Advanced Checkup- General Medicine/ Check Up

Advanced health checkups help you know the state of your health, create a plan for improving it, and direct you toward better health and wellness.

Importance of Advanced Health Checkup

Advanced checkups focus on preventing illness rather than treating an active symptom or a disease already diagnosed. While maintaining health through exercise, a balanced diet, and a healthy lifestyle is essential, getting health checkups at periodic intervals is also important.

The value of advanced health checkups is often understated. These examinations not only aid in spotting problem areas that could otherwise go undetected but also support early diagnosis of symptoms. In the long term, these examinations can prevent significant problems that could cripple or damage the body.

Listed below are five reasons why you need an advanced health checkup.

1. Regular medical checkups can lower your risk of getting sick

Many physical and mental examinations are part of routine and advanced medical checkups, ensuring your body and mind are healthy. This is done to identify any diseases promptly and provide you with the appropriate treatment.

2. Advanced checkups can help detect disorders linked to stress

These days, most people experience stress due to deadlines, long commutes, ongoing pressure at work (or school, college), and other events. Excessive stress could lead to diseases and disorders that can present physically or psychologically.

A thorough examination will allow your doctor to diagnose such problems and give you a chance to talk about your stress and receive the required care.

3. Periodic medical exams will increase your health awareness

Most of us rarely go to a hospital or see a doctor until we are genuinely ill and in need of care since we often take our health for granted. Also, without periodic checkups, we can become more inclined to make poor health-related decisions, particularly concerning exercise and diet.

Regular health examinations will naturally increase your health awareness and what you can do to live a healthy life. This is mainly due to simply visiting the hospital, meeting your doctor, and interacting with other patients and visitors.

4. Advanced checkups help identify blood test results

Most people are familiar with the symptoms of common diseases, such as a fever or cold, since these usually have physical symptoms. While this might be sufficient for minor illnesses, you might have a more severe condition that, if left untreated, could get worse.

Due to this, doctors frequently request a blood test, which is also a must for any advanced checkup package (although the exact tests can differ depending on your age and lifestyle). These blood tests also help in the early detection of some disorders.

5. Advanced checkups can lower healthcare expenses

Regular advanced checkups help in the prevention, early diagnosis, and treatment of diseases. This, in turn, lowers your risk of being ill (or your condition worsening), thereby reducing your medical expenses.

Not to mention the time factor: getting sick might force you to miss time from work or school, which can wreak havoc on your entire schedule. Regular medical checkups help maintain your health and reduce the likelihood of being absent from work or requiring hospital admission.

Assessments and Tests Included In Advanced Health Checkup

Below are tests that could be included in your advanced checkup.

Physical Examination

During a physical exam, your doctor will listen to your concerns and suggest preventive screenings if necessary. Then, they will use a physical exam to do the following:

• Check your vital signs, including your breathing, heart rate, and body temperature.
• Determine whether your lifestyle poses any specific risks.
• Recognize any ailments you may have a family history of.
• Check your immunization record

Your doctor could want an update on any new changes and additions to your medical history. This could involve inquiries about your place of employment, relationships, use of supplements, medications, and any recent procedures.

Your physician will examine your physical features to look for any potential issues. They will examine the areas of your body where visible health problems could exist. This involves looking at the following:

• Eyes
• Head
• Belly
• Chest
• Nervous system functions, such as walking and speech
• Musculoskeletal systems, such as your wrists and hands

As a part of the physical examination, the doctor will use instruments to look into your ears, eyes, and throat. They will also check your lungs and heart. A physical exam also includes the following:

• 'Palpating' parts of your body to check for anomalies such as your tummy
• Evaluating your rectum and genitalia
• Checking your hair, skin, and nails
• Assessing motor function and reflexes[1] 

Blood pressure

Your doctor will check your blood pressure to see if it is high or low, both of which are conditions that can impair the blood flow to your brain and the rest of your body. Normal blood pressure level is 120 over 80. Doctors define high blood pressure, or hypertension, as 130 over 80 or higher.

You should monitor your blood pressure at least every two years, starting at age 18. This is because a heart attack, kidney disease, or stroke can all be brought on by high blood pressure. Controlling blood pressure will help in preventing these conditions. Males over 45 or those at risk for high blood pressure should have this test performed every year.

BMI

When you visit your doctor for any type of checkup, they will likely check your height and weight. This is required to calculate your BMI (body mass index). Keeping a healthy BMI reduces your risk of contracting diseases like heart diabetes, type 2 diabetes, and certain cancers.

A formula based on height and weight determines your BMI. Your doctor will recommend ways to achieve your ideal weight if you are not within the range.

Blood analysis

Your doctor may prescribe bloodwork involving several laboratory tests to complete the checkup.Tests such as a complete metabolic panel, commonly known as a chemical panel, and a complete blood count are among those that are requested. The panel analyzes your blood plasma and can detect any problems with your immune system, blood chemistry, kidneys, or liver.

Blood tests help identify abnormalities in the body that can point to a more significant issue. Here are some of the common blood tests.

Complete Blood Count (CBC)

Red blood cells, white blood cells, and platelets are all measured and examined as part of the complete blood count (CBC). A CBC evaluates, counts, measures, and studies many blood-related factors, such as:

• A CBC without differential counts the total white blood cells in the body.
• A CBC with differential counts the five different kinds of white blood cells in the body.
• The hemoglobin test measures hemoglobin, the protein in red blood cells that delivers oxygen.
• A platelet test measures the number of platelets, the cells that help your blood clot.
• The hematocrit value indicates the concentration of red blood cells.

A CBC tells your doctor how many new blood cells your body is producing. Your doctor can also identify several ailments, disorders, diseases, and infections using a CBC blood test. These include:

• Anemia (when the body does not have enough red blood cells to deliver oxygen).
• Infections or other conditions lead to unusually high or low white blood cell counts.
• Diseases like sickle cell anemia, thalassemia, and agranulocytosis.
• Bone marrow disorders such as myelodysplastic syndromes.
• Several cancers, including lymphoma and leukemia.
• Side effects of certain prescription drugs and chemotherapy.

Peripheral blood smear

Healthcare professionals can check your red, white, and platelet blood cells with a peripheral blood smear test. Unlike blood tests analyzed by machines, here, healthcare providers manually evaluate blood tests under a microscope.

Your doctor may order a peripheral blood smear along with a CBC. A peripheral blood smear examination reveals the microscopic appearance of your blood cells and platelets. Your healthcare professional might observe these things under a microscope:

• Blood cancer or a blood disorder may be indicated by changes in the size and structure of your blood cells and platelets.
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• Changes in the count or number of your blood cells and platelets may indicate a problem in your bone marrow, which produces these cells.
• Signs that your blood may be infected with parasites.
• Abnormal changes in any of the five types of white blood cells can indicate cancer.

Lipid profile

A lipid panel measures the amount of specific fat molecules, or lipids, in your blood. The panel typically includes a test of your triglycerides as well as four separate cholesterol measurements.

High blood lipid levels (cholesterol and triglycerides) can accumulate in your arteries and blood vessels, damaging them and increasing your risk of cardiovascular issues. As a result, lipid panels are used by medical professionals to assess the risk of cardiovascular disorders such as heart disease, myocardial infarction (heart attack), and stroke in both children and adults.

If you are healthy, you can start getting this test at age 20 and every five years after that. However, if you have risk factors like diabetes, a genetic predisposition to heart attack or stroke, are overweight, or smoke, you might need to get tested more frequently.

A lipid panel analyzes a blood sample for five different lipid types, including:

Total cholesterol: This is the combination of your LDL, VLDL, and HDL cholesterol levels.

Triglycerides: These are a type of fat found in food that we consume. High triglyceride levels in the blood are linked to pancreatic inflammation and cardiovascular disease.

Very low-density lipoprotein (VLDL) cholesterol: This form of cholesterol is typically only found in minimal concentrations in fasting blood samples since it is mainly derived from recently consumed meals. Increased VLDL concentration in a fasting sample may indicate an abnormal lipid metabolism.

This type of cholesterol is called "bad cholesterol." The risk of cardiovascular disease may increase if it builds up in your blood vessels.

High-density lipoprotein (HDL): this kind of cholesterol is called the "good cholesterol." It helps in reducing LDL buildup in your blood vessels.

While these are the main measurements in a typical lipid panel, more tests may be present in some versions.

Thyroid profile

A thyroid function test (TFT) or thyroid profile can be performed to determine if your thyroid gland is working normally. The test evaluates the amount of thyroid hormones in your blood and will decide whether or not you have an overactive thyroid (hyperthyroidism) or an underactive one (hypothyroidism).

Blood testing for the thyroid includes:

Thyroid-stimulating hormone (TSH): The pituitary gland produces TSH, which controls the ratio of thyroid hormones, including T4 and T3, in the bloodstream. This is usually the initial test your doctor will perform to look for an imbalance in thyroid hormones. For example, hyperthyroidism is typically linked to a low TSH level, whereas hypothyroidism is linked to a raised TSH level.

If TSH is abnormal, it may be necessary to measure thyroid hormones directly, such as triiodothyronine (T3) and thyroxine (T4), to further assess the problem. The normal test range of TSH for an adult is 0.40 to 4.50 mIU/mL. (milli-international units per liter of blood).

T4: thyroxine checks for hypo and hyperthyroidism and is used to track the effectiveness of treatment for thyroid disorders. While high T4 levels may signify hyperthyroidism, low T4 levels are seen with hypothyroidism.

The normal range of T4 for adults is between 5.0 and 11.0 ug/dL. (micrograms per deciliter of blood).

Free T4 (FT4): This is also known as free thyroxin. The test is a way to measure T4 that eliminates the effects of proteins that naturally bind the hormone and could lead to inaccurate results. The normal test range of FT4 for adults is 0.9 to 1.7 ng/dL. (nanograms per deciliter of blood)

T3: Triiodothyronine tests are used to identify hyperthyroidism or to assess its severity. Although elevated T3 levels in hyperthyroidism make diagnosing and treating the condition easier, low T3 levels can also be seen in hypothyroidism.

T3 levels should be between 100 and 200 ng/dL. (nanograms per deciliter of blood).

FT3: Free T3, also known as free triiodothyronine, is a way to measure T3 that eliminates the effects of proteins that naturally bind the substance and could lead to inaccurate results. FT3 typically ranges from 2.3 to 4.1 pg/mL. (picograms per milliliter of blood).

Renal profile

Kidney function tests are urine or blood tests used to assess how well your kidneys are functioning. Most of these examinations gauge glomerular filtration rate (GFR). The GFR measures how well your kidneys remove waste from your body.

Your doctor may order one or more of the kidney function test types. Kidney function may be assessed using blood tests, such as:

• Estimated GFR (eGFR) calculates the rate of filtration in your body based on your protein levels, age, race, gender, and size.
• Blood urea nitrogen (BUN) is a test for blood nitrogen produced when proteins are broken down.
• Serum creatinine tests for creatinine, the waste product from the breakdown of muscle tissue.

In addition, your healthcare provider might request 24-hour urine testing, such as:

• Urinalysis - evaluates your urine for proteins, blood, and function.
• Microalbuminuria - searches for an albumin-specific protein.

Urinalysis

A urine examination, also known as a urinalysis, is a test that looks at your urine's appearance, chemical composition, and microscopic structure. It may consist of various tests that use a single urine sample to identify and quantify different substances that travel through your urine.

The following characteristics of a urinalysis urine sample can be checked by a medical professional or laboratory technician:

• Color and appearance.
• Chemical results (protein, pH level, ketone, sugar, bilirubin, nitrite, specific gravity)
• Microscopic findings (Cells, cell fragments, urinary casts, mucus, bacteria, or other germs and crystals)

Liver profile

A liver function test measures the various substances your liver produces.

