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###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain. ###Human: burning, sharp ###Assistant: Do you feel pain somewhere? ###Human: mouth, cheek(R), nose, eye(R) ###Assistant: On a scale of 0 to 10, How intense is the pain? ###Human: 6 ###Assistant: Does the pain radiate to another location? ###Human: back of head, forehead, temple(R) ###Assistant: On a scale of 0 to 10, How precisely is the pain located? ###Human: 6 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 0 ###Assistant: Have you lost your sense of smell? ###Human: Yes ###Assistant: Do you have greenish or yellowish nasal discharge? ###Human: Yes ###Assistant: Do you have a cough? ###Human: Yes ###Assistant: Do you smoke cigarettes? ###Human: Yes ###Assistant: Have you had a cold in the last 2 weeks? ###Human: Yes ###Assistant: Do you have polyps in your nose? ###Human: Yes ###Assistant: Do you have a deviated nasal septum? ###Human: Yes ###Assistant: Do you have asthma or have you ever had to use a bronchodilator in the past? ###Human: Yes ###Assistant: Have you ever been diagnosed with gastroesophageal reflux? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Are your vaccinations up to date? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Acute rhinosinusitis at 23.9% probability, and Chronic rhinosinusitis at 22.3% probability. Does the pain increase with any specific movements or positions? ###Human: The pain does not increase with any specific movements or positions. ###Assistant: I recommend a nasal endoscopy to further evaluate your sinus condition.

###Assistant: Can you describe the pain you're feeling in your neck and head?### ###Human: The pain is heavy and located on the side of the neck (R), side of the neck (L), top of the head, and forehead. The intensity is 2 out of 10 and it appeared relatively fast with a score of 4.### ###Assistant: Have you traveled out of the country in the last 4 weeks?### ###Human: Yes, I have traveled out of the country in the last 4 weeks and I also smoke cigarettes.### ###Assistant: Based on your symptoms and antecedents, the two most likely diagnoses are Influenza with a probability of 23.9% and HIV (initial infection) with a probability of 19.9%. Does the rash on your neck and forehead peel off?### ###Human: No, the rash does not peel off.### ###Assistant: I recommend getting a blood test to check for HIV infection as a next step for diagnosis.### ###Human: Thank you for your help.

### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### Human: Yes ### Assistant: Have you had diarrhea or an increase in stool frequency? ### Human: Yes ### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: a knife stroke, sharp ### Assistant: Do you feel pain somewhere? ### Human: flank(R), flank(L), iliac fossa(L), pubis, belly ### Assistant: On a scale of 0 to 10, How intense is the pain? ### Human: 7 ### Assistant: Does the pain radiate to another location? ### Human: nowhere ### Assistant: On a scale of 0 to 10, How precisely is the pain located? ### Human: 5 ### Assistant: On a scale of 0 to 10, How fast did the pain appear? ### Human: 8 ### Assistant: Do you have any lesions, redness or problems on your skin that you believe are related to the condition you are consulting for? ### Human: Yes ### Assistant: What color is the rash? ### Human: pink ### Assistant: Do your lesions peel off? ### Human: N ### Assistant: On a scale of 0 to 10, Is the rash swollen? ### Human: 0 ### Assistant: Where is the affected region located? ### Human: back of the neck, biceps(R), mouth, thyroid cartilage, ankle(R) ### Assistant: On a scale of 0 to 10, How intense is the pain caused by the rash? ### Human: 2 ### Assistant: Is the lesion (or are the lesions) larger than 1cm? ### Human: Y ### Assistant: On a scale of 0 to 10, How severe is the itching? ### Human: 10 ### Assistant: Are you feeling nauseous or do you feel like vomiting? ### Human: Yes ### Assistant: Do you have swelling in one or more areas of your body? ### Human: Yes ### Assistant: Where is the swelling located? ### Human: forehead, cheek(R), cheek(L), nose ### Assistant: Did you lose consciousness? ### Human: Yes ### Assistant: Have you noticed a high pitched sound when breathing in? ### Human: Yes ### Assistant: Do you have a known severe food allergy? ### Human: Yes ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Are you more likely to develop common allergies than the general population? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Anaphylaxis at 11.1% probability, and Boerhaave at 8% probability. Does the pain increase or decrease with physical exertion? ### Human: The pain does not increase or decrease with physical exertion. ### Assistant: Let's perform a skin prick test to confirm if the symptoms are due to an allergic reaction. ###

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Characterize your pain as sensitive. Do you feel pain somewhere in your body? ### Human: Yes, I have pain in the back of the neck, ankle (L), dorsal aspect of the wrist (R), dorsal aspect of the wrist (L), and shoulder (R). ### Assistant: On a scale of 0 to 10, how intense is the pain? ### Human: 5 ### Assistant: Does the pain radiate to another location? ### Human: Nowhere ### Assistant: On a scale of 0 to 10, how precisely is the pain located? ### Human: 10 ### Assistant: On a scale of 0 to 10, how fast did the pain appear? ### Human: 1 ### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### Human: Yes ### Assistant: Do you constantly feel fatigued or do you have non-restful sleep? ### Human: Yes ### Assistant: Do you have any lesions, redness, or problems on your skin that you believe are related to the condition you are consulting for? ### Human: Yes, I have a red rash on my cheek (L) and nose. The rash is swollen at a level of 3. The lesions are larger than 1cm and do not peel off. The itching is at a level of 3. ### Assistant: Do you have painful mouth ulcers or sores? ### Human: Yes ### Assistant: Have you ever had pericarditis, breastfed one of your children for more than 9 months, had your first menstrual period before the age of 12, or traveled out of the country in the last 4 weeks? ### Human: Yes to all of those. ### Assistant: Based on your history, the two most likely diagnoses are SLE at 9.3% probability and pulmonary neoplasm at 8.9% probability. Does the pain in your wrist (R) worsen with movement? ### Human: Yes, the pain in my wrist (R) worsens with movement. ### Assistant: Let's proceed with a blood test to check for autoimmune markers and a chest X-ray to examine for any potential pulmonary neoplasm.

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Characterize your pain. ### Human: tedious ### Assistant: Do you feel pain somewhere? ### Human: top of the head, cheek(R), cheek(L) ### Assistant: On a scale of 0 to 10, How intense is the pain? ### Human: 3 ### Assistant: Does the pain radiate to another location? ### Human: nowhere ### Assistant: On a scale of 0 to 10, How precisely is the pain located? ### Human: 6 ### Assistant: On a scale of 0 to 10, How fast did the pain appear? ### Human: 3 ### Assistant: Do you have a fever (either felt or measured with a thermometer)? ### Human: Yes ### Assistant: Do you have diffuse (widespread) muscle pain? ### Human: Yes ### Assistant: Do you have nasal congestion or a clear runny nose? ### Human: Yes ### Assistant: Have you been in contact with a person with similar symptoms in the past 2 weeks? ### Human: Yes ### Assistant: Do you attend or work in a daycare? ### Human: Yes ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are URTI at 100% probability. Does the pain increase with movement or touch? ### Human: The pain does not increase with movement or touch. ### Assistant: Let's recommend a throat swab test to confirm the diagnosis of URTI. ### Human: Thank you for your help.

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Can you please characterize your pain for me? Is it tedious, sensitive, or heavy? ### Human: It is tedious, sensitive, and heavy. ### Assistant: Do you feel pain in specific locations? Such as your forehead, cheek (R), occiput, or temple (L)? ### Human: Yes, I feel pain in my forehead, cheek (R), occiput, and temple (L). ### Assistant: On a scale of 0 to 10, how intense is the pain? ### Human: The pain is a 5 in intensity. ### Assistant: Does the pain radiate to another location? ### Human: No, the pain does not radiate to another location. ### Assistant: On a scale of 0 to 10, how precisely is the pain located? ### Human: The pain is located at a 3 on the scale. ### Assistant: On a scale of 0 to 10, how fast did the pain appear? ### Human: The pain appeared at a 4 on the scale. ### Assistant: Do you have a fever (either felt or measured with a thermometer)? ### Human: Yes, I have a fever. ### Assistant: Do you have a sore throat? ### Human: Yes, I have a sore throat. ### Assistant: Do you have diffuse (widespread) muscle pain? ### Human: Yes, I have diffuse muscle pain. ### Assistant: Do you have a cough? ### Human: Yes, I have a cough. ### Assistant: Have you been in contact with a person with similar symptoms in the past 2 weeks? ### Human: Yes, I have been in contact with a person with similar symptoms. ### Assistant: Do you smoke cigarettes? ### Human: Yes, I smoke cigarettes. ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes, I have traveled out of the country in the last 4 weeks. ### Assistant: Are you exposed to secondhand cigarette smoke on a daily basis? ### Human: Yes, I am exposed to secondhand cigarette smoke on a daily basis. ### Assistant: Based on your history, the two most likely diagnoses are URTI at 20.1% probability, and Bronchitis at 19.7% probability. Does the pain increase or decrease with physical exertion? ### Human: The pain does not increase or decrease with physical exertion. ### Assistant: Let's recommend a throat swab to confirm the diagnosis of URTI.

###Assistant: Can you describe the pain you're experiencing in more detail?### ###Human: The pain is burning and sharp. It is located in my cheek (R), cheek (L), nose, eye (L), and temple (R). On a scale of 0 to 10, the intensity is 2. The pain radiates to my nose, temple (R), and temple (L). It appeared relatively fast, with a rating of 2.### ###Assistant: Have you ever had pneumonia before?### ###Human: Yes, I have had pneumonia before. I also have polyps in my nose, and I am more likely to develop common allergies than the general population. I have traveled out of the country in the last 4 weeks and I smoke cigarettes.### ###Assistant: Based on your history, the two most likely diagnoses are Acute rhinosinusitis at 31.8% probability and Chronic rhinosinusitis at 25.5% probability. Does the pain worsen with any specific triggers or activities?### ###Human: The pain doesn't seem to worsen with any specific triggers or activities.### ###Assistant: I recommend a nasal endoscopy to further evaluate your symptoms and determine the underlying cause of your chronic rhinosinusitis.###

###Assistant: What are your symptoms? ###Human: I am experiencing shortness of breath or difficulty breathing in a significant way. I have had an involuntary weight loss over the last 3 months. I also have a cough. ###Assistant: Any relevant medical history? ###Human: I am infected with the human immunodeficiency virus (HIV). I take corticosteroids. I am currently using intravenous drugs. I have diabetes. I have traveled out of the country in the last 4 weeks. My BMI is less than 18.5, and I am underweight. ###Assistant: Based on your history, the two most likely diagnoses are Pulmonary neoplasm at 13.8% probability, and Bronchitis at 13.4% probability. Does your cough produce any blood or mucus? ###Human: My cough does produce mucus. ###Assistant: Let's perform a chest X-ray to further evaluate your symptoms and rule out any potential pulmonary neoplasm.

###Assistant: What are your symptoms? ###Human: I have pain somewhere, related to my reason for consulting. The pain is sharp in my breast (R), breast (L), and posterior chest wall (R). On a scale of 0 to 10, the pain intensity is 3. The pain appeared with a speed of 3. I am also experiencing shortness of breath, cough with colored sputum, fever, and a pink rash on the back of my neck, commissure (R), commissure (L), flank (L), and shoulder (R). The rash is swollen at a level of 5 and causes pain at a level of 5. The itching is mild at a level of 1. I have also noticed new fatigue and generalized discomfort. ###Assistant: Any relevant medical history? ###Human: I drink alcohol excessively, smoke cigarettes, have Parkinson’s disease, had a stroke, pneumonia, chronic obstructive pulmonary disease (COPD), traveled out of the country in the last 4 weeks, and have a BMI less than 18.5. ###Assistant: Based on your history, the two most likely diagnoses are Bronchitis at 13.1% probability, and Pneumonia at 13% probability. Does the pain in your chest radiate to another location? ###Human: The pain does not radiate to another location. ###Assistant: Let's get a chest X-ray to examine for potential pneumonia.

