jshargo/medical-interview-conversations2 huggingface dataset:
user: No, just, just this week. 

assistant: Alright, have you had any changes to your weight over the last several months? 

user: No, it's been pretty steady. 

assistant: Alright, and the fever this week, has it been there the whole time, or has it come and gone?
user: It kind of comes and goes. I've probably taken temperatures like every day. But I would say it's definitely, for the last few days it's been more of a fever, like the nightsweats sensation. Before it was a bit fine, like, but the highest temperatures have been in the last few days. 

assistant: OK, have you noticed any skin changes or rashes?
user: Uhm, just like, I, I don't know, like I don't think there are any changes, but I did notice some, like kind of just pink, pink spots on my arm the other day. 

assistant: OK, well uh, were they itchy?
user: No, they weren't really itchy. Just like a couple I would say like raised, not raised spots, just like flat, kind of pinkish spots. 

assistant: OK, and has that, has that spread anywhere or has it gone away? 

user: No, hasn't really started spreading yet, I just noticed it on, on my arm, and I, I don't think it has really spread at all. 

assistant: OK, this is on, on one arm?
user: Yeah. 

assistant: OK. And you've had some body aches, uh, have you had any joint pains?
user: No join pains, no. 

assistant: OK, and are you currently sexually active?
user: Yes. 

assistant: Alright, and could you tell me a little bit about your partners or, or partner and I, and I was wondering if you use condoms? 

user: Yeah, so I, I just have one partner right now, my fiance, and we Uh, I actually like have in an IUD, so like we, we don't use condoms, but like we're pretty honest and safe with each other. I fully trust him, like he doesn't have any partners or anything like that and I only have, I don't have any other partners as well. 

assistant: OK, have you had a sexually transmitted infection before?
user: No, never. 

assistant: OK, any concerns currently? Any vaginal discharge or itchiness or, or pain? 

user: No, nothing like that. 

assistant: OK, and have you been pregnant before?
user: No, I haven't no. 

assistant: OK. And have you been diagnosed with any medical conditions before? 

user: Uhm, just uh, I have had just eczema in the past, but that, that's fairly stable. It's been treated, I don't really have it anymore. 

assistant: OK, do you take any medications regularly?
user: Currently, no, no. 

assistant: Any allergies to medications?
user: No. 

assistant: Alright, uhm, and any hospitalizations or surgeries in the past?
user: No. 

assistant: OK. And could you tell me a little bit about your living situation currently, like, who you live with, and, and where? 

user: Yeah, so I'm just living with my fiance and that's, we're living in like a small apartment. And right now we're not really seeing anyone else really during the pandemic. 

assistant: OK, so have you been around anybody who's been sick?
user: I just had to go into work like one day last week just to grab some of my stuff, but didn't really come into contact with anyone. My fiance does go to his work like a couple, like three or four times during the week, so I don't know if he got into contact with anyone, It's, it's hard to say. 

assistant: Has he been sick at all? Like any, any cough, sore throat, anything, like that?
user: He did have a sore throat last week, but it kind of just went away on its own in a couple of days and compared to me, like, his was nothing really. 

assistant: OK, uh. And have you traveled anywhere?
user: No. 

assistant: And do you smoke cigarettes?
user: No. 

assistant: How about do you smoke marijuana or use any cannabis products? 

user: Uh, probably smoke marijuana, just maybe once or twice a month. 

assistant: OK, so it sounds like socially?
user: Yeah. 

assistant: Do you use any other recreational drugs? 

user: No, nothing else. 

assistant: OK. And do you drink alcohol?
user: Yeah, I, Probably have some red wine every other day, I would say. 

assistant: OK, and this is like one glass or two? 

user: Yeah, no, It's just like a normal glass of wine. Maybe, like we probably go through like a bottle between both of us, like every two weeks, maybe. 

assistant: OK. And in the family, has there been anybody who's had any cancers?
user: No, no, no cancer is in the family. 

assistant: OK, how about any genetic diseases or anything congenital that runs in the family?
user: Not that I know of. 

assistant: OK. So that was everything that I wanted to ask about on history, and so next we'll go ahead and get vitals and do a physical exam. But did you have anything else that maybe I forgot to ask about, or any other symptoms maybe? 

user: No, I don't think so. Do you think it can be covid at all? 

assistant: Uhm, so covid does present in a variety of non specific ways and so it certainly could be on the differential for causing a sore throat and abdominal pain and as well as a fever. However, it could be caused by other things as well. Uhm, currently your constellation of symptoms, with the enlarged lymph nodes in the neck, sore throat, it sounds like you may have uhm, an inflamed spleen as well, which could all be signs and symptoms of something called EBV or, or mono. And it sounds like you might have had an exposure, like your husband or fiance rather may have had this last week with the sore throat. All that being said, today we'll do the monospot test to check for that as well as some blood work. And we will do a covid swab as well, just in case.
user: Yeah, I've had a sore throat that's been really bugging me the past four days and I've had a cough as well. 

assistant: Mhmm. Uhm, when did the cough start? 

user: Yeah, so the the the cough started last week actually, and then and then I I got this sore throat afterwards. 

assistant: Mhmm. OK, and is it a dry cough or wet cough?
user: It's dry. 

assistant: OK. And has it gotten better or worse or stayed the same since last week?
user: Uh, it's it's gotten a little bit, little bit better. 

assistant: OK, that's good. And the sore throat started four days ago, are you having any difficulties swallowing at all? 

user: Yeah, it's, it's, it's really sore. 

assistant: OK. Uhm, and I guess going back to the cough, does it make it difficult for you to fall asleep at night or does it wake you up in the middle of the night?
user: No I, it hasn't done that. 

assistant: OK, alright. Other uh, and and I guess this sore throat has just gotten worse over the past four days or has been kind of the same or better?
user: Yeah, it's gotten a little, it's gotten a little bit worse over the last few days. 

assistant: OK, do you have any other symptoms like headaches, stuffy nose, runny nose, uhm any discharge from your eyes, red eyes, any pain in your ears? Anything like that?
user: Yeah, but that you mention that yeah, I I have had like some itchy eyes, that and a runny nose. I was sneezing quite a bit last week, but that has kind of ah, gone away now. 

assistant: OK. Uhm and were sneezing last week, and you had itchy eyes, had and thats gone. OK so all you have right now is that cough and sore throat, uhm, OK.
user: Yeah, and I've been really like achy and and tired as well. 

assistant: Have you had any fevers or chills?
user: Yeah, I've, I've felt feverish these last two days. No chills. 

assistant: Uhm, and have you had any changes in your sense of smell?
user: No, I haven't. 

assistant: Changes in your sense of taste?
user: No. 

assistant: OK, alright, and any chest pain? 

user: No, I haven't had any chest pain. 

assistant: Difficulties breathing?
user: No. 

assistant: Any, uhm, I guess headache or any pressure in your cheeks or your head when you bend down or squat down?
user: No, I haven't felt anything like that. 

assistant: OK. Uhm, any belly pain, nausea or vomiting, any changes in your bowel movements or any urinary symptoms? 

user: No. 

assistant: OK. Alright. And do you have any medical conditions that you've been diagnosed with?
user: I've had uhm, like tonsillitis a few times in the, in the past. The last time happened about about six months ago, I'm wondering if I have strep throat. 

assistant: How often do you get that tonsillitis? 

user: Uh, so I've had it four times. Yeah, 4 four times in the last few years. 

assistant: Uhm, do you still have your tonsils or have you?
user: I do, yeah I do, yes, yeah. 

assistant: OK, uhm and any other medical conditions? 

user: No. 

assistant: OK, any surgeries?
user: No. 

assistant: Have you ever been hospitalized?
user: No. 

assistant: OK. And any when you were younger would you have a lot of infections uhm, when you were a child or when you were born? Were you born prematurely? Were there any complications at birth?
user: Uh, I did have a couple of ear infections when I was, when I was younger, but I haven't had any since. 

assistant: OK. And no pneumonia or anything like that, right?
user: No, nothing like that. 

assistant: OK. Uhm, any history of asthma or eczema or allergic rhinitis? 

user: No, I haven't heard of those before. 

assistant: Alright. Are you taking any medications?
user: No, I'm not. 

assistant: Were you given any antibiotics six months ago when you had your tonsillitis? 

user: I was yeah, I think I, I think a like amoxicillin. 

assistant: Right and uh, do you have allergies to food or environmental allergies or allergies to any medications?
user: Yeah I, I have allergies to peanuts. 

assistant: What happens?
user: Yeah, I do get anaphylaxis from it. I've uhm, or I'll get yeah like hives and throat swelling. And so I do carry an EpiPen, I haven't had to use it though. 

assistant: Yeah, that's good, that's good. And so couple questions about, uhm, I guess more general questions, do you, who do you live with and where do you live, in a house or an apartment? 

user: Live in a house with uhm, with my parents and older sister. 

assistant: OK, and uhm, are you, uhm, are you currently smoking or have you ever smoked in the past?
user: No. 

assistant: OK. Also I just want to remind you that these questions will remain confidential between you and me. In case you're worried, no one's going to find out about what we're talking about unless you, unless there's concern about harm to you or harm to anyone else. Do you feel safe at home? 

user: I do, yes. 

assistant: OK, are things going well at school? Any bullying? Are you happy with your grades?
user: Yeah there everything I, I mean school is school, but it's been good. 

assistant: OK, and you said you don't smoke. Have you tried any other any recreational drugs? Any marijuana? 

user: No, I haven't. 

assistant: OK, any alcohol?
user: No. 

assistant: OK. And are you so sexually active? 

user: No, I'm not. 

assistant: OK. Uhm, alright, have you had contact with anyone who might be sick?
user: I don't think so. I mean, going to, we both I mean, we've been going back to school recently, but nobody's been off. 

assistant: OK. So you've been doing schooling in person, then, OK.
user: Yeah. 

assistant: Alright. Any medical conditions that run in your family, anything related to the lungs, or otherwise? 

user: Uh, no. 

assistant: OK, uhm, alright, well those are all the questions I had for you. So it sounds like last week you had itchy eyes runny nose, you were sneezing and you had a dry cough. And then over time some of those symptoms resolved and you continued to have a cough that was also getting better, but you then developed a sore throat. And you have been feeling feverish over the past two days. Did you measure, did you check your temperature last week?
user: I didn't check it last week, but I checked it yesterday and it was 38.2, I think. 

assistant: OK. 

user: But yeah, but but those are the symptoms that that I've been having. 