Liver enzyme test: This is one of the most widely used liver tests. Aspartate aminotransferase (AST),  Alkaline phosphatase (ALP), alanine transaminase (ALT), and gamma-glutamyl transferase are among the liver enzymes (GGT). These are elevated when the liver is injured.

Test for total proteins: This test measures the amount of protein in your blood. Since your liver creates protein, low protein levels may indicate that your liver is not working properly.

Test for bilirubin: This test estimates bilirubin, the waste products stored in your liver.

LDH test: Lactate dehydrogenase (LDH) is an enzyme present in numerous bodily tissues, including the liver.

Prothrombin Time (PT) test: This test measures the duration of the blood clotting process, which requires protein produced by the liver.

Eye Test

A comprehensive eye exam includes several tests to assess your eyesight and check for eye disease. For example, your eye doctor may ask you to look through various lenses, use multiple tools, and shine strong lights in your eyes. During an eye exam, several aspects of your vision or eye health are assessed using various tests.

The common eye tests are as follows:

Visual acuity test: This examination gauges your visual acuity, or how clearly you see. Your doctor instructs you to recognize several alphabet letters written on a chart or screen placed some distance away.

Visual field test: This test evaluates your side vision or peripheral vision. The most frequent uses of this test are for glaucoma diagnosis and monitoring.

Refraction test: Refraction is how light waves are distorted as they travel through your cornea and lens. With a refraction test, your eye doctor can evaluate whether you require vision correction and the corrective lens prescription that will help you see as clearly and sharply as possible.

Slit-lamp exam: This test examines the front of the eye by flashing a light beam that resembles a tiny slit on the eye. Your pupils may also enlarge as the eye doctor does this examination. The test can help diagnose several diseases, including retinal detachments, cataracts, macular degeneration, presbyopia, and corneal injuries.

Color Blind Test: This test evaluates your capacity to recognize colors to check for color blindness. You may be asked to find a number or letter within a pattern of variously colored circles.

Hearing Tests

Healthcare professionals use hearing tests to identify hearing loss. Hearing tests come in a variety of formats. For example, some hearing tests are primarily used on adults, while others are utilized on infants, kids, and adults. Types of hearing tests include:

Pure-tone testing: This common hearing test determines what pitch you can hear at the quietest volume. Pure-tone testing is done on both adults and children.

Bone conduction testing: This is performed to determine if your outer or middle ear is blocked by wax or fluid or whether you have hearing loss in your sensory cells.

Otoacoustic emissions test (OAE): Audiologists perform this examination to test the functioning of your inner ear.

Speech testing: This type of hearing test may be performed on adults and some youngsters. It involves listening and repetition of specific words. The examination reveals how well you comprehend speech.

Tympanometry: This examination measures the flexibility of your eardrum. Audiologists may perform tympanometry tests to check for a ruptured eardrum, fluid in the middle ear, or wax in the ear canal.

Auditory brainstem response (ABR): This test examines the neural pathways that connect your inner ear to your brain. This test aims to assess hearing in youngsters and individuals who cannot successfully complete pure-tone tests. This test might also be performed on those whose hearing has been affected by a brain injury.

Gastrointestinal Study

The esophagus, small and large intestines, stomach, anal canal, and rectum make up the gastrointestinal tract, or GI tract. A GI study examines the entire GI tract. Common GI examinations include:

Barium swallow test (esophagram): This examines the esophagus, where barium is used during swallowing. Certain areas of the GI tract show up more clearly on an X-ray.

Upper GI series:  The esophagus, stomach, and duodenum (upper small intestine) are all examined as part of the upper gastrointestinal series.

Small bowel series: The test looks at the small intestine's (small bowel's) role in digestion.

Lower bowel series or barium enema: Examination of the colon, rectum, and lower small intestine (ileum) using a barium enema.

Pulmonary Study

PFTs (pulmonary function tests) are non-invasive examinations that show how effectively the lungs function. The examinations gauge lung size, function, flow rates, and gas exchange. Your healthcare professional may use this information to diagnose and treat some lung conditions.

PFT is possible using two techniques. Depending on the data your healthcare professional needs, these two approaches may be combined to perform other tests:

• Spirometry:  A mouthpiece-equipped spirometer instrument is connected to a tiny electrical device.
• Plethysmography: To conduct the tests, you must sit or stand inside an airtight box resembling a short, square telephone booth.

PFT measures:

Tidal volume (VT): This is the air volume breathed in or out normally.

Vital capacity (VC): This is the total amount of air that can be exhaled after taking in as much air as possible.

Minute duration (MV): This represents the total air breathed out each minute.

Residual volume: This is how much air is still in your lungs after you have exhaled as much as you can.

Functional residual capacity (FRC): This measures how much air remains in your lungs after exhaling normally.

Total lung capacity: This is the lungs' total volume when fully inflated with air.

Peak expiratory flow rate (PEFR): This is the quickest rate at which you can expel air from your lungs.

Forced vital capacity (FVC): This is the amount of air that is forced and quickly released after taking in as much air as possible.

Forced expiratory volume (FEV): The amount of air expelled in the first, second, and third seconds of the FVC test is shown here.

Forced expiratory flow (FEF): This is the average flow rate for the middle portion of the FVC test.

Imaging tests

Imaging tests use different forms of energy, such as ultrasound (high-energy sound waves), X-rays (high-energy radiation), radioactive substances, and radio waves. These tests give a detailed picture of areas inside the body.

Here are the commonly used imaging tests:

X-ray

X-rays are a kind of electromagnetic wave. Medical X-ray imaging produces images of the structures inside your body.

The X-ray photos depict the various bodily parts in shades of black and white. This is because different tissues absorb radiation in different ways.

Although looking for fractures (broken bones) is the most common application of X-rays, there are other uses too. For instance, chest radiographs can detect pneumonia.

Ultrasounds

An ultrasound imaging test employs sound waves to produce a sonogram, or image, of the organs, tissues, and other internal body structures. Ultrasounds do not use radiation as X-rays do. Moreover, an ultrasound can depict bodily functions in motion, such as a beating heart or blood coursing through blood vessels.

CT Scan

Using specialized X-ray equipment, computed tomography (CT) creates cross-sectional images of your body. Doctors use CT scans to look for:

• Fractures (broken bones)
• Blood clots
• Cancers
• Internal bleeding
• Signs of heart disease

2D Echo

A 2D echocardiogram, sometimes known as 2D echo, is a non-invasive examination used to evaluate and examine the various parts of your heart. With the help of sound waves, this test produces images of the different heart regions. In addition, it assists in looking for damage, obstructions, and blood flow.

Doctors advise routine 2D echo exams to diagnose and treat any heart problems early on and keep you healthy and active as you age.

ECG

During an electrocardiogram (EKG/ECG), temporary electrodes are placed on your chest and limbs, which document, track, and monitor your heart's electrical activity (which regulates your heartbeats) for diagnostic purposes. A computer converts the data into a wave pattern your healthcare physician can understand. This is a short, painless test. An electrocardiogram can be obtained while resting or working out as part of a stress test.

Screening Tests

A screening test is performed to look for potential health issues or diseases, even when a person does not exhibit any symptoms of a condition. The objective is early identification, lifestyle modifications, or monitoring to lower the disease risk. Depending on your gender, screening exams can be different.

Both men and women:

Lung cancer screening: Doctors advise a yearly low-dose CT scan of the lungs for both men and women aged 55 to 80 who smoke or have previously smoked for a significant amount of time. If you smoke, check with your doctor to see if a lung cancer screening is necessary.

Testing for colon cancer (colorectal cancer): The screening typically starts at age 50. Your doctor may recommend it sooner based on your health issues and family history.

