Conversation: The conversation between human and AI assistant.
[|Human|] Hi, I am a breast cancer survivor, had mastectomies and 4 rounds of chemo. Diagnosed in 2012. Finished treatment. Stage 1, ER+ My ALT, AST and triglycerides are elevated and vitamin D is low. Having RUQ pain, burning, bores through to my shoulder, R L....sometimes the pain is on the L, mostly R. Have lost 25lbs. in 8 weeks, feverish, sickly, sweet smelling sweat, urine and feces. CBC, Ca, tumor markers, glucose, thyroid WNL, urine clean. No constitutional symptoms. HTN, Depression, Anxiety colonoscopy diverticulosis 2013 S/p BSO 2012 S/p B mastectomies with immediate latissimus dorsi flap reconstruction 2012 S/p umbilical hernia repair with mesh 2011 S/p laparoscopic cholecystectomy 2006 Meds: 300mg Wellbutrin XL, 300mg Zoloft, 2.5mg Losartan/Hcz...all QD Getting Mammogram and ultrasound tomorrow. Redrawing labs in two weeks. See oncologist in 3 weeks. What are your top 3 differential diagnosis and what tests would you recommend? Thank you. H
[|AI|]  Hi, I had gone through your question and understand your concerns. This may be causes by several issues and most common are choledocholithasis which suggests that there is stone in common bile duct, secondly, it may indicate cholangitis or cholecystitis and thirdly, hepatitis, so you need to do liver ultrasound, check viral markers and do ERCP for a start. This will show us if I am right. By this you need to avoid hematologic medications and have easier diet. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.