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### Assistant: Can you describe your pain for me?### Human: The pain is tedious, sensitive, and heavy. It is located in the lower chest, side of the chest (R), and side of the chest (L). On a scale of 0 to 10, the intensity of the pain is 9.### Assistant: Have you ever had fluid in your lungs?### Human: Yes, I have had fluid in my lungs. I currently undergo dialysis and have high blood pressure. I have also had a heart attack and have heart failure.### Assistant: The top two potential diagnoses are Acute pulmonary edema at 8.4% probability and Pericarditis at 7.1% probability. Does the pain radiate to another location, such as the biceps (R) or shoulder (R)?### Human: Yes, the pain does radiate to the biceps (R) and shoulder (R).### Assistant: I recommend a chest X-ray to further evaluate for Acute pulmonary edema.

###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: forehead, cheek(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: 5 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 2 ###Assistant: Do you have a cough that produces colored or more abundant sputum than usual? ###Human: Yes ###Assistant: Do you have a sore throat? ###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: Do you have a cough? ###Human: Yes ###Assistant: Have you been in contact with a person with similar symptoms in the past 2 weeks? ###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: Do you smoke cigarettes? ###Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Are you exposed to secondhand cigarette smoke on a daily basis? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are URTI at 16.3% probability, and Bronchitis at 15.7% probability. Does the pain in your forehead and cheek(L) worsen with movement or touch? ###Human: The pain remains the same regardless of movement or touch. ###Assistant: Let's perform a chest X-ray to rule out bronchitis and further evaluate your symptoms.

###Assistant: Can you describe the pain you're feeling in more detail? Where exactly is it located and how intense is it on a scale of 0 to 10?### ###Human: The pain is burning and located in my mouth, forehead, cheek (R), and nose. It's about a 3 in intensity.### ###Assistant: Have you ever had pneumonia, polyps in your nose, asthma, or gastroesophageal reflux in the past? Have you traveled out of the country recently and are your vaccinations up to date?### ###Human: Yes, I have had pneumonia, polyps in my nose, asthma, and gastroesophageal reflux. I have traveled out of the country in the last 4 weeks, and my vaccinations are up to date.### ###Assistant: Based on your symptoms and medical history, the top two potential diagnoses are Acute rhinosinusitis with a probability of 20.9% and Chronic rhinosinusitis with a probability of 19.5%. Does the pain you're experiencing radiate to the back of your head or nose?### ###Human: Yes, the pain does radiate to the back of my head and nose.### ###Assistant: I recommend a nasal endoscopy to further evaluate your sinuses and determine the best course of treatment.###

### Assistant: Do you have the perception of seeing two images of a single object seen overlapping or adjacent to each other (double vision)? ### Human: Yes ### Assistant: Are there any members of your family who have been diagnosed myasthenia gravis? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Myasthenia gravis at 15.7% probability, and Pulmonary embolism at 14.7% probability. Do you feel weakness in both arms and/or both legs? ### Human: Yes ### Assistant: Let's conduct a blood test to check for acetylcholine receptor antibodies to confirm a diagnosis of Myasthenia gravis.

### Assistant: Can you describe the pain you are experiencing in your lower chest, hypochondrium (R), and hypochondrium (L)?### Human: The pain is heartbreaking, haunting, violent, and sickening. It is located in my lower chest, hypochondrium (R), and hypochondrium (L). The intensity of the pain is 6 out of 10, and it radiates to my thoracic spine and scapula (R). The pain appeared rapidly with a score of 7 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 and antecedents, the two most likely diagnoses are Boerhaave at 70.4% probability and Pancreatic neoplasm at 22.7% probability. Does the pain worsen after eating or drinking?### Human: The pain does not specifically worsen after eating or drinking.### Assistant: I recommend a CT scan to further evaluate the possible Boerhaave diagnosis.

###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: ear(R), ear(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: 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: 7 ###Assistant: Do you have a fever (either felt or measured with a thermometer)? ###Human: Yes ###Assistant: Are you more irritable or has your mood been very unstable recently? ###Human: Yes ###Assistant: Do you have a cough? ###Human: Yes ###Assistant: Are you currently being treated or have you recently been treated with an oral antibiotic for an ear infection? ###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 Bronchitis at 42.5% probability, and Acute otitis media at 36.7% probability. Does the pain in your ear increase with chewing or swallowing? ###Human: No ###Assistant: I recommend a physical examination of your ears to further evaluate for Acute otitis media.

###Assistant: Can you describe the pain you're experiencing in your ankle, dorsal aspect of the wrist (R), dorsal aspect of the wrist (L), shoulder (R), and shoulder (L)?### Human: The pain is sensitive and sharp, with an intensity of 5 on a scale of 0 to 10. It appeared relatively fast, with a precise location of 10. ###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 NSTEMI / STEMI at 28.7% probability, and Unstable angina at 26.8% probability. Does the pain in your ankle, wrists, and shoulders worsen with movement or rest?### Human: The pain does not radiate to another location and is precisely located, but it does not worsen with movement or rest. ###Assistant: Let's proceed with a blood test to check for cardiac enzymes and markers to further evaluate for NSTEMI / STEMI or Unstable angina.###

###Assistant: What are your symptoms? ###Human: I have pain in my belly, specifically in the epigastric region. The pain is a cramp with an intensity of 6 on a scale of 0 to 10. It appeared relatively fast with a rating of 5. I also feel constantly fatigued and have non-restful sleep. I have yellow lesions on my skin in the epigastric region that are larger than 1cm. The rash is not swollen and causes a mild itching with a severity of 2. I have had involuntary weight loss over the last 3 months, pale stools, dark urine, and a cough. ###Assistant: Any relevant medical history? ###Human: I have chronic pancreatitis, diabetes, and I smoke cigarettes. I have also traveled out of the country in the last 4 weeks. ###Assistant: Based on your history, the two most likely diagnoses are Pancreatic neoplasm at 12.2% probability, and Bronchitis at 11.1% probability. Does the pain in your belly radiate to any other location? ###Human: The pain does not radiate to another location. ###Assistant: I recommend getting a CT scan of your abdomen to further evaluate the possibility of a pancreatic neoplasm.

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes, the pain is sensitive and burning in my tonsil (R). ### 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 Bronchitis at 33.8% probability, and Viral pharyngitis at 21.6% probability. Does the pain radiate to another location? ### Human: No, the pain does not radiate to another location. ### Assistant: Let's do a throat swab to confirm the diagnosis of viral pharyngitis.

### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### Human: Yes ### Assistant: Do you have a cough? ### Human: Yes ### Assistant: Have you noticed a wheezing sound when you exhale? ### Human: Yes ### Assistant: Do you have any family members who have asthma? ### Human: Yes ### Assistant: Have you been hospitalized for an asthma attack in the past year? ### Human: Yes ### Assistant: Have you had a cold in the last 2 weeks? ### Human: Yes ### Assistant: Have you been diagnosed with chronic sinusitis? ### Human: Yes ### Assistant: Do you have asthma or have you ever had to use a bronchodilator in the past? ### Human: Yes ### Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Do you live in a big city? ### 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 Bronchospasm / acute asthma exacerbation at 11.7% probability, and Bronchitis at 10.1% probability. Does your cough produce any phlegm or mucus? ### Human: No ### Assistant: Let's perform a pulmonary function test to further evaluate your lung function and help differentiate between the two potential diagnoses.

###Assistant: Have you felt confused or disorientated lately? ###Human: Yes ###Assistant: Have you had diarrhea or an increase in stool frequency? ###Human: Yes ###Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ###Human: Yes ###Assistant: Have you noticed any unusual bleeding or bruising related to your consultation today? ###Human: Yes ###Assistant: Do you have a cough? ###Human: Yes ###Assistant: Have you been in contact with a person with similar symptoms in the past 2 weeks? ###Human: Yes ###Assistant: In the last month, have you been in contact with anyone infected with the Ebola virus? ###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 Ebola at 16.6% probability, and Pulmonary neoplasm at 12.9% probability. Does your cough produce any sputum or blood? ###Human: My cough does produce blood. ###Assistant: Let's perform a blood test to check for Ebola virus.

###Assistant: Can you characterize your pain for me?### Human: The pain is 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 Viral pharyngitis at 28.5% probability, and Bronchitis at 25.4% probability. Does the pain radiate to another location?### Human: Nowhere.### Assistant: I recommend a throat swab to confirm the diagnosis.

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes, the pain is heartbreaking and violent. ### Assistant: Where do you feel the pain? ### Human: I feel the pain in my lower chest, side of the chest (R), and side of the chest (L), as well as my breast (R). ### Assistant: On a scale of 0 to 10, how intense is the pain? ### Human: The pain intensity is 8. ### Assistant: How fast did the pain appear? ### Human: The pain appeared with a speed of 7. ### Assistant: Have you ever had a spontaneous pneumothorax? ### Human: Yes, I have had a spontaneous pneumothorax. ### Assistant: Do you smoke cigarettes? ### Human: Yes, I smoke cigarettes. ### Assistant: Based on your history, the two most likely diagnoses are unstable angina at 27.2% probability, and stable angina at 24.3% 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 get a chest X-ray to examine for a potential pneumothorax.

