Acute adrenal crisis

A patient (39 yo female) arrives at your clinic. She complains of back pain, frequent and painful urination, and nausea. The symptoms have been present for 2 days and are worsening. There is also a chronic headache, abdominal pain, lack of appetite, and fatigue in the patient’s medical history.
What are we going to do next?

Help

Refer the patient to a urologist as our impression is a urinary infection.

Order an abdominal ultrasound and the following treatment will be determined according to findings.

The ABCDE approach.

Examination

HPC: back pain, frequent and painful urination for 2 days, nausea, symptoms are worsening
Family history: unrelevant
PMH: chronic headache, abdominal pain, lack of appetite, fatigue
Injuries: 0, surgeries: 0, transfusions: 0
Allergies: 0
Medications: Urosept tea for 2 days, 3x per day
Gynecological history: regular menstruation á 29 days, 2 deliveries, no contraception
Physiological functions: dysuria, polakisuria
Social history: married, office work in an IT company
Drug abuse: alcohol occasionally, non-smoker, 1 coffee per day