Obstetrics & Gynecology>>>>>Preventive Care and Health Maintenance
Question 3#

A 65-year-old G3P3 presents to your office for annual checkup. She had her last well-woman examination 20 years ago when she had a hysterectomy for fibroids. She reports no medical problems, except some occasional stiffness in her joints early in the morning. She takes a multivitamin daily. Her family history is significant for cardiac disease in both her parents and breast cancer in a maternal aunt at the age of 42 years. Her physical examination is normal.

Which of the following is the most appropriate set of laboratory tests to order for this patient?

A) Lipid profile and fasting blood sugar
B) Lipid profile, fasting blood sugar, and TSH
C) Lipid profile, fasting blood sugar, TSH, and CA-125
D) Lipid profile, fasting blood sugar, TSH, and urinalysis
E) Lipid profile, fasting blood sugar, TSH, urinalysis, and CA-125

Correct Answer is D

Comment:

Women older than 65 years should undergo cholesterol testing every 5 years, fasting glucose testing every 3 years, screening for thyroid disease with a TSH every 5 years, and periodic urinalysis is recommended in women older than 65 years. CA-125 testing is not recommended for screening for ovarian cancer. There are many benign conditions which can cause an elevated CA-125, such as pregnancy, endometriosis, fibroids, menses, pelvic inflammatory disease, peritoneal disease, and liver disease.