###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 your heart is beating fast (racing), irregularly (missing a beat) or do you feel palpitations?### ###Human: Yes ###Assistant: Do you regularly drink coffee or tea?### ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are PSVT at 15.6% probability, and Panic attack at 11.8% probability. Does the pain radiate to another location?### ###Human: Nowhere ###Assistant: Let's perform an ECG to further evaluate your heart rhythm and determine if PSVT is the cause of your symptoms.

###Assistant: Do you have a cough that produces colored or more abundant sputum than usual?### ###Human: Yes ###Assistant: Do you have pain somewhere, related to your reason for consulting? Can you characterize your pain as a knife stroke in your breast (R) and posterior chest wall (R)? On a scale of 0 to 10, how intense is the pain?### ###Human: Yes, the pain is a knife stroke in my breast (R) and posterior chest wall (R) with an intensity of 5. ###Assistant: Do you have a fever and any lesions on your skin that are pink in color and peel off?### ###Human: Yes, I have a fever and pink lesions on my lumbar spine, side of the neck (L), and shoulder (L) that peel off. ###Assistant: Have you ever had pneumonia, COPD, asthma, or used a bronchodilator in the past?### ###Human: Yes, I have had pneumonia, COPD, asthma, and used a bronchodilator in the past. ###Assistant: Based on your history, the two most likely diagnoses are Bronchitis at 15.4% probability and Pneumonia at 11.8% probability. Does the pain caused by the rash increase or decrease with physical exertion?### ###Human: The pain caused by the rash does not change with physical exertion. ###Assistant: Let's get a chest X-ray to further evaluate for pneumonia.### ###Human: Okay.

### Assistant: What are your symptoms? ### Human: I have haunting, tugging, violent, sharp pain in my forehead, right eye, left eye, right temple, and left temple. The pain intensity is 10 out of 10, and it appeared very fast. I also feel that my eyes produce excessive tears. ### Assistant: Have any of your family members been diagnosed with cluster headaches? ### Human: Yes. ### Assistant: Based on your history, the two most likely diagnoses are Cluster headache at 100% probability. Does the pain worsen with physical activity or movement? ### Human: The pain does not radiate to another location and is precisely located at 9 out of 10. ### Assistant: Let's schedule a neurological examination to confirm the diagnosis of Cluster headache.

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes, the pain is heavy. ### Assistant: Where do you feel the pain? ### Human: I feel the pain in the iliac fossa (R), iliac fossa (L), and hip (R). ### Assistant: Are you significantly overweight compared to people of the same height as you? ### Human: Yes. ### Assistant: Based on your history, the two most likely diagnoses are inguinal hernia at 100% probability. Is the pain more intense in the iliac fossa (L) or hip (R)? ### Human: The pain is more intense in the iliac fossa (L). ### Assistant: I recommend a physical examination to confirm the diagnosis of an inguinal hernia.

### Assistant: Do you have nasal congestion or a clear runny nose? ### Human: Yes ### Assistant: Do you have any family members who have asthma? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Allergic sinusitis at 40.8% probability, and Bronchitis at 33.9% probability. Does the cough you have produce any phlegm or mucus? ### Human: Yes, it produces yellowish-green mucus. ### Assistant: I recommend getting a chest X-ray to rule out bronchitis as a next step for diagnosis. ### Human: Thank you for your recommendation.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes, the pain is a knife stroke, sharp in my lower chest. ###Assistant: Have you ever had a pericarditis? ###Human: Yes, I have. ###Assistant: Based on your history, the two most likely diagnoses are Pericarditis at 22.4% probability, and Possible NSTEMI / STEMI at 15.4% probability. Does the pain radiate to another location, such as your arm or jaw? ###Human: The pain radiates to my thoracic spine, posterior chest wall (R), and posterior chest wall (L). ###Assistant: Let's perform an ECG to further evaluate for any signs of a possible NSTEMI/STEMI.

### Assistant: What are your symptoms? ### Human: I have pain somewhere, related to my reason for consulting. The pain is tedious, sensitive, tugging, and heavy. I feel pain in my ankle (L), side of the chest (L), calf (R), breast (L), and posterior chest wall (L). The pain intensity is 4 on a scale of 0 to 10. The pain radiates to my biceps (L), scapula (L), triceps (R), and shoulder (L). The pain location precision is 3 on a scale of 0 to 10, and it appeared with a speed of 3. I am also experiencing shortness of breath and difficulty breathing, bouts of choking at night, and swelling in my left ankle. My symptoms worsen when lying down and improve when sitting up. They also increase with physical exertion but alleviate with rest. ### Assistant: Any relevant medical history? ### Human: I have had fluid in my lungs, currently undergo dialysis, 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 8.7% probability, and Pulmonary embolism at 7.1% 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 a chest X-ray to examine for a potential pulmonary edema.

### 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? Characterize your pain. Do you feel pain somewhere? On a scale of 0 to 10, How intense is the pain? Does the pain radiate to another location? On a scale of 0 to 10, How precisely is the pain located? On a scale of 0 to 10, How fast did the pain appear? ### Human: Yes, tedious, lower chest, thyroid cartilage, side of the chest(R), side of the chest(L), epigastric, 7, biceps(R), thyroid cartilage, thoracic spine, under the jaw, shoulder(R), 5, 9 ### Assistant: Do you constantly feel fatigued or do you have non-restful sleep? ### 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? Do you smoke cigarettes? Have you ever had a heart attack or do you have angina (chest pain)? Do you exercise regularly, 4 times per week or more? 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, Yes, Yes ### Assistant: Based on your history, the two most likely diagnoses are Possible NSTEMI / STEMI at 12.6% probability, and Anemia at 10.0% probability. Does the pain increase or decrease with physical exertion? ### Human: The pain increases with physical exertion. ### Assistant: Let's recommend getting an ECG to further evaluate for a possible NSTEMI/STEMI. ###

###Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way?### ###Human: Yes ###Assistant: Do you have a cough?### ###Human: Yes ###Assistant: Have you been hospitalized for an asthma attack in the past year?### ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Bronchospasm / acute asthma exacerbation at 11.1% probability, and Bronchitis at 9.7% probability. Does the wheezing sound when you exhale occur more during the day or at night?### ###Human: The wheezing sound is more noticeable at night. ###Assistant: Let's perform a pulmonary function test to further evaluate your breathing and determine the underlying cause of your symptoms.

### Assistant: Can you describe the pain you're experiencing in your chest?### Human: The pain feels like a knife stroke, sharp, and is located on the side of the chest (R), side of the chest (L), and posterior chest wall (L). The intensity of the pain is 5 on a scale of 0 to 10, and it appeared relatively fast.### Assistant: Do you have any relevant medical history that may be related to your current symptoms?### Human: Yes, I have had pneumonia before, I smoke cigarettes, and I have chronic obstructive pulmonary disease.### Assistant: Based on your history, the two most likely diagnoses are Pneumonia at 7.8% probability and Bronchitis at 6.8% probability. Does the pain in your chest worsen when you breathe in deeply?### Human: Yes, the pain does increase when I breathe in deeply.### Assistant: Let's schedule a chest X-ray to further investigate your symptoms and rule out any potential pneumonia.

###Assistant: Do you feel your heart is beating fast (racing), irregularly (missing a beat) or do you feel palpitations? ### Human: Yes ###Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ###Assistant: Characterize your pain. ### Human: Haunting ###Assistant: Do you feel pain somewhere? ### Human: temple(R), temple(L) ###Assistant: On a scale of 0 to 10, How intense is the pain? ### Human: 6 ###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: 7 ###Assistant: Do you feel slightly dizzy or lightheaded? ### 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 your heart is beating fast (racing), irregularly (missing a beat) or do you feel palpitations? ### Human: Yes ###Assistant: Do you feel anxious? ### Human: Yes ###Assistant: Do you consume energy drinks regularly? ### Human: Yes ###Assistant: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ###Assistant: Have you recently taken decongestants or other substances that may have stimulant effects? ### Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are PSVT at 26.9% probability, and Atrial fibrillation at 20.7% probability. Does the pain radiate to another location? ### Human: Nowhere ###Assistant: Let's perform an ECG to further evaluate your heart rhythm.

