GENERAL HEALTH SCREENING

General Health Screening is a basic group of tests designed to ascertain an individual's state of health. This page provides a general overview and importance of tests done. However, you are advised to consult your family doctor for further information or explanation.

FULL BLOOD EXAMINATION

Red Cell Indices
Red cell indices give indication of red blood cells abnormalities.

Haematocrit (PCV)
Low PCV value may be due to anaemia, blood loss and haemolytic anaemia. High PCV value may suggest polycythaemia or macrocytosis.

Haemoglobin (Hb)
Hb is essential for transport of oxygen to the cells. Hb value below normal range indicates anaemia.

WBC and DC
White blood cells (WBC) act as the body's defence system against harmful microorganisms and are differentiated into 5 types; neutrophils, lymphocytes, monocytes, eosinophils and basophils.
Presence of abnormal cells may indicate ongoing chronic infection.
Presence of immature cells, called blasts, in peripheral blood and marked increase in white cell count is indicative of leukaemia.

Platelet
Platelet may play a vital role in normal blood clotting mechanism to prevent excessive blood loss.

ESR
Erythrocyte Sedimentation Rate (ESR) represents the sedimentation rate of cellular components in plasma in one hour.

PBF ( Peripheral Blood Film)
A thin blood smear is stained with a special dye and examined under the microscope. An impression is given based on blood film and results of other blood tests.

Blood Grouping
2 common system in typing blood is the ABO and Rhesus (Rh) system. With the ABO system, blood can be categorized into A, B, AB and O. The distribution of group is A (23%), B (23%), AB (5%) and O (49%).
Under Rhesus grouping, blood can be categorized into rhesus positive or negative.


URINE
Urine is produced as a result of filtration of blood through the kidneys. Contents of urine may vary depending on condition of the individual's body and dietary intake.

Reaction (pH)
pH of urine for a normal individual ranges between 5.0 to 7.0. Factors which influence pH are food intake, age of specimen, urinary tract infection and hormonal imbalance.

Glucose
A positive screening test for urinary glucose is a significant sign and indicate the likelihood of diabetes mellitus. However, the presence of urinary glucose in individuals with normal blood glucose may occur in patients with low renal threshold; a condition known as renal glycosuria.

Ketones
Ketones are the by product of fat metabolism and are excreted in urine. Ketones are usually present in diabetes patients as the cells are unable to utilize blood glucose effectively as a source of energy.

Blood
Presence of blood in urine (haematuria) may come from the kidneys, urinary tract or bladder. If associated with pain, it is a likely indication of stones. However, presence of blood in urine of females during menstruation is usually considered normal.

Protein
Amount of protein may be increased in individuals with urinary tract infection, hypertension, diabetes mellitus and nephrotic syndrome.

Specific Gravity (SG)
SG evaluates the concentration and excretory power of the kidneys. Normal SG ranges from 1.015 to 1.030.


URINE MICROSCOPY
Direct examination of urine under the microscope.

WBC (Pus cells)
Counts of less than 5 per HPF is considered normal. Urinary tract infection is associated with increased WBC count and presence of bacteria in urine. A culture test will then be required to detect the type of bacteria and medication required.

RBC (Red blood cells)
Indicates the presence of blood in urine.

Epithelial cells
Counts of more than 10 per HPF indicates urinary tract infection.

Casts
Granular casts is usually associated with kidney disorders. However, hyaline casts may be found in individuals after strenous exercise or high protein diet.

Crystals
Common urinary crystals found are uric acid and calcium oxalate crystals. Presence of triple phosphate crystals is highly indicative of kidney stones.


LIVER FUNCTION TEST

Protein (Albumin & Globulin)
Both albumin and globulin are used to measure an individual's nutritional status. Both tests help to diagnose liver, gastrointestinal and kidney diseases; protein abnormalities; cancer and blood cell disorders.

Bilirubin
Increased levels of bilirubin can be caused by the liver, gallbladder or red blood cell disorders and clinically it results in jaundice (yellowish tinge of the skin and sclera of eyes).

SGOT/AST/Aspartate Aminotransferase
Enzymes are released when cells are injured and serum levels rise proportionally to the extent of damage.

SGPT/ALT/Alanine Aminotransferase
It is often used in conjunction with SGOT to measure liver function and diagnose liver disease.

ALP/Alkaline Phosphatase
High ALP levels are observed in children, liver disease, bile obstruction and bone disorders.


RENAL FUNCTION TEST

Electrolytes
Electrolytes are important components of the body fluids and their balance determines the well being of various cells and organs.

Urea
Urea measures kidney function and hydration. However, it should not be used alone to measure kidney function but rather as a screening test.

Creatinine
Creatinine is often used in conjunction with blood urea level to determine renal function.

Uric Acid
Gout is the clinical syndrome whereby patients with high uric acid level causes deposit of urate cyrstals in soft tissues; especially joints; resulting in inflammatory response. Serum levels are affected by the amount of uric acid produced and the efficiency of renal excretion.


LIPID STUDIES
Blood cholesterol level reflects the risk of cardiovascular disease and may also be used to evaluate liver and thyroid function.

Total Cholesterol
Excessive cholesterol may cause deposition on arterial walls resulting in narrowing and subsequent blockage of the vessels leading to atherosclerosis.

HDL-Cholesterol
HDL is also known as the good cholesterol. It functions as a carrier to remove excessive cholesterol from cells. The value can be increased through exercise.

LDL-Cholesterol
LDL is also known as the bad cholesterol. Excessive cholesterol, as in LDL, causes deposition on arterial wall leading to atherosclerosis.

Triglycerides
Triglycerides are fatty acids found in the blood stream. Elevated levels may increase risk of cardiovascular disease.

Blood Glucose
It is most often used to diagnose diabetes mellitus or to evaluate the control of the disease. Blood levels fluctuate depending on the individual's activity and time lapse after meal.
Individuals with a borderline fasting blood glucose result will be required to go for a Glucose Tolerance Test. (GTT) to confirm the diagnosis of diabetes mellitus.

T4 (Thyroxine)
Blood T4 value is used as a screening test to detect thyroid disorders.

Calcium & Phosphorus
Both tests are used in the diagnosis of kidney and skeletal diseases as well as to evaluate electrolytes and acid-bace imbalance.

HBsAg
An individual with HBsAg reactive results is also known as a Hepatitis B carrier. Hepatitis B carriers have a higher risk of developing liver cirrhosis and cancer.

Anti-HBs
Anti-HBs is the antibody produced against the Heptitis B surface antigen.

Rheumatoid Factor (RF)
RF may be present in patients with rheumatoid arthritis and chronic inflammatory diseases such as syphilis, hepatitis, infectious mononucleosis and leprosy.

VDRL
VDRL is used as a screening test for syphilis. A positive VDRL finding may not necessarily indicate that the individual has syphilis as cross reactivity with other strains may occur. TPHA is used to confirm the diagnosis of syphilis if the initial VDRL result is found to be positive.


TUMOUR MARKERS
Tumour markers are the necessary complement to other diagnostic tools. Besides monitoring and follow-up disease course, the determination of a distinct panel of markers represents a constant support in clinical diagnosis.

CEA (Carcino Embryonic Antigen)
It is specifically synthesised by abnormally proliferating cells.
CEA has been detected in elevated amount in patients with malignancies of the gastrointestinal tract (pancreas, colon, rectum), lung, breast, prostatic and ovary. Its concentration in serum is also dependent on certain factors such as presence of inflammation and heavy smoking.

AFP (Alpha feto Protein)
AFP is an oncofetal antigen that is expressed in some germ line tumours e.g. teratoblastoma, testicular and ovarian carcinomas, hepatocellular carcinoma and liver diseases e.g. cirrhosis, hepatitis, necrosis. It is used extensively in the diagnosis of liver cancer.

PSA (Prostatic Specific Antigen)
PSA is found only in prostatic tissues. It is used widely in assisting the diagnosis of prostatic carcinoma. Blood levels may also be elevated in benign conditions such as benign prostatic hypertrophy (BPH).

CA-125
CA-125 is a glycoprotein that is normally found in adult female fallopian tube, endometrium and endocervix. It is useful in monitoring disease progression and serum levels shows correlation with tumour size.

CA-153
Serum CA-153 is elevated in patients with breast and lung cancer. Besides monitoring disease progression, it is also used to detect recurrent disease after primary therapy before it can be detected clinically.

CA-199
CA-199 level is frequently elevated in patients with intra-abdominal carcinomas, adenocarcