jshargo/medical-interview-conversations2 huggingface dataset:
user: Right now it's not that bad, probably like a two or three, but when it was, just a few days ago, it was like probably an 8 or 9. 

assistant: Yeah, and then have you ever experienced something like this before?
user: No, I'm not usually one to get headaches. My wife, she gets migraines, but like I rarely ever have headaches. 

assistant: Yeah, OK, and then you mentioned the headache is getting a little bit better now? 

user: Yeah, the headache has improved a bit, the body aches are still there and the fever is still there but like the headaches I feel have gone down. 

assistant: OK, alright. Have you had any fainting spells or dizziness?
user: No, nothing like that. 

assistant: Any confusion or memory loss?
user: No. 

assistant: Any neck pain? 

user: Uhm, not neck pain but like just below my neck, like my back, upper back hurts as well. 

assistant: OK, and, any weight loss recently?
user: Uhm, no, I don't, I don't think so. 

assistant: Any excessive fatigue? 

user: Yeah, I have been feeling pretty tired and just, uh, I haven't even gone to work this whole week, just kind of laying in bed honestly with all the pain and the fever and headaches, just yeah, it's exhausting. 

assistant: OK, any changes in your hair, nails or skin, like rashes?
user: No, nothing that I've noticed. 

assistant: How about changes in your vision or hearing? 

user: No. 

assistant: No OK, how about a stuffy nose or runny nose?
user: Uh, I do feel a bit more stuffy like today, but there's no like runny nose or anything like that, but I do feel a bit more pressure and stuffiness in my face today. 

assistant: OK, OK, how about changes in smell or taste?
user: Yeah, I think, just last night dinner, it was just kind of a funky like, different taste. I couldn't really tell, uh, everything was kind of a bit bland. Yeah, I think my taste buds are acting all weird too. 

assistant: OK, um, any coughing or shortness of breath? 

user: Uh, no, no, I haven't been coughing or no shortness of breath at all. 

assistant: OK and how about wheezing?
user: No, no wheezing? 

assistant: OK, any chest pain?
user: No. 

assistant: How about feeling like your heart's racing?
user: No, nothing like that. 

assistant: No, OK. Any swelling that you've noticed in your limbs? 

user: No. 

assistant: No, ok. Any issues with your bowel movements or urine?
user: No, nothing. 

assistant: OK, how about nausea or vomiting? 

user: uh no, no nausea or vomiting. 

assistant: OK, and those were all the questions I had about your symptoms. Are you otherwise healthy or do you have any longstanding medical conditions?
user: Yeah, I have a couple conditions that I see my family doctor for. I do have diabetes, then I have high cholesterol. I also have this thing called fatty liver but that's that's about it, and a high blood pressure. 

assistant: OK, when were you diagnosed with all of these things? 

user: Yeah, probably like, it all kind of went down in my 40s. I did gain a lot of weight at some point during my 40s and that's when all these things started happening. 

assistant: OK, so you said diabetes, high blood pressure, fatty liver, and sorry, what was the other one?
user: High cholesterol. 

assistant: High cholesterol, OK, are you on medications for all of these things? 

user: Yeah so I am on a statin medication for the cholesterol, then I'm on metformin, and then I'm on a blood pressure medication as well. I can't recall the name. Uh, so yeah, those are the medications that I'm on. 

assistant: OK. And do you take your medications regularly as prescribed?
user: Yeah, I don't miss any doses. 

assistant: OK, good. And, are you up to date with all your immunizations? 

user: Yeah, I think so. 

assistant: OK, good. Do you have any allergies?
user: No, no allergies. 

assistant: How about family history of lung conditions or heart conditions?
user: Yes, I have a pretty significant family history for heart conditions. My father passed away from a heart attack in his 50s. My mom has high blood pressure. Diabetes is also pretty big in my family as well. 

assistant: OK, well I'm sorry to hear that. Any cancers in the family?
user: No, no cancers. 

assistant: OK, do you smoke? 

user: I used to when I was in my 30s. I quit a pretty long time ago. 

assistant: OK, how much did you smoke before that?
user: I probably smoked up until I was 35, so for probably like 10 years from 25 to 35 and probably smoked a pack a day at that time. 

assistant: OK, yeah, and do you drink alcohol? 

user: I've been told like, not to for my liver, but I sometimes maybe have the rare red wine maybe once a month. 

assistant: Once a month, OK, any other recreational drugs?
user: No, no recreational drugs. 

assistant: OK, no recreational drugs, and where do you live right now? 

user: I just live with my wife in an apartment in the city, and yeah. 

assistant: OK, any old carpet, dust, mold, anything that is concerning from that standpoint?
user: Nope. 

assistant: No, and have you been in contact with anyone who's been sick recently? 

user: Not that I know of. 

assistant: Do you still go to work?
user: I just have like a desk job. I have my own room. It's not like, I don't see too many people and like, when I do I'm wearing a mask so I don't think so. 

assistant: OK.
user: I have stopped going to work though like, just in case. 

assistant: OK, good and have you traveled to anywhere recently?
user: No, we've been pretty homebound. 

assistant: Pretty homebound, OK, alright, well that's good and those are all the questions that I had for you. Did you have any questions for myself?
user: Yeah, I don't know, what do you think is causing all of this? 

assistant: Yeah, it sounds like you have some sort of infection, so the first thing we need to rule out is covid, of course. So we'll do a swab and those swabs should come back to you in about 24 to 48 hours and until then, it's important that you do isolate and you isolate for 14 days at least, and that includes from other people at home. And if those swabs come back negative, you could possibly have like, another infection. But if your symptoms worsen, like you start getting neurological deficits like weakness or seizures or anything like that, you should come back to the ER and we'll get that checked out. And, so that's where we'll start for now, because your presentation is acute, we think it's likely infection related. 

user: OK, that sounds good to me and should I be staying in my own room or anything like that at home? 

assistant: Yeah, if you can like, it's recommended that you try to isolate in your own room for the next 14 days because your symptoms do overlap with that of covid, yeah.
user: OK, sounds good.Thank you. 

assistant: Yeah, no worries, take care.
user: So I've had this ankle pain for the past day, and and it doesn't seem to be getting better. My right ankle looks swollen and it's bruised and is pretty painful so I just wanted to come here to check, check it out, see if I need any thing done to it. 

assistant: Yeah, absolutely, uh OK. So you said that this started yesterday. Was there any like trauma to the ankle or leg or did you have a fall or or some sort of injury?
user: Yeah so I play rugby and I might have, so I fell during a tackle motion type thing and I fell on that leg and my leg, my foot kind of in, pointed inwards as I fell an I kind of fell on um on my ankle kind of just above, above my lateral side of the foot, so where that bony prominence is. 

assistant: OK, I see and and your foot kind of it turned inwards when you fell?
user: Yes, that's right. 

assistant: OK, and was there pain immediately after the this incident?
user: Yes. 

assistant: OK, were you able to like walk off the field at all, or did you need to be carried? Or were you able to walk at any point after? 

user: Um so I can walk um, but. It is very painful and I'm putting a lot of weight on my left foot so it's almost like I'm hopping on my left foot. 

assistant: OK. And and is the pain. Actually, so where is the pain specifically located on your foot or ankle?
user: So it's um specifically, it's on the like lateral malleolus area. 

assistant: OK, and how would you describe the pain in terms of its character or quality, like is it sharp burning, stinging?
user: It feels sharp. 

assistant: OK, and do you feel the pain radiating anywhere else? 

user: Oh no, it's pretty much in that area just in the ankle area. 

assistant: OK, and has there been anything you've tried to make the pain better?
user: I've tried some ibuprofen and some ice that seems to help temporarily, but it doesn't help with like like it's not permanent. 

assistant: OK, and. Has there been anything that's made it worse?
user: Um just putting weight or like trying to bear any weight on that ankle has made it worse. 

assistant: OK, and what would you say the severity of the pain is on a scale of 10 to one, with 10 being the worst pain you've ever felt.
user: I would say it's like a 7 or 8. 

assistant: OK, and have you ever had a pain like this before to the ankle or ever injured your foot before? 

user: No, nothing like this. 

assistant: OK. And have you had any any headaches?
user: Uh no headaches. 

assistant: Had any fevers or chills?
user: No 

assistant: How about night sweats?
user: No. 

assistant: Have you had any unexpected weight loss? 

user: No. 

assistant: OK, and have you had any sensory changes like changes your vision, hearing or even your sense of smell or sense of taste?
user: No, nothing like that. 

assistant: OK, and have you had any neurological symptoms such as like numbness or tingling?
user: No. 

assistant: OK, now have you noticed any sensory loss over your leg or ankle? 

user: No, no, no no sensory loss. 

assistant: OK. And have you had any muscle weakness?
user: No. 

assistant: OK. and, and have you had any infectious symptoms, like having like a runny nose or feeling congested or maybe even a sore throat?
user: No. 

assistant: Alright, and have you had a cough?
user: No cough. 

assistant: How about shortness of breath? 

user: No. 

assistant: Alright, have you had any chest pain or feeling like your heart's racing?
user: No. 

assistant: Have you had any dizziness or lightheadedness?
user: No. 

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

assistant: How about any loss of appetite?
user: No. 

assistant: Have you any diarrhea, constipation, or or blood in the stool?
user: No. 

assistant: OK, and have you had any changes to urinary patterns?
user: No. 

assistant: OK, and have you had any changes to your energy recently?
user: No, no changes to my energy. 

assistant: Alright, and in the past, have you been diagnosed with any medical conditions or any reason to see a doctor regularly? 

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

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

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

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

user: I think so. I gave them the most recent ones I've received in high school. 

assistant: OK, OK that's good and have you had any surgeries before or any reasons for hospitalizations?
user: Um no I've never, yeah I've never been hospitalized. 

assistant: OK, uh and. Alright, could you tell me a little bit about your living situation right now, like who you're living with and whereabouts?
user: I live with both my parents as well as two of my siblings. They are younger. We live in a house downtown. 

assistant: OK and are you currently in school?
user: I am. I'm in grade 11. 

assistant: OK, awesome and then how's that been going so far? 

user: Going pretty well. 

assistant: OK. And have you been around anybody who's been sick recently?
user: No, no one's been sick. 

assistant: OK, and how about have you traveling anywhere? 

user: No, we haven't been doing any of that so since COVID. 

assistant: OK, and and I know sometimes people at like in high school and certainly in your age group may experience with things like smoking. Smoking tobacco or cigarettes, drinking alcohol or using marijuana. Have you used any of those, those substances?
user: No. 

