Patient: I have had a cough and cold for a few days and I feel run down.

Patient: The cough is mostly dry. I feel hot and cold and achy, and my throat and ears feel blocked. I do not have chest pain. I am a bit more short of breath than usual but can still speak and move around. I have type 2 diabetes, high blood pressure, and obesity.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I have had a cough and cold for a few days and I feel run down.

Patient: The cough is mostly dry. I feel hot and cold and achy, and my throat and ears feel blocked. I do not have chest pain. I am a bit more short of breath than usual but can still speak and move around. I have type 2 diabetes, high blood pressure, and obesity.

Patient: Since yesterday I have become much more short of breath, I have chest pain when I cough, and I keep feeling feverish.


Patient: I have had really dry, itchy skin on my hands for a few days.


Patient: I have had really dry, itchy skin on my hands for a few days.

Patient: It is mainly my hands and palms. It started after I went swimming a few days ago. It is red, dry, and itchy, but there is no cracked skin, bleeding, pus, fever, vomiting, swelling, or breathing problem.


Patient: It hurts when I pee and I am worried about what to do.


Patient: It hurts when I pee and I am worried about what to do.

Patient: It has been three days. It stings when I pee and I get cramping low in my tummy. I am not going more often. I saw a little blood earlier but it stopped, and the urine smells strange. I do not have fever, vomiting, back pain, bowel symptoms, or vaginal discharge. I am sexually active and my last period was two weeks ago.


Patient: I have had pouring watery diarrhea for about three days and it is happening very often.


Patient: I have had pouring watery diarrhea for about three days and it is happening very often.

Patient: It is watery and happens almost every hour when I am awake. There is no blood. I have central crampy pain that comes and goes, about 6 out of 10. I feel nauseous and have vomited a few times. I feel hot and cold. I am drinking and can keep some fluids down, but I am passing less urine. My brother had similar symptoms and is getting better.


Patient: I have had really bad diarrhea for the last three days. It started with vomiting, but now it is mostly diarrhea.


Patient: I have had really bad diarrhea for the last three days. It started with vomiting, but now it is mostly diarrhea.

Patient: I go about five or six times a day. It is watery and loose. There is no blood and no abdominal pain. The vomiting has stopped. I have a poor appetite and feel dehydrated because I am not drinking enough, but I can take some fluids. I feel warm and weak but do not have a measured fever.


Patient: I have had a blinding headache for a few days, mainly around my right eye, and it is getting worse.


Patient: I have had a blinding headache for a few days, mainly around my right eye, and it is getting worse.

Patient: It started gradually three days ago. It is there all the time but sometimes stronger, about 8 out of 10. It is dull with some sharper pain. I saw shooting lights when it started and light bothers me. I feel nauseous but have not vomited. I do not have fever, rash, neck stiffness, speech trouble, weakness, numbness, vision loss, head injury, or walking problems. My mother and sister get migraines.


Patient: I have a cough and cold. My nose is running and the cough has been keeping me up at night.


Patient: I have a cough and cold. My nose is running and the cough has been keeping me up at night.

Patient: It started about five or six days ago. The cough is dry. My throat is irritated from coughing but I can swallow. I do not have shortness of breath or chest pain. I feel tired, weak, achy, and shivery. I have type 2 diabetes and high blood pressure.


Patient: I have a cough and cold. My nose is running and the cough has been keeping me up at night.

Patient: It started about five or six days ago. The cough is dry. My throat is irritated from coughing but I can swallow. I do not have shortness of breath or chest pain. I feel tired, weak, achy, and shivery. I have type 2 diabetes and high blood pressure.

Patient: Now I have chest pain when breathing and I am getting short of breath walking around the flat. I also feel feverish.


Patient: I have sore, cracked skin on my hands. It has been going on for months and now it is affecting my job.


Patient: I have sore, cracked skin on my hands. It has been going on for months and now it is affecting my job.

Patient: It is mainly my palms. It is cracked and sometimes itchy, and it bleeds if I scratch. I work as a housekeeper and I am not always good about wearing gloves. It started after I changed jobs a few months ago. I have type 2 diabetes. I tried E45 cream and antihistamines but they have not helped much. There is no fever or pus.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I do not hear as well as I used to.


Patient: I do not hear as well as I used to.

Patient: It is my left ear and it has been about six weeks. I sometimes get ringing in that ear and feel slightly sick or a bit off balance, but not true room-spinning dizziness. I have no pain, discharge, fever, itchiness, sudden complete hearing loss, weakness, or numbness.


Patient: I noticed a strange swelling on my left elbow about a week ago.


Patient: I noticed a strange swelling on my left elbow about a week ago.

Patient: I did not injure it. It is not painful and I can move the elbow normally. It feels a little warm and like there may be fluid, but I otherwise feel well and have no fever. It has not happened before.


Patient: I cannot hear very well and my face feels a bit numb on one side.


Patient: I cannot hear very well and my face feels a bit numb on one side.

Patient: It is on the left side, around my left ear and jawline, and it is present now. My left hearing is reduced and I sometimes get ringing in that ear. I do not have arm or leg weakness, vision problems, trouble speaking, trouble swallowing, ear pain, discharge, or fever. I do not see facial drooping.


Patient: I feel breathless today.


Patient: I feel breathless today.

Patient: It started today. When I breathe deeply, I get a catching pain on the right side of my back. I feel warm, I coughed up a bit of blood twice, and I can feel my heart beating. I have also been very tired for a couple of weeks. I have lupus and take methotrexate.


Patient: I feel breathless today.

Patient: It started today. When I breathe deeply, I get a catching pain on the right side of my back. I feel warm, I coughed up a bit of blood twice, and I can feel my heart beating. I have also been very tired for a couple of weeks. I have lupus and take methotrexate.

Patient: I am still short of breath and the blood in the sputum has happened again.


Patient: I wrote that my asthma was not responding, but that is not really the problem. I have been getting weird episodes of pins and needles and weakness on my right side.


Patient: I wrote that my asthma was not responding, but that is not really the problem. I have been getting weird episodes of pins and needles and weakness on my right side.

Patient: It is always my right hand with pins and needles, and my right arm feels weak for a few days. At the same time my right leg feels weak and a colleague noticed I walk differently. This has been happening for about a month and a half, first weekly and now almost daily. It is not happening right now. I do not have speech or swallowing problems or vision changes.


Patient: I was stung by a wasp a few minutes ago. I feel anxious, I think I am struggling to breathe, my tongue feels weird, and one side of my lip may be swelling.


Patient: I was stung by a wasp a few minutes ago. I feel anxious, I think I am struggling to breathe, my tongue feels weird, and one side of my lip may be swelling.

Patient: I can speak normally and breathe normally now. I do not have wheezing, throat swelling, faintness, vomiting, chest tightness, or widespread hives. The lip does not look swollen now. There is only soreness and a small local mark where I was stung, and I think anxiety made it feel worse.


Patient: I am having chest discomfort. It started while I was gardening earlier today.


Patient: I am having chest discomfort. It started while I was gardening earlier today.

Patient: Yes, it is still present. It feels like pressure in the middle of my chest, like someone is sitting on it. I feel sweaty and nauseous, a bit short of breath, and my heart feels like it is beating strongly.


Patient: I am having chest discomfort. It started while I was gardening earlier today.

Patient: Yes, it is still present. It feels like pressure in the middle of my chest, like someone is sitting on it. I feel sweaty and nauseous, a bit short of breath, and my heart feels like it is beating strongly.

Patient: It also goes into my left arm, shoulder, and neck. I smoke and have high blood pressure.


Patient: I have been feeling very hot and sweaty for the past week and generally unwell.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I have been feeling very hot and sweaty for the past week and generally unwell.

Patient: I have had feverish hot and cold episodes for about seven days, with night sweats, body aches, nausea, fatigue, and poor appetite. I am drinking less than normal. I do not have cough, sore throat, diarrhea, urinary symptoms, rash, neck stiffness, or a new severe headache. I recently returned from Vietnam after rural and urban travel, trekking, and cycling. I took malaria prevention but I cannot remember which one.


Patient: I have been feeling very hot and sweaty for the past week and generally unwell.

Patient: I have had feverish hot and cold episodes for about seven days, with night sweats, body aches, nausea, fatigue, and poor appetite. I am drinking less than normal. I do not have cough, sore throat, diarrhea, urinary symptoms, rash, neck stiffness, or a new severe headache. I recently returned from Vietnam after rural and urban travel, trekking, and cycling. I took malaria prevention but I cannot remember which one.

Patient: I am still sweating at night and now feel weaker because I have not been drinking much.


Patient: I woke up about an hour ago and I cannot move my left arm. There is no pain.


Patient: I woke up about an hour ago and I cannot move my left arm. There is no pain.

Patient: I also have tingling on the left side of my face. When I tried to drink water it dribbled, and my speech feels slower or harder. I have diabetes and high blood pressure and I am alone at home.


Patient: My lips started swelling after I ate prawn soup about an hour ago. At first they just felt weird, but now the swelling is more obvious.


Patient: My lips started swelling after I ate prawn soup about an hour ago. At first they just felt weird, but now the swelling is more obvious.

Patient: It is mainly my upper lip swelling so far. I have not vomited or felt faint. I have asthma and had a bad peanut allergy as a child.


Patient: My lips started swelling after I ate prawn soup about an hour ago. At first they just felt weird, but now the swelling is more obvious.

Patient: It is mainly my upper lip swelling so far. I have not vomited or felt faint. I have asthma and had a bad peanut allergy as a child.

Patient: Now my throat feels like it is closing, my chest feels tight, and it is getting hard to breathe. My lip is still swelling.


Patient: I have felt hot and I have had a severe headache for four days. Paracetamol and ibuprofen are not helping.


Patient: I have felt hot and I have had a severe headache for four days. Paracetamol and ibuprofen are not helping.

Patient: I got back from Thailand about a week ago. I had mosquito bites there, a friend is also unwell, and I now have a rash over my body, but it fades when I press a glass on it. I have body aches. I do not have neck stiffness, vomiting, confusion, weakness, or pain with light.


