jshargo/medical-interview-conversations2 huggingface dataset:
user: Yeah, I've actually lost a significant amount of weight. I would say within the last 1 and a 1/2 months probably lost like 8 to 10 pounds. 

assistant: OK, have you been trying to lose weight? 

user: No, not really I've just been sitting around like I can barely walk that much anymore too. I used to be able to walk at least 400 meters around the block, but now I can barely even go to the kitchen. 

assistant: OK, is this because of the shortness of breath when you are are exerting?
user: Yeah, that and I just start coughing so much that I just have to sit down. 

assistant: OK. Um, and have you been having any headaches? 

user: No headaches. 

assistant: Alright, and how about and how is your appetite been?
user: Um, I think it's been pretty much the same. Sometimes when I'm coughing a lot, I don't feel like eating, but other than that it's been around the same. 

assistant: OK, any nausea or vomiting? 

user: No. 

assistant: Any runny nose or sore throat?
user: No. 

assistant: OK. And then how about a loss of smell or a loss of taste? 

user: No, nothing like that. 

assistant: OK, have you been having any chest pain?
user: No. 

assistant: Any heart palpitations? 

user: Nope. 

assistant: Any wheezing when you're breathing?
user: Sometimes I would say like when when, it gets worse when I'm exerting myself more, I I can get some wheezing. 

assistant: OK, and have you noticed any swelling in your feet or ankles? 

user: No, nothing like that. 

assistant: Alright. And have you woken up at night extremely short of breath?
user: No, I'm pretty fine during the night. 

assistant: Alright And, uh, have you been having any abdominal pain? 

user: No. 

assistant: Any urinary problems?
user: Uh no. 

assistant: Any bowel problems like diarrhea or constipation?
user: No, nothing like that. 

assistant: Alright, any skin rashes? 

user: Nope. 

assistant: Any joint pains or or muscle pains?
user: No. 

assistant: Any weakness?
user: Not weakness, I'll just say more fatigue. 

assistant: Alright so I know you told me a COPD, but do you have any other medical diagnosis?
user: Yeah, I have high blood pressure as well. 

assistant: Alright. 

user: I think I have high cholesterol too. 

assistant: I see, OK. Do you take any medications regularly?
user: Yeah, so for the cholesterol taking Rosuvastatin and I forget what I'm taking for the blood pressure, but it's pretty well under control. 

assistant: OK, do you use any inhalers for COPD? 

user: I used to. I used to have I think like 3 different inhalers but haven't had to use them for more than 10 years now. 

assistant: OK, and what was the reason for not needing them anymore?
user: I just didn't have any symptoms for a pretty long time and my doc said like if I don't really need them then I could just stop. 

assistant: OK, and have you had any recent hospitalizations?
user: No. 

assistant: Any allergies to medications? 

user: Nope. 

assistant: Any surgeries that you had in the past?
user: No surgeries. 

assistant: OK, And are your vaccinations up to date?
user: Yup. 

assistant: OK, and could you tell me a little bit about your social situation or living situation?
user: Yeah, so currently I'm just living by myself in an apartment. I've been there for more than 10 years now. Um, I am retired so I'm not working anymore. But yeah, that's that's me. 

assistant: OK, great um. What did you do previously for for work? Did you have any exposures for two chemicals or dusts or asbestos? Things like of that nature?
user: Oh yes, I worked in the steel factory for most of my working life. I think yeah, there might have been some exposures to chemicals and dust particles. Asbestos I don't think there was exposure, but definitely I may have lived in places that had asbestos. I mean, yeah. 

assistant: OK, how long have you been living where you you've been now? 

user: So this this is like the one I'm living in is a new place, but before that, I lived in another apartment for around five years and that was a pretty old building. 

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

assistant: OK um. And do you smoke cigarettes? 

user: Yeah, I smoke, I'd say around 20 cigarettes a day right now. 

assistant: Alright, and did you smoke more previously?
user: Yeah, I think I've been smoking for almost like 40 years now and I used to smoke up to 30 cigarettes a day. 

assistant: OK, do you smoke cannabis?
user: No. 

assistant: Alright. Do you drink alcohol? 

user: Um just maybe a couple times a month. Nothing, nothing throughout the week. 

assistant: OK, so do you use any recreational drugs like IV drugs or opioids or cocaine?
user: No, nothing like that. 

assistant: Alright. And anybody in the family have any similar symptoms before like coughing up blood or? 

user: No. Not that I know of. My father passed away from a heart attack when he was in his 60s. And I think my mother had a, um like I think one of the like, an arthritis. But yeah, like, but I think that was just like the one that you get with old age. 

assistant: OK, like osteoarthritis?
user: Yeah that that was the one. 

assistant: OK. Any cancers in the family? 

user: Um, not that, one of my uncles had like um bladder cancer, but that's that's that's about it. 

assistant: OK, and have you have you traveled anywhere recently or been around any sick contacts? Possibly people anybody who's had tuberculosis or any infections?
user: No, I've been pretty much to myself over the last few months, so not really. 

assistant: OK um. Was there anything that you're worried that this could be? 

user: Um Yeah, just the blood I kind of got scared maybe I thought like you know what if it's a cancer? One of my friends had lung cancer and I I know I've been smoking for most of my life, so that's something I was worried about. 

assistant: Um, I can certainly see that the concern and I understand where you're coming from. I think it would be very reasonable to investigate that today. So we'll start with a chest CT along with some lab work and we will get a CBC and some electrolytes, also get an ECG as well to just check your heart and we will see what what the investigations show
user: Sounds good. 

assistant: OK, and um, other things that um to think about this could be, uh, also like to COPD I know it's been going on a long time, but possibly could have a pneumonia that's been lingering on, particularly if it's a fungal type of infection and as well as things like you mentioned you possibly unsure if you've had an asbestos exposure in the past and stuff like that can possibly lead to scarring of the lung, and so all of these factors will be looked into. 

user: OK, sounds good. Thank you so much. 

assistant: Alright, you're welcome, thank you.
user: Hi I'm coming in because I've had this like on and off runny nose and stuffy nose for the past week. Um and I just came to make sure it's not something serious like Covid. 

assistant: OK, yeah no I completely understand why you might be worried um with everything going on. So just to get an idea of the timeline, so when did this start? 

user: So it started about I'd say, seven days ago. 

assistant: Seven days ago, OK. And was it just a runny nose that started or did you have any other symptoms?
user: So at first I felt kind of stuffy um and then now it's more runny. Um and no other symptoms. 

assistant: And are you coughing at all? 

user: No. 

assistant: Are you bringing up any discharge from like your nose, or are you coughing any material up?
user: No, no. I mean there's some discharge from my nose, like it's runny, but it's it's not yellow or anything, it's clear. 

assistant: OK, and do you think this issue has gone worse over the last seven days or is it improving at all? 

user: Um I don't think it's improving. It's changed 'cause it used to be stuffy, now it's more of a runny nose. Um but yeah, it seems to be runny, like it's the same amount of runniness for the past couple of days. 

assistant: And are you having any symptoms of loss of smell at all?
user: No, no loss of smell. 

assistant: How about loss of taste? 

user: No. 

assistant: Um were you uh with anyone around you sick at all before those seven days?
user: Uh I don't think so, I visited my sister and she has a nephew who goes to daycare, but my nephew's been OK, no, no runny nose or stuffy nose. 

assistant: Uhm, and is it just a constant issue that goes on throughout the day or is it worse at night, during the day, how would you describe it? 

user: Um it's it's pretty constant throughout the day. It's just it just feels bad at night because it um makes it hard for me to fall asleep. 

assistant: OK, uh have you tried any medications at all over the counter that would help?
user: Um I tried some antihistamines because I do have seasonal allergies. Uh but they don't seem to be helping. 

assistant: Um any anything that makes your symptoms worse at all, like any exertion or any kind of uh position? 

user: No. 

assistant: Um do you have any shortness of breath or chest pain at all?
user: Uh no. 

assistant: Any sore throat or muscle aches?
user: No. 

assistant: Any uh headaches?
user: Nope. 

assistant: Have you traveled at all recently?
user: No. 

assistant: Have you had any nausea or vomiting?
user: Uh no. 

assistant: Any fevers or chills? 

user: No. 

assistant: Any night sweats or fatigue?
user: No. 

assistant: OK. Um any kind of sensation that your heart is racing? 

user: Uh no, nothing like that. 

assistant: Any changes in your bowel movements like any constipation or diarrhea?
user: No. 

assistant: Any changes in your urinary pattern?
user: No. 

assistant: Uh any issues with your sleep or appetite?
user: No. 

assistant: Have you lost any weight, significant weight, uh recently in the last few months?
user: No. 

assistant: And uh do you have any exposure to like fumes, dust, or like uh carpet, pets, or animals? Anything that you might have an allergic reaction to? 

user: Uh no nothing like that. 

assistant: OK and currently are you sexually active?
user: I am. 

assistant: And um can you just tell me a little a little bit of a detail like about like a partner? Uh and if you've had any new partners recently at all?
user: No, I've been with the same partner for the past five years. 

assistant: OK, and uh do you have any history of any STI's?
user: No. 

assistant: OK nice, um, in terms of your uh past medical history, do you have any um diagnoses or anything any medical conditions at all? 

user: Uhm no, no nothing, nothing long standing. 

assistant: Um anything you take medications for?
user: No. 

assistant: Are you allergic to any medications?
user: Uh not medications. 

assistant: Uh any environmental allergies?
user: Just yeah, some seasonal allergies. 

assistant: OK. Any previous hospitalizations or surgeries? 

user: Um I was hospitalized for um Like an appendectomy when I was younger. Um but that's about it. 

assistant: And when was that?
user: That was when I was 18. 

assistant: And any complications after that? 

user: No. 

assistant: And uh in terms of your family history, does anyone have any lung conditions, heart conditions, or any cancers?
user: Uh nope, nothing like that. 

assistant: And currently uh do you work? 

user: I do. I work from home though. 

assistant: OK. And how would you describe your living situation right now?
user: Um I live in an apartment with um my partner and we have a dog. 

assistant: Um and currently, uh do you smoke at all?
user: Uh no. 

assistant: Do you use any recreational drugs like marijuana?
user: No. 

assistant: How about uh any alcohol?
user: Uh I drink like a glass of wine every other day. 

assistant: OK. Um yeah, so those were some of the questions I had for you. I know it's a bit concerning because of the pandemic going on and um a runny nose can be a symptom uh of Covid as well, but uh it can also be a symptom of just the common cold or any other virus. Um but since you're having, uh you're symptomatic right now, we will definitely get like a Covid swab test done for you. 

user: OK. 

assistant: And if you start having any, just monitor for your symptoms. Um you should have the test back within 48 hours. Until then, uh at least for 14 days you should try to isolate in your own room, wear a mask around uh your partner, uh and not go outside, so just self isolate.
user: OK. 

assistant: And and then you will get the test results back in a, hopefully in a few days. So do you have any questions at all? 

user: Uh no, thank you, that was good. 

assistant: Take care, bye
user: Sure, you know I've been feeling a little hot for the past two days. I've had this awful cough and I just feel so tired. 

assistant: OK and, this started two days ago? 

user: Ah yes, two days ago. 

assistant: OK. Yeah, you've been feeling hot, have you checked your temperature?
user: Um no, I haven't actually checked my temperature, I just kind of put my hand on my forehead and I just feel really, really hot. 

assistant: OK, so we'll we'll check it right now and. OK, so we're seeing that it's your temperature is elevated at 38.3 right now, so it does sound like you you have a fever. OK, and you mentioned that you had you have a cough? 

user: Yeah, I do. It's it's a dry cough and it's awful. I've been hacking for the past two days. 

assistant: Oh no, that doesn't sound very nice. Has it been any blood or any sputum?
user: No blood and no definitely no sputum. OK. 

assistant: Anything that's like triggered the cough?
user: Um I don't, I don't think so. Um, No, I don't think so. 

assistant: No. OK, have you had a cough like this before? 

user: Maybe like 10 years ago when I had some sort of viral infection, they said um. I had a dry cough, but nothing to this extent. 

assistant: OK, um have you had any infections recently, like in the last month or so, like a viral illness? Um, like where you had maybe like a runny nose sore throat and and a cough?
user: No, no not not recently. 

assistant: OK, so you've been feeling well recently?
user: Yeah. 

assistant: OK, and you've you been fatigued. Can you tell me a little bit about about how you been feeling?
user: Ah yeah, like you mean in terms of my fever or cough? 

assistant: Oh sorry I mean in terms of your energy. 

user: Oh my energy yeah, I've just been feeling so tired, it seems like I can't do normally would be. I would normally have no issues doing. 

assistant: I see OK, and any changes to sleep or any kind of stressful events happen in the last few days that, might be causing you to be more tired.
user: I don't think so. Nothing, nothing big has happened in my life. No big changes. 

assistant: OK um. And so you've had a fever, cough, and being tired. Have you experienced any other symptoms these last few days?
user: Um yep, fever, cough, fatigue. But um I don't have anything any other symptoms besides those. 

assistant: OK, so you you do you have any headaches? 

user: Oh headaches? No, no. 

assistant: OK, how about any eye or or ear symptoms like discharge or pain?
user: No, nothing like that. 

assistant: OK, have you had a loss of taste or a loss of smell? 

user: No. 

assistant: Alright, and have you had a runny nose or sore throat?
user: Nope, no chest pain. 

assistant: And how about difficulty breathing or shortness of breath? 

user: Nope, no. 

assistant: OK, and any wheezing or whistling noises while you're breathing?
user: No. 

assistant: OK, and have you felt like your heart's racing at all? 

user: Ah no. 

assistant: Have you had any like fainting spells or feeling as though you might pass out?
user: Um nope, no. 

assistant: Alright, and how about any dizziness? 

user: Oh no no dizziness either. 

assistant: Alright and have you had any nausea or vomiting?
user: No. 

assistant: Alright, and how about any diarrhea or constipation?
user: No. 

assistant: Alright, um any abdominal pain? 

user: No. 

assistant: And any like, painful urination or or like going to the bathroom frequently?
user: No. 

assistant: Alright. Any night sweats 

user: No. 

assistant: And how about any chills or rigors?
user: No. 

assistant: Have you had any weight loss over the last several months?
user: None. 

assistant: Alright, have you noticed any rashes or skin changes over this past week? 

user: No. 

assistant: Alright, and how about any muscle aches or or joint pains?
user: Um no. 

assistant: Alright, so is there any reason that you see a physician regularly for, or been diagnosed with any medical conditions? 

user: Mmm, I have rheumatoid arthritis. 

assistant: OK, uh, are you taking medications for that?
user: Um, yeah, you know they put me on some sort of DMARD. 

assistant: OK, so you're you're seeing a rheumatologist for that? 

user: Mmm, I am. 

assistant: OK, great um, any other diagnoses?
user: No. 

assistant: OK, and so uh. Are there any other medications that you that you take, either over the counter or prescription besides the DMARD?
user: I take iron and vitamin D, as well as biotin. 

assistant: OK, uh, what's the reason for taking iron? 

user: Uhh at one point or another they said my iron levels were low, but it went back to being normal, but I just take it now to maintain those levels. 

assistant: OK, um do you have like heavy menstrual periods?
user: No. 

assistant: OK, and have you noticed any blood in the stool, either either being red or or your stool being really dark, kind of like a black colour? 

user: Nope. 

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

assistant: Alright, uh, and then. Can you tell me a little bit about your living situation?
user: I live with two of my children. They are five and three, as well as my new boyfriend. 

assistant: OK, great and for either of your pregnancies, were there any complications?
user: No. 

assistant: OK, great um and are there any concerns for safety in the home?
user: No. 

assistant: OK, excellent. And what do you do for work? 

user: I work as a secretary for an accounting firm. 

assistant: OK, that sounds like a great job. And. Uh, do you smoke cigarettes?
user: I used to. I quit five years ago. 

assistant: Alright, and do you smoke marijuana? 

user: No. 

assistant: OK, and do you use any other recreational drugs?
user: No. 

assistant: OK um. And. Has anybody in the house been sick? Either your boyfriend or or your children?
user: No. 

assistant: OK, are they going to like daycare right now or in school? 

user: They are in daycare, yeah. 

assistant: OK. Um, any kids in their daycare that have been sick?
user: No. I checked no one's been sick. 

assistant: Alright, excellent is that anybody in the office where you work been sick?
user: No. 

assistant: And have you traveled anywhere? 

user: No. 

assistant: OK, and then anybody in the family have a heart condition or or lung condition?
user: No. 

assistant: OK, no. An any cancer that that's runs in the family?
user: Um, one of my aunts had pancreatic cancer. 

assistant: OK, any relatives have breast cancer?
user: No. 

assistant: How about any relatives with ovarian or colon cancer?
user: No. 

assistant: OK. And so I think that was all of the questions that I wanted to ask. Actually I just remembered one. Have you had any prior surgeries? 

user: No. No priors. 

assistant: OK, sorry, so that was the last question that I wanted to ask about on on history um was there anything that you wanted to tell me that I maybe I didn't ask about?
user: No, I think you covered it all. 

assistant: OK, excellent, so with your symptoms of having a kind of a fever, cough, and being tired, definitely concerned of viral infection and possibly COVID-19 or something more common, like the common cold, like an adenovirus. And so will do some testing for for COVID-19 with a nasal PCR swab as well as run some blood work. Um because there is a possibility that there's a bacterial infection, such as like a pneumonia or lower respiratory tract infection that would be treated with antibiotics so. We uh yeah, we'll order those investigations along with a chest X Ray. And we will go from there. 

user: OK, that sounds great. Thank you so much. 

assistant: You're welcome.
user: My child has been having a sore throat and chills yesterday as well. 

assistant: OK, so you mentioned the sore throat started three to four days ago and the chills started yesterday. And is he having any issues swallowing food or fluids?
user: Yeah, it seems like appetite's gone down, like a lot of pain in his throat, especially when swallowing solid foods. 

assistant: Have you taken a look into his throat? Is it red? Do you see any yellow streaking white stuff, anything like that? 

user: I definitely did take a look yesterday and definitely saw a lot of redness. I don't know if I saw any white or yellow streaks, but definitely looks very red in there. 

assistant: OK, do his tonsils look enlarged?
user: Uh, everything looks swollen in there, I don't know what's what, but it does look very angry in there. 

assistant: OK, OK. And has he had a stuffy nose or runny nose? 

user: No, not really, no. 

assistant: Any loss of taste or smell?
user: No, nothing like that. 

assistant: OK, how about changes in vision or hearing? Any changes in her nails or skin like rashes?
user: No, no rashes. 

assistant: OK. Have you taken his temperature at home? 

user: No, I think he might have had a fever yesterday, but we didn't really take a temperature. 

assistant: OK. And, any fatigue or exhaustion?
user: Energy's pretty much the same, just really complaining a lot about the throat. 

assistant: OK, OK, have you noticed any swelling in in the neck area?
user: Uhm, I think there might be like a few lumps near his neck, so I don't know if that's swelling, but definitely there is. There's a few that I felt over the last few days. 

assistant: OK, coughing? 

user: No, hasn't been coughing at all 

assistant: OK, um, and how about shortness of breath or wheezing?
user: No, nothing like that. 

assistant: Chest pain?
user: No. 

assistant: Feeling like his heart is racing?
user: No. 

assistant: Swelling in his limbs? 

user: No. I haven't noticed anything like that. 

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

assistant: Headaches? 

user: He was complaining of a headache a few days ago, but it kind of went away on its own. 

assistant: OK. So the headache's gone completely now.
user: Yeah, yeah. 

assistant: OK. Have any confusion or memory loss?
user: No, not that I know. 

assistant: Joint pain or muscle aches?
user: No. 

assistant: OK, how about his bowel movements? Have those been normal?  P Yeah, they've been normal. No diarrhea or constipation.  OK, how about in nausea or vomiting? 

user: No, no, he hasn't told me anything about that. 

assistant: Any appetite changes?
user: Yeah, just with the trouble swallowing I'm trying to make sure that he gets like liquids because over the last few days he can't tolerate like solid foods at all. 

assistant: Yeah, how about a weight loss over the past few weeks? 

user: No, not really. t's just been over the last few days that he hasn't been eating like himself. 

assistant: OK. Alright and has he been healthy otherwise?
user: Yeah, otherwise he's a very healthy child. We have rarely gone to a doctor for him before, so yeah, nothing. Nothing else with him. 

assistant: OK, have you tried anything for his sore throat? Anything over the counter?
user: We did try, uh, like Tylenol cold. It helped with this headache, but it didn't really help with his sore throat 

assistant: OK, and has he ever experienced anything like this in the past? 

user: No, not that I know of. 

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

assistant: Any medications that he's on?
user: No, no medication. 

assistant: OK, is he up to date with all his immunizations?
user: Yeah, all his immunizations are up to date. 

assistant: OK, any allergies?
user: No, not that I know. 

