| """ |
| generate_samples.py |
| Generates realistic healthcare sample files for testing the Agentic RAG app. |
| - sample_clinical_guidelines.pdf (clinical protocol document) |
| - sample_drug_interactions.csv (drug interaction database) |
| - sample_patient_records.xlsx (patient records + prescriptions) |
| - sample_treatment_notes.txt (doctor's clinical notes) |
| """ |
| import os |
| from fpdf import FPDF |
| import openpyxl |
| from openpyxl.styles import Font, PatternFill, Alignment |
| import csv |
|
|
| OUTPUT_DIR = os.path.join(os.path.dirname(__file__), "sample_data") |
| os.makedirs(OUTPUT_DIR, exist_ok=True) |
|
|
|
|
| |
| |
| |
| def make_pdf(): |
| pdf = FPDF() |
| pdf.set_auto_page_break(auto=True, margin=15) |
| pdf.add_page() |
|
|
| def heading(text, size=14): |
| pdf.set_font("Helvetica", "B", size) |
| pdf.set_fill_color(220, 235, 245) |
| pdf.cell(0, 10, text, ln=True, fill=True) |
| pdf.ln(2) |
|
|
| def body(text, size=10): |
| pdf.set_font("Helvetica", "", size) |
| pdf.multi_cell(0, 6, text) |
| pdf.ln(2) |
|
|
| |
| pdf.set_font("Helvetica", "B", 20) |
| pdf.cell(0, 15, "City General Hospital", ln=True, align="C") |
| pdf.set_font("Helvetica", "B", 16) |
| pdf.cell(0, 10, "Clinical Treatment Guidelines — 2025 Edition", ln=True, align="C") |
| pdf.set_font("Helvetica", "", 10) |
| pdf.cell(0, 8, "Department of Internal Medicine | Version 4.2", ln=True, align="C") |
| pdf.ln(10) |
|
|
| heading("1. Hypertension Management Protocol") |
| body( |
| "Hypertension is defined as systolic blood pressure >= 130 mmHg or diastolic BP >= 80 mmHg " |
| "(ACC/AHA 2025 Guidelines). First-line treatment includes lifestyle modification for all stages.\n\n" |
| "Stage 1 (130-139 / 80-89 mmHg): Lifestyle changes for 3-6 months. If no improvement, initiate " |
| "antihypertensive monotherapy. Preferred agents: ACE inhibitors (e.g., Lisinopril 10mg OD), " |
| "ARBs (e.g., Losartan 50mg OD), or Thiazide diuretics (e.g., Hydrochlorothiazide 12.5mg OD).\n\n" |
| "Stage 2 (>= 140/90 mmHg): Dual-agent therapy recommended. Combine ACE inhibitor + Calcium " |
| "Channel Blocker (e.g., Amlodipine 5mg OD). Monitor BP every 4 weeks until controlled.\n\n" |
| "Contraindications: ACE inhibitors are contraindicated in pregnancy (Category D). ARBs should " |
| "not be used concurrently with ACE inhibitors due to increased risk of hyperkalaemia and AKI." |
| ) |
|
|
| heading("2. Type 2 Diabetes Mellitus Protocol") |
| body( |
| "Diagnosis: Fasting blood glucose >= 126 mg/dL, HbA1c >= 6.5%, or 2-hour OGTT >= 200 mg/dL.\n\n" |
| "First-Line Therapy: Metformin 500mg BD with meals (titrate to 2000mg/day). Contraindicated in " |
| "eGFR < 30 mL/min/1.73m2 and active liver disease.\n\n" |
| "Second-Line Options:\n" |
| " - SGLT2 inhibitors (Empagliflozin 10mg OD) — preferred in patients with HF or CKD.\n" |
| " - GLP-1 agonists (Semaglutide 0.5mg SC weekly) — preferred for weight reduction.\n" |
| " - DPP-4 inhibitors (Sitagliptin 100mg OD) — weight neutral, good tolerability.\n\n" |
| "Monitoring: HbA1c every 3 months until target (< 7.0%), then every 6 months. " |
| "Annual renal function (eGFR, urine ACR), lipid panel, and retinal screening." |
| ) |
|
