Which laboratory tests are included?
During the check-up examination, a blood sample is taken and various blood values are determined. Of particular interest is the glucose level in the blood. Glucose is a sugar which is colloquially known as blood sugar.
This value is best determined when fasting, as this is the best way to determine it. This means that you should not eat anything for about 8 to 10 hours before the scheduled blood test and that you should drink even small amounts of liquid. If the glucose value exceeds a fixed limit, there is a possibility of diabetes mellitus, the so-called diabetes disease.
If this is suspected, further tests are carried out to confirm or rule out the diagnosis. Furthermore, the value for total cholesterol is also determined. Cholesterol is a blood fat, which in high concentrations can cause damage to the blood vessels.
This is especially the case when too high a cholesterol level is combined with high blood pressure. This combination increases the risk of arteriosclerosis. Arteriosclerosis is a hardening or calcification of the blood vessels, which is accompanied by a narrowing of the vessels.
Urine diagnostics – What is examined?
In addition to the blood sample, a urine sample is also analysed. The morning urine is best suited for this. By means of common urine test strips, also called urine sticks, various components in the urine can be measured.
It can be determined whether there is blood in the urine. Blood in the urine does not always turn red, so a test strip must be used to detect non-visible blood components. Blood in the urine can indicate stones in the urinary tract or inflammation.
The protein content of the urine is also determined. An excessive protein content in the urine can indicate kidney disease, but must be clarified more precisely by other laboratory methods. The glucose content of the urine can also be determined.
This is a good method for obtaining further information on sugar metabolism in addition to taking blood samples. During pregnancy or in the case of known kidney diseases, an increased glucose level in the urine is normal. However, if the glucose level in the urine is elevated without an explanatory underlying disease being present, further diagnosis in the direction of diabetes mellitus should be initiated. The three urine components mentioned above probably play the greatest role in the check-up examination. However, the test strips can be used to measure many other components of the urine.
Advanced Check-Up Examinations
In addition to the basic diagnostics, the family doctor can also carry out special examinations. These are useful if abnormalities have occurred during previous examinations. However, they are not part of the standard check-up examinations.
If abnormalities are noticed during the physical examination or while listening to the heart, the examining doctor can additionally carry out an ECG (electrocardiogram). The examination can be performed quickly and is painless. During an ECG examination, electrodes are attached to various parts of the chest, as well as to the hands and legs.
With the help of these electrodes, the electrical activity of the heart can be deduced. The heart rate and rhythm are also recorded during this examination. The characteristic curves obtained as a result of the examination allow conclusions to be drawn about the contraction of the atria and the ventricles.
In addition to the normal ECG examination, an ECG can also be recorded over 24 hours. This is then called a long-term ECG. Recording over a longer period of time can be helpful when looking for certain heart malfunctions that only occur sporadically.
It is also possible to perform a stress ECG, whereby the patient sits on a bicycle ergometer while the doctor takes an ECG. The lung function examination gives the examiner information about the different lung volumes and can reveal pathological changes in breathing. During the examination, the patient must perform various breathing movements with a special measuring device (pneumotachograph) in the mouth.
For example, an interesting measurement is the exhalation speed after complete inhalation. Although the examination is easy and quick to perform, its quality depends largely on how well the patient cooperates. Based on the patient’s breathing, various curves are recorded by a computer, from which it can be seen whether changes in lung volumes have occurred or whether respiratory movement is restricted.
The examination is also carried out, for example, on patients with asthma, chronic lung diseases or tumours in the lungs. An extension of the lung function examination, analogous to the ECG, is ergospirometry, i.e. a lung function examination under stress. For this examination, the patient is physically stressed by means of a bicycle ergometer and other measured values can be recorded, such as oxygen uptake and the release of carbon dioxide.
Sonography is a non-invasive diagnostic imaging technique that can be used in a wide variety of ways. If abnormalities in the abdominal organs or vessels are detected during the regular check-up examinations, sonography can help to obtain more detailed information. The organs in the abdominal cavity, such as the liver, gall bladder, pancreas or kidneys, can be examined using this method.
The large vessels in the abdominal cavity can also be assessed in this way, and signs of arteriosclerosis can be looked for if the blood pressure measurement and the determination of the cholesterol level lead to the suspicion that this vascular change could be present. If there is also a suspicion that diabetes mellitus could be present or is already known, the blood circulation in the legs can be measured with ultrasound. For this examination, the ultrasound image is used to look for the vessels in the legs and a special procedure (duplex sonography) is used to measure how fast the blood flows through the vessels.
This can help in assessing whether there is already a restriction in the blood flow in the feet or legs due to diabetes or other previous illnesses. If there is a well-founded suspicion, the stool can be examined for bacteria, fungi, parasites or environmental toxins. It is important to note that in the case of conventional gastrointestinal diseases, stool examinations are generally not necessary, as they do not have any consequences for the therapy, and therefore represent a waste of resources.
However, in case of gastrointestinal complaints after travelling abroad or if there is a suspicion of a notifiable infection, a stool examination may be useful. As part of bowel cancer screening, which is recommended for men and women over the age of 50, a stool examination for hidden blood is performed. The blood is often not visible, but can be detected with a test. If the test is positive for blood, this can be a sign of bowel cancer and should be investigated further.
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