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Characterize your pain. ### Human: Haunting, a knife stroke, tugging ### Assistant: Do you feel pain somewhere? ### Human: Forehead, eye(R), eye(L), temple(R), temple(L) ### Assistant: On a scale of 0 to 10, How intense is the pain? ### Human: 8 ### Assistant: Does the pain radiate to another location? ### Human: Nowhere ### Assistant: On a scale of 0 to 10, How precisely is the pain located? ### Human: 10 ### Assistant: On a scale of 0 to 10, How fast did the pain appear? ### Human: 7 ### Assistant: Do you feel that your eyes produce excessive tears? ### Human: Yes ### Assistant: Do you have nasal congestion or a clear runny nose? ### Human: Yes ### Assistant: Have any of your family members been diagnosed with cluster headaches? ### Human: Yes ### Assistant: Do you drink alcohol excessively or do you have an addiction to alcohol? ### Human: Yes ### Assistant: Do you take medication that dilates your blood vessels? ### Human: Yes ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Cluster headache at 56.1% probability, and Chagas at 21.9% probability. Does the pain increase or decrease with physical exertion? ### Human: The pain does not increase or decrease with physical exertion. ### Assistant: Let's recommend a brain imaging test to further investigate the headache and confirm the diagnosis of Cluster headache.

### Assistant: What are your symptoms? ### Human: I have been coughing up blood and have intense pain in the side of my chest (R) that feels like a knife stroke. The pain is a 10 out of 10 and appeared relatively fast. It radiates to the side of the chest (L), scapula (R), breast (R), posterior chest wall (R), and posterior chest wall (L). I also have swelling in the posterior aspect of my ankle (R) and the pain increases when I breathe in deeply. I lost consciousness as well. ### Assistant: Any relevant medical history? ### Human: I have active cancer, take hormones, had surgery within the last month, and traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Pulmonary embolism at 27.4% probability, and Localized edema at 21.1% probability. Does the pain in your chest (R) worsen with movement or is it constant? ### Human: The pain in my chest (R) is constant and does not worsen with movement. ### Assistant: Let's get a CT pulmonary angiography to further investigate for a potential pulmonary embolism.

### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### Human: Yes ### Assistant: Do you feel weakness in both arms and/or both legs? ### Human: Yes ### Assistant: Have you recently had a viral infection? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Guillain-Barré syndrome at 16.9% probability, and Myasthenia gravis at 13.6% probability. Do you have any specific areas on your body where you feel numbness, loss of sensation, or tingling in the feet? ### Human: I have numbness in both feet. ### Assistant: Let's conduct a nerve conduction study to help confirm the diagnosis.

###Assistant: What are your symptoms? ###Human: I have haunting, a knife stroke, violent, sharp pain in my cheek (R) with an intensity of 9 on a scale of 0 to 10. The pain appeared very fast, at a 10. I also have excessive tears in my eyes and nasal congestion with a clear runny nose. ###Assistant: Any relevant medical history? ###Human: Yes, some of my family members have been diagnosed with cluster headaches. I also drink alcohol excessively and have traveled out of the country in the last 4 weeks. ###Assistant: Based on your history, the two most likely diagnoses are Cluster headache at 59.3% probability, and Chagas at 20.4% probability. Does the pain radiate to another location besides your cheek (R)? ###Human: The pain does not radiate to another location. ###Assistant: Let's recommend a neurological examination to further investigate the possibility of a Cluster headache.

###Assistant: What are your symptoms? ###Human: I have pain in my left ear that is sensitive and sharp. The pain is a 5 out of 10 in intensity and appeared relatively fast. I also have a fever and have been feeling more irritable lately. I have nasal congestion and a clear runny nose. ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes. ###Assistant: Based on your history, the two most likely diagnoses are Acute otitis media at 47.6% probability, and Croup at 23.6% probability. Does the pain in your ear radiate to another location? ###Human: No, the pain is only in my ear. ###Assistant: Let's perform a physical examination to check for signs of inflammation in your ear and throat to help differentiate between Acute otitis media and Croup.

###Assistant: Can you describe the pain you're experiencing in your iliac fossa on the right side?### Human: The pain is heavy and has a intensity of 6 on a scale of 0 to 10. It appeared quickly with a rating of 7.### ###Assistant: Have you traveled out of the country in the last 4 weeks?### Human: Yes, I have.### ###Assistant: Based on your history, the two most likely diagnoses are Inguinal hernia at 26.9% probability, and Bronchitis at 21.3% probability. Does the pain in your iliac fossa on the right side worsen with coughing fits?### Human: Yes, the pain does increase with coughing fits.### ###Assistant: I recommend a physical examination to further evaluate your symptoms and determine the cause of your pain.###

###Assistant: Do you have pain somewhere, related to your reason for consulting?### ###Human: Yes, the pain is like a knife stroke on the side of the chest (R) and posterior chest wall (R). The intensity of the pain is 1 on a scale of 0 to 10, and it appeared quickly with a rating of 6.### ###Assistant: Have you ever had pneumonia before?### ###Human: Yes, I have had pneumonia in the past.### ###Assistant: Based on your history, the two most likely diagnoses are pneumonia at 6.96% probability and bronchitis at 6.70% probability. Does the pain increase when you breathe in deeply?### ###Human: Yes, I do have pain that is increased when I breathe in deeply.### ###Assistant: Let's get a chest X-ray to examine for potential pneumonia.### ###Human: Sounds like a good plan. Thank you.###

###Assistant: Have you noticed that the tone of your voice has become deeper, softer or hoarse?### Human: Yes ###Assistant: Do you have pain somewhere, related to your reason for consulting? Characterize your pain as burning. Do you feel pain in your tonsil (R), tonsil (L), thyroid cartilage, or palace? On a scale of 0 to 10, how intense is the pain? Does the pain radiate to another location? How precisely is the pain located on a scale of 0 to 10? How fast did the pain appear on a scale of 0 to 10? Do you have a fever?### Human: Yes, I have pain in my tonsil (R) and tonsil (L). The pain intensity is 7, it is located at a 5, appeared at a 4, and I have a fever. ###Assistant: Do you live with 4 or more people? Do you smoke cigarettes? Have you traveled out of the country in the last 4 weeks?### Human: Yes, I live with 4 or more people, I smoke cigarettes, and I have traveled out of the country in the last 4 weeks. ###Assistant: Based on your history, the two most likely diagnoses are Acute laryngitis at 43.9% probability and Possible NSTEMI / STEMI at 26.9% probability. Does the pain in your tonsils worsen with swallowing or talking?### Human: The pain in my tonsils worsens with talking. ###Assistant: Let's perform a throat swab to check for any bacterial infection that could be causing the acute laryngitis.

### Assistant: Can you tell me more about the pain you're experiencing? Where is it located and how intense is it on a scale of 0 to 10?### Human: The pain is a cramp in my flank (L), hypochondrium (L), and belly. It's a 3 out of 10 in intensity.### Assistant: Have any members of your family been diagnosed with pancreatic cancer?### Human: Yes, there are members of my family who have been diagnosed with pancreatic cancer.### Assistant: Based on your history, the two most likely diagnoses are Pancreatic neoplasm at 29.3% probability, and Chagas at 19.7% probability. Can you describe the nature of the pain you're feeling in more detail?### Human: The pain is a cramp and it appeared with a 3 out of 10 in terms of speed.### Assistant: I recommend we proceed with a CT scan to further investigate the possibility of a pancreatic neoplasm.

### Assistant: Do you feel your heart is beating fast (racing), irregularly (missing a beat) or do you feel palpitations? ### Human: Yes ### Assistant: Have you been diagnosed with hyperthyroidism? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Atrial fibrillation at 13.6% probability, and PSVT at 11.9% probability. Do you feel your heart is beating very irregularly or in a disorganized pattern? ### Human: Yes ### Assistant: Do you feel your heart is beating very irregularly or in a disorganized pattern? ### Human: Yes ### Assistant: Let's perform an ECG to further evaluate your heart rhythm.

###Assistant: What are your symptoms?### Human: I have significantly increased sweating. I have a cramp, sharp pain on the side of the chest (R) and side of the chest (L). The pain intensity is 2 on a scale of 0 to 10, and it appeared quickly with a rating of 6. I am experiencing shortness of breath, feeling like I am choking or suffocating, lightheaded and dizzy, and feeling like I am about to faint. I also feel like I am dying, have palpitations, numbness in both arms and legs, and feel detached from my own body or surroundings. ###Assistant: Any relevant medical history?### Human: Yes, some members of my immediate family have a psychiatric illness. I drink alcohol excessively and have an addiction to alcohol. I suffer from chronic anxiety. I have had a head trauma. I have traveled out of the country in the last 4 weeks. ###Assistant: Based on your history, the two most likely diagnoses are Panic attack at 9.7% probability, and PSVT at 7.4% probability. Does the pain radiate to another location?### Human: The pain does not radiate to another location. ###Assistant: Let's recommend a next step for diagnosis.### Human: What would be the next step for diagnosis?

### Assistant: What are your symptoms? ### Human: I have haunting, a knife stroke, tugging, violent, sharp pain in my forehead, cheek(R), eye(L), temple(R), and temple(L). The pain intensity is 9 on a scale of 0 to 10, and it appeared very fast with a rating of 10. I also feel that my eyes produce excessive tears. ### Assistant: Do you drink alcohol excessively or do you have an addiction to alcohol? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Cluster headache at 100% probability. Does the pain increase or decrease with physical exertion? ### Human: The pain does not radiate to another location and is precisely located at 8 on a scale of 0 to 10. ### Assistant: Let's recommend a neurological examination to confirm the diagnosis of Cluster headache. ### Human: Thank you for your help.

### Assistant: Do you have swollen or painful lymph nodes? ### Human: Yes ### Assistant: Do you have pain somewhere, related to your reason for consulting? Can you characterize your pain as tedious, sensitive, tugging, a cramp, or sharp? Where do you feel the pain and how intense is it on a scale of 0 to 10? ### Human: Yes, the pain is tedious and sensitive. I feel it on the top of my head and it's a 4 in intensity. ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Based on your history, the top 2 potential diagnoses are Chagas at 100% probability and no other potential diagnosis. Does the pain radiate to another location? ### Human: Nowhere ### Assistant: Let's proceed with a blood test to confirm the diagnosis of Chagas.

###Assistant: Can you characterize your pain for me?### ###Human: The pain is sensitive and exhausting. It is located at the back of my head, side of the neck (L), top of the head, forehead, and occiput. On a scale of 0 to 10, the intensity is 5. The pain appeared fast with a rating of 1.### ###Assistant: Have you traveled out of the country in the last 4 weeks?### ###Human: Yes, I have. I am also immunosuppressed.### ###Assistant: Based on your history, the two most likely diagnoses are Influenza at 16.5% probability, and URTI at 13.4% probability. Does the rash on the side of your neck (R) peel off?### ###Human: No, it does not peel off.### ###Assistant: Let's get a flu test to confirm if you have Influenza.###

###Assistant: Can you describe the pain you're experiencing in more detail?### ###Human: The pain is sensitive and burning, located in my tonsil (L), palace, and under the jaw. It's an 8 out of 10 in intensity and appeared relatively fast, at a level of 3.### ###Assistant: Have you been in contact with a person with similar symptoms in the past 2 weeks?### ###Human: Yes, I have. I have also traveled out of the country in the last 4 weeks.### ###Assistant: Based on your history, the two most likely diagnoses are Bronchitis at 21.8% probability and Acute laryngitis at 14.9% probability. Does the pain radiate to another location?### ###Human: No, the pain does not radiate to another location.### ###Assistant: Let's perform a throat swab to check for any bacterial infection that could be causing your symptoms.###

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes, the pain is sensitive and burning. It is located in my tonsil (R) and tonsil (L), thyroid cartilage, pharynx, and under the jaw. The intensity of the pain is 4 on a scale of 0 to 10, and it appeared relatively fast with a score of 3. ### Assistant: Have you been in contact with a person with similar symptoms in the past 2 weeks? ### Human: Yes, I have been in contact with someone with similar symptoms. I also attend a daycare and have traveled out of the country in the last 4 weeks. I am immunosuppressed. ### Assistant: Based on your history, the two most likely diagnoses are Viral pharyngitis at 22.7% probability and Bronchitis at 19.1% probability. Does the pain in your tonsils radiate to another location? ### Human: No, the pain does not radiate to another location. ### Assistant: Let's perform a throat swab to confirm the diagnosis of Viral pharyngitis.

###Assistant: Can you describe the pain you're feeling in your ear?### Human: The pain is sensitive and sharp, with an intensity of 9 out of 10. It appeared relatively fast, at a level of 5 out of 10.### Assistant: Have you recently been treated with an oral antibiotic for an ear infection?### Human: Yes, I have. I have also traveled out of the country in the last 4 weeks.### Assistant: Based on your history, the two most likely diagnoses are URTI at 24.4% probability, and Acute otitis media at 23.5% probability. Does the pain in your ear radiate to another location?### Human: No, the pain does not radiate to another location.### Assistant: I recommend a physical examination of your ear to further evaluate for Acute otitis media.

