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

Patient: It is a constant aching pain low in my abdomen. I feel nauseated but have not vomited. I feel hot and sweaty. I am urinating more than usual but it does not burn. I was constipated last week but that has settled. I am sexually active, have an implant, had some spotting, and my last period was about three and a half weeks ago.


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 noticed some blood in my stool and I have also been having abdominal pain, bloating, and gas. The pain is not constant, but I am concerned.


Patient: I have noticed some blood in my stool and I have also been having abdominal pain, bloating, and gas. The pain is not constant, but I am concerned.

Patient: It has been about a week. The blood is bright red and mostly on the toilet paper with a little streaking on the stool. The pain is mild cramping low in my belly with bloating. It did not come on suddenly. I do not feel lightheaded or dizzy, have not fallen, and do not have palpitations.


Patient: I have been having some bleeding after intercourse. It is not heavy, but it worries me. Could this be serious, and should I come in soon?


Patient: I have been having some bleeding after intercourse. It is not heavy, but it worries me. Could this be serious, and should I come in soon?

Patient: It has happened a few times over the last two weeks. My last period was about three weeks ago and I do not think I am pregnant. I do not have fever, pelvic pain, painful sex, abnormal discharge, odor, weight loss, or night sweats.


Patient: For weeks I have had trouble fully emptying my bladder and I get up to use the bathroom multiple times at night. It is disrupting my sleep.


Patient: For weeks I have had trouble fully emptying my bladder and I get up to use the bathroom multiple times at night. It is disrupting my sleep.

Patient: It is staying about the same. It does not burn, I do not see blood, and I do not have abdominal pain or a tight swollen lower belly. No new medicines, confusion, foamy urine, or new tingling or weakness.


Patient: I have been sneezing a lot and my lips are swollen and itchy. I am worried it might be an allergy.


Patient: I have been sneezing a lot and my lips are swollen and itchy. I am worried it might be an allergy.

Patient: It started after I was outside around pollen. My lips are mildly puffy and itchy, but my tongue and throat feel normal and I can breathe normally. I do not have a rash or swelling elsewhere. An antihistamine helped the sneezing a bit.


Patient: I have been sneezing a lot and my lips are swollen and itchy. I am worried it might be an allergy.

Patient: It started after I was outside around pollen. My lips are mildly puffy and itchy, but my tongue and throat feel normal and I can breathe normally. I do not have a rash or swelling elsewhere. An antihistamine helped the sneezing a bit.

Patient: Now my tongue feels swollen and I am having trouble catching my breath.


Patient: I have had diarrhea for a few weeks. It has been persistent, but I am not sure if it is worth coming in for a check-up.


Patient: I have had diarrhea for a few weeks. It has been persistent, but I am not sure if it is worth coming in for a check-up.

Patient: It is staying about the same. I have loose stools a few times a day and some gas, but no blood, fever, weight loss, dizziness, or falls. I have not traveled, taken antibiotics, or had C. diff before.


Patient: I have had diarrhea for a few weeks. It has been persistent, but I am not sure if it is worth coming in for a check-up.

Patient: It is staying about the same. I have loose stools a few times a day and some gas, but no blood, fever, weight loss, dizziness, or falls. I have not traveled, taken antibiotics, or had C. diff before.

Patient: Today there is blood in the stool and I feel lightheaded when I stand. I almost fell in the bathroom.


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

Patient: It has been four days. I do not have fever, trouble breathing, tongue swelling, facial pain, a new medication, one red eye, or pus-like drainage. I have asthma, but this does not feel like an asthma flare and I have not needed my inhaler.


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

Patient: It has been four days. I do not have fever, trouble breathing, tongue swelling, facial pain, a new medication, one red eye, or pus-like drainage. I have asthma, but this does not feel like an asthma flare and I have not needed my inhaler.

Patient: After taking a new medicine today, my tongue feels swollen and I am starting to have trouble breathing.


Patient: My arthritis flare-ups have become much worse and unpredictable. Some days I can barely move my joints because of pain and swelling. Rest and ice are not enough.


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 arthritis flare-ups have become much worse and unpredictable. Some days I can barely move my joints because of pain and swelling. Rest and ice are not enough.

Patient: It is mostly my knees and hands. It has been worsening over the past month. The joints are swollen and painful, but not red, hot, or draining anything. I do not have a fever. Ibuprofen and ice help only a little, and prednisone helped in the past.


Patient: I have been exhausted all the time and I get random sweating episodes out of nowhere. I am worried something might be wrong.


Patient: I have been exhausted all the time and I get random sweating episodes out of nowhere. I am worried something might be wrong.

Patient: It has been about three weeks and is slowly getting worse. I have not lost weight, do not have a fever, cough, rash, sick contacts, foreign travel, new medicines, pregnancy possibility, or joint swelling.


Patient: I have been exhausted all the time and I get random sweating episodes out of nowhere. I am worried something might be wrong.

Patient: It has been about three weeks and is slowly getting worse. I have not lost weight, do not have a fever, cough, rash, sick contacts, foreign travel, new medicines, pregnancy possibility, or joint swelling.

Patient: Today I developed a fever over 102 F, I feel confused, and I am short of breath walking across the room.


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


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

Patient: It has been three days and is about the same. It burns a little when I pee, and the urine is cloudy and smells bad. I do not have blood, back pain, swollen lower abdomen, fever, chills, nausea, vomiting, confusion, vaginal discharge, lesions, ulcers, a new sexual partner, or pregnancy possibility.


Patient: I am having a really tough time breathing through my nose because it is congested and stuffy. It has been on and off all day and nasal spray is not helping much.


Patient: I am having a really tough time breathing through my nose because it is congested and stuffy. It has been on and off all day and nasal spray is not helping much.

Patient: It is just my nose feeling blocked. I can breathe normally through my mouth and do not feel short of breath in my chest. It started today. I have no fever, COVID exposure, asthma symptoms, facial pain, tongue swelling, new medication, red eye, or eye drainage.


Patient: I am having a really tough time breathing through my nose because it is congested and stuffy. It has been on and off all day and nasal spray is not helping much.

Patient: It is just my nose feeling blocked. I can breathe normally through my mouth and do not feel short of breath in my chest. It started today. I have no fever, COVID exposure, asthma symptoms, facial pain, tongue swelling, new medication, red eye, or eye drainage.

Patient: After using a new nasal spray, my tongue started swelling and now I am having trouble catching my breath.


Patient: My periods have been pretty heavy lately with a lot of clotting, and I am also having mood swings and hot flashes. It has been going on for weeks and I am concerned.


Patient: My periods have been pretty heavy lately with a lot of clotting, and I am also having mood swings and hot flashes. It has been going on for weeks and I am concerned.

Patient: My last period started about a week ago. I am using about six pads a day, with clots, but I am not soaking a pad every hour. I do not feel lightheaded or dizzy and have not fallen. I do not have fever, abnormal discharge, pregnancy possibility, weight loss, night sweats, or blood in my urine.


Patient: I have weird sweating episodes on and off throughout the day, even when I am just sitting. I also feel warm even when the room is cool.


Patient: I have weird sweating episodes on and off throughout the day, even when I am just sitting. I also feel warm even when the room is cool.

