah, now that I think about it, I mean, maybe like a month ago I had like a runny nose for a couple of days and it just went away. 

assistant: OK, were you on any kind of medications or antibiotics at all?
user: No, just went away on its own pretty quickly. 

assistant: Alright, do you have any past medical conditions, like high blood pressure, diabetes, anything like that?
user: No, I don't, I'm healthy. 

assistant: OK, do you have any allergies?
user: No. 

assistant: Do you take any medications regularly? 

user: Uh, no. 

assistant: OK, any hospitalizations or surgeries in the past?
user: No. 

assistant: OK, and any family history of any lung or heart conditions or any cancers? 

user: I think my mom has high blood pressure, but that's about it. 

assistant: OK. I forgot to ask you this earlier. Have you been experiencing any wheezing?
user: Yeah I have noticed a bit of a wheeze, yes. 

assistant: And currently you are nursing student. Where do you live?
user: I live with a couple of my classmates downtown. 

assistant: OK, and do you live in an apartment or dorm, a house?
user: An apartment. 

assistant: OK, anyone sick in your household at all? 

user: No, nobody's been sick. 

assistant: OK, do you drink alcohol at all?
user: Sometimes with friends, on a weekend. 

assistant: Do you smoke cigarettes at all? 

user: No, I don't. 

assistant: And any recreational drugs like marijuana?
user: Nope. 

assistant: OK. Alright, so yeah those are all the questions I had for you. Do you have any questions or concerns?
user: No, I was just hoping to feel better. It's been going on for so long now. 

assistant: You said it's more than a week now, right? 

user: Yes. 

assistant: Yeah, so what we will do today is, uh, first of all, with the pandemic going on, with some of these symptoms, we need to rule out coronavirus. And so we will be getting a swab done for you as well today and considering you are having these symptoms, we will also get another test done for you today to see if there's any bacteria causing what we call walking pneumonia. It's community acquired pneumonia that's fairly common in like the younger population. And so we'll see if you could have that. And so from there we'll see if we need to put you on any antibiotics which will help you. And if we need to get any blood work or X Rays we'll let you know as well. Is that OK? And if you feel like you have worsening symptoms like shortness of breath, you need to make sure you come back to the Emergency Department.
user: Yeah, that sounds great. Thank you. 

assistant: Yeah, you're welcome and take care, and we'll get all those things done for you and we'll be with you shortly.
user: I am just calling about my daughter. She's been sick over the last few days. She has fever and a cough. 

assistant: I see, OK. When did the fever and cough start?
user: So they started around three to four days ago. And around the same time she was also having like a runny nose. 

assistant: OK, and has the fever and cough been present the whole time? 

user: Uh, yeah I would say they started around the same time and ah, they have been going on for the last three and a half to four days. 

assistant: OK, so has there been a period when she hasn't had a fever or a cough?
user: Uh no, every time I've measured it, she has had a fever and she's been coughing for the last few days. Hasn't really changed. 

assistant: OK, can you think of anything leading up to these symptoms?
user: Uh, no, she was she was fine, just three to four days ago. Like before that she was her playful self. No issues. But yeah, it's for the last couple of days just this nonstop cough and the fevers is what's really worrying me. 

assistant: OK, uh, have the symptoms have gotten worse or stayed the same?
user: I would say the fever has been getting a little bit worse over the last like, especially today, but the cough, coughing is about the same as what it was when it first started three days ago. 

assistant: OK. Has she been sick like this before?
user: She's, she often gets sick, like her brother goes to daycare and he brings a lot of bugs from there and every time he gets sick, she also gets sick. The last time she had like a similar cough was around two months ago, but at that time I wasn't that worried because she didn't have any fevers. 

assistant: OK, um, have you, has there been anything that you've tried to help with the cough or fever? 

user: Uh Tylenol, I gave her Tylenol. It did help her a little bit, but then the fever came right back, uhm say like a few hours later. 

assistant: OK, and anything you notice that's made the cough or fever worse over the last three or four days?
user: Not anything that I know of. Her fevers been getting worse, but I don't really know why that is. 

assistant: OK, uh, has she been having any other symptoms?
user: Um, other than like, yeah, she had that runny nose when it first started, and then she's also been having some diarrhea. 

assistant: OK, and when did the diarrhea start?
user: I think I would say it started around two days ago. She's, like every time I change her diaper she would have like 4-5 different diaper changes throughout the day, and they they seem pretty liquid. So I think yeah, she's been having diarrhea for the last two days. 

assistant: OK, uh you mentioned liquid appearing stool, what would you say say, so I guess, could you comment on the consistency and colour? 

user: Consistency, I'd say it's pretty watery, like diarrhea and colour I didn't really think there's any changes in in the colour. 

assistant: OK. So you didn't think there was any blood in the stool?
user: No, no, no, I didn't see any blood. 

assistant: OK, as for the fever, what was the maximum temperature that you noted and how did you check it? 

user: So I used, we have just a regular non digital thermometer in her ear and her temperature today was around 103 degrees Fahrenheit. 

assistant: OK. Uh, did you notice any tugging or pulling at her ear?
user: No, no, she doesn't seem to have any irritation there. 

assistant: OK, uh, how about any vomiting or regurgitation?
user: No, she's been keeping food down. No issues there. 

assistant: OK, and notice any discharge from either eye? 

user: Uh, no. 

assistant: How about any discharge from ears?
user: Not that I've noticed, no. 

assistant: Notice any rashes?
user: Uh, no, I didn't not know like new rashes, no. 

assistant: OK and how is she been in terms of mood or or behaviour?
user: Oh she's been pretty like she's not herself over the last few days. She's been crying a lot more, just very irritable. 

assistant: OK, would you say inconsolable at times?
user: Sometimes like yesterday like she, I couldn't get her to stop crying. 

assistant: OK and uh, I know you said no vomiting, but has she been coughing up any sputum?
user: Yeah, I would say, uh, this green slimy content. Yeah, it's like green and slimy. 

assistant: OK, um, how much would you say, uhm, like a cup, or more?
user: I would say probably like at least, at least a couple spoonfuls at a time, she would cough up. 

assistant: OK, and did you notice any blood in it? 

user: No, I didn't notice any blood at all. 

assistant: OK, and with the cough, have you noticed any difficulties breathing?