Recommended Laboratory Tests for a Routine Workup in a 22-Year-Old Female
A routine laboratory workup for a 22-year-old female should include a complete blood count (CBC), comprehensive metabolic panel, thyroid-stimulating hormone (TSH), lipid profile, and cervical cancer screening. 1
Core Laboratory Tests
Essential Tests
- Complete Blood Count (CBC) - Screens for anemia, particularly iron deficiency anemia which is common in menstruating women 1
- Comprehensive Metabolic Panel - Assesses kidney and liver function, electrolyte balance, and glucose levels 2
- Ferritin - To evaluate iron stores, particularly important in menstruating women 1
- Thyroid-Stimulating Hormone (TSH) - To screen for thyroid dysfunction 1
- Lipid Profile - To assess cardiovascular risk factors 3
- Urinalysis - To screen for kidney disease, urinary tract infections, and diabetes 2
Cancer Screening
- Pap Test - Should begin approximately 3 years after first vaginal intercourse, but no later than age 21 2
- For women ages 21-29: Cytology screening every 3 years
- HPV testing should not be used for screening in this age group
Additional Tests Based on Risk Factors
For Women with Menstrual Disorders
- Serum estradiol and LH/FSH - If there is menstrual irregularity 1
- Serum testosterone/SHBG - For evaluation of hyperandrogenic states 1
For Women with Family History of Genetic Disorders
- Genetic screening - Based on family history, ethnic background, and risk factors 2
- Cystic fibrosis carrier screening - If indicated by family history or ethnicity 2
For Women with Gastrointestinal Symptoms
- Celiac serology (tTG Ab) - Particularly important if iron deficiency anemia is present, as celiac disease is present in up to 4% of premenopausal women with iron deficiency anemia 1
Tests That Are Not Routinely Recommended
- Bone mineral density testing - Not routinely recommended unless specific risk factors are present (eating disorders, chronic renal failure, inflammatory arthritis) 1
- CA-125 - Not recommended for routine screening; only indicated for evaluation of pelvic masses 1
- Extensive GI investigations - Not recommended in young women without GI symptoms or family history 1
Common Pitfalls to Avoid
- Overlooking celiac disease as a cause of iron deficiency in premenopausal women 1
- Annual screening for cervical cancer is no longer recommended for women in this age group 2
- Unnecessary GI investigations in young women with iron deficiency anemia but no GI symptoms 1
- Misinterpreting laboratory values without considering age and sex-specific reference ranges 4
Follow-up Recommendations
- Laboratory tests should be repeated every 1-2 years in healthy young women 2
- More frequent testing may be indicated based on specific risk factors or abnormal findings
- Cervical cancer screening should follow the 3-year interval recommendation for women ages 21-29 2
By following these evidence-based recommendations, clinicians can provide appropriate screening while avoiding unnecessary testing in healthy young women.