Patient: I do not have much appetite or energy lately, and I feel out of place. I am not sure what is going on.


Patient: I do not have much appetite or energy lately, and I feel out of place. I am not sure what is going on.

Patient: It has been around three months. I feel nauseous a lot and I have lost about a stone over the last six months. I sometimes feel breathless and get palpitations, but I do not have chest pain, vomiting, or bowel changes. I do not think I am depressed or especially stressed.


Patient: I do not have much appetite or energy lately, and I feel out of place. I am not sure what is going on.

Patient: It has been around three months. I feel nauseous a lot and I have lost about a stone over the last six months. I sometimes feel breathless and get palpitations, but I do not have chest pain, vomiting, or bowel changes. I do not think I am depressed or especially stressed.

Patient: I have an underactive thyroid, but I have not been taking my thyroxine for a while since I changed practice. I do not remember when I last had blood tests.


Patient: My chest feels very tight and I have been more short of breath over the last few days. I have asthma.


Patient: My chest feels very tight and I have been more short of breath over the last few days. I have asthma.

Patient: It started about three or four days ago. I get short of breath when I walk briskly or run, with some wheeze and cough. I am not bringing up phlegm. I use my preventer every day and now need my blue inhaler about twice a day, when normally I use it only occasionally.


Patient: My chest feels very tight and I have been more short of breath over the last few days. I have asthma.

Patient: It started about three or four days ago. I get short of breath when I walk briskly or run, with some wheeze and cough. I am not bringing up phlegm. I use my preventer every day and now need my blue inhaler about twice a day, when normally I use it only occasionally.

Patient: Since then I am getting more breathless and the blue inhaler is not helping much. I have not been able to get a doctor review yet.


Patient: I have been feeling dizzy for the past few hours. The room feels like it is moving and I feel sick.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I have been feeling dizzy for the past few hours. The room feels like it is moving and I feel sick.

Patient: My arms and legs work normally, and I do not have trouble speaking, severe headache, fainting, chest pain, vomiting, ear pain, ear discharge, or hearing loss. My ears are buzzing and I feel nauseous. I had something similar a month ago, but it only lasted about ten minutes.


Patient: I was stung by a wasp about twenty minutes ago and I am not sure if I should go to hospital.


Patient: I was stung by a wasp about twenty minutes ago and I am not sure if I should go to hospital.

Patient: The sting area is sore and a bit swollen, but I do not have breathing trouble, chest tightness, lip or tongue symptoms, throat tightness, dizziness, fainting, vomiting, or a rash elsewhere.


Patient: I was stung by a wasp about twenty minutes ago and I am not sure if I should go to hospital.

Patient: The sting area is sore and a bit swollen, but I do not have breathing trouble, chest tightness, lip or tongue symptoms, throat tightness, dizziness, fainting, vomiting, or a rash elsewhere.

Patient: Now I have shallow breathing, some chest tightness, a blotchy rash, and tingling around my lips. My wife is with me.


Patient: I have sore red skin. It is on my chest, hands, and arms, especially inside my elbows.


Patient: I have sore red skin. It is on my chest, hands, and arms, especially inside my elbows.

Patient: It is very itchy and dry. I do not have fever, joint pain, pus, weeping fluid, swelling of my lips or tongue, throat symptoms, or breathing problems. I have eczema and asthma.


Patient: I have sore red skin. It is on my chest, hands, and arms, especially inside my elbows.

Patient: It is very itchy and dry. I do not have fever, joint pain, pus, weeping fluid, swelling of my lips or tongue, throat symptoms, or breathing problems. I have eczema and asthma.

Patient: I use Diprobase and Dermol, and I tried hydrocortisone and cetirizine, but it is not really improving.


Patient: I have had a cough and a cold for a few days, with a runny nose and some aches.


Patient: I have had a cough and a cold for a few days, with a runny nose and some aches.

Patient: It has been about five days. The cough is dry. I am not coughing blood or phlegm, and I do not have shortness of breath, wheezing, or chest pain. I have diabetes and high blood pressure, but my sugar and blood pressure are normal today. I take metformin and lisinopril.


Patient: My chest feels tight and I am having a hard time catching my breath. I feel winded even when I am sitting still.


Patient: Since having my last child, my periods have become much heavier and more painful, and I am spotting between cycles. Could this just be hormones, or should I come in?


Patient: Since having my last child, my periods have become much heavier and more painful, and I am spotting between cycles. Could this just be hormones, or should I come in?

Patient: I do not think I am pregnant. My last period started two weeks ago, and during my period I used about seven pads a day. The cramps are stronger than before, and the spotting keeps happening between periods. No urinary or bowel changes.


Patient: My voice keeps getting hoarse on and off. Sometimes it is fine, and other times I can barely talk. Should I get it checked?


Patient: My voice keeps getting hoarse on and off. Sometimes it is fine, and other times I can barely talk. Should I get it checked?

Patient: It has been going on for about a month. I do not have fever, chills, cough, congestion, runny nose, or eye drainage. I do get burning after eating and belching sometimes.


Patient: My neck pain is pretty bad and I can barely turn my head. It is starting to go down my arms and my fingers feel numb and tingly.


Patient: My neck pain is pretty bad and I can barely turn my head. It is starting to go down my arms and my fingers feel numb and tingly.

Patient: It started about five days ago. The pain is a 7 out of 10 and keeps waking me up. I have tingling in both hands, but I can grip normally and do not have hand weakness. Heat helps only a little.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I have been having cramping and I am not sure what is causing it. Should I come in or try something at home?


Patient: I have been having cramping and I am not sure what is causing it. Should I come in or try something at home?

Patient: I still have periods, but this cramping is not at the usual time. I have a dull lower-abdominal ache with bloating. No burning with urination and no bowel changes.


Patient: I am getting up to pee 3 or 4 times a night, and each time only a small amount comes out. It is ruining my sleep.


Patient: I am getting up to pee 3 or 4 times a night, and each time only a small amount comes out. It is ruining my sleep.

Patient: There is no burning, fever, or blood. The urine looks normal and has no strong odor. My bowels are the same, and my weight has not changed. It has been happening most nights for about three weeks.


Patient: I have pelvic pressure and pain that comes and goes. Sometimes it is a dull ache, and sometimes it is sharp. It has happened a few times this month.


Patient: I have pelvic pressure and pain that comes and goes. Sometimes it is a dull ache, and sometimes it is sharp. It has happened a few times this month.

Patient: It is strongest low in the pelvis. It has not spread and is not related to eating. I have been peeing more often, but there is no burning, no redness, no bowel change, and no medication change.


Patient: I woke up with nausea that has lingered today. I can keep down water and crackers, but I do not want a full meal. Should I come in?


Patient: I woke up with nausea that has lingered today. I can keep down water and crackers, but I do not want a full meal. Should I come in?

Patient: I am not pregnant. No fever, chills, cough, abdominal pain, vomiting, or bowel changes. This has just been today, and I can still keep fluids down.


Patient: My joints and muscles keep swelling on and off, mostly in my hands and feet, and some days it is painful. What should I do?


Patient: My joints and muscles keep swelling on and off, mostly in my hands and feet, and some days it is painful. What should I do?

Patient: It started a few months ago. It is mainly my fingers and ankles, worse at the end of the day. There is no numbness or tingling, no medication change, and I can move everything normally.


Patient: My joints and muscles keep swelling on and off, mostly in my hands and feet, and some days it is painful. What should I do?

Patient: It started a few months ago. It is mainly my fingers and ankles, worse at the end of the day. There is no numbness or tingling, no medication change, and I can move everything normally.

Patient: Today my left hand suddenly became very swollen, my fingers are numb and tingling, and I can barely bend them.


Patient: For weeks my muscles have felt weak. It is getting harder to carry groceries and walk up stairs. I am getting worried.


Patient: For weeks my muscles have felt weak. It is getting harder to carry groceries and walk up stairs. I am getting worried.

Patient: It is mostly in my thighs and shoulders. No recent illness, no shortness of breath, no numbness or tingling, and only mild cramping.


Patient: For weeks my muscles have felt weak. It is getting harder to carry groceries and walk up stairs. I am getting worried.

Patient: It is mostly in my thighs and shoulders. No recent illness, no shortness of breath, no numbness or tingling, and only mild cramping.

Patient: Since this afternoon the weakness is worse, and now I feel short of breath just walking across the room.


Patient: For the past few days I get dizzy when I stand up and I have nausea on and off. Should I come in or try something at home?


Patient: For the past few days I get dizzy when I stand up and I have nausea on and off. Should I come in or try something at home?

Patient: No medication changes, no vomiting, no headache, and no vision changes. It mainly happens when I stand up, but it has kept happening for several days and makes me afraid to walk around.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I have nausea and chills, and I do not know what is going on. Should I come see you or wait it out?


Patient: I have nausea and chills, and I do not know what is going on. Should I come see you or wait it out?

Patient: I am not pregnant. It started yesterday. My temperature is 99.8, and I have been peeing more often with burning. No blood in the urine, no back pain, no bowel changes, and no sick contacts.


Patient: I have been getting dizzy spells, sometimes when I stand up too fast and sometimes out of the blue. It is starting to freak me out.


Patient: I have been getting dizzy spells, sometimes when I stand up too fast and sometimes out of the blue. It is starting to freak me out.

Patient: It started about two weeks ago. I have not been sick. My blood pressure at home was 98/62 once. No headache or vision changes. I feel lightheaded when standing, not spinning, and I have not passed out.


Patient: My seasonal allergies are bad. My eyes itch, I am congested, and I keep sneezing. The over-the-counter medicines are not helping enough. Can I get something stronger?


Patient: My seasonal allergies are bad. My eyes itch, I am congested, and I keep sneezing. The over-the-counter medicines are not helping enough. Can I get something stronger?

Patient: I tried loratadine and a saline spray for a week. No fever, chills, forehead pain, or ear pain. My diabetes medicines are unchanged and my sugars are stable.


Patient: For the past few days I have been dizzy and lightheaded when I stand up, and I am having trouble concentrating. Could it be blood pressure or medication?


Patient: For the past few days I have been dizzy and lightheaded when I stand up, and I am having trouble concentrating. Could it be blood pressure or medication?

Patient: It came on gradually. My blood pressure was a little low, 100/64. No headache, chest pain, sudden shortness of breath, dark urine, recent illness, or medication change. I probably have not been drinking much water.


Patient: For the past few days I have been dizzy and lightheaded when I stand up, and I am having trouble concentrating. Could it be blood pressure or medication?

Patient: It came on gradually. My blood pressure was a little low, 100/64. No headache, chest pain, sudden shortness of breath, dark urine, recent illness, or medication change. I probably have not been drinking much water.

Patient: I just got dizzy again, and now I also have chest pain and sudden shortness of breath.


Patient: Sometimes it is hard to start peeing, and when I do my urine smells bad and looks cloudy. Should I get checked?


Patient: Sometimes it is hard to start peeing, and when I do my urine smells bad and looks cloudy. Should I get checked?

Patient: This has not happened before. I am going more often and there is mild burning. No blood, fever, chills, racing heart, back pain, belly pain, or medication change.


Patient: My urine has been darker and amber colored for a few days, sometimes with a strong odor. I am drinking water and have mild discomfort when peeing. Could it be a UTI or kidney stone?


Patient: My urine has been darker and amber colored for a few days, sometimes with a strong odor. I am drinking water and have mild discomfort when peeing. Could it be a UTI or kidney stone?

Patient: It feels more like my past UTI than a kidney stone. I am going more often and it burns a little. No fever, chills, unusual fatigue, back pain, abdominal pain, pelvic pain, discharge, new partner, or medication change.


Patient: I have sharp sinus pain in my cheekbones and forehead with congestion and headaches. A humidifier and saline spray have not helped. Should I come in?


Patient: I have sharp sinus pain in my cheekbones and forehead with congestion and headaches. A humidifier and saline spray have not helped. Should I come in?

Patient: It has been about 12 days. I was sick first, then improved, and now the facial pain is worse again. No fever, but I have thick nasal drainage and it is waking me up.


Patient: I have been wheezing on and off during the day, especially with exertion or dust. I am not sure if it is allergies.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I have been wheezing on and off during the day, especially with exertion or dust. I am not sure if it is allergies.

Patient: I have had this with allergies before. No shortness of breath at rest, no recent illness, no smoke exposure, no missed medicines, and I can lie flat. It is mostly with dust or exercise.


Patient: I have been wheezing on and off during the day, especially with exertion or dust. I am not sure if it is allergies.

Patient: I have had this with allergies before. No shortness of breath at rest, no recent illness, no smoke exposure, no missed medicines, and I can lie flat. It is mostly with dust or exercise.

Patient: Now I am wheezing and short of breath while sitting still, and I cannot lie flat without feeling worse.


Patient: I have been having tummy issues. I get a burning feeling after I eat, and I have diarrhea. Can you help?


Patient: I have been having tummy issues. I get a burning feeling after I eat, and I have diarrhea. Can you help?

Patient: The burning is high in my stomach and starts about 30 minutes after eating. I have gas and a sour taste in the morning. Diarrhea happens three to four times a day for the past week, with no incontinence.


Patient: I have been having some chest tightness and I am not sure what is going on. Should I come in or do something at home?


Patient: I have been having some chest tightness and I am not sure what is going on. Should I come in or do something at home?

Patient: It has happened a couple of times with stress and goes away when I rest. No shortness of breath, palpitations, cough, one-sided pain, or missed medicines.


Patient: I have been having some chest tightness and I am not sure what is going on. Should I come in or do something at home?

Patient: It has happened a couple of times with stress and goes away when I rest. No shortness of breath, palpitations, cough, one-sided pain, or missed medicines.

Patient: The tightness came back and now I am short of breath and my heart feels like it is racing.


Patient: I have been dizzy and lightheaded, and it makes me nauseous. It is worse when I stand up quickly or change positions. I am trying to hydrate, but it is affecting my day.


Patient: I have been dizzy and lightheaded, and it makes me nauseous. It is worse when I stand up quickly or change positions. I am trying to hydrate, but it is affecting my day.

Patient: I am not pregnant or breastfeeding. No recent illness, vomiting, urinary changes, or bowel changes. I drink water, but it is not improving. The dizziness lasts a few minutes after I stand and I am eating less because of nausea.


Patient: My hands, feet, and ankles have been swollen and painful for a few days, and it is getting harder to move around. I am worried and want to know what to do.


Patient: My hands, feet, and ankles have been swollen and painful for a few days, and it is getting harder to move around. I am worried and want to know what to do.

Patient: It started about three days ago. I do not have fever, rash, shortness of breath, or kidney-stone pain. I am peeing normally. The swelling is painful but I can still walk slowly.


Patient: My hands, feet, and ankles have been swollen and painful for a few days, and it is getting harder to move around. I am worried and want to know what to do.

Patient: It started about three days ago. I do not have fever, rash, shortness of breath, or kidney-stone pain. I am peeing normally. The swelling is painful but I can still walk slowly.

Patient: Since I messaged you, I have started feeling short of breath when I walk across the room, and I have barely urinated today. The swelling is worse.


Patient: I woke up with a sudden severe arthritis flare. My hands and knees are swollen and very painful, and my usual medicines are not helping like they normally do.


Patient: I woke up with a sudden severe arthritis flare. My hands and knees are swollen and very painful, and my usual medicines are not helping like they normally do.

Patient: I have not taken extra lithium. I took my usual arthritis medicine only. I am drinking water, peeing normally, and I am not dizzy. The joints are swollen but not red or hot, and I do not have a fever.


Patient: I woke up with a sudden severe arthritis flare. My hands and knees are swollen and very painful, and my usual medicines are not helping like they normally do.

Patient: I have not taken extra lithium. I took my usual arthritis medicine only. I am drinking water, peeing normally, and I am not dizzy. The joints are swollen but not red or hot, and I do not have a fever.

Patient: Now I feel very dizzy and shaky, and I have barely urinated since this morning. I am worried because I take lithium.


Patient: I have had much heavier bleeding than my normal period for the past few days with cramps and fatigue. I am changing pads often and I am not sure if this is an emergency.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I have had much heavier bleeding than my normal period for the past few days with cramps and fatigue. I am changing pads often and I am not sure if this is an emergency.

Patient: My pregnancy test is negative. My last period started about five weeks ago. I am changing a pad every two to three hours, with a few small clots, no fever, no dizziness, and no leg or groin pain.


Patient: My period is late, and I have had some light on-and-off bleeding today. I am worried and want to know what could be going on.


Patient: My period is late, and I have had some light on-and-off bleeding today. I am worried and want to know what could be going on.

Patient: My last period was about six weeks ago. My home pregnancy test was negative. My cycles are sometimes irregular, I use condoms, and I do not have unusual discharge, significant cramps, or abdominal pain. The bleeding is light pink spotting.


Patient: I have been getting frequent dizziness and lightheadedness, and my legs and ankles are swollen. The swelling is not going down and I am getting worried.


Patient: I have been getting frequent dizziness and lightheadedness, and my legs and ankles are swollen. The swelling is not going down and I am getting worried.

Patient: It started about a week ago. I get lightheaded mostly when I stand up, not while sitting. I can walk but more slowly. I am not short of breath and I do not have cough, leg redness, heat, or leaking skin. My urination seems normal.


Patient: I have been getting frequent dizziness and lightheadedness, and my legs and ankles are swollen. The swelling is not going down and I am getting worried.

Patient: It started about a week ago. I get lightheaded mostly when I stand up, not while sitting. I can walk but more slowly. I am not short of breath and I do not have cough, leg redness, heat, or leaking skin. My urination seems normal.

Patient: Today I am short of breath walking to the bathroom, and I almost fainted. My ankles look more swollen than before.


Patient: I have been through menopause, but lately I have had unexpected bleeding. I do not have pain, just bleeding, and I want to know if I should come in.


Patient: I have been through menopause, but lately I have had unexpected bleeding. I do not have pain, just bleeding, and I want to know if I should come in.

Patient: The bleeding started three days ago. It is light bright-red spotting, no clots, no discharge or odor, no urinary symptoms, and no pain. I do not know of any reproductive cancer history.


Patient: I have had stomach cramping after meals and acid reflux waking me up at night. It leaves a burning sensation in my chest. Antacids are not helping much.


Patient: I have had stomach cramping after meals and acid reflux waking me up at night. It leaves a burning sensation in my chest. Antacids are not helping much.

Patient: No chest pressure or tightening, no shortness of breath, no sweating, no arm tingling, no back pain, and no blood or black stools. It mainly happens after meals and when lying flat.


Patient: I have had stomach cramping after meals and acid reflux waking me up at night. It leaves a burning sensation in my chest. Antacids are not helping much.

Patient: No chest pressure or tightening, no shortness of breath, no sweating, no arm tingling, no back pain, and no blood or black stools. It mainly happens after meals and when lying flat.

Patient: Now the chest feeling is more like tight pressure, I am sweating, and my left arm feels tingly. It does not feel like my usual reflux.


Patient: I have pretty bad bone pain all over, not just one spot. I do not know what is causing it, and I am worried. Should I come in?


Patient: I have pretty bad bone pain all over, not just one spot. I do not know what is causing it, and I am worried. Should I come in?

Patient: It started about four days ago and is a constant deep ache. No injury or accident, no fever, no known illness exposure, and no tick bite. Ibuprofen helps a little but it keeps coming back.


Patient: I have had nausea on and off for the past few days. I am not sure if it was something I ate, but it has been persistent.


Patient: I have had nausea on and off for the past few days. I am not sure if it was something I ate, but it has been persistent.

Patient: No fever, no sick contacts, no new medicines, no chest pain, no shortness of breath, and I can do normal activities. I did eat heavier food than usual. I am taking my medicines as prescribed.


Patient: I have had nausea on and off for the past few days. I am not sure if it was something I ate, but it has been persistent.

Patient: No fever, no sick contacts, no new medicines, no chest pain, no shortness of breath, and I can do normal activities. I did eat heavier food than usual. I am taking my medicines as prescribed.

Patient: This afternoon I became short of breath and felt pressure in my chest along with the nausea. I also feel much weaker than usual.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I have nausea and chills and do not know what is going on. Should I come see you or wait it out?


Patient: I have nausea and chills and do not know what is going on. Should I come see you or wait it out?

Patient: No shortness of breath, cough, wheezing, or pain. My temperature is 99.4 F, and no one around me is sick. I have been drinking less than usual but can keep fluids down.


Patient: I have nausea and chills and do not know what is going on. Should I come see you or wait it out?

Patient: No shortness of breath, cough, wheezing, or pain. My temperature is 99.4 F, and no one around me is sick. I have been drinking less than usual but can keep fluids down.

Patient: Now I am wheezing and feel short of breath. I also have a fever of 102.5 F and feel too weak to get up.


Patient: I have stiffness in my joints and muscles throughout the day. Walking and stairs are getting harder, and stretching has not helped.


Patient: I have stiffness in my joints and muscles throughout the day. Walking and stairs are getting harder, and stretching has not helped.

Patient: It started about two weeks after my valsartan dose was increased. No joint redness, warmth, or swelling, no fever, no abdominal pain, no bowel changes, and no yellowing of my skin or eyes.


Patient: I have stiffness in my joints and muscles throughout the day. Walking and stairs are getting harder, and stretching has not helped.

Patient: It started about two weeks after my valsartan dose was increased. No joint redness, warmth, or swelling, no fever, no abdominal pain, no bowel changes, and no yellowing of my skin or eyes.

Patient: Today my eyes look yellow, I have upper abdominal pain, and the muscle stiffness feels much worse.


Patient: My seasonal allergies are bad. My eyes are itchy, I am congested, and I keep sneezing. Over-the-counter medicine is not giving enough relief.


Patient: My seasonal allergies are bad. My eyes are itchy, I am congested, and I keep sneezing. Over-the-counter medicine is not giving enough relief.

Patient: No fever, sore throat, cough, shortness of breath, or wheezing. No sick contacts. It started after heavy pollen this week. I tried an oral antihistamine but no nasal spray yet.


Patient: My seasonal allergies are bad. My eyes are itchy, I am congested, and I keep sneezing. Over-the-counter medicine is not giving enough relief.

Patient: No fever, sore throat, cough, shortness of breath, or wheezing. No sick contacts. It started after heavy pollen this week. I tried an oral antihistamine but no nasal spray yet.

Patient: Now I am wheezing and feel short of breath. My rescue inhaler is not helping much.


Patient: I have watery diarrhea multiple times per hour with cramping. I am trying electrolyte drinks, but I still feel like I am getting dehydrated.


Patient: I have watery diarrhea multiple times per hour with cramping. I am trying electrolyte drinks, but I still feel like I am getting dehydrated.

Patient: It started last night. I am going about three times per hour, small watery amounts each time. No blood, no fever, no foul odor, and the cramping is mild around my lower abdomen. I can keep fluids down, I am not dizzy or confused, and I am still urinating a normal amount. My mouth feels a little dry, and my roommate is home.


Patient: It is hard to start peeing, and when I do, my urine smells bad and looks cloudy. I am worried and wonder if I should come in.


Patient: It is hard to start peeing, and when I do, my urine smells bad and looks cloudy. I am worried and wonder if I should come in.

Patient: It started two days ago. No fever, no back or flank pain, no nausea or vomiting, no vaginal bleeding or discharge. I have mild lower belly pressure.


Patient: I woke up with my shoulder and elbow feeling stiff and hard to move, with sharp pains. I think tendonitis may be flaring up again.


Patient: I woke up with my shoulder and elbow feeling stiff and hard to move, with sharp pains. I think tendonitis may be flaring up again.

Patient: It is my right shoulder and elbow. I have had tendonitis there before. No injury, no swelling, redness, or warmth. The sharp pain happens mainly when I lift or rotate the arm, not at rest.


Patient: I have some joint and muscle stiffness, and it is getting a bit harder to move around. It is not terrible, but I want to know if I should worry.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I have some joint and muscle stiffness, and it is getting a bit harder to move around. It is not terrible, but I want to know if I should worry.

Patient: It does loosen up after I move around. No swelling, redness, or warmth. I have prednisone from a prior flare but have not taken extra doses. My appetite and fluids are normal.


Patient: I have some joint and muscle stiffness, and it is getting a bit harder to move around. It is not terrible, but I want to know if I should worry.

Patient: It does loosen up after I move around. No swelling, redness, or warmth. I have prednisone from a prior flare but have not taken extra doses. My appetite and fluids are normal.

Patient: Now one knee is hot, red, and swollen. I am having much more trouble bending it than before.


Patient: I have noticed blood in my urine a few times and I am getting up to pee a lot more at night. I do not have pain, but I am worried.


Patient: I have noticed blood in my urine a few times and I am getting up to pee a lot more at night. I do not have pain, but I am worried.

Patient: It started about a week ago. No fever, no burning, no vaginal discharge, no back or flank pain, and no abdominal pain. I have seen pink urine three times.


Patient: I stopped taking my birth control a few days ago and started spotting today. I am older and thought I would not have periods anymore. Should I be concerned?


Patient: I stopped taking my birth control a few days ago and started spotting today. I am older and thought I would not have periods anymore. Should I be concerned?

Patient: No abdominal pain, only mild cramping, no discharge, no urinary changes, no itching. I have vaginal dryness. My last natural period was more than a year ago before I was on hormones.


Patient: I have been feeling really bloated and uncomfortable lately. I am getting worried and want to discuss what might be going on.


Patient: I have been feeling really bloated and uncomfortable lately. I am getting worried and want to discuss what might be going on.

Patient: It started after a week of constipation and eating more salty processed food. I am passing stool every other day, no shortness of breath, no cough, no swelling elsewhere, normal urination, no yellow skin or eyes, and appetite is normal.


Patient: I have been feeling really bloated and uncomfortable lately. I am getting worried and want to discuss what might be going on.

Patient: It started after a week of constipation and eating more salty processed food. I am passing stool every other day, no shortness of breath, no cough, no swelling elsewhere, normal urination, no yellow skin or eyes, and appetite is normal.

Patient: Now my belly looks much bigger, my legs are swollen too, I am short of breath walking around the apartment, and I am urinating much less.


Patient: I have had black, tarry stools on and off and feel a bit fatigued. I do not have abdominal pain or vomiting, but I am worried about possible GI bleeding.


Patient: I have had black, tarry stools on and off and feel a bit fatigued. I do not have abdominal pain or vomiting, but I am worried about possible GI bleeding.

Patient: It started two days ago. The stool is black and sticky with a strong foul smell. No bright red blood. I have not taken iron, black licorice, or bismuth. I have taken ibuprofen several times this week.


Patient: My legs and feet are very swollen and I can barely fit into my shoes. I am also having a hard time breathing, and it feels like there is a weight on my chest. I am scared.


Patient: My neck has been painful, and I have been experiencing muscle weakness. It is getting hard to move around and do everyday things.


Patient: My neck has been painful, and I have been experiencing muscle weakness. It is getting hard to move around and do everyday things.

Patient: It started after I lifted boxes two days ago. The pain is in the back of my neck and feels like a spasm. I say weak because moving hurts, but I have not lost strength or feeling. No falls and no bowel or bladder problems.


Patient: I woke up with post-nasal drip and a runny nose. It has bothered me all day. I do not have a fever, just congestion and throat discomfort, and over-the-counter medicine has not helped much.


Patient: I woke up with post-nasal drip and a runny nose. It has bothered me all day. I do not have a fever, just congestion and throat discomfort, and over-the-counter medicine has not helped much.

Patient: No trouble breathing, no wheezing, no COVID exposure that I know of, and this is day one. I have asthma but have not needed my rescue inhaler. No facial pain. I tried a decongestant.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I woke up with post-nasal drip and a runny nose. It has bothered me all day. I do not have a fever, just congestion and throat discomfort, and over-the-counter medicine has not helped much.

Patient: No trouble breathing, no wheezing, no COVID exposure that I know of, and this is day one. I have asthma but have not needed my rescue inhaler. No facial pain. I tried a decongestant.

Patient: Now I am wheezing and having trouble catching my breath. I used my rescue inhaler, but it did not help much.


Patient: I have had neck pain on and off lately. It comes and goes, and I wonder if it could be tendonitis. Should I come in or do something at home?


Patient: I have had neck pain on and off lately. It comes and goes, and I wonder if it could be tendonitis. Should I come in or do something at home?

Patient: It has been about a week and is about the same. No fall or hit to my neck. No fever. It is in the back of my neck and feels worse after working at my desk. No recent cold, flu, or COVID.


Patient: I noticed a new sore lump on my bum cheek near the crack earlier today. I cannot tell if it is a bite or a spot. What should I do?


Patient: I noticed a new sore lump on my bum cheek near the crack earlier today. I cannot tell if it is a bite or a spot. What should I do?

Patient: It has a bright red dot in the middle and a pink ring around it. It is sore when I walk, but I do not have fever.


Patient: I noticed a new sore lump on my bum cheek near the crack earlier today. I cannot tell if it is a bite or a spot. What should I do?

Patient: It has a bright red dot in the middle and a pink ring around it. It is sore when I walk, but I do not have fever.

Patient: The pink area looks larger now and it is more painful to sit or walk.


Patient: My 10-month-old got hold of a calamine lotion bottle and put some on his lips and face. I rinsed his mouth and face right away, and he has no reaction right now.


Patient: My 10-month-old got hold of a calamine lotion bottle and put some on his lips and face. I rinsed his mouth and face right away, and he has no reaction right now.

Patient: He still seems normal after a few hours. He is drinking and breathing normally.


Patient: My 10-month-old got hold of a calamine lotion bottle and put some on his lips and face. I rinsed his mouth and face right away, and he has no reaction right now.

Patient: He still seems normal after a few hours. He is drinking and breathing normally.

Patient: Now he has vomited twice and has started coughing.


Patient: I was bitten by my neighbor’s pet dog 15 days ago. I washed the bite with soap and water, got a tetanus shot, and took antibiotics. The dog is vaccinated and is still healthy. Do I still need rabies vaccine?


Patient: I was bitten by my neighbor’s pet dog 15 days ago. I washed the bite with soap and water, got a tetanus shot, and took antibiotics. The dog is vaccinated and is still healthy. Do I still need rabies vaccine?

Patient: What if I cannot confirm the dog’s vaccine records and I cannot reliably observe the dog now?


Patient: I was bitten by my neighbor’s pet dog 15 days ago. I washed the bite with soap and water, got a tetanus shot, and took antibiotics. The dog is vaccinated and is still healthy. Do I still need rabies vaccine?

Patient: What if I cannot confirm the dog’s vaccine records and I cannot reliably observe the dog now?

Patient: I checked with the owner and confirmed the vaccine record. The dog is still behaving normally.


Patient: My 83-year-old mother had some kind of incident today, and I am trying to remember the stroke acronym. What should I check?


Patient: My 83-year-old mother had some kind of incident today, and I am trying to remember the stroke acronym. What should I check?

Patient: Her speech sounded slurred for a while and one side of her face looked uneven.


Patient: My 83-year-old mother had some kind of incident today, and I am trying to remember the stroke acronym. What should I check?

Patient: Her speech sounded slurred for a while and one side of her face looked uneven.

Patient: The speech sounds a little better now, but she still seems off.


Patient: I take Rexipra 10 mg at night for severe anxiety. My dermatologist prescribed Nizoral 200 mg daily for a scalp infection. Can I take them together?


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I take Rexipra 10 mg at night for severe anxiety. My dermatologist prescribed Nizoral 200 mg daily for a scalp infection. Can I take them together?

Patient: I have not taken the Nizoral yet, and I do not have dizziness or palpitations.


Patient: I take Rexipra 10 mg at night for severe anxiety. My dermatologist prescribed Nizoral 200 mg daily for a scalp infection. Can I take them together?

Patient: I have not taken the Nizoral yet, and I do not have dizziness or palpitations.

Patient: I already took them together and now I feel faint and my heart is racing.


Patient: My husband has small fiber neuropathy and takes Lyrica 100 mg twice a day. He has severe joint and muscle pain and spends most days in a recliner. Could Lyrica be the cause?


Patient: My husband has small fiber neuropathy and takes Lyrica 100 mg twice a day. He has severe joint and muscle pain and spends most days in a recliner. Could Lyrica be the cause?

Patient: He also has muscle tenderness and occasional twitching, but no new emergency symptoms.


Patient: My husband has small fiber neuropathy and takes Lyrica 100 mg twice a day. He has severe joint and muscle pain and spends most days in a recliner. Could Lyrica be the cause?

Patient: He also has muscle tenderness and occasional twitching, but no new emergency symptoms.

Patient: We are mainly trying to decide whether to ask for gabapentin or another medicine instead.


Patient: I have psoriasis, anxiety disorder, and a long dry cough. I recently took hydroxychloroquine and azithromycin with my usual sertraline, montelukast, rosuvastatin, and topical steroid. Do I need adjustments?


Patient: I have psoriasis, anxiety disorder, and a long dry cough. I recently took hydroxychloroquine and azithromycin with my usual sertraline, montelukast, rosuvastatin, and topical steroid. Do I need adjustments?

Patient: I do not have dizziness, fainting, shortness of breath, or palpitations right now.


Patient: I have psoriasis, anxiety disorder, and a long dry cough. I recently took hydroxychloroquine and azithromycin with my usual sertraline, montelukast, rosuvastatin, and topical steroid. Do I need adjustments?

Patient: I do not have dizziness, fainting, shortness of breath, or palpitations right now.

Patient: Now I feel lightheaded and my heart is pounding.


Patient: I dropped a bottle of Clorox bathroom cleaner at work. It splashed on my lips and near my right eye. I rinsed right away, but now I have mild nausea, headache, lightheadedness, and my eye feels sore.


Patient: I dropped a bottle of Clorox bathroom cleaner at work. It splashed on my lips and near my right eye. I rinsed right away, but now I have mild nausea, headache, lightheadedness, and my eye feels sore.

Patient: My eye still feels mildly uncomfortable, but I can see normally and I am breathing normally.


Patient: I dropped a bottle of Clorox bathroom cleaner at work. It splashed on my lips and near my right eye. I rinsed right away, but now I have mild nausea, headache, lightheadedness, and my eye feels sore.

Patient: My eye still feels mildly uncomfortable, but I can see normally and I am breathing normally.

Patient: Now my chest feels very tight and I am short of breath. My eye pain is also worse.


Patient: My one-year-old son has a blocked right nostril. Water comes from his mouth, eyes, and nose, and his breathing sounds noisy during sleep. Should he have surgery for DNS?


Patient: My one-year-old son has a blocked right nostril. Water comes from his mouth, eyes, and nose, and his breathing sounds noisy during sleep. Should he have surgery for DNS?

Patient: He is not blue and is feeding, but the right side still seems fully blocked at night.


Patient: My one-year-old son has a blocked right nostril. Water comes from his mouth, eyes, and nose, and his breathing sounds noisy during sleep. Should he have surgery for DNS?

Patient: He is not blue and is feeding, but the right side still seems fully blocked at night.

Patient: We mainly want to know whether a pipe or another method could open the nose until he grows.


Patient: I am 72 and was diagnosed with pneumonia a week ago. I was discharged from hospital and feel much better, but I still have left chest pain and a bubbling feeling that improves after coughing up phlegm. Is this normal?


Patient: I am 72 and was diagnosed with pneumonia a week ago. I was discharged from hospital and feel much better, but I still have left chest pain and a bubbling feeling that improves after coughing up phlegm. Is this normal?

Patient: I have no new fever and the cough is slowly improving.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I am 72 and was diagnosed with pneumonia a week ago. I was discharged from hospital and feel much better, but I still have left chest pain and a bubbling feeling that improves after coughing up phlegm. Is this normal?

Patient: I have no new fever and the cough is slowly improving.

Patient: Two weeks later I have a new fever and the cough and chest pain are worse.


Patient: I had lumbar surgery 4 months ago for stenosis and discectomy. My left foot has had intermittent numbness since surgery. What should I do?


Patient: I had lumbar surgery 4 months ago for stenosis and discectomy. My left foot has had intermittent numbness since surgery. What should I do?

Patient: In the last 2 weeks my right foot has also become numb, and I have right hip and knee pain.


Patient: I had lumbar surgery 4 months ago for stenosis and discectomy. My left foot has had intermittent numbness since surgery. What should I do?

Patient: In the last 2 weeks my right foot has also become numb, and I have right hip and knee pain.

Patient: The numbness is still intermittent, but I am worried because I am usually active.


Patient: I am 21 and have had chilblains for 10 years. In winter my fingers and toes become swollen and itchy. Is this from a deficiency, and what medicine should I take?


Patient: I am 21 and have had chilblains for 10 years. In winter my fingers and toes become swollen and itchy. Is this from a deficiency, and what medicine should I take?

Patient: So I do not need vitamins for this?


Patient: I am 21 and have had chilblains for 10 years. In winter my fingers and toes become swollen and itchy. Is this from a deficiency, and what medicine should I take?

Patient: So I do not need vitamins for this?

Patient: It happens every winter, but right now it is just swelling and itching.


Patient: For about 3.5 weeks, bright lights give me mild headaches. My nearsightedness is a little worse and focusing sometimes takes longer. I saw an optometrist and ophthalmologist, and they found no eye damage. I do not see black or white spots.


Patient: For about 3.5 weeks, bright lights give me mild headaches. My nearsightedness is a little worse and focusing sometimes takes longer. I saw an optometrist and ophthalmologist, and they found no eye damage. I do not see black or white spots.

Patient: I work outside all day, and street lights at night also bother me.


Patient: For about 3.5 weeks, bright lights give me mild headaches. My nearsightedness is a little worse and focusing sometimes takes longer. I saw an optometrist and ophthalmologist, and they found no eye damage. I do not see black or white spots.

Patient: I work outside all day, and street lights at night also bother me.

Patient: Now I see a new black spot in my vision.


Patient: I had an ingrown toenail removed and was told the toe was infected. I took antibiotics for 5 days, but the tip of my big toe still hurts.


Patient: I had an ingrown toenail removed and was told the toe was infected. I took antibiotics for 5 days, but the tip of my big toe still hurts.

Patient: Now just the tip of the toe has turned purple. It looks unhealthy and hurts to touch.


Patient: I had an ingrown toenail removed and was told the toe was infected. I took antibiotics for 5 days, but the tip of my big toe still hurts.

Patient: Now just the tip of the toe has turned purple. It looks unhealthy and hurts to touch.

Patient: The purple area is still there and the toe is more painful.


Patient: I had a gallbladder surgery two years ago that injured my bile duct. I later had liver infection and reconstruction surgery, and I have been fine since. But now I have these spots.


Patient: I had a gallbladder surgery two years ago that injured my bile duct. I later had liver infection and reconstruction surgery, and I have been fine since. But now I have these spots.

Patient: They are small skin spots only. I do not have fever, jaundice, abdominal pain, dark urine, or vomiting.


Patient: I had a gallbladder surgery two years ago that injured my bile duct. I later had liver infection and reconstruction surgery, and I have been fine since. But now I have these spots.

Patient: They are small skin spots only. I do not have fever, jaundice, abdominal pain, dark urine, or vomiting.

Patient: Now I have fever and my eyes look yellow.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: My MRI shows disc bulge with mild to moderate compression around L4-L5. I have difficulty sitting or walking more than 15 minutes. My spine surgeon advised medicine and physiotherapy. What else should I do?


Patient: My MRI shows disc bulge with mild to moderate compression around L4-L5. I have difficulty sitting or walking more than 15 minutes. My spine surgeon advised medicine and physiotherapy. What else should I do?

Patient: I have been doing physiotherapy, but the pain still persists and is limiting sitting and walking.


Patient: My MRI shows disc bulge with mild to moderate compression around L4-L5. I have difficulty sitting or walking more than 15 minutes. My spine surgeon advised medicine and physiotherapy. What else should I do?

Patient: I have been doing physiotherapy, but the pain still persists and is limiting sitting and walking.

Patient: I have now developed numbness and some weakness in my leg.


Patient: My wife took an emergency contraceptive pill. Since then her periods are irregular, and she has not had a period for about one and a half months.


Patient: My wife took an emergency contraceptive pill. Since then her periods are irregular, and she has not had a period for about one and a half months.

Patient: She also has weight loss, headache, body pain, tiredness, weakness, and had blood clots during the last period.


Patient: My wife took an emergency contraceptive pill. Since then her periods are irregular, and she has not had a period for about one and a half months.

Patient: She also has weight loss, headache, body pain, tiredness, weakness, and had blood clots during the last period.

Patient: We also want to know what diet and routine can make her look fresh again.


Patient: I keep getting little twinges in my chest and I am under a lot of stress. I have a cardiology referral, but I am not sure if this should be urgent today.


Patient: I keep getting little twinges in my chest and I am under a lot of stress. I have a cardiology referral, but I am not sure if this should be urgent today.

Patient: The twinge was there when I woke up this afternoon after sleeping late, but it is gone now. It has been intermittent for a few weeks and has not clearly become more frequent or intense. I do not have shortness of breath or sweating right now.


Patient: I keep getting little twinges in my chest and I am under a lot of stress. I have a cardiology referral, but I am not sure if this should be urgent today.

Patient: The twinge was there when I woke up this afternoon after sleeping late, but it is gone now. It has been intermittent for a few weeks and has not clearly become more frequent or intense. I do not have shortness of breath or sweating right now.

Patient: It just came back and now it feels tighter and is happening more often than before. I also feel a little short of breath.


Patient: I was in the hospital for pneumonia for 3 days on IV antibiotics. Since discharge I have more back pain and chest tight pain. Can I keep taking Hifenac-MR because it gives immediate relief?


Patient: I was in the hospital for pneumonia for 3 days on IV antibiotics. Since discharge I have more back pain and chest tight pain. Can I keep taking Hifenac-MR because it gives immediate relief?

Patient: I do not have fever or worsening cough. I can breathe normally. The back pain feels stiff and gets better quickly after I take the medicine.


Patient: I was in the hospital for pneumonia for 3 days on IV antibiotics. Since discharge I have more back pain and chest tight pain. Can I keep taking Hifenac-MR because it gives immediate relief?

Patient: I do not have fever or worsening cough. I can breathe normally. The back pain feels stiff and gets better quickly after I take the medicine.

Patient: Now the chest tightness is worse and I feel short of breath when walking around the room.


Patient: I was bitten by a copperhead and got antivenom in the ER. I was discharged a few days ago, but the swelling still has not gone down and it is itchy and sore. Should I wait?


Patient: I was bitten by a copperhead and got antivenom in the ER. I was discharged a few days ago, but the swelling still has not gone down and it is itchy and sore. Should I wait?

Patient: No eyelid drooping, no numbness, and no bleeding. It is mainly swelling, soreness, and itching.


Patient: I was bitten by a copperhead and got antivenom in the ER. I was discharged a few days ago, but the swelling still has not gone down and it is itchy and sore. Should I wait?

Patient: No eyelid drooping, no numbness, and no bleeding. It is mainly swelling, soreness, and itching.

Patient: Today I started feeling numbness around the bitten area and I noticed bleeding from my nose.


Patient: My 3.5-year-old son had his first bite of shrimp and now there are some bumps near his mouth. What should I watch for?


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: My 3.5-year-old son had his first bite of shrimp and now there are some bumps near his mouth. What should I watch for?

Patient: There is swelling and pimple-like blotches at the corner of his cheek and mouth. He is not saying it bothers him and he is breathing normally.


Patient: My 3.5-year-old son had his first bite of shrimp and now there are some bumps near his mouth. What should I watch for?

Patient: There is swelling and pimple-like blotches at the corner of his cheek and mouth. He is not saying it bothers him and he is breathing normally.

Patient: Now his lips look more swollen and the rash is spreading.


Patient: My 10-year-old has chickenpox and some spots look wet or open. Is that normal?


Patient: My 10-year-old has chickenpox and some spots look wet or open. Is that normal?

Patient: A few spots bled after she scratched them, but there is no pus, no spreading redness, and no fever.


Patient: My 10-year-old has chickenpox and some spots look wet or open. Is that normal?

Patient: A few spots bled after she scratched them, but there is no pus, no spreading redness, and no fever.

Patient: One area now looks like an open sore and is wet, with little blisters around it.


Patient: My one-year-old has one side of his nose blocked. Should I ask about surgery or something to open the nose?


Patient: My one-year-old has one side of his nose blocked. Should I ask about surgery or something to open the nose?

Patient: He is 1 year old and weighs 11 kg. The right side of his nose seems completely blocked, watery fluid comes from his mouth, eyes, and nose, and during sleep he has difficulty breathing with a voice from his chest.


Patient: My one-year-old has one side of his nose blocked. Should I ask about surgery or something to open the nose?

Patient: He is 1 year old and weighs 11 kg. The right side of his nose seems completely blocked, watery fluid comes from his mouth, eyes, and nose, and during sleep he has difficulty breathing with a voice from his chest.

Patient: Tonight he is struggling to breathe and cannot feed normally.


Patient: My 4-year-old has had cold and cough for 15 days. The doctor said bronchitis. What precautions should we take?


Patient: My 4-year-old has had cold and cough for 15 days. The doctor said bronchitis. What precautions should we take?

Patient: The cough keeps coming back after a few days of medicine and it is worse at night, but he is not struggling to breathe right now.


Patient: My 4-year-old has had cold and cough for 15 days. The doctor said bronchitis. What precautions should we take?

Patient: The cough keeps coming back after a few days of medicine and it is worse at night, but he is not struggling to breathe right now.

Patient: Now he is wheezing and seems to be having trouble breathing.


Patient: I was stung by a wasp and the area got swollen and itchy. Now the skin is turning kind of purple. I also got stung again on my foot and it itches badly.


Patient: I was stung by a wasp and the area got swollen and itchy. Now the skin is turning kind of purple. I also got stung again on my foot and it itches badly.

Patient: It is only around the sting areas, but the arm area widened over the first few days, was hot to the touch, and now looks purplish. The foot sting itches badly. I still have no breathing trouble, no hives away from the stings, and no face, mouth, or throat swelling.


Patient: I was stung by a wasp and the area got swollen and itchy. Now the skin is turning kind of purple. I also got stung again on my foot and it itches badly.

Patient: It is only around the sting areas, but the arm area widened over the first few days, was hot to the touch, and now looks purplish. The foot sting itches badly. I still have no breathing trouble, no hives away from the stings, and no face, mouth, or throat swelling.

Patient: Now I have hives away from the sting and my mouth feels swollen.


Patient: I am 21 weeks pregnant and I get a dull pain on my right side when I breathe, change sides while sleeping, or press the area. Why is that?


Patient: I am 21 weeks pregnant and I get a dull pain on my right side when I breathe, change sides while sleeping, or press the area. Why is that?

Patient: No fever, no burning urination, no bleeding. The pain is dull and happens when I press the side or move in bed.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I am 21 weeks pregnant and I get a dull pain on my right side when I breathe, change sides while sleeping, or press the area. Why is that?

Patient: No fever, no burning urination, no bleeding. The pain is dull and happens when I press the side or move in bed.

Patient: Now I also have fever, back pain, and burning when I pass urine.


Patient: I have lupus SLE and started Herbalife cleansing products, green tea, meal formula, multivitamin, and cell activator. Now I am very itchy. Is this cleansing or allergy?


Patient: I have lupus SLE and started Herbalife cleansing products, green tea, meal formula, multivitamin, and cell activator. Now I am very itchy. Is this cleansing or allergy?

Patient: I am very itchy, but I do not have swollen lips and I can breathe normally.


Patient: I have lupus SLE and started Herbalife cleansing products, green tea, meal formula, multivitamin, and cell activator. Now I am very itchy. Is this cleansing or allergy?

Patient: I am very itchy, but I do not have swollen lips and I can breathe normally.

Patient: My lips are swelling and I am starting to have trouble breathing.


Patient: I had a CT and MRI after ER dizziness and headache, and they found a 1 cm pineal cyst. I am scared and still dizzy.


Patient: I had a CT and MRI after ER dizziness and headache, and they found a 1 cm pineal cyst. I am scared and still dizzy.

Patient: The dizziness is still horrible, but I am not confused and I am not vomiting. I have a neurosurgeon appointment on the 16th.


Patient: I had a CT and MRI after ER dizziness and headache, and they found a 1 cm pineal cyst. I am scared and still dizzy.

Patient: The dizziness is still horrible, but I am not confused and I am not vomiting. I have a neurosurgeon appointment on the 16th.

Patient: Now my headache and nausea are worse and I vomited twice. I also feel confused.


Patient: I had diskitis from tuberculosis in May and have been treated since then. Can I go back to the gym?


Patient: I had diskitis from tuberculosis in May and have been treated since then. Can I go back to the gym?

Patient: It has been about five months of treatment and all parameters are okay. I do not have new pain now.


Patient: I had diskitis from tuberculosis in May and have been treated since then. Can I go back to the gym?

Patient: It has been about five months of treatment and all parameters are okay. I do not have new pain now.

Patient: After trying heavier exercise, I developed back pain again.


Patient: My top lip started itching after I ate crabs with butter, then I got tiny bumps and dryness. Now it looks like carpet burn and is a little bigger than the bottom lip.


Patient: My top lip started itching after I ate crabs with butter, then I got tiny bumps and dryness. Now it looks like carpet burn and is a little bigger than the bottom lip.

Patient: It is just my top lip. It is dry and itchy and slightly bigger, but no trouble breathing and no tongue or throat swelling.


Patient: My top lip started itching after I ate crabs with butter, then I got tiny bumps and dryness. Now it looks like carpet burn and is a little bigger than the bottom lip.

Patient: It is just my top lip. It is dry and itchy and slightly bigger, but no trouble breathing and no tongue or throat swelling.

Patient: It still has not come under control and the lip irritation is getting worse.


Patient: My appendix was removed 20 years ago, but now I have slight pain and burning in that area. Ultrasounds found nothing and it is getting worse.


Patient: My appendix was removed 20 years ago, but now I have slight pain and burning in that area. Ultrasounds found nothing and it is getting worse.

Patient: No fever, no vomiting, no blood in stool, and my abdomen is not rigid. The pain worsens after sunflower seeds or beer, and ultrasound did not show anything.


Patient: My appendix was removed 20 years ago, but now I have slight pain and burning in that area. Ultrasounds found nothing and it is getting worse.

Patient: No fever, no vomiting, no blood in stool, and my abdomen is not rigid. The pain worsens after sunflower seeds or beer, and ultrasound did not show anything.

Patient: Now I have fever, nausea, and my abdomen feels hard and rigid.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: My 2-year-6-month-old has headaches maybe twice a month. She says the forehead aches, sweats a lot, feels like vomiting, and gets very tired.


Patient: My 2-year-6-month-old has headaches maybe twice a month. She says the forehead aches, sweats a lot, feels like vomiting, and gets very tired.

Patient: Each episode lasts a few hours, she feels like vomiting but does not vomit continuously, and she has no seizures, no ear or nose discharge, and no unconsciousness or behavior change.


Patient: My 2-year-6-month-old has headaches maybe twice a month. She says the forehead aches, sweats a lot, feels like vomiting, and gets very tired.

Patient: Each episode lasts a few hours, she feels like vomiting but does not vomit continuously, and she has no seizures, no ear or nose discharge, and no unconsciousness or behavior change.

Patient: This time she is vomiting continuously and acting confused.


Patient: I have fibromyalgia and RA. Today I started having right-sided chest tightening and later felt short of breath. Now it is sharp and goes to my right shoulder blade.


Patient: I have fibromyalgia and RA. Today I started having right-sided chest tightening and later felt short of breath. Now it is sharp and goes to my right shoulder blade.

Patient: It is worse when I move the arm and when I breathe. It has stayed about the same since 6 pm, and I cannot lift my arm past shoulder height.


Patient: I have fibromyalgia and RA. Today I started having right-sided chest tightening and later felt short of breath. Now it is sharp and goes to my right shoulder blade.

Patient: It is worse when I move the arm and when I breathe. It has stayed about the same since 6 pm, and I cannot lift my arm past shoulder height.

Patient: The shortness of breath is now severe and I feel faint.


Patient: A condom broke about a month and a half ago and I took morning-after pills 36 hours later. I still have breast soreness, cramps, and my vagina feels different. Could I be pregnant?


Patient: A condom broke about a month and a half ago and I took morning-after pills 36 hours later. I still have breast soreness, cramps, and my vagina feels different. Could I be pregnant?

Patient: I bled for six days a few days after taking the pills, then nearly a month later I got my period again. Home pregnancy tests are negative, and it has been a month and 18 days since sex.


Patient: A condom broke about a month and a half ago and I took morning-after pills 36 hours later. I still have breast soreness, cramps, and my vagina feels different. Could I be pregnant?

Patient: I bled for six days a few days after taking the pills, then nearly a month later I got my period again. Home pregnancy tests are negative, and it has been a month and 18 days since sex.

Patient: My period is still a little irregular this cycle, but the pregnancy tests remain negative.


Patient: I had unprotected sex the day before my period started. Now I have backache, breast soreness, and sticky egg-white discharge. Am I pregnant?


Patient: I had unprotected sex the day before my period started. Now I have backache, breast soreness, and sticky egg-white discharge. Am I pregnant?

Patient: Yes, my period started the next day and lasted four days like normal. The pregnancy test before that period was negative. Now it is day 13 from when the period started.


Patient: I had unprotected sex the day before my period started. Now I have backache, breast soreness, and sticky egg-white discharge. Am I pregnant?

Patient: Yes, my period started the next day and lasted four days like normal. The pregnancy test before that period was negative. Now it is day 13 from when the period started.

Patient: I still feel worried because my periods are irregular from mild PCOS.


Patient: I am 23 and my penis gets erect but not hard enough for sex, and I ejaculate within 10 to 15 seconds. I am very tense about my future sex life.


Patient: I am 23 and my penis gets erect but not hard enough for sex, and I ejaculate within 10 to 15 seconds. I am very tense about my future sex life.

Patient: It has been happening repeatedly. I smoke regularly, drink occasionally, used to watch a lot of porn, and now I avoid sex because I am tense.


Patient: I am 23 and my penis gets erect but not hard enough for sex, and I ejaculate within 10 to 15 seconds. I am very tense about my future sex life.

Patient: It has been happening repeatedly. I smoke regularly, drink occasionally, used to watch a lot of porn, and now I avoid sex because I am tense.

Patient: I feel less interested in sex day by day because I am worried it will keep happening.


Patient: I recently tested positive for HIV, but I do not understand how I got it because I used condoms. Could something mimic HIV in tests?


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I recently tested positive for HIV, but I do not understand how I got it because I used condoms. Could something mimic HIV in tests?

Patient: My viral load was 160k and my CD4 count was 145. I have not started treatment yet.


Patient: I recently tested positive for HIV, but I do not understand how I got it because I used condoms. Could something mimic HIV in tests?

Patient: My viral load was 160k and my CD4 count was 145. I have not started treatment yet.

Patient: I still do not have symptoms, so I wondered if I can wait and retest later.


Patient: I have some dark circles appearing on my body and my blood has some problem. I get PT and INR tests regularly.


Patient: I have some dark circles appearing on my body and my blood has some problem. I get PT and INR tests regularly.

Patient: I do not have calf pain or swelling, chest pain, or shortness of breath. I just know I am being treated and monitored with PT and INR.


Patient: I have some dark circles appearing on my body and my blood has some problem. I get PT and INR tests regularly.

Patient: I do not have calf pain or swelling, chest pain, or shortness of breath. I just know I am being treated and monitored with PT and INR.

Patient: Now one calf is painful and swollen, and I am short of breath with chest pain.


Patient: I am an 18-year-old female. I have had a cold with chest pain, fatigue, and some difficulty breathing for three days. I had pneumonia last year and I am scared this could be pneumonia again. Should I be concerned?


Patient: I am an 18-year-old female. I have had a cold with chest pain, fatigue, and some difficulty breathing for three days. I had pneumonia last year and I am scared this could be pneumonia again. Should I be concerned?

Patient: I do have fever, I feel short of breath when walking around, and I am coughing up yellow phlegm. The chest discomfort is still there.


Patient: I am an 18-year-old female. I have had a cold with chest pain, fatigue, and some difficulty breathing for three days. I had pneumonia last year and I am scared this could be pneumonia again. Should I be concerned?

Patient: I do have fever, I feel short of breath when walking around, and I am coughing up yellow phlegm. The chest discomfort is still there.

Patient: I started the medicines I was given, but the fever and breathing symptoms are not improving.


Patient: I have sinus problems and use a neti pot. Yesterday I ran out of unopened water bottles and used water from a bottle my boyfriend had been drinking from. Am I in danger?


Patient: I have sinus problems and use a neti pot. Yesterday I ran out of unopened water bottles and used water from a bottle my boyfriend had been drinking from. Am I in danger?

Patient: It has been a day and I still do not have fever, worsening congestion, facial pain, or discharge. I just feel anxious about it.


Patient: I have sinus problems and use a neti pot. Yesterday I ran out of unopened water bottles and used water from a bottle my boyfriend had been drinking from. Am I in danger?

Patient: It has been a day and I still do not have fever, worsening congestion, facial pain, or discharge. I just feel anxious about it.

Patient: Now I have worsening sinus pressure, thick yellow discharge, and fever after that rinse.


Patient: I am 21 and have had chilblains every winter for about 10 years. My fingers and toes swell and itch. Is this from a vitamin deficiency? What medicine should I take?


Patient: I am 21 and have had chilblains every winter for about 10 years. My fingers and toes swell and itch. Is this from a vitamin deficiency? What medicine should I take?

Patient: This winter the swelling and itching are the same as usual. There are no sores, pus, fever, or color change that stays after warming.


Patient: I am 21 and have had chilblains every winter for about 10 years. My fingers and toes swell and itch. Is this from a vitamin deficiency? What medicine should I take?

Patient: This winter the swelling and itching are the same as usual. There are no sores, pus, fever, or color change that stays after warming.

Patient: One toe now has a painful sore that is not healing, and the area is more swollen than my usual chilblains.


Patient: I want to try LSD out of curiosity. I know the risks and I do not have depression or a family history of mental illness. Could I do anything to be safer?


Patient: I want to try LSD out of curiosity. I know the risks and I do not have depression or a family history of mental illness. Could I do anything to be safer?

Patient: If I go to my GP and explain that I want to try it, could they prescribe one antipsychotic pill just in case I have a bad trip?


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I want to try LSD out of curiosity. I know the risks and I do not have depression or a family history of mental illness. Could I do anything to be safer?

Patient: If I go to my GP and explain that I want to try it, could they prescribe one antipsychotic pill just in case I have a bad trip?

Patient: I ended up taking LSD yesterday. I am still confused, frightened, and not thinking normally many hours later.


Patient: I have had a tickly dry cough since yesterday with some nasal congestion. I am going on vacation and want a suitable medicine.


Patient: I have had a tickly dry cough since yesterday with some nasal congestion. I am going on vacation and want a suitable medicine.

Patient: Today I have some body aches and a mild fever, but I am breathing normally and the cough is still dry.


Patient: I have had a tickly dry cough since yesterday with some nasal congestion. I am going on vacation and want a suitable medicine.

Patient: Today I have some body aches and a mild fever, but I am breathing normally and the cough is still dry.

Patient: It has now been four days and the cough and congestion are not improving.


Patient: My left eye touched the wall and became red. When I try to close it, I feel a little pain in the left corner. What medicine can I take now?


Patient: My left eye touched the wall and became red. When I try to close it, I feel a little pain in the left corner. What medicine can I take now?

Patient: After rinsing, the redness is still there but my vision is normal. The pain is mild and only at the corner when I blink.


Patient: I have had a cough for almost eight days. It is not frequent and I have no fever. Sometimes I feel like something is in my throat. Could it be COVID-19?


Patient: I have had a cough for almost eight days. It is not frequent and I have no fever. Sometimes I feel like something is in my throat. Could it be COVID-19?

Patient: No recent travel and no known exposure. I still do not have fever or trouble breathing.


Patient: I have had a cough for almost eight days. It is not frequent and I have no fever. Sometimes I feel like something is in my throat. Could it be COVID-19?

Patient: No recent travel and no known exposure. I still do not have fever or trouble breathing.

Patient: Now I have developed a fever and I am starting to feel short of breath with the cough.


Patient: I am 14. Last week I had bad pain around my tonsils and a doctor said they were infected, but I was not given medication. Now they still hurt.


Patient: I am 14. Last week I had bad pain around my tonsils and a doctor said they were infected, but I was not given medication. Now they still hurt.

Patient: Now I have a really bad cough. When I cough, my tonsils and chest hurt, but I have not had blood or breathing trouble yet.


Patient: I am 14. Last week I had bad pain around my tonsils and a doctor said they were infected, but I was not given medication. Now they still hurt.

Patient: Now I have a really bad cough. When I cough, my tonsils and chest hurt, but I have not had blood or breathing trouble yet.

Patient: Last night I had a coughing fit where I could not breathe and I coughed up blood. When I sleep it feels like someone is pressing on my chest, it is hard to breathe, and it is hard to swallow. My mom says I look pale.


Patient: I was hit on the right side of my neck with a basketball. Part of it hit my chin. I have mild neck pain and mild shortness of breath, but no wheezing or hoarseness. My pulse oximeter and peak flow are normal. Should I go to the ER now or can I wait for ENT?


Patient: I was hit on the right side of my neck with a basketball. Part of it hit my chin. I have mild neck pain and mild shortness of breath, but no wheezing or hoarseness. My pulse oximeter and peak flow are normal. Should I go to the ER now or can I wait for ENT?

Patient: I checked. There is no swelling, no crackling feeling, no hoarseness, no trouble swallowing, no blood when I cough, and the shortness of breath has settled. It just feels mildly sore.


Patient: I was hit on the right side of my neck with a basketball. Part of it hit my chin. I have mild neck pain and mild shortness of breath, but no wheezing or hoarseness. My pulse oximeter and peak flow are normal. Should I go to the ER now or can I wait for ENT?

Patient: I checked. There is no swelling, no crackling feeling, no hoarseness, no trouble swallowing, no blood when I cough, and the shortness of breath has settled. It just feels mildly sore.

Patient: A few hours later my voice became hoarse and my breathing feels worse. The side of my neck also looks swollen.


Patient: I am 45 and have diabetes. My fasting blood sugar is usually 140 to 150. My urine test shows infection with plenty of pus cells. What should I do to control the urine infection?


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I am 45 and have diabetes. My fasting blood sugar is usually 140 to 150. My urine test shows infection with plenty of pus cells. What should I do to control the urine infection?

Patient: I have burning urination but no fever, chills, back pain, vomiting, or weakness. I am otherwise okay.


Patient: I am 45 and have diabetes. My fasting blood sugar is usually 140 to 150. My urine test shows infection with plenty of pus cells. What should I do to control the urine infection?

Patient: I have burning urination but no fever, chills, back pain, vomiting, or weakness. I am otherwise okay.

Patient: Now I have fever and shivering and I feel generally unwell.


Patient: My dad had an angioplasty one month ago. Now he gets short of breath and numbness in his hands when he walks, but otherwise he is normal. He takes Concor, Ascard, Lipiget, and Brilanta. Please help.


Patient: My dad had an angioplasty one month ago. Now he gets short of breath and numbness in his hands when he walks, but otherwise he is normal. He takes Concor, Ascard, Lipiget, and Brilanta. Please help.

Patient: He has no foot swelling, no cough, and no difficulty breathing when lying down. The shortness of breath only happens during walks.


Patient: My dad had an angioplasty one month ago. Now he gets short of breath and numbness in his hands when he walks, but otherwise he is normal. He takes Concor, Ascard, Lipiget, and Brilanta. Please help.

Patient: He has no foot swelling, no cough, and no difficulty breathing when lying down. The shortness of breath only happens during walks.

Patient: Now he also has swelling in his feet and gets breathless when lying down.


Patient: I have had a sore throat since yesterday with a slight fever of 37.4 C. I suspect my tonsil is swollen. I gargled warm salt water and took paracetamol if needed.


Patient: I had sex for the first time and then did not get my period. A gynecologist took a blood sample and it was negative, but my period is still a week late. What could be the reason?


Patient: I have pain in my jaw, but I also typed that quickly and I am not sure it explains the problem.


Patient: I have pain in my jaw, but I also typed that quickly and I am not sure it explains the problem.

Patient: The bigger issue is that my left arm has been numb for about two weeks and it is getting worse. I have tingling in my second, third, and fourth fingers, mild weakness when holding things and playing piano, and I had a 20-minute disturbance in my left peripheral vision two weeks ago. My walking is normal and I have no fits.


Patient: I have really bad diarrhea and I am confused about what to do.


Patient: I have really bad diarrhea and I am confused about what to do.

Patient: It has been three days. I go about four to five times a day, watery or loose. I had mild abdominal pain and vomited once, but I can still eat and drink. No blood, no mucus, no fever, no travel, and I do not feel dehydrated.


Patient: I am having chest discomfort.


Patient: I am having chest discomfort.

Patient: It started suddenly about two hours ago while I was gardening. It is pressure in the middle or left side of my chest, like someone is sitting on my chest, about 7 out of 10, and it is still there.


Patient: I am having chest discomfort.

Patient: It started suddenly about two hours ago while I was gardening. It is pressure in the middle or left side of my chest, like someone is sitting on my chest, about 7 out of 10, and it is still there.

Patient: It also goes into my left shoulder and arm, and I feel nauseated and short of breath. I have high blood pressure and high cholesterol.


Patient: I am feeling short of breath.


Patient: I am feeling short of breath.

Patient: It started suddenly over the last hour while I was watching TV. I had a C-section about four weeks ago. I also feel my heart racing.


Patient: I am feeling short of breath.

Patient: It started suddenly over the last hour while I was watching TV. I had a C-section about four weeks ago. I also feel my heart racing.

Patient: My heart rate feels about 120. My mother has had clots in her legs. I do not have fever and the baby is fine.


Patient: I am wheezy.


Patient: I am wheezy.

Patient: It started after I cleaned a dusty room two days ago. It has gradually worsened, especially at night. I had asthma as a child and hay fever, but I am still able to speak normally.


You are a careful patient-facing medical assistant. Respond to the patient's current message using only the information available in the conversation. Ask targeted questions if needed, give self-care advice when appropriate, and recommend nonurgent or urgent care when warranted.

Patient: I am wheezy.

Patient: It started after I cleaned a dusty room two days ago. It has gradually worsened, especially at night. I had asthma as a child and hay fever, but I am still able to speak normally.

Patient: Now I am short of breath and sometimes I cannot finish full sentences when talking.


Patient: I have a cold with cough and sore throat for about a week. I had to miss work and I am worried it could be something serious.


Patient: I have a cold with cough and sore throat for about a week. I had to miss work and I am worried it could be something serious.

Patient: It started as a sore throat and then a dry cough. No sputum, no blood, no chest pain, no asthma, no smoking, and no significant travel. I have mild shortness of breath only with activity, not at rest, and it is gradually improving.


Patient: I have a cold with cough and sore throat for about a week. I had to miss work and I am worried it could be something serious.

Patient: It started as a sore throat and then a dry cough. No sputum, no blood, no chest pain, no asthma, no smoking, and no significant travel. I have mild shortness of breath only with activity, not at rest, and it is gradually improving.

Patient: Five days later, it still is not better, although I do not have sudden severe shortness of breath or chest pain.


Patient: Lately I have not had much appetite or energy. Getting through the day has felt harder than usual.


Patient: Lately I have not had much appetite or energy. Getting through the day has felt harder than usual.

Patient: It has been about eight weeks. I struggle to get up in the morning, have low energy during the day, eat very little, sleep badly, feel low, and find it hard to focus. My sex drive is lower too. I do not have any thoughts of harming myself. I started a new job two months ago. I have hypothyroidism and take thyroxine.


Patient: My chest has been feeling tight today and I am worried it might be my breathing.


Patient: My chest has been feeling tight today and I am worried it might be my breathing.

Patient: It started about three hours ago. I am a little short of breath and wheezy, with a slight cough after a cold last week. I have asthma and usually use salbutamol and Clenil, but I forgot them while away and have barely used them this week.


Patient: My chest has been feeling tight today and I am worried it might be my breathing.

Patient: It started about three hours ago. I am a little short of breath and wheezy, with a slight cough after a cold last week. I have asthma and usually use salbutamol and Clenil, but I forgot them while away and have barely used them this week.

Patient: Since then my breathing has got worse. I feel short of breath even sitting still, I am wheezing more, and my salbutamol is not helping much.


Patient: I have had a really upset lower stomach for the last couple of days and I feel sick and sweaty.