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

assistant: OK, and could you tell me about your partners or or partner?
user: Um yeah, she's been my girlfriend for the past two years. And we use protection. 

assistant: OK, great. And any concerns for any sexually transmitted infection at this time?
user: No. 

assistant: OK. And in the family, has there been any history of musculoskeletal or neurological problems? 

user: Uh, no, nothing like that. 

assistant: OK, and how about any autoimmune conditions?
user: No. 

assistant: OK, and so I next wanted to move to the physical exam component and ask you to have a look at your ankles. And are you seeing any swelling or redness or discolouration?
user: So I there's a. Like there's a bruise about 4 centimeters wide and it appear swollen, but just by right ankle. 

assistant: Just your right ankle, OK. And is there any temperature changes like warmth when you touch it?
user: Uh slightly warm yeah. 

assistant: OK. And are you seeing any muscle atrophy or deformities of the of the ankle or foot. 

user: No. 

assistant: OK. Uhm and, uh if you press on areas of your of your ankle and foot, do you feel pain at the lateral malleolus or the medial malleolus?
user: Uh, there's a lot of pain on the lateral malleolus. 

assistant: OK. Um and do you feel pain if you press on the top of your foot like a? 

user: Um on the, no no pain at the top of my foot. 

assistant: OK, and how about on the like outside or lateral aspect of your foot you'll feel a kind of, it's a bony prominence that that sticks out at the base of the 5th or you're kind of last metatarsals is there any pain there?
user: No, no pain there. 

assistant: OK, and then how about any pains on that like medial side of your foot? 

user: On the medial side, no. 

assistant: OK, and then when it comes to moving the foot, are you able to point your toes on your foot up towards your face?
user: Up towards my face that's hard. 

assistant: OK, so dorsiflexion is limited. And how about pushing your foot down like you're pressing on the gas pedal?
user: I can do that, but it's still painful just to move the ankle. 

assistant: OK, so planter flexion is is painful as well. And then any issues with moving your toes? 

user: No. 

assistant: OK, and then you mentioned that with walking you're having a limp currently?
user: Yes. 

assistant: OK, so we have an antalgic gates with an inability to bear weight as well. OK, so the that was everything that I wanted to ask and check today and based on these features it is starting like it could be either an ankle fracture or an ankle sprain. But because of the pin-point tenderness or that you're finding on the lateral side as well as some of the the inability to bear weight as you're describing it'll be important to get an X-Ray to make sure that there's not a fracture. Um and yeah, and if there is then it will be important to have some sort of air boot or casting so that to make sure that we're offloading the area for the bones to heal, but we'll see what the X-Ray shows. 

user: OK, that sounds great, thank you. 

assistant: Thank you.
user: Hi, I've I've had this pain on the outside of my uh right elbow now it's it I first started knowing, noticing it several months ago, but recently it's just been more painful. 

assistant: OK, so you said several months ago. Um did anything happen several months ago? Was there any sort of trigger, trauma, anything like that to that area? 

user: No, there wasn't any any trauma or any triggers that that I noticed, I was just um feeling it, uh, a bit more at the end of of work. Um yeah, I was just having it uh, feeling the pain a bit more at the end of work. 

assistant: OK, does uh anything make it better or worse, the pain?
user: Um yeah, if I, really if I'm just resting the elbow um it makes it better, and I've tried uh things like ibuprofen um which has helped with the pain, I'll I'll do that for um hoping I can get through work sometimes if the pain is bad enough. 

assistant: Right, OK. Um and if you were to describe the quality of the pain, is it sharp, throbby, achy? 

user: Uh it's um kind of uh, well, it's achy and then sometimes depending on the movement it can get, it can be sharp as well. 

assistant: It can be sharp, OK. OK, um and what sorts of movements make it worse?
user: Um, so like, really it's mostly the movements at my wrist, if I'm bending my wrist down, uh I can I can feel it, or um if I'm having to pick things up or hold heavy objects at work, I do a lot of repetitive uh things at at work, I work on a line. 

assistant: OK, OK. And 1 to 10, 10 being the worst pain you've ever felt, how bad is this pain?
user: It is about a four. 

assistant: About a four, OK. And have you ever experienced this type of pain before? 

user: Uh, no I haven't. 

assistant: No, OK, and do you feel like your pain is getting worse over the past several months, or is it the same, getting better?
user: Uh it's been getting worse. 

assistant: It's been getting worse, OK. OK, um have you tried any like topical ointments or anything like that for it? 

user: Uh I did, I yeah, I tried some um some stuff that you can get at the um drugstore and it did help take the edge off a little bit. 

assistant: OK. Um alright and are you still able to move that arm, your right arm, um as well as your hand?
user: I am, yeah, I I have full range of motion of both the elbow and uh hand. 

assistant: OK and it's not like preventing you from doing everyday tasks? 

user: Uh, no. I I've been been able to manage so far at work, but um it is starting to become an issue um yeah, with my job. 

assistant: OK. Um alright, and then do you have any sorts of aches or pains uh in any other joint or muscle groups?
user: No, it's just right there on the outside of my right elbow, and it's really annoying 'cause I'm right handed as well, so um yeah, it's causing problems there. 

assistant: Right, um and is the pain radiating upwards or downwards?
user: Uh no, I kinda just feel it right over that that one spot. 

assistant: OK, any numbness or tingling in that arm?
user: No, no, no numbness or tingling. 

assistant: Yeah, um OK, and then how about um like your arm feeling like it's cold? 

user: No, I haven't had anything like that. 

assistant: OK, alright, um and then otherwise do you have any other symptoms?
user: Um no I, it's just been the elbow pain. 

assistant: OK, so no weight loss? 

user: No, my weights been stable over these last few months. 

assistant: OK, fevers or chills?
user: No, I haven't had any fevers or chills. 

assistant: OK, any fatigue?
user: No, my energy's been good. 

assistant: OK. How about um rashes? 

user: Uh no rashes. 

assistant: OK. Changes to your senses like vision, hearing, smell, smell or taste?
user: No changes there. 

assistant: OK any coughing, shortness of breath, or wheezing?
user: No. 

assistant: OK. Chest pain, any heart palpitations, or uh dizziness?
user: Nothing like that. 

assistant: OK, changes to your bowel movements?
user: No. 

assistant: No, no no nausea or vomiting? 

user: No, I haven't had any nausea or vomiting. 

assistant: OK. Changes to your urine?
user: No, I haven't had any urinary uh symptoms. 

assistant: OK. Memory loss or confusion?
user: No. 

assistant: OK, so if you look at that right elbow, um do you notice any redness or swelling?
user: Uh no, I don't. 

assistant: No, OK. Does it seem misaligned or like asymmetrical compared to your other elbow? 

user: No, it looks, it looks the same. 

assistant: Looks the same, OK so no um skin changes or deformities there?
user: Uh no. 

assistant: No, OK, alright and now I'm going to get you to um just palpate uh that lateral or yeah, the lateral aspect of that elbow and you let me know if you feel pain when you push, push on that. 

user: Uh there is pain at the lateral uh lateral elbow. 

assistant: How about the medial aspect?
user: No pain. 

assistant: No pain, OK, and how about when you palpate your um forearm and your biceps?
user: Uh no no pain. 

assistant: OK, alright and then do you feel like it's hot, that area?
user: No. 

assistant: No, OK now I am going to get you to um extend your wrist. 

user: OK. 

assistant: And then keep your elbow in full extension as well. Does that hurt?
user: Uh it does, yeah. 

assistant: Yeah, OK, how about when you flex your wrist with the elbow still in full extension? 

user: Uh it does, yeah that hurts as well. 

assistant: OK, how about when you flex your elbow?
user: Uh no, that that doesn't cause any pain. 

assistant: OK. How about when you extend your shoulder all the way up?
user: No, nothing there, that feels fine. 

assistant: OK, and then flexing your uh, or sorry abducting your shoulder?
user: That feels normal. 

assistant: OK, alright, and then how about when you pronate and supinate your forearms?
user: Uh, pronation um? 

assistant: So like twist your um arm inwards so that your palm is facing the floor. 

user: No, that doesn't really cause any pain, pronation and supination. 

assistant: OK, alright. Um alright, and then are you otherwise healthy or do you have any longstanding medical conditions?
user: Um I'm uh healthy. 

assistant: You're healthy, OK. And then UM do you have, have you had any hospitalizations or surgeries in the past? 

user: I had a surgery for um a C-section for uh my, my son, um but that's that's it. 

assistant: OK. OK, and um how long ago was that?
user: That was about uh 17 years ago. 

assistant: OK. And was that an emergency C-section?
user: Uh no, it was not. 

assistant: OK um and then are you on any medications? 

user: Um no, I've just been taking uh Tylenol and Advil um for the pain. 

assistant: OK, alright um immunizations wise, are you up to date?
user: Uh I I am, yes. 

assistant: OK. Do you have any allergies?
user: Uh no allergies. 

assistant: OK, family history of any uh skeletal or muscular um issues? 

user: Um no, nothing like that in the family. 

assistant: OK, neurological issues in the family?
user: Um no neurological issues in the family. 

assistant: OK, how about um autoimmune conditions?
user: Uh no, nothing like that. 

assistant: OK and then um do you smoke? 

user: Uh no, I haven't smoked before. 

assistant: OK, uh do you do um marijuana.
user: No, I I don't use that. 

assistant: OK. Um Alcohol?
user: Um uh yeah, I'll have a glass of wine every once in awhile, but maybe just one, one a week. 

assistant: OK, and have you been around sick contacts recently? 

user: Um no, I haven't been around anybody who's been sick. 

assistant: OK. Any recent travel?
user: Uh nope, I've been at home. 

assistant: OK. Um I think those are all the questions that I had for you, um did you have any questions of your own for myself? 

user: Uh no, I was just wondering what this pain could be on my, in my elbow. 

assistant: Yeah, so right now it seems like you may have a case of something called um lateral epicondylitis. So, it's also known as uh tennis elbow, um and there are a lot of things that could kind of predispose you to this, um so it could be like the repetitive strain at work, um and like continuous contraction of your wrist extensor muscle group there. Um so for this we basically recommend um a couple of things to manage the pain. Uh but first, like in terms of imaging, I don't think it is necessary because it doesn't seem like there was any trauma and I'm not too worried about any fractures. Um so to help you treat this, um we recommend some activity modifications, so um at work not doing things that are too repetitive, especially if it's using those um extensor forearm muscles. Um and then you can use some, use a compression sleeve as well, continue taking Tylenol or NSAIDs for the pain and uh really important is physical therapy um to increase mobility and strength in that arm. Uh and as well you can apply things like ice um to it for like the pain and swelling if you see any. Uh, yeah, so it should resolve in about six months to two years at most, uh but normally it does um go away in a couple of months with some physical therapy and the compression and splints if you choose to do that. How does that sound?
user: Yeah I've had, a fever and a cough that started just like four days ago. 

assistant: OK, when did you, when did you start having your, so the cough started four days ago, what about the fever? 

user: I think, like, last night was when I checked, it was high, like over thirty eight. 

assistant: I see, OK. And, did you check your fever before that? The night before?
user: Yeah, I just checked it last night. I felt hot previously, but, I don't know, I thought I was going to just get better, but this morning still, well, feeling a bit a little bit worse. 

assistant: OK, and the cough that started four days ago, has it been a dry cough or wet cough? 

user: It's been dry. 

assistant: OK, so there's been no sputum or any, or blood?
user: No sputum or blood 

assistant: OK. Has it gotten worse over the past four days?
user: Uh, a little bit, yeah.  D; And, other than the fever and the cough, do you have any fatigue?  Uhm, yes. 

assistant: We do, OK. Any muscle aches? 

user: Uh, no. 

assistant: OK, Sore throat?
user: No. 

assistant: Any difficulties breathing? 

user: No. 

assistant: Any wheezing?
user: No. 

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

assistant: OK, any runny nose?
user: Yeah, my nose has been a little bit runny. 

assistant: OK, that started over the past four days as well? 

user: Yeah. 

assistant: OK, what about pain in your belly?
user: No pain. 

assistant: OK, any diarrhea or Constipation?
user: Uhm, no. 

assistant: Any nausea or vomitting?
user: No. 

assistant: Any urinary symptoms?
user: No. 

assistant: OK, any rash that you've noticed on your skin? 

user: No. 

assistant: Any changes in your sense of taste or your sense of smell?
user: Uh, yeah, I haven't been able to smell as well. 

assistant: You feel like you have a runny nose, but is it sort of congested?
user: Not really, it,  yeah, just kind of running, and yeah, I haven't been able to smell very well. 

assistant: OK, and do you have any past medical, any conditions, medical conditions?
user: Uh, depression and anxiety. 

assistant: And have you had any surgeries in the past or hospitalizations?
user: Uhm, no 

assistant: OK, are you taking any medications, including over the counter pills?
user: I do take a multi-vitamin. 

assistant: And, uh.
user: sorry I do take, um, I take, uh, an SSRI, Citalopram as well. 

assistant: OK, that's good. OK, any allergies?
user: No allergies 

assistant: OK, specifically allergies to medications? 

user: Uhm,  yeah no, no medications, I don't think so. 

assistant: Good, ok, and do you currently smoke or have you ever smoked in the past?
user: Uhm, I smoked when I was in high school very briefly, but I haven't smoked anything in the last twenty years. 

assistant: Alright, do you consume marijuana?
user: Uh, we'll use edibles every once in a while. I buy them from the, like, I guess government store, OCS. 

assistant: I see, OK, any recreational drugs?
user: No, 

assistant: OK, and do you currently live alone or do you live with others?
user: I live with others, I live with my girlfriend, and a dog. 

assistant: OK, and has she been sick or have you been in contact with anyone who's been sick recently? 

user: Uh, she just came back from a work trip. I've been working from home but she was, uhm, in Saskatchewan, and just got back last week. 

assistant: OK, and has she had any symptoms?
user: She's been fatigued since coming back, but I mean, we thought that was maybe just from the travels, but, maybe not. 

assistant: Has she been quarantining, or are you both spending time together? 

user: Well, we've been, I mean, trying to distance in the home, but I mean, we've been living together in an apartment so. 

assistant: Fair enough, fair enough. OK, have you had any travels?
user: No, I've been working from home. 

assistant: OK, alright, and uh, any, you don't have any asthma or COPD or any lung conditions, right? 

user: Right, I don't have anything like that. 

assistant: OK, and, any conditions that run in your family?
user: Uhm, no, nothing that runs in the family. 

assistant: Alright, OK, so if I understand correctly, you've been feeling tired and you've had a cough and a runny nose and changes in your sense of smell for the past three or four days and you also were feeling a little bit hot and yesterday you noticed that you had spiked a high fever. Is there anything that I'm missing? 

user: No, I think that covers all the symptoms. 

assistant: And you might have potentially had, some exposure through your girlfriend potentially, so it's possible that, well, it's possible that you just have a cold, but it's also,  we'll still have to rule out covid as a cause, and so we'll have to do a covid swab and go from there and we'll check your temperature here as well. Just, uh, I think something that I forgot to ask, have you taken any medications that has helped you with your symptoms?
user: Uh no, I haven't taken anything. 

assistant: OK, alright, well, thank you, I'll go talk to my attending and we'll come back and discuss this further with you.
user: Hey, I'm I'm the mom of, of the patient. He's he's a kid, he has had, he just had a cough and stuffy nose for the past three days. 

assistant: OK, and so did they both start around the same time or one started before the other? 

user: They started the same time. He's also had like these, these, his eyes have been like kind of red and watery as well. 

assistant: OK, and is he, what kind of cough is he having a dry cough or wet cough?
user: It's a dry cough. 

assistant: Dry cough, OK and and so with the congestion is he also having any kind of nasal drainage? 

user: Yeah, it's it's like watery. 

assistant: Watery OK so now are you noticing any kind of yellow or greenish material?
user: No. 

assistant: OK, and he hasn't, is he coughing up any blood at all at any point?
user: No no no. 

assistant: And so this started just recently three days ago. Was he in contact with anyone that's been sick recently?
user: I don't think so, but he has been like playing outside quite a bit. And sometimes he's just playing with the neighbours kids. 

assistant: OK. Has this happened before?
user: Yeah it has, but I guess what I'm concerned about is the rash that he has now that he's never had before. 

assistant: OK, and where is the rash, exactly?
user: It's on his face. It started this morning. 

assistant: OK, and can you describe the rash for me like it's color, shapes, and what kind of looks like?
user: Small really small dots like kind of, uhm, like I'd say like brown in color. Like brownish dark reddish. 

assistant: OK, let's just are they just located on his face? 

user: Yeah, like it was on his face and it's kind of a little bit on his neck. 

assistant: OK, uh and is he scratching at them at all?
user: Yeah. 

assistant: OK, Um, OK and so they just started today. Have you had these rashes before at all?
user: No, no he hasn't. 

assistant: OK, anything new at all that he has either eaten or any new clothing or new laundry detergent or soap, so anything at all? 

user: No no. 

assistant: OK. OK, And has he had any fevers or chills anything like that?
user: Uh, he has been feeling a little bit warm. I didn't really check his temperature. 

assistant: And. And busy so, it started three days ago. Anything happened before 3 days at all that might have caused the symptoms? 

user: I don't think so. As I said, he has been playing around with others so could have caught something? 

assistant: OK, And OK, any kind of ah, have you tried anything that has helped him at all? Any medications?
user: Uhm? I haven't tried anything yet, no. 

assistant: OK, and how often is he coughing? Is he coughing throughout the day or is it more so with exerting himself? 

user: Um, it's just kind of all through the day. It's actually gotten a little bit better. Uhm, the cough has gotten better. But what I'm concerned about is the, the rash? 

assistant: OK cough's gotten better yeah. Does he have visit rush it so is it mainly just on his forehead or also on his cheeks?
user: It's on his cheeks on his chin. It's kind of on his neck. It's kind of like this blotchy reddish, brownish like little dots. Kind of, it's not like, it's not raised, it's like flat. 

assistant: OK, and uh. Is it kind of just a bit like a bright red rash that's kind of covering the cheeks or little little dots everywhere?
user: Kind of little dots. 

assistant: OK, any anything on his nose? 

user: Yeah, yeah, it's on his nose as well. 

assistant: OK, um, OK, but no fevers, right?
user: He, I guess he might have had a fever. He was feeling warm. 

assistant: OK. And any other symptoms like shortness of breath, sore throat, anything like that? 

user: No, no, nothing like that. 

assistant: OK. And otherwise, any other symptoms like just not like behavioural changes, not being himself, being more irritable at all?
user: So yeah, he's just been tired. He hasn't been doing anything, he's just been lying in bed. Hasn't eaten. 

assistant: OK. Any at all, is he having any nausea or vomiting? 

user: No. 

assistant: Any diarrhea or constipation?
user: No. 

assistant: Any changes in his urination?
user: No. 

assistant: Any changes in his sleep or appetite?
user: No. Well, he has been eating little less, but nothing like nothing else. 

assistant: OK. And has he been complaining at all of any abdominal pain or anything like that?
user: No. 

assistant: OK. Otherwise that has he been healthy or if he had any medical conditions diagnosed? 

user: He's been healthy. 

assistant: OK. And and any previous surgeries or hospitalizations?
user: No. 

assistant: Any medications that he takes regularly?
user: No. 

assistant: And any family history of any lung or heart conditions?
user: No. 

assistant: Concurrently, or like during your pregnancy with him, any complications at all? 

user: No. 

assistant: And did, was he meeting his milestones that developmentally in terms of, also with growth and height and everything like that?
user: Yeah, he seems to be doing OK come when he's doing as well as his other brother, his two brothers. 

assistant: OK, and does he go to school at all? What grade is he in? 

user: He's going to school. Um, online. 

assistant: Online right now? OK, yeah. And any issues at school at all. Any complaints that we've been told?
user: No. 

assistant: OK. Great, so, uh and how is the houses or your living situation like? 

user: It's, uh, things are good, so it's him, his two older brothers, my husband and me. 

assistant: OK, and has anyone been sick recently or had similar symptoms?
user: No. 

assistant: OK. Alright. Has anyone in the family ever had any diagnosis of asthma, eczema, allergic rhinitis? 

user: No. 

assistant: No, nothing like that, OK. Alright, so yeah those are all the questions I had for you today. Do you have any questions or concerns?
user: No. 

assistant: OK. So yeah, so, we'll, we'll be doing a couple we'll do a physical examination, I want to see examined with the rash looks like and there's many things that can cause a rash. There's uh viral infections that can cause some of the symptoms. The symptoms he's having mainly seen viral with a dry cough and runny nose. And then you can we have a rash as well. One thing I forgot to ask actually is is he fully immunized? 

user: Um, he I guess he didn't get all his immunizations done earlier. He did get them a little bit later so we came from Syria as refugees. But I I'm thinking he got all his immunizations when he, uh, came to, when we moved to Canada. 

assistant: OK, and is he complaining of joint or muscle aches at all?
user: No. 

