Are you doing the right tests during your year-end physical examination?

At the end of the year, various units have started to organize physical examinations for employees. Do you know what items should be done and what should be paid attention to before the physical examination? Let's take a look.

The focus of physical examination is different for different age groups

20-30 years old: infectious diseases, mental illness. People in this age group often have irregular lives and more frequent sexual activities, and the chances of contracting various infectious diseases increase accordingly. Moreover, when they first enter the workplace, they are under great pressure and cannot deal with various problems skillfully, which leads to many young people being entangled in mental illness and insomnia. Therefore, young people aged 20 to 30 should pay special attention to screening for infectious diseases and mental illnesses during physical examinations. Common examinations include hepatitis B, Helicobacter pylori, and self-measurement scales for mental illnesses. Some malignant tumors are also more common in young people, such as leukemia, osteosarcoma, etc. In addition to routine physical examination items, such as blood routine, blood lipids, blood sugar, liver function, kidney function, abdominal color ultrasound, chest X-ray, etc., you should also seek medical attention in time in combination with physical changes.

30-40 years old: Chronic diseases. People in their thirties and forties are in the rising career stage. In addition, they have a heavy family financial burden, poor diet control, and many social activities. Chronic diseases such as hypertension, hyperlipidemia, and diabetes are particularly likely to target middle-aged people. It is recommended that this group of people focus on screening for the "three highs" and cancer during physical examinations. Women should pay special attention to cervical cancer and breast cancer. They can undergo HPV, TCT, vaginal color ultrasound and other examinations, and can also choose targeted tumor marker examinations. The occurrence of chronic diseases is hereditary. If there are patients with the "three highs" in the family, they must strictly manage their health on a daily basis and seek medical attention as soon as symptoms are found.

40-50 years old: Tumors. After the age of 40, physical fitness begins to decline, hormone secretion levels in the body change, emotions are particularly prone to fluctuations, and chronic diseases will also come knocking. During this period, nodules, tumors, cardiovascular and cerebrovascular diseases will begin to show signs, and the incidence of family genetic diseases will increase. It is recommended that people with a family history of disease and relatives within three generations who have developed tumors need to have an early physical examination. Taking a family history of gastric cancer as an example, subtract 15 years from the age of the family member when they had cancer, which is the age at which a gastroscopy is required. In addition, lung cancer is the tumor with the highest incidence in my country, and high-risk groups should focus on low-dose spiral CT screening and tumor marker testing. It is worth noting that some women have entered perimenopause at this stage, and early screening for breast cancer can be performed through breast color ultrasound, molybdenum target, tumor markers and other examinations.

Over 50 years old: Osteoporosis. When people reach middle age, they should pay attention to three key points in physical examinations: In terms of cardiovascular and cerebrovascular screening, people who already have cardiovascular and cerebrovascular diseases should regularly undergo cerebrovascular, electrocardiogram, cardiac ultrasound, head magnetic resonance imaging and other examinations, which are of great significance for preventing acute cardiovascular and cerebrovascular events. In terms of tumor screening, focus on the screening of lung cancer, liver cancer, gastric cancer, colorectal cancer, prostate cancer, etc. Once early cancer is found, early diagnosis and early treatment are the principles to improve the treatment effect. Due to the fear of gastrointestinal endoscopy, people at this stage are most likely to ignore gastrointestinal tumor screening. Regular gastrointestinal endoscopy, combined with tumor marker testing, can timely detect precancerous lesions and early canceration, greatly improving the cure rate of gastrointestinal tumors. At the same time, bone loss accelerates after the age of 50, and attention should be paid to bone density testing, calcium supplements should be supplemented in time, and active exercise should be carried out to prevent various complications caused by osteoporosis.

Things you must know before a medical examination

How to fast

In order to ensure that the test results are objective and accurate, many blood tests require fasting. The fasting standard is 8 to 14 hours without caloric intake, that is, the night before the blood draw, try to maintain your usual lifestyle, eat normally, eat light meals, and do not drink alcohol, coffee, or strong tea. The next morning, do not eat breakfast, drink little or no water, do not exercise, and calmly go to the hospital to wait for blood draw.

If the fasting time reaches more than 18 hours, the body will be in a state of mild hunger. In the hungry state, many components in the blood will change. First, a series of indicators related to metabolism, such as blood sugar, blood lipids, serum protein, blood ketones, etc.; secondly, indicators related to liver and kidney function will also be abnormal, such as serum bilirubin, creatinine, uric acid, etc. Therefore, it is necessary to grasp the reasonable fasting time.

Should patients with chronic diseases stop taking medication?

There are many patients with chronic diseases who must take medication regularly all year round, such as patients with hypertension, diabetes, and some patients undergoing postoperative anticoagulation therapy. For these patients, rashly stopping or delaying medication can cause adverse events or even life-threatening conditions, so these patients should take medication regularly before undergoing a physical examination.

If you are taking antibiotics, vitamin C, weight loss drugs or contraceptives, you should wait for 3 days after stopping the medication before taking a physical examination. This is because these drugs will affect the accuracy of many test items. For example, vitamin C has a good reducing property and will interfere with most of the test items based on the principle of redox reaction, resulting in inaccurate results.

What to eat before a physical examination

It is advisable to eat a light diet before the physical examination. Greasy diet is the main factor affecting the results of blood lipid test. Since triglycerides are greatly affected by diet, the examinee must eat less or no high-fat foods within 3 days before the test, and do not drink alcohol. Fasting for 12 hours before the test can get an objective and accurate blood lipid result. In addition, a high-fat diet can cause an increase in chylomicrons in the blood, which will affect many blood test items and lead to inaccurate test results. Therefore, you must avoid greasy food before the physical examination.

Some special examinations have special requirements for diet due to different detection methods. For example, for fecal occult blood test, if the o-toluidine chemical method is used, animal blood, viscera and vegetables rich in chlorophyll should be avoided for 3 days before the test; if the colloidal gold method is used, no special requirements are required.

When to have a physical examination

Human metabolism fluctuates throughout the day, not unchanged. Generally speaking, the reference range of normal human serum substance levels is defined based on a baseline of around 8 a.m., so physical examinations require fasting blood samples to be collected between 7:30 and 8:30 a.m., and no later than 12:00 p.m. Too early or too late will distort the test values ​​or deviate from the existing reference range and appear "abnormal" due to the influence of physiological endocrine hormones in the body.

In addition, women should avoid general examinations during their menstrual period. Women should not undergo gynecological examinations, blood tests, liver function tests, etc. before and after their menstrual period. If sex hormone testing is to be performed, blood sampling should be done on the third day of menstruation to reflect the basic levels of various indicators in the early stage of follicles.

Can I do strenuous exercise before a physical examination?

Exercise and mood swings can affect the body's metabolism, nerves, and endocrine functions, causing changes in the composition of blood and body fluids. Intense exercise may lead to increases in myoglobin, creatine kinase, and other substances. Due to hormonal changes, even mild activity and emotional excitement can cause increases in blood sugar, non-esterified fatty acids, lactic acid, etc. Some hormone tests have stricter requirements for the "calm state", and the examinee can consult the medical examination institution in detail before the examination.

Therefore, do not do strenuous exercise two days before the physical examination, and do not do light activities such as walking one hour before the blood test. Do not walk back and forth before the blood test, and keep your mood stable, do not be overjoyed or sad and irritable. Remember to rest for at least 15 minutes before the blood test.

Understand key data and understand the physical examination report

Heart: ECG data can generally be used to determine whether there is a problem with the heart. Common ECG problems include sinus arrhythmia, myocardial ischemia, tachycardia, incomplete conduction block, etc. Sinus tachycardia and right-sided conduction block usually occur due to tension, emotions, etc. Most of them do not represent health problems, but some are diseases or heart problems themselves. Therefore, if there is a problem with the ECG, it is best to consult a specialist or do further examinations.

Liver: Generally, the health of the liver is judged by testing the data of glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and liver B-ultrasound. If there is a problem with the liver B-ultrasound, and there are also problems with the data of glutamyl transpeptidase, alanine aminotransferase, and aspartate aminotransferase, there is a high possibility of liver damage. Generally, more than 2 times means liver damage, but less than 2 times may not mean it, and further examination is needed.

Kidney: Creatinine (CREA), urine protein, uric acid (UA), etc. are important indicators of kidney function. Increased urine protein and uric acid may be caused by some diseases that damage the kidneys, and creatinine will only increase when 60%-70% of the nephrons are damaged. Therefore, when creatinine is found to be elevated, kidney disease has often developed to a certain extent (some kidney function problems have normal creatinine in the early stages). When creatinine is elevated, creatinine should be rechecked. If there is still a problem, further treatment should be sought from the Department of Nephrology.

Routine blood test: Routine blood test includes hemoglobin determination, red blood cell count, white blood cell count and white blood cell classification count. Infectious diseases in various parts of the body can cause changes in the values ​​of white blood cells and neutrophils. When red blood cells, hemoglobin and hematocrit are reduced at the same time, it indicates anemia. According to the size and staining of the cells, it is divided into iron deficiency anemia, hemorrhagic anemia and pernicious anemia. It is recommended to go to a specialist hospital for further examination and treatment; thrombocytopenia can be seen in certain physiological states, such as women's menstrual period, and long-term and significant reduction can be seen in systemic bleeding diseases, such as thrombocytopenic purpura, hypersplenism, leukemia, etc.

Blood lipids: Blood lipid tests usually include four items: total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Among these four blood lipid indicators, the most harmful is low-density lipoprotein cholesterol, which is the main risk factor for atherosclerosis; followed by total cholesterol and triglycerides, which are also risk factors for cardiovascular and cerebrovascular diseases. If these three indicators are high, you need to be careful.