### Assistant: Have you noticed that the tone of your voice has become deeper, softer or hoarse? ### Human: Yes ### Assistant: Do you have pain somewhere, related to your reason for consulting? Characterize your pain as burning. Do you feel pain in your tonsil (L), thyroid cartilage, palace, pharynx, or under the jaw? On a scale of 0 to 10, how intense is the pain? How precisely is the pain located on a scale of 0 to 10? How fast did the pain appear on a scale of 0 to 10? ### Human: Yes, the pain is a 5 in intensity, located at a 7 precision, and appeared at a 3 speed. ### Assistant: Do you live with 4 or more people? Do you attend or work in a daycare? Have you traveled out of the country in the last 4 weeks? ### Human: Yes, Yes, Yes ### Assistant: Based on your history, the two most likely diagnoses are Acute laryngitis at 86.5% probability, and Viral pharyngitis at 13.5% probability. Does the pain radiate to another location? ### Human: The pain does not radiate to another location. ### Assistant: I recommend a throat swab to confirm the diagnosis.

###Assistant: Can you describe the pain you're experiencing in more detail? Where is it located, and how intense is it on a scale of 0 to 10?### ###Human: The pain is sharp and located in my mouth, forehead, right cheek, left cheek, and right eye. It's a 3 in intensity.### ###Assistant: Have you ever had pneumonia or do you have a history of asthma or bronchodilator use?### ###Human: Yes, I have had pneumonia before, and I have asthma with a history of using a bronchodilator.### ###Assistant: Based on your history, the two most likely diagnoses are Viral pharyngitis at 31.5% probability and Cluster headache at 19.8% probability. Does the pain radiate to the back of your head, forehead, or left temple?### ###Human: Yes, the pain does radiate to the back of my head, forehead, and left temple.### ###Assistant: I recommend a nasal endoscopy to further evaluate your symptoms and help differentiate between the potential diagnoses.### ###Human: Thank you for your recommendation.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain. ###Human: It feels like a knife stroke. ###Assistant: Do you feel pain somewhere? ###Human: Yes, in my upper chest, posterior chest wall (R), and posterior chest wall (L). ###Assistant: On a scale of 0 to 10, How intense is the pain? ###Human: 1 ###Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ###Human: Yes ###Assistant: Do you have a cough that produces colored or more abundant sputum than usual? ###Human: Yes ###Assistant: Do you have any lesions, redness, or problems on your skin that you believe are related to the condition you are consulting for? ###Human: Yes, I have a pink rash that peels off on my lumbar spine, side of the neck (R), flank (L), posterior chest wall (R), and posterior chest wall (L). ###Assistant: On a scale of 0 to 10, How intense is the pain caused by the rash? ###Human: 4 ###Assistant: Do you have diffuse (widespread) muscle pain? ###Human: Yes ###Assistant: Do you have a cough? ###Human: Yes ###Assistant: Are your symptoms more prominent at night? ###Human: Yes ###Assistant: Do you drink alcohol excessively or do you have an addiction to alcohol? ###Human: Yes ###Assistant: Do you smoke cigarettes? ###Human: Yes ###Assistant: Do you have heart failure? ###Human: Yes ###Assistant: Have you ever had pneumonia? ###Human: Yes ###Assistant: Do you have a chronic obstructive pulmonary disease (COPD)? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Is your BMI less than 18.5, or are you underweight? ###Human: Yes ###Assistant: Are your vaccinations up to date? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Bronchitis at 8.2% probability and Pneumonia at 7.9% probability. Does the pain radiate to another location? ###Human: The pain does not radiate to another location. ###Assistant: Let's perform a chest X-ray to further evaluate for pneumonia.

### Assistant: Do you feel weakness in both arms and/or both legs? ### Human: Yes ### Assistant: Have you recently had a viral infection? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Guillain-Barré syndrome at 100% probability, and another condition at 0% probability. Does the weakness in your arms and legs start suddenly or gradually? ### Human: The weakness started suddenly. ### Assistant: Let's perform a nerve conduction study to confirm the diagnosis of Guillain-Barré syndrome. ### Human: Thank you for your help.

###Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way?### ###Human: Yes ###Assistant: Do you have pain somewhere, related to your reason for consulting?### ###Human: Yes ###Assistant: Characterize your pain.### ###Human: tedious, heavy, exhausting ###Assistant: Do you feel pain somewhere?### ###Human: lower chest, side of the chest(L), upper chest, breast(L), epigastric ###Assistant: On a scale of 0 to 10, How intense is the pain?### ###Human: 3 ###Assistant: Does the pain radiate to another location?### ###Human: biceps(R), thyroid cartilage, trachea, shoulder(R), shoulder(L) ###Assistant: On a scale of 0 to 10, How precisely is the pain located?### ###Human: 2 ###Assistant: On a scale of 0 to 10, How fast did the pain appear?### ###Human: 6 ###Assistant: Are you constantly feeling fatigued or do you have non-restful sleep?### ###Human: Yes ###Assistant: Are you significantly overweight compared to people of the same height as you?### ###Human: Yes ###Assistant: Do you have high cholesterol or do you take medications to treat high cholesterol?### ###Human: Yes ###Assistant: Do you drink alcohol excessively or do you have an addiction to alcohol?### ###Human: Yes ###Assistant: Have you ever had a heart attack or do you have angina (chest pain)?### ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks?### ###Human: Yes ###Assistant: Do you have close family members who had a cardiovascular disease problem before the age of 50?### ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are NSTEMI / STEMI at 9.1% probability, and Panic attack at 6.9% probability. Does the pain radiate to the shoulder on the right or left side?### ###Human: The pain radiates to the shoulder on the left side. ###Assistant: Let's get an ECG to check for any signs of a heart attack.

### Assistant: Do you have nasal congestion or a clear runny nose? ### Human: Yes ### Assistant: Do you have severe itching in one or both eyes? ### Human: Yes ### Assistant: Do you have any close family members who suffer from allergies (any type), hay fever or eczema? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are allergic sinusitis at 100% probability, and another potential diagnosis is not provided. Does the itching in your eyes worsen in certain environments or times of day? ### Human: The itching in my eyes tends to worsen when I'm outdoors or exposed to pollen. ### Assistant: I recommend getting an allergy test to confirm the diagnosis of allergic sinusitis. ### Human: Thank you for your recommendation.

###Assistant: What are your symptoms? ###Human: I have pain somewhere, related to my reason for consulting. The pain is heartbreaking, violent, and sickening. I feel pain in my lower chest, flank(L), upper chest, belly, and epigastric. The pain is a 7 out of 10 in intensity and appeared at a 7 out of 10 pace. The pain radiates to my thoracic spine, scapula(R), and scapula(L). ###Assistant: Any relevant medical history? ###Human: I drink alcohol excessively and have traveled out of the country in the last 4 weeks. ###Assistant: Based on your history, the two most likely diagnoses are Boerhaave at 70.4% probability and Pancreatic neoplasm at 22.7% probability. Does the pain increase or decrease with physical exertion? ###Human: The pain does not change with physical exertion. ###Assistant: Let's get an upper endoscopy to further evaluate the source of your symptoms and potential Boerhaave diagnosis.

###Assistant: Do you feel pain somewhere, related to your reason for consulting? ###Human: Yes, the pain is tugging and exhausting. It is located at the top of the head, forehead, temple (R), and temple (L). The intensity of the pain is 3 out of 10, and it appeared at a rate of 5 out of 10. ###Assistant: Have you ever had a diagnosis of anemia? ###Human: Yes, I have had a diagnosis of anemia. I also have chronic kidney failure, traveled out of the country in the last 4 weeks, and my BMI is less than 18.5. ###Assistant: Based on your history, the two most likely diagnoses are Anemia at 16% probability and Atrial fibrillation at 10.7% probability. Does the pain in your head increase with movement or change in position? ###Human: The pain in my head does not increase with movement or change in position. ###Assistant: I recommend getting a complete blood count (CBC) to further evaluate your anemia and kidney function.

###Assistant: Can you describe your pain for me?### Human: The pain is heartbreaking, haunting, violent, and sickening. It is located in my lower chest, flank (L), hypochondrium (L), belly, and epigastric area. The intensity of the pain is 8 out of 10, and it radiates to my thoracic spine, scapula (R), and scapula (L). It appeared very fast, with a rating of 10 out of 10. ###Assistant: Have you traveled out of the country in the last 4 weeks?### Human: Yes, I have. ###Assistant: Based on your symptoms, the top two potential diagnoses are Boerhaave at 14.8% probability and GERD at 9.9% probability. Does the pain worsen after eating or lying down?### Human: The pain does worsen after eating. ###Assistant: I recommend we perform an upper endoscopy to further evaluate for Boerhaave.

### Assistant: Do you constantly feel fatigued or do you have non-restful sleep? ### Human: Yes ### Assistant: Do you have chest pain even at rest? ### Human: Yes ### Assistant: Have you had significantly increased sweating? ### Human: Yes ### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Characterize your pain. ### Human: heavy ### Assistant: Do you feel pain somewhere? ### Human: lower chest, side of the chest(R), side of the chest(L), upper chest, breast(L) ### Assistant: On a scale of 0 to 10, How intense is the pain? ### Human: 6 ### Assistant: Does the pain radiate to another location? ### Human: biceps(R), thoracic spine, trachea, triceps(R), shoulder(R) ### Assistant: On a scale of 0 to 10, How precisely is the pain located? ### Human: 2 ### Assistant: On a scale of 0 to 10, How fast did the pain appear? ### Human: 8 ### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### Human: Yes ### Assistant: Do you constantly feel fatigued or do you have non-restful sleep? ### Human: Yes ### Assistant: Do you have symptoms that are increased with physical exertion but alleviated with rest? ### Human: Yes ### Assistant: Are you significantly overweight compared to people of the same height as you? ### Human: Yes ### Assistant: Do you have high cholesterol or do you take medications to treat high cholesterol? ### Human: Yes ### Assistant: Do you smoke cigarettes? ### Human: Yes ### Assistant: Do you have high blood pressure or do you take medications to treat high blood pressure? ### Human: Yes ### Assistant: Have you ever had a heart attack or do you have angina (chest pain)? ### Human: Yes ### Assistant: Do you exercise regularly, 4 times per week or more? ### Human: Yes ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Do you have close family members who had a cardiovascular disease problem before the age of 50? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are unstable angina at 8.47% probability, and acute pulmonary edema at 7.50% probability. Does the pain increase or decrease with physical exertion? ### Human: I have symptoms that increase with physical exertion but alleviate with rest. ### Assistant: Let's get an ECG to further evaluate for unstable angina.

###Assistant: Can you describe the pain you're experiencing in your chest?### Human: The pain feels like a knife stroke on the side of my chest (R) and posterior chest wall (R). It's a 3 out of 10 in intensity and appeared quickly with a 4 out of 10.### ###Assistant: Have you ever had pneumonia before?### Human: Yes, I have had pneumonia in the past. I also have a history of chronic obstructive pulmonary disease (COPD) and asthma.### ###Assistant: Based on your history, the two most likely diagnoses are Pneumonia at 10.7% probability, and Bronchitis at 9.6% probability. Does your cough produce colored or more abundant sputum than usual?### Human: Yes, my cough does produce colored or more abundant sputum than usual.

###Assistant: Can you characterize your pain for me?### ###Human: The pain is sharp.### ###Assistant: Have you ever been diagnosed with gastroesophageal reflux?### ###Human: Yes.### ###Assistant: Based on your history, the two most likely diagnoses are Bronchitis at 22.5% probability, and Acute laryngitis at 16% probability. Does the pain radiate to another location?### ###Human: Yes, the pain radiates to the forehead, temple(R), and temple(L).### ###Assistant: Let's recommend a nasal endoscopy to further evaluate your symptoms.###

### Assistant: Have you noticed any new fatigue, generalized and vague discomfort, diffuse (widespread) muscle aches or a change in your general well-being related to your consultation today? ### Human: Yes ### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Characterize your pain. ### Human: tedious, sensitive, a pulse, sharp, exhausting ### Assistant: Do you feel pain somewhere? ### Human: back of head, back of the neck, cervical spine, occiput, temple(L) ### Assistant: On a scale of 0 to 10, How intense is the pain? ### Human: 3 ### Assistant: Does the pain radiate to another location? ### Human: nowhere ### Assistant: On a scale of 0 to 10, How precisely is the pain located? ### Human: 9 ### Assistant: On a scale of 0 to 10, How fast did the pain appear? ### Human: 0 ### Assistant: Do you have a fever (either felt or measured with a thermometer)? ### Human: Yes ### Assistant: Where is the swelling located? ### Human: nowhere ### Assistant: Have you been unintentionally losing weight or have you lost your appetite? ### Human: Yes ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Chagas at 100% probability. Does the pain increase or decrease with any specific movements or positions? ### Human: The pain does not change with any specific movements or positions. ### Assistant: Let's proceed with a blood test to check for Chagas disease.

###Assistant: Do you feel lightheaded and dizzy or do you feel like you are about to faint?### ###Human: Yes ###Assistant: Have you been in contact with or ate something that you have an allergy to?### ###Human: Yes ###Assistant: Do you have a known severe food allergy?### ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Anaphylaxis at 7.4% probability, and Panic attack at 5.9% probability. Does the rash you mentioned peel off or is it swollen?### ###Human: The rash does not peel off and is swollen. ###Assistant: Let's perform a skin prick test to confirm if this is an allergic reaction causing the symptoms.

### Assistant: What are your symptoms? ### Human: I have pain in the side of my chest (R), upper chest, breast (R), and breast (L). The pain feels like a knife stroke with an intensity of 7 on a scale of 0 to 10. It appeared quickly with a rating of 1. I also feel out of breath with minimal physical effort and have palpitations. ### Assistant: Any relevant medical history? ### Human: I have recently had a viral infection and traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Myocarditis at 9.4% probability and Acute pulmonary edema at 9.3% probability. Does the pain radiate to another location? ### Human: The pain does not radiate to another location. ### Assistant: Let's get an ECG to further evaluate your heart function and rule out any potential cardiac issues.

###Assistant: Can you characterize your pain for me?### ###Human: The pain is tugging.### ###Assistant: Do you have a known issue with one of your heart valves?### ###Human: Yes### ###Assistant: The top 2 potential diagnoses are Localized edema with a probability of 67.8% and Chagas with a probability of 20.4%. Does the pain radiate to another location?### ###Human: Nowhere### ###Assistant: I recommend conducting a blood test to check for any underlying conditions.###

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes, the pain is like a knife stroke in my upper chest, breast (R), and breast (L). The intensity of the pain is 4 on a scale of 0 to 10, and it appeared with a pace of 3. ### Assistant: Have you recently had a viral infection and traveled out of the country in the last 4 weeks? ### Human: Yes, I have recently had a viral infection and traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Acute pulmonary edema at 13.6% probability and Unstable angina at 12.9% probability. Does the pain radiate to another location? ### Human: No, the pain does not radiate to another location. ### Assistant: Let's focus on differentiating between Acute pulmonary edema and Unstable angina. Do you have shortness of breath or difficulty breathing in a significant way? ### Human: Yes, I am experiencing shortness of breath or difficulty breathing in a significant way. ### Assistant: Let's recommend getting a chest X-ray to examine for potential causes.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain. ###Human: burning, sharp ###Assistant: Do you feel pain somewhere? ###Human: mouth, cheek(L), nose, eye(R), temple(R) ###Assistant: On a scale of 0 to 10, How intense is the pain? ###Human: 4 ###Assistant: Does the pain radiate to another location? ###Human: back of head, forehead, temple(L) ###Assistant: On a scale of 0 to 10, How precisely is the pain located? ###Human: 2 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 0 ###Assistant: Have you lost your sense of smell? ###Human: Yes ###Assistant: Do you have nasal congestion or a clear runny nose? ###Human: Yes ###Assistant: Do you have a cough? ###Human: Yes ###Assistant: Do you smoke cigarettes? ###Human: Yes ###Assistant: Have you ever had pneumonia? ###Human: Yes ###Assistant: Do you have polyps in your nose? ###Human: Yes ###Assistant: Do you have a deviated nasal septum? ###Human: Yes ###Assistant: Do you have asthma or have you ever had to use a bronchodilator in the past? ###Human: Yes ###Assistant: Have you ever been diagnosed with gastroesophageal reflux? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Chronic rhinosinusitis at 16.4% probability, and Acute rhinosinusitis at 14.6% probability. Does the pain increase with any specific triggers or activities? ###Human: The pain does not increase with any specific triggers or activities. ###Assistant: Let's recommend a nasal endoscopy to further evaluate your sinuses and nasal passages. ###Human: Thank you for your recommendation.

###Assistant: What are your symptoms? ### Human: I have pain somewhere, related to my reason for consulting. The pain is sensitive and sharp. It is located in my ankle (R), dorsal aspect of the wrist (R), dorsal aspect of the wrist (L), palmar face of the wrist (R), and shoulder (R). The pain intensity is 6 on a scale of 0 to 10, and it appeared with a speed of 3. I am also experiencing shortness of breath and have a red rash on my cheek (R), cheek (L), and nose. The rash is larger than 1cm and is not swollen. The itching is mild, with a severity of 1. I also have painful mouth ulcers or sores. ### Assistant: Have you breastfed one of your children for more than 9 months, had your first menstrual period before the age of 12, and traveled out of the country in the last 4 weeks? ### Human: Yes, I have breastfed one of my children for more than 9 months, had my first menstrual period before the age of 12, and traveled out of the country in the last 4 weeks. ### Assistant: The two most likely diagnoses are SLE at 15.9% probability and Possible NSTEMI / STEMI at 15.6% probability. Does the pain in your ankle (R), wrist, and shoulder (R) worsen with movement or rest? ### Human: The pain does not worsen with movement or rest. ### Assistant: I recommend conducting an ANA blood test to further investigate the possibility of SLE.

###Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way?### ###Human: Yes ###Assistant: Did you eat dark-fleshed fish (such as tuna) or Swiss cheese before the reaction occurred?### ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Scombroid food poisoning at 14.3% probability, and PSVT at 11.4% probability. Does the rash on your skin peel off?### ###Human: No ###Assistant: Let's perform a skin biopsy to further investigate the rash and confirm the diagnosis.

###Assistant: Can you characterize your pain for me?### Human: The pain is sensitive and burning.### Assistant: Have you traveled out of the country in the last 4 weeks?### Human: Yes, I have.### Assistant: Based on your history, the two most likely diagnoses are Viral pharyngitis at 15.5% probability, and URTI at 14.7% probability. Does the pain radiate to another location?### Human: No, it does not.### Assistant: I recommend a throat swab to test for viral pharyngitis.

### Assistant: Do you have pain that is increased when you breathe in deeply? ### Human: Yes, I do. ### Assistant: Any relevant medical history? ### Human: I drink alcohol excessively, I am being treated for osteoporosis, and I have traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Pulmonary embolism at 7.5% probability, and Bronchitis at 7.5% probability. Does the pain radiate to another location? ### Human: Yes, the pain radiates to the posterior chest wall on both sides. ### Assistant: Let's get a chest X-ray to examine for a potential bronchitis or pulmonary embolism.

###Assistant: Can you describe the pain you're experiencing in more detail?### ###Human: The pain is sensitive and exhausting, located at the back of the head, top of the head, temple (R), and temple (L). It's a 2 on a scale of 0 to 10 in intensity, appeared at a 4 on the same scale, and is precisely located at a 6.### ###Assistant: Have you ever had a sexually transmitted infection?### ###Human: Yes, I have. I have also used intravenous drugs, had unprotected sex with multiple partners in the last 6 months, had sexual intercourse with an HIV-positive partner in the past year, and traveled out of the country in the last 4 weeks.### ###Assistant: Based on your history, the two most likely diagnoses are HIV (initial infection) at 32.8% probability and Chagas at 20.6% probability. Does the rash on your skin peel off or is it persistent?### ###Human: The rash is pale in color, located on my lower gum, upper gum, labia majora (R), labia majora (L), and internal cheek (R). It's larger than 1cm, causing a pain intensity of 6, and is not peeling off.### ###Assistant: I recommend getting a blood test to check for HIV and Chagas to confirm the diagnosis.###

###Assistant: Can you describe your pain for me?### ###Human: The pain is sensitive and burning. It is located in my tonsil (R) and tonsil (L), thyroid cartilage, palace, and pharynx. The intensity of the pain is 6 out of 10, and it appeared relatively fast with a score of 3.### ###Assistant: Have you been in contact with a person with similar symptoms in the past 2 weeks?### ###Human: Yes, I have. I live with 4 or more people, attend a daycare, and have traveled out of the country in the last 4 weeks. I am also immunosuppressed.### ###Assistant: Based on your symptoms and antecedents, the top two potential diagnoses are Viral pharyngitis with a probability of 100%. Is there any specific location where the pain is most intense?### ###Human: The pain is most intense in my tonsil (R) and tonsil (L).### ###Assistant: I recommend a throat swab test to confirm the diagnosis of Viral pharyngitis.###

### Assistant: What are your symptoms? ### Human: I am experiencing shortness of breath or difficulty breathing in a significant way. I have had an involuntary weight loss over the last 3 months. I also have a cough. ### Assistant: Any relevant medical history? ### Human: I have diabetes. I drink alcohol excessively and have an addiction to alcohol. I have traveled out of the country in the last 4 weeks. My BMI is less than 18.5, and I am underweight. ### Assistant: Based on your history, the two most likely diagnoses are Bronchitis at 13.7% probability, and Pulmonary embolism at 9.9% probability. Do you have any chest pain associated with your symptoms? ### Human: No, I do not have any chest pain. ### Assistant: Let's proceed with a chest X-ray to rule out any potential pulmonary issues.

### Assistant: Are you feeling nauseous or do you feel like vomiting? ### Human: Yes ### Assistant: Have you had significantly increased sweating? ### Human: Yes ### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes, the pain is a cramp, sharp. It is located on the side of the chest (R), flank (R), flank (L), iliac fossa (L), and belly. The intensity of the pain is 2 on a scale of 0 to 10. It appeared with a speed of 6 out of 10. ### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### Human: Yes ### Assistant: Do you feel lightheaded and dizzy or do you feel like you are about to faint? ### Human: Yes ### Assistant: Do you feel like you are dying or were you afraid that you were about to die? ### Human: Yes ### Assistant: Do you feel your heart is beating fast (racing), irregularly (missing a beat) or do you feel palpitations? ### Human: Yes ### Assistant: Have you recently had numbness, loss of sensation or tingling, in both arms and legs and around your mouth? ### Human: Yes ### Assistant: Do you feel like you are detached from your own body or your surroundings? ### Human: Yes ### Assistant: Do any members of your immediate family have a psychiatric illness? ### Human: Yes ### Assistant: Do you drink alcohol excessively or do you have an addiction to alcohol? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Panic attack at 8.9% probability, and Possible NSTEMI / STEMI at 7.2% probability. Does the pain radiate to another location? ### Human: No ### Assistant: Let's perform an ECG to further evaluate for a possible NSTEMI/STEMI.

### Assistant: What are your symptoms? ### Human: I have swollen or painful lymph nodes, significantly increased sweating, diarrhea, pain in the back of the neck and forehead with a pain intensity of 5, a fever, pale rash on upper gum, labia majora(R), labia majora(L), internal cheek(R), internal cheek(L) with pain intensity of 2, diffuse muscle pain. ### Assistant: Any relevant medical history? ### Human: I have had a sexually transmitted infection, unprotected sex with more than one partner in the last 6 months, sexual intercourse with an HIV-positive partner in the past 12 months, and traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are HIV (initial infection) at 57.3% probability, and Chagas at 30.8% probability. Does the pain in the back of your neck and forehead radiate to any other location? ### Human: The pain does not radiate to another location. ### Assistant: Let's proceed with a blood test to check for HIV infection.

###Assistant: Do you feel like you are detached from your own body or your surroundings?### ###Human: Yes ###Assistant: Have you had significantly increased sweating?### ###Human: Yes ###Assistant: Do you have pain somewhere, related to your reason for consulting?### ###Human: Yes ###Assistant: Characterize your pain.### ###Human: sharp ###Assistant: Do you feel pain somewhere?### ###Human: side of the chest(R), flank(R), flank(L), iliac fossa(L), hypochondrium(R) ###Assistant: On a scale of 0 to 10, How intense is the pain?### ###Human: 2 ###Assistant: Does the pain radiate to another location?### ###Human: nowhere ###Assistant: On a scale of 0 to 10, How precisely is the pain located?### ###Human: 8 ###Assistant: On a scale of 0 to 10, How fast did the pain appear?### ###Human: 7 ###Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way?### ###Human: Yes ###Assistant: Do you feel like you are (or were) choking or suffocating?### ###Human: Yes ###Assistant: Do you feel lightheaded and dizzy or do you feel like you are about to faint?### ###Human: Yes ###Assistant: Do you feel like you are dying or were you afraid that you were about do die?### ###Human: Yes ###Assistant: Have you recently had numbness, loss of sensation or tingling, in both arms and legs and around your mouth?### ###Human: Yes ###Assistant: Do you feel anxious?### ###Human: Yes ###Assistant: Do any members of your immediate family have a psychiatric illness?### ###Human: Yes ###Assistant: Have you ever been diagnosed with depression?### ###Human: Yes ###Assistant: Do you suffer from chronic anxiety?### ###Human: Yes ###Assistant: Have you ever had a migraine or is a member of your family known to have migraines?### ###Human: Yes ###Assistant: Have you ever had a head trauma?### ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks?### ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Panic attack at 11.3% probability, and Guillain-Barré syndrome at 8.7% probability. Does the pain increase or decrease with physical exertion?### ###Human: The pain does not increase or decrease with physical exertion. ###Assistant: Let's recommend a psychological evaluation to further assess the possibility of a panic attack.###

### Assistant: Have you had significantly increased sweating? ### Human: Yes ### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Characterize your pain. ### Human: The pain is sharp. ### Assistant: Do you feel pain somewhere? ### Human: I feel pain in the side of the chest (R), flank (R), hypochondrium (R), hypochondrium (L), and belly. ### Assistant: On a scale of 0 to 10, How intense is the pain? ### Human: 3 ### Assistant: Does the pain radiate to another location? ### Human: The pain does not radiate. ### Assistant: On a scale of 0 to 10, How precisely is the pain located? ### Human: 6 ### Assistant: On a scale of 0 to 10, How fast did the pain appear? ### Human: 9 ### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### Human: Yes ### Assistant: Do you feel like you are dying or were you afraid that you were about to die? ### Human: Yes ### Assistant: Are you feeling nauseous or do you feel like vomiting? ### Human: Yes ### Assistant: Do you feel your heart is beating fast, irregularly, or do you feel palpitations? ### Human: Yes ### Assistant: Have you recently had numbness, loss of sensation, or tingling in both arms and legs and around your mouth? ### Human: Yes ### Assistant: Do you feel anxious? ### Human: Yes ### Assistant: Do any members of your immediate family have a psychiatric illness? ### Human: Yes ### Assistant: Have you ever been diagnosed with depression? ### Human: Yes ### Assistant: Do you suffer from chronic anxiety? ### Human: Yes ### Assistant: Have you ever had a migraine or is a member of your family known to have migraines? ### Human: Yes ### Assistant: Do you have asthma or have you ever had to use a bronchodilator in the past? ### Human: Yes ### Assistant: Do you suffer from fibromyalgia? ### Human: Yes ### Assistant: Have you ever had a head trauma? ### Human: Yes ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Panic attack at 9.1% probability, and Possible NSTEMI / STEMI at 7.9% probability. Does the pain increase or decrease with physical exertion? ### Human: The pain intensity does not change with physical exertion. ### Assistant: Let's get an ECG to further evaluate for a possible NSTEMI/STEMI. ### Human: Thank you for your help.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain. ###Human: sensitive, a cramp, exhausting ###Assistant: Do you feel pain somewhere? ###Human: back of head, top of the head, forehead, temple(R), temple(L) ###Assistant: On a scale of 0 to 10, How intense is the pain? ###Human: 3 ###Assistant: Does the pain radiate to another location? ###Human: nowhere ###Assistant: On a scale of 0 to 10, How precisely is the pain located? ###Human: 4 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 4 ###Assistant: Do you feel so tired that you are unable to do your usual activities or are you stuck in your bed all day long? ###Human: Yes ###Assistant: Have you recently had stools that were black (like coal)? ###Human: Yes ###Assistant: Do you have very abundant or very long menstruation periods? ###Human: Yes ###Assistant: Is your skin much paler than usual? ###Human: Yes ###Assistant: Do you have a poor diet? ###Human: Yes ###Assistant: Have you ever had a diagnosis of anemia? ###Human: Yes ###Assistant: Do you have any family members who have been diagnosed with anemia? ###Human: Yes ###Assistant: Do you have chronic kidney failure? ###Human: Yes ###Assistant: Are you taking any new oral anticoagulants (NOACs)? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Is your BMI less than 18.5, or are you underweight? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Anemia at 40.7% probability and Cluster headache at 20.3% probability. Does the pain increase or decrease with physical exertion? ###Human: The pain does not increase or decrease with physical exertion. ###Assistant: I recommend getting a blood test to check your hemoglobin levels to further investigate the possibility of anemia.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Can you characterize your pain for me? Is it sensitive, tugging, or exhausting? ###Human: It's sensitive, tugging, and exhausting. ###Assistant: Where do you feel the pain? Is it in the back of your head, top of the head, forehead, or right temple? ###Human: It's in the back of my head, top of my head, forehead, and right temple. ###Assistant: On a scale of 0 to 10, how intense is the pain? ###Human: It's a 4. ###Assistant: Does the pain radiate to another location? ###Human: Nowhere. ###Assistant: On a scale of 0 to 10, how precisely is the pain located? ###Human: It's a 3. ###Assistant: On a scale of 0 to 10, how fast did the pain appear? ###Human: It appeared at a 2. ###Assistant: Do you constantly feel fatigued or have non-restful sleep? ###Human: Yes ###Assistant: Have you recently had stools that were black like coal? ###Human: Yes ###Assistant: Is your skin much paler than usual? ###Human: Yes ###Assistant: Do you have a poor diet? ###Human: Yes ###Assistant: Have you ever had a diagnosis of anemia? ###Human: Yes ###Assistant: Do you have any family members who have been diagnosed with anemia? ###Human: Yes ###Assistant: Do you have chronic kidney failure? ###Human: Yes ###Assistant: Are you taking any new oral anticoagulants (NOACs)? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Is your BMI less than 18.5, or are you underweight? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Anemia at 55.4% probability and Cluster headache at 29.9% probability. Does the pain increase or decrease with physical exertion? ###Human: The pain does not increase or decrease with physical exertion. ###Assistant: Let's focus on the location of the pain. Does the pain in your head move or stay in one specific area? ###Human: The pain stays in one specific area. ###Assistant: I recommend getting a blood test to check your hemoglobin levels and further evaluate for anemia.

###Assistant: Can you characterize your pain for me?### ###Human: The pain is sensitive and burning.### ###Assistant: Have you been in contact with a person with similar symptoms in the past 2 weeks?### ###Human: Yes, I have.### ###Assistant: Based on your history, the two most likely diagnoses are Viral pharyngitis at 15.96% probability, and URTI at 15.40% probability. Does the pain radiate to another location?### ###Human: No, it does not.### ###Assistant: I recommend a throat swab to confirm the diagnosis.### ###Human: Thank you for your help.### ###Assistant: The dialogue must end with the Assistant.

###Assistant: Do you suddenly have difficulty or an inability to open your mouth or have jaw pain when opening it?### ###Human: Yes ###Assistant: Have you started or taken any antipsychotic medication within the last 7 days?### ###Human: Yes ###Assistant: The two most likely diagnoses are Acute dystonic reactions at 15.4% probability, and Pulmonary embolism at 11.2% probability. Do you feel that muscle spasms or soreness in your neck are keeping you from turning your head to one side?### ###Human: Yes ###Assistant: Let's perform a physical examination to assess the muscle spasms in your neck and jaw to help differentiate between the two potential diagnoses.

### Assistant: Do you have nasal congestion or a clear runny nose? ### Human: Yes ### Assistant: Do you have any close family members who suffer from allergies (any type), hay fever or eczema? ### Human: Yes ### Assistant: Based on your history, the top 2 potential diagnoses are Allergic sinusitis with a probability of 100% and another diagnosis with a lower probability. Does the nasal congestion worsen at night or in the morning? ### Human: The nasal congestion is worse in the morning. ### Assistant: I recommend a skin prick test to confirm the diagnosis of allergic sinusitis.

###Assistant: Have you been coughing up blood?### ###Human: Yes ###Assistant: Do you have pain somewhere, related to your reason for consulting?### ###Human: Yes ###Assistant: Characterize your pain.### ###Human: sensitive, burning ###Assistant: Do you feel pain somewhere?### ###Human: thyroid cartilage, palace, pharynx, under the jaw ###Assistant: On a scale of 0 to 10, How intense is the pain?### ###Human: 9 ###Assistant: Does the pain radiate to another location?### ###Human: nowhere ###Assistant: On a scale of 0 to 10, How precisely is the pain located?### ###Human: 10 ###Assistant: On a scale of 0 to 10, How fast did the pain appear?### ###Human: 3 ###Assistant: Do you have a fever (either felt or measured with a thermometer)?### ###Human: Yes ###Assistant: Do you have nasal congestion or a clear runny nose?### ###Human: Yes ###Assistant: Do you live with 4 or more people?### ###Human: Yes ###Assistant: Do you attend or work in a daycare?### ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks?### ###Human: Yes ###Assistant: Are you immunosuppressed?### ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Viral pharyngitis at 26% probability and Possible NSTEMI / STEMI at 15.6% probability. Does the pain in your throat worsen when you swallow?### ###Human: Yes ###Assistant: Let's perform a rapid strep test to confirm if it is viral pharyngitis.

### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### ### Human: Yes ### Assistant: Do you have pain somewhere, related to your reason for consulting? ### ### Human: Yes ### Assistant: Characterize your pain. ### ### Human: exhausting ### Assistant: Do you feel pain somewhere? ### ### Human: lower chest, biceps(R), side of the chest(L), upper chest, breast(L) ### Assistant: On a scale of 0 to 10, How intense is the pain? ### ### Human: 8 ### Assistant: Does the pain radiate to another location? ### ### Human: biceps(R), biceps(L), thoracic spine, trachea, shoulder(R) ### Assistant: On a scale of 0 to 10, How precisely is the pain located? ### ### Human: 6 ### Assistant: On a scale of 0 to 10, How fast did the pain appear? ### ### Human: 3 ### Assistant: Do you have symptoms that are increased with physical exertion but alleviated with rest? ### ### Human: Yes ### Assistant: Do you have diabetes? Are you significantly overweight compared to people of the same height as you? Do you have high cholesterol or do you take medications to treat high cholesterol? Do you drink alcohol excessively or do you have an addiction to alcohol? Have you ever had a heart attack or do you have angina (chest pain)? Have you traveled out of the country in the last 4 weeks? Do you have close family members who had a cardiovascular disease problem before the age of 50? ### ### Human: Yes, Yes, Yes, Yes, Yes, Yes, Yes ### Assistant: Based on your history, the two most likely diagnoses are unstable angina at 14.1% probability, and possible NSTEMI / STEMI at 13.5% probability. Does the pain radiate to your biceps more on the right or left side? ### ### Human: The pain radiates more to my biceps on the right side. ### Assistant: Let's schedule a stress test to further evaluate for unstable angina. ###

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain. ###Human: sharp ###Assistant: Do you feel pain somewhere? ###Human: mouth, forehead, cheek(R), nose, eye(R) ###Assistant: On a scale of 0 to 10, How intense is the pain? ###Human: 5 ###Assistant: Does the pain radiate to another location? ###Human: back of head, nose, temple(R), temple(L) ###Assistant: On a scale of 0 to 10, How precisely is the pain located? ###Human: 3 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 1 ###Assistant: Have you lost your sense of smell? ###Human: Yes ###Assistant: Do you have greenish or yellowish nasal discharge? ###Human: Yes ###Assistant: Do you have a cough? ###Human: Yes ###Assistant: Have you had a cold in the last 2 weeks? ###Human: Yes ###Assistant: Have you ever had pneumonia? ###Human: Yes ###Assistant: Do you have polyps in your nose? ###Human: Yes ###Assistant: Do you have a deviated nasal septum? ###Human: Yes ###Assistant: Do you have asthma or have you ever had to use a bronchodilator in the past? ###Human: Yes ###Assistant: Have you ever been diagnosed with gastroesophageal reflux? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Acute rhinosinusitis at 20.2% probability, and Chronic rhinosinusitis at 18.8% probability. Does the pain increase with bending forward or lying down? ###Human: The pain does increase when I bend forward.

### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### ### Human: Yes ### Assistant: Do you have chest pain even at rest? ### ### Human: Yes ### Assistant: Have you had significantly increased sweating? ### ### Human: Yes ### Assistant: Do you have pain somewhere, related to your reason for consulting? ### ### Human: Yes ### Assistant: Characterize your pain. ### ### Human: tedious, heavy ### Assistant: Do you feel pain somewhere? ### ### Human: lower chest, biceps(L), side of the chest(L), breast(R), breast(L) ### Assistant: On a scale of 0 to 10, How intense is the pain? ### ### Human: 10 ### Assistant: Does the pain radiate to another location? ### ### Human: biceps(L), thyroid cartilage, under the jaw, shoulder(R), shoulder(L) ### Assistant: On a scale of 0 to 10, How precisely is the pain located? ### ### Human: 8 ### Assistant: On a scale of 0 to 10, How fast did the pain appear? ### ### Human: 9 ### Assistant: Are you significantly overweight compared to people of the same height as you? ### ### Human: Yes ### Assistant: Do you have high cholesterol or do you take medications to treat high cholesterol? ### ### Human: Yes ### Assistant: Do you drink alcohol excessively or do you have an addiction to alcohol? ### ### Human: Yes ### Assistant: Do you smoke cigarettes? ### ### Human: Yes ### Assistant: Do you have high blood pressure or do you take medications to treat high blood pressure? ### ### Human: Yes ### Assistant: Have you ever had a heart attack or do you have angina (chest pain)? ### ### Human: Yes ### Assistant: Do you exercise regularly, 4 times per week or more? ### ### Human: Yes ### Assistant: Have you traveled out of the country in the last 4 weeks? ### ### Human: Yes ### Assistant: Do you have close family members who had a cardiovascular disease problem before the age of 50? ### ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are unstable angina at 10% probability, and possible NSTEMI / STEMI at 8.8% probability. Does the pain increase or decrease with physical exertion? ### ### Human: I have symptoms that increase with physical exertion but alleviate with rest. ### Assistant: Let's get an ECG to further evaluate for possible NSTEMI / STEMI. ### ### Human: Okay.

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Characterize your pain. ### Human: haunting, a knife stroke, violent, sharp ### Assistant: Do you feel pain somewhere? ### Human: forehead, cheek(R), cheek(L), eye(R), eye(L) ### Assistant: On a scale of 0 to 10, How intense is the pain? ### Human: 10 ### Assistant: Does the pain radiate to another location? ### Human: nowhere ### Assistant: On a scale of 0 to 10, How precisely is the pain located? ### Human: 9 ### Assistant: On a scale of 0 to 10, How fast did the pain appear? ### Human: 8 ### Assistant: Do you feel that your eyes produce excessive tears? ### Human: Yes ### Assistant: Do you have nasal congestion or a clear runny nose? ### Human: Yes ### Assistant: Have any of your family members been diagnosed with cluster headaches? ### Human: Yes ### Assistant: Do you drink alcohol excessively or do you have an addiction to alcohol? ### Human: Yes ### Assistant: Do you take medication that dilates your blood vessels? ### Human: Yes ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Cluster headache at 56.1% probability, and Chagas at 21.9% probability. Does the pain increase or decrease with physical exertion? ### Human: The pain does not increase or decrease with physical exertion. ### Assistant: Let's recommend a brain MRI to further investigate the possibility of a Cluster headache.

### Assistant: Do you have difficulty articulating words/speaking? ### Human: Yes ### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### Human: Yes ### Assistant: Do you feel weakness in both arms and/or both legs? ### Human: Yes ### Assistant: Are there any members of your family who have been diagnosed myasthenia gravis? ### Human: Yes ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Myasthenia gravis at 35.1% probability, and Anemia at 25.1% probability. Does the weakness in your arms and legs come and go or is it constant? ### Human: The weakness comes and goes. ### Assistant: Let's proceed with a blood test to check for any signs of anemia.

###Assistant: Do you feel pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain. ###Human: It's a cramp. ###Assistant: Do you feel pain somewhere? ###Human: In my forehead and temple (L). ###Assistant: On a scale of 0 to 10, How intense is the pain? ###Human: 2 ###Assistant: Does the pain radiate to another location? ###Human: Nowhere ###Assistant: On a scale of 0 to 10, How precisely is the pain located? ###Human: 4 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 0 ###Assistant: Have you recently had stools that were black (like coal)? ###Human: Yes ###Assistant: Do you have a poor diet? ###Human: Yes ###Assistant: Have you ever had a diagnosis of anemia? ###Human: Yes ###Assistant: Do you have chronic kidney failure? ###Human: Yes ###Assistant: Are you taking any new oral anticoagulants (NOACs)? ###Human: Yes ###Assistant: Do you think you are pregnant or are you currently pregnant? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Is your BMI less than 18.5, or are you underweight? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Anemia at 50.3% probability, and Cluster headache at 49.7% probability. Does the pain increase with physical activity or stress? ###Human: The pain does not increase with physical activity or stress. ###Assistant: Let's proceed with a blood test to confirm the diagnosis of Anemia.

### Assistant: Do you constantly feel fatigued or do you have non-restful sleep? ### Human: Yes ### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Characterize your pain. ### Human: sensitive, sharp ### Assistant: Do you feel pain somewhere? ### Human: back of the neck, ankle(R), ankle(L), shoulder(R), shoulder(L) ### Assistant: On a scale of 0 to 10, How intense is the pain? ### Human: 2 ### Assistant: Does the pain radiate to another location? ### Human: nowhere ### Assistant: On a scale of 0 to 10, How precisely is the pain located? ### Human: 10 ### Assistant: On a scale of 0 to 10, How fast did the pain appear? ### Human: 2 ### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### Human: Yes ### Assistant: Do you have any lesions, redness or problems on your skin that you believe are related to the condition you are consulting for? ### Human: Yes ### Assistant: What color is the rash? ### Human: red ### Assistant: Do your lesions peel off? ### Human: N ### Assistant: On a scale of 0 to 10, Is the rash swollen? ### Human: 0 ### Assistant: Where is the affected region located? ### Human: nose ### Assistant: Is the lesion (or are the lesions) larger than 1cm? ### Human: Y ### Assistant: On a scale of 0 to 10, How severe is the itching? ### Human: 3 ### Assistant: Have you ever had a pericarditis? ### Human: Yes ### Assistant: Are you consulting because you have high blood pressure? ### Human: Yes ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are SLE at 16.9% probability, and Pulmonary embolism at 15.3% probability. Does the pain in your neck and shoulders worsen with movement or rest? ### Human: The pain remains the same regardless of movement or rest. ### Assistant: I recommend conducting a blood test to check for specific antibodies related to SLE for further diagnosis.

### Assistant: What are your symptoms? ### Human: I have significantly increased sweating, sharp cramp-like pain on the side of my chest (R), flank (R), breast (R), breast (L), and belly. The pain intensity is 8 on a scale of 0 to 10, and it appeared with a speed of 5. I am also experiencing shortness of breath, feeling like I am dying, and feeling nauseous. I have numbness, loss of sensitivity, or tingling on my body. ### Assistant: Any relevant medical history? ### Human: I feel anxious, have a family history of psychiatric illness, drink alcohol excessively, have been diagnosed with depression, suffer from chronic anxiety, and have traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Boerhaave at 20.5% probability and GERD at 19.3% probability. Does the pain radiate to another location? ### Human: The pain does not radiate to another location. ### Assistant: Let's ask one more question to differentiate between the potential diagnoses. Does the pain increase or decrease with eating or lying down? ### Human: The pain does not change with eating or lying down. ### Assistant: I recommend conducting an upper endoscopy to further evaluate for GERD.

###Assistant: What are your symptoms? ###Human: I have significantly increased sweating, sensitive, heavy, exhausting pain in the back of my head, back of the neck, top of the head, occiput, and right temple. The pain intensity is 5 on a scale of 0 to 10, and it appeared quickly. I have a fever, chills, sore throat, pink rash on the side of my neck, loss of appetite, and a cough. ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes, I have. ###Assistant: Based on your history, the two most likely diagnoses are URTI at 18.2% probability, and Influenza at 17.7% probability. Does the pain in the back of your head radiate to any other location? ###Human: No, the pain does not radiate to another location. ###Assistant: Let's perform a rapid influenza test to confirm the diagnosis.

###Assistant: Do you find that your symptoms have worsened over the last 2 weeks and that progressively less effort is required to cause the symptoms? ###Human: Yes ###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: I have pain in my biceps (L), thyroid cartilage, scapula (L), posterior chest wall (L), and shoulder (R). The pain is tedious, heavy, and exhausting. On a scale of 0 to 10, the intensity is 5. The pain radiates to biceps (R), biceps (L), thyroid cartilage, thoracic spine, and shoulder (L). ###Assistant: Do you have diabetes, high cholesterol, addiction to alcohol, smoke cigarettes, high blood pressure, history of heart attack or angina, exercise regularly, traveled out of the country in the last 4 weeks, and family members with cardiovascular disease before the age of 50? ###Human: Yes, I have diabetes, high cholesterol, addiction to alcohol, smoke cigarettes, high blood pressure, history of heart attack, exercise regularly, traveled out of the country in the last 4 weeks, and family members with cardiovascular disease before the age of 50. ###Assistant: Based on your history, the two most likely diagnoses are unstable angina at 12.2% probability, and possible NSTEMI / STEMI at 10.9% probability. Does the pain increase or decrease with physical exertion? ###Human: I have symptoms that increase with physical exertion but alleviate with rest. ###Assistant: Let's schedule a stress test to further evaluate your symptoms and determine the best course of action.

### Assistant: Have you noticed any new fatigue, generalized and vague discomfort, diffuse (widespread) muscle aches or a change in your general well-being related to your consultation today? ### Human: Yes ### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: sensitive, a cramp, a pulse, exhausting ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Chagas at 100% probability, and spontaneous pneumothorax at 0% probability. Does the pain radiate to another location? ### Human: nowhere ### Assistant: Let's get a blood test to check for Chagas disease.

### Assistant: What are your symptoms? ### Human: I am experiencing shortness of breath and difficulty breathing. My cheeks suddenly turned red, and I have a pink rash on my biceps (R), biceps (L), mouth, thyroid cartilage, and left ankle. The rash is swollen at a level of 6 out of 10, but the pain caused by the rash is 0. The itching is severe at a level of 9. I also feel nauseous and like vomiting. ### Assistant: Did you eat dark-fleshed fish (such as tuna) or Swiss cheese before the reaction occurred? ### Human: Yes, I did. ### Assistant: Based on your history, the two most likely diagnoses are Scombroid food poisoning at 22.6% probability and Anaphylaxis at 15.7% probability. Does the rash appear suddenly or gradually develop over time? ### Human: The rash appeared suddenly. ### Assistant: Let's perform a skin prick test to help differentiate between Scombroid food poisoning and Anaphylaxis.

###Assistant: Do you constantly feel fatigued or do you have non-restful sleep? ###Human: Yes ###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain. ###Human: It's heavy. ###Assistant: Do you feel pain somewhere? ###Human: In my lower chest, thoracic spine, breast (L), shoulder (L), and epigastric. ###Assistant: On a scale of 0 to 10, How intense is the pain? ###Human: 5 ###Assistant: Does the pain radiate to another location? ###Human: Yes, it radiates to my biceps (R), trachea, triceps (R), triceps (L), and shoulder (L). ###Assistant: On a scale of 0 to 10, How precisely is the pain located? ###Human: 6 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 3 ###Assistant: Do you constantly feel fatigued or do you have non-restful sleep? ###Human: Yes ###Assistant: Do you have symptoms that are increased with physical exertion but alleviated with rest? ###Human: Yes ###Assistant: Do you have diabetes? ###Human: Yes ###Assistant: Do you have high cholesterol or do you take medications to treat high cholesterol? ###Human: Yes ###Assistant: Do you smoke cigarettes? ###Human: Yes ###Assistant: Do you exercise regularly, 4 times per week or more? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Do you have close family members who had a cardiovascular disease problem before the age of 50? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are unstable angina at 21% probability and stable angina at 18.3% probability. Does the pain increase or decrease with physical exertion? ###Human: I have symptoms that increase with physical exertion but alleviate with rest. ###Assistant: Let's schedule a stress test to further evaluate your symptoms and determine the underlying cause.

