Otolaryngology (ENT) · Model history
Twelve days of sinus pain that came back worse: a model ENT history
- Setting
- Outpatient ENT clinic
- Patient
- Ms. Davis, 41, has had nasal congestion for twelve days that improved briefly, then came back worse with facial pain.
- Listen
- 3 min
After listening
Say the next question
Read the patient’s answer, say your next question aloud, then reveal the model.
“I've had thick green drainage from my nose, and the pain on my right cheek has become much worse.”
Ask the patient to localize the facial pain precisely.
Can you point to exactly where the pain is?
Model interview
Full transcript
- Doctor
Ms. Davis, I'm Dr. Novak. What's been going on?
- Patient
I've had a stuffy nose and facial pressure for twelve days now. It seemed to be getting better, but then it got much worse again.
- Doctor
Walk me through that pattern. When did it start improving, and when did it turn worse?
- Patient
It started about twelve days ago like a normal cold. Around day five I felt like I was getting better, but then two days ago it came back stronger than before.
- Doctor
What's changed since it came back?
- Patient
I've had thick green drainage from my nose, and the pain on my right cheek has become much worse.
- Doctor
Can you point to exactly where the pain is?
- Patient
Right here, over my right cheekbone, just under my eye.
- Doctor
Does anything make the pain worse, like bending forward?
- Patient
Yes, leaning forward makes it throb even more.
- Doctor
Have you had a fever?
- Patient
I've felt warm and achy, but I haven't taken my temperature.
- Doctor
Any pain or pressure in your teeth on that side?
- Patient
No, my teeth feel fine.
- Doctor
Have you noticed any swelling around your eye, changes in your vision, or a severe headache?
- Patient
No, my eye looks normal and my vision is fine. No bad headache either.
- Doctor
Any cough, sore throat, or drainage running down the back of your throat?
- Patient
A little bit of drainage down my throat, and a mild cough, especially at night.
- Doctor
Do you have any history of allergies or previous sinus infections?
- Patient
I get occasional seasonal allergies in the spring, but nothing like this before.
- Doctor
Do you have any other medical conditions, or take any regular medicines?
- Patient
No, I'm generally healthy and don't take anything regularly.
- Doctor
Any medicine allergies?
- Patient
No, none that I know of.
- Doctor
What do you think is going on?
- Patient
I think my cold turned into a sinus infection, since it got worse again after I thought I was getting better.
- Doctor
What's worrying you most?
- Patient
I'm a little worried this could spread or turn into something more serious if I don't treat it.
- Doctor
What were you hoping we'd do today?
- Patient
I want to know if I need antibiotics, or if this will just clear up on its own.
- Doctor
Let me summarize. For twelve days you've had nasal congestion that briefly improved around day five, then worsened with thick green drainage and severe right cheek pain that's worse leaning forward. You've felt warm without checking a fever, and you have no eye swelling, vision changes, severe headache, or tooth pain. Is that accurate, and is there anything else?
- Patient
That's exactly right, nothing else.
- Doctor
Thank you. This better-then-worse pattern, along with how long it's lasted and how severe the pain is, tells us this has likely become a bacterial sinus infection, not just a lingering cold. I'm going to prescribe an antibiotic, along with saline rinses and a nasal steroid spray to help you feel better faster. If you develop any swelling around your eye, vision changes, or a severe headache, you'll need to come back right away.
- Patient
That's really helpful, thank you for explaining what to watch for.
Flow at a glance
The route through the history
- Invite the patient's description
- Establish the duration and double-sickening pattern
- Characterize the discharge and facial pain
- Screen for orbital and intracranial red flags
- Check respiratory and allergy history
- Review background, medicines, and allergies
- Explore the patient's own theory and worry
- Summarize and explain the antibiotic decision
Free · No card · No account
Practice this patient conversation out loud
Ask the questions in your own words, hear an AI patient respond, and use live feedback for your next speaking attempt.
Editorial record
Tied to one reviewed case
This model uses a fictional Bedside English case as its source. The page and pre-generated WAV audio are checked against the same transcript and source-case fingerprints.
Editorial update: