Gina Samps is a 24 year-old-female who presents to the emergency department with sudden onset of sharp pain in the right side of her lower back

Gina Samps is a 24 year-old-female who presents to the emergency department with sudden onset of sharp pain in the right side of her lower back that radiates to the right side of her adbomen and into her groin. The pain started suddenly, about five hours ago, when she was walking her dog. She took ibuprofen 600 mg po an hour ago, but it has not helped. Gina is grimacing and squirming in the bed. She has a medical history of GERD and states that this pain is different. She feels nauseous but has not vomitted. She pleads with the nurse, “please do something for the pain! What is wrong with me?” Gina is an elementary teacher. She weighs 263 pounds and has a BMI of 43. Gina is single, lives alone, and does not smoke tobacco, drink alcohol, or use any medications or substances. She has no known allergies.

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