###Assistant: What are your symptoms? ###Human: I have swollen or painful lymph nodes, lost consciousness associated with violent and sustained muscle contractions, and have pain in my fingers (ring finger)(R), (L), (index)(L), (middle)(R), (L). The pain is sensitive, burning, and sharp with an intensity of 1 on a scale of 0 to 10. I also have shortness of breath, diffuse redness in one or both eyes, and vaginal discharge. ###Assistant: Any relevant medical history? ###Human: I am significantly overweight compared to people of the same height as me, work in agriculture, and have traveled out of the country in the last 4 weeks. ###Assistant: Based on your history, the two most likely diagnoses are Sarcoidosis at 20.9% probability, and Guillain-Barré syndrome at 14.7% probability. Does the pain in your fingers radiate to another location? ###Human: The pain in my fingers does not radiate to another location. ###Assistant: Let's recommend a chest X-ray to examine for potential signs of Sarcoidosis.

###Assistant: Can you describe the pain you're experiencing in your tonsil, thyroid cartilage, palace, and pharynx?### Human: The pain is burning in my tonsil (R) and tonsil (L). On a scale of 0 to 10, the intensity is 3. The pain is precisely located at 7 and appeared suddenly at 0.### ###Assistant: Have you been in contact with a person with similar symptoms in the past 2 weeks? Do you live with 4 or more people? Do you smoke cigarettes? Have you traveled out of the country in the last 4 weeks? Are you immunosuppressed?### Human: Yes, I have been in contact with a person with similar symptoms. I live with 4 or more people. I smoke cigarettes. I have traveled out of the country in the last 4 weeks. I am immunosuppressed.### ###Assistant: Based on your history, the two most likely diagnoses are Viral pharyngitis at 26% probability and Possible NSTEMI / STEMI at 15.6% probability. Does the pain in your tonsil radiate to another location?### Human: No, the pain does not radiate to another location.### ###Assistant: Let's do a throat swab to confirm if it is indeed Viral pharyngitis.###

### Assistant: Have you noticed any new fatigue, generalized and vague discomfort, diffuse (widespread) muscle aches or a change in your general well-being related to your consultation today? ### ### Human: Yes ### Assistant: Do you have pain somewhere, related to your reason for consulting? ### ### Human: Yes ### Assistant: Characterize your pain as tedious, sensitive, tugging, heavy. Do you feel pain in the side of the chest (R), side of the chest (L), upper chest, breast (L), or posterior chest wall (R)? On a scale of 0 to 10, how intense is the pain? Does it radiate to biceps (R), chin, jaw, scapula (R), or scapula (L)? How precisely is the pain located and how fast did it appear? ### ### Human: The pain is in the side of the chest (R) and side of the chest (L). The pain intensity is 8. It radiates to biceps (R) and scapula (R). The pain location precision is 4, and it appeared at a pace of 3. ### Assistant: Do you have bouts of choking or shortness of breath that wake you up at night? Do you have swelling in the ankle (L), calf (R), tibia (R), or tibia (L)? ### ### Human: Yes, I have bouts of choking or shortness of breath at night. I have swelling in the ankle (L), calf (R), tibia (R), and tibia (L). ### Assistant: Have you ever had fluid in your lungs? Do you currently undergo dialysis? Have you ever had a heart attack or do you have angina (chest pain)? Do you have heart failure? Have you traveled out of the country in the last 4 weeks? ### ### Human: Yes, I have had fluid in my lungs. Yes, I currently undergo dialysis. Yes, I have had a heart attack and have angina. Yes, I have heart failure. Yes, I have traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Unstable angina at 24.0% probability and Stable angina at 21.4% probability. Does the pain increase or decrease with physical exertion? ### ### Human: I have symptoms that increase with physical exertion but alleviate with rest. ### Assistant: Do you have any symptoms that are increased with physical exertion but alleviated with rest that could help differentiate between unstable angina and stable angina? ### ### Human: Yes, I have symptoms that increase with physical exertion but alleviate with rest. ### Assistant: Let's recommend getting an ECG to further evaluate for unstable angina. ### ### Human: Thank you for your recommendation.

### Assistant: What are your symptoms? ### Human: I have pain somewhere, related to my reason for consulting. The pain is heavy and located in the iliac fossa (L) and hip (R). On a scale of 0 to 10, the intensity of the pain is 7. The pain appeared quickly, with a rating of 6. I also have a pale rash in the iliac fossa (R) that is swollen, larger than 1cm, and causes mild pain. ### Assistant: Any relevant medical history? ### Human: I was born prematurely and have traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Inguinal hernia at 30.5% probability, and Bronchitis at 24.2% probability. Does the pain in your iliac fossa (L) increase with coughing or physical exertion? ### Human: Yes, the pain is increased with coughing and physical exertion. ### Assistant: Let's schedule a physical examination to further evaluate the pain in your iliac fossa and hip, as well as the rash. This will help us determine the underlying cause of your symptoms.

###Assistant: Do you have pain or weakness in your jaw? ###Human: Yes ###Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ###Human: Yes ###Assistant: Are there any members of your family who have been diagnosed with myasthenia gravis? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Myasthenia gravis at 19.1% probability, and Guillain-Barré syndrome at 15.4% probability. Do you feel weakness in both arms and legs equally, or is one side more affected than the other? ###Human: I feel weakness in both arms and legs equally. ###Assistant: Let's conduct a blood test to check for specific antibodies related to myasthenia gravis.

###Assistant: Do you have pain or weakness in your jaw? ###Human: Yes ###Assistant: Do you have difficulty articulating words/speaking? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Myasthenia gravis at 17.4% probability, and Guillain-Barré syndrome at 14.5% probability. Do you have a hard time opening/raising one or both eyelids? ###Human: Yes ###Assistant: Let's perform a nerve conduction study to help differentiate between Myasthenia gravis and Guillain-Barré syndrome.

###Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ###Human: Yes ###Assistant: Do you feel slightly dizzy or lightheaded? ###Human: Yes ###Assistant: Do you feel your heart is beating very irregularly or in a disorganized pattern? ###Human: Yes ###Assistant: Do you have a known issue with one of your heart valves? ###Human: Yes ###Assistant: Do you have severe Chronic Obstructive Pulmonary Disease (COPD)? ###Human: Yes ###Assistant: Are you significantly overweight compared to people of the same height as you? ###Human: Yes ###Assistant: Do you have high blood pressure or do you take medications to treat high blood pressure? ###Human: Yes ###Assistant: Have you ever had a heart attack or do you have angina (chest pain)? ###Human: Yes ###Assistant: Do you have a known heart defect? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Atrial fibrillation at 15.3% probability, and PSVT at 14.0% probability. Does the irregular heartbeats occur suddenly or gradually? ###Human: The irregular heartbeats occur suddenly. ###Assistant: Let's perform an ECG to further evaluate your heart rhythm.

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes, the pain is tedious, sensitive, tugging, and heavy. It is located in my ankle (R), side of the chest (R), side of the chest (L), posterior chest wall (R), and posterior chest wall (L). The intensity of the pain is 8 on a scale of 0 to 10, and it radiates to my jaw, triceps (R), triceps (L), shoulder (R), and shoulder (L). The pain is precisely located at 6 and appeared at a pace of 4. ### Assistant: Do you currently undergo dialysis? ### Human: Yes, I do. I also have high blood pressure, have had a heart attack, have heart failure, and have traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Acute pulmonary edema at 9.9% probability, and Possible NSTEMI / STEMI at 8% probability. Does the pain worsen when lying down and improve when sitting up? ### Human: Yes, my symptoms are worse when lying down and alleviated while sitting up. ### Assistant: Let's perform an ECG to further evaluate for a possible NSTEMI/STEMI.

### Assistant: Have you been coughing up blood and experiencing sharp pain in your lower chest, side of the chest (R), upper chest, and posterior chest wall (R)? ### ### Human: Yes, I have been coughing up blood and have sharp pain in those areas. The pain intensity is 7 on a scale of 0 to 10 and it appeared quickly with a rating of 6. ### ### Assistant: Do you have a history of heart failure, stroke, pneumonia, COPD, or recent surgery? ### ### Human: Yes, I have a history of heart failure, stroke, pneumonia, COPD, and I had surgery within the last month. ### ### Assistant: Based on your history, the two most likely diagnoses are Pneumonia at 6.9% probability and Bronchitis at 6.3% probability. Does the pain radiate to another location? ### ### Human: No, the pain does not radiate to another location. ### ### Assistant: Let's proceed with a chest X-ray to further evaluate your symptoms and rule out any potential pneumonia. ###

###Assistant: What are your symptoms? ###Human: I have pain in my forehead, cheek (R), cheek (L), eye (R), and temple (R). The pain feels like a knife stroke, tugging, and violent. On a scale of 0 to 10, the intensity is 9. The pain appeared very fast, at a 9 out of 10. I also have excessive tears and nasal congestion. ###Assistant: Have any of your family members been diagnosed with cluster headaches? ###Human: Yes, some of my family members have been diagnosed with cluster headaches. I also drink alcohol excessively, have an addiction to alcohol, take medication that dilates my blood vessels, and have traveled out of the country in the last 4 weeks. ###Assistant: Based on your history, the two most likely diagnoses are Cluster headache at 59.3% probability, and Chagas at 20.4% probability. Does the pain increase or decrease with physical exertion? ###Human: The pain does not increase or decrease with physical exertion. ###Assistant: Let's schedule a neurological examination to further evaluate your symptoms and confirm the diagnosis of Cluster headache.

###Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ###Human: Yes ###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain. ###Human: tedious, sharp, sickening, scary ###Assistant: Do you feel pain somewhere? ###Human: lower chest, biceps(R), thyroid cartilage, side of the chest(R), breast(L) ###Assistant: On a scale of 0 to 10, How intense is the pain? ###Human: 7 ###Assistant: Does the pain radiate to another location? ###Human: biceps(R), thyroid cartilage, thoracic spine, trachea, shoulder(R) ###Assistant: On a scale of 0 to 10, How precisely is the pain located? ###Human: 7 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 7 ###Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ###Human: Yes ###Assistant: Do you constantly feel fatigued or do you have non-restful sleep? ###Human: Yes ###Assistant: Are you feeling nauseous or do you feel like vomiting? ###Human: Yes ###Assistant: Have you recently had a loss of appetite or do you get full more quickly than usual? ###Human: Yes ###Assistant: Are you infected with the human immunodeficiency virus (HIV)? ###Human: Yes ###Assistant: Are you significantly overweight compared to people of the same height as you? ###Human: Yes ###Assistant: Do you smoke cigarettes? ###Human: Yes ###Assistant: Do you have high blood pressure or do you take medications to treat high blood pressure? ###Human: Yes ###Assistant: Have you ever had a heart attack or do you have angina (chest pain)? ###Human: Yes ###Assistant: Are you a former smoker? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Do you have close family members who had a cardiovascular disease problem before the age of 50? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Possible NSTEMI / STEMI at 12.5% probability and Pulmonary neoplasm at 9.3% probability. Does the pain worsen with deep breathing or coughing? ###Human: The pain does not worsen with deep breathing or coughing. ###Assistant: Let's schedule a cardiac enzyme blood test to check for markers of a possible heart attack.

###Assistant: What are your symptoms? ###Human: I have swollen or painful lymph nodes, significantly increased sweating, diarrhea, exhausting pain in the back of my head, cervical spine, top of the head, and temple (R). The pain intensity is 3 on a scale of 0 to 10, and it appeared quickly with a rating of 6. I feel so tired that I am unable to do my usual activities, have a fever, and pale lesions on my lower gum, upper gum, labia majora (R), labia majora (L), and internal cheek (R). The pain caused by the rash is a 3 on a scale of 0 to 10, and the lesions are larger than 1cm. I also have diffuse muscle pain. ###Assistant: Have you ever had a sexually transmitted infection? Are you currently using intravenous drugs? Have you had unprotected sex with more than one partner in the last 6 months? Have you had sexual intercourse with an HIV-positive partner in the past 12 months? Have you traveled out of the country in the last 4 weeks? ###Human: Yes, I have had a sexually transmitted infection, currently using intravenous drugs, had unprotected sex with more than one partner in the last 6 months, had sexual intercourse with an HIV-positive partner in the past 12 months, and traveled out of the country in the last 4 weeks. ###Assistant: Based on your history, the two most likely diagnoses are HIV (initial infection) at 35.6% probability and Influenza at 28.9% probability. Does the pain in the back of your head and cervical spine radiate to any other location? ###Human: The pain does not radiate to another location. ###Assistant: I recommend getting a HIV test to confirm the diagnosis.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain as burning. Do you feel pain somewhere in the side of the chest (R), side of the chest (L), pharynx, posterior chest wall (R), or posterior chest wall (L)? ###Human: Yes, I feel pain in the side of the chest (R) and side of the chest (L). ###Assistant: On a scale of 0 to 10, How intense is the pain? ###Human: 4 ###Assistant: Does the pain radiate to another location? ###Human: Nowhere ###Assistant: On a scale of 0 to 10, How precisely is the pain located? ###Human: 3 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 1 ###Assistant: Do you have a sore throat? ###Human: Yes ###Assistant: Do you have nasal congestion or a clear runny nose? ###Human: Yes ###Assistant: Do you have a cough? ###Human: Yes ###Assistant: Are your symptoms more prominent at night? ###Human: Yes ###Assistant: Do you smoke cigarettes? ###Human: Yes ###Assistant: Do you have a chronic obstructive pulmonary disease (COPD)? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Are your vaccinations up to date? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are URTI at 20% probability and Viral pharyngitis at 17.5% probability. Does the pain increase or decrease with physical exertion? ###Human: The pain does not increase with physical exertion. ###Assistant: Let's recommend a throat swab to differentiate between URTI and Viral pharyngitis.

