History

HPI

Core features

OPQRST

OPQRST framework

Onset

Onset details

Provocation and palliation

Triggers and relief

Quality

Pain character

Region and radiation

Location pattern

Severity

Severity and impact

Timing

Course

Associated symptoms

Gynecologic and obstetric history

Reproductive history

Sexual history and STI risk

STI exposure features

Urinary and renal history

GU context

GI and surgical history elements

GI context

Special populations

Population modifiers

Alarm Features

Hemodynamic instability

Shock red flags

Hemorrhage risk

Hemorrhage features

Pregnancy related emergencies

Pregnancy red flags

Infection and sepsis

Severe infection features

Ovarian torsion concern

Torsion features

Surgical abdomen concern

Peritonitis features

Aortic catastrophe concern

Vascular red flags

Immediate escalation triggers

Escalation logic

Medications

Current and recent medications

Exposure list

OTC and supplements

Non prescription exposures

Recent changes and adherence

Medication pattern

High risk interactions and contraindications

Therapy constraints

Diet

Recent intake and hydration

Intake pattern

Potential triggers

Exposure pattern

Bowel habit modifiers

Diet bowel linkage

Review of Systems

Constitutional

General symptoms

Gynecologic

Reproductive symptoms

GU

Urinary symptoms

GI

GI symptoms

Cardiopulmonary

Cardiorespiratory symptoms

Neurologic

Neuro symptoms

Collateral History and Family History

Collateral source and reliability

Source details

Family history relevant conditions

Family history

Household and exposure context

Exposure context

Risk Factors

Pregnancy and ectopic pregnancy risk

Ectopic risk factors

PID and STI risk

PID risk factors

Ovarian torsion risk

Torsion risk factors

Urologic and renal risk

Stone and UTI risks

GI and surgical risk

Appendicitis and diverticulitis context

Bleeding and thrombosis risk

Hemorrhage modifiers

Thrombosis modifiers

Malignancy risk

Cancer risk factors

Differential Diagnosis

Life threatening

Cannot miss

Common

High frequency

Less common

Lower probability

Mimics and pitfalls

Diagnostic traps

Past Medical History

Chronic conditions and prior episodes

Relevant conditions

Prior surgeries and procedures

Surgical history

Baseline function and supports

Baseline status

Physical Exam

Initial appearance and vitals

General assessment

Vital sign patterns

Abdominal exam

Abdominal findings

Pelvic exam for patients with vagina

Pelvic exam components

GU exam for patients with penis

GU findings

CVA and back exam

Renal and back findings

Skin and rash

Dermatologic clues

Focused special maneuvers

Maneuvers

Pitfalls and subtle findings

Caveats

Lab Studies

Pregnancy and bleeding evaluation

Core pregnancy labs

Infection and inflammation

Infection labs

GU testing

Urinary tests

STI and vaginitis testing

STI diagnostics

Vaginitis testing

Metabolic and organ function

General labs

Limits and pitfalls

Interpretation pearls

Imaging

Scoring Systems

Decision tools

MRI

MRI use cases

CT

CT selection

Ultrasound

Ultrasound first line

Special Tests

Bedside tests and maneuvers

Bedside diagnostics

Procedural diagnostics

Procedures

Specialty specific testing

Targeted testing

ECG

Indications and high risk patterns

When ECG matters

Red flags

Serial ECG logic

Repeat strategy

Assessment

Problem representation

Summary statement

Working diagnosis and alternatives

Most likely diagnosis

Alternative diagnoses

Severity and risk stratification

Risk level

Plan

First 5 minutes critical pathway

Immediate priorities

Analgesia and symptom control

Pain and nausea control

Diagnostic sequencing

Testing sequence

Condition specific management

Suspected ectopic pregnancy

Suspected ovarian torsion

Suspected PID

Suspected ruptured hemorrhagic cyst

Reassessment loop

Recheck triggers

Consultations

Specialty involvement

Disposition

Level of care criteria

ICU indications

Inpatient admission indications

Observation pathway indications

Discharge criteria

Safe discharge features

Follow up timing

Follow up targets

Discharge Instructions

Copy discharge instructions

Pelvic pain discharge summary

Medications

Activity

Follow up

Return to ED now for

References

Guidelines and key sources

Reference list