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Tests and Examinations Your visit to Jersey Shore will be tailored to meet your individual health needs, based on personal preferences and your patient information questionnaire. Detailed Medical History and Physical Examination A thorough medical history is the cornerstone for effective assessment and diagnosis. It reviews any past problems and looks for susceptibilities based on your personal and family background, as well as your health habits. This is the opportunity for you to raise any medical concerns you may have. In order for us to properly review your history, please complete and submit your medical history at least two weeks prior to your appointment. Comprehensive Laboratory Screening Tests These detect anemia, diabetes, thyroid disease, liver and kidney disease, and include a lipid panel to assess cardiac and stroke risk factors. Testing for men also includes Prostate Specific Antigen (PSA) screening. The use of the PSA is controversial. We continue to begin testing men at age 40 if there is a family history or other risk factors and at age 45 in all other men. We discourage screening men over the age of 75 given evidence that it may do more harm than good. We also screen for infectious diseases, causes of erectile dysfunction, and other metabolic diseases. (Women’s tests are located on the next page.) Complete Blood Count (CBC) Chemistry profile Lipid profile with advanced Cardiovascular Lipid Analysis Thyroid Function Test (TSH) HgA1C* PSA* Testosterone Level* Vitamin D Level Cardiac C-Reactive Protein (CRP) Iron Profile Erythrocyte Sedimentation Rate HIV Test Hepatitis Serology Urinalysis *If indicated Cardiovascular Testing Your evaluation may include: Resting electrocardiogram (EKG) – Detects changes in the heart’s electrical activity. Patterns seen in the tracing indicate where tissue may have been damaged, if coronary arteries may be blocked, or if irregular beats occur frequently. Ultrafast CT Scan of the Coronary Arteries with Calcium Score – recommended for most patients over 40 to detect asymptomatic coronary artery disease. Exercise Stress Test – detects how your heart responds to physical activity. Recommended for symptomatic patients or those at high risk for coronary artery disease Echocardiogram – detects enlargement of the heart muscle. Recommended for individuals with hypertension and others with certain symptoms or risk factors Abdominal Aortic Ultrasound – detects enlargement of the abdominal aorta (aneurysm). Recommended based on age and risk factors, especially smoking PAD Screening – The ankle – brachial index detects diminished blood flow to the lower extremities due to narrowing of the arteries. Recommended based on age and risk factors, especially smoking history. Ultrasound of the Carotid Arteries – detects narrowing of the carotid arteries, the major blood vessels supplying the brain. Recommended based on age, risk factors and symptoms. Pulmonary Testing Your evaluation may include: Chest X-ray – Assesses heart size (thickened walls may reflect decreased pumping ability) and pulmonary disease, including lung masses. A baseline chest X-ray will be obtained at your first visit. Subsequent studies may be needed if you have a history of respiratory symptoms, smoking or known lung disease. Pulmonary function test (PFT) – Help diagnose emphysema, bronchitis, asthma or other pulmonary problems. PFTs are obtained at your first visit. Follow-up studies on subsequent visits may be obtained if you have a history of respiratory symptoms, smoking or known lung disease. Low Dose CT Scan of the Lungs – detects very small lung cancers before they can be seen on Chest X-Ray. It is recommended for smokers. Gastrointestinal Testing Hemoccult Test – detects the presence of blood in the stool Colonoscopy – recommended for anyone 50 or older and beginning earlier if there is a Family History of Colon Cancer or symptoms. (Because this test requires anesthesia, our staff will assist in scheduling an appointment on a separate day.) Women’s Health Pelvic examination with Cervical Cancer Screening (Thin Prep/HPV) – these tests identify cervical cancer in the precancerous stage. Recommended for all women under the age of 65 and for women older than 65 based on risk. Mammography – recommended for all women over 40 (earlier if high risk) at least every two years Bone Density Study – detects bone thinning (osteoporosis or osteopenia) Women – recommended for all post-menopausal women Men – all men over 70, younger men with risk factors Audiogram - Performed by an audiologist who also makes recommendations to help preserve hearing or who may suggest sound amplification. Hearing loss of some degree affects 22 million Americans; high frequency loss, which impairs speech comprehension, is the most common form. An audiogram should be obtained at the first visit. Subsequent studies will be determined based on your needs. Eye Examination – Visual acuity and Glaucoma Testing. Nutrition Counseling with Body Fat Analysis - A registered dietician will determine your body fat composition and be provided with nutritional counseling to optimize your health and promote weight loss if indicated. Exercise Counseling – An exercise physiologist will establish a specific fitness plan for you based after consulting with the medical staff and taking into account your personal goals and current activity level. Vaccination Review – the current immunization status will be reviewed and updated as necessary Travel Medicine Consultation – If your travel includes international destinations, we can arrange a consultation to discuss risks, update travel immunizations and provide appropriate prescriptions. Sleep Assessment - recommended based on specific history and risks (requires overnight stay in sleep lab) Whole-body CT Scan Screening – There is no current evidence that routine WBCT screening in the asymptomatic person is effective therefore this is not recommended. In addition there are very real downsides including significant radiation exposure and the frequent detection of abnormalities that have no clinical significance but which require further additional expensive and sometimes risky testing with the generation of needless anxiety, expense and harm. Final Conference Review of Test Results Recommendation for further testing and follow up with your primary care physician Counseling on Lifestyle Management Personalized written report to be sent within two weeks with a copy to your primary care physician