Patient: It has been happening for about two weeks. I do not have chest pain, shortness of breath, palpitations, fever, dizziness, falls, vomiting, severe chills, headache, confusion, or pregnancy possibility.


Patient: I have weird sweating episodes on and off throughout the day, even when I am just sitting. I also feel warm even when the room is cool.

Patient: It has been happening for about two weeks. I do not have chest pain, shortness of breath, palpitations, fever, dizziness, falls, vomiting, severe chills, headache, confusion, or pregnancy possibility.

Patient: This episode is different. I am sweating heavily, my chest hurts, I feel short of breath, my heart is racing, and I feel lightheaded.


Patient: My nose is all stuffed up and I am having trouble breathing through it. Can you help?


Patient: My nose is all stuffed up and I am having trouble breathing through it. Can you help?

Patient: It is only nasal blockage. It has been three days. I can catch my breath fine and do not have fever, COVID exposure, asthma symptoms, facial pain, tongue swelling, new medication exposure, red eye, or pus-like drainage.


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 nose is all stuffed up and I am having trouble breathing through it. Can you help?

Patient: It is only nasal blockage. It has been three days. I can catch my breath fine and do not have fever, COVID exposure, asthma symptoms, facial pain, tongue swelling, new medication exposure, red eye, or pus-like drainage.

Patient: Now my tongue is swelling and I am having trouble catching my breath.


Patient: I am having clotting during my periods, and the bleeding has been quite heavy and painful on and off. It feels different from my usual rough periods, and I am worried it could be fibroids or hormonal changes.


Patient: I am having clotting during my periods, and the bleeding has been quite heavy and painful on and off. It feels different from my usual rough periods, and I am worried it could be fibroids or hormonal changes.

Patient: This has been going on for three cycles. My last period started five days ago. I use about five to six pads a day and pass clots, but I am not soaking a pad every hour. I do not feel dizzy or lightheaded and have not fallen. I do not have fever, abnormal discharge, pregnancy possibility, weight loss, night sweats, or pain with sex.


Patient: I have had pretty bad gas for weeks and it is getting uncomfortable. I do not know if I should worry or come in.


Patient: I have had pretty bad gas for weeks and it is getting uncomfortable. I do not know if I should worry or come in.

Patient: It is mostly bloating and passing gas. I started eating a lot more beans and protein bars. I do not have chest pain, reflux, blood in the stool, weight loss, watery or foul-smelling stool, dizziness, or falls. My bowel movements are otherwise normal.


Patient: I have had pretty bad gas for weeks and it is getting uncomfortable. I do not know if I should worry or come in.

Patient: It is mostly bloating and passing gas. I started eating a lot more beans and protein bars. I do not have chest pain, reflux, blood in the stool, weight loss, watery or foul-smelling stool, dizziness, or falls. My bowel movements are otherwise normal.

Patient: This time the discomfort has turned into chest pain, and I feel lightheaded when I stand up.


Patient: I have been having heartburn and diarrhea. Antacids are not helping much, and I feel like I am running to the bathroom all the time. Should I come in or manage it myself?


Patient: I have been having heartburn and diarrhea. Antacids are not helping much, and I feel like I am running to the bathroom all the time. Should I come in or manage it myself?

Patient: It has been about two weeks and is not improving. I have diarrhea about six times a day. There is no blood, weight loss, dizziness, falls, fever, foul smell, recent antibiotics, C. diff history, travel, pregnancy possibility, or incontinence.


Patient: I have shortness of breath even with everyday activities like walking or going up stairs, and I have also been having night sweats. I feel a bit more tired than usual.


Patient: I have shortness of breath even with everyday activities like walking or going up stairs, and I have also been having night sweats. I feel a bit more tired than usual.

Patient: It has been about a week. I am short of breath with stairs but not at rest. I do not have chest pain or palpitations. I had a DVT before and I am not on a blood thinner now. I have not had recent surgery or immobilization, and I do not notice leg swelling. My asthma inhaler has not helped much.


Patient: I have shortness of breath even with everyday activities like walking or going up stairs, and I have also been having night sweats. I feel a bit more tired than usual.

Patient: It has been about a week. I am short of breath with stairs but not at rest. I do not have chest pain or palpitations. I had a DVT before and I am not on a blood thinner now. I have not had recent surgery or immobilization, and I do not notice leg swelling. My asthma inhaler has not helped much.

Patient: Now I am short of breath even sitting still and I have chest pain when I breathe in.


Patient: I am 20 and have been taking the tuberculosis medicines my doctor prescribed for about 6 months. I have acne on my face now. Could this be from the TB medicine, and will it harm me later?


Patient: I am 20 and have been taking the tuberculosis medicines my doctor prescribed for about 6 months. I have acne on my face now. Could this be from the TB medicine, and will it harm me later?

Patient: I also noticed orange-colored urine and tears, but I do not have fever, vomiting, abdominal pain, or yellow eyes.


Patient: I am 20 and have been taking the tuberculosis medicines my doctor prescribed for about 6 months. I have acne on my face now. Could this be from the TB medicine, and will it harm me later?

Patient: I also noticed orange-colored urine and tears, but I do not have fever, vomiting, abdominal pain, or yellow eyes.

Patient: Now I have fever, vomiting, pain on the right side of my upper abdomen, and my eyes look yellow.


Patient: I put on new rubber gloves to wash dishes and my hands started itching with slight puffiness. I may have rubbed my face and got a similar mild reaction. I have several allergies and carry an EpiPen and Benadryl.


Patient: I put on new rubber gloves to wash dishes and my hands started itching with slight puffiness. I may have rubbed my face and got a similar mild reaction. I have several allergies and carry an EpiPen and Benadryl.

Patient: The itching is calming down after I took the gloves off. I do not have wheezing, throat tightness, chest pain, dizziness, or a racing heartbeat.


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 put on new rubber gloves to wash dishes and my hands started itching with slight puffiness. I may have rubbed my face and got a similar mild reaction. I have several allergies and carry an EpiPen and Benadryl.

Patient: The itching is calming down after I took the gloves off. I do not have wheezing, throat tightness, chest pain, dizziness, or a racing heartbeat.

Patient: Now I feel tightness in my throat and chest, I am short of breath, and I feel lightheaded after the glove reaction.


Patient: I am a 43-year-old woman. I was told kidney stones broke down into my bladder a couple of days ago. Now I have abdominal pain, lower back pain, pale stools, and constipation, but I cannot see my doctor for a couple more days.


Patient: I am a 43-year-old woman. I was told kidney stones broke down into my bladder a couple of days ago. Now I have abdominal pain, lower back pain, pale stools, and constipation, but I cannot see my doctor for a couple more days.

Patient: I still have pain and pale stools, but I am not vomiting, my belly is not swollen, and my eyes are not yellow.


Patient: I am a 43-year-old woman. I was told kidney stones broke down into my bladder a couple of days ago. Now I have abdominal pain, lower back pain, pale stools, and constipation, but I cannot see my doctor for a couple more days.

Patient: I still have pain and pale stools, but I am not vomiting, my belly is not swollen, and my eyes are not yellow.

Patient: Since then my eyes look yellow, my abdomen is more swollen, and I have started vomiting.


Patient: I had osteomyelitis a few months ago and had the top rib on my left side removed. The stitch area is oozing pus. My surgeon said the chest X-ray looked fine, but my GP thinks there may still be infection and took a swab.


Patient: I had osteomyelitis a few months ago and had the top rib on my left side removed. The stitch area is oozing pus. My surgeon said the chest X-ray looked fine, but my GP thinks there may still be infection and took a swab.

Patient: The drainage is still there, but I do not have a high fever and the pain is not severe.


Patient: I had osteomyelitis a few months ago and had the top rib on my left side removed. The stitch area is oozing pus. My surgeon said the chest X-ray looked fine, but my GP thinks there may still be infection and took a swab.

Patient: The drainage is still there, but I do not have a high fever and the pain is not severe.

Patient: Now I have a high fever and the surgery area is severely painful.


Patient: My 10-month-old has a dark purple line around his lips, like lip liner. He keeps getting temperatures over 38 C and has a painful chesty cough and wheeze. His oxygen levels were tested today and were fine.


Patient: My 10-month-old has a dark purple line around his lips, like lip liner. He keeps getting temperatures over 38 C and has a painful chesty cough and wheeze. His oxygen levels were tested today and were fine.

Patient: He is awake, feeding, not cold or clammy, and he is not pulling in around the ribs or struggling to breathe. It is just the line around the lips, and the doctor said his oxygen was okay today.


Patient: My 10-month-old has a dark purple line around his lips, like lip liner. He keeps getting temperatures over 38 C and has a painful chesty cough and wheeze. His oxygen levels were tested today and were fine.

Patient: He is awake, feeding, not cold or clammy, and he is not pulling in around the ribs or struggling to breathe. It is just the line around the lips, and the doctor said his oxygen was okay today.

Patient: Now his lips look blue, he is very sleepy and hard to wake, his skin feels cold and clammy, and he seems to be working hard to breathe.


Patient: My mother is 65 and has had rheumatoid arthritis for nine years. She is bedridden now. I want to know what treatment is advisable and whether we can get an urgent appointment.


Patient: I have been taking fluoxetine 20 mg for a week. I have stomach upset and headaches at times, and my lips are sore and peeling. Is the peeling a sign that something is wrong?


Patient: About a week ago I noticed a tiny flat dot on the inside tip of my 23-month-old daughter’s pointer finger. It was red last week and now it is dark purple or black. It is not going away. Should I be worried?


Patient: I am taking Cipro for my first UTI and I am on day 5. I am not running to the bathroom as much, but I still feel the urge to urinate and have pressure and weakness in my pelvic area and lower limbs. I planned to go back to my doctor Monday. Should I wait?


Patient: My 28-year-old friend had a seizure disorder years ago with a left frontal granuloma and edema on CT. He took Eptoin for 3 years and tapered it with his neurologist. Recently he has vague headaches and occasional giddiness. His blood work also showed impaired fasting glucose controlled by diet and exercise. Does he need a neurologist?


Patient: My 11-year-old has headaches every day for the past two weeks. Before the headache starts, she says her forehead feels like a nettle sting. Painkillers make it go away, but it keeps coming back. She is otherwise well.


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 11-year-old has headaches every day for the past two weeks. Before the headache starts, she says her forehead feels like a nettle sting. Painkillers make it go away, but it keeps coming back. She is otherwise well.

Patient: No. She has not vomited, had seizures, fainted, had ear or nose discharge, or acted confused. She is normal between headaches.


Patient: My 11-year-old has headaches every day for the past two weeks. Before the headache starts, she says her forehead feels like a nettle sting. Painkillers make it go away, but it keeps coming back. She is otherwise well.

Patient: No. She has not vomited, had seizures, fainted, had ear or nose discharge, or acted confused. She is normal between headaches.

Patient: Today she had a seizure and then became confused after the headache started.


Patient: My husband has a lump on the right side of his neck. FNAC says granulomatous lymphadenitis suggestive of tuberculosis in the right cervical lymph node, and ZN stain was done.


Patient: My husband has a lump on the right side of his neck. FNAC says granulomatous lymphadenitis suggestive of tuberculosis in the right cervical lymph node, and ZN stain was done.

Patient: He started the TB medicines. His urine looks red-orange, but he feels better and has no tingling, burning feet, or vision problems.


Patient: My husband has a lump on the right side of his neck. FNAC says granulomatous lymphadenitis suggestive of tuberculosis in the right cervical lymph node, and ZN stain was done.

Patient: He started the TB medicines. His urine looks red-orange, but he feels better and has no tingling, burning feet, or vision problems.

Patient: Now he has new blurred vision and burning in his feet after starting the TB medicines.


Patient: My front lower teeth are really sensitive and throbbing. My chest also feels tight and it is difficult to breathe. This started suddenly a couple of days ago. I know I grind my teeth and they are worn down. Please help.


Patient: My grandchildren were around a child today who might have MRSA. We did not know until after my daughter took the child home. We also have a 3-month-old baby in the house. Do we need to take them to a doctor?


Patient: My grandchildren were around a child today who might have MRSA. We did not know until after my daughter took the child home. We also have a 3-month-old baby in the house. Do we need to take them to a doctor?

Patient: No one has fever, cough, rash, boils, or skin sores right now, including the baby.


Patient: My grandchildren were around a child today who might have MRSA. We did not know until after my daughter took the child home. We also have a 3-month-old baby in the house. Do we need to take them to a doctor?

Patient: No one has fever, cough, rash, boils, or skin sores right now, including the baby.

Patient: The 3-month-old now has a fever and a red swollen spot on the skin after the exposure.


Patient: My 8-year-old grandson was jumping rope at school when he got a headache and then could not see the words on the page. The doctors were concerned and want him to see a neurologist as soon as possible. Is this a migraine?


Patient: My 8-year-old grandson was jumping rope at school when he got a headache and then could not see the words on the page. The doctors were concerned and want him to see a neurologist as soon as possible. Is this a migraine?

Patient: The vision problem went away, he is acting normally, and he has no vomiting, seizure, weakness, confusion, or trouble walking.


Patient: My 8-year-old grandson was jumping rope at school when he got a headache and then could not see the words on the page. The doctors were concerned and want him to see a neurologist as soon as possible. Is this a migraine?

Patient: The vision problem went away, he is acting normally, and he has no vomiting, seizure, weakness, confusion, or trouble walking.

Patient: The vision problem has not gone away and now he is vomiting and seems confused.


Patient: I am male and recently noticed a painful lump under my left nipple about the size of a quarter. I also have stomach pains that stop me from eating, and I feel full immediately with extreme pain. Please help.


Patient: I had surgery 5 months ago for scar tissue and adhesion removal. My gynecologist found a cyst on my right ovary. I still get severe cervical pain during sex, severe abdominal cramps afterward that make me lightheaded, rectal pain before and during bowel movements, and abdominal pain during urination. I am 26. What could it be?


Patient: I am recovering from jaundice due to hepatitis E. I was in the hospital for 5 days and now feel better. My total bilirubin is down to 5 and liver enzymes are around 1400. I am resting and taking Monolive, but Liv52 seems more famous. Should I change?


Patient: I think I may be having panic or anxiety attacks. I get a tight feeling in the back of my head that moves to my temples, throat, and chest. I get emotional, cannot catch my breath, and my heart beats fast. It goes away in 2 or 3 minutes if I sit and focus on breathing. A recent MRI and heart check were OK. Any ideas?


