Diagnostic Workup
Great work with your presentation! Based on the patient’s symptoms, I would have also gone with the three differential diagnoses you presented: appendicitis, cholecystitis, and gastroenteritis. The common symptoms of acute appendicitis include right abdominal pain, anorexia, fever, nausea, vomiting, and bloating (Catanzaro & Kwon, 2017). Pain is the first initial symptom of appendicitis. The symptoms of cholecystitis include abdominal tenderness, nausea, vomiting, fever, chills, and bloating (Gross et al., 2020). The symptoms of gastroenteritis include appetite loss, bloating, nausea, vomiting, abdominal pain, and lethargy (Schmutz et al., 2017).
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You have indicated the correct laboratory workup necessary for diagnosing these conditions. The CBC count is elevated in patients with acute appendicitis due to inflammation and infection (Catanzaro & Kwon, 2017). It is also essential to carry out other tests, such as pregnancy and urinalysis, to rule out other conditions with similar symptoms. For the case of cholelithiasis, ultrasound is the best option for diagnosing this condition. It is cheap and cost-effective, as you have correctly noted. As you have accurately indicated, a viral workup is not needed for viral gastroenteritis; symptoms alone are enough to diagnose this condition (Schmutz et al., 2017). However, it is critical to rule out other conditions by doing bacterial workup and pregnancy tests.
I would have, however, loved to see your choice of primary diagnosis and the treatment options. This would have allowed me to give my thoughts and offer an alternative diagnosis and treatments that I feel would have effectively served to treat this patient. Your references are scholarly and have effectively supported your discussion. Great presentation!
References
Catanzaro, M. P., & Kwon, R. J. (2017). Acute appendicitis. Oxford Medicine Online. https://doi.org/10.1093/med/9780199384075.003.0049
Gross, A. R., Bacaj, P. J., & Williams, H. J. (2020). Educational case: Gallstones, cholelithiasis, and cholecystitis. Academic Pathology, 7, 237428952095190. https://doi.org/10.1177/2374289520951902
Schmutz, C., Bless, P. J., Mäusezahl, D., Jost, M., & Mäusezahl-Feuz, M. (2017). Acute gastroenteritis in primary care: A longitudinal study in the Swiss Sentinel surveillance network, Sentinella. Infection, 45(6), 811-824. https://doi.org/10.1007/s15010-017-1049-5
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Question 
Diagnostic Workup
Diagnostic Workup Discussion Response
You should also view their work and provide quality, substantive comments in a scholarly fashion about their differentials and treatment choices.