|
| heading("3. Antibiotic Prescribing Guidelines — Respiratory Infections") |
| body( |
| "Community-Acquired Pneumonia (CAP):\n" |
| " Outpatient (mild): Amoxicillin 1g TDS x 5 days OR Doxycycline 100mg BD x 5 days.\n" |
| " Inpatient (moderate): Amoxicillin-Clavulanate 1.2g IV TDS + Clarithromycin 500mg BD.\n" |
| " ICU (severe): Piperacillin-Tazobactam 4.5g IV TDS + Azithromycin 500mg IV OD.\n\n" |
| "Penicillin Allergy: Replace Amoxicillin with Levofloxacin 750mg OD (5 days, outpatient) " |
| "or Meropenem 1g IV TDS (severe inpatient).\n\n" |
| "Duration: Minimum 5 days. Extend to 7 days if Legionella or Staphylococcal pneumonia.\n\n" |
| "Note: Blood cultures MUST be drawn before initiating antibiotics in all inpatients." |
| ) |
|
|
| heading("4. Sepsis — Early Recognition and Management (Sepsis-3)") |
| body( |
| "Definition: Life-threatening organ dysfunction caused by dysregulated host response to infection.\n" |
| "SOFA score increase >= 2 points from baseline in the presence of suspected infection.\n\n" |
| "Hour-1 Bundle (complete within 60 minutes of recognition):\n" |
| " 1. Measure lactate. Re-measure if initial lactate > 2 mmol/L.\n" |
| " 2. Obtain blood cultures (2 sets) BEFORE antibiotics.\n" |
| " 3. Administer broad-spectrum antibiotics (e.g., Meropenem 1g IV + Vancomycin 25mg/kg).\n" |
| " 4. Begin rapid infusion of 30 mL/kg IV crystalloid (Normal Saline or Lactated Ringer's).\n" |
| " 5. Apply vasopressors if MAP < 65 mmHg despite resuscitation. Norepinephrine is first-line.\n\n" |
| "Septic Shock: Refractory hypotension requiring vasopressors. Add Hydrocortisone 200mg/day " |
| "IV if norepinephrine dose > 0.25 mcg/kg/min." |
| ) |
|
|
| heading("5. Drug Contraindications in Renal Failure (eGFR < 30)") |
| body( |
| "The following medications require dose adjustment or are contraindicated in severe renal impairment:\n\n" |
| "AVOID entirely:\n" |
| " - Metformin (risk of lactic acidosis)\n" |
| " - NSAIDs including Ibuprofen, Naproxen (further deterioration of renal function)\n" |
| " - Nitrofurantoin (ineffective and accumulates)\n" |
| " - Direct oral anticoagulants: Dabigatran (renally cleared — use Warfarin instead)\n\n" |
| "Dose-reduce:\n" |
| " - Enoxaparin: reduce to 1 mg/kg SC OD (from normal BD)\n" |
| " - Gabapentin: max 300mg OD (normal dose up to 3600mg/day)\n" |
| " - Ciprofloxacin: 250-500mg BD (reduce by 50%)\n\n" |
| "Monitor closely:\n" |
| " - Digoxin, Lithium — narrow therapeutic index; check levels weekly." |
| ) |
|
|
| out = os.path.join(OUTPUT_DIR, "sample_clinical_guidelines.pdf") |
| pdf.output(out) |
| print(f" ✓ PDF created: {out}") |
|
|
|
|
| |
| |
| |
| def make_csv(): |
| rows = [ |
| ["Drug A", "Drug B", "Severity", "Interaction Effect", "Clinical Action"], |
| ["Warfarin", "Aspirin", "Major", "Increased bleeding risk — additive anticoagulant effect", "Avoid combination; if necessary, use lowest aspirin dose and monitor INR closely"], |
| ["Metformin", "Contrast Dye (IV)", "Major", "Risk of contrast-induced nephropathy and lactic acidosis", "Hold Metformin 48h before and after IV contrast; check renal function before restarting"], |
| ["Lisinopril", "Potassium supplements", "Moderate", "Hyperkalaemia — ACE inhibitor reduces potassium excretion", "Monitor serum potassium every 1-2 weeks; target K+ 3.5-5.0 mEq/L"], |
| ["Simvastatin", "Clarithromycin", "Major", "CYP3A4 inhibition increases Simvastatin levels — risk of myopathy/rhabdomyolysis", "Switch to Azithromycin or hold Simvastatin during antibiotic course"], |
| ["Amlodipine", "Simvastatin", "Moderate", "Amlodipine inhibits CYP3A4 — Simvastatin levels may increase", "Limit Simvastatin dose to 20mg/day when combined with Amlodipine"], |
| ["Ciprofloxacin", "Antacids (Aluminium/Magnesium)", "Moderate", "Chelation reduces Ciprofloxacin absorption by up to 90%", "Take Ciprofloxacin 2 hours before or 6 hours after antacids"], |
| ["Clopidogrel", "Omeprazole", "Moderate", "Omeprazole inhibits CYP2C19 — reduces Clopidogrel antiplatelet effect", "Switch PPI to Pantoprazole (lower CYP2C19 inhibition)"], |
| ["Methotrexate", "NSAIDs", "Major", "NSAIDs reduce renal clearance of Methotrexate — toxicity risk", "Avoid NSAIDs; use Paracetamol for analgesia in patients on Methotrexate"], |
| ["Lithium", "Thiazide diuretics", "Major", "Diuretics reduce renal Lithium excretion — risk of lithium toxicity", "Monitor Lithium levels weekly; consider alternative diuretic or reduce Lithium dose"], |
| ["Sildenafil", "Nitrates", "Contraindicated", "Severe hypotension — both vasodilate via different pathways", "Absolute contraindication; do not co-prescribe under any circumstance"], |
| ["Digoxin", "Amiodarone", "Major", "Amiodarone inhibits P-glycoprotein — Digoxin levels increase by 50-100%", "Reduce Digoxin dose by 50% when starting Amiodarone; monitor levels and ECG"], |
| ["Tramadol", "SSRIs (e.g., Sertraline)", "Major", "Serotonin syndrome — additive serotonergic effects", "Avoid combination; use alternative analgesics (e.g., low-dose opioids with caution)"], |
| ["Fluconazole", "Warfarin", "Major", "CYP2C9 inhibition dramatically increases Warfarin effect", "Reduce Warfarin dose by 30-50%; monitor INR every 2-3 days during fluconazole course"], |
| ["Atorvastatin", "Rifampicin", "Major", "Rifampicin induces CYP3A4 — Atorvastatin levels reduced by 80%", "Increase Atorvastatin dose or switch to Rosuvastatin (less CYP3A4-dependent)"], |
| ["Phenytoin", "Carbamazepine", "Moderate", "Carbamazepine induces CYP3A4 — may reduce Phenytoin levels", "Monitor Phenytoin levels monthly; adjust dose as required"], |
| ["Doxycycline", "Calcium supplements", "Moderate", "Chelation reduces Doxycycline absorption", "Take Doxycycline 1-2 hours before calcium supplements"], |
| ["Enoxaparin", "Ketorolac", "Major", "Additive anticoagulant effect — high bleeding risk", "Avoid concurrent use; if pain management needed, use Paracetamol"], |
| ["Tacrolimus", "Grapefruit juice", "Moderate", "CYP3A4 inhibition — increases Tacrolimus blood levels unpredictably", "Advise patients to avoid grapefruit and grapefruit juice entirely"], |
| ["Metoprolol", "Verapamil", "Major", "Additive negative chronotropic/inotropic effect — bradycardia and heart block risk", "Avoid combination; if essential, monitor ECG continuously and use lowest doses"], |
| ] |
|
|
| out = os.path.join(OUTPUT_DIR, "sample_drug_interactions.csv") |
| with open(out, "w", newline="", encoding="utf-8") as f: |
| writer = csv.writer(f) |
| writer.writerows(rows) |
| print(f" ✓ CSV created: {out}") |
|
|
|
|
| |
| |
| |
| def make_excel(): |
| wb = openpyxl.Workbook() |
|
|
| HEADER_FONT = Font(bold=True, color="FFFFFF", size=11) |
| HEADER_FILL = PatternFill("solid", fgColor="1F4E79") |
| ALT_FILL = PatternFill("solid", fgColor="D6E4F0") |
| CENTER = Alignment(horizontal="center", vertical="center", wrap_text=True) |
|
|
| def style_sheet(ws, headers): |
| ws.row_dimensions[1].height = 28 |
| for col_idx, h in enumerate(headers, 1): |
| cell = ws.cell(row=1, column=col_idx, value=h) |
| cell.font = HEADER_FONT |
| cell.fill = HEADER_FILL |
| cell.alignment = CENTER |
| return ws |
|
|
| |
| ws1 = wb.active |
| ws1.title = "Patient Registry" |
| h1 = ["Patient ID", "Full Name", "DOB", "Age", "Gender", "Blood Group", |
| "Primary Diagnosis", "Secondary Diagnosis", "Allergies", "Attending Physician", "Ward"] |
| style_sheet(ws1, h1) |
| patients = [ |
| ["P-1001", "James Mitchell", "1952-03-14", 72, "M", "A+", "Hypertension Stage 2", "Type 2 Diabetes", "Penicillin", "Dr. Sarah Chen", "Cardiology"], |
| ["P-1002", "Mary Patel", "1968-07-22", 56, "F", "B+", "Type 2 Diabetes", "CKD Stage 3", "Sulphonamides", "Dr. Raj Kumar", "Endocrinology"], |
| ["P-1003", "Robert Nguyen", "1945-11-05", 79, "M", "O-", "COPD — Gold Stage 3", "Atrial Fibrillation", "Aspirin, NSAIDs", "Dr. Lisa Tran", "Respiratory"], |
| ["P-1004", "Angela Brooks", "1980-01-30", 45, "F", "AB+", "Rheumatoid Arthritis", "Osteoporosis", "None known", "Dr. Tom Walsh", "Rheumatology"], |
| ["P-1005", "David Park", "1975-09-18", 49, "M", "A-", "Sepsis — Day 3", "Pneumonia (CAP)", "Cephalosporins", "Dr. Sarah Chen", "ICU"], |
| ["P-1006", "Helen Costa", "1960-06-03", 64, "F", "B-", "Heart Failure (EF 35%)","Hypertension", "ACE inhibitors", "Dr. Raj Kumar", "Cardiology"], |
| ["P-1007", "Michael Okafor", "1992-12-27", 32, "M", "O+", "Epilepsy", "Depression", "Carbamazepine", "Dr. Emma Singh", "Neurology"], |
| ["P-1008", "Susan Lee", "1958-04-16", 66, "F", "A+", "Breast Cancer — Stage 2","Anaemia", "Methotrexate", "Dr. James Roy", "Oncology"], |
| ["P-1009", "Carlos Reyes", "1988-08-09", 36, "M", "B+", "HIV/AIDS — on ART", "Hepatitis B", "Doxycycline", "Dr. Emma Singh", "Infectious Disease"], |
| ["P-1010", "Margaret Johnson", "1940-02-20", 85, "F", "O+", "Dementia — Alzheimer's","Hypertension, AF", "Warfarin", "Dr. Lisa Tran", "Geriatrics"], |
| ] |
| for i, row in enumerate(patients, 2): |
| for j, val in enumerate(row, 1): |
| c = ws1.cell(row=i, column=j, value=val) |
| if i % 2 == 0: |
| c.fill = ALT_FILL |
| ws1.column_dimensions["A"].width = 10 |
| ws1.column_dimensions["B"].width = 20 |
| ws1.column_dimensions["G"].width = 28 |
| ws1.column_dimensions["H"].width = 22 |
| ws1.column_dimensions["I"].width = 22 |
|
|
| |
| ws2 = wb.create_sheet("Prescriptions") |
| h2 = ["Patient ID", "Medication", "Dose", "Route", "Frequency", "Indication", |
| "Start Date", "Review Date", "Prescribing Doctor", "Notes"] |
| style_sheet(ws2, h2) |
| prescriptions = [ |
| ["P-1001", "Amlodipine", "10mg", "Oral", "Once daily", "Stage 2 HTN", "2025-01-10", "2025-04-10", "Dr. Sarah Chen", "Monitor ankle oedema"], |
| ["P-1001", "Metformin", "1000mg", "Oral", "Twice daily", "Type 2 DM", "2025-01-10", "2025-04-10", "Dr. Sarah Chen", "Take with meals"], |
| ["P-1002", "Insulin Glargine", "20 units","SC", "At bedtime", "Type 2 DM — poor control","2025-02-01","2025-05-01","Dr. Raj Kumar","Adjust dose per SMBG"], |
| ["P-1002", "Losartan", "50mg", "Oral", "Once daily", "HTN + CKD renoprotection","2025-02-01","2025-05-01","Dr. Raj Kumar","Monitor K+ monthly"], |
| ["P-1003", "Tiotropium inhaler", "18mcg", "Inhaled","Once daily", "COPD — bronchodilation","2024-11-15","2025-05-15","Dr. Lisa Tran","Rinse mouth after use"], |
| ["P-1003", "Edoxaban", "30mg", "Oral", "Once daily", "Atrial Fibrillation","2024-11-15","2025-05-15","Dr. Lisa Tran","Reduce dose for low weight/CrCl"], |
| ["P-1004", "Methotrexate", "15mg", "Oral", "Weekly (Monday)", "Rheumatoid Arthritis","2024-09-01","2025-03-01","Dr. Tom Walsh","MUST take Folic Acid 5mg 6 days/week"], |
| ["P-1004", "Folic Acid", "5mg", "Oral", "Six days/week", "MTX side-effect prevention","2024-09-01","2025-03-01","Dr. Tom Walsh","Take every day EXCEPT MTX day"], |
| ["P-1005", "Meropenem", "1g", "IV", "Every 8 hours", "Sepsis / CAP", "2025-03-01", "2025-03-08", "Dr. Sarah Chen", "Day 3 of 7-day course; culture-guided de-escalation"], |
| ["P-1005", "Norepinephrine", "0.1 mcg/kg/min","IV drip","Continuous","Septic shock — MAP support","2025-03-01","2025-03-03","Dr. Sarah Chen","Titrate to MAP >= 65 mmHg"], |
| ["P-1006", "Furosemide", "40mg", "Oral", "Twice daily", "Heart Failure — fluid overload","2025-01-20","2025-04-20","Dr. Raj Kumar","Monitor daily weights; target -0.5 to -1 kg/day"], |
| ["P-1006", "Carvedilol", "6.25mg", "Oral", "Twice daily", "HF — EF reduction", "2025-01-20", "2025-04-20", "Dr. Raj Kumar", "Uptitrate slowly every 2 weeks"], |
| ["P-1007", "Levetiracetam", "1000mg", "Oral", "Twice daily", "Epilepsy control", "2024-06-15", "2025-06-15", "Dr. Emma Singh","Review seizure diary at each visit"], |
| ["P-1008", "Paclitaxel", "175 mg/m2","IV", "Every 3 weeks", "Breast Cancer — adjuvant chemo","2025-02-10","2025-05-10","Dr. James Roy","Pre-medicate: Dexamethasone + Diphenhydramine"], |
| ["P-1009", "Tenofovir/Emtricitabine","300/200mg","Oral","Once daily", "HIV ART", "2023-07-01", "2025-07-01", "Dr. Emma Singh","Renal function every 6 months"], |
| ["P-1010", "Donepezil", "10mg", "Oral", "At bedtime", "Alzheimer's dementia","2024-03-01","2025-03-01","Dr. Lisa Tran", "Watch for bradycardia — check pulse monthly"], |
| ["P-1010", "Apixaban", "2.5mg", "Oral", "Twice daily", "Atrial Fibrillation","2024-03-01","2025-03-01","Dr. Lisa Tran", "Reduced dose: age >80, low weight"], |
| ] |
| for i, row in enumerate(prescriptions, 2): |
| for j, val in enumerate(row, 1): |
| c = ws2.cell(row=i, column=j, value=val) |
| if i % 2 == 0: |
| c.fill = ALT_FILL |
| for col in ["B","F","J"]: |
| ws2.column_dimensions[col].width = 28 |
|
|
| |
| ws3 = wb.create_sheet("Lab Results") |
| h3 = ["Patient ID", "Test Name", "Result", "Unit", "Reference Range", "Flag", "Date", "Ordering Doctor"] |
| style_sheet(ws3, h3) |
| labs = [ |
| ["P-1001", "HbA1c", "8.2", "%", "4.0–5.6", "HIGH", "2025-02-28", "Dr. Sarah Chen"], |
| ["P-1001", "Serum Creatinine","112", "umol/L", "62–115", "Normal","2025-02-28","Dr. Sarah Chen"], |
| ["P-1001", "eGFR", "58", "mL/min/1.73m2",">=60", "LOW", "2025-02-28", "Dr. Sarah Chen"], |
| ["P-1002", "HbA1c", "10.1", "%", "4.0–5.6", "HIGH", "2025-02-20", "Dr. Raj Kumar"], |
| ["P-1002", "Serum Potassium","5.6", "mEq/L", "3.5–5.0", "HIGH", "2025-02-20", "Dr. Raj Kumar"], |
| ["P-1002", "eGFR", "22", "mL/min/1.73m2",">=60", "CRITICAL LOW","2025-02-20","Dr. Raj Kumar"], |
| ["P-1003", "FEV1", "42", "% predicted",">=80", "LOW", "2025-01-15", "Dr. Lisa Tran"], |
| ["P-1003", "INR", "2.4", "ratio", "2.0–3.0 (AF)", "Normal","2025-02-25","Dr. Lisa Tran"], |
| ["P-1005", "Lactate", "4.8", "mmol/L", "<2.0", "CRITICAL HIGH","2025-03-01","Dr. Sarah Chen"], |
| ["P-1005", "WBC", "22.4", "x10^9/L", "4.0–11.0", "HIGH", "2025-03-01", "Dr. Sarah Chen"], |
| ["P-1005", "CRP", "286", "mg/L", "<5", "HIGH", "2025-03-01", "Dr. Sarah Chen"], |
| ["P-1006", "BNP", "1820", "pg/mL", "<100", "CRITICAL HIGH","2025-01-18","Dr. Raj Kumar"], |
| ["P-1006", "Serum Sodium", "128", "mEq/L", "135–145", "LOW", "2025-01-18", "Dr. Raj Kumar"], |
| ["P-1008", "Neutrophil count","0.8","x10^9/L", ">2.0", "CRITICAL LOW","2025-02-25","Dr. James Roy"], |
| ["P-1010", "Serum Digoxin", "2.8", "nmol/L", "1.0–2.6", "HIGH", "2025-02-10", "Dr. Lisa Tran"], |
| ] |
| for i, row in enumerate(labs, 2): |
| for j, val in enumerate(row, 1): |
| c = ws3.cell(row=i, column=j, value=val) |
| if row[5] in ("CRITICAL HIGH", "CRITICAL LOW"): |
| c.fill = PatternFill("solid", fgColor="FFD7D7") |
| elif i % 2 == 0: |
| c.fill = ALT_FILL |
| ws3.column_dimensions["B"].width = 22 |
| ws3.column_dimensions["E"].width = 22 |
|
|
| out = os.path.join(OUTPUT_DIR, "sample_patient_records.xlsx") |
| wb.save(out) |
| print(f" ✓ Excel created: {out}") |
|
|
|
|
| |
| |
| |
| def make_txt(): |
| content = """\ |
| ================================================================================ |
| CITY GENERAL HOSPITAL — CLINICAL NOTES REPOSITORY |
| Department of Internal Medicine & Critical Care |
| Generated: March 2025 |
| ================================================================================ |
| |
| ──────────────────────────────────────────────────────────────────────────────── |
| PATIENT: James Mitchell | ID: P-1001 | DOB: 14-Mar-1952 | Ward: Cardiology |
| ATTENDING: Dr. Sarah Chen | Date: 28-Feb-2025 |
| ──────────────────────────────────────────────────────────────────────────────── |
| |
| PRESENTING COMPLAINT: |
| Patient presents for routine follow-up of Stage 2 hypertension and Type 2 Diabetes |
| Mellitus. Reports intermittent headaches in the morning, rated 4/10. Denies chest pain, |
| palpitations, or visual disturbances. Good medication compliance per patient report. |
| |
| VITAL SIGNS: |
| BP: 158/96 mmHg (elevated — target <130/80) HR: 78 bpm SpO2: 97% Temp: 36.8°C |
| Weight: 94 kg BMI: 31.2 (Obese Class I) |
| |
| ASSESSMENT & PLAN: |
| 1. Hypertension — suboptimally controlled. Increase Amlodipine from 5mg to 10mg OD. |
| Add Indapamide 1.5mg MR if BP remains >140/90 at next visit in 4 weeks. |
| 2. Type 2 DM — HbA1c 8.2% (target <7%). Increase Metformin to 1000mg BD. |
| Refer to dietitian for medical nutrition therapy. Consider adding Empagliflozin |
| 10mg OD at next visit given BMI and cardiovascular risk. |
| 3. CKD Stage 2 (eGFR 58) — monitor. AVOID NSAIDs. Annual urine ACR. |
| 4. Statin therapy — Atorvastatin 40mg OD continued. LDL target <1.8 mmol/L. |
| REVIEW: 4 weeks. FBC, U&E, HbA1c, fasting lipids to be repeated. |
| |
| ──────────────────────────────────────────────────────────────────────────────── |
| PATIENT: David Park | ID: P-1005 | DOB: 18-Sep-1975 | Ward: ICU (Bed 4) |
| ATTENDING: Dr. Sarah Chen | Date: 01-Mar-2025 | Time: 06:30 |
| ──────────────────────────────────────────────────────────────────────────────── |
| |
| PRESENTING COMPLAINT: |
| 49-year-old male admitted via Emergency Dept with 3-day history of productive cough, |
| fever (Tmax 39.4°C), and rigors. Developed sudden haemodynamic deterioration at 02:00. |
| BP dropped to 72/40 mmHg. Diagnosed as Septic Shock secondary to Community-Acquired |
| Pneumonia. History of allergy to Cephalosporins (rash). |
| |
| MANAGEMENT (Hour-1 Sepsis Bundle — COMPLETED at 03:15): |
| ✓ Blood cultures x2 taken at 02:45 — results pending |
| ✓ Lactate: 4.8 mmol/L (critical — repeat at 06:00) |
| ✓ IV access: 2x large-bore venflon + Central venous catheter (right subclavian) |
| ✓ IV Meropenem 1g q8h commenced 03:00 (Day 1) |
| ✓ IV Norepinephrine 0.1 mcg/kg/min commenced — MAP now 66 mmHg |
| ✓ 30 mL/kg crystalloid bolus (2L 0.9% NaCl) over 30 min — completed |
| ✓ Chest X-Ray: Right lower lobe consolidation consistent with pneumonia |
| ✓ ABG: pH 7.28, pCO2 33, pO2 68, HCO3 15 — metabolic acidosis with respiratory compensation |
| |
| CURRENT STATUS (06:30 round): |
| MAP: 67 mmHg on Norepinephrine 0.12 mcg/kg/min |
| SpO2: 91% on High Flow Nasal Cannula (HFNC) 60L/min, FiO2 0.5 |
| Urine output: 35 mL/hour (adequate) |
| Lactate repeat (06:00): 3.2 mmol/L — trending down, reassuring |
| |
| PLAN: Continue Meropenem. Low threshold for intubation if SpO2 deteriorates below 88%. |
| Microbiology to call with sensitivities — de-escalate antibiotics when available. |
| Echo at 08:00 to assess cardiac function. ICU consultant review at 09:00. |
| Family updated at 07:00 — understand severity; wife consent obtained for ICU level care. |
| |
| ──────────────────────────────────────────────────────────────────────────────── |
| PATIENT: Helen Costa | ID: P-1006 | DOB: 03-Jun-1960 | Ward: Cardiology |
| ATTENDING: Dr. Raj Kumar | Date: 18-Jan-2025 |
| ──────────────────────────────────────────────────────────────────────────────── |
| |
| PRESENTING COMPLAINT: |
| 64F with known ischaemic cardiomyopathy (EF 35%) presents with 5-day history of |
| progressive dyspnoea (now NYHA Class III), bilateral leg swelling to knees, and |
| orthopnoea (sleeps on 3 pillows). Weight gain of 5 kg over 10 days. |
| |
| VITAL SIGNS: |
| BP: 102/68 mmHg HR: 102 bpm (irregular — AF) SpO2: 89% on room air |
| JVP elevated 6 cm. Bilateral crackles to mid-zones. Pitting oedema 2+ to knees. |
| |
| ECG: Atrial fibrillation with rapid ventricular response, rate 105 bpm. Widespread |
| ST depression — consistent with demand ischaemia. |
