Comments on: http://www.kevinmd.com/blog/2005/05/are-these-top-10-medical-tests-you.html Tue, 14 Feb 2012 19:56:00 +0000 hourly 1 By: Palmdochttp://www.kevinmd.com/blog/2005/05/are-these-top-10-medical-tests-you.html#comment-66264 Palmdoc Wed, 16 Aug 2006 22:39:00 +0000 http://clients.emmense.com/kevinmd/2005/05/18310.html#comment-66264 Kevin, thanks for highlighting your Classic post. I have pointed it out to Malaysian readers here:<br/><a HREF="http://medicine.com.my/wp/?p=1313" REL="nofollow">Malaysian Medical Resources on Top 10 Medical Tests</a><br/>as some of these tests are rampant in my country and much abused. Kevin, thanks for highlighting your Classic post. I have pointed it out to Malaysian readers here:
Malaysian Medical Resources on Top 10 Medical Tests
as some of these tests are rampant in my country and much abused.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2005/05/are-these-top-10-medical-tests-you.html#comment-52878 Anonymous Tue, 17 May 2005 15:39:00 +0000 http://clients.emmense.com/kevinmd/2005/05/18310.html#comment-52878 Who in the world did this reporter talk to???? Yikes! And to have it posted on the MSNBC website to boot. I'm an OB/GYN (but work for a county hospital where the OB/GYN dept makes up part of the PCP panel) who is trying to juggle GYN surgery/L&D stuff/resident supervision/medical student teaching/and trying to keep up on the PCP stuff. <br/><br/>I have way too many obese pts (who already have a genetic/ethnic propensity towards diabetes). It's been a while since I've ordered just a cholesterol level. I always check chol/LDL/HDL/TG/fasting glucose on these pts (oh, and do the TSH screening). Those obese women with irregular menses...they're such a set up for endometrial CA! Oh, and our pediatric dept has been ordering lipids on a lot of their obese kids too (once again, this might just be because of the ethnic make-up of the population we work with)<br/><br/>Many of my pts meet criteria for metabolic syndrome. Most have elevated TG, low HDL, and most definitely an abd circumference greater than 35" (the female cutoff). And the current popular belief is that insulin resistance may lead to "polycystic ovary syndrome" (y'know...irregular menses, hirsutism, acne, anovulation...) Just don't make the mistake that you need to order an ultrasound to cinch the diagnosis...in the US, Dx is based on history/exam/labs but not imaging) We routinely will use metformin to treat PCOS type pts with infertility (and it works). <br/><br/>Other routine things I do: I always calculate out a BMI when I see a pt for her annual exam. And almost invariably, the pt will tell me that she doesn't exercise "But I don't eat much and I walk around a lot". Of course, when I have the pt recall what she ate...that's a different story. <br/><br/>Our GI dept is so swamped, that it takes months (try over 6 months to a yr) to get a routine screening colonoscopy. Now if the pt had bleeding...that might expedite things ;-) Who in the world did this reporter talk to???? Yikes! And to have it posted on the MSNBC website to boot. I’m an OB/GYN (but work for a county hospital where the OB/GYN dept makes up part of the PCP panel) who is trying to juggle GYN surgery/L&D stuff/resident supervision/medical student teaching/and trying to keep up on the PCP stuff.

I have way too many obese pts (who already have a genetic/ethnic propensity towards diabetes). It’s been a while since I’ve ordered just a cholesterol level. I always check chol/LDL/HDL/TG/fasting glucose on these pts (oh, and do the TSH screening). Those obese women with irregular menses…they’re such a set up for endometrial CA! Oh, and our pediatric dept has been ordering lipids on a lot of their obese kids too (once again, this might just be because of the ethnic make-up of the population we work with)

Many of my pts meet criteria for metabolic syndrome. Most have elevated TG, low HDL, and most definitely an abd circumference greater than 35″ (the female cutoff). And the current popular belief is that insulin resistance may lead to “polycystic ovary syndrome” (y’know…irregular menses, hirsutism, acne, anovulation…) Just don’t make the mistake that you need to order an ultrasound to cinch the diagnosis…in the US, Dx is based on history/exam/labs but not imaging) We routinely will use metformin to treat PCOS type pts with infertility (and it works).

Other routine things I do: I always calculate out a BMI when I see a pt for her annual exam. And almost invariably, the pt will tell me that she doesn’t exercise “But I don’t eat much and I walk around a lot”. Of course, when I have the pt recall what she ate…that’s a different story.

Our GI dept is so swamped, that it takes months (try over 6 months to a yr) to get a routine screening colonoscopy. Now if the pt had bleeding…that might expedite things ;-)

]]> By: KidneyNoteshttp://www.kevinmd.com/blog/2005/05/are-these-top-10-medical-tests-you.html#comment-52872 KidneyNotes Mon, 16 May 2005 03:26:00 +0000 http://clients.emmense.com/kevinmd/2005/05/18310.html#comment-52872 The CYP450 test is intriguing. How soon will it be before a patient arrives in my office asking for this test? How soon until the first lawsuit by someone who was (for example) particularly sensitive to coumadin and had a bleeding complication, and then argued that this sensitivity could have been identified by the Cytochrome P450 test? I've been searching for more information on this, and I'd love to see what a sample profile looks like. Awaiting information from Roche. The CYP450 test is intriguing. How soon will it be before a patient arrives in my office asking for this test? How soon until the first lawsuit by someone who was (for example) particularly sensitive to coumadin and had a bleeding complication, and then argued that this sensitivity could have been identified by the Cytochrome P450 test? I’ve been searching for more information on this, and I’d love to see what a sample profile looks like. Awaiting information from Roche.

]]> By: GGhttp://www.kevinmd.com/blog/2005/05/are-these-top-10-medical-tests-you.html#comment-52870 GG Sun, 15 May 2005 23:24:00 +0000 http://clients.emmense.com/kevinmd/2005/05/18310.html#comment-52870 I love the CYP450 recommendation; nothing better than a test no one can interpret! I want to cast a vote for abdominal aortic aneurysm screening. I know the recommendations are not that strong, but if the results are addressed cautiously unnecessary surgeries should be avoidable. What I don't know is how expensive ultrasound is. I know the recommendation is only for men, but the list also included Pap smear and PSA. I love the CYP450 recommendation; nothing better than a test no one can interpret! I want to cast a vote for abdominal aortic aneurysm screening. I know the recommendations are not that strong, but if the results are addressed cautiously unnecessary surgeries should be avoidable. What I don’t know is how expensive ultrasound is. I know the recommendation is only for men, but the list also included Pap smear and PSA.

]]> By: Clayhttp://www.kevinmd.com/blog/2005/05/are-these-top-10-medical-tests-you.html#comment-52868 Clay Sun, 15 May 2005 13:55:00 +0000 http://clients.emmense.com/kevinmd/2005/05/18310.html#comment-52868 Good post, and I agree with your stated views on these. I also agree that a TSH screening should beat out some of the other tests listed. Good post, and I agree with your stated views on these. I also agree that a TSH screening should beat out some of the other tests listed.

]]> By: zzhttp://www.kevinmd.com/blog/2005/05/are-these-top-10-medical-tests-you.html#comment-52867 zz Sun, 15 May 2005 08:58:00 +0000 http://clients.emmense.com/kevinmd/2005/05/18310.html#comment-52867 great post. great post.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2005/05/are-these-top-10-medical-tests-you.html#comment-52864 Anonymous Sun, 15 May 2005 00:10:00 +0000 http://clients.emmense.com/kevinmd/2005/05/18310.html#comment-52864 One or two comments. I agree that colonoscopy is the best test for screening for colon ca but I'm not aware of any evidence based data that supports a certain age to start (or stop) screening, or that screening actually lowers the mortality from colon cancer.The ACS recommends FSC and/or occult blood testing or colonoscopy for routine screening; they are not specific about the test.<br/>I would add a TSH as a routine screen-starting at age 35 in women and around 50 in men.Hypothyroidism is easily treated and a TSH is cheap. Furthermore, even mild aysymptomatic hypothyroidism can raise the cholesterol and increase CV risk.The TSH screening is now recommended by the ACP and other organizations. One or two comments. I agree that colonoscopy is the best test for screening for colon ca but I’m not aware of any evidence based data that supports a certain age to start (or stop) screening, or that screening actually lowers the mortality from colon cancer.The ACS recommends FSC and/or occult blood testing or colonoscopy for routine screening; they are not specific about the test.
I would add a TSH as a routine screen-starting at age 35 in women and around 50 in men.Hypothyroidism is easily treated and a TSH is cheap. Furthermore, even mild aysymptomatic hypothyroidism can raise the cholesterol and increase CV risk.The TSH screening is now recommended by the ACP and other organizations.

]]>