[patient] Hello?
[doctor] Hello?
[doctor] Hello? I can hear you, can you hear me? . Excellent, just before I go any further, can you confirm your name and your age, please?
[patient] Hi. Can you hear me?
[patient] Yeah, I can hear you now.
[patient] Uh, yeah. My name is Jessica Smith, and I'm nineteen years old.
[doctor] OK. And how can I help you Mrs Smith?
[patient] Um, yeah so uh, I mean this is, this is a bit embarrassing, but it's, it's uh, hurting when I, , when I use the bathroom, when I pee. And um, it's been going on for a few days, so I'm a, I'm a little bit worried about it. Uh, not sure what to do.
[doctor] Right, well , I, thank you for coming in, so hopefully we can help with your symptoms. Um, so you mentioned it started a few days ago. Um, so, can you tell me a bit more about that, what kind of pain it is, that you're experiencing?
[patient] Um, it's, it's not too bad, it's sort of like a stinging kind of pain. Um.
[patient] It's not like unbearable, but uh, it's , it's definitely uh, it definitely bothers me when I pee. Um.
[patient] And uh, yeah I also maybe sometimes get some like, pain kind of lower down in my tummy, when I, when I go to the bathroom. Uh, yeah.
[doctor] , OK. And, and, uh, the pain in your tummy, is it, can you describe the , the pain to me? Is it cramping, burning, sharp?
[patient] , yeah, I don't know maybe uh, sort of, sort of cramping. I'm not really sure, but it's not like, it's not like cramping like when I get, when I have a period or something. It's like, I don't know, .
[doctor] Right, right, OK, OK. Um, fine. And, have you found yourself going to the toilet more often than normal?
[patient] Um, not, I don't think so, I haven't noticed that.
[doctor] No, OK, fine. Have you noticed any, any funny colour to your urine? So, has there been, uh, , any blood in your urine? Have you noticed any other darkening of urine?
[patient] Um, there was a little bit of blood earlier today, um, but besides that, not at all, no. Um.
[patient] It does kind of, it, it kind of like, doesn't smell very, it smells a bit weird I guess, um, but, no, not really anything uh, anything drastic.
[doctor] Yes.
[doctor] OK, fine, OK. Um, right, let me just , write a few notes down as well. Um.
[doctor] , and you mentioned a tummy pain, that also started a few days ago. Does the pain move anywhere else? Does it move towards the back, or towards your flank, the sides?
[patient] No, not really, no.
[doctor] No, OK, fine. With those symptoms, have you noticed any other symptoms like nausea, vomiting?
[patient] Uh, no, not , not at all.
[doctor] OK. Any fevers, or temperatures?
[patient] think so.
[doctor] , sorry, was there any, any fevers or temperatures? Sorry, I didn't hear you.
[patient] No, no, no fever, no.
[doctor] No fever, OK, fine, sorry. Um, OK. Um, in terms of your bowel, are your bowels working OK?
[patient] Um, uh, I think so, yeah, it seems .
[doctor] So, uh, by that I mean, um, any, any diarrhoea, loose stool?
[patient] Uh, no, not that I've, not that I've noticed at all.
[doctor] OK, all right. And um, Jessica, sometimes we have to ask very private sensitive questions, uh, just to , get a full history. Um, hope you don't mind me asking, but are you currently sexually active?
[patient] Uh, yeah I am.
[doctor] OK, is that with a regular, partner?
[patient] Ohh, yeah, so I, I've had a boyfriend for about a, a couple of months now, yeah.
[doctor] Fine, OK. Um, have you noticed any other discharge from, from down below?
[patient] I haven't noticed anything.
[doctor] No, OK. When was your last um, uh, last STD screen? If, if ever?
[patient] Don't think I've ever, I don't think I've ever had one.
[doctor] No, OK, fine. And, and um.
[doctor] Do you use any form of contraception, at all?
[patient] Uh, yeah, we use condoms.
[doctor] You use condoms, OK. And when was your last, period?
[patient] Uh, couple of weeks ago.
[doctor] Three weeks ago, OK. Is there any chance you could be pregnant perhaps?
[patient] Say again.
[doctor] Is there any chance you could be pregnant?
[patient] Uh, I don't think so, I don't.
[doctor] No, no. , it's always worth asking uh, young females like yourself, um. Uh, um, so if that obviously you are worried about the pain.
[patient] Yeah.
[doctor] Um, not getting any better, uh, then I'd always , advise getting a pregnancy test, to rule out pregnancy. OK? Um, fine. So just moving on, moving on. Are you otherwise fit and well?
[patient] Uh-huh.
[patient] Um, yeah, I think I'm, I'm feeling OK, otherwise, yeah.
