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Microsoft word - gynecologypaneltestsexplained.doc

Tests Explained
Gynecology Panel
Human Immunodeficiency Virus 1 & 2
Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, ejaculate or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells. The four major routes of transmission are unprotected sexual intercourse, contaminated needles, breast milk and transmission from an infected mother to her baby at birth (vertical transmission). Screening of blood products for HIV has largely eliminated transmission through blood transfusions or infected blood products. Women who are antibody positive to HIV have a significant chance of transmitting this virus to their newborns. There is a cocktail of pills that the mother can take before birth to prevent the transmission to the newborn. Eventually most HIV-infected individuals develop AIDS (Acquired Immunodeficiency Syndrome). These individuals mostly die from opportunistic infections or malignancies associated with the progressive failure of the immune system. Without treatment, about 9 out of every 10 persons with HIV will progress to AIDS after 10-15 years. Many progress much sooner. Treatment with anti-retroviral drugs increases the life expectancy of people infected with HIV. We test for the nucleic acid of the virus which is the most accurate method for determining the presence of infection. We also test for the presence of antibodies against the virus in the body. Positive cases are deferred from donation. Voice (630) 427-0300 Fax (630) 427-0302 • Rapid Plasma Reagin qualitative (RPR).
RPR refers to a type of test that looks for non-specific antibodies in the blood of the patient that may indicate that the syphilis-causing spirochete bacterium Treponema pallidum is present. If positive, a confirmatory test for specific antibodies is done. The route of transmission of syphilis is almost always through sexual contact, although there are examples of congenital syphilis via transmission from mother to child in utero. The signs and symptoms of syphilis are numerous. It can generally be treated with antibiotics, including penicillin. One of the oldest and still the most effective method is an intramuscular injection of benzathine penicillin. If left untreated, syphilis can damage the heart, aorta, brain, eyes and bones. In some cases these effects can be fatal. When left untreated, syphilis can lead to infertility as well as other serious health problems including psychological impairment. A positive case is deferred from donation. • Chlamydia trachomatis (CT) Nucleic Acid Testing (NAT)
Chlamydia infection is one of the most common sexually transmitted infections worldwide — it is estimated that about 2.3 million individuals in the United States are infected with Chlamydia. It is the most common bacterial STD in humans. C. trachomatis is naturally found living only inside human cells. Chlamydia can be transmitted during vaginal, anal or oral sex, and can be passed from an infected mother to her baby during vaginal childbirth. Between half and three-quarters of all women who have a chlamydia infection of the neck of the womb (cervicitis) have no symptoms and do not know that they are infected. In men, infection of the urethra (urethritis) is usually symptomatic, causing a white discharge from the penis with or without pain on urinating (dysuria). Occasionally, the condition spreads to the upper genital tract in women (causing pelvic inflammatory disease) or to the epididymis in men (causing epididymitis). If untreated, chlamydial infections can cause serious reproductive and other health problems with both short- and long-term consequences. Chlamydia is easily treated with antibiotics. Chlamydia conjunctivitis or trachoma is a common cause of blindness worldwide. We test for the nucleic acid of the bacteria in a swab or body secretion. Positive cases are deferred from donation. • Neisseria gonorrhea (NG) Nucleic Acid Testing (NAT)
Also known as Neisseria Gonococci (plural), or Gonococcus (singular), is a species of Gram-negative kidney bean-shaped diplococci bacteria responsible for the sexually transmitted disease gonorrhoea. Symptoms of infection with N. gonorrhoeae differ depending on the site of infection. Voice (630) 427-0300 Fax (630) 427-0302 Infection of the genitals can result in a purulent (or pus-like) discharge from the genitals which may be foul smelling, inflammation, redness, swelling, dysuria and a burning sensation during urination. N. gonorrhoeae can also cause conjunctivitis, pharyngitis, proctitis or urethritis, prostatitis and orchitis. Conjunctivitis is common in neonates. Neonatal gonorrheal conjunctivitis is contracted when the infant is exposed to N. gonorrhoeae in the birth canal and can result in corneal scarring or perforation. Infection of the genitals in females with N. gonorrhoeae can result in pelvic inflammatory disease if left untreated, which can result in infertility. Pelvic inflammatory disease results if N. gonorrhea travels into the pelvic peritoneum via the cervix, endometrium and fallopian tubes. We test for the nucleic acid of the bacteria in swabs or body secretions. Positive cases are deferred from donation. • Pap smear (Thin prep & REFLEX HPV typing in any abnormal PAP)
The Papanicolaou test (also called Pap smear) is a screening test used in gynecology to detect premalignant and malignant processes in the cervix. In taking a Pap smear, a tool is used to gather cells from the cervix. The cells are examined under a microscope to look for abnormalities to detect potentially pre-cancerous changes (cervical dysplasia), which are usually caused by sexually transmitted human papillomaviruses (HPVs). The test remains an effective, widely used method for early detection of pre-cancer and cervical cancer. Human papillomavirus (HPV) infects the skin and mucous membranes of humans. Approximately 130 HPV types have been identified. Some HPV types can cause warts or cancer, while others have no symptoms. Persistent infection with "high-risk" HPV types (different from the ones that cause warts) may progress to precancerous lesions and invasive cancer. HPV infection is a cause of nearly all cases of cervical cancer. A cervical Pap smear is used to detect cellular abnormalities, which if found, merit DNA typing of the HPV virus to detect the strain. This allows targeted surgical removal of potentially precancerous lesions prior to the development of invasive cervical cancer. • Genital culture
Anaerobic culture
A swab is taken from the vagina and cultured on special media in Petri dishes under a controlled environment. The bacterial or fungal colony growth is then reviewed and chemical tests performed to confirm the diagnosis. The bacterial colonies are then subjected to different antibiotics to determine sensitivity, which is scored and reported to the physician. Voice (630) 427-0300 Fax (630) 427-0302

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November 2009 Dear Participating Provider: Please find highlights of the changes made to the Coventry Commercial Formulary that will take effect for January 1, 2010. We have also enclosed a copy of the Member/Physician Reference 2010 Prescription Drug List. In addition, our formulary is available through Epocrates and on our website at . The formulary is viewable in the Provider Section unde

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