assistant: No, nothing like that, OK. Alright, so yeah, we'll do it like a full physical examination, and if it's more just a viral, it'll be something that we'll just have to monitor and do supportive care for. But if it's anything else we might need to do further investigations. OK, and we'll just do a COVID swab for him today as well as some of the symptoms overlap with COVID symptoms and you will get the results back in 24 hours to 48 hours and then further instruction from public health. 

user: Sounds great. 

assistant: Alright, well, take care, talk to you soon.
user: Yeah hi, I've had this cough, um, for the past four days and it just can't, it won't go away. So, I was just wondering if, you know, I can get something for it. 

assistant: Okay, so uh, so you've been having the cough for four days. Can you describe the cough a little bit? Is it like a dry cough or wet cough? 

user: Uh, it's dry. 

assistant: It's dry, okay. Um, are you coughing up blood at all?
user: No, no blood. 

assistant: Okay, are you bringing up any, although you're not coughing, are you bringing up any kind of sputum?
user: No, no, it's, it's pretty, it's pretty dry. 

assistant: Okay. Um, and any other symptoms at all, besides the cough? 

user: No, nothing else. 

assistant: Okay, and have you been sick at all recently with fever, chills, runny nose, um any cold like symptoms?
user: Um, you know, a week back I had a runny nose. Um, and sometimes like a stuffy nose, but that went away. 

assistant: Okay. Um, and after that, did you have any fevers at all? 

user: No. 

assistant: Okay, and has this happened to you before at all? Like a cough lasting more than four days?
user: Yeah, it's happened to me in the past. Um, yeah it, yeah it has. Um, but it's just more bothersome this time cause I'm coughing a lot more. 

assistant: Okay, and is there anything that you've tried that has helped you relieve the cough at all? 

user: I tried some over-the-counter cough suppressants. Uh, they don't seem to be working too well. 

assistant: I see, and anything that's making your cough worse at all? No?
user: No. 

assistant: Do you have any other symptoms, like a sore throat, runny nose, headache, anything like that? 

user: No, nothing like that. 

assistant: Okay. Have you been around anyone that's sick recently?
user: No. 

assistant: No. Um, have you had any, um have you traveled at all outside of the province or country at all recently? 

user: Nope, not outside the province. 

assistant: Okay, and other than that, are you having any symptoms of, kind of, muscle aches uh, or anything like that?
user: Uh no, no muscle aches. Um, nothing else that I can think of. 

assistant: Okay, any shortness of breath?
user: No, no shortness of breath. 

assistant: Is the cough like constant, goes on throughout the day, or is there a time that it's worse?
user: Uh, it's pretty, it's pretty constant. 

assistant: Okay. And do you have any kind of um increased tired, like getting more tired or fatigued? 

user: Um, no. 

assistant: Um, any kind of chest pain or feeling that your heart is racing?
user: Um no, nothing like that. 

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

assistant: Okay, any um nausea or vomiting?
user: Um nope, nothing like that. 

assistant: Okay, um, any kind of uh, changes in your sleep or appetite?
user: Uh, no. 

assistant: And um, have you lost any significant weight recently? 

user: No. 

assistant: No, okay. Um, otherwise, are you healthy? Do you have any medical conditions at all?
user: Uh, no I don't, I'm otherwise healthy. 

assistant: Otherwise healthy, okay. Any allergies to any medications? 

user: No. 

assistant: Any allergies to any environmental, or any environmental factors?
user: No. 

assistant: Okay. Um, any family history of any medical conditions related to the heart, lungs, any cancers at all?
user: Uh no, nothing like that. 

assistant: Okay, alright. Um, are you, so, what, what is your living situation like right now? 

user: I live in um, an apartment by myself, I'm a student. 

assistant: Okay. Um, and are you working at all or are you a student seeming?
user: Um, I work part time. I work as a barista. 

assistant: Okay, and anyone, anyone in your work environment, or uh in your home environment, or at school that has been sick around you? 

user: Not that I've heard of, no. 

assistant: Okay. Um, and other than that, do you smoke at all?
user: Um, no I, well, I used to smoke before. I stopped last year. 

assistant: Last year, okay. And how long did you smoke for?
user: I smoked just a couple, like two years. 

assistant: Okay, yeah. So congratulations, that's a really great thing to do, especially like right now, with the pandemic going on and everything it's, earlier you stop, it's really good. 

user: Thank you. 

assistant: Besides uh, like smoking, um do you use any recreational drugs like marijuana?
user: No. 

assistant: No, okay. And how about alcohol? 

user: Nope, I don't drink too much alcohol. I drink like over the Holidays. 

assistant: Okay. And I forgot to ask you this earlier, but any hospitalization or surgeries in the past?
user: No, nothing like that. 

assistant: Nothing like that, okay. Those are all the questions, um, I have for you. Do you have any questions or concerns? 

user: Um, yeah, what should I do about this cough? 

assistant: Yeah, so this cough, um, it's been going on for the last four days. Since you do have a cough, um and right now that, like, is considered a symptom, like, like a potential symptom for COVID, we definitely want to do a COVID swab test for you, which will come back in 24 hours to 48 hours. You should still try and isolate as much as you can away from any roommates, or family members for the next, so, 14 days since you first experienced the, the cough.
user: Okay. 

assistant: Based on, like, public health will call you as well so you can follow their instructions. And if, it can be anything else too, like, with a cough, there can be multiple things going on. You can have um, like an upper respiratory, viral, or bacterial infection. But since you're not having too many other symptoms right now, it can just be bronchitis. Um, this is something that we'll try and keep an eye on and make sure it's nothing else like, uh pneumonia, for example. But right now, yeah, we'll get that testing done and then just, kind of wait and watch. 