[doctor] And so by that I mean, do you have any other medical problems, medical , medical history?
[patient] Um, so, in the past I've had some uh, some IBS. Um.
[patient] But, other than that I think no like uh, real serious medical problems that seem, yeah.
[doctor] OK. Do you take any regular medications?
[patient] Uh, no, I did uh, I did uh, a little bit ago, or a couple of days ago, try some uh, over the counter bicarbonate, to try and help with the pain but it wasn't, it wasn't really helping.
[doctor] OK. So you've tried that and it didn't help? OK, all right. Um, do you have any allergies to any medications?
[patient] Uh, yeah, I'm allergic to, Clindamycin.
[doctor] And what happens when you take Clindamycin?
[patient] Um, I, I get some like a, a, a swelling, basically.
[doctor] Right then, OK. So it's quite a, seems like a quite severe allergy to it, is , is that right? Um, OK. Fine. In terms of your family history, is there anything I should be aware of, um, related to kidneys, bladder, bowels, guts?
[patient] Yeah.
[patient] Uh, no I don't think so, not that I, not anything I know about.
[doctor] OK, all right. And tell me a bit more about your home situation. Who's lives, who's at home with you?
[patient] Um, so I live in a, live in a flat near my college, with a, a couple of like friends of mine. Uh, so I'm, I'm not like living at home or anything. Um.
[doctor] OK, and what .
[patient] about sorry.
[doctor] OK, and are you a, are you working at the moment, or are you a student?
[patient] I'm a student.
[doctor] OK, and what are you studying?
[patient] Uh, I'm studying biology.
[doctor] And how's that going?
[patient] Um, it's good yeah, it's really, it's really interesting uh, learning about, learning about how uh, how the world works, yeah.
[doctor] great. Do you have any aspirations for the future, in terms of careers?
[patient] Uh, I don't know, maybe a doctor someday, you never know.
[doctor] , recommend it, we need doctors. Um, what about smoking and alcohol? Do you drink much in the way of, , do you, do you smoke, or do you drink much in the way of alcohol?
[patient] Uh, I don't, I don't smoke, uh, I do drink, like on the weekends, yeah.
[doctor] , so socially, OK. All right. Um, right, excellent. So, um, at this stage I , I would proceed to examination.
[patient] Yeah.
[doctor] But um, based on your story, um, just to summarise really. So, last three days, you've been having bit of burning pain on passing urine. A bit of, crampy tummy pain lower down.
[doctor] Um, , essentially but, but no other fevers or back pain, uh, if I, if I understand correctly.
[doctor] I think probably do have what we call a simple UTI or urinary tract infection, bladder infection, um, which can be readily treated. So, I'll give you a course of antibiotics today.
[patient] Mm-hmm.
[patient] OK.
[doctor] Something, called either Nitrofurantoin, or Trimethoprim. Uh, and it's normally a three day course. Uh, so, one tablet, twice a day, for three days.
[patient] OK.
[doctor] And , that should hopefully help your symptoms, but I also advise you to drink plenty of fluids. Let's try and flush that, you know, that infection out of your body, if you can.
[patient] OK.
[doctor] Um, you can try, cranberry juice, that can sometimes help with your symptoms.
[doctor] Um, and if you're still not better, by the end of this week, I want you to give me a call or come back and see me. And uh, we can have another look at your symptoms.
[patient] OK, so three days of the medication, and then wait a little bit, if it still doesn't go away, call back, that OK?
[doctor] OK.
[doctor] Yeah, yeah absolutely. And things to look out for would be, you know, if you are having kind of, high temperatures, a back pain, um just , generally feeling more unwell.
[doctor] Uh, you know, I do want you give me a call back, 'cause then we do worry whether your infection may be spreading up towards your kidneys, which is something we wanna avoid. So, do, do give me a call if you're having any concerns, OK.
[patient] OK.
[patient] OK, is there, is there anything like, like, should I be worried about? Like, like, not having sex or anything within the next week, or anything like this?
[doctor] Yeah I mean if you can try and avoid it, I think that'd be sensible. Um, uh, it's great that you're using barrier contraception. I would recommend you to continue using barrier contraception, but if you can avoid it while your symptoms clear up. That'd probably be the best for you and your boyfriend,.
[patient] OK, OK. Uh, that, that makes sense. Ohh, OK, thank you so much.
[doctor] All right.
[doctor] Great.
[doctor] Thank you very much. Wish you all the best.
[patient] Yeah, thank you. Take care.

Medical orders:
description: Nitrofurantoin three day course one tablet twice a day
order_type: medication
reason: probably do have what we call a simple UTI bladder infection
description: Trimethoprim three day course one tablet twice a day
order_type: medication
reason: probably do have what we call a simple UTI bladder infection