assistant: Uhm, so it sounds like you your symptoms have evolved quite a bit over the past two weeks. It could have, it could be potentially that you had a viral infection initially and might you might have like a superimposed bacterial infection, but we don't know that for sure. Uhm, we, we'll do a physical exam. Have a listen to your chest, have a look inside your mouth, look at your throat. Uhm, we, uhm, I guess the original symptoms you had last week., uhm, were seem a little bit different. It could be pharyngitis, maybe what you have right now could potentially be pharyngitis with a sore throat and the fever that you've developed over the past three or four days. So, I'll definitely have a look inside your throat as well, and if necessary we could do a rapid strep test. Uhm, and we would also have to do a Covid test just in case, and I would recommend that you quarantine at home. The results should come out in the next 12 to 20 for 24 to 48 hours. Just self isolate, stay away from other family members and then you'll find out the results. If it's positive, someone will call you from public health and then let you know what to do.
user: OK, yeah, that sounds good. 

assistant: Alright. 

user: Thank you. 

assistant: Yeah, you're welcome.
user: Thats great, thank you. 

assistant: Awesome OK. It says here that you have been having a sore throat. Can you tell me a little bit more about that?
user: Sure, yeah the sore throat it started about four days ago. And it's really it's it's very sore. I can drink fluids OK but I'm even having some issues swallowing food. 

assistant: OK, so you said four days ago?
user: Yes, four days ago. 

assistant: OK. So it's been kind of sore, some issues swallowing food OK, and over the last four days has it gotten worse, Better that it stayed the same? 

user: Um the sore throat has it's got, it's getting worse for sure. 

assistant: OK, have you ever had anything like this before?
user: I I, I guess when I was younger I had mono. And I had a sore throat when I had that, yeah. 

assistant: OK, is there anything that makes it worse or like anything that makes it feel better right now?
user: No, not really. I've tried, you know, I've tried gargling with salt water. I've tried some painkillers like nothing, nothing seems to be working. 

assistant: Uhm OK, and you said you've also had some difficulty breathing.
user: Yeah, that's right. 

assistant: Did that start around the same time? 

user: That actually started yesterday, and it's gotten me very concerned. 

assistant: OK. Yeah, I can understand how that would be concerning. We're definitely going to try to get to the bottom of it today. Um OK so started yesterday, said then has it gotten any worse? Is it the same way better?
user: Um the, well, I guess it's getting worse, yeah. 

assistant: Do you feel like it's all the time or is it on and off?
user: It's it's just there all the time. 

assistant: Have you ever had any difficulty breathing in the past?
user: Um no no, no, not like this. 

assistant: OK. Uh. Have you have you recently been in contact with anyone that's been sick?
user: Um. I have, no. I don't leave the house much nowadays. I go to the grocery store, I go to the bank. Just essential things. 

assistant: OK, have you traveled recently? 

user: Um no, no, I haven't left the city for anything. 

assistant: OK. Do you know if your immunizations are up to date?
user: Ah yes, everything's up to date. 

assistant: OK. That’s good. See you so I'm just gonna ask you about a few other symptoms. I just like to get an idea if there's anything else you been experiencing. Have you had a cough at all?
user: No. 

assistant: Have you had a runny nose? 

user: No runny nose. 

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

assistant: Have you had any chest pain?
user: Ah nope, no chest pain. 

assistant: Have you have you lost any of your sense of smell or taste? 

user: Um maybe taste a little bit but not smell. 

assistant: OK, OK, when did that start?
user: The taste ah. Maybe two days ago? 

assistant: OK. OK taste two days ago. Has it been on and off or has it been kind of constantly like a reduced sense of taste?
user: It's it's. It's been pretty constant. 

assistant: OK. Have you had anything like that before? 

user: No. 

assistant: Have you had any fevers?
user: I don't think so. 

assistant: OK. Have you had any chills or night sweats?
user: No. 

assistant: Have you felt overall really tired and weak? 

user: I. I felt tired, maybe not weak, but my I feel like my muscles all ache. 

assistant: OK. OK, and when did that start?
user: That started. Like immediately after my sore throat. 

assistant: OK. OK. OK, well we might circle back. I think there is any more questions you want to ask. Right now, but just in general, in terms of your overall health, do you have any chronic conditions that you take medications for or see a doctor for regularly? 

user: Um I have mild COPD. 

assistant: OK. And what medications are you currently taking?
user: Um I'm on a long acting beta agonist. 

assistant: OK, is that the only medication you take? 

user: Pardon me. 

assistant: Is that the only medication that you take?
user: And I also take a couple of vitamins. 

assistant: OK. Do you have any allergies? 

user: Um no, no allergies. 

assistant: Just gonna ask you few questions about your lifestyle. Do you live here in town?
user: I do. 

assistant: Do you ah live alone or with family?
user: I live alone. 

assistant: OK. And do you smoke?
user: I quit two years ago. 

assistant: Oh congratulations, before that did you did you smoke for many years?
user: I did, I smoked for 40 years. 

assistant: OK. Do you drink alcohol?
user: I drink occasionally, maybe like on the weekends. 

assistant: OK. Uhm, and do you use cannabis? 

user: No. 

assistant: OK any other drugs?
user: No, no other drugs. 

assistant: OK. And are you retired? Do you work? 

user: I am retired, yeah. 

assistant: OK, what did you do for work before?
user: I worked for GM. 

assistant: Crock. OK. And do you have any family history of respiratory problems, heart problems and?
user: No. 

assistant: OK. Uhm. OK, I think that that about covers my questions for you right now. Is there anything else that you wanted to add that I didn't ask you about? 

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

assistant: OK. I’m going to go over this with the document I'm working with today, I'm guessing just because some of your symptoms are in line with common symptoms of covid 19, that will probably do a covid swab, and what happens with that is since we do have some syptoms, will have to isolate until the result come back and potentially after that if you still have symptoms, even if it is negative. So that's just kind of a heads up on that. Maybe one of the next things that happens. We will probably get you a chest xray 'cause we want to get an idea of what's going on in there. Did you have any other questions?
user: No, thank you very much. 

assistant: OK well thanks for chatting with me we should be back shortly to kind of let you know with the next step.
user: OK, great, thank you. 

assistant: Thanks.
user: I've I I've had a, ah really runny nose and kind of feeling like like my nose has been obstructed. And I've kind of had this like sore throat as well over the last several days. 

assistant: OK, so did the rhino start first or the nasal obstruction?
user: Yeah, they they kind of started it around the same time. 

assistant: OK, and when was that? 

user: About four days ago. 

assistant: Four days ago. And then when did the sore throat start?
user: Uh, yeah, that started about two days ago. 

assistant: Two days ago, OK. And and the, uh discharge is it is it clear? Or are you seeing colors?
user: It's pretty clear and watery. 

assistant: So you're not seeing anything yellow, green or bloody?
user: No, not nothing like that. I haven't seen any yellow, green or or bloody. 

assistant: OK and then your sore throat. Is it making it hard for you to swallow solids and fluids?
user: No pain with swallowing, just can kind of feel it there. 

assistant: Yeah, any coughing?
user: Yeah, actually I started to have a bit of a cough. Uh, just this past day it's it's just started. 

assistant: Is it a dry cough or is it a wet cough?
user: It's dry. 

assistant: It's dry, OK. So you're not bringing up any sputum or blood? 

user: No sputum or or blood. 

assistant: OK good. And and then any shortness of breath?
user: No. 

assistant: No, any wheezing? 

user: No. 

assistant: No wheezing, OK. Any chest pain?
user: No. 

assistant: No, um, any fainting spells or dizziness? 

user: No. 

assistant: No, OK. And then any changes in your vision or hearing?
user: No. 

assistant: Any changes to your smaller taste?
user: No. 

assistant: OK. And any weight loss? 

user: No, it's been stable. 

assistant: OK, how about fevers?
user: No, I don't think I've had a fever. 

assistant: No, OK. Uh, chills or night sweats? 

user: No. 

assistant: No, OK. Uhm, any rashes?
user: No. 

assistant: No, OK. Uhm, and then any changes in your bowel movements? 

user: No, I haven't had any diarrhea or, or constipation. Nothing like that. 

assistant: OK and nausea or vomiting?
user: No. 

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

assistant: OK, any changes in your urine? 

user: No, no pain with urination. 

assistant: OK, how about uhm gassiness or bloating?
user: No, I haven't felt anything like that. 

assistant: OK, headaches?
user: Yeah, I have had a bit of a headache. I felt kind of like a a pressure of, well, I felt kind of like a pressure in my face and a headache. 

assistant: OK. Uhm pressure in your face and a headache, OK. And do you normally get these? 

user: Wait, no, I think I get headaches when I'm sick or I don't don't sleep well. And I mean I, I have been feeling pretty fatigued the last few days and, uh, yeah. 

assistant: Yeah. Is it the worst headache you've ever had?
user: No, there, it's pretty mild, it's just kind of annoying 'cause it's still there. 

assistant: Yeah, for sure. Uhm, alright. And then any muscle aches or joint pains? 

user: No, nothing like that. 

assistant: No, OK, good. And are you otherwise healthy or do you have any longstanding medical conditions?
user: I'm healthy, I haven't had any any conditions. 

assistant: OK, that's good. Have you been hospitalized for anything? Have you ever needed surgeries? 

user: No, I haven't. 

assistant: OK, that's good. And are you on any medications?
user: No medications. 

assistant: Alright, that's good, and then I'm are your immunizations up to date?
user: They are, yes. 

assistant: OK, any allergies? 

user: No allergies. 

assistant: OK. Any of your family, history of lung or heart conditions?
user: No. No. Everyone in the family is healthy. 

assistant: OK, do you smoke?
user: Nope, I don't. 

assistant: How about recreational drugs? 

user: No. Well, I I use like I'll have a joint every once in awhile, like socially with friends, but uh, that's I mean, maybe a couple of times per month. 

assistant: OK, OK, how about alcohol? Do you drink?
user: Yeah, I'll have uhm, like I don't know, a few beers on the weekend maybe so I don't know, maybe like four or five drinks per week. 

assistant: OK. And then have you been in contact with anyone sick recently? 

user: No, I am. I don't, I don't think so. I live, uh, in a student house, though, with that like four other people. 

assistant: Oh, I see.
user: Yeah, just finishing up some school here in town. 

assistant: OK, and had they been sick at all or had similar symptoms?
user: I think one of the guys last week had I had a little bit of a cough. And I don't know that yeah, said he wasn't wasn't feeling well. 

assistant: OK, OK, and have you traveled anywhere recently? 

user: No, been been just at home. 

assistant: OK, Alright, no travel. And where do you live right now?
user: So I, I just live in a student house with a. 

assistant: Oh yeah, sorry, you said that.
user: Oh, no problem. 

assistant: I guess I'm trying to get at. Uh, are there any old carpets you know reasons for you to believe that there may be a lot of mold or asbestos or anything like that in the house that may be making your symptoms worse? 

user: It's mostly like hardwood or like kind of ceramic flooring so there aren't many carpets and things like that, so I guess no. 

