A 21-year-old woman presents to your office for well-women examination and screening for sexually transmitted infections. Her menses started at the age of 13 years and are regular. She is currently sexually active with her 20-year-old boyfriend and has had three sexual partners in her lifetime. She uses Depo-Provera and condoms for contraception. She has a history of asthma, for which she uses an inhaler as needed. She reports no prior surgeries. Her family history is significant for hypertension, high cholesterol and heart disease in her father, aged 48. She weighs 125 lb and is normotensive.
Besides screening for cervical cancer and sexually transmitted infections, what other routine screening should be done for her at this visit?
A. Bone mineral densityThe National Cholesterol Education Program recommends that all adults 20 years and older have a serum lipoprotein profile every 5 years. Lipid profiles are also recommended if there is a family history of premature cardiovascular disease (age younger than 50 in men and 60 in women). Even though use of Depo-Provera is associated with decreased bone mineral density there is no indication for bone mineral density screening for women using it. Testing for diabetes is indicated for individuals with BMI greater than 25, family history of diabetes, polycystic ovarian syndrome, hypertension, prior history of gestational diabetes. Thyroid testing is reserved for symptoms, strong family history of thyroid disease or autoimmune disease. Urinalysis is indicated for symptoms of infection or yearly screening in diabetics and periodically in women older than 65 years.