In a female with typical symptoms of appendicitis, the summaries recommend an ultrasound first to exclude gynaecological causes, then surgery. Ultrasound avoids radiation and assesses both the appendix and the pelvic organs. CT is kept for atypical or uncertain cases. The word single signals that pregnancy is unlikely, so beta-hCG is not the key next step here, although many protocols still check it in all women of reproductive age.