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

user: No, no lung or heart conditions. His father does have diabetes though. 

assistant: OK, how old was he when he was diagnosed with diabetes?
user: I think probably in his late 30s with type 2 diabetes. 

assistant: Type 2, OK and then any sick contacts recently that he may have had?
user: I don't think at home at least, uh, but maybe at school, like you never know who they are in contact with, so I'm wondering if he just picked it up somewhere from school. 

assistant: OK.
user: Yeah, yeah, they're all wearing masks right now, but I don't know if he picked something something up from his classmates. 

assistant: Yeah for sure. OK, and then any travel to anywhere recently?
user: No, we've been at home, haven't left even to go to like a different city, have been in London the whole time. 

assistant: OK, yeah, and who does he live with at home? 

user: So he lives with myself and his dad. 

assistant: Any siblings?
user: No, he's an only child. 

assistant: OK, any reason to believe you have old carpets, mold, asbestos, anything that could be triggering his symptoms?
user: You know we don't have any pets. We don't have any like old carpets, it's a fairly new apartment, so I don't think any of that should be an issue. 

assistant: Okay, well, I think those are all the questions that I had for him. Anything that you wanted to add or anything that I missed today? 

user: Uh, no, I think those are everything I wanted to talk about but I just was wondering if he needs to get tested or like if there's anything we can do today for him. 

assistant: Yeah, so he does seem to be checking off some of the criteria for strep throat. So just to make sure, because he does have a score of right now at least three or four, or maybe even five, definitely over four, we can prescribe him some antibiotics. But we will do a rapid strep test first in the clinic here today just to rule out in or rule that out. If it comes back positive and I guess even if it isn't positive because he checked off a lot of the boxes for strep throat, we will give him a prescription for penicillin or amoxicillin for 10 days. And then you can take that if his symptoms don't go away in a day or two. Because his symptoms also overlap with COVID, we will. do a swab for that as well and you should hear back within 24 to 48 hours and then you should isolate for 14 days. Does that sound good?
user: So yeah I've been having for the last two days, uh, it just started randomly. I had to miss work, Just a headache started at the beginning and then I noticed the same day, so this was two days ago. A headache started and my body just started aching throughout the day and yesterday I just developed, I think it was a fever, I didn't really get a chance to check, like, but I was very chilly yesterday and now I have this cough as well. 

assistant: OK, so just to confirm, so the, the symptoms at first started with a headache and, and fatigue, and that started two days ago? 

user: Yeah, like with fatigue, like also just the, my muscles were aching. 

assistant: OK, and any particular muscles that were achy or is this more of a, uhm, general kind of whole body feeling?
user: Just a general whole body feeling. 

assistant: OK. Uh, and in terms of the headache, could you describe, uhm, could you describe the headache?
user: Yes, it's just kind of like at the front like near my forehead, on, on kind of like both sides more. It just feels like, like pressure in there. 

assistant: OK, have you had headaches like this before? 

user: Uh, no, not really. 

assistant: OK. Uhm, is the headache on one side or, or the other or on both sides?
user: I think it's like both sides. 

assistant: And is the headache like pulsating or is it more, continuous kind of constant pain? 

user: I think it's more continuous constant. 

assistant: Alright, and have you had any sensitivity to light or sound that, that's made the headache a lot worse?
user: No, it's, it's kind of just there, it's about the same as when it was when it started. 

assistant: OK, have you had any nausea and vomiting associated with that, the headache or anything else? 

user: Uh, no. 

assistant: OK. And so, and then, last question for the headache piece. Does it feel like it was a like kind of sudden onset, worst headache of your life sensation?
user: Uh, no, it's still like, like I can still cope with it, like, if I wanted to I would have gone into work. But it was the muscle aches that really started bothering me. 

assistant: OK. And so you had a cough as well, when did this start, and is it a dry or wet cough? 

user: It's a dry cough and it started yesterday, probably in the morning when I woke up. 

assistant: OK, and has the cough been getting any better or worse?
user: Uhm, since yesterday I would sayit's probably a bit worse now. 

assistant: Alright, and it's dry, but have you seen any blood that's come up? 

user: No, no, no blood. 

assistant: And have you had any shortness of breath?
user: No. 

assistant: OK. And have you had any flu like symptoms or infectious symptoms like a red eyes, runny eyes, runny nose, or a sore throat?
user: No, I don't have any of those symptoms. 

assistant: OK, you mentioned you felt feverish. Do you feel hot now?
user: Not right now, but I did have, last night just, was just very chilly and Uh, I had to just wrap myself up in a couple blankets. 

assistant: OK. Did you have any night sweats? 

user: No, I, I didn't have any night sweats. 

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

assistant: Alright, so how about any dizziness or lightheadedness? 

user: Nope. 

assistant: OK. And have you had any wheeze?
user: No wheezing. 

assistant: OK. Uhm, and have you noticed any swelling to any of your extremities? Like your ankles? 

user: Uh, no. Nope. 

assistant: OK. And have you had any belly pain?
user: No belly pain. 

assistant: Any urinary problems like pain or, or frequency going to the bathroom? 

user: No. 

assistant: And any diarrhea?
user: No diarrhea. 

assistant: Alright, and have you noticed any rashes or, or changes to your skin?
user: No, not at all. 

assistant: Alright, and I don't know, you've had muscle aches, have you had any joint pains? 

user: Uh, no, no musc, sorry no joint pain. It's mainly just like in, I would say in around my upper back like my upper arms and kind of like my thighs and glutes areas 

assistant: OK. And how has your energy been these last couple of days?
user: Yesterday I felt a bit drained. I just kind of like stayed in bed the whole day. 

assistant: OK, and have you tried any medications for the, for the headache or any of your symptoms so far? 

user: I, I took a Tylenol. I actually took a couple Tylenols, uh, when the headache and pain started. It did help a bit for a couple hours, but it just kind of came back. 

assistant: OK. And in the past, have you been diagnosed with any medical conditions?
user: Uhm, Just uh, like I had type 2 diabetes, that's it. 

assistant: OK, and are you using medications for your diabetes? 

user: Yeah, I've been on Metformin. 

assistant: OK, have you used insulin before?
user: No, no, I've never had to use insulin. It's pretty stable, like my family doctors even considering taking me off the metformin. 

assistant: OK, no, that's great. And that reminds me, actually, how has your weight been over the last several months? Have you had any weight changes?
user: Not really, like I, I, I think over the last two years I've just been very focused on my fitness, so I feel like I've probably lost around 30 pounds over the last year. Last one to two, yeah, year, but like I, I've been exercising a lot like uhm, gym every day, it's, it's been, it's been a journey. 

assistant: no that's great though, good for you. I encourage you to keep that up for sure. OK, and so do you take any other medications, other, over the counter or prescribed? 

user: Uhm, just a multi vitamins. 

assistant: Alright, and do you have any allergies to medications?
user: No, not that I know of. 

assistant: All right. So have you had any hospitalizations or surgeries? 

user: No. 

assistant: Alright, and uh, anybody in the family have any like lung conditions, heart conditions or diseases that run in the family?
user: Uh, my, my son actually just recently was diagnosed with asthma. But I think that he gets that from his mom's side. 

assistant: OK. Uhm, you don't have any asthma or problems breathing like that?
user: No, nothing like that. 

assistant: OK, and right now, so you mentioned your son and wife, is that who you're living with? 

user: Yeah, it's just us three. 

assistant: OK, and uh, any exposures to, to anybody who's been sick, either at home or at work or, or any other activities?
user: Uh, unfortunately I do have to, uh, I'm one of the unlucky ones that still has to go into work. And yeah, it's it's hard to say like at work, there are times when we, like at lunch we eat like without a mask. I don't know if, I didn't notice anyone having any symptoms, but like, I don't know if someone, you know, who knows where anyone has been. 

assistant: Yeah, so nobody that you're aware of who's been sick though?
user: No. 

assistant: And everybody at home has been OK? 

user: Yeah, at home everyone's good. I kind of just distance myself into like one room. 

assistant: Mhm.
user: Just in case anything goes wrong. 

assistant: OK. And have you traveled anywhere?
user: No, we've been, we've been at home this whole time. 

assistant: OK. And do you smoke cigarettes?
user: No, I've never smoked. 

assistant: OK, so do you, do you smoke marijuana?
user: No. 

assistant: Alright and you use any other recreational drugs like cocaine, opioids, heroin? And how, have you used anything like that in the past?
user: No. Never. 

assistant: OK, uhm, and do you drink alcohol?
user: Yeah, well just occasionally, like I would say maybe, maybe some wine, once, uh, like once every couple days. Maybe a beer on the weekend, but that's it. 

assistant: Alright. So I think that was all I wanted to ask on history today. Was there anything else that, that you wanted to add before we go on to the exam and? 

user: Yeah, so I, I, I don't know if I should get a test done, like for covid. Uhm yeah, that's all, just wondering if I, if I can do that here? 

assistant: Yeah, so that is something that that is on the differential for what could be causing your symptoms, especially with uhm, starting at having a cough and the nonspecific viral type symptoms with the cough, headache, muscle aches, so certainly could be caused by covid, but there are other reasons for, that could explain these symptoms, such as other types of viral illnesses, and so we will do a PCR swab today, as well as do, well, check your vitals to see if you have a fever now and we'll also maybe send an influenza swab as well, and and do some blood work. But in the meantime, since we're running the covid swab, it will be important to self isolate for the next 14 days and we will let you know what the test results show. But despite, even if they are negative, it will be important to still stay self isolating for the next 14 days.
user: I just came in because of I just got into like this uh, incident while I was playing rugby. I kind of got tackled and then fell onto my right shoulder. Um, and after I got up, I haven't, I've just been, this just happened a couple hours ago actually and uh, I've just been in intense pain in my right shoulder and I can't seem to move it at all. 

assistant: Okay, um, and sorry, when was this exactly? 

user: Uh, probably 2 hours ago. 

assistant: 2 hours ago, okay. Um, and is this pain persistent or is it like on and off?
user: It's, it's constant. It hasn't gone away at all. 

assistant: Okay. 1 to 10, 10 being the worst. How bad is this pain? 

user: I don't know, like probably like 8 or, 8 or 9. 

assistant: 8 or 9, okay. Um, and is it a sharp kind of pain or is it dull and aching?
user: It's, it's sharp. Like if I try to move it at all, it's like a sharp pain. 

assistant: Okay, um, and have you ever had anything like this in the past?
user: Uh, no, never. 

assistant: Never, okay. And are you able to move your arm at all or you can't move it?
user: I could move my fingers and hand and elbow, but um, elbow a little bit, but like uh, yeah, I can't move my shoulder whatsoever. 

assistant: Okay, um, and do you, are you experiencing any tingling or numbness?
user: Um, no, I don't think so. 

assistant: No, okay. Uh, how about any muscle weakness? 

user: Um, in that area, I don't know if it's weakness or pain, but I just can't move it up and I, I, I do feel some like numbness just above my shoulder. No tingling though. 

assistant: Okay, any pain elsewhere in your body?
user: No. 

assistant: No, okay. Any headaches? 

user: Um, no. 

assistant: Confusion or memory loss?
user: Uh, no. 

assistant: Uh, weight loss? 

user: Uh, no. 

assistant: Fevers or chills?
user: No. 

assistant: Rashes?
user: Um, no. 

assistant: Uh, changes in your vision, hearing, smell or taste? 

user: Uh, no. 

assistant: Um, coughing, shortness of breath or wheezing?
user: Um, no. 

assistant: Chest pain or heart palpitations? 

user: No. 

assistant: Changes in your bowel movements?
user: No. 

assistant: Changes in voiding? 

user: No. 

assistant: Um, okay. And then with regards to this pain, does anything make it better or worse?
user: Um, um not anything that I've tried that's made it better. Worse is probably just if I try to move it at all. 

assistant: Okay, and the pains in your shoulder, does it radiate down or up elsewhere?
user: Uh, mostly towards my shoulder, um, kind of down towards my upper arm as well. 

assistant: Okay, I see. Um, alright, and um, are you otherwise healthy? Do you have any other medical conditions? 

user: No. Yeah, otherwise I'm healthy. I've never been to the doctor much. 

assistant: Okay, alright. Um, and are you on any medications?
user: No. 

assistant: No, okay. And um, are you up-to-date with your immunizations? 

user: Yes. 

assistant: Okay, and do you have any allergies?
user: Uh, no. 

assistant: Any family history of musculoskeletal diseases? 

user: No, not that I know of. 

assistant: Okay. Uh, and any family history of autoimmune conditions?
user: Um, no. 

assistant: Okay. Um, do you smoke at all?
user: Uh, no. 

assistant: Uh, do you drink alcohol? 

user: Uh no, just, just with friends sometimes on the weekends, but not really. 

assistant: Okay. Um, and then, where do you live right now and who do you live with?
user: Uh, I live just outside of town with my parents in a house. 

assistant: Okay. And um, have you traveled anywhere recently? 

user: Um, no, I've been at home. 

assistant: Okay, any sick contacts?
user: No. 

assistant: No, okay. So now we're just going to move on to um, the physical exam part of this. So can you take a look at both your shoulders and let me know if you see any redness or swelling?
user: Um, I don't think I see any redness or swelling, but um, my right shoulder and my arm just seems a little bit lower than my left one. 

assistant: Okay, okay, any um, warmth on, on that shoulder?
user: Uh, no, not that I can feel. 

assistant: Okay, any atrophy, deformities, or skin changes?
user: Um, deformity, I, I do feel like kind of uh, like my shoulder's dropped and like there's just kind of this uh, little, like divots, where like the shoulder should be. 

assistant: Okay, okay. And can you palpate that area for me? Just um, the bones in that area, so like right where your arm would connect to your shoulder and then kind of on your shoulder blade. Does that hurt when you press down? 

user: Yeah, it hurts a lot. 

assistant: Okay, so some tenderness and pain in the acromion process and scapula. Um, and if you press down on your biceps, triceps, does that hurt?
user: Not as much, no. 

assistant: No, okay. And then can I get you to um, can you lift your shoulder up at all? Like to where, to the point where your fingers are touch, like reaching the ceiling?
user: No, I, I can't. I can't move it at all. 

assistant: Alright, so um, it sounds like you have a shoulder dislocation. Um, so we are going to do an x-ray of your shoulder joint first to make sure that it's, it's just a dislocation and there aren't any broken bones or fractures. And then um, we can resolve this by doing something called a closed reduction, um, to try to put the joint back in its place. 

user: Okay. 

assistant: Um, and if that closed reduction doesn't work, then uh, you may need surgery for like a, um, a weak shoulder joint, or if like ligaments um, aren't like, strong enough and it's it continues to happen.
user: Hi there, umm, so I've had this runny nose for the past five days and it doesn't seem to be going away so I thought I should get some help. 

assistant: OK, and ah, with the runny nose, could you describe the discharge?
user: Yeah, it's, it's pretty clear. 

assistant: OK, and have you had any nasal obstruction or feeling as though like one of your nostrils is plugged when you're breathing in? 

user: Uh yeah, I have that feeling. 

assistant: OK, have you had any pain on your face?
user: Pain? Ah no, nothing like that. 

assistant: OK, how about a change to your sense of smell? Like loss of smell?
user: No, I haven't had that. 

assistant: OK. Have you had any discharge from your eyes or eye redness or any eye pain?
user: No. 

assistant: Alright, have you had a sore throat? 

user: Uhm, no sore throat. 

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

assistant: OK. Have you had any headaches?
user: Ah, just a slight headache. 

assistant: OK, I mean, have you experienced headaches like this in the past? 

user: Yeah, usually when I get sick, I get get a headache. 

assistant: OK. OK, can you describe where you feel the headache the most and is it pulsating or kind of always there?
user: It's kind of always there and it's just on the sides of my head. 

assistant: OK, have you tried anything for it? 

user: Just some Tylenol, which seems to have helped. 

assistant: OK. Uhm, and umm, yeah, have you had a cough?
user: Ah no cough like now, uhm, I I did have a slight cough last week. 

assistant: OK, and it went away? 

user: Mhmm. 

assistant: Was it dry or did you were bringing up any sputum or phlegm?
user: No, it's pretty dry. 

assistant: OK. Uhm, and do you have a sore throat?
user: No. 

assistant: OK, and have you had any wheezing or shortness of breath? 

user: No. 

