A 15-year-old gravida 0 adolescent presents to the emergency room complaining of severe abdominal pain. She states that she had a sudden onset of sharp right lower quadrant pain after her physical education class earlier in the day. Her pain has been increasing, and she now reports additional upper abdominal pain radiating to her shoulder. She rates the pain an 8 out of 10 and notes associated nausea. She denies any further complaints other than some lightheadedness with sitting up. She reports menarche at age 13, with regular monthly bleeding that lasts for five days. Her last menstrual period was three weeks ago. She is not sexually active. The patient denies any medical problems or prior surgeries. She takes no medications.