What are the four items checked in a routine physical examination?

Currently, there are four general routine health examinations, the core of which are the four modules of basic physical examination, basic laboratory examination, physiological function examination, and preliminary imaging screening, which can basically cover the core risk points of ordinary people's annual routine screening.

However, I have to mention that the "four routine physical examination items" that people refer to in different scenarios are quite different. Last week, I helped my cousin who had just graduated to run a job physical examination, and the "four routine items for employment" required by his unit were simplified into blood routine, urine routine, and electrocardiogram. , chest X-ray, are all targeted to check whether there are diseases that affect normal performance of work. They are completely different from the four free routine physical examinations for the elderly that my parents went to the community to get. The four items of annual routine health examinations we usually talk about still refer to the four major categories mentioned earlier.

The first thing you encounter when you go for a physical examination is a basic physical examination. There is no need to draw blood or queue up for equipment. The nurse will first measure your height, weight, and blood pressure to calculate your BMI. The internal medicine doctor uses a stethoscope to listen to the heart and lung rhythm, and feels the thyroid gland and abdomen to see if there are any abnormal masses. The surgeon looks at the skin and superficial lymph nodes, and even asks a few questions about whether you feel uncomfortable in any way. They all seem unskilled. In terms of content manipulation, many initial problems were discovered first in this step. My former colleague had his blood pressure checked last year, and it was above 145/95mmHg three times in a row. Originally, he was only 32 years old and usually didn’t feel anything at all. Later, further investigation was conducted and he was diagnosed with essential hypertension. After early intervention, he took medicine for half a year and exercised. Now his blood pressure is very stable, and even the doctor said it was discovered in time.

After drawing a few tubes of blood and sending urine samples for testing, this is the scope of basic laboratory tests. Generally speaking, these include routine hematuria, liver and kidney function, fasting blood sugar, and blood lipids. There is no need to do thousands of tumor marker screenings. These few basic tubes can detect many problems: whether there is anemia, whether there is hidden inflammation in the urinary system, whether there is any hidden inflammation in the urinary system, liver and kidney metabolism, etc. Is there anything unusual about Xie? Has he stepped on the red line of diabetes or hyperlipidemia? Last year, my mother found out that her fasting blood sugar was 6.3mmol/L, just on the threshold of pre-diabetes. She quickly gave up drinking sugar water for decades and went downstairs to dance for half an hour every day. This year, after checking again, it returned to the normal range of 5.4mmol/L.

Next, among the items that do not require fasting, physiological function tests account for the most part. The most common ones are electrocardiogram and pulmonary function test. They can be completed in a few minutes while lying there. They can directly capture abnormal electrical activity of the heart and whether there are signs of premature beats or myocardial ischemia. Many young people who usually stay up late and work overtime every day and feel that they are in good health often find sinus arrhythmia at this step, which can be regarded as a wake-up call for unhealthy living habits.

The last step is the initial imaging screening. Nowadays, most of them are chest X-rays or low-dose chest CT, plus abdominal ultrasound, which does not require contrast agents and is not painful. With a scan, you can see whether there are small nodules in the lungs, whether there are fatty livers, cysts and other abnormalities in the liver, gallbladder, spleen and kidneys. Many early-stage lung nodules without any symptoms are detected during routine physical examinations. Regular follow-up is enough. If you really wait until you feel pain and cough before checking, it may lead to a more serious situation.

Nowadays, many people complain on the Internet, saying that these four routine items are useless and nothing can be found after spending money. In fact, this is reasonable. If you have a family history of cancer, or you already have clear symptoms such as chest tightness and stomach pain, relying on these four items is really not enough. You need to do targeted additional special examinations such as gastrointestinal endoscopy and tumor markers. But if you don’t feel uncomfortable at ordinary times, you can just do a routine health check every year. These four items are actually the most cost-effective and can fully cover most common basic health risks. If it is a physical examination required by the unit or in a specific scenario, it is best to ask the other party's specific reference in advance to avoid a wasted trip if the project does not meet the requirements.