[doctor] next patient is grace ross . date of birth 8-23-97 . ms. ross is a new patient . she's here today for a full spectrum std testing . the patient states that she's having symptoms of discomfort , a change in discharge , and odor in her vaginal region . she says that the right side of her vagina is starting to become painful . she denies any fevers or chills . she reports , that she recently learned , her partner has been in sexual encounters with other people , and she wants to be evaluated for all stds .
[doctor] hello , ms. ross . i'm dr. diaz . it's good to meet you .
[patient] hi . yes . nice to meet you , too .
[doctor] so , how are you doing today ? i hear that you're here for std testing . is that correct ?
[patient] yeah . actually , i found out earlier this week , that my boyfriend has been cheating on me , for some time . i'm really worried , that i could have caught something , you know ?
[doctor] mm-hmm .
[patient] i wanted to make sure i do n't have anything .
[doctor] yeah . i'm sorry to hear that . of course , we can do that today . um . well , let's see . how do you feel ? do you have any symptoms ?
[patient] well , um , i started noticing some weird discharge last week .
[doctor] mm-hmm .
[patient] uh , it smells different . it's not the same color , or consistency , as usually , it is .
[doctor] right .
[patient] um . that part did n't even phase me , until i noticed that the right side of my vagina was hurting . just sore , you know , but that has n't gone away .
[doctor] yep . nah , that does sound like a cause for concern . how long have you been with him ?
[patient] hmm , we've been dating for three years .
[doctor] mm-hmm .
[patient] as far as , i can figure , he started cheating on me , i think , about three months ago .
[doctor] uh- . um , okay . do you ... have you ever had an irregular pap smear ?
[patient] well , yeah , i did , but it was back whenever i was 20 or so . it has n't ... and i have n't had one since .
[doctor] okay . and when was your last pap smear ?
[patient] uh , about six months ago . it came back normal , though .
[doctor] okay . good , okay . well , let's see ... let's take a look at you , and then , we'll get some samples for std testing . okay ?
[patient] all right .
[doctor] you'll hear me talk through your exam , so that i can get it all documented . uh- ?
[doctor] use my general physical exam template . pelvic exam demonstrates no external lesions . normal labia majora and labia minora . normal physiological discharge , with normal color and smell .
[doctor] ms. ross , i'm going to touch you , now . you'll feel my fingers , and the speculum in your vagina . you'll feel some pressure , now .
[doctor] cervix is normal . vaginal wall is normal . no cervical motion tenderness and no adnexal tenderness or masses noted . swabs were done for std testing .
[doctor] okay , ms. ross . everything looks good from a visual standpoint . i'm going to send off std testing for , uh , gonorrhea , chlamydia , trichomoniasis , and i'll have you give some blood for syphilis , hiv and hepatitis c. some of these tests will take longer than others . we will call you , if we see anything , but if you have n't heard anything , you can call us in three days for results .
[patient] okay . sounds good . thank you , so much .
[doctor] of course , my pleasure . and , if everything is normal , i'll see you again , at your next annual checkup .
[doctor] assessment : is screen for std .
[doctor] plan : discussed with patient , and please add that she is high risk due to an abnormal pap smear in the past , and the recent discovery of her sexual partner having multiple partners , for some period of time .
[doctor] end of recording .

Medical orders:
description: swabs gonorrhea
order_type: lab
reason: screen for std
description: swabs chlamydia
order_type: lab
reason: screen for std
description: swabs trichomoniasis
order_type: lab
reason: screen for std
description: blood syphilis
order_type: lab
reason: screen for std
description: blood hiv
order_type: lab
reason: screen for std
description: blood hepatitis c.
order_type: lab
reason: screen for std