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Justine is a 17-year-old girl who presents for evaluation of lower abdominal pain that has been increasing over the past few days. Earlier today she was eating and drinking, but has developed some nausea in the past couple of hours without vomiting. She has had soft, regular bowel movements that are free of blood and mucus. She denies dysuria, but has had some light vaginal discharge that started about 1 week ago. Justine continues to have regular periods. She also recently started having sex with her boyfriend of 9 months. The couple uses condoms about 60% of the time. She reports that when they had sex 2 days ago it was painful. Her partner does not have any symptoms.

Her mom is aware that she is having sex, though not happy about it. The HEADSSS assessment (Home/Environment, Education/Employment/Eating,...

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