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 baby is 3 months old. She cannot sleep at night. She sleeps on our lap, but when we put her down in bed she wakes up. We checked whether her nose is blocked, but it is not. What can we do?


Patient: I have a history of kidney stones and recently passed another stone. Today I woke up in terrible pain, feel like I am going to vomit, feel very hot, and there is blood in my stool. Could this be another kidney stone?


Patient: My 30-year-old friend had two drops of phenol after mistaking it for milk. He vomited and drank a lot of salt water. Please advise about side effects.


Patient: My partner performed oral sex on me, and I am worried he might have trench mouth or acute necrotizing ulcerative gingivitis. He does not have bad breath and can eat normal food. Can someone have trench mouth without bad breath and still eat normally?


Patient: I am 18. For a few years my teeth have looked creamy or white, but the back parts look dark or black, and I often have bad breath. Whitening toothpaste has not helped. My mother has a similar problem. What should I do?


Patient: I am a 23-year-old woman. I have had shortness of breath for a week and it has not gone away. I feel like I have phlegm I cannot bring up, and there is heaviness on the right side of my chest going through to my back. I have been taking herbal cough medicine but it has not helped. I am worried about COVID and afraid to go to the hospital.


Patient: My lower-left wisdom tooth is coming in. I have enough space, it seems to be growing straight, and I do not have tooth pain. About half the tooth is out, but I cannot open my mouth fully. Should I worry?


Patient: My 9-month-old daughter has five brown marks. Two are about 2 cm and three are about 0.5 cm. The first two appeared when she was 3 months old, and three lighter ones appeared by 9 months. Are these birthmarks? Will they fade? Do we need precautions or medicine?


Patient: I just had an EGD with biopsy and polypectomy. It showed a 2 cm hiatal hernia, and the doctor said no cancer, but I have a past history of breast cancer. Today I have chest and sternum pain when I swallow. I am taking pantoprazole. Will this subside, what should I eat, and can I be assured this is not cancer?


Patient: I have a really bad headache.


Patient: I have a really bad headache.

Patient: It started yesterday morning when I woke up. It is mainly on the left side, throbbing, and comes and goes but never fully disappears. Light bothers me, but my vision is normal. I have no vomiting, weakness, numbness, rash, neck stiffness, feverish feeling, or cold symptoms. I do not usually get headaches. I took paracetamol only.


Patient: It hurts when I pee.


Patient: It hurts when I pee.

Patient: It has been six days. It burns and stings when I pass urine, and the urine smells strong. I have some lower tummy pain in the middle and a few spots of blood in the urine. I can pass urine. I do not have fever, back or loin pain, vomiting, or vaginal discharge.


Patient: I am feeling very anxious.


Patient: I am feeling very anxious.

Patient: It has been about two months and started after I began a new job. I dread going to work every morning. I sleep only about three or four hours, feel tired and low in energy, and I avoid things I used to enjoy like running, tennis, and seeing friends.


Patient: I am feeling very anxious.

Patient: It has been about two months and started after I began a new job. I dread going to work every morning. I sleep only about three or four hours, feel tired and low in energy, and I avoid things I used to enjoy like running, tennis, and seeing friends.

Patient: I have low mood most of the time but no thoughts of harming myself. I get palpitations that feel fast or irregular with some chest discomfort, lasting around 2 to 10 minutes, and they only started with the anxiety. I have not missed work. I drink on Friday and Saturday and sometimes overdo it, smoke occasionally, and do not use illicit drugs. My parents are supportive.


Patient: I have lower stomach pain.


Patient: I have lower stomach pain.

Patient: It is in the lower middle of my abdomen around/below the belly button. It has been getting worse and is constant, about 8 out of 10. I have some light vaginal bleeding and nausea. My last period was about two weeks ago. I am sexually active and have an implant. I do not feel faint, have no vomiting or diarrhea, no shoulder-tip pain, no feverish feeling, and no pain when peeing.


Patient: My tummy hurts.


Patient: My tummy hurts.

Patient: It has been two days. The pain is in the lower middle of my tummy. I feel a bit nauseated but have not vomited. I noticed a little pink blood in my urine. My temperature was 37 C. I do not have back pain, pain when passing urine, urinary frequency, blood in stool, or diarrhea.


Patient: I have diarrhea.


Patient: I have diarrhea.

Patient: It has been three days. It started watery and is still very loose, and I have gone at least four times today. I feel like I am running a temperature. I have been vomiting and cannot keep down water, tea, or other fluids. I last vomited about two hours ago. I am still urinating, last about an hour ago. There is no blood in the stool.


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 a stuffy nose and think it might be allergies. Should I just take Claritin?


Patient: I have a stuffy nose and think it might be allergies. Should I just take Claritin?

Patient: It started yesterday. I have no fever, no trouble breathing, no facial pain, and no known COVID exposure. I have not tested yet. I have not tried anything except saline spray, which helps a little.


Patient: I have a stuffy nose and think it might be allergies. Should I just take Claritin?

Patient: It started yesterday. I have no fever, no trouble breathing, no facial pain, and no known COVID exposure. I have not tested yet. I have not tried anything except saline spray, which helps a little.

Patient: Today I developed a fever of 101.8 F and now I feel short of breath when walking across the room.


Patient: I have been wheezing on and off today and my inhaler does not seem to help as much as usual. I am getting worried.


Patient: I have been wheezing on and off today and my inhaler does not seem to help as much as usual. I am getting worried.

Patient: It started this morning. I use a rescue inhaler and have used it more than usual. I can talk normally and I am not short of breath while sitting still, but walking up stairs makes me wheeze. I do not have chest pain, palpitations, fever, dizziness, swelling, recent surgery, or immobilization.


Patient: I have been wheezing on and off today and my inhaler does not seem to help as much as usual. I am getting worried.

Patient: It started this morning. I use a rescue inhaler and have used it more than usual. I can talk normally and I am not short of breath while sitting still, but walking up stairs makes me wheeze. I do not have chest pain, palpitations, fever, dizziness, swelling, recent surgery, or immobilization.

Patient: Now I am short of breath even sitting still, and I have tight chest pain with the wheezing.


Patient: I have had a runny nose on and off today. I do not have fever or sore throat. Is this a cold, allergies, or something else?


Patient: I have had a runny nose on and off today. I do not have fever or sore throat. Is this a cold, allergies, or something else?

Patient: It has only been one day. I have no trouble breathing, no facial pain, no known COVID exposure, and no fever. I have not tried medicine yet.


Patient: I have had a runny nose on and off today. I do not have fever or sore throat. Is this a cold, allergies, or something else?

Patient: It has only been one day. I have no trouble breathing, no facial pain, no known COVID exposure, and no fever. I have not tried medicine yet.

Patient: Since then I started feeling short of breath and I am wheezing when I walk around the house.


Patient: I have weird indigestion that comes out of nowhere. It is uncomfortable and scary. Should I come in?


Patient: I have weird indigestion that comes out of nowhere. It is uncomfortable and scary. Should I come in?

Patient: It feels like burning after meals and lasts about 20 minutes. I have no chest pressure, shortness of breath, palpitations, dizziness, vomiting, black stools, blood in stool, drooling, or painful swallowing. I am eating normally and have not lost weight.


Patient: I have weird indigestion that comes out of nowhere. It is uncomfortable and scary. Should I come in?

