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The pain does not radiate. The patient rates the pain a 7 on a scale of 1–10, with 10 being the worst. The pain has been worsening over the 24 hours since the onset. She has had no nausea, vomiting, or diarrhea. Patient denies fever. Her last menstrual period was approximately 5 weeks ago. Patient reports that her periods are often irregular but never as late as this. She is sexually active with one partner, her husband, and denies vaginal discharge. She and her husband use 27 Copyright © 2007 by The McGraw-Hill Companies, Inc.

She is sexually active with one partner, her husband, and denies vaginal discharge. She and her husband use 27 Copyright © 2007 by The McGraw-Hill Companies, Inc. Click here for terms of use. 28 COMPLETE WRITE-UP condoms as a method of birth control. She has no dysuria/frequency or urgency. The patient has been healthy in the past and denies ever having experienced this pain before. Her appetite has been poor since the onset of the pain. She has not taken any medications to try to relieve the pain.

He reports that her behavior has been strange over the past 2 weeks. ” She seems to be having difficulty concentrating for any significant period of time. She also seems to be unable to sit still and is constantly fidgeting and finding things to do. He does not think that his wife has been sleeping through the night as there have been multiple times over the past 2 weeks that he has woken up and she has not been in the bed. He has noticed that she seems to be dressing differently from her usual. He finds that her dress is flamboyant and she is applying much more makeup than she usually does.

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