What are the reasons for failing routine physical examination?

The first reaction of many people when receiving a notice of failed physical examination is "Am I seriously ill?" In fact, judging from the daily consultation data of the physical examination department, about 70% of the abnormalities in the first physical examination are not organic diseases. They are either caused by lack of preparation before the examination, or are caused by temporary fluctuations in physical status or special menstrual cycle effects. Only about 20% to 25% of abnormal results truly indicate the need for further medical treatment to diagnose the disease.

Last week, I met a young girl who had just graduated. Her physical examination showed two plus levels of protein in her urine. She became red-eyed on the spot, thinking she had nephritis and was about to lose her job offer. After careful questioning, she found out that she rode a shared bicycle for 20 minutes in the morning and climbed three flights of stairs in order not to be late for the physical examination. She took a urine sample without taking a two-minute break. She was asked to go back to a regular schedule for two days. She sat quietly for half an hour to avoid strenuous exercise before taking a urine test. After checking the indicators, everything was normal. Similar situations are not uncommon. For example, a young man who works in Internet operations had a dinner with his colleagues and drank three bottles of beer the day before his physical examination. He stayed up until 3 o'clock to change his plan. The next day, his alanine aminotransferase was twice as high. After three days of rest, the reexamination fell back to the normal range. This was a transient metabolic abnormality and not a real liver problem.

Of course, you can't take it seriously with the mentality of "it's all errors". It depends on the type of abnormal indicators and the degree of deviation from the normal range. Last year, a 32-year-old man had a physical examination at his work unit. B-ultrasound showed that there was a 2-centimeter space occupying his liver and that his alpha-fetoprotein was three times higher than the normal value. He had only felt tired recently and thought it was because he was tired from working overtime. He did not take it seriously. After further enhanced CT, he was diagnosed with early-stage liver cancer. Fortunately, he was discovered early and underwent minimally invasive surgery and is now recovering well.

There are also some abnormal results that are actually caused by "human" factors. For example, some people are afraid that eating something will affect the results, so they go hungry for almost 20 hours before taking blood, and they are found to have low blood sugar and positive urine ketones.； A girl collected urine before and after her menstrual period. The sample was accidentally stained with a small amount of menstrual blood, and the urine sample was found to be positive for occult blood. ； Normally, the blood pressure measured at home is normal. However, when I go to the hospital and see the doctors and nurses in white coats, my heart beats so nervously that my blood pressure exceeds the standard, which is often referred to as "white coat hypertension." In these cases, you can apply to the physical examination institution for retesting as required, and most of them can return to the normal range.

If you really get an unqualified report, don't panic. First, go back and check whether you stayed up late, drank alcohol, or exercised strenuously in the three days before the test, and whether you took any drugs that may affect the indicators. When you go to the doctor to interpret the report, explain these situations clearly, and whether you need a reexamination or further targeted examinations. Just listen to professional advice. Don't blindly search for symptoms and make yourself anxious.