Patient: It feels like burning after meals and lasts about 20 minutes. I have no chest pressure, shortness of breath, palpitations, dizziness, vomiting, black stools, blood in stool, drooling, or painful swallowing. I am eating normally and have not lost weight.

Patient: This episode feels different. I now have pressure in the center of my chest, I feel short of breath, and I am lightheaded.


Patient: I am 67 and having what feels like really bad menstrual cramps, which is strange because I thought I was long past that. It has been going on for a few days and is getting worse, with heavy bleeding and sharp pains. Should I come in?


Patient: I am 67 and having what feels like really bad menstrual cramps, which is strange because I thought I was long past that. It has been going on for a few days and is getting worse, with heavy bleeding and sharp pains. Should I come in?

Patient: I am not dizzy or faint and have not fallen. I am not soaking pads rapidly. I do not have fever or abnormal discharge. I have not had a hysterectomy.


Patient: My urine is cloudy and smells bad, and I have pressure and pain in my pelvic area. I am worried and do not know what to do.


Patient: My urine is cloudy and smells bad, and I have pressure and pain in my pelvic area. I am worried and do not know what to do.

Patient: It has been two days and is about the same. It burns when I pee and I have pelvic pressure, but no fever, chills, vomiting, confusion, back pain, pregnancy possibility, blood in the urine, or new vaginal discharge or lesions.


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 urine is really dark, cloudy, and smells awful. It just started today and it is scaring me. Should I come in?


Patient: My urine is really dark, cloudy, and smells awful. It just started today and it is scaring me. Should I come in?

Patient: I have burning when I pee and some lower abdominal discomfort. I do not have fever, chills, back pain, vomiting, confusion, pregnancy possibility, vaginal discharge, or blood that I can see.


Patient: My joints and muscles are swollen and painful, and it is hard to move around. Pain relievers are not helping much. Can I come in to see you?


Patient: My joints and muscles are swollen and painful, and it is hard to move around. Pain relievers are not helping much. Can I come in to see you?

Patient: Both hands and knees have been swollen and painful for about a week. It is staying about the same. The joints are not red or hot, nothing is draining, and I do not have a fever. Ibuprofen has not helped much, and I am not taking prednisone. I have no new stool changes or blood in stool.


Patient: I think I might have food allergies. When I eat peanuts or shellfish, I get stomach cramps, my throat feels tight, and sometimes I get hives. Should I get tests?


Patient: I think I might have food allergies. When I eat peanuts or shellfish, I get stomach cramps, my throat feels tight, and sometimes I get hives. Should I get tests?

Patient: I am not having symptoms right now. It has happened after peanuts and shellfish. The hives are on my chest and arms. I have not gone to urgent care before, and I have no known medication trigger.


Patient: I think I might have food allergies. When I eat peanuts or shellfish, I get stomach cramps, my throat feels tight, and sometimes I get hives. Should I get tests?

Patient: I am not having symptoms right now. It has happened after peanuts and shellfish. The hives are on my chest and arms. I have not gone to urgent care before, and I have no known medication trigger.

Patient: I just ate shrimp by accident and now I have hives, my throat feels tight, and I am having trouble catching my breath.


Patient: I have urinary leakage and trouble starting urination on and off. It has been happening for a while and seems worse after coffee or citrus juice. What can I do?


Patient: I have urinary leakage and trouble starting urination on and off. It has been happening for a while and seems worse after coffee or citrus juice. What can I do?

Patient: It has been several months and is about the same. I can urinate, but it takes a few minutes to start. I sometimes leak when I have urgency, not usually with coughing or sneezing. No burning, blood, fever, chills, nausea, vomiting, pregnancy possibility, new medicines, or vaginal symptoms.


Patient: I have had a few episodes where I feel faint or actually faint, and I am worried. I am otherwise okay. Could this be blood pressure?


Patient: I have had a few episodes where I feel faint or actually faint, and I am worried. I am otherwise okay. Could this be blood pressure?

Patient: It has happened twice over the past month. I had a sweaty warning before passing out, did not hit my head or neck, and recovered quickly. I have no chest pain, shortness of breath, palpitations, fever, black or bloody stools, pregnancy possibility, or recent blood-pressure medicine change.


Patient: I have had a few episodes where I feel faint or actually faint, and I am worried. I am otherwise okay. Could this be blood pressure?

Patient: It has happened twice over the past month. I had a sweaty warning before passing out, did not hit my head or neck, and recovered quickly. I have no chest pain, shortness of breath, palpitations, fever, black or bloody stools, pregnancy possibility, or recent blood-pressure medicine change.

Patient: It just happened again, and this time I had chest pressure and shortness of breath before I fainted. I also hit my head when I fell.


Patient: I am scheduled to have separators placed tomorrow before braces, but I have a tooth infection after a deep filling and may need a root canal. The pain improved after antibiotics from the emergency room. Can I still get the separators and wait on the root canal?


Patient: I have been trying to get pregnant for 11 months with no positive result. My gynecologist prescribed Fertyl 100 mg, but it has not worked, and I also had a miscarriage. What should I do next?


Patient: For about a month I have pain around my rectum that goes to the left side of my lower back and my left leg. I have no stomach pain, fever, or blood. My doctor gave me anti-inflammatory medicine for two weeks, but the pain is still there.


Patient: I have a soft lump on the roof of my mouth in the soft palate area. It looks normal and is not red, but it hurts when I swallow. Could it be a blood clot or a swollen gland?


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 28, smoke and drink a lot, and for a few weeks I have had a mass under my chin that is still growing. It is hard, painful to touch, and barely moves. I do not have fever, shortness of breath, chest pressure, rash, or itching. Could this be cancer?


Patient: I am 32 and have been married for 3.5 years. My semen report says my sperm quality and quantity are low. IVF did not work, and my wife's condition was said to be normal. We do not want another IVF cycle. How can I improve fertility, and can we expect a natural pregnancy?


Patient: I help care for someone who takes warfarin and has dry mouth. I am considering a mouthwash product and want to know whether its ingredients could interact with warfarin. The ingredients include glycerin, xylitol, sodium benzoate, peppermint oil, lemon peel oil, enzymes such as lysozyme, amylase, and papain, lactoferrin, and other components.


Patient: I am 18 and have psoriasis. After about a month of taking Lamisil for toenail fungus, I developed a rash on the left side of my nose that has lasted more than a week. My back also feels itchy, and I have some joint stiffness. I am worried because I read that Lamisil plus psoriasis can cause lupus.


Patient: I am 58 and had back surgery in August. X-rays looked normal, but I still have a lot of pain along my back, hip, and calf. I also have bowel problems alternating between constipation and chronic diarrhea, and I no longer have control over my bladder. This has been going on for at least six months, and I already had a colonoscopy.


Patient: I am 66 and developed a foreskin problem about 40 to 45 days ago. A doctor said it is phimosis and suggested surgery, but I do not want surgery. Now there is too much swelling and pain in the foreskin. I tried ketoconazole cream and homeopathy. What should I do?


Patient: I had my wisdom teeth removed on Friday. I heard the doctor say he was worried about my back molars. Now the back molars seem off to the side and do not touch when I bite down. One had pain and a large cavity under a filling before. I also have a pus taste. Will it heal, or do I need more teeth removed?


Patient: I am 87 and had cellulitis for about four months. The warmth and redness are gone, but swelling remains in my ankle and sometimes there is tightness and pain. Antibiotics have not helped. I elevate the leg and use a compression stocking. Do I need to stay in bed with the leg up most of the time?


Patient: For three months I have had a very itchy penis with red glossy patches after scratching, pain during intercourse, itchy red spots over my thighs, itchy nipple, and dry patches on my eyelids and hairline. I had a lot of unprotected sex recently and worry this might be an STD, but the symptoms do not seem to match one. I am in China and having trouble getting a diagnosis.


Patient: I have thymic cancer and am receiving chemotherapy and radiation. The treatments improved most things except my breathing. I avoid prescribed pain medicines because of side effects and have been taking ibuprofen at the recommended dose for about four months. Could ibuprofen be causing my respiratory issues?


Patient: I am having a lot of stomach and abdominal pain and chest pain. I woke up this morning with swelling in my face and swollen lips. I have also had breathing problems since working around chemicals and fumes. I have been to a few doctors and still feel like I am suffering. What could be going on?


Patient: I have had moderate headaches for quite some time, mainly high on the left back side of my head. Pain medicine helps, but the pain often radiates to other parts of my head. I also have swelling on the left side of my neck that my physician said was not serious. Is it worth getting an MRI?


Patient: My doctor told me this afternoon that I have H. pylori disease. Can it be detected where I got it from? My employer has H. pylori too. Is it possible she gave it to me?


Patient: I had abdominal tuberculosis two years ago and completed treatment. For the last year I felt okay without medicine. Now my abdomen feels larger and tight after food, but I have no fever, pain, or weight loss. I am worried it might be abdominal TB again.


Patient: I have had depression and intrusive thoughts for five years. I tried Zoloft for two weeks and became very ill with stomach cramps and other side effects. I am afraid of medication tolerance and other side effects, but I am tired of trying to handle this naturally. What help can you suggest?


Patient: I have high blood pressure and was told my potassium level was low. I bought potassium gluconate pills, 595 mg, but I am scared to take them after reading the side effects. I have an appointment with a cardiologist next Monday. What should I do?


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: Is there a difference between alcoholic and non-alcoholic mouthwash? Which is better for combating bad breath from smoking? I want to know whether to recommend non-alcohol mouthwash for patients with bad breath from smoking who also drink alcohol. They are not going to stop smoking or drinking. I am looking for a way to avoid drying out tissues.


Patient: I have blood dots under my skin that appear only on my arms. They are on a different arm every morning. They do not itch and are not raised.


Patient: I have had a small pimple-like spot on my penis and testicles for about six years. A doctor told me a long time ago that it was normal, but I am still worried. What should I do?


Patient: I am 18 and have been forgetful since elementary school. I often misplace things, forget what I was doing when I am on autopilot, and worry that this could be early Alzheimer disease.


Patient: I had spotting for most of this month, then heavy bleeding for two days. I passed something that looked like grey muscle and then the bleeding suddenly stopped. What could that mean?


Patient: I had spotting for most of this month, then heavy bleeding for two days. I passed something that looked like grey muscle and then the bleeding suddenly stopped. What could that mean?

Patient: There is a chance I could be pregnant. I am not bleeding heavily now and I do not feel dizzy or faint, but I am worried about what I passed.


Patient: My six-year-old has had a blocked nose for two weeks and now has fever with swollen throat and tonsils. A doctor gave Benadryl and Crocin but no antibiotic. Is that okay?


Patient: My six-year-old has had a blocked nose for two weeks and now has fever with swollen throat and tonsils. A doctor gave Benadryl and Crocin but no antibiotic. Is that okay?

Patient: He is breathing normally and drinking fluids. No drooling, neck swelling, severe sleepiness, or dehydration. The fever and swollen tonsils are still there.


Patient: I fell from my bike onto my right side yesterday. My chest X-ray was normal, but now my right shoulder blade area hurts a lot when I sit up or raise my arm. Is this normal?


Patient: I fell from my bike onto my right side yesterday. My chest X-ray was normal, but now my right shoulder blade area hurts a lot when I sit up or raise my arm. Is this normal?

Patient: No deformity, numbness, weakness, breathing trouble, or severe chest or belly pain now. The shoulder pain is still much worse with movement.


Patient: My first molar feels a little loose. I keep pushing it with my tongue and I also clench my teeth. It does not hurt and looks healthy. Could this be from grinding or wisdom teeth pressure?


Patient: My first molar feels a little loose. I keep pushing it with my tongue and I also clench my teeth. It does not hurt and looks healthy. Could this be from grinding or wisdom teeth pressure?

Patient: No trauma, swelling, pus, fever, or severe pain. It is just looser than before and I clench my teeth a lot.


Patient: I am in the middle of a root canal. The dentist keeps opening the tooth and putting medicine in, but the treatment is not finished and I am in a lot of pain. Is that standard?


Patient: I am in the middle of a root canal. The dentist keeps opening the tooth and putting medicine in, but the treatment is not finished and I am in a lot of pain. Is that standard?

Patient: No fever, facial swelling, pus, trouble opening my mouth, swallowing trouble, or breathing trouble. The tooth pain is still severe.


Patient: I am 29 and want to take a small weekly testosterone injection to look more masculine. Would that help my face, voice, hands, or body build?


Patient: I am 29 and want to take a small weekly testosterone injection to look more masculine. Would that help my face, voice, hands, or body build?

Patient: My testosterone blood test was normal. My sexual function and erections are good. I mainly want a more masculine build and voice.


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 wheezy recently and feel a bit short of breath. I had asthma when I was younger. What should I do?


Patient: I have been wheezy recently and feel a bit short of breath. I had asthma when I was younger. What should I do?

Patient: It has been two or three days. I am more wheezy walking to work, have missed work, and today the wheeze is not settling. Sometimes I feel too short of breath to finish a sentence when talking. I still have salbutamol.


Patient: I have felt tired and run down for about six weeks, with aching in my shoulders, legs, and back. I am not sure what is going on.


Patient: I have felt tired and run down for about six weeks, with aching in my shoulders, legs, and back. I am not sure what is going on.

Patient: It started a couple of weeks after a trip to Yosemite. I had a red circular rash on my calf that lasted a few weeks and faded, and I had fever and sore throat around then. No weight loss.


Patient: I have had a blinding headache for a few days. It is bothering me and making it hard to work.


Patient: I have had a blinding headache for a few days. It is bothering me and making it hard to work.

Patient: It started when I woke up three days ago and has persisted. It is worse over my right eye, lights bother me, and I sometimes see lights. No weakness, numbness, fever, neck stiffness, vomiting, head injury, or vision loss.


Patient: I am having a bit of trouble breathing today and I am not sure what is going on. It started suddenly and I am concerned.


Patient: I am having a bit of trouble breathing today and I am not sure what is going on. It started suddenly and I am concerned.

Patient: It happened after climbing stairs and settled after I rested. I am breathing normally now. No chest pain, palpitations, fainting, dizziness, or leg swelling.


Patient: I am having a bit of trouble breathing today and I am not sure what is going on. It started suddenly and I am concerned.

Patient: It happened after climbing stairs and settled after I rested. I am breathing normally now. No chest pain, palpitations, fainting, dizziness, or leg swelling.

Patient: Now I feel short of breath even while sitting, with chest pressure and lightheadedness.


Patient: I woke up feeling fine, but today I developed sudden weakness in my arms and legs. I am having trouble lifting things, my grip feels weak, and walking feels like a struggle.


Patient: I woke up feeling fine, but today I developed sudden weakness in my arms and legs. I am having trouble lifting things, my grip feels weak, and walking feels like a struggle.

Patient: It is in both arms and legs. My speech is normal, and I do not have double vision or trouble breathing, but I still feel weak when walking and gripping things.


Patient: I woke up feeling fine, but today I developed sudden weakness in my arms and legs. I am having trouble lifting things, my grip feels weak, and walking feels like a struggle.

Patient: It is in both arms and legs. My speech is normal, and I do not have double vision or trouble breathing, but I still feel weak when walking and gripping things.

Patient: I can still talk normally, so I was hoping to wait and see if it passes.


Patient: I have had a scratchy throat lately. It is not too bad, but it is always there. Could it be a cold or allergies?


Patient: I have had a scratchy throat lately. It is not too bad, but it is always there. Could it be a cold or allergies?

Patient: It has been about five days. No fever, trouble swallowing liquids, breathing trouble, neck swelling, or major voice change. It is just scratchy.


Patient: I have had a scratchy throat lately. It is not too bad, but it is always there. Could it be a cold or allergies?

Patient: It has been about five days. No fever, trouble swallowing liquids, breathing trouble, neck swelling, or major voice change. It is just scratchy.

Patient: Today my throat feels swollen and I am having trouble breathing and swallowing saliva.


Patient: I have pretty bad abdominal cramps that come and go, with bloating. Sometimes it is worse after I eat, and over-the-counter remedies do not always help.


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 pretty bad abdominal cramps that come and go, with bloating. Sometimes it is worse after I eat, and over-the-counter remedies do not always help.

Patient: It has been going on for a few weeks. No fever, possible pregnancy, vaginal discharge, vomiting, blood in stool, or major stool changes. It is affecting my daily life.


Patient: I have a lot of back pain and stiffness. It is hard to bend or twist, and it is affecting my daily activities.


Patient: I have a lot of back pain and stiffness. It is hard to bend or twist, and it is affecting my daily activities.

Patient: It has been about a week. I do not have leg weakness, numbness, bowel or bladder accidents, fever, trauma, chest pain, or shortness of breath. It is still limiting what I can do.


Patient: I have a lot of back pain and stiffness. It is hard to bend or twist, and it is affecting my daily activities.

Patient: It has been about a week. I do not have leg weakness, numbness, bowel or bladder accidents, fever, trauma, chest pain, or shortness of breath. It is still limiting what I can do.

Patient: Now I am having trouble controlling my bladder and my legs feel weaker.


Patient: I have had nausea for a few days and it is getting worse. I am having trouble keeping food down and I feel dehydrated.


Patient: I have had nausea for a few days and it is getting worse. I am having trouble keeping food down and I feel dehydrated.

Patient: I can keep small sips of water down. No fever, severe dizziness, fainting, confusion, severe headache, or trouble breathing. Food is harder.


Patient: I have had nausea for a few days and it is getting worse. I am having trouble keeping food down and I feel dehydrated.

Patient: I can keep small sips of water down. No fever, severe dizziness, fainting, confusion, severe headache, or trouble breathing. Food is harder.

Patient: Now I cannot keep water down, I feel very dizzy when I stand, and I am confused about what time it is.


Patient: I have had persistent body aches for weeks. They are widespread in my muscles and joints, worsening, and interfering with daily life.


Patient: I have had persistent body aches for weeks. They are widespread in my muscles and joints, worsening, and interfering with daily life.

Patient: No fever, breathing trouble, severe chills, confusion, headache, vomiting, or inability to eat. It has just been weeks of worsening aches and temporary relief from pain relievers.


Patient: I have had persistent body aches for weeks. They are widespread in my muscles and joints, worsening, and interfering with daily life.

Patient: No fever, breathing trouble, severe chills, confusion, headache, vomiting, or inability to eat. It has just been weeks of worsening aches and temporary relief from pain relievers.

Patient: Today I developed a fever, severe shaking chills, shortness of breath, and I feel confused.


Patient: My lips are swollen and itchy, and I also have post-nasal drip. Over-the-counter medicine is not helping and I am worried about angioedema.


Patient: My lips are swollen and itchy, and I also have post-nasal drip. Over-the-counter medicine is not helping and I am worried about angioedema.

Patient: No trouble breathing, tongue swelling, throat swelling, new medicine, or widespread rash. The lip swelling is still there and the over-the-counter medicine has not helped.


Patient: My lips are swollen and itchy, and I also have post-nasal drip. Over-the-counter medicine is not helping and I am worried about angioedema.

Patient: No trouble breathing, tongue swelling, throat swelling, new medicine, or widespread rash. The lip swelling is still there and the over-the-counter medicine has not helped.

Patient: My throat now feels tight and I am starting to have trouble breathing.


Patient: I am having trouble starting to pee, and my urine has been darker than usual. I do not have pain or burning, but I am not sure if I should be concerned.


Patient: I am having trouble starting to pee, and my urine has been darker than usual. I do not have pain or burning, but I am not sure if I should be concerned.

Patient: It has been several days. No blood, fever, chills, vomiting, back or side pain, pregnancy possibility, or complete inability to pass urine. It is just hard to start and the urine is dark.


Patient: My voice has been really hoarse lately. I am not sure what is going on. Should I come in to get it checked?


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 voice has been really hoarse lately. I am not sure what is going on. Should I come in to get it checked?

Patient: It has been five days after a cold. No trouble breathing or swallowing, no fever, no neck swelling, and no recent procedure or intubation.


Patient: My voice has been really hoarse lately. I am not sure what is going on. Should I come in to get it checked?

Patient: It has been five days after a cold. No trouble breathing or swallowing, no fever, no neck swelling, and no recent procedure or intubation.

Patient: Now my neck looks swollen and I am having trouble breathing.


Patient: My daughter has had a rash under one armpit for about two weeks. It does not itch, she has no fever, and she seems well. We already have an appointment in a few days. Should I be worried before then?


Patient: I fell more than a year ago and still have noticeable painless lumps near both knees in the same spot. They shrink somewhat when I take the water pills my doctor prescribed, but they have not gone away. What is the next step?


Patient: I am 62. I fell on my tailbone years ago, and now I get pain from that area into both hips when I have been on my feet or walking. It stops when I sit down. My doctor mentioned weak abdominal muscles, but I am not sure. What should I do?


Patient: My one-month-old baby cries a lot at night and can be hard to settle. He is breastfed and also gets formula, and we burp him after feeds. Friends suggested colic medicines, but our doctor did not want us to use them. What should we do?


Patient: I have a cold with throat and nose congestion, and I noticed one yellowish bump at the very back of my tongue. I started worrying after searching online. What should I do?


Patient: I have a cold with throat and nose congestion, and I noticed one yellowish bump at the very back of my tongue. I started worrying after searching online. What should I do?

Patient: It has not gone away, and now the area looks more discolored and uneven than the rest of my tongue.