| |
| ECHO (today): EF 33% (deteriorated from 38% in October). Moderate mitral regurgitation. |
| LV hypokinesis — diffuse. No pericardial effusion. |
| |
| ASSESSMENT & PLAN: |
| Diagnosis: Acute decompensated heart failure with reduced EF (HFrEF) |
| |
| 1. IV Furosemide 80mg twice daily — target diuresis 1.5–2L/day. Daily weights. |
| Strict fluid restriction 1.5L/day. Daily U&E — watch for hypokalaemia. |
| 2. Carvedilol 6.25mg BD — continue but HOLD if SBP falls below 90 mmHg. |
| 3. AF with RVR — IV Digoxin loading 0.5mg now, then 0.25mg in 6 hours. |
| Maintain Apixaban anticoagulation. Target resting HR <80 bpm. |
| 4. Hyponatraemia (Na 128) — secondary to fluid overload + neurohormonal activation. |
| Restrict free water. Avoid Hypotonic IV fluids. Repeat lytes in 8 hours. |
| 5. Cardiac rehabilitation referral once stabilised. |
| REVIEW: Twice daily. Cardiology consultant ward round 08:00. |
| |
| ──────────────────────────────────────────────────────────────────────────────── |
| PATIENT: Margaret Johnson | ID: P-1010 | DOB: 20-Feb-1940 | Ward: Geriatrics |
| ATTENDING: Dr. Lisa Tran | Date: 10-Feb-2025 |
| ──────────────────────────────────────────────────────────────────────────────── |
| |
| PRESENTING COMPLAINT: |
| 85F with Alzheimer's dementia, hypertension, and atrial fibrillation on Apixaban and |
| Donepezil. Brought in by family; confused and uncooperative. Serum Digoxin level 2.8 |
| nmol/L (above therapeutic range 1.0–2.6). Last Digoxin dose unknown — possible |
| inadvertent double dosing at nursing home. |
| |
| CLINICAL ASSESSMENT: |
| - Mild Digoxin toxicity: nausea, vomiting, visual disturbance (yellow-green halos) |
| - Bradycardia: HR 48 bpm, BP 105/65 mmHg, SpO2 96% |
| - ECG: Sinus bradycardia, PR prolongation (240ms). No heart block. No ventricular ectopy. |
| |
| MANAGEMENT: |
| 1. HOLD Digoxin — do not give further doses until repeat level in 24h is <2.0 nmol/L. |
| 2. Continuous cardiac monitoring — alert for AV block or VT. |
| 3. IV access. Check electrolytes — hypokalaemia worsens Digoxin toxicity. |
| K+ 3.1 (low) — IV potassium replacement 40 mmol in 500ml NaCl over 4 hours. |
| 4. Digoxin-specific antibody fragments (DigiFab) — NOT indicated at this level; |
| threshold for DigiFab: life-threatening arrhythmias or K+ >5.5 with toxicity. |
| 5. Contact nursing home pharmacist — review medication administration records. |
| Notify Pharmacy for clinical review of drug chart. |
| REVIEW: 4-hourly obs. Repeat ECG in 4 hours. Senior review if HR <40 or AV block. |
| |
| ================================================================================ |
| END OF CLINICAL NOTES — CONFIDENTIAL — FOR AUTHORISED HEALTHCARE PERSONNEL ONLY |
| ================================================================================ |
| """ |
| out = os.path.join(OUTPUT_DIR, "sample_treatment_notes.txt") |
| with open(out, "w", encoding="utf-8") as f: |
| f.write(content) |
| print(f" ✓ TXT created: {out}") |
|
|
|
|
| |
| |
| |
| if __name__ == "__main__": |
| print("Generating healthcare sample test files...") |
| make_pdf() |
| make_csv() |
| make_excel() |
| make_txt() |
| print(f"\nAll files saved to: {OUTPUT_DIR}/") |
|
|