assistant: No. OK, alright and those were kind of all the questions that I had. Did you have anything to add or anything you wanted to discuss today?
user: No, I was just I. wondering what might be going on. It's been a few days. 

assistant: Yeah, for sure uhm so it sounds like you may have a viral infection, and because your symptoms overlap with those of Covid, we will do a Covid swab on you just to rule that out. Uhm, but from the sounds of what your symptoms are, it, it is most likely to be a common cold, in which case you can just manage it with a lot of hydration, nutrition, good sleep. But if your symptoms get worse or they're not going away after a couple of weeks, or you're having neurological deficits like weakness or seizures, you should get help from the ER. Does that sound OK? 

user: Yeah, for sure I haven't had any any symptoms like that, so so far, so that's good. 

assistant: Yeah for sure. Alright, take care.
user: Yeah so I'm bringing in my year old son here with, I because he's had a fever and and a cough and a runny nose. These symptoms have been going on now for the last two days. 

assistant: Last two days. OK. Uhm, all of these symptoms have been going on for the last two days or just like one or two?
user: I think, I think the cough and runny nose started 1st and then he then he kind of had some fever and had some chills as well last night. Kept saying that, like he was just cold, even though he had a had blankets on. 

assistant: OK. OK. Alright, so the cough is it a productive cough or is it a dry cough? 

user: It's dry. 

assistant: Dry, OK. So no sputum, no blood?
user: No no no sputum or blood. 

assistant: Any shortness of breath with that?
user: No, his breathing has been been good. 

assistant: OK, wheeziness?
user: No. 

assistant: Chest pain? 

user: No, no. 

assistant: OK. The fever, did you measure it yourself?
user: I did. Yeah it was 38 point, ah point 8. 

assistant: OK, and the runny nose is it clear? Or does it have like a colour to it like yellow or green?
user: It's pretty, yeah it's more clear. 

assistant: Clear, OK. Alright and does he feel like he also has a stuffy nose or is it just a runny nose? 

user: More just runny. Yeah he doesn't mention anything about feeling stuffy. 

assistant: OK. Any symptoms like redness, any discharge?
user: Uh, no, yeah, uh, he hasn't had any any eye symptoms. 

assistant: OK, how about hearing wise?
user: Uh, hearing has been been normal. 

assistant: And visions been normal? 

user: It has, yeah. 

assistant: OK. Any ear pain or discharge?
user: Ah, nope, no ear pain or, or discharge. 

assistant: OK, how about a change in smell or taste? 

user: No. 

assistant: No, OK. Weight loss?
user: He he's been gaining weight, hasn't had any weight loss. 

assistant: OK, any rashes?
user: No. 

assistant: No. Sore throat? 

user: Yeah, yeah, he's had a bit of a sore throat. 

assistant: OK.
user: But he hasn't he's just kind of mentioned it. He said it wasn't too bad. He's still been been eating. Eating is that hasn't been eating as much, but he's got a poor appetite, but he, so this sore throat isn't bugging him that much that much. 

assistant: OK. And how about dizziness or fainting spells? 

user: No. 

assistant: No, OK. Numbness or tingling?
user: No. 

assistant: Muscle ache or joint pains? 

user: Yeah, yeah he has had uh, he did mention that he just feels like a key a little bit all over. 

assistant: OK, any changes in his bowel movements?
user: No diarrhea. 

assistant: No, OK. Natural vomiting? 

user: No, he hasn't had any nausea or vomiting. 

assistant: OK, uhm how about changes to his appetite?
user: Yeah, his appetite's been a bit down, yeah. 

assistant: Is he still eating solids? 

user: He is, yeah, he's still eating solids just a little bit. Probably just just smaller portions though. 

assistant: OK, yeah. And ah, are there any changes to his urine?
user: No, there there hasn't been any any changes to his hearing. 

assistant: OK. Uhm, any past medical illnesses or any longstanding medical conditions that he has?
user: No, he's he's been um he's been pretty healthy. Yeah, I mean, he's got got gets a cold every once in awhile maybe in the winter, but that's about it. 

assistant: OK, any hospitalizations or surgeries?
user: Uh, no, he's been healthy. 

assistant: OK. Any complications with his mother's pregnancy with him? 

user: No, it's been ah it was normal pregnancy throughout it was to term and it was a C-section delivery but that went well and he was a normal weight. 

assistant: OK. And was it an emergency C-section?
user: Ah no. I think it was like Labor was taking, it was prolonged, I mean so it they ended up deciding to just convert throughout. It wasn't an emergency, but like they could have waited a bit longer they were saying but just kind of what went made the decision. 

assistant: OK, OK. And is he on any medications?
user: Uh, no he's not. 

assistant: No, OK. And developmental wise has he been hitting all his milestones for like motor movements, speech, behaviour, social, socialization wise? 

user: He has yeah, he's been meeting all of his milestones for that, for that. 

assistant: OK, good. Is he up to date with his immunizations?
user: He is, yeah. 

assistant: OK. Does he have any allergies? 

user: Uh, no, no allergies. 

assistant: OK, any family history of lung or heart conditions?
user: Uh, no, it his grandfather had high blood pressure and like high cholesterol, but that's that's it. 

assistant: OK. And has he been in contact with sick, sick people recently. 

