Chief Compliant: The patient is a 40 year old white female who complains of flank pain for 8 hours.

History of the Present Illness: Severe, colicky, intermittent,, lower abdominal pain; flank pain, hematuria, fever, dysuria; prior history of renal stones. Abdominal pain may radiate laterally around abdomen to groin, testicles or labia. History of low fluid intake, urinary tract infection, parenteral nutrition. Excessive calcium administration, immobilization, furosemide.

Past Medical History: Chemotherapy, inflammatory bowel disease, ileal resection. Diet high in oxalate: Spinach, rhubarb, nuts, tea, cocoa.

Medications: Excess vitamin C, hydrochlorothiazide, indinavir, unusual dietary habits.

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