Comprehensive Laboratory Panel for Annual Physical Examination
A comprehensive annual physical examination should include a complete blood count (CBC) with differential, comprehensive metabolic panel (CMP), lipid profile, hemoglobin A1C, and urinalysis with albumin-to-creatinine ratio as core laboratory tests for all adults. 1
Core Laboratory Tests for All Adults
- Complete Blood Count (CBC) with differential - screens for anemia, infection, and blood disorders 1, 2
- Comprehensive Metabolic Panel (CMP) - assesses kidney function, liver function, and electrolyte balance 1, 2
- Lipid Profile - includes total cholesterol, LDL, HDL, and triglycerides to assess cardiovascular risk 1, 2
- Hemoglobin A1C - screens for diabetes and prediabetes 1, 2
- Urinalysis with albumin-to-creatinine ratio - screens for kidney disease and urinary tract infections 1, 2
Age and Sex-Specific Tests
- Thyroid-stimulating hormone (TSH) - particularly important for women and older adults 1
- Prostate-specific antigen (PSA) - recommended annually for men aged 50+ years (earlier in high-risk men) 1, 3
- Bone densitometry - recommended for postmenopausal women and men age ≥50 years 2
- Abdominal ultrasonography - recommended once for men aged 65-75 years who have ever smoked 2
Medication-Specific Monitoring
- Vitamin B12 levels - should be checked annually in patients taking metformin 1, 2
- Serum potassium levels - should be monitored in patients taking ACE inhibitors, ARBs, or diuretics 1, 2, 4
Frequency Recommendations
- Most laboratory tests should be performed annually as part of routine physical examination 1
- Lipid profile may be performed less frequently (every 2 years) in people without dyslipidemia and not on cholesterol-lowering therapy 1, 5
- Hemoglobin A1C testing should be done yearly for patients with prediabetes (A1C 5.7-6.4%) 2
- For patients with diabetes, A1C should be tested at least twice yearly if meeting treatment goals, quarterly if therapy has changed or not meeting goals 1
Special Considerations for Older Adults
- Functional performance assessment is recommended for adults ≥65 years 2
- Screening for cognitive impairment is recommended in older adults with risk factors 2
- Structural brain imaging (MRI preferred, or CT if MRI is contraindicated) is recommended for older adults with cognitive or behavioral symptoms 2
Common Pitfalls to Avoid
- Failing to consider patient-specific risk factors when determining which tests to order can lead to unnecessary testing 1
- Overlooking the need for more frequent monitoring in patients with chronic conditions or on medications that affect laboratory values can lead to delayed diagnosis or treatment 1, 6
- Not ordering appropriate screening tests for obese patients - research shows many obese patients don't receive recommended laboratory screening tests even after diagnosis 7
- Waiting for laboratory results can delay care - point-of-care testing can reduce wait times in urgent situations 8
By following these comprehensive laboratory testing guidelines during annual physical examinations, healthcare providers can effectively screen for common conditions, assess overall health status, and identify potential health issues early for better patient outcomes.