### Assistant: Can you describe 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 heavy and located in my iliac fossa (L), hip (R), hip (L), testicle (R), and testicle (L). It's a 5 in intensity.### Assistant: Have you had any complications at birth or are you significantly overweight compared to people of the same height as you?### Human: Yes, I was born prematurely and I am significantly overweight compared to people of the same height as me.### Assistant: Based on your symptoms and antecedents, the two most likely diagnoses are Inguinal hernia at 32.7% probability and Bronchitis at 32.3% probability. Does the pain in your iliac fossa (L) radiate to any other location?### Human: The pain does not radiate to any other location.### Assistant: Let's schedule a physical examination to further evaluate your symptoms and determine the underlying cause.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain. ###Human: Haunting, a knife stroke, tugging, violent, sharp ###Assistant: Do you feel pain somewhere? ###Human: Forehead, cheek(L), eye(R), temple(R), temple(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: 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: 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 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 neurological examination to further investigate the possibility of a Cluster headache.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain as haunting, tugging, or sharp. Where do you feel the pain specifically? ###Human: The pain is haunting, tugging, and sharp. I feel it in my forehead, right eye, left eye, and left temple. ###Assistant: Have any of your family members been diagnosed with cluster headaches? Do you take medication that dilates your blood vessels? Have you traveled out of the country in the last 4 weeks? ###Human: Yes, some family members have been diagnosed with cluster headaches. Yes, I take medication that dilates my blood vessels. Yes, I 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 56.1% probability and Chagas at 21.9% probability. Do you feel that your eyes produce excessive tears? ###Human: Yes, I do feel that my eyes produce excessive tears. ###Assistant: I recommend a neurological examination to further evaluate your symptoms and confirm the diagnosis.

###Assistant: Can you describe the pain you're feeling in your ear?### Human: The pain is sensitive and located in my left ear. It's a 3 out of 10 in intensity and appeared relatively fast.### 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 is only in my left ear.### Assistant: Let's perform a physical examination to further evaluate your ear infection.

###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 a cough?### 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 30.1% probability, and Bronchitis at 21.7% probability. Does the itching in your eyes worsen in certain environments or with specific triggers?### Human: The itching in my eyes seems to worsen when I'm outdoors or around pets. ###Assistant: Let's recommend an allergy test to further investigate the potential allergic sinusitis.

###Assistant: What are your symptoms? ###Human: I have swelling in my cheek (R) and nose. I have a rash on the back of my neck, biceps (R), ankle (R), cervical spine, and lumbar spine. The rash is pink, not swollen, and larger than 1cm. The pain caused by the rash is a 3 on a scale of 0-10, and the itching is a 9. I also feel lightheaded and dizzy, like I'm about to faint. I have nausea and vomiting, and I noticed a high-pitched sound when breathing in. ###Assistant: Do you have a known severe food allergy? ###Human: Yes, I do have a known severe food allergy. ###Assistant: Based on your history, the two most likely diagnoses are Anaphylaxis at 18.1% probability, and Localized edema at 12.3% probability. Does the swelling in your cheek (R) and nose increase or decrease with time? ###Human: The swelling in my cheek (R) and nose has been increasing over time. ###Assistant: Let's perform a skin prick test to confirm if the swelling and rash are due to an allergic reaction.

### Assistant: Do you suddenly have difficulty or an inability to open your mouth or have jaw pain when opening it? ### Human: Yes ### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### Human: Yes ### Assistant: Have you started or taken any antipsychotic medication within the last 7 days? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Acute dystonic reactions at 15.5% probability, and Myasthenia gravis at 12.9% probability. Do you have annoying muscle spasms in your face, neck, or any other part of your body? ### Human: Yes ### Assistant: Do you have a hard time opening/raising one or both eyelids? ### Human: Yes ### Assistant: Let's perform a blood test to check for acetylcholine receptor antibodies to help differentiate between Acute dystonic reactions and Myasthenia gravis.

###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: tonsil(R), palace, pharynx, under the jaw ###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: 6 ###Assistant: On a scale of 0 to 10, How fast did the pain appear?### Human: 0 ###Assistant: Do you have a fever?### 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: 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 tonsil(R) worsen with swallowing?### Human: Yes ###Assistant: Let's perform a rapid strep test to confirm the diagnosis of Viral pharyngitis.

###Assistant: Do you have pain somewhere, related to your reason for consulting?### ###Human: Yes ###Assistant: Characterize your pain.### ###Human: Heartbreaking, a knife stroke, violent ###Assistant: Do you feel pain somewhere?### ###Human: Side of the chest(R), breast(R), breast(L), posterior chest wall(R), posterior chest wall(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: Posterior chest wall(R), posterior chest wall(L) ###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: 10 ###Assistant: Do you have intense coughing fits?### ###Human: Yes ###Assistant: Do you have pain that is increased with movement?### ###Human: Yes ###Assistant: Do you have pain that is increased when you breathe in deeply?### ###Human: Yes ###Assistant: Do you have metastatic cancer?### ###Human: Yes ###Assistant: Are you being treated for osteoporosis?### ###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 spontaneous rib fracture at 20.5% probability, and bronchitis at 18.7% probability. Does the pain increase or decrease with coughing fits?### ###Human: The pain increases with coughing fits. ###Assistant: Let's get a chest X-ray to examine for a potential rib fracture.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes, I have pain in my finger (ring finger)(L), finger (little finger)(R), finger (middle)(R), dorsal aspect of the wrist(R), and shoulder(R). The pain is sensitive and burning, with an intensity of 1 on a scale of 0 to 10. It appeared relatively fast, with a rating of 5. ###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 Sarcoidosis at 46.5% probability, and Possible NSTEMI / STEMI at 41.8% probability. Does the pain in your fingers and shoulder worsen with movement or rest? ###Human: The pain does not radiate to another location and is precisely located at a 3 on a scale of 0 to 10. It does not worsen with movement or rest. ###Assistant: I recommend getting a chest X-ray to further evaluate for Sarcoidosis.

### Assistant: What are your symptoms? ### Human: I have haunting, a knife stroke, violent, sharp pain in my forehead, eye(R), eye(L), temple(R), and temple(L). The pain intensity is 9 on a scale of 0 to 10. It appeared very fast, with a rating of 10. I also feel that my eyes produce excessive tears. ### Assistant: Have any of your family members been diagnosed with cluster headaches? ### Human: Yes, some family members have been diagnosed with cluster headaches. ### 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. It does not increase or decrease with physical exertion. ### Assistant: Do you experience any specific triggers that worsen your headaches, such as certain foods or activities? ### Human: No, I do not experience any specific triggers that worsen my headaches. ### Assistant: I recommend a neurological examination to confirm the diagnosis of Cluster headache.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Can you characterize your pain for me? ###Human: It feels like a knife stroke. ###Assistant: Do you feel pain in your lower chest, upper chest, and right breast? ###Human: Yes ###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: 1 ###Assistant: On a scale of 0 to 10, how fast did the pain appear? ###Human: 4 ###Assistant: Do you feel your heart is beating fast, irregularly, or do you feel palpitations? ###Human: Yes ###Assistant: Have you noticed any new fatigue, generalized discomfort, muscle aches, or a change in your general well-being? ###Human: Yes ###Assistant: Are your symptoms worse when lying down and better when sitting up? ###Human: Yes ###Assistant: Do your symptoms increase with physical exertion but improve with rest? ###Human: Yes ###Assistant: Have you recently had a viral infection and traveled out of the country in the last 4 weeks? ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are unstable angina at 17.6% probability and myocarditis at 11.9% probability. Does the pain increase or decrease with physical exertion? ###Human: My symptoms increase with physical exertion but improve with rest. ###Assistant: Let's proceed with an ECG to further evaluate your symptoms.

### Assistant: What are your symptoms? ### Human: I have swollen or painful lymph nodes. I have burning pain in my fingers (ring finger)(R), (L), (index)(L), (middle)(R), (L). The pain intensity is 3 out of 10. The pain does not radiate to another location and is precisely located. The pain appeared suddenly. I have had vaginal discharge. ### Assistant: Any relevant medical history? ### Human: I am significantly overweight compared to people of the same height as me. I 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 100% probability. Does the pain in your fingers worsen with any specific activities or movements? ### Human: The pain in my fingers does not worsen with any specific activities or movements. ### Assistant: Let's recommend a biopsy of the affected lymph nodes to confirm the diagnosis of Sarcoidosis. ### Human: Thank you for your recommendation.

### Assistant: Do you constantly feel fatigued or do you have non-restful sleep? ### 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: Yes ### Assistant: Characterize your pain. ### Human: a cramp ### Assistant: Do you feel pain somewhere? ### Human: hypochondrium(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: thoracic spine ### 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: 3 ### 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 ### Assistant: What color is the rash? ### Human: yellow ### Assistant: Do your lesions peel off? ### Human: N ### Assistant: On a scale of 0 to 10, Is the rash swollen? ### Human: 1 ### Assistant: Where is the affected region located? ### Human: epigastric ### Assistant: On a scale of 0 to 10, How intense is the pain caused by the rash? ### Human: 1 ### 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: 4 ### Assistant: Are you feeling nauseous or do you feel like vomiting? ### Human: Yes ### Assistant: Do you have diabetes? ### 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: Have you traveled out of the country in the last 4 weeks? ### Human: Yes ### Assistant: Are there members of your family who have been diagnosed with pancreatic cancer? ### Human: Yes ### Assistant: Based on your history, the two most likely diagnoses are Pancreatic neoplasm at 31.3% probability, and Anaphylaxis at 25.9% probability. Does the pain in your hypochondrium (L) worsen after eating? ### Human: No ### Assistant: Let's schedule a CT scan to further investigate the possibility of a pancreatic neoplasm.

### 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(R), side of the chest(L), breast(R), 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: 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: 6 ### Assistant: On a scale of 0 to 10, How fast did the pain appear? ### Human: 9 ### 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: 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 27.2% probability, and stable angina at 24.3% 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 get an ECG to further evaluate your chest pain and rule out any potential cardiac issues.

### Assistant: What are your symptoms? ### Human: I feel my abdomen is bloated and I have pain in my iliac fossa (R) and iliac fossa (L). The pain is heavy, with an intensity of 7 on a scale of 0 to 10. It appeared quite fast, with a rating of 5. I also have a pale rash in the affected regions, which is not peeling off. The rash is swollen with a rating of 3 in intensity. The lesions are larger than 1cm but I do not have severe itching. The pain caused by the rash is rated at 6. The symptoms are not radiating to another location and the pain is not precisely located. I have been able to pass stools and gas, but I do have intense coughing fits that worsen the symptoms. ### Assistant: Were you born prematurely or did you suffer any complication at birth? ### Human: Yes, I suffered complications at birth. ### Assistant: Based on your history, the two most likely diagnoses are Inguinal hernia at 31.1% probability, and Bronchitis at 24% probability. Does the pain in your iliac fossa (R) or iliac fossa (L) worsen with coughing or any effort like lifting a weight? ### Human: Yes, the symptoms and pain do worsen with coughing and effort. ### Assistant: I recommend a physical examination to further evaluate the possibility of an inguinal hernia.

###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: ear(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: 6 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 1 ###Assistant: Do you have a fever (either felt or measured with a thermometer)? ###Human: Yes ###Assistant: Do you have a cough? ###Human: Yes ###Assistant: Are you currently being treated or have you recently been treated with an oral antibiotic for an ear infection? ###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 Bronchitis at 28.0% probability, and Pneumonia at 24.8% probability. Does the pain in your ear worsen with movement or touch? ###Human: No ###Assistant: Let's perform a physical examination to further evaluate your symptoms and consider a chest X-ray to rule out pneumonia.

### Assistant: Have you been coughing up blood? ### Human: Yes ### Assistant: Do you have a cough that produces colored or more abundant sputum than usual? ### Human: Yes ### Assistant: Do you have a cough? ### Human: Yes ### Assistant: Do you have cystic fibrosis? ### Human: Yes ### Assistant: Do you suffer from Crohn’s disease or ulcerative colitis (UC)? ### Human: Yes ### Assistant: Have you ever had pneumonia? ### 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 Bronchitis at 25.1% probability, and Bronchiectasis at 19.3% probability. Does the color of the sputum change throughout the day or with certain activities? ### Human: The color of the sputum remains consistent throughout the day. ### Assistant: Let's schedule a chest CT scan to further evaluate your condition.

###Assistant: What are your symptoms?### Human: I have significantly increased sweating, tedious, heavy pain in my left temple with an intensity of 8, cough producing colored sputum, fever, sore throat, nasal congestion, and a clear runny nose. ###Assistant: Any relevant medical history?### Human: I have been in contact with a person with similar symptoms in the past 2 weeks, live with 4 or more people, attend a daycare, smoke cigarettes, and have traveled out of the country in the last 4 weeks. ###Assistant: Based on your history, the two most likely diagnoses are URTI at 17.8% probability, and Bronchitis at 16.1% probability. Does the pain radiate to another location besides your left temple?### Human: The pain does not radiate to another location. ###Assistant: Let's recommend a chest X-ray to rule out Bronchitis and further evaluate your symptoms for URTI.

###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? Can you characterize your pain as burning? Do you feel pain in your tonsil (R), palace, or trachea? 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? ###Human: Yes, the pain is burning and located in my tonsil (R), palace, and trachea with an intensity of 1. The pain is located precisely at 3 and appeared relatively fast at 4. ###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 78.7% probability and Chagas at 21.3% probability. Does the pain in your tonsil (R), palace, and trachea worsen with swallowing or speaking? ###Human: The pain does not worsen with swallowing or speaking. ###Assistant: I recommend a throat swab to confirm the diagnosis of Acute laryngitis. ###Human: Thank you for your recommendation.

###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. Do you feel pain somewhere? On a scale of 0 to 10, How intense is the pain? Does the pain radiate to another location? On a scale of 0 to 10, How precisely is the pain located? On a scale of 0 to 10, How fast did the pain appear? ###Human: The pain is sensitive, burning. I feel pain in my tonsil (R), tonsil (L), palace, pharynx, under the jaw. The pain intensity is 9. The pain is located precisely at 5. The pain appeared slowly at 1. ###Assistant: Do you have a fever? Do you have nasal congestion or a clear runny nose? Do you have a cough? ###Human: Yes, I have a fever. Yes, I have nasal congestion and a clear runny nose. Yes, I have a cough. ###Assistant: Have you been in contact with a person with similar symptoms in the past 2 weeks? 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. Yes, I smoke cigarettes. Yes, I have traveled out of the country. ###Assistant: Based on your history, the two most likely diagnoses are Viral pharyngitis at 16.8% probability, and URTI at 15.9% probability. Does the pain increase when you swallow or talk? ###Human: The pain does increase when I swallow. ###Assistant: Let's perform a throat swab to test for viral pharyngitis.

###Assistant: Can you please describe your pain in more detail?### ###Human: The pain feels like a knife stroke, tugging, violent, and sharp. It is located in my forehead, cheek (R), cheek (L), eye (R), and eye (L). The intensity of the pain is 8 out of 10, and it appeared very quickly at a 9 out of 10.### ###Assistant: Have any of your family members been diagnosed with cluster headaches?### ###Human: Yes, some family members have been diagnosed with cluster headaches. I also have a history of excessive alcohol consumption and recent international travel.### ###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?### ###Human: The pain does not radiate to another location.### ###Assistant: Let's schedule a neurological examination to further evaluate your symptoms and confirm the diagnosis of Cluster headache.###

### Assistant: Can you describe the pain you're experiencing in more detail?### Human: The pain is sharp and located in the back of the neck, ankle(R), ankle(L), dorsal aspect of the wrist(L), and palmar face of the wrist(R). It's an 8 out of 10 in intensity and appeared relatively fast with a rating of 6.### Assistant: Have you ever had pericarditis before?### Human: Yes, I have. I also have high blood pressure and had my first menstrual period before the age of 12. I have traveled out of the country in the last 4 weeks.### Assistant: The top two potential diagnoses are SLE with a probability of 53.6% and Anemia with a probability of 46.4%. Does the rash on your nose peel off?### Human: No, the rash does not peel off.### Assistant: I recommend getting further testing to confirm the diagnosis, such as blood tests to check for autoimmune markers related to SLE.

### Assistant: Do you have nasal congestion or a clear runny nose? ### Human: Yes ### Assistant: Have you or any member of your family ever had croup? ### Human: Yes ### Assistant: The top 2 potential diagnoses are Croup with a probability of 33.6% and HIV (initial infection) with a probability of 21.9%. ### Assistant: Do you notice a high-pitched sound when breathing in more during the day or at night? ### Human: My symptoms are more prominent at night. ### Assistant: I recommend a throat swab to test for the presence of the virus causing croup.

### Assistant: Can you please describe the pain you are experiencing?### Human: The pain is sensitive, like a cramp, and located in the back of my head, top of the head, forehead, and temple (L). On a scale of 0 to 10, the intensity is 4. It appeared with a speed of 4.### Assistant: Do you have any relevant medical history that may be related to your symptoms?### Human: Yes, I have a poor diet, a history of anemia, family members with anemia, chronic kidney failure, and a BMI less than 18.5. I have also traveled out of the country in the last 4 weeks.### Assistant: Based on your history, the two most likely diagnoses are Anemia at 64.97% probability, and Cluster headache at 35.03% probability. Does the pain radiate to another location besides where you mentioned?### Human: No, the pain does not radiate to another location.### Assistant: I recommend getting a complete blood count (CBC) test to further investigate the possibility of anemia.

