Pain onset, location, duration, description, intensity, relationship to menses. Sudden onset is suggestive of torsion, Mittelschmerz, urolithiasis, ruptured corpus luteum cyst, ruptured ectopic pregnancy. More gradual onset is suggestive of appendicitis, PID, abscess, etc. Evidence of hypovolemia. Peritoneal signs, masses, tenderness, bowel sounds, rectal exam with occult blood testing, flank tenderness.
Repeat testing over time can be informative.
Blood, cervix, urine, as indicated. Helpful to differentiate GU disorders. May be negative if complete obstruction is present. Points toward GI tract if positive. Must know sensitivity of the test you are using.