### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
29 year old female. Made Dr. appt. for RLQ abdominal pain. Physical examination , including palpitation of the RLQ produced increasing pain. Dr. Ordered labs drawn - WBC was elevated, potassium was slightly low. Ultrasound was ordered for the following day, as well as 500mg amoxacillin tid. Ultrasound of lower and upper abdomen showed irregular heterogenous area in upper aspect of the right lobe of the liver of mixed echogenicity. Suggested atypical pattern of fatty infiltration, or atypical hemangioma . Recommended CT scan of abdomen and pelvis to evaluate the liver. CT scan showed fatty liver with area of enhancement in the lateral aspect of the right lobe of the liver (2.9 cm), normal pancreas, spleen, adrenal glands , and appendix. CT summary: may reflect an atypical hemangioma, focal nodular hyperplasia (I am on birth control pills), or hepatic adenoma. Suggests a nuclear medicine sulfur colloid study. Since these test, I have continued to have lower right abdominal pain as well as new onset lower left abdominal pain, less frequent. I also have had what I used to think was heartburn or acid reflux pain in right upper abdomen directly under the ribs and near the center of the upper abdomen. I now suspect this pain is related to the findings on the liver. I also have sharp pains randomly that seem to shoot from the front of my chest to my middle to upper back on the right. I have bright yellow urine and I do not take any vitamins. My medications are metoprolol, maxide, triphasil, and cymbalta. I am also currently taking the amoxacillin and potassium. I have fluid retention in my ankles and sometimes in my hands so badly I cannot remove my ring. My belly swells directly under my ribcage making me feel pregnant, which I am not. Any information would be helpful as my next appt (nuc med) is not for another week and I m driving myself crazy looking for answers! Thanks!

### output:

Hi, Thanks for writing in. It is possible that your symptoms (abdominal pain and bloating) may be related to focal nodular hyperplasia. However, we do need to rule out problems like gastroesophageal reflux disease. In this regard, small meals at regular intervals; an early dinner and Tablet Prevail OTC 20 will help. It is unlikely that the amoxicillin and potassium will actually help relieve your symptomsHowever, the fluid retention in the ankles and the hands needs to be looked into. To help you further in this regard, I would like to know the reason that you are taking metoprolol, and Maxine. Awaiting your reply. Regards