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

assistant: No, OK. And and any travel recently?
user: No, he he he's been doing some schooling, some schooling online and some some in person. And but, but otherwise they've just been at home. 

assistant: OK. Uhm, alright and does anyone at home smoke? 

user: No smoking at home. 

assistant: No, OK. And who does he live with?
user: So he lives with myself as well as his his mom and then he's got a younger brother and a younger sister as well. 

assistant: OK. And at home. any reason to think that old carpet, dust, mold, asbestos, anything like that could be making his symptoms worse?
user: I don't think so, yeah, it's been all that's been OK. 

assistant: OK, and and those are all the questions that I had for you today. Did you have any questions of your own?
user: No, I I I just wanted to figure out what this was. 

assistant: OK, yeah, so it sounds or actually I should start by saying we should get a Covid swab on him just in case it is Covid because some of his symptoms overlap with those symptoms of Covid. Umm, you should hear back in about 24 to 48 hours with the results of those swabs. And in the meantime, it could be another viral infection that's going around at this time of year. And from the sounds of it, you said he has a fever. He's coughing and he has a runny nose and has muscle aches. It could also be the flu. Regardless of what kind of viral and viral infection he has, the best way to manage it right now is just supportive care, so making sure he's hydrated, eating foods with a lot of nutrition and just keep an eye on his symptoms. If it gets worse or if it's very severe and he has focal neurological deficits like weakness or seizures, take him to the ER right away. How does that sound? 

user: Yeah, that sounds good. Thank you. 

assistant: Yeah no problem.
user: Yeah, I've had this sore throat for the past three days and it doesn't seem to be getting any better at all. I feel sort of feverish so. I just thought I should come in and get this checked out. 

assistant: OK, and when did you start having this sore throat?
user: Three days ago. 

assistant: OK, and how about the fever? 

user: The fever I noticed maybe a day back. 

assistant: OK, and did you get any temperature measurements?
user: I didn't take any myself. But I felt hot, and I felt chills. 

assistant: OK, and have your sore throat or fever gone worse at all? 

user: I think it's getting worse, yeah. 

assistant: And does it usually happen during the day, throughout the night or does it have any sort of pattern?
user: I would say that it doesn't really have a pattern. The sore throat is always there and the fever started a day back and it seems to break sometimes, but right now there is no real pattern to it. 

assistant: OK. And besides that, do you have any cough?
user: No, no cough. 

assistant: OK, and have you tried anything that has helped you at all? 

user: I tried just like those Lozenges and seems to be helping just soothe my throat, but it's a temporary relief. 

assistant: OK. And have you had anything like this happen to you before?
user: No, nothing like this. 

assistant: And is the sore throat constant? Or does it come and go?
user: I would say it's pretty constant now. 

assistant: OK. And have you been around anyone that has been sick recently? 

user: Not that I know of. 

assistant: Anything that makes your sore throat worse?
user: I guess swallowing foods makes it worse, or at least it's painful. 

assistant: OK. And have you at all noticed any like swelling around your neck region, like swelling of your lymph nodes?
user: So yeah, not swelling of my entire neck, but I have felt some lumps in my neck. 

assistant: OK, and how about any swelling anywhere else on your body?
user: Nowhere else. 

assistant: OK, have you noticed any kind of skin changes like rashes or anything like that?
user: No. 

assistant: OK. And have you traveled at all recently?
user: No, nowhere. 

assistant: OK, do you have any headaches or nausea or vomiting?
user: No, nothing like that. 

assistant: OK, and any night sweats. 

user: No. 

assistant: And do you feel fatigued like increased tiredness at all?
user: Umm, yeah, I've been feeling really tired. 

assistant: OK, any chest pain or feeling that your heart is racing?
user: No, nothing like that. 

assistant: OK. Any issues with bowel movements, like any diarrhea or constipation?
user: No, no changes. 

assistant: Have you been getting sleep at night or do you have to keep waking up? 

user: Um, I've been getting OK, I sleep like, I've been sleeping about 7 to 8 hours. 

assistant: OK. And how about your appetite?
user: I would say that's been OK as well, it's just hard to eat a lot of food because of this sore throat. 

assistant: And is it just with solids or do you get the soreness with liquids too? 

user: I would say mostly with solids, sometimes with liquid. If it's like really cold or something. 

assistant: OK. Do you have any kind of allergies to anything in your house like carpets, pets or anything like that?
user: No. 

assistant: OK, have you had any recent infections like a cold? 

user: No. 

assistant: No, OK. And do you have any past medical conditions?
user: Um, I have Crohn's disease. 

assistant: And when did you get diagnosed with Crohn's?
user: That would have been last year. 

assistant: Last year, OK. And are you taking any medications for your Crohn's disease? 

user: I am on something for it, I think it's Sulfasalazine or something like that. 

assistant: OK. And any other medications besides that?
user: Uhm, no, I don't think so. 

assistant: Any previous hospitalizations or surgeries? 

user: Um, I had a colonoscopy done. I just needed hospitalization for just the day I guess. 

assistant: OK, and when was that?
user: That was also last year. 

assistant: Last year, OK. And do you have any family history of any conditions that run in the family? Like do you have any Crohn's disease or Ulcerative Colitis that run in the family?
user: Yeah, both do. 

assistant: Both do, OK. Any anything else that runs in the family? 

user: Uhm, I know there's some asthma and eczema that run in the family too. 

assistant: OK. And you mentioned you haven't been around anyone that was sick or recently got sick?
user: No. 

assistant: OK. And where do you currently live?
user: I live in an apartment by myself. Sorry, not by myself, with my parents and my younger brother. 

assistant: And do you at all drink alcohol?
user: No, I drank once or twice in the past, but I didn't like it. It makes my Crohn's worse so I stay away from it. 

assistant: OK, and do you smoke cigarettes? 

user: No. 

assistant: And how about any other drugs like marijuana?
user: No. 

assistant: OK. Alright, so do you partake in any like sports or activities or anything like that?
user: Um, I swim. 

assistant: OK, any contact sports?
user: No. 

assistant: OK. Alright, so yeah, overall it seems that you had this sore throat which is constant, getting worse and a bit of a fever in th last one or two days and you've also had swelling in your neck and so yeah, do you have any other questions or concerns?
user: No, like what do you think I have? Do you think it's COVID? 

assistant: Yeah, so definitely at this time, you know whenever people have any respiratory symptoms we always want to rule out COVID.  So will definitely get a swab for COVID testing done for you today which should come back within 24 to 48 hours and in the meantime you should self isolate. And other than that, it can also be, due to this swelling in your lymph nodes and also just the other symptoms, it can be other viral infections. It can be mono so we definitely have to do a couple of tests, and there's one test that will do for mono as well which is called EBV antibody testing. So we'll do a couple of these tests today and then see what what comes back. And in the meantime you should definitely self isolate if you haven't been doing so already.
user: OK, sure I can do that. 

assistant: Yeah, do you have any questions?
user: No, that sounds good. Thank you so much. 

assistant: You're welcome. Take care.
user: Sure, you know I've been having this chest pain for the since last night. Um, and I'm also having a hard time breathing so thought I should check it out. 

assistant: Ok, um and so the chest pain came on last night. Were you doing anything before before it coming on? 

user: No, I was just about to head to bed and suddenly I felt this crampy pain in my chest. 

assistant: Ok, and where is this pain located?
user: I'd say like the center of my chest. 

assistant: Ok, uh, has the pain been going on constantly since last night?
user: Yeah, I would say so. 

assistant: Ok, has it changed in character at all? You said it was crampy, but has it felt like anything else? 

user: Um, no. Just just crampy, yeah. 

assistant: I see, did you feel the pain anywhere else, or do you feel it just in the center of your chest?
user: Ah yes, center of my chest going up to around my throat area maybe. 

assistant: OK, I see and anything that you've done, that's made the pain worse? 

user: Um, I guess taking in a deep breath. 

assistant: Ok, and how about changing positions, does the pain get worse if you lie flat or or if you lean forward?
user: No. 

assistant: Ok, um, and have you ever had a pain like this in your chest before?
user: No. 

assistant: Ok, and and has the pain get been getting worse, getting better, staying the same?
user: It's been the same. 

assistant: Ok, have you taken anything for it, to help with the pain?
user: No. 

assistant: Ok, and the shortness of breath you mentioned, uh, when did that start?
user: Around the same time. 

assistant: Ok and, is this trouble breathing like after walking a certain distance or exerting yourself?
user: No, it it it, it's just always there. 

assistant: Ok, and have you noticed any changes to the sounds of your breathing, like a wheeze or whistling sound? 

user: Yeah, maybe maybe a slight wheeze. 

assistant: Ok, do you think that you're breathing more quickly?
user: No. 

assistant: Ok um, have you had a cough?
user: No cough, no. 

assistant: Alright, and so you haven't been bringing up any sputum or or any blood? 

user: No. 

assistant: Ok and, have you had a sore throat?
user: No sore throat. 

assistant: Alright, so you've had this chest pain since last night and shortness of breath that started around a similar time last night. Have you had any other symptoms?
user: Just just some fatigue, some tiredness. 

assistant: Alright, and did that start around the same time? 

user: That started a few days before, like maybe two days before. 

assistant: Ok, has there been any change to your sleep or any stressful events happen that might be tiring you out?
user: No. 

assistant: Ok, and have you had any headaches? 

user: Nope, no headaches. 

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

assistant: Any any redness of your eye? 

user: Nope. 

assistant: Alright, so have you had a runny nose?
user: No. 

assistant: Alright, and uh have you felt like your heart is racing at all?
user: No. 

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

user: Nope. 

assistant: And have you had a decrease in your appetite?
user: Um, no. 

assistant: I see, ok and have you had any changes to your weight in the last several months? 

user: No. 

assistant: Alright and, have you had any diarrhea or constipation?
user: No. 

assistant: Alright, and how about any nausea or vomiting? 

user: Uh, none. 

assistant: Any abdominal pains?
user: No. 

assistant: Alright, and how about any confusion or or concerns around memory?
user: No. 

assistant: Alright, and, any muscle aches or pains? 

user: Maybe slight muscle aches. 