user: Sure, yeah. Thank you. 

assistant: You're welcome, take care.
user: Yeah, so this chest pain has just been coming on for the last couple of weeks now. 

assistant: OK, uhm. So 2 weeks, and can you tell me kind of where you're feeling that pain?
user: Um yeah, I'm I'm just feeling this chest discomfort, sort of over on the left side. 

assistant: The left side, OK. Does does it stay just in one spot or does it kind of spread anywhere else? 

user: No, I don't really feel it anywhere else. Yeah, I just feel it in that one spot on the left side. 

assistant: OK, does it feel dull and achy, or does it feel more sharp?
user: It feels pretty sharp. 

assistant: OK, and is it constant like on all the time, or do you feel like it kind of comes and goes? 

user: It comes and goes. I would say I it might last for um 20-30 minutes at a time and then it goes away. 

assistant: OK, and over the last two weeks since you said it started, has it gotten any worse?
user: Uh, no. It's been about the same. 

assistant: About the same, OK, and has it gotten more frequent, these like 20 to 30 minute episodes?
user: No, it's happened about two or three times during the 2 weeks. 

assistant: And if you were to rate it on a scale of zero to 10, zero being no pain and 10 being like the worst pain you've ever felt, where would it fall?
user: I would say a 4 out of 10. 

assistant: OK. Uh, can you think of anything that that you've done differently recently that could have brought it on or is there any kind of common factor between the times that you had the pain? 

user: Um,  I don't know I've separated from my husband 2 two years ago which has been really stressful but other than that I mean I can't really think of any changes to my health or anything like that recently. 

assistant: OK, but do you feel like you have been more stressed out in general?
user: Uh, yeah the last couple of years have been a lot more stressful because of those issues in my personal life. 

assistant: OK, I'm sorry to hear that, but I'm glad that you're coming in and we can hopefully get to the bottom of this. Not that I think that's necessarily the source of your pain, and we definitely want to look into everything, but it is really helpful to know that. So when you've had these episodes, have you taken anything to help with the pain or done anything that's that you felt it made it go away? 

user: Uhm, I've tried some Advil, some Tylenol and actually some Tums as well, and it hasn't really helped. 

assistant: OK, do you think it's worse when you're moving around, if you're if you're kind of doing more exercise, or is it kind of just the same no matter what you're doing when you get the episodes?
user: Oh, it actually I I feel like it happens most of the time when I'm either at work or or driving. 

assistant: OK. OK, and before this two week period, have you ever had anything like this before? 

user: No, I haven't had anything like this happen before. 

assistant: Do you have any chronic conditions that you see your family doctor for?
user: No, previously healthy. 

assistant: And just jumping back to these pain episodes when you have them, do you experience anything else? Do you get any nausea or vomiting? 

user: No. 

assistant: OK, do you get any, do you have any difficulty breathing during these times?
user: No, I haven't. 

assistant: OK, and have you noticed any fevers? 

user: Uh, no, no fevers. 

assistant: OK, have you been in contact with anyone that's been sick recently?
user: Uhm, no, I haven't. 

assistant: And have you traveled anywhere outside of Canada?
user: No, I've been home. 

assistant: OK so you have, you said you have been previously healthy, nothing that you've been seeing your family doctor for on a regular basis. Do you take any medications?
user: Uhm, I do not, no medications, just the Tylenol and Advil I tried for the pain. 

assistant: OK, do you have any allergies? 

user: No allergies. 

assistant: And is there any history of heart problems in your family?
user: Yeah, my father had a heart attack when he was 60 just last year and it's actually one of the reasons what concerns me about the chest pain that I thought I was having. 

assistant: For sure, it always feels very concerning when when you have these these symptoms and that and you know people in your life that have had issues like similar issues in the past. I don't know that this is related to that. I I personally don't think so at this point, but we're definitely going to do everything to look into it and and rule out something that would be scary like that. I'm going to ask you few more questions about your lifestyle in general. Do you smoke cigarettes? 

user: Yeah, I smoke about half a pack to a pack per day. I've been trying to quit and I was smoking more one pack per day, but so it is down a little bit, but, It's still something I'm trying to work on. 

assistant: Congratulations, that's a really tough thing to do so, good for you. That's that's really exciting. Step in the right direction, right? Do you drink alcohol?
user: Um, I do, but, uh, I'll have maybe one or two glasses of wine on the weekend. 

assistant: Do you use any other substances? 

user: Uh no. 

assistant: I know that you said you don't see your family doctor for anything regularly, but I just want to check a couple of specific things like have you ever been told you have high blood pressure?
user: No, I've never been told I've I've had high blood pressure. 

assistant: And have you ever been told you have like high cholesterol? 

user: I haven't, but I've actually never been tested either. 

assistant: OK, and do you exercise regularly?
user: Yeah, actually, I'll either do some running or cycling, probably three or four days per week and I haven't had any chest pain or or problems exercising. 

assistant: OK, that's good to hear. And have you ever had problems with heartburn? 

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

assistant: OK. OK, so just to kind of summarize what we've talked about, over the last two weeks, you started having these 20 to 30 minute episodes of chest pain that's on the left side, it feels more sharp, is that correct?