EM@3AM: Urolithiasis

A 34-year-old male presents with intermittent, sharp, left-sided flank pain. He took ibuprofen with minimal relief, but came to the ED when he noticed blood-tinged urine. He has also experienced severe nausea without emesis. He appears uncomfortable, writhing in bed. What is the patient’s diagnosis? What’s the next step in your evaluation and treatment?