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

assistant: How about any we, sorry, fainting or dizziness?
user: No, nothing like that. 

assistant: OK, have you had any heart palpitations or feeling like your heart's racing? 

user: No. 

assistant: OK, uhm, and have you had any abdominal pain?
user: Uhm, I have had some, like diarrhea so I think part like my stomach hurt a little bit during that time, but I don't have that anymore. 

assistant: OK, when did you have diarrhea?
user: Last week as well. 

assistant: OK. Uh, was there any blood in the stool?
user: No. 

assistant: OK, have you had any changes to your urinary habits? Like any pain or frequency? 

user: No. 

assistant: Alright, and have you had any nausea or vomiting?
user: Uh, no. 

assistant: Have you had any night sweats? 

user: Uh, no, nothing like that. 

assistant: I see, OK. And have you had any weight loss recently?
user: No. 

assistant: Alright, have you had any rashes or skin rashes? 

user: No. 

assistant: And how about any muscle aches or or body pains?
user: Oh, no. 

assistant: Alright and how has your energy been? Have you had fatigue?
user: Uhm, a little bit. 

assistant: OK, little fatigue and and how has your appetite been? 

user: Appetite's been OK, I'm still eating. 

assistant: Alright. And, uhm have you been diagnosed with any medical conditions before?
user: Uh, no, I've been pretty healthy. 

assistant: OK, great and so do you take any medications regularly, either over the counter or prescribed?
user: No. 

assistant: OK, and do you have any allergies?
user: No, I don't. 

assistant: OK, and any recent hospitalizations in the past or any prior surgeries? 

user: Uh, no. Actually, I had my appendix taken out when I was younger, but that was a long time ago. 

assistant: OK, I see. And are you living, ah, can you tell me about where you're living now and who you're living with?
user: I'm I'm living by myself. I'm a student. I live in an apartment. 

assistant: OK, and are you going to classes in person right now? 

user: No, they're all online. 

assistant: OK. And have, have you been around anybody who's been sick?
user: No, not that I can think of. 

assistant: OK, and have you traveled anywhere recently?
user: No. 

assistant: OK. And you smoke cigarettes? 

user: I don't. 

assistant: And do you smoke cannabis or use any cannabis products?
user: Occasionally, I will. 

assistant: OK, how often? 

user: Uhm I will maybe smoke once a week. 

assistant: OK, uh, and use any recreational drugs like cocaine or opioids?
user: Oh gosh, no. 

assistant: And do you drink alcohol?
user: Uh yeah, occasionally. 

assistant: OK, how many drinks would you say you have per week?
user: Uhm, I'll have like a bottle of wine a week. 

assistant: OK, and are there any heart or lung conditions that run in the family? 

user: No. 

assistant: OK. How about any cancers?
user: I think like colon cancer runs in the family. 

assistant: OK, umm and alright so that was everything that I think I wanted to ask about on that on the history today. I was wondering if there was anything else that you wanted to mention that I maybe forgot to ask about? 

user: No, nothing else I I I was just wondering what I could do to feel better or make this go away. 

assistant: Yeah, certainly. So, I, so it's sounds like you have the common cold or a viral illness, which it could be caused by something like adenovirus or there are others as well. However, the symptoms do overlap with COVID. As you can be like nonspecific symptoms, such as having kind of just like a runny nose like you do here, and so we will do a COVID swab and we'll await those results, but in the meantime it's mostly supportive care, so it means just trying to stay hydrated, stay rested. And just monitor your symptoms because if things do get worse, it'll be important to, uh, go to the emergency room.
user: OK. 

assistant: Alright, so we'll get the swab now and get that testing started.
user: Uh, I've had this cough. It's been going on now for like last six months or so and been losing some weight as well. I've lost, I think like 20 or 30 pounds in the last six months. 

assistant: OK, yeah, that's a lot of weight. So the weight loss, you said 20 to 30 pounds?
user: Yeah yeah. 

assistant: OK.
user: Like just over 200 and I'm in the 170s now. 

assistant: OK, so that was in the past six months. When do the cough start?
user: Well, I've had a cough before, uh, like a smokers cough. Ah, and that's been like a few couple of years, but that's just a cough that I would have in the morning and it would just go away but I mean around six months ago I started having this cough all day. 

assistant: Hm, OK. And is it a dry cough or is it a productive cough?
user: Uhm, it's been it's been dry. 

assistant: It's been dry? 

user: Yeah. 

assistant: So no blood or sputum?
user: Uh no, no blood or sputum. 

assistant: OK. And have you been feeling short of breath at all? 

user: Uhm, I have, yeah the shortness of breath has been like similarly getting a bit worse over the last, over the last six months. 

assistant: OK. Alright, and is there wheeziness as well?
user: No wheezing. 

assistant: How about chest pain? 

user: Uh, yeah, I've had this kind of like dull kind of aching pain that, that I've had kind of work just on the right side of my chest. It, yeah. It's kind of aching and not that bad, but uncomfortable. 

assistant: OK, and and is it a sharp pain or is it a dull, achy pain?
user: It's more like dull. 

assistant: OK, and is it always there or is it worse with like exertion?
user: It's always there. 

assistant: OK. Uhm, and sorry, you said it was at the centre of your chest? 

user: More kind of on the right side. 

assistant: OK, does it get worse with like deep breaths?
user: Not really, no. 

assistant: No, OK. How about when you lean forward?
user: No. 

assistant: No, OK. Uhm, and hm. Have you ever been worked up for the chest pain in the past, like to rule out heart attacks, blocked arteries, anything like that?
user: Uh, yeah actually, I had a stress test about a year ago and it the results of that were, were normal. 

assistant: OK, OK good. And do you ever feel like your heart's racing?