Routine screening tests Hai Ho, M.D.. Most expensive part of medical practice? Your Pen.
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Transcript of Routine screening tests Hai Ho, M.D.. Most expensive part of medical practice? Your Pen.
![Page 1: Routine screening tests Hai Ho, M.D.. Most expensive part of medical practice? Your Pen.](https://reader035.fdocuments.us/reader035/viewer/2022072011/56649e045503460f94aefbeb/html5/thumbnails/1.jpg)
Routine screening tests
Hai Ho, M.D.
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Most expensive part of medical practice?
Your Pen
![Page 3: Routine screening tests Hai Ho, M.D.. Most expensive part of medical practice? Your Pen.](https://reader035.fdocuments.us/reader035/viewer/2022072011/56649e045503460f94aefbeb/html5/thumbnails/3.jpg)
Case
55-year-old male comes to you for a routine physical examination. He is a nonsmoker who takes no medications and has no signs of acute or chronic disease, and he has not seen a doctor in years. What blood work should you order for this patients?
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Complete metabolic panel?
$212
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Basic metabolic panel
$175
![Page 6: Routine screening tests Hai Ho, M.D.. Most expensive part of medical practice? Your Pen.](https://reader035.fdocuments.us/reader035/viewer/2022072011/56649e045503460f94aefbeb/html5/thumbnails/6.jpg)
CBC?
$36.40
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Urinalysis?
$23.80 Microscopic Examination
$30.80Total
$54.60
![Page 8: Routine screening tests Hai Ho, M.D.. Most expensive part of medical practice? Your Pen.](https://reader035.fdocuments.us/reader035/viewer/2022072011/56649e045503460f94aefbeb/html5/thumbnails/8.jpg)
Cost of FCC welcoming package?
Chemistry $212
CBC $36.40
Urinalysis $54.80
Total $303.20
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Cost of ER welcoming package?
Chemistry $212
CBC $36.40
Urinalysis $54.80
Total CK $86
CK-MB $86
PT $49
PTT $61.60
Total $585.80
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Pap smear after hysterectomy
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Recommended screening tests
The disease must have high prevalence in the population tested
Favorable outcome when the disease is detected early
High sensitivity and specificity Not too expensive
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Fasting plasma glucose – adults?
Age ≥ 45, and if normal q3 years
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Fasting plasma glucose - adults Younger or more frequently
Obese >120% of ideal body weight or BMI ≥ 27 kg/m2
First-degree relative with diabetes High-risk ethnicity – African American, Latino, Native
American, Asian-American, Pacific Islander Delivered a baby weighed > 9 lbs. or history of GDM Hypertension HDL ≤ 45 mg/dl and/or TG ≥ 250 mg/dl Glucose intolerance on previous testing Associated insulin resistance – hypertension,
hyperlipidemia, PCOS
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Fasting plasma glucose - children Overweight
BMI > 85 percentile for age and sex Weight for height > 85 percentile >120% of ideal body weight for heightPLUS:
Any two of the following Family history of type 2 diabetes in first or second
degree relative Ethnicity – Native American, African-American, Latino,
Asian-American, Pacific Islander Associated insulin resistance – hypertension,
hyperlipidemia, PCOS Every 2 years
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Lipid panel
Lipid panel Total cholesterol, LDL, HDL, TG Cost: $95
Age ≥ 20 Every 5 years Metabolic syndrome – diabetes
mellitus, hypertension
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Chlamydia
AAFP: Annually all sexually active female age ≤ 25 and other women at increased risk for chlamydia
Molina or IEHP: Annually all female age 16-26, identified as sexually active
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Fecal occult blood testing
Annually for adults age ≥ 50