Diabetes: You should be screened for diabetes if it runs in the family or if you have risk factors, such as being overweight, having high blood pressure, or having high cholesterol. Your doctor might order an A1C test or a fasting blood sugar test.

Vaccinations: Adults continually require vaccination throughout their lives. Speak with your doctor about the immunizations that are recommended for your age.

HIV test: If you frequently engage in unprotected intercourse, your doctor may advise getting an HIV test more than once as a prophylactic measure.

Depression: Because the potential symptoms of depression are often mistaken for those of other conditions, many people are unaware of them. To determine whether your symptoms are caused by depression, your doctor may perform a depression screening at each visit.

Hepatitis C: It is advised that everyone born between 1945 and 1965 undergo a single blood test to check for hepatitis C.

STI screening: Regular STI testing at each standard physical exam may be advised depending on your specific sexual history. Testing for syphilis and HIV may be part of this.

Test for syphilis: If you are pregnant or at risk for syphilis, you might need to get this test.

Gout screening: Uric acid testing for gout determines how much uric acid is present in a sample of your blood. Gout can result from a buildup of uric acid in the blood, which can cause needle-shaped crystals to grow in and around the joints.

Women:

Mammogram: A mammography is advised for women with a low or moderate risk of breast cancer. Between the ages of 50 and 74, mammography is advised every two years. However, based on your personal and family history of breast cancer, more frequent and earlier testing may be advised.

Pap smear: The pap smear is a cervical cancer screening test. Around age 21, women should start getting screened. After that, as long as the woman has a robust immune system, additional examinations are advised every three years. Up until age 65, pap smears are recommended once every five years after age 30. Most women no longer need pap smears after the age of 65.

Pelvic examination: This can be done with or without a pap test. During a pelvic exam, the vagina, cervix, and vulva are checked for signs of an STI or other disorders.

Osteoporosis examination: By age 65, bone density scans should start. They might start earlier in some medical circumstances.

Breast exam: During a breast exam, doctors can look for any unusual lumps or breast cancer warning signs.

Cholesterol test: Most women should start getting their cholesterol checked regularly from age 45. Cholesterol screenings may need to begin as early as age 20 if you have a family history of diabetes or heart disease.

Men:

Cholesterol test: It is recommended that most men begin routine cholesterol screenings around age 35. Cholesterol screenings may need to start as early as age 20 if you have a family history of diabetes or heart disease or are genetically predisposed to either condition.

Prostate cancer screening:  Starting at age 50, some men may benefit from screening for prostate cancer. If there is a long family history, it may begin as early as age 40. This may include a digital rectal examination and estimating prostate-specific antigen (PSA) in the blood.

Having a low PSA level in your blood is normal. However, benign prostatic hyperplasia (BPH), prostate cancer, other common prostate problems, and using specific medications can all contribute to a high PSA score. A PSA test cannot identify the cause of abnormal PSA levels. So, if your level is high, you might need more examinations.

Testicular exam: Your doctor may want to look for lumps, soreness, and changes in the size of each testicle. This may indicate various problems.

Abdominal aortic aneurysm screening: This ultrasonic screening exam is a one-time procedure. It is advised for all men who have ever smoked between the ages of 65 and 75.

Resources:

• Ridley, Jane et al. “Adult health checkup: Update on the Preventive Care Checklist Form©.” Canadian family physician Medecin de famille canadien vol. 62,4 (2016): 307-13.
• George-Gay, Beverly, and Katherine Parker. “Understanding the complete blood count with differential.” Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses vol. 18,2 (2003): 96-114; quiz 115-7. doi:10.1053/jpan.2003.50013
• Yadav, Saumya, and Radhika Tandon. “Comprehensive eye examination: what does it mean?.” Community eye health vol. 32,107 (2019): S1-S4.
• Givler, Donald N. and Amy Givler. “Health Screening.” StatPearls, StatPearls Publishing, 19 February 2023.

 

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