A 19 year old female patient presents to the urgent care center and a 10 day history of right lower quadrant pain.

A 19 year old female patient presents to the urgent care center and a 10 day history of right lower quadrant pain. Both are feeling frustrated due to a lack of a diagnosis. Patient was seen 10 days ago in the ER, and discharge being told she had a hernia. She saw her primary care provider 3 days later who referred her to a surgeon that can’t see her for a month. Tonight she comes in with continuation of pain, and mother’s pressuring her to “find out what is wrong”. Patient denies nausea, vomiting or diarrhea. But has dysuria with frequency . She denies movement increases her pain, and no bulges to her abdomen except for a small bump in tithe right lower quadrant that is non-tender. It is difficult to obtain a history because mother keeps answering the questions. Further questioning reveals that patient as a vaginal discharge, dysuria and sexual activity without a barrier protection. Her last gyn exam was l year ago, and she had normal menses 2 weeks ago. She does not know if her boyfriend has multiple or previous partners. A rapid swab indicated she has a sexually transmitted disease. She does not wish to