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med_intent_classification

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wow okay that's that's a lot of siblings
[ "Chitchat" ]
[ "Null" ]
2,300
it's it they they move pretty fast i'm not gon na lie alright so if you do n't mind i'm gon na go ahead and do my my physical exam i'm gon na be calling out some of my findings but if you have any questions go ahead stop me let me know but i will be explaining along the way okay
[ "Physical Examination" ]
[ "Objective" ]
2,301
and are you eating and drinking okay ? any nausea or vomiting , heartburn or indigestion ?
[ "Vegetative History" ]
[ "Subjective" ]
2,302
okay . hey , dragon ? order lisinopril 10 milligrams po daily . okay . uh , so the nurse will be in soon , and she'll get you checked out . okay ?
[ "Chitchat" ]
[ "Null" ]
2,303
and have you had any headaches or swelling or anything like that that's been abnormal ?
[ "Vegetative History" ]
[ "Subjective" ]
2,304
yeah , so my nurse told me you have been going out to eat some on friday nights and saturday nights and that you have had some spicy foods or spicy shrimp .
[ "Acute Symptoms" ]
[ "Subjective" ]
2,305
okay ? i wan na just go ahead and look at some of your results , okay ?
[ "Chitchat" ]
[ "Null" ]
2,306
it's in your outer ankle okay alright and do you have any numbing or tingling in your toes at all
[ "Vegetative History" ]
[ "Subjective" ]
2,307
okay , good . so yeah , you can take two of them twice a day , of what you have . the new prescription will be for four milligrams twice a day .
[ "Discussion", "Medication" ]
[ "Plan" ]
2,308
and does that help ?
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
2,309
turned out to be benign .
[ "Personal History" ]
[ "Subjective" ]
2,310
okay . and no other injuries ? just the finger ?
[ "Acute Symptoms" ]
[ "Subjective" ]
2,311
alright that sounds good we'll see you next week then
[ "Chitchat" ]
[ "Null" ]
2,312
right so this is this is the looks like this is the third day
[ "Acute Symptoms" ]
[ "Subjective" ]
2,313
okay excellent and how about any headaches or other neurologic symptoms like numbness or weakness or you know balance instability or anything like that
[ "Vegetative History" ]
[ "Subjective" ]
2,314
thank you you you're feeling short of breath
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
2,315
okay could stop doing what
[ "Discussion" ]
[ "Plan" ]
2,316
so many knee places there's some right by the harbor that i've i've done some runs there before too it's pretty nice well i mean the boston marathon what can you say right
[ "Chitchat" ]
[ "Null" ]
2,317
yeah i i am addicted to diet coke myself so i i hear you on that one and we had checked your hemoglobin a1c last time it was you know seven . which is pretty good it's not you know it could be better but it's not it's not bad and we talked about sending you to ophthalmology also for an eye exam have you seen ophthalmology in the last few months or last before i saw you
[ "Personal History" ]
[ "Subjective" ]
2,318
great . well ... all right . it's so nice to meet all of you . i wish it was under better circumstances , but we're gon na figure it all out , uh , here today . um , speaking of that , let's go ahead and review some of your past medical history , and then i'll complete an exam of her heart and lungs and kind of move from there . would that be all right with you , ashley ?
[ "Discussion" ]
[ "Subjective" ]
2,319
six eight weeks maybe
[ "Personal History" ]
[ "Subjective" ]
2,320
okay and how about watching your diet are you able to watch your salt intake i know that you really liked a good pizza every now and again are you
[ "Personal History" ]
[ "Subjective" ]
2,321
no willpower like me ?
