[doctor] elizabeth , how are you ?
[patient] i'm doing okay . how are you ?
[doctor] doing okay . so i know the nurse told you about dax . i'd like to tell dax a little bit about you , okay ?
[patient] okay .
[doctor] all right . elizabeth is a 66-year-old female with a past medical history of significant for depression and hypertension who presents for her annual exam . so elizabeth , it's been a year since i've seen you .
[patient] mm-hmm .
[doctor] how are you doing ?
[patient] i'm doing well . there's been so many events now that we've been able to get vaccinated , i've been able to see my grandkids again , go to more birthday parties , it's been fantastic .
[doctor] yeah , i know . i've ... i mean , we've had some communication over telehealth and that type of thing , but it's not the same as being in-person , so i'm happy to see you today . now tell me a little bit about , you know , we have n't really got a chance to talk about your depression . how are you ... how are you doing with that ? i know we have n't had you on medication in the past because you're on medication for other things . what are your strategies with dealing with it ?
[patient] so i've been going to therapy once a week for the past year . um , mostly virtually , um , but starting to get in-person . virtual was a bit of a struggle , but i feel like being in-person with someone really helps me .
[doctor] okay . and do y- do you have a good support system at home ?
[patient] yes , i do . i have my husband and , uh , my kids are right down the street from me , so i'm very lucky .
[doctor] okay . all right . so that's good to hear .
[doctor] how about your blood pressure ? did you buy the blood pressure cuff that i-
[patient] yes .
[doctor] . told you to ? okay . i know that we've been in communication and your blood pressures have been running okay . the last time i spoke with you , how are they doing since we last spoke ?
[patient] they've been doing well . i've been using the cuff , um , once a day , and they seem pretty normal .
[doctor] okay . and are you taking the lisinopril that i prescribed ?
[patient] yes .
[doctor] okay . great . all right . so i know that you did a review of systems sheet with the nurse when you checked in . you know , i know that you were talking about some nasal congestion . do you have any other symptoms , chest pain , shortness of breath , abdominal pain , nausea or vomiting , anything like that ?
[patient] no .
[doctor] no ? okay . all right . well , i wan na go ahead and do a quick physical exam , okay ?
[patient] okay .
[doctor] hey , dragon , show me the vital signs . so here in the office , you know , your blood pressure looks really good , as does your heart rate . so you are doing a good job managing your blood pressure . so i'm gon na take a listen to your heart and lungs , okay ?
[patient] okay .
[doctor] okay . so on physical examination , i do n't appreciate any carotid bruits in your neck . on your heart exam i do notice a slight 2/6 systolic ejection murmur , which we've heard in the past , so i think that's stable . your lungs in- are nice and clear , and you have some trace lower extremity edema bilaterally , so all that means is , you know , i agree , you know , maybe we should watch your diet a little bit better , okay ? but i wan na take a look at some of your results , okay ?
[patient] okay .
[doctor] all right . hey , dragon , show me the ekg . and the nurses did an ekg before you came in , and that looks perfectly fine , okay ? so i wan na just go ahead and talk a little about your assessment and my plan for you . so for your first problem , your depression , i think you're doing a really good job with your strategies . i do n't think ... it does n't sound to me like i need to start you on any medication at this time , unless you feel differently .
[patient] no , i'm , i'm , good in that department .
[doctor] for your second problem , your high blood pressure , i agree , everything looks fine here now . i wan na just continue on the lisinopril , 20 milligrams a day . and i want you to continue to watch your blood pressures as well , and if they start rising , i want you to contact me , okay ?
[patient] okay .
[doctor] and for your third problem , for an annual exam maintenance , you know , you're due for a mammogram , so we'll go ahead and schedule that , okay ?
[patient] all right .
[doctor] all right . do you have any questions ?
[patient] um , can i take all my medicine at the same time ? does it matter ?
[doctor] yeah . you can set an alarm so that it reminds you to take your medication . but yeah , you can , you can take them altogether .
[patient] okay .
[doctor] all right . hey , dragon , finalize the note .

Medical orders:
description: mammogram
order_type: imaging