Cindy is a 35 year old female who presented to the family physician’s office with 1 day history of acute onset left lower quadrant pain. The pain is 9 out of 10 on intensity and gradually increasing over a day and is associated with 2 episodes of vomiting. She is otherwise healthy and is not on any medications. On further examination, she has a temp of 37.5 in the axilla and is slightly tachycardic. She is in distress from pain. She guards on palpation of the LLQ but does not have any signs of peritonitis. Her abdomen is not distended. She had a bowel movement earlier this morning that was normal. Her urine dip is negative for leuks, blood and nitrites.

Cindy is a 35 year old female who presented to the family physician’s office with 1 day history of acute onset left lower quadrant pain. The pain is 9 out of 10 on intensity and gradually increasing over a day and is associated with 2 episodes of vomiting. She is otherwise healthy and is not on any medications. On further examination, she has a temp of 37.5 in the axilla and is slightly tachycardic. She is in distress from pain. She guards on palpation of the LLQ but does not have any signs of peritonitis. Her abdomen is not distended. She had a bowel movement earlier this morning that was normal. Her urine dip is negative for leuks, blood and nitrites.

indy is a 35 year old female who presented to the family physician’s office with 1 day history of acute onset left lower quadrant pain. The pain is 9 out of 10 on intensity and gradually increasing over a day and is associated with 2 episodes of vomiting. She is otherwise healthy and is not on any medications. On further examination, she has a temp of 37.5 in the axilla and is slightly tachycardic. She is in distress from pain. She guards on palpation of the LLQ but does not have any signs of peritonitis. Her abdomen is not distended. She had a bowel movement earlier this morning that was normal. Her urine dip is negative for leuks, blood and nitrites.