###Assistant: Have you noticed that the tone of your voice has become deeper, softer or hoarse?### ###Human: Yes ###Assistant: Do you have pain somewhere, related to your reason for consulting?### ###Human: Yes ###Assistant: Can you characterize your pain for me?### ###Human: It is sensitive and burning. ###Assistant: On a scale of 0 to 10, how intense is the pain?### ###Human: 1 ###Assistant: Does the pain radiate to another location?### ###Human: Nowhere ###Assistant: On a scale of 0 to 10, how precisely is the pain located?### ###Human: 6 ###Assistant: On a scale of 0 to 10, how fast did the pain appear?### ###Human: 0 ###Assistant: Do you attend or work in a daycare?### ###Human: Yes ###Assistant: Do you smoke cigarettes?### ###Human: Yes ###Assistant: Have you had a cold in the last 2 weeks?### ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks?### ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Acute laryngitis at 47.1% probability, and Possible NSTEMI / STEMI at 28.9% probability. Does the pain in your throat worsen with swallowing?### ###Human: No ###Assistant: I recommend a throat swab to check for any bacterial infection that may be causing your symptoms.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain. ###Human: Haunting, sensitive, tugging, burning, sickening ###Assistant: Do you feel pain somewhere? ###Human: Epigastric ###Assistant: On a scale of 0 to 10, How intense is the pain? ###Human: 6 ###Assistant: Does the pain radiate to another location? ###Human: Upper chest ###Assistant: On a scale of 0 to 10, How precisely is the pain located? ###Human: 3 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 4 ###Assistant: Have you recently had stools that were black (like coal)? ###Human: Yes ###Assistant: Do you have a burning sensation that starts in your stomach then goes up into your throat, and can be associated with a bitter taste in your mouth? ###Human: Yes ###Assistant: Do you have a cough? ###Human: Yes ###Assistant: Have you recently thrown up blood or something resembling coffee beans? ###Human: Yes ###Assistant: Do you have symptoms that get worse after eating? ###Human: Yes ###Assistant: Are your symptoms worse when lying down and alleviated while sitting up? ###Human: Yes ###Assistant: Do you smoke cigarettes? ###Human: Yes ###Assistant: Do you have a hiatal hernia? ###Human: Yes ###Assistant: Do you think you are pregnant or are you currently pregnant? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are GERD at 30.5% probability and Bronchitis at 26.8% probability. Does your cough worsen at night or in the morning? ###Human: My cough tends to worsen at night. ###Assistant: Let's schedule an upper endoscopy to further evaluate for GERD.

###Assistant: What are your symptoms? ###Human: I have pain somewhere related to my reason for consulting. The pain is tedious in my forehead, with an intensity of 2 on a scale of 0 to 10. The pain is precisely located at 4 and appeared at a rate of 4. I also feel slightly dizzy or lightheaded and have palpitations. ###Assistant: Any relevant medical history? ###Human: I feel anxious, regularly drink coffee or tea, consume energy drinks regularly, take stimulant drugs, traveled out of the country in the last 4 weeks, and recently took decongestants or other substances that may have stimulant effects. ###Assistant: Based on your history, the two most likely diagnoses are PSVT at 36.8% probability and Cluster headache at 19.9% probability. Does the pain in your forehead radiate to another location? ###Human: The pain in my forehead does not radiate to another location. ###Assistant: Let's perform an ECG to further evaluate and diagnose your condition.

###Assistant: Can you describe the pain you're experiencing in more detail?### Human: The pain is tedious, tugging, heavy, and sharp. It is located in my ankle (R), ankle (L), dorsal aspect of the foot (R), sole (R), and sole (L). The intensity of the pain is 2 out of 10, and it appeared relatively fast with a score of 4 out of 10. ###Assistant: Have you ever had surgery to remove lymph nodes?### Human: Yes, I have had surgery to remove lymph nodes. ###Assistant: Based on your history, the two most likely diagnoses are Localized edema at 46.8% probability and Pulmonary embolism at 32.5% probability. Does the pain in your ankle (R) worsen with movement or rest?### Human: The pain in my ankle (R) does not worsen with movement or rest. ###Assistant: I recommend getting a D-dimer blood test to help differentiate between Localized edema and Pulmonary embolism.

###Assistant: Can you describe the pain you're experiencing in more detail? Where is it located and how intense is it on a scale of 0 to 10?### Human: I have burning, sharp pain in my mouth, forehead, cheek (R), cheek (L), and nose. The pain is a 1 in intensity and it radiates to the back of my head, forehead, and temple (R). ###Assistant: Have you ever had pneumonia or do you have polyps in your nose?### Human: Yes, I have had pneumonia and I do have polyps in my nose. ###Assistant: Based on your history, the two most likely diagnoses are Acute rhinosinusitis at 20.2% probability, and Bronchitis at 18.1% probability. Does the nasal discharge you have appear greenish or yellowish?### Human: Yes, I do have greenish or yellowish nasal discharge. ###Assistant: Let's recommend a nasal endoscopy to further evaluate your symptoms and help differentiate between Acute rhinosinusitis and Bronchitis.

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Can you characterize your pain for me? Is it tedious, heavy, or exhausting? ### Human: The pain is tedious, heavy, and exhausting. ### Assistant: On a scale of 0 to 10, how intense is the pain? ### Human: 7 ### Assistant: Does the pain radiate to another location, such as the thoracic spine, under the jaw, triceps (R), shoulder (R), or shoulder (L)? ### Human: Yes, it radiates to the thoracic spine, under the jaw, triceps (R), shoulder (R), and shoulder (L). ### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### Human: Yes ### Assistant: Are you significantly overweight compared to people of the same height as you? ### Human: Yes ### Assistant: Do you have high cholesterol or do you take medications to treat high cholesterol? ### Human: Yes ### Assistant: Do you have high blood pressure or do you take medications to treat high blood pressure? ### Human: Yes ### Assistant: Have you ever had a heart attack or do you have angina (chest pain)? ### Human: Yes ### Assistant: Do you exercise regularly, 4 times per week or more? ### Human: Yes ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Possible NSTEMI / STEMI at 12.3% probability, and Panic attack at 9.3% probability. Does the pain increase or decrease with physical exertion? ### Human: The pain does not increase with physical exertion. ### Assistant: Let's proceed with an ECG to further evaluate for possible NSTEMI/STEMI.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes, the pain is tedious, heavy, and sharp. It is located in my ankle (R), thigh (L), dorsal aspect of the foot (R), dorsal aspect of the foot (L), and sole (R). The intensity of the pain is 6 on a scale of 0 to 10, and it appeared rapidly with a score of 8. ###Assistant: Have you ever had deep vein thrombosis (DVT)? ###Human: Yes, I have had deep vein thrombosis. ###Assistant: Based on your history, the two most likely diagnoses are Localized edema at 67.5% probability and Chagas at 20.3% probability. Does the pain in your ankle (R) worsen with movement or rest? ###Human: The pain in my ankle (R) worsens with movement. ###Assistant: Let's perform a Doppler ultrasound to check for any signs of deep vein thrombosis.

###Assistant: Do you have pain somewhere, related to your reason for consulting?### ###Human: Yes ###Assistant: Characterize your pain. ###Human: It's heavy and exhausting. ###Assistant: On a scale of 0 to 10, How intense is the pain? ###Human: 7 ###Assistant: Does the pain radiate to another location? ###Human: Yes, it radiates to biceps (L), triceps (R), and shoulder (L). ###Assistant: On a scale of 0 to 10, How precisely is the pain located? ###Human: 3 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 7 ###Assistant: Do you constantly feel fatigued or do you have non-restful sleep? ###Human: Yes ###Assistant: Do you have symptoms that are increased with physical exertion but alleviated with rest? ###Human: Yes ###Assistant: Do you have diabetes, are you significantly overweight, drink alcohol excessively, smoke cigarettes, have high blood pressure, had a heart attack, exercise regularly, and have traveled out of the country in the last 4 weeks? ###Human: Yes to all. ###Assistant: Based on your history, the two most likely diagnoses are unstable angina at 18.8% probability, and stable angina at 16.8% probability. Does the pain increase or decrease with physical exertion? ###Human: I have symptoms that increase with physical exertion but alleviate with rest. ###Assistant: Let's get an ECG to further evaluate for unstable angina.

### Assistant: Can you characterize your pain for me?### Human: The pain is sensitive and sharp.### Assistant: Have you recently been treated with an oral antibiotic for an ear infection?### Human: Yes.### Assistant: Based on your history, the two most likely diagnoses are Acute otitis media at 100% probability. Does the pain radiate to another location?### Human: Nowhere.### Assistant: Let's perform a physical examination of your ear to confirm the diagnosis.

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes, I have pain in my forehead, cheek (R), and temple (L). The pain is sensitive and heavy, with an intensity of 7 on a scale of 0 to 10. It appeared with a speed of 4. ### Assistant: Have you been in contact with a person with similar symptoms in the past 2 weeks? ### Human: Yes, I have been in contact with a person with similar symptoms. ### Assistant: Based on your history, the two most likely diagnoses are URTI at 34.8% probability, and Influenza at 25.7% probability. Does the pain in your forehead, cheek, and temple worsen with movement or touch? ### Human: The pain does not worsen with movement or touch. ### Assistant: Let's perform a rapid influenza test to help differentiate between URTI and Influenza.

###Assistant: Can you characterize your pain for me?### Human: The pain is burning.### Assistant: Do you have a history of smoking cigarettes, nasal polyps, deviated nasal septum, asthma, gastroesophageal reflux, recent travel, or common allergies?### Human: Yes, I smoke cigarettes, have nasal polyps, deviated nasal septum, asthma, gastroesophageal reflux, recent travel, and common allergies.### Assistant: Based on your history, the two most likely diagnoses are Acute rhinosinusitis at 26.5% probability, and Bronchitis at 24.7% probability. Does the pain in your forehead and cheeks worsen with coughing or sneezing?### Human: Yes, the pain in my forehead and cheeks worsens with coughing or sneezing.### Assistant: Let's perform a nasal endoscopy to further evaluate your symptoms and confirm the diagnosis.

###Assistant: Can you characterize your pain for me?### Human: The pain is tedious and sensitive.### Assistant: Have you traveled out of the country in the last 4 weeks?### Human: Yes.### Assistant: Based on your history, the two most likely diagnoses are URTI at 42.04% probability, and Cluster headache at 30.57% probability. Does the pain radiate to another location?### Human: The pain does not radiate to another location.### Assistant: I recommend a physical examination to further evaluate your symptoms.

###Assistant: What are your symptoms? ###Human: I have been coughing up blood. I have a burning pain in my tonsil (R) and tonsil (L), thyroid cartilage, palace, and pharynx. The pain intensity is 8 on a scale of 0 to 10, and it appeared relatively fast with a score of 4. I also have nasal congestion or a clear runny nose. ###Assistant: Have you been in contact with a person with similar symptoms in the past 2 weeks? Do you attend or work in a daycare? Do you smoke cigarettes? Have you traveled out of the country in the last 4 weeks? ###Human: Yes, I have been in contact with a person with similar symptoms, I attend a daycare, I smoke cigarettes, and I have traveled out of the country in the last 4 weeks. ###Assistant: Based on your history, the two most likely diagnoses are Viral pharyngitis at 41.5% probability and Possible NSTEMI / STEMI at 24.9% probability. Does the pain radiate to another location? ###Human: The pain does not radiate to another location. ###Assistant: Let's perform a rapid strep test to confirm if it is viral pharyngitis.