Ketography

Introduction of physical examination items

Clinical significance of the project

Generally speaking, height, weight and blood pressure cooperate with on-site physical examination to understand the physical differences.

Draw blood (for laboratory examination) to collect blood samples.

X-ray examination X-ray fluoroscopy X-ray fluoroscopy of the chest can screen out diseases such as tuberculosis, lung tumor, pleural effusion, pneumothorax, bronchiectasis, tracheal dilatation, ventricular hypertrophy, aortic arch protrusion, scoliosis, and thoracic bone diseases. If the frontal chest X-ray examination is normal, but there is a long-term cough with bloodshot sputum, it is necessary to add a lateral chest X-ray examination.

Bone mineral density BMD screening people's bone mineral density reaches its peak around the age of 30, and then the bone is lost year by year, which leads to the looseness and fragility of bone structure and gradually leads to "osteoporosis". Therefore, it is best for normal people to have a screening every year after the age of 30.

Five abdominal ultrasound (liver, gallbladder, spleen, pancreas and kidney) (black and white ultrasound) to check whether there are lesions in liver, gallbladder, pancreas, spleen and kidney. It mainly examines eight parts, including liver, intrahepatic bile duct, common bile duct, gallbladder, kidney, hepatic portal vein, pancreas, spleen and others. Detect fatty liver, liver cirrhosis, hepatolithiasis, unexplained abdominal pain and other diseases.

Prostate B-ultrasound screening prostate whether there are the following conditions: prostatic hyperplasia, prostatitis, prostate cancer, prostate cyst, prostate abscess, prostate tuberculosis, prostate stones and so on.

Electrocardiogram 12 lead ECG examination is to trace the potential changes related to heart beat by graphs, so as to judge whether there are abnormal conditions such as atrial or ventricular hypertrophy, myocardial infarction, irregular pulse, pericarditis, systemic diseases and so on.

Five items of internal medicine (heart, lung, liver, spleen, nervous system, etc. ) ruled out medical diseases or found signs of medical diseases through physical examination.

Seven surgical items (skin, spine, limbs, thyroid, breast, anus, external genitalia, etc. Understand the basic situation of the surgical system through palpation and physical examination.

Ophthalmology 4 items (vision, color discrimination, external eye, intraocular pressure, fundus, slit lamp examination, etc. ) The eyes are an important tool for transmitting external conditions to the brain. To know whether it is normal, you need to have an eye exam; Understand whether there are lesions in fundus and blood vessels through fundus photography; Such as diabetic retinopathy, glaucoma, cataract, optic neuritis and optic atrophy.

Stomatology 10 (lip, cheek, tooth, gum, periodontal ligament, tongue, palate, parotid gland, submandibular gland and infratemporal gland) passed the physical examination, and dental diseases were ruled out or signs of dental diseases were found.

Otolaryngology seven items (hearing, external ear, inner ear, nasal cavity, nasal septum, pharynx, larynx, etc. ) mainly includes: ear, nose, nasopharynx, oropharynx, throat and other parts. Ears: eardrum rupture, otitis media, etc. Nose: sinusitis, curvature of diaphragm, tonsil lesions, etc. Throat: Polyps, nodules, laryngeal tumors, etc.

Fourth, gynecological routine screening of cervical size, color and shape of external orifice; Whether there is erosion, polyp, tumor and inflammation; And quantity, nature, color, smell, etc. And touch the elasticity, smoothness and tenderness of the vagina; And touch the uterus and accessories for tenderness, lumps, etc.

Cervical curettage is very important for screening cervical cancer through cervical smear. The incidence of cervical cancer is high, but the mortality rate is not so high, mainly because of the effect of early detection and early treatment. Because cervical smear examination is an effective method to screen cervical cancer, all women who have sex should be examined once a year.

Breast infrared scanning photography is an X-ray instrument to see through the compressed breast. This X-ray examination can find many breast lesions that cannot be touched by hands, and the probability of finding early breast cancer is quite high.

Gynecological B-ultrasound gynecological ultrasound examination can find out whether there are lesions in reproductive organs such as uterus and ovary. Screening diseases: diseases such as hysteromyoma, hysterofibroma, uterine cancer, endometrial hyperplasia, endometrial cancer, ovarian cyst and ovarian cancer can be found.

Blood routine 18 white blood cell count (WBC) is mainly used for defense work. If white blood cells increase or decrease, it is necessary to preliminarily determine whether it is bacterial infection, viral infection or leukemia (commonly known as blood tumor) in combination with white blood cell classification.

The value of white blood cell classification of lymphocytes (LYN) is helpful for the diagnosis and treatment of various diseases.

granulocyte

Red blood cell count Anemia or blood loss will affect the number of red blood cells.

High values may lead to polycythemia or thalassemia;

The low value may be anemia.