### Assistant: Do you feel that your eyes produce excessive tears? ### Human: Yes ### Assistant: Have any of your family members been diagnosed with cluster headaches? ### Human: Yes ### 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? ### Human: The pain does not radiate to another location. ### Assistant: Let's schedule a neurological examination to further evaluate your symptoms and confirm the diagnosis.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Can you please characterize your pain as sensitive, tugging, and sharp? And where do you feel this pain? ###Human: The pain is sensitive, tugging, and sharp. I feel it in my ankle (L), thigh (R), dorsal aspect of the foot (L), calf (R), and calf (L). ###Assistant: Have you gained weight recently and do you have swelling in multiple areas of your body? ###Human: Yes, I have gained weight recently and I have swelling in my ankle (R), ankle (L), thigh (R), thigh (L), and dorsal aspect of the foot (R). ###Assistant: Based on your symptoms and medical history, the top 2 potential diagnoses are Localized edema with a probability of 69.6% and Chagas with a probability of 19.2%. Does the pain radiate to another location? ###Human: Nowhere ###Assistant: To differentiate between Localized edema and Chagas, can you specify on a scale of 0 to 10 how precisely the pain is located? ###Human: The pain is located precisely at an 8. ###Assistant: I recommend getting a Doppler ultrasound to further investigate the swelling and pain. ###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 tugging. I feel pain in the back of my head, top of the head, and temple (R). On a scale of 0 to 10, the intensity of the pain is 2. The pain appeared at a rate of 5. I am experiencing shortness of breath and difficulty breathing in a significant way. I feel so tired that I am unable to do my usual activities or stuck in bed all day long. I have noticed light red blood or blood clots in my stool. ###Assistant: Have you ever had a diagnosis of anemia? ###Human: Yes, I have had a diagnosis of anemia. I also have chronic kidney failure. I am taking new oral anticoagulants (NOACs). 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 Anemia at 30.3% probability, and Atrial fibrillation at 22.7% probability. Does the pain in your head radiate to another location? ###Human: The pain in my head does not radiate to another location. ###Assistant: Let's schedule a blood test to further investigate your anemia and assess your iron levels.

### Assistant: Have you noticed a wheezing sound when you exhale? ### Human: Yes ### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? Do you have a cough that produces colored or more abundant sputum than usual? Do you have a cough? Have you noticed a wheezing sound when you exhale? ### Human: Yes, I am experiencing shortness of breath and have a cough that produces colored sputum. I also have a cough and wheezing sound when I exhale. ### Assistant: Do you have severe Chronic Obstructive Pulmonary Disease (COPD)? Do you smoke cigarettes? Do you have a chronic obstructive pulmonary disease (COPD)? Have you ever been diagnosed with gastroesophageal reflux? Do you work in agriculture? Do you work in construction? Do you work in the mining sector? Have you traveled out of the country in the last 4 weeks? ### Human: Yes, I have severe COPD, smoke cigarettes, have COPD, have been diagnosed with gastroesophageal reflux, work in agriculture, construction, and the mining sector, and have traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Acute COPD exacerbation / infection at 12.4% probability, and Bronchitis at 11.6% probability. Does the cough worsen at night or with certain triggers? ### Human: My cough tends to worsen at night. ### Assistant: Let's perform a chest X-ray to further evaluate your condition.

###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: tonsil(L), thyroid cartilage, pharynx, under the jaw, trachea ###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 noticed that the tone of your voice has become deeper, softer or hoarse? ###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 42.6% probability, and Possible NSTEMI / STEMI at 38.6% probability. Does the pain increase with swallowing or talking? ###Human: The pain does not increase with swallowing or talking. ###Assistant: I recommend a throat swab to confirm the diagnosis of Acute laryngitis.

### Assistant: Do you feel your heart is beating fast (racing), irregularly (missing a beat) or do you feel palpitations? ### 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: upper chest, breast(R) ### Assistant: On a scale of 0 to 10, How intense is the pain? ### Human: 9 ### Assistant: Does the pain radiate to another location? ### Human: thoracic spine, posterior chest wall(R), posterior chest wall(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: 4 ### Assistant: Have you recently had a viral infection? ### Human: Yes ### Assistant: Have you ever had a pericarditis? ### 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 55.5% probability, and Pericarditis at 44.5% probability. Does the pain increase with deep breathing or when you lie down? ### Human: The pain does not increase with deep breathing or when I lie down. ### Assistant: Let's schedule an echocardiogram to further evaluate for pericarditis.

###Assistant: Can you describe the pain you're experiencing in more detail?### ###Human: The pain is sensitive and burning in my tonsil (R), palace, pharynx, and under the jaw. It's a 9 out of 10 in intensity and appeared quickly at a level of 7.### ###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 and 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 51.4% probability, and Possible NSTEMI / STEMI at 32.0% 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 of Viral pharyngitis. This will help us determine the best course of treatment.###

###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 lightheaded and dizzy or do you feel like you are about to faint?### ###Human: Yes ###Assistant: Do you regularly take stimulant drugs?### ###Human: Yes ###Assistant: Based on your history, the two most likely diagnoses are Atrial fibrillation at 21.5% probability, and Pulmonary embolism at 18.7% probability. Does the dizziness and lightheadedness worsen with certain movements or positions?### ###Human: The dizziness and lightheadedness do not worsen with any specific movements or positions. ###Assistant: Let's recommend an ECG to further evaluate for Atrial fibrillation.### ###Human: Thank you for your recommendation.

### Assistant: What are your symptoms? ### Human: I have pain somewhere, related to my reason for consulting. The pain feels like a knife stroke, sharp. I feel pain in my scapula (R), breast (R), breast (L), posterior chest wall (R), and posterior chest wall (L). On a scale of 0 to 10, the intensity of the pain is 3. The pain radiates to the side of the chest (R), side of the chest (L), scapula (R), posterior chest wall (R), and posterior chest wall (L). The pain is precisely located at 7 and appeared at a pace of 2. I also have swelling in my calf (R) and calf (L). I lost consciousness. ### Assistant: Any relevant medical history? ### Human: I currently take hormones. I have had deep vein thrombosis (DVT). I have been unable to move or get up for more than 3 consecutive days within the last 4 weeks. I have had surgery within the last month. I have traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Localized edema at 26.1% probability and Pulmonary embolism at 25.3% probability. Does the pain in your scapula (R) worsen with deep breathing or coughing? ### Human: Yes, the pain in my scapula (R) worsens with deep breathing or coughing. ### Assistant: Let's get a D-dimer blood test to help diagnose a potential pulmonary embolism.

###Assistant: Can you describe the pain you're experiencing in more detail?### ###Human: The pain is sensitive and burning in my tonsil (R), tonsil (L), palace, pharynx, and under the jaw. It's a 7 out of 10 in intensity and appeared relatively fast.### ###Assistant: Have you traveled out of the country in the last 4 weeks?### ###Human: Yes, I have. I also live with 4 or more people and attend a daycare.### ###Assistant: Based on your history, the two most likely diagnoses are Bronchitis at 22% probability and Tuberculosis at 21%. Does the pain in your tonsils worsen when you swallow?### ###Human: Yes, the pain does worsen when I swallow.### ###Assistant: Let's schedule a throat swab to test for any bacterial infections that could be causing your symptoms.###

### Assistant: Can you describe the pain you're experiencing in more detail?### Human: The pain is burning and sharp, located in my forehead, cheek (L), nose, and eye (L). It radiates to the back of my head, forehead, nose, temple (R), and temple (L). On a scale of 0 to 10, the intensity is 6 and it appeared relatively fast with a score of 4.### Assistant: Have you ever had pneumonia or been diagnosed with gastroesophageal reflux?### Human: Yes, I have had pneumonia and been diagnosed with gastroesophageal reflux.### Assistant: Based on your symptoms and medical history, the two most likely diagnoses are acute rhinosinusitis at 26.9% probability and chronic rhinosinusitis at 25.2% probability. Does the pain worsen with any specific triggers or movements?### Human: The pain doesn't seem to worsen with any specific triggers or movements.### Assistant: I recommend a nasal endoscopy to further evaluate and differentiate between acute and chronic rhinosinusitis.

### Assistant: Have you noticed a wheezing sound when you exhale? ### Human: Yes ### Assistant: Do you have a cough that produces colored or more abundant sputum than usual? Do you have a cough? Have you noticed a wheezing sound when you exhale? ### Human: Yes, Yes, Yes ### Assistant: Do you smoke cigarettes? Do you have a chronic obstructive pulmonary disease (COPD)? Do you work in agriculture? Have you traveled out of the country in the last 4 weeks? ### Human: Yes, Yes, Yes, Yes ### Assistant: Based on your history, the two most likely diagnoses are Bronchitis at 25.5% probability, and Acute COPD exacerbation / infection at 24.9% probability. Does the cough produce any blood or have you experienced any recent fever? ### Human: No, there is no blood in the sputum and no recent fever. ### Assistant: I recommend we perform a chest X-ray to further evaluate your condition.

### Assistant: Do you feel pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Can you characterize your pain for me? Is it sensitive and exhausting? ### Human: Yes ### Assistant: Have you ever had a diagnosis of anemia? ### Human: Yes ### Assistant: The top two potential diagnoses are Anemia with a probability of 57.4% and Atrial fibrillation with a probability of 42.6%. Does the pain you feel in your head increase or decrease with physical exertion? ### Human: Nowhere ### Assistant: I recommend getting a complete blood count (CBC) test to further investigate the possibility of anemia. Thank you for your responses. ### Human: Thank you for your help.

###Assistant: Can you describe your pain for me?### Human: The pain is sensitive, a knife stroke, tugging, burning, and sickening. It is located in my lower chest, belly, and epigastric area. The intensity of the pain is 5 on a scale of 0 to 10, and it radiates to my upper chest. It appeared relatively fast, with a rating of 5 out of 10.### 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 GERD at 84.9% probability and Anaphylaxis at 15.0% probability. Does the burning sensation in your stomach that goes up into your throat come with a bitter taste in your mouth?### Human: Yes, it does.### Assistant: I recommend an upper endoscopy to further evaluate your symptoms.

### 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 fast (racing), irregularly (missing a beat) or do you feel palpitations? ### Human: Yes ### Assistant: Do you feel your heart is beating very irregularly or in a disorganized pattern? ### Human: Yes ### Assistant: Do you have symptoms that are increased with physical exertion but alleviated with rest? ### 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: Do you have diabetes? ### Human: Yes ### Assistant: Do you have high blood pressure or do you take medications to treat 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 Atrial fibrillation at 13.8% probability, and PSVT at 12.2% probability. Does the irregular heartbeat feel like a rapid fluttering or a sudden racing sensation? ### Human: It feels like a rapid fluttering. ### Assistant: Let's schedule an ECG to further evaluate your heart rhythm.

###Assistant: Are you feeling nauseous or do you feel like vomiting?### ###Human: Yes ###Assistant: Did you eat dark-fleshed fish (such as tuna) or Swiss cheese before the reaction occurred?### ###Human: Yes ###Assistant: The top 2 potential diagnoses are Scombroid food poisoning with a probability of 18.4% and Anemia with a probability of 13.2%. Does the rash on your skin peel off?### ###Human: No ###Assistant: I recommend getting a skin biopsy to further investigate the rash and confirm the diagnosis.

###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: It's a cramp, sharp ###Assistant: Do you feel pain somewhere?### ###Human: side of the chest(R), iliac fossa(L), hypochondrium(R), hypochondrium(L), 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: 8 ###Assistant: On a scale of 0 to 10, How fast did the pain appear?### ###Human: 10 ###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 you currently, or did you ever, have numbness, loss of sensitivity or tingling anywhere on your body?### ###Human: Yes ###Assistant: Do you feel anxious?### ###Human: Yes ###Assistant: Do any members of your immediate family have a psychiatric illness?### ###Human: Yes ###Assistant: Do you suffer from chronic anxiety?### ###Human: Yes ###Assistant: Do you suffer from fibromyalgia?### ###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 15.8% probability, and PSVT at 13.2% probability. Does the pain radiate to another location?### ###Human: The pain does not radiate to another location. ###Assistant: Let's recommend a psychological evaluation to further assess the possibility of a panic attack.

###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, cheek (L), nose, and eye (R). It's a 3 in intensity on a scale of 0 to 10. ###Assistant: Have you ever been diagnosed with gastroesophageal reflux?### Human: Yes, I have been diagnosed with gastroesophageal reflux. ###Assistant: Based on your history, the two most likely diagnoses are Acute rhinosinusitis at 20.4% probability and Chronic rhinosinusitis at 19.1% probability. Does the pain radiate to another location, and if so, where does it radiate to?### Human: Yes, the pain radiates to my forehead, nose, and temple (R). ###Assistant: I recommend a nasal endoscopy to further evaluate your symptoms and determine the underlying cause.

###Assistant: What are your symptoms?### Human: I have pain somewhere, related to my reason for consulting. The pain is tedious and located at the top of the head, temple (R), and temple (L). On a scale of 0 to 10, the intensity of the pain is 4 and it appeared relatively fast. I also have a cough that produces colored sputum, a fever, a sore throat, diffuse muscle pain, and nasal congestion. ###Assistant: Any relevant medical history?### Human: I live with 4 or more people, attend a daycare, smoke cigarettes, have traveled out of the country in the last 4 weeks, and am exposed to secondhand cigarette smoke on a daily basis. ###Assistant: Based on your history, the two most likely diagnoses are URTI at 16.9% probability, and Pneumonia at 16.4% probability. Does the pain in your head and temples worsen with movement or certain positions?### Human: The pain in my head and temples does not worsen with movement or certain positions. ###Assistant: Let's recommend a throat swab to confirm the diagnosis of URTI.

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Characterize your pain. ### Human: haunting, a knife stroke, tugging, violent ### Assistant: Do you feel pain somewhere? ### Human: cheek(R), cheek(L), eye(R), eye(L), temple(R) ### 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: 8 ### 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: 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 schedule a head CT scan to further investigate the cause of your headaches.

### Assistant: What are your symptoms? ### Human: I have been coughing up blood, experiencing sharp pain in my lower chest, side of the chest (R), upper chest, and posterior chest wall (R). The pain intensity is 4 on a scale of 0 to 10, and it appeared with a pace of 3. I also have shortness of breath, cough with colored sputum, chills, and a pink rash on the back of the neck, commissure (L), buttock (L), flank (R), and shoulder (L). The rash is not swollen, and the pain caused by it is 3 on a scale of 0 to 10. I have diffuse muscle pain, fatigue, and my symptoms worsen at night. The pain increases when I breathe in deeply. ### Assistant: Any relevant medical history? ### Human: I drink alcohol excessively, smoke cigarettes, have heart failure, have had pneumonia before, have chronic obstructive pulmonary disease (COPD), asthma, and a BMI less than 18.5. I have also traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Pneumonia at 5.99% probability, and Bronchitis at 5.68% probability. Does the pain in your chest radiate to any other location? ### Human: The pain does not radiate to any other location. ### Assistant: Let's schedule a chest X-ray to further evaluate your symptoms and rule out any potential pneumonia.

### 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 chest pain even at rest? ### Human: Yes ### Assistant: Do you feel pain somewhere related to your reason for consulting? Can you characterize your pain as exhausting? ### Human: I have pain in my upper chest, breast (R), breast (L), shoulder (R), and shoulder (L). The pain intensity is 6 on a scale of 0 to 10. ### Assistant: Are you feeling nauseous or do you feel like vomiting? ### Human: Yes ### Assistant: Do you have diabetes, are you significantly overweight, have high cholesterol, smoke cigarettes, had a heart attack or angina, traveled out of the country in the last 4 weeks, and have close family members with cardiovascular disease before the age of 50? ### Human: Yes to all. ### Assistant: Based on your history, the two most likely diagnoses are unstable angina at 23.4% probability, and possible NSTEMI / STEMI at 16.3% probability. Does the pain radiate to another location, such as biceps (R) or biceps (L)? ### Human: Yes, the pain radiates to biceps (R) and biceps (L). ### Assistant: Let's schedule a stress test to further evaluate your symptoms and determine the best course of action.

### Assistant: Did you vomit after coughing? ### ### Human: Yes ### Assistant: Do you have intense coughing fits? ### ### Human: Yes ### Assistant: Have you ever had asthma or had to use a bronchodilator in the past? ### ### 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 Whooping cough at 51.3% probability, and Bronchitis at 48.7% probability. ### Assistant: Do you have any specific triggers that worsen your coughing fits, such as exposure to certain environments or activities? ### ### Human: No, I haven't noticed any specific triggers that worsen my coughing fits. ### Assistant: Let's perform a test to check for pertussis antibodies to confirm the diagnosis of Whooping cough.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain. ###Human: burning ###Assistant: Do you feel pain somewhere? ###Human: lower chest, side of the chest(L), posterior chest wall(R), posterior chest wall(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: 1 ###Assistant: On a scale of 0 to 10, How fast did the pain appear? ###Human: 5 ###Assistant: Do you have a cough that produces colored or more abundant sputum than usual? ###Human: Yes ###Assistant: Do you have a sore throat? ###Human: Yes ###Assistant: Do you have a cough? ###Human: Yes ###Assistant: Have you noticed a wheezing sound when you exhale? ###Human: Yes ###Assistant: Are your symptoms more prominent at night? ###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: Based on your history, the two most likely diagnoses are Bronchitis at 14.5% probability and Pneumonia at 12.6% probability. Does the pain increase or decrease with physical exertion? ###Human: The pain does not increase or decrease with physical exertion. ###Assistant: Let's get a chest X-ray to examine for potential pneumonia.

###Assistant: What are your symptoms? ###Human: I feel my abdomen is bloated and I have pain in my iliac fossa (R) and iliac fossa (L). The pain is heavy and has a intensity of 6 on a scale of 0 to 10. It appeared with a speed of 5 and is precisely located at 1. I also have a pale rash on my iliac fossa (R) that is swollen with a pain intensity of 4. ###Assistant: Have you traveled out of the country in the last 4 weeks? ###Human: Yes. ###Assistant: Based on your symptoms and history, the two most likely diagnoses are Inguinal hernia at 28.2% probability, and Bronchitis at 21.5% probability. Does the pain in your iliac fossa (R) worsen with coughing or any physical effort? ###Human: Yes, the pain does increase with coughing and physical effort. ###Assistant: Let's schedule 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 ### Assistant: Characterize your pain. ### Human: Haunting, a knife stroke, tugging, violent, sharp ### Assistant: Do you feel pain somewhere? ### Human: Cheek(R), cheek(L), eye(R), eye(L), temple(R) ### 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: 10 ### Assistant: On a scale of 0 to 10, How fast did the pain appear? ### Human: 10 ### 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: 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 69.1% probability, and Anemia at 30.9% probability. Does the pain increase or decrease with any specific triggers or activities? ### Human: The pain does not increase or decrease with any specific triggers or activities. ### Assistant: I recommend a neurological examination to further evaluate the symptoms and confirm the diagnosis of Cluster headache.

###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes, it feels like a knife stroke. ###Assistant: Do you have difficulty swallowing, or have a feeling of discomfort/blockage when swallowing? ###Human: Yes, I do. ###Assistant: Do you regularly take stimulant drugs? ###Human: Yes, I do. ###Assistant: The top 2 potential diagnoses are Epiglottitis with a probability of 27.9% and Acute laryngitis with a probability of 19.9%. Does the pain radiate to another location? ###Human: No, it does not. ###Assistant: Let's perform a throat examination to further evaluate your symptoms.

###Assistant: Can you characterize your pain for me?### ###Human: The pain is sensitive and tugging.### ###Assistant: Have you ever had surgery to remove lymph nodes?### ###Human: Yes.### ###Assistant: Based on your history, the two most likely diagnoses are Localized edema at 67.8% probability, and Chagas at 20.4% probability. Does the pain radiate to another location?### ###Human: Nowhere.### ###Assistant: I recommend conducting a blood test to check for any underlying conditions that may be causing the localized edema.### ###Human: Thank you for your help.### The dialogue must end with the Assistant.

### Assistant: Do you have pain somewhere, related to your reason for consulting? ### Human: Yes ### Assistant: Characterize your pain. ### Human: It's sharp. ### Assistant: Do you feel pain somewhere? ### Human: In my right ear and left ear. ### Assistant: On a scale of 0 to 10, How intense is the pain? ### Human: 8 ### Assistant: Do you have nasal congestion or a clear runny nose? ### Human: Yes ### Assistant: Are you currently being treated or have you recently been treated with an oral antibiotic for an ear infection? ### 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 otitis media at 100% probability. Does the pain radiate to another location? ### Human: Nowhere ### Assistant: Let's perform a physical examination to confirm the diagnosis of Acute otitis media.

### Assistant: Are you experiencing shortness of breath or difficulty breathing in a significant way? ### Human: Yes ### Assistant: Have you noticed weakness in your facial muscles and/or eyes? ### 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 Guillain-Barré syndrome at 17.8% probability, and Panic attack at 13% probability. Do you feel any tingling or numbness specifically in your feet? ### Human: Yes ### Assistant: Let's perform a nerve conduction study to help confirm the diagnosis of Guillain-Barré syndrome.

###Assistant: What are your symptoms? ###Human: I feel pain in the back of my head, top of the head, forehead, temple(R), and temple(L). The pain is sensitive, tugging, and exhausting. It's a 4 on a scale of 0 to 10 in intensity, located at a 3, and appeared at a 3. I also have shortness of breath, dizziness, fatigue, and pale skin. I've noticed light red blood in my stool. ###Assistant: Do you have a poor diet? ###Human: Yes, I have a poor diet. ###Assistant: Based on your symptoms and medical history, the two most likely diagnoses are Anemia at 13.9% probability and Acute pulmonary edema at 11.4% 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: Let's conduct a complete blood count (CBC) to further investigate the possibility of Anemia.

### 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? Can you characterize your pain as tedious, heavy, sharp, sickening, or scary? Where do you feel the pain and how intense is it on a scale of 0 to 10? Does the pain radiate to another location? How precisely is the pain located and how fast did it appear? ### Human: Yes, the pain is tedious, heavy, sharp, sickening, and scary. I feel it in my lower chest, side of the chest (R), upper chest, breast (R), and epigastric. The intensity is 6 out of 10. It radiates to my biceps (R), biceps (L), thyroid cartilage, thoracic spine, and shoulder (L). The pain is located at a 7 out of 10 and appeared rapidly at a 9 out of 10. ### Assistant: Are you constantly feeling fatigued, experiencing non-restful sleep, feeling nauseous, or having a loss of appetite or getting full more quickly than usual? ### Human: Yes ### Assistant: Are you infected with the human immunodeficiency virus (HIV), significantly overweight, have high cholesterol, smoke cigarettes, have high blood pressure, have poor circulation, or have traveled out of the country in the last 4 weeks? ### Human: Yes, I am infected with HIV, significantly overweight, have high cholesterol, smoke cigarettes, have high blood pressure, have poor circulation, and have traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Possible NSTEMI / STEMI at 11.3% probability, and Pulmonary neoplasm at 8.2% probability. Does the pain increase or decrease with physical exertion? ### Human: The pain does not specifically increase or decrease with physical exertion. ### Assistant: Let's schedule a cardiac enzyme test to further investigate the possibility of NSTEMI / STEMI. ###

###Assistant: Can you characterize your pain for me?### ###Human: The pain is tedious, sensitive, and heavy. It is located on my forehead, cheek (R), and temple (R). The intensity of the pain is 6 out of 10.### ###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, smoke cigarettes, and have traveled out of the country in the last 4 weeks.### ###Assistant: Based on your history, the two most likely diagnoses are URTI at 17.1% probability, and Bronchitis at 15.5% probability. Does the pain radiate to another location?### ###Human: No, the pain does not radiate to another location.### ###Assistant: Let's perform a chest X-ray to rule out bronchitis and further evaluate your symptoms.###

###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: ear(R), ear(L) ###Assistant: On a scale of 0 to 10, How intense is the pain? ###Human: 4 ###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: 5 ###Assistant: Are you currently being treated or have you recently been treated with an oral antibiotic for an ear infection? ###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 otitis media at 100% probability. Does the pain radiate to another location? ###Human: nowhere ###Assistant: Let's perform a physical examination to further evaluate your ear pain.

### 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 two most likely diagnoses are Allergic sinusitis at 40.8% probability, and Bronchitis at 33.9% probability. Does the cough you have produce any phlegm or mucus? ### Human: Yes, it produces phlegm. ### Assistant: I recommend a nasal endoscopy to further evaluate your symptoms and determine the underlying cause. Thank you for providing your information. ### Human: Thank you for your help.

###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), palace, pharynx, or under the jaw? On a scale of 0 to 10, how intense is the pain? How precisely is the pain located? How fast did the pain appear?### Human: Yes, the pain is in my tonsil (R) and tonsil (L). The pain intensity is 4, the pain location is 6, and the pain appeared slowly. ###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, I live with 4 or more people, attend a daycare, and 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 37.6% probability and Possible NSTEMI / STEMI at 34.1% 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: What are your symptoms? ###Human: I have been coughing up blood and have pain in my tonsil (R) and tonsil (L). The pain is sensitive, with an intensity of 4 on a scale of 0 to 10. It appeared at a pace of 4 and is precisely located at 9. I also have nasal congestion and a cough. ###Assistant: Any relevant medical history? ###Human: I have been in contact with a person with similar symptoms in the past 2 weeks, live with 4 or more people, attend a daycare, traveled out of the country in the last 4 weeks, and am immunosuppressed. ###Assistant: Based on your history, the two most likely diagnoses are Viral pharyngitis at 17.4% probability and Bronchitis at 14.4% probability. Does the pain in your tonsils radiate to another location? ###Human: No, the pain does not radiate to another location. ###Assistant: Let's do a throat swab to confirm the diagnosis of Viral pharyngitis.

### 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 and burning? ### Human: Yes, it is sensitive and burning. ### Assistant: Do you feel pain in your tonsil (R), tonsil (L), thyroid cartilage, palace, or under the jaw? ### Human: Yes, I feel pain in my tonsil (R) and tonsil (L). ### Assistant: On a scale of 0 to 10, how intense is the pain? ### Human: 7 ### Assistant: Has the tone of your voice become deeper, softer, or hoarse? ### Human: Yes ### Assistant: Do you live with 4 or more people, attend or work in a daycare, smoke cigarettes, had a cold in the last 2 weeks, and 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 Acute laryngitis at 47.1% probability and Possible NSTEMI / STEMI at 28.9% probability. Does the pain radiate to another location? ### Human: No, the pain does not radiate to another location. ### Assistant: Let's focus on the location of the pain. Can you specify if the pain is more precisely located in your tonsils (R) or tonsils (L)? ### Human: The pain is more precisely located in my tonsil (R). ### Assistant: I recommend a throat swab to confirm the diagnosis of Acute laryngitis.

### Assistant: Can you describe the pain you're experiencing in more detail?### Human: The pain is sensitive and located in my tonsil (R) and tonsil (L). It's a 6 out of 10 in intensity and appeared relatively fast at a 4 out of 10.### Assistant: Have you traveled out of the country in the last 4 weeks?### Human: Yes, I have. I also smoke cigarettes.### Assistant: Based on your history, the two most likely diagnoses are Bronchitis at 20.5% probability and Acute laryngitis at 17.6% probability. Does the pain in your tonsils worsen when you swallow?### Human: Yes, the pain does worsen when I swallow.### Assistant: Let's perform a throat swab to check for any bacterial infection that could be causing your symptoms.

### Assistant: Do you feel your heart is beating very irregularly or in a disorganized pattern? ### 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 42.2% probability, and PSVT at 32.7% probability. Does the irregular heartbeat worsen with physical exertion or does it stay the same? ### Human: I have symptoms that are increased with physical exertion but alleviated with rest. ### Assistant: Let's schedule an electrocardiogram (ECG) to further evaluate your heart rhythm.

###Assistant: What are your symptoms? ###Human: I have pain in my lower chest, upper chest, breast (R), and breast (L). The pain feels like a knife stroke and has an intensity of 9. It radiates to the posterior chest wall (L) and appeared rapidly with a score of 9. I also have shortness of breath and feel my heart beating fast. ###Assistant: Have you ever had pericarditis? ###Human: Yes, I have had pericarditis. I have also traveled out of the country in the last 4 weeks. ###Assistant: Based on your history, the two most likely diagnoses are pericarditis at 16.6% probability and myocarditis at 14% probability. Does the pain worsen with deep breathing or coughing? ###Human: Yes, the pain does worsen with deep breathing and coughing. ###Assistant: Let's perform an echocardiogram to further evaluate the condition of your heart.

###Assistant: What are your symptoms? ###Human: I have been coughing up blood and have pain in my tonsil (R) and tonsil (L) that is sensitive and burning. The pain intensity is 3 on a scale of 0 to 10, and it appeared relatively fast with a rating of 5. I also have nasal congestion and a clear runny nose. ###Assistant: Any relevant medical history? ###Human: Yes, I smoke cigarettes and 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 17.4% probability and Bronchitis at 14.4% probability. Does the pain in your tonsils radiate to any other location? ###Human: No, the pain is localized to my tonsils. ###Assistant: Let's do a throat swab to confirm the diagnosis of Viral pharyngitis.

### 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? Can you characterize your pain as tugging and exhausting? Do you feel pain in the back of your head, top of the head, and left temple? On a scale of 0 to 10, how intense is the pain? Does it radiate to another location? How precisely is the pain located? How fast did the pain appear? ### Human: Yes, the pain is tugging and exhausting. It is located in the back of my head, top of the head, and left temple. The intensity is 1 out of 10. The pain does not radiate to another location. The pain is located precisely at 5 out of 10, and it appeared at a pace of 2 out of 10. ### Assistant: Have you ever had a diagnosis of anemia? Do you have chronic kidney failure? Are you taking any new oral anticoagulants (NOACs)? Have you traveled out of the country in the last 4 weeks? ### Human: Yes, I have had a diagnosis of anemia. Yes, I have chronic kidney failure. Yes, I am taking new oral anticoagulants (NOACs). Yes, I have traveled out of the country in the last 4 weeks. ### Assistant: Based on your history, the two most likely diagnoses are Anemia at 64.97% probability and Cluster headache at 35.03% probability. Does the pain increase with any specific triggers or activities? ### Human: The pain does not increase with any specific triggers or activities. ### Assistant: I recommend getting a complete blood count (CBC) to further investigate your anemia and consider a neurological examination to assess for cluster headache symptoms. ### Human: Thank you for your recommendations.

###Assistant: Do you feel your abdomen is bloated or distended (swollen due to pressure from inside)? ###Human: Yes ###Assistant: Do you have pain somewhere, related to your reason for consulting? ###Human: Yes ###Assistant: Characterize your pain as heavy. Do you feel pain somewhere in your iliac fossa (R), iliac fossa (L), hip (R), hip (L), or testicle (R)? ###Human: iliac fossa(R) ###Assistant: On a scale of 0 to 10, how intense is the pain in your iliac fossa (R)? ###Human: 3 ###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 and where is the affected region located? ###Human: The rash is pale and located in the iliac fossa(R) ###Assistant: Is the lesion larger than 1cm and how intense is the pain caused by the rash? ###Human: Yes, the lesion is larger than 1cm and the pain caused by the rash is 6 ###Assistant: Have you been able to pass stools or gas since your symptoms increased? ###Human: Yes ###Assistant: Are the symptoms or pain increased with coughing, with an effort like lifting a weight, or from forcing a bowel movement? ###Human: Yes ###Assistant: Are you significantly overweight compared to people of the same height as you and have you traveled out of the country in the last 4 weeks? ###Human: Yes, I am significantly overweight compared to people of the same height as me and I 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 43.8% probability and Anaphylaxis at 26.8% probability. Does the pain in your iliac fossa (R) radiate to another location? ###Human: No ###Assistant: I recommend a physical examination to further evaluate your symptoms and determine the cause of your pain.

### 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 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, exhausting ### Assistant: Do you feel pain somewhere? ### Human: side of the chest(L), scapula(L), breast(L), shoulder(R), 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: biceps(L), thyroid cartilage, thoracic spine, shoulder(R), 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: 9 ### 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: Do you have diabetes? ### 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: 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 7.9% probability, and unstable angina at 7.0% probability. Does the pain increase or decrease with physical exertion? ### Human: The pain increases with physical exertion. ### Assistant: Let's schedule a stress test to further evaluate your symptoms and determine the underlying cause.

###Assistant: Can you please characterize your pain for me?### ###Human: The pain is tedious, sensitive, a cramp, a pulse.### ###Assistant: Have you traveled out of the country in the last 4 weeks?### ###Human: Yes.### ###Assistant: The top 2 potential diagnoses are Chagas with a probability of 54.8% and HIV (initial infection) with a probability of 34.8%. Does the pain radiate to another location?### ###Human: Nowhere.### ###Assistant: Based on your symptoms and travel history, I recommend getting tested for Chagas disease.###

###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: It's a cramp, sharp ###Assistant: Do you feel pain somewhere?### ###Human: lower chest, side of the chest(R), flank(R), iliac fossa(L), hypochondrium(R) ###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: 10 ###Assistant: On a scale of 0 to 10, How fast did the pain appear?### ###Human: 10 ###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 anxious?### ###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 8.2% probability, and Guillain-Barré syndrome at 7.1% 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: Are you experiencing shortness of breath or difficulty breathing in a significant way? ###Human: Yes ###Assistant: Do you have trouble keeping your tongue in your mouth? ###Human: Yes ###Assistant: Have you started or taken any antipsychotic medication within the last 7 days? ###Human: Yes ###Assistant: The top 2 potential diagnoses are Acute dystonic reactions at 33.7% probability and Atrial fibrillation at 21.9% probability. Do you have any muscle stiffness or spasms in addition to the symptoms mentioned? ###Human: Yes, I have a hard time opening/raising one or both eyelids. ###Assistant: I recommend conducting a physical examination to assess muscle tone and coordination. This will help differentiate between the two potential diagnoses.

### Assistant: Do you have pain that is increased when you breathe in deeply? ### Human: Yes ### Assistant: What are your symptoms? ### Human: I have haunting, knife stroke-like sharp pain on the side of the chest (R) and the side of the chest (L), as well as on the posterior chest wall (R) and posterior chest wall (L). The pain intensity is 9 on a scale of 0 to 10. It radiates to the posterior chest wall (R) and is precisely located at 7. The pain appeared very fast, with a score of 10. I also have shortness of breath, intense coughing fits, and the pain increases with movement. ### 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 spontaneous pneumothorax at 7.3% probability and pulmonary embolism at 7.2% probability. Does the pain increase or decrease with physical exertion? ### Human: The pain increases with physical exertion. ### Assistant: Let's get a chest X-ray to examine for a potential pneumothorax. ### Human: Sounds like a good idea.

### Assistant: What are your symptoms? ### Human: I have had diarrhea and an increase in stool frequency. I feel a sharp pain in my flank (L), iliac fossa (R), iliac fossa (L), hypochondrium (R), and epigastric regions. The pain intensity is 4 on a scale of 0 to 10, and it appeared rapidly with a score of 8. I am also experiencing shortness of breath and have difficulty breathing. I have a pink rash on the back of my neck, biceps (R), biceps (L), mouth, and ankle (R). The rash is not swollen but larger than 1cm. It causes mild pain with a score of 2 and severe itching with a score of 8. I have swelling on my forehead, cheek (R), cheek (L), and nose. I lost consciousness and noticed a high-pitched sound when breathing in.### Assistant: Any relevant medical history?### Human: I have a known severe food allergy and have traveled out of the country in the last 4 weeks.### Assistant: Based on your history, the two most likely diagnoses are Anaphylaxis at 8.3% probability and Acute pulmonary edema at 6.8% probability. Does the shortness of breath worsen when lying down or improve when sitting up?### Human: The shortness of breath worsens when lying down.### Assistant: Let's perform a skin prick test to confirm the presence of allergens that may be causing the symptoms.

###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.### Assistant: Based on your history, the two most likely diagnoses are Viral pharyngitis at 17.3% probability, and URTI at 16.7% probability. Does the pain radiate to another location?### Human: Nowhere.### Assistant: I recommend a throat swab to confirm the diagnosis.