[ "Chitchat" ]
[ "Null" ]
2,322
hi jeremy how are you
[ "Greetings" ]
[ "Subjective" ]
2,323
yeah alright well i wan na just go ahead and do a quick physical exam on you okay so you know looking at your vital signs here in the office you know your your blood pressure is about one thirty five over eighty so it's it's not too bad and maybe like to see it a little bit lower i'm just gon na be calling out my physical exam findings and i'm gon na let you know what they mean when i'm done okay so on your neck exam i appreciate some jugular venous distention up to about nine centimeters there are no carotid bruits on your lung exam i do appreciate bibasilar crackles with occasional rhonchi that clears when you cough on your heart exam i do appreciate a three out of six systolic ejection murmur heard at the left base and on your lower extremity exam i do appreciate one to two plus pitting edema bilaterally so frank what does that mean all that means is that you have findings on you that suggest that you're retaining fluid now we'll have to talk a little bit about how we're going to address that okay so i wan na just go over a little bit about my assessment and my plan for you okay so for the for your first problem of your shortness of breath i do believe you're having a an acute heart failure exacerbation so i wan na go ahead and increase your lasix from forty milligrams a day to eighty milligrams a day and i want you to call me in two days and let me know how your weight has been with increasing the diuretic now if you start to have worsening shortness of breath before that i want you to yeah call me we may have to admit you to the hospital for some intravenous diuretics okay i also wan na go ahead and just obtain
[ "Physical Examination", "Medication", "Other Treatments", "Acute Assessment" ]
[ "Objective", "Assessment", "Plan" ]
2,324
so i also see you're here for you have a past medical history of of hypertension and when you came in today your blood pressure was a little bit high it was a one fifty over ninety i'm reading here in your chart you're on two point five of norvasc
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
2,325
okay now you mentioned earlier that you you have some tried tried some things in the past so tell me what were they
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
2,326
you're going home who you going for
[ "Chitchat" ]
[ "Null" ]
2,327
you get you get dizzy okay yeah you know we do have you on a what we call a beta-blocker metoprolol i think your dose is fifty milligrams once a day and you know sometimes it takes a little bit for your body to adjust to that but yes if you stand up too quickly it can cause you to be a little dizzy so
[ "Medication", "Therapeutic History" ]
[ "Subjective", "Plan" ]
2,328
so , i'm just gon na check out your heart and your lungs . and you know , let you know what i find , okay ?
[ "Physical Examination" ]
[ "Objective" ]
2,329
mhm . okay .
[ "Acute Symptoms" ]
[ "Subjective" ]
2,330
so , we need to investigate why it's low . hey , dragon , show me the anemia labs . okay . so , looking here at your labs , uh , everything looks good from , from this standpoint . i think some of your anemia labs are still pending at this time that's part of the workup .
[ "Lab Examination" ]
[ "Objective" ]
2,331
mm-hmm . how many times do you have to get up at night ?
[ "Vegetative History" ]
[ "Subjective" ]
2,332
maybe maybe we could we could always stick them in they could get some work done the holidays must be fun at your place
[ "Chitchat" ]
[ "Null" ]
2,333
yeah i mean are you having any thoughts of of harming yourself or harming others
[ "Vegetative History" ]
[ "Subjective" ]
2,334
alright that sounds good i'll i'll be in touch with you with those results okay
[ "Chitchat" ]
[ "Null" ]
2,335
okay well you know that's not good we'll we'll hopefully we can get you fixed up here so how much how much pain have you been in on a scale of one to ten with ten being the worst pain you ever felt
[ "Acute Symptoms" ]
[ "Subjective" ]
2,336
okay that that that's definitely good because when you came in i think we did a glucose test on you couple of months ago and you were around three hundred which is which is pretty up there so i'm glad that you know those levels are down and have you been taking that metformin everyday
[ "Discussion" ]
[ "Plan" ]
2,337
okay . and it does n't happen for multiple days in a row or is it just one time ?
[ "Personal History", "Vegetative History" ]
[ "Subjective" ]
2,338
doctor: that sounds great . and then we can get it all in process . and it was so nice to meet you . and catherine will be right in to get your photos . julia jones is a 25 year old female with symptomatic macromastia , presenting for evaluation of breast reduction . the patient has attempted nonsurgical treatments , but the minimal relief , and is an ideal candidate for bilateral reduction mammoplasty . her minimum required resection , based on a bsa of 2.65 , with the schnur scale is 1,792 grams , which should be attainable . given her extremely large breasts and the measurements above , there is potential for using a nipple graft . physical exam findings of breast , inspection reveals asymmetrical breasts with severe ptosis bilaterally . there is no nipple retraction or discharge bilaterally . no breast tenderness , masses , or axillary lymphadenopathy is palpable .
[ "Physical Examination", "Personal History" ]
[ "Subjective", "Objective" ]
2,339
hmm . has it been keeping you from doing things during the day ?
[ "Other Socials" ]
[ "Subjective" ]
2,340
good i'm doctor sanchez and i'm gon na go ahead and take a look i saw with your notes that you've been having some knee pain yes that's that's true you know it's been going on for a while i like to run i do jogs i sign up for the 5k tack you know sometimes the marathon and i have n't been doing longer distances because
[ "Acute Symptoms" ]
[ "Subjective" ]
2,341
any recent travel or contact or exposure to the coronavirus ?
[ "Other Socials" ]
[ "Subjective" ]
2,342
okay , good . all right . well , let me do a quick physical exam , okay ?
[ "Physical Examination" ]
[ "Objective" ]
2,343
hey , dragon , order a thyroid panel . and then for your last problem , the arthritis , you know , we just kinda talked about that . you know , it's gon na be a struggle for you because again , you ca n't take some of those anti-inflammatory medications because of your kidney transplant , so ...
[ "Discussion", "Medication", "Diagnostic Testing", "Reassessment" ]
[ "Assessment", "Plan" ]
2,344
hey , dragon . show me the glucose . so , right now , your blood sugar is about 162 . have you eaten before you came in here ?
[ "Lab Examination" ]
[ "Objective" ]
2,345
um , for your second problem of your type two diabetes i'd like to go ahead and order a hemoglobin a1c in the next couple months . i want to increase the metformin to 1000 milligrams twice a day . and we're gon na go ahead and order a lipid panel , okay .
[ "Reassessment", "Diagnostic Testing", "Medication" ]
[ "Assessment", "Plan" ]
2,346
okay , great . and that way you do n't have to share , um , with his sister .
[ "Chitchat" ]
[ "Null" ]
2,347
hi billy how are you what's been going on the medical assistant told me that you're having some difficulty urinating
[ "Acute Symptoms", "Greetings" ]
[ "Subjective" ]
2,348
. which we've heard in the past . okay , so that seems stable . on your knee exam , there is some edema and some erythema of your right knee , but your left knee looks fine , okay ? um , you do have some pain to palpation of the right knee and some decreased range of motion , um , on exam , okay ? so what does that mean ? so we'll go ahead and we'll see if we can take a look at some of these things . i know that they did an x-ray before you came in , okay ?
[ "Physical Examination" ]
[ "Objective" ]
2,349
okay and outside of physical activity you're not having any problems
[ "Acute Symptoms", "Drug History" ]
[ "Subjective" ]
2,350
well that's good that you're trying to help her with the learning how to ride a bike
[ "Other Socials" ]
[ "Subjective" ]
2,351
um , maybe . let's see how you're doing in the next three weeks .
[ "Discussion", "Follow-up" ]
[ "Plan" ]
2,352
okay alright no weakness or numbness in your legs right now
[ "Acute Symptoms" ]
[ "Subjective" ]
2,353
i do i do believe that that pain is gon na go away many of my patients are successful with pt so we are gon na start with that take a conservative approach and see how you do
[ "Discussion" ]
[ "Plan" ]
2,354
i'm gon na kinda leave that up to you and the and the therapist i would start with a couple visits and then we'll just really see how you progress and what you can do at home if what if you have access to some equipment or things that we need to do but i want you to go you know at least a few times so somebody can kinda keep an eye on you make sure you're doing the exercises right
[ "Discussion" ]
[ "Plan" ]
2,355
okay . and how about your ... your acid reflux ? how are you doing with ... i know you were making some diet changes .
[ "Personal History" ]
[ "Subjective" ]
2,356
how is his energy ? does he seem like he wants to take more naps , or does he have pretty good energy ?
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
2,357
not yet let's let's get the that's a great question i may end up referring you to a a pain doctor for that low back pain but i really would like to start with some of the diagnostics first let's get an x-ray and if there is you know any question of that x-ray and the pain continues i'm gon na go ahead and maybe order a cat scan and then at that point in time we can refer you to a pain doctor if we're still having significant pain
[ "Discussion", "Diagnostic Testing", "Referral" ]
[ "Plan" ]
2,358
alright has the ibuprofen helped at all
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
2,359
okay , so you've gone a couple days without it ?
[ "Vegetative History" ]
[ "Subjective" ]
2,360
take care jacqueline
[ "Chitchat" ]
[ "Null" ]
2,361
wow it sounds like a variety of projects but if you're putting down stone you're probably lifting those as well and then
[ "Other Socials" ]
[ "Subjective" ]
2,362
hey dragon ? show me the diabetes labs . okay , so ... in reviewing the results of your diabetes labs , your hemoglobin a1c is a little elevated at eight . i'd like to see it a little bit better , okay ?
[ "Lab Examination" ]
[ "Objective" ]
2,363
okay . any blood ?
[ "Vegetative History" ]
[ "Subjective" ]
2,364
my gosh alright we're gon na have to work on you
[ "Chitchat" ]
[ "Null" ]
2,365
no not by any means i am saying
[ "Acute Assessment" ]
[ "Assessment" ]
2,366
okay . if you wan na lay down here on the table for me and lets take a look at you .
[ "Physical Examination" ]
[ "Objective" ]
2,367
doctor: no problem
[ "Chitchat" ]
[ "Null" ]
2,368
yes it is , yeah .
[ "Discussion" ]
[ "Plan" ]
2,369
okay , you can go ahead and sit him back up if you like .
[ "Physical Examination" ]
[ "Objective" ]
2,370
okay alright
[ "Acute Symptoms" ]
[ "Subjective" ]
2,371
okay and
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
2,372
jerry is a 54 year old male with a past medical history , significant for osteoporosis and multiple sclerosis who presents for an annual exam . so jerry , what's been going on since the last time i saw you ?
[ "Personal History" ]
[ "Subjective" ]
2,373
how 'bout when i lift this leg ?
[ "Physical Examination" ]
[ "Objective" ]
2,374
okay okay the how is there anything that you were doing out of the ordinary when this started
[ "Acute Symptoms" ]
[ "Subjective" ]
2,375
correct .
[ "Physical Examination" ]
[ "Objective" ]
2,376
hey george how are you today i understand you're here for some numbness and tingling in your fingers and some pain in your wrist
[ "Acute Symptoms", "Greetings" ]
[ "Subjective" ]
2,377
okay , and any cough ?
[ "Acute Symptoms" ]
[ "Subjective" ]
2,378
okay do you know which ones that they prescribed for you
[ "Therapeutic History" ]
[ "Subjective" ]
2,379
okay . so tell me about the diarrhea , how often do you get it ?
[ "Personal History", "Vegetative History" ]
[ "Subjective" ]
2,380
okay and i may miss did you say what have you been taking for pain for that
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
2,381
you could but what we found is the best outcome is aligning those bones with plates and screws to make sure that they heal properly so you have the best outcome possible
[ "Discussion", "Other Treatments" ]
[ "Plan" ]
2,382
all right , and then , for your last problem , the peptic ulcer disease , um , i want you to continue on the protonix , 40 mg , once a day before meals , okay ?
[ "Medication", "Reassessment" ]
[ "Assessment", "Plan" ]
2,383
okay . and i'm gon na hold your leg out , i'm gon na hold , i want you to stiffen your upper ... does that hurt when i do that ?
[ "Physical Examination" ]
[ "Objective" ]
2,384
perfect ! we will give you a reminder as well . we will also need to complete a pre-op check within two weeks of your surgery during the first or second week of june .
[ "Follow-up" ]
[ "Plan" ]
2,385
okay and when you have that kind of pain does it keep you from doing other type of activities
[ "Other Socials" ]
[ "Subjective" ]
2,386
okay yeah so you want
[ "Vegetative History" ]
[ "Subjective" ]
2,387
no okay just the chest pain alright
[ "Vegetative History" ]
[ "Subjective" ]
2,388
okay is the ibuprofen any better than the tylenol
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
2,389
okay , all right . um , and any other symptoms ? i know you went through the review of symptoms-
[ "Vegetative History" ]
[ "Subjective" ]
2,390
and expect a call from radiology scheduling about setting up your ultrasound .
[ "Diagnostic Testing" ]
[ "Plan" ]
2,391
horrible nerve pain it sounds like
[ "Therapeutic History" ]
[ "Subjective" ]
2,392
okay , great . all right . well , that is it for the exam .
[ "Physical Examination" ]
[ "Objective" ]
2,393
so it can you know your kidney function we've you know i think you've been really lucky it's been normal i checked it about two months ago and it looks pretty good it looks pretty normal but since we're doing blood work on you i can go ahead and order a a basic metabolic panel just to make sure that your kidney function is stable
[ "Discussion", "Diagnostic Testing" ]
[ "Plan" ]
2,394
okay . can you tell me if the pain radiates , or if you have any other symptoms ? specifically feeling sick , fever , rashes , neck stiffness , numbness , weakness , passing out ?
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
2,395
do you have any like plans for the holiday
[ "Other Socials" ]
[ "Subjective" ]
2,396
yeah definitely take your medication on time and see that nutritionist and hopefully we can get your get your diet on track as well
[ "Discussion", "Medication", "Other Treatments" ]
[ "Plan" ]
2,397
on the right . is there anything that makes it better or worse ?
[ "Acute Symptoms" ]
[ "Subjective" ]
2,398
yeah yeah it's a definitely a good time to come see me so what part of your knee would you say it hurts
[ "Acute Symptoms" ]
[ "Subjective" ]
2,399