Patient: I am pregnant and was considering taking Chymoral Forte once daily for three days. Is this safe?


Patient: My 7-year-old daughter has had urine infections for a long time. Her urine test and culture show infection, and she often holds her urine until she cannot hold it anymore. What should we do next?


Patient: I have had a fever for a few days. It goes up and down, and medicine brings it down only for a short time. I feel awful. Should I come in or keep trying home care?


Patient: I am getting weird palpitations and sweating a lot. It is worrying me. Should I come in?


Patient: For a few weeks I have been waking up a lot at night to urinate, and my urine looks darker than usual. Do I need a check-up, or is there something I can do first?


Patient: My husband had a stroke and has had behavior problems since then. Seroquel has helped, but he seems very tired and the therapists say he is sleepy during sessions. He is coming home soon, and I am worried about the medication plan.


Patient: I had a venous Doppler for possible DVT, and someone mentioned that the blood vessels having a pulse could suggest cardiac dysfunction. I am waiting for a cardiology consult. What should I do with this information?


Patient: Lately I feel like I am breathing faster than usual. I am not having major trouble catching my breath, but I get a bit more winded with my normal activities. Should I come in?


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 29, a bodybuilder, and my doctor told me I have an umbilical hernia. I want to know whether open surgery or laparoscopic surgery is better, and when I could lift heavy weights again.


Patient: Today I suddenly started feeling a lot of pelvic pressure, and I am having trouble starting to urinate. I am worried and do not know if I should come in today or go to the ER.


Patient: For the last two days I have felt fine in the morning and most of the day, but around late afternoon I get very dizzy. I have not changed my eating much. What should I do?


Patient: For the last two days I have felt fine in the morning and most of the day, but around late afternoon I get very dizzy. I have not changed my eating much. What should I do?

Patient: I tried drinking more water and resting, but the dizziness is still happening after a few more days.


Patient: I got a contraceptive shot on October 26 and started Minigynon on November 2. My period started on November 12 and has not stopped. Today is my last pill. Should I continue the pills or take the usual break?


Patient: I had unprotected sex around my fertile day. I started taking my pill again and now I have not had bleeding when I expected it. This is unusual for me. Could I be pregnant?


Patient: I had unprotected sex around my fertile day. I started taking my pill again and now I have not had bleeding when I expected it. This is unusual for me. Could I be pregnant?

Patient: Yes, I had stopped the pill for a while and only started again after the unprotected sex.


Patient: My 15-year-old daughter has been missing a front tooth for 7 years. The dentist said the tooth is up there but not coming down. Can she use a flipper or denture until we can afford treatment?


Patient: I keep getting small itchy bumps on the shaft of my penis about every 6 months. They have clear pus, hurt if they burst and rub on clothing, and go away after about a week. I was told before it was not herpes. What could this be?


Patient: My son came home from nursery with one red spot on his inner thigh. A few hours later several more appeared, some with yellow heads, and they look big and angry red. What should I do?


Patient: I first had burning after ejaculation, then intermittent burning and slight penis and groin pain. The burning after ejaculation is gone, but I still feel like I have to urinate constantly. What should I do?


Patient: My boyfriend has had stomach pain for the past few days. He thought it was something he ate, but now he is not sure. He has barely been eating because food does not feel like it will stay down, and he feels like he may throw up or need the bathroom but does not really get the urge.


Patient: My 9-year-old daughter has chest pain and says it feels like something is stuck in her chest. She is generally healthy, but she gained weight quickly over the last year, from 68 lb to 95 lb, and is 55 inches tall.


Patient: My 74-year-old husband has mantle cell lymphoma. Treatment was stopped after two treatments because it was not working. Over the last month he has become weaker, eats only small amounts, has swelling in his feet, and now has pain on the right side near the upper abdomen and underarm that radiates to his back and shoulder blades. What should we do?


Patient: My 72-year-old mother has a left femoral neck fracture. Is there any treatment other than surgery?


Patient: My fiancee and I are not known to be HIV positive, but we have had unprotected anal sex about ten times. Could we be infected with HIV?


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 a soft squishy roll or lump under my left breast, on top of the ribcage. It fills the gap from under the breast to the ribs. It is not hard and does not hurt. Can fat collect on only one side like this?


Patient: I am a 26-year-old woman with high blood pressure for the last month, and I was told my kidneys are being affected. My platelet count has kept rising over eight months from 6 lakhs to 8, then 11, and now 12 lakhs. My leg and foot pain are increasing. What should I do?


Patient: I am A+ and my boyfriend is A1+. Is there any problem if people with different blood groups get married, or any risk for children?


Patient: I get lower back pain whenever I am hungry. It can be on either side or both sides. Tests showed bacterial overgrowth, and omeprazole plus metronidazole helped somewhat, but the problem is still there.


Patient: I have had irregular periods for the past year. On day 12 from my last period, ultrasound showed multiple small follicles in both ovaries, about 4 to 6 mm. Can I still conceive, and when would the follicle mature?


Patient: My lower left wisdom tooth is coming through and painful. My lymph nodes are swollen and sore, and I also have a large patch on my left cheek. Can this be treated without a dentist?


Patient: My 21-month-old daughter scratched herself near her clitoris. What is the best thing to do at home?


Patient: I am not satisfied with bonding on my front left tooth. The enamel feels too thin and sharp to my tongue, and the shape does not match the front right tooth. Can this be fixed conservatively?


Patient: I am 29. Three months ago I had an open myomectomy for fibroids and surgery for a right endometriotic cyst. I am taking Novelon. Can I start trying for a baby now?


Patient: My eye power was -0.5 and has increased to -1.5. I think it may be from Perinorm tablets I took six months ago. I am taking homeopathic medicines to remove my glasses. How can I get rid of spectacles?


Patient: Since having my baby, my periods have been irregular and sometimes very light. I may go a month or more without one, then have a very heavy period. I also have spotting between periods, which is new for me. Should I come in or monitor this?


Patient: I am 26, 5 feet 5 inches, and 230 pounds. I have had severe back pain like pinched nerves since pregnancy years ago. Sometimes the pain is so bad I have to crawl, and it can make it hard to breathe. What can I do?


Patient: I get hives, itching, and stomach upset after eating nuts or shellfish. It comes and goes through the day, and I am wondering whether I need allergy testing.


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 itchy red bumpy rashes on my arms and legs, and my eyes feel gritty and itchy. Over-the-counter cream and drops have not helped. Can I come in about this?


Patient: My allergies are bad this year. My eyes are itchy and watery, and I have constant nasal congestion that makes it hard to breathe through my nose. Over-the-counter allergy medicine has not helped much. What should I try?


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 13-year-old daughter has had vomiting and loose watery stools for two days. Her fever is gone and the stools are less frequent, but she has little appetite and nausea. Is this a normal stomach infection?


Patient: I have cavities in my front two teeth and have delayed seeing a dentist because of work. I have an upcoming appointment but I am worried about infection reaching the bone. What should I do?


Patient: I had surgery for ulnar nerve entrapment 14 weeks ago, including decompression and a nerve transfer. I still have no improvement and wonder if muscle transfer could fill in my hand. Is it too soon?


Patient: My mother-in-law is in remission from limited-stage small cell lung cancer and has been cleared by her doctors for a partial hip replacement. Could the surgery stress her body and make the cancer relapse?