In the ED, their vitals/exam are as above. Patient’s Alvarado score is *** prior to labs, however with findings consistent with appendicitis on exam. Without concern for ovarian torsion. Less likely UTI vs. cystitis. Less likely pyelo.
– Labs/Tests: EKG, D-stick, CBC, CMP, lipase, coags, UA, Upeg, urine culture
– Imaging: BSUS (start just above right iliac crest looking for non-compressible, >6mm, donut-shaped structure/free fluid above psoas muscle), Appendix ultrasound, CT abdomen pelvis if indeterminate
– Treatments: IVF, Zofran, Tylenol
– Consults: Pending imaging
– Dispo: Pending further testing