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Dr. Carol Meynen, M.D., F.A.C.O.G

Practice Limited to Gynecology. Hours by Appointment
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333 Anjou Drive
Northbrook, IL 60062

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About screening laboratory tests

Urinary Tract InfectionUrinalysis and Culture: A urinalysis screens for many diseases, but is not very accurate. We use it to determine the need for more specific tests. Unsuspected urinary tract infections are not uncommon in women and can cause damage to the kidneys. Urine cultures are done in suspected cases.
Heart DiseaseLipid Profile: This is cholesterol screening to determine risk of heart disease. An HDL over 50 and an LDL under 100 is optimal. Diet and exercise have some effect, heredity has a great deal of effect, and drug treatment is usually very successful.
Sexually-Transmitted DiseaseSTD check: A screening test for chlamydia and gonorrhea, the most common STDs in women and responsibe for 50% of female infertility. The Center for Disease Control (CDC) recommends regular screening for women under the age of 25 and any older women at risk.
OsteoporosisDEXA: A test for osteoporosis. It reveals relative risk for fracture. Treatment (Boniva, Fosamax, Actonel, Evista, Miacalcin, etc.) reduces the risk further than what is indicated by the numbers. When this test is normal without treatment, no further action is required. The test may be repeated in 2 years. If there is documented improvement with treatment, no further testing is required. If there is no documented improvement with treatment, an NTX will be recommended. The bone density studies you may see offered for low cost test the forearm or the heel, neither of which is as accurate as a DEXA.
NTX: This urine test measures bone breakdown products. It tells us how well you are conserving bone at the present time, protecting you from osteoporosis. If it is less than 50, it is in the pre-menopausal range and current management should be continued. If not, management needs to be modified.
MalignanciesPap smear: A screening test for cervical cancer (the part of the uterus visible in the vagina). This test in 90% accurate for each test and when done annually is close to 100%. See my views on the frequency of this test.
Screening Mammogram: This test is 90% accurate but regular testing does not reduce the risk further. It needs to be done annually after age 45 and accompanied by regular clinical exam and self-exam. There is also about a 20% call-back possibility for additional pictures. This does not necessarily mean the radiologist sees something suspicious. If you have a lump and the mammogram is normal, you must still follow up with a surgeon for evaluation.
Diagnostic Mammogram:If you have had breast cancer, or have pain or a lump in your breast, your mammogram must be done at the hospital with a radiologist present to review it immediately to determine if any further studies need to be done. The radiologist wil then discuss the results with you.
Hemoccult: This is a screening test for blood in the bowel movement. Sometimes it can be obtained by rectal exam, sometimes it must be performed at home. If positive, a colonoscopy is recommended.
CA-125: This is a screening test for inflammation in the abdominal cavity. It is often used as a screening test for ovarian cancer, but there are many false positives and false negatives. In combination with suspicious symptoms and a CT scan, ovarian cancer risk can be evaluated, but there will still be false negatives (disease that is not apparent) and false positives.

© Carol A. Meynen, M.D. All rights reserved.