Hemoglobin (HGB) is mainly used to check whether there is anemia.

Hematocrit (HCT) refers to the percentage of red blood cells in the blood, which can help us to understand the degree of anemia more correctly.

Mean red blood cell volume (MCV) is a reference index to distinguish various anemia.

Average erythrocyte hemoglobin content

mean corpuscular hemoglobin concentration

Red blood cell volume distribution width (RDW) When the size of red blood cells changes greatly, RDW will increase, which can be used as a reference for the diagnosis of anemia.

High platelet count (PLT) may be related to polycythemia, chronic myeloid leukemia, myelofibrosis, splenectomy, chronic infection or acute infection recovery period. When the platelet value is too low, there may be aplastic anemia with bleeding tendency and poor coagulation.

Mean platelet volume

Platelet distribution width (PDW)

Platelet hematocrit (percentage)

The value of the classification of monocytes and leukocytes is helpful for the diagnosis and treatment of various diseases.

Relative percentage of lymphocytes (LRR%)

Relative percentage of granulocytes (RPR%)

Relative percentage of monocytes (MPR%)

Routine urine 10 urine specific gravity (SG) The normal value of adult urine is1.010 ~1.030. Low specific gravity urine: seen in diabetes insipidus, polycystic kidney disease or those who use diuretics and drink too much water. High specific gravity urine: seen in diabetes, congestive heart failure, dehydration and vomiting.

Urine PH When fresh urine is normal, it is weakly acidic, with an acidity of about 5 to 8. If the pH value is greater than 8, the urine is alkaline, and there may be urinary tract infection, inflammation or poor renal function. If the pH value is less than 5, the urine is acidic and may be in a state of starvation or ketoacidosis.

LEU test paper is used to detect whether there are white blood cells in urine. If the white blood cells in the urine increase, it means that there is inflammation in the urinary tract, which can be explained by urine protein and nitrite. However, women often test positive for vaginal secretion pollution, so the perineum should be cleaned before collecting urine.

Nitrite (NIT) determines whether there is bacterial infection in the urinary system; If there is nitrite reaction, further microscopic examination is needed to know what kind of bacterial infection it is.

Urinary protein (PRO) is normal, there are trace proteins in urine (150mg// day), and the test paper is negative (-). If it is positive (+), it may be: physiological proteinuria: excessive muscle exercise, too long cold bath time, and too much protein intake. Postural proteinuria: Some people have proteinuria after standing for too long. Pathological proteinuria: renal inflammation, nephrotic syndrome, high fever, toxemia of pregnancy, etc.

Urine sugar (GLU) Under normal circumstances, no sugar in urine is negative (-), or a small amount of sugar appears. If urine sugar is positive (+), it is necessary to consider whether it is diabetes, and continuous follow-up examination must be carried out.

Urinary ketone bodies (KET) are formed due to incomplete fat metabolism. No KET in normal urine is negative (-). If KET is positive (+) in urine, it is more common in patients with diabetes, hunger, fever, long-term diarrhea and vomiting. Dieters who restrict starchy foods will also have ketone bodies in their urine.

Uridine (UBG) If the level of uridine in urine is too high, it may indicate hemolytic jaundice, acute hepatitis, liver cirrhosis and other diseases. If there is no urine urobilinogen in urine, it may indicate biliary obstruction.

Bilirubin (U-BIL) is negative (-) because there is no bilirubin in normal urine. When there is bilirubin in the urine, it is positive (+), indicating that there may be biliary obstruction or liver disease.

Urine red blood cells (ERY) determine whether there is blood in urine. No blood in urine is negative (-); If there is blood in the urine, it is positive (+), which may be urinary calculi, renal inflammation or urinary system cancer. However, if the urine sample is left for too long, women in physiological period may cause false positives; When eating a lot of vitamin C, it will cause false negatives.

Liver function 1 1 serum alanine aminotransferase (ALT) sGPT represents the degree of liver cell injury. The value of patients with acute hepatitis may be as high as 500 ~ 1000 iu/L, in addition, chronic hepatitis, alcoholic liver disease, liver cirrhosis, liver cancer and so on. It will also create high value.

Aspartate aminotransferase (GOT) is an enzyme in the body, which exists in organs or cells such as liver, heart, brain and blood cells. A high sGOT means that these parts may get sick.

Glutamyl transpeptidase (GGT) is an enzyme existing in liver, pancreas, spleen and kidney, which is most commonly used to screen abnormal liver function and cirrhosis, especially alcoholic liver disease and drug-induced liver disease.

Total protein (TPO) is used to check nutritional status, liver function, renal function and infection.

Albumin (ALB) Albumin is used to maintain the osmotic pressure of plasma, which is made in the liver. Therefore, when diseases, diarrhea and malnutrition occur in the liver, albumin will be significantly reduced.

Globulin (GLO) may increase or decrease during infection, liver disease, nephropathy, autoimmune diseases and cancer, which should be explained by doctors in combination with other test results.

Albumin/globulin (A/G)

Alkaline phosphatase (ALP) is an enzyme in the body. When cells are damaged, the ALP value increases. Although the ALP value can be as high as 2 ~ 3 times, it is still normal for developing children or adolescents. When the value is high, it may be hepatobiliary problems, bone cancer or bone metastasis.

A high lactate dehydrogenase (LDH) value indicates that you may have myocardial infarction, pulmonary embolism, liver injury, muscular dystrophy, leukemia, anemia or cancer, which usually needs to be judged in combination with other examination items. The limit of normal value is 10%, so it is necessary to judge what disease it is if it exceeds 50 units.

When total bilirubin (TBS) is high, there may be hepatobiliary problems or hemolytic diseases. If the skin turns yellow, it is called jaundice.

When direct bilirubin is high, there may be hepatobiliary problems.

Blood lipid 4 Total cholesterol The most representative fat in the body. When the serum cholesterol content is too high, it is easy to cause hypertension, arteriosclerosis and stroke; If the content is too low, anemia, liver disease and malnutrition may occur.

Triglycerides Triglycerides are mostly derived from fermented grains and carbohydrates (rice, bread and other cereals). When the neutral fat value is high, it is easy to suffer from diabetes, arteriosclerosis, myocardial infarction and obesity.

HDL- cholesterol, commonly known as "good" cholesterol, has a protective effect on blood vessels. The blood content should not be lower than 40 mg/dl (0.9 1 mmol/L), otherwise it is easy to get arteriosclerosis.

Low density lipoprotein cholesterol (LDL- cholesterol) This is "bad" cholesterol, and the higher it is, the worse it is. It is an important index for prevent coronary heart disease and treating hyperlipidemia.

The final products of BUN renal filtration metabolism, three items of renal function, can not be excreted normally when renal function is damaged, and the BUN value in serum increases at this time. However, this value is easily influenced by drug dosage and must be diagnosed together with other test values.

Creatinine Cr Creatinine is the main energy source of muscle movement and the substance of creatine decomposition. As long as the renal function is normal, creatinine will be excreted through urine. The excretion function of the kidney can be understood by measuring creatinine.

The metabolites of purine in uric acid are the most in animal viscera. Excessive drinking, diabetes, gout, nephritis, lead poisoning, hyperthyroidism and other uric acid will be high.

Blood glucose Fasting blood glucose refers to the glucose content in blood when fasting. It is the most basic method for screening diabetes. When the fasting blood glucose is found to be greater than110 mg/dl (6.1mmol/l) during physical examination, it is suggested to test the fasting blood glucose again another day to confirm the diagnosis.

Helicobacter pylori antibody (Helicobacter pylori Ab) Helicobacter pylori is a bacterium that grows in the gastric mucosa. The medical community has confirmed that this bacterium is closely related to chronic gastritis, peptic ulcer, partial gastric cancer and partial gastric lymphoma.

The general physical examination is to check the "Helicobacter pylori antibody", so it is more convenient to draw blood. If the antibody is positive, it has three meanings:

1. This bacterium is infected in the body and causes diseases.

This kind of bacteria is infected in the body, but it will not cause disease.

Bacteria have been eliminated, but antibodies have not disappeared.

Therefore, antibody-positive patients should go to the hospital for further examination, and the gastroenterologist should decide whether to take eradication treatment (using antibiotics).

Calcium (Ca) Calcium (Ca) blood calcium is mainly seen in malignant tumors, hyperparathyroidism and vitamin D poisoning, while the decrease is mainly seen in osteomalacia, rickets, vitamin D deficiency and hypothyroidism. It should be read together with phosphorus (P).

Phosphorus (P) Phosphorus (P) Blood phosphorus should be read together with calcium. Calcium is elevated, and if phosphorus is also elevated, it is necessary to consider the possibility of malignant tumors; If phosphorus drops, it may be hyperparathyroidism or excessive vitamin D. When calcium decreases, if phosphorus also decreases, it may be osteomalacia, rickets or vitamin D deficiency; If phosphorus increases, it may be hypoparathyroidism or chronic renal insufficiency.

Iron (Fe/SI) Iron (Fe/SI) The determination of serum iron is mainly to screen whether there is iron deficiency in the body. If the serum iron is low, but hemoglobin is still in the normal range, it indicates that there is initial iron deficiency; If serum iron and heme are low at the same time, it means that iron deficiency anemia has occurred. High serum iron can be seen in pernicious anemia, thalassemia and hemolytic anemia. Excessive iron intake will increase serum iron.

Rapid detection of treponema pallidum reagin (RPR) is the most commonly used method for screening syphilis. If it is positive or weakly positive, it does not mean syphilis, and further TPHA (Treponema pallidum hemagglutination test) is needed to confirm the diagnosis.

Thyroid triiodothyronine (T3) increased in hyperthyroidism, and decreased in hypothyroidism during tissue inflammation screening.

Thyroxine (T4) T4 is a thyroid hormone. By analyzing its blood content, we can know the thyroid function, and it is best to read it together with TSH. T4 is increased due to hyperthyroidism, while T4 is decreased due to hypothyroidism.

Thyroid stimulating hormone (TSH) is a hormone secreted by the anterior lobe of the brain, which can stimulate the thyroid gland to secrete thyroxine. TSH examination can screen thyroid function, and it must usually be explained together with thyroxine (T4). Generally speaking, TSH is decreased in hyperthyroidism; When this function is low, TSH rises.

AIDS Screening (HIV) This test is used to check AIDS (Acquired Immunodeficiency Syndrome). If the test is positive, it needs to be checked again. If it is positive again, it needs to be reported to the superior health department, which will further diagnose and test it.

Hepatitis B Five Hepatitis B Surface Antigen (HbsAg) can know whether you are infected with hepatitis B virus, whether you produce antibodies to hepatitis B virus, whether you should be vaccinated, and the effect after vaccination.

Hepatitis B surface antibody

Hepatitis B E antigen

Hepatitis b e antibody

Hepatitis B core antibody

Tumor carcinoembryonic antigen (CEA) CEA is a tumor marker. Usually, in the case of tumors such as large intestine, rectal cancer and pancreas, the value of this examination is the highest, and the value of other cancers may be higher, but the proportion is smaller. The test results should be combined with clinical symptoms and other references.

alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-a Lpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-alpha-if the value is high, it may be liver cancer or chronic hepatitis. But in proliferative diseases such as gastric cancer, teratoma, testicular cancer, ovarian cancer, pregnancy or acute hepatitis, the value will be higher, so we must judge according to the clinical symptoms.

Prostate Tumor Marker (PSA) PSA is a "prostate specific antigen" and a tumor marker, which can be used to screen prostate cancer. Suitable for men over 50 years old.

Breast tumor marker (CA 15-3) CA 15-3 is an auxiliary examination of breast cancer. If CA 15-3 is normal, breast self-examination must not be ignored. The most important thing to prevent and treat breast cancer is self-examination. If you are in doubt, you should see a doctor immediately for further mammography. Because the highest positive rate of CA 15-3 is only about 50%, it should be carefully interpreted by professionals when it is used for screening, not by itself.

Pancreatic tumor marker (CA 19-9) CA 19-9 is a glycoprotein contained in cancer cells, which is mainly related to digestive tract cancer, and the positive rate of pancreatic cancer and gallbladder cancer is higher. The positive rates of various cancers (CA 19-9) are as follows: pancreatic cancer 84%, gallbladder cholangiocarcinoma 69%, colorectal cancer 39% and ovarian cancer 35%. In some benign diseases, CA 19-9 may increase: chronic pancreatitis 14%, cholelithiasis 1 1%, liver cirrhosis 17%, diabetes 10%, and renal insufficiency 9%.

Ovarian tumor marker (CA 125) CA 125 is a glycoprotein contained in cancer cells, which has a high positive rate (97. 1%) in the diagnosis of ovarian cancer, so it is generally considered as a marker of ovarian cancer. In addition, CA 125 also has a high value in endometriosis, with a positive rate of 78.8%. The positive rates of CA 125 in various tumors are as follows: cervical cancer 20.9%, pancreatic cancer 48.6%, cholangiocarcinoma 38. 1%, liver cancer 42.9%, endometrial cancer 37.5%, gastric cancer 23.5%, colorectal cancer 10.6% and lung cancer 6.6.

Tumor specific growth factor > 7 1U/L was positive. Those who are positive in the initial examination should be rechecked once every five weeks for three consecutive times. If the concentration increases gradually, it should be considered that the probability of suffering from malignant tumor is very high. TSGF can be used for general survey, auxiliary diagnosis and curative effect observation of various malignant tumors, as well as differential diagnosis and disease monitoring of benign and malignant tumors.

The magnetic resonance imaging system used in magnetic resonance medical diagnosis equipment mainly includes magnet, gradient system, radio frequency system (including MRI spectrometer), computer system and patient system. Magnets add an external magnetic field to the nucleus, so that the nucleus in human tissue produces corresponding vibration frequency; The RF system provides RF pulses with the same precession frequency, causing nuclear magnetic resonance; Gradient system, computer system, etc. Then the imaging and processing are completed. Magnetic resonance imaging (MRI) can observe the image of the concentration or state of a nucleus on any cross section of the human body. Through the accumulated knowledge and experience, we can interpret the structure and physiological state of the imaging tissue and know whether the tissue is normal or not. Are there any lesions?