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

assistant: Ok, and any rashes you noticed anywhere? 

user: No none. 

assistant: Ok, and have you had a fever?
user: Um, nope. 

assistant: How about any any chills? 

user: No chills. 

assistant: Alright and then any night sweats?
user: No. 

assistant: Alright, and do you have any medical conditions that you see a physician regularly for? 

user: No, actually sorry, I have diabetes. 

assistant: Ok, is that type 2?
user: Type 2. 

assistant: Ok, and are you taking any medications for that or is it kind of diet or lifestyle controlled?
user: I'm on insulin for that. 

assistant: Ok, and you use a sliding scale or do you have a regimen you use?
user: Um, I have, so I have like a long acting and short acting, so I just take the long acting before I go to bed and then the short acting before meals. 

assistant: I see ok. So that sounds like a great, a great plan. Do you take any other medications? 

user: Yes, I take some vitamins and you know, like vitamin D and calcium, but that's it. 

assistant: Ok, any allergies?
user: I'm allergic to penicillin. 

assistant: Ok, have you had antibiotics recently for any reason? 

user: No. 

assistant: Ok, and are your immunizations up to date?
user: I think so. I think the only thing is I have to see if I'm up to date with my Pneumovax. 

assistant: Ok, great yeah I was wondering about that one so we can look into that certainly. And do you know if you've had the Zoster or the Shingles vaccine?
user: Yes, I had that one. 

assistant: Ok great um, and um next could you I was wondering if you could tell me a little bit about your living situation?
user: Sure, I live with my husband. We live in a 3 bedroom townhouse. It's a fairly new home. 

assistant: Ok, great. Did you recently move there? 

user: Yes we did. 

assistant: Ok, cool. And so there's no concerns with like old carpets or being exposed to kind of like dust or or molds or anything like that in the home?
user: No, nothing like that. 

assistant: Ok, and um, has your husband been sick at all?
user: No, he's been fine. 

assistant: Ok, and do you have any pets in the home?
user: We have a cat. 

assistant: OK, and do you have any allergies to pets? 

user: No. 

assistant: Alright, um and how do you support yourself financially right now?
user: Um, we're both retired, but we have our RESP savings. 

assistant: Oh excellent, ok, and for your previous occupation, were you exposed to any chemicals or like asbestos or inhalants that you're aware of? 

user: Uh no no, nothing like that. 

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

assistant: Do you drink alcohol? 

user: I have maybe a glass or two glasses of wine over the weekends. 

assistant: Ok, and do you smoke marijuana or use any cannabis products?
user: No, I don't. 

assistant: OK, and how about the use of any other recreational drugs?
user: No, no, nothing like that. 

assistant: Ok and, and has anybody in your family had a heart condition before?
user: My mother passed away when she was 80, she had some valvular issues. 

assistant: Ok um, uh, ok, and has anybody in the family had a heart attack before?
user: No, not that I know of. 

assistant: Alright, and, anybody have any lung conditions? 

user: No. 

assistant: Alright, and then any cancer that runs in the family?
user: Cancer? No no. 

assistant: Ok um, I think that's all I wanted to cover on the the history today. Was there anything else you'd like to tell me that I was, that I maybe didn't ask about?
user: Uh no, I think you asked me all those other questions, I'm just wondering what do you like, what do you think I have? 

assistant: Yeah, certainly, uh, so it could possibly be something related to the heart. I don't, and sometimes especially people in your age group who have diabetes can have chest pain and symptoms that could be nonspecific. And so we will, we will check that for sure. We'll get an ECG and some lab work with the troponin and also a chest X Ray so that we can investigate for that. And also the chest X Ray could help us look to see if you have something going on in your lungs, like a possible pneumonia or, maybe a viral infection as well, which could include something like COVID-19. So we'll be ordering a PCR nasal swab as well to test for that. And so in the meantime, because we'll be doing that test, it requires self quarantine for 14 days so, if possible, that would mean distancing from your husband in the home as well for that 14 day period, but the results should come back from that test within the next several days. And and sorry, also if it is positive, we will have to notify public health as well so that the appropriate contact tracing can be done.
user: Ok, ok well thank you very much. 

assistant: Now you're very welcome. We'll get the investigations started now.
user: So, I just came in here because for the last day I've been just getting shortness of breath. I recently, yesterday actually, was just busy at home, cleaning out my basement. And, like that was yesterday afternoon, I did that for a couple hours and then at night I just started to get the shortness of breath. It's continued until today. I'm also getting some wheezing and tightness in my chest as well as some cough. So yeah, that's all just been happening over the last day. 

assistant: OK, and uh, is the shortness of breath here now? is it, is at rest? Or are you having that when you're exerting yourself?  p: More so when I'm like exerting myself, if I'm sitting down it's better, but I still have, I would say, like my breathing is not normal right now, like it's, I still have to take deeper breaths. And I do have that chest tightness when I take those deep breaths.  OK, do you have any chest pain? 

user: No, it's more so just the tightness. I wouldn't call it pain, but I do still have a little bit of wheezing. 

assistant: OK.
user: So yeah, that's, that's that. 

assistant: And you mentioned a cough as well. With the cough is it, has it been dry, or have you been bringing up sputum?
user: Uhm, it was, it was mainly dry yesterday, like, like the cough has kind of gone away, but yesterday night I was coughing a lot and it was mostly dry. 

assistant: OK, have you brought up any blood? 

user: No. 

assistant: OK, and have you had any infectious symptoms like, eye tearing or red eyes, maybe a runny nose or sore throat?
user: Uhm, not a sore throat, but it does feel like it, it's kind of like just constricted in there like, uhm, I don't know if it's relevant, but I, I do have asthma. Uh, like I was diagnosed ten years ago, but it's been pretty stable, like it's, like just right now. I haven't had shortness of breath for a pretty long time. 

assistant: OK, uh, and, uh, we'll get back to the past medical history shortly, I just wanted to ask a few more symptoms, but certainly could be relevant today. Uhm, so uhm, so you mentioned that you have had some throat tightness. Have you had any loss of smell or, or loss of taste?
user: No, nothing like that. 

assistant: OK, and have you had any fevers or chills? 

user: No. 

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

assistant: How about, any diarrhea or Constipation?