MDM:

Suspect most likely nausea vomiting of benign etiology.

Diagnostically:

CBC

BMP

Urine analysis

Urine pregnancy

Interpretation of diagnostics: Mild leukocytosis without any metabolic derangements. Noninfectious urinary analysis. Negative urine pregnancy.

Therapeutically:

Antiemetics

Plan to reevaluate patient after antiemetics to ensure that patient is tolerating by mouth fluids.

Differential diagnosis includes: Acute intra-abdominal process, acute gastroenteritis, infection-urinary tract infection.

On reevaluation, repeat abdominal exam is benign, patient is tolerating by mouth fluids and states feeling better.

Given patient is well-appearing, does not have any abdominal pain at this time, is tolerating by mouth fluids, and on serial abdominal exams has a benign abdominal exam, I think the likelihood of an acute intra-abdominal process-specifically appendicitis, cholecystitis, or ovarian pathology specifically torsion is sufficiently unlikely and patient does not meet criteria for further diagnostics at this time.

Given on history, patient endorses symptomatology concerning for potential appendicitis, rule out retained CT to further evaluate.

Given on history patient endorses symptomatology concerning for potential ovarian torsion, will obtain pelvic ultrasound with Doppler to further evaluate