From the Guidelines
Standard laboratory tests during a physical examination should include a complete blood count (CBC), comprehensive metabolic panel (CMP), lipid panel, urinalysis, and thyroid stimulating hormone (TSH) test, as these provide valuable baseline information about overall health status and can detect potential health issues before symptoms develop, allowing for earlier intervention and treatment. The CBC evaluates red and white blood cells and platelets to screen for anemia, infection, and bleeding disorders. The CMP assesses kidney and liver function, electrolyte balance, and blood sugar levels. A lipid panel measures cholesterol levels (total, HDL, LDL) and triglycerides to evaluate cardiovascular risk. Urinalysis can detect urinary tract infections, kidney disease, and diabetes. TSH screening helps identify thyroid dysfunction. Additional tests may be recommended based on age, sex, and risk factors, such as hemoglobin A1C for diabetes screening, prostate-specific antigen (PSA) for men over 50, or sexually transmitted infection testing for sexually active individuals 1.
Some key laboratory tests to consider during a physical examination include:
- Haemoglobin and/or haematocrit
- Fasting plasma glucose
- Serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol
- Fasting serum triglycerides
- Serum potassium and sodium
- Serum uric acid
- Serum creatinine (with estimation of GFR)
- Urine analysis: microscopic examination; urinary protein by dipstick test; test for microalbuminuria
- 12-lead ECG 1.
It's also important to consider other tests such as:
- Complete blood count (CBC) with differential leukocyte count and platelet count
- Measurement of serum levels of creatinine and blood urea nitrogen
- Measurement of electrolytes, hepatic transaminase enzymes, and total bilirubin 1.
However, the most recent and highest quality study 1 provides a comprehensive list of laboratory tests that may be considered during a physical examination, including calcium, magnesium, and liver function tests, ESR, and others.
In terms of specific recommendations, a complete blood count, routine blood chemistry including lactate dehydrogenase (LDH) and uric acid, as well as screening tests for human immunodeficiency virus (HIV) and hepatitis B and C are required 1.
Additionally, physical examination, electrocardiogram tracing, biochemistry analysis, full blood count, exercise test and/or transthoracic echocardiography may also be considered 1.
Overall, the specific laboratory tests ordered during a physical examination will depend on the individual patient's needs and risk factors, and should be guided by the most recent and highest quality evidence available.
From the Research
Laboratory Tests for Standard Physical Examination
The following laboratory tests are commonly ordered during a standard physical examination:
- Complete Blood Cell Count (CBC) 2, 3, 4, 5: This test provides information about the production of all blood cells and identifies the patient's oxygen-carrying capacity.
- Chemistry Panel 2: This test is used in conjunction with the CBC to provide a more comprehensive understanding of the patient's health.
- Urinalysis 2: This test is used to evaluate the patient's urinary system and detect any potential abnormalities.
- Basic Metabolic Panel (BMP) 6: This test provides information about the patient's electrolyte levels, renal function, and acid-base homeostasis.
Components of the Complete Blood Cell Count
The CBC includes the following components:
- Red Blood Cell Count
- Hemoglobin
- Hematocrit
- Red Blood Cell Indices (including the mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, and red cell distribution width)
- Reticulocyte Count
- White Blood Cell Count and Differential
- Platelet Count 4, 5
Uses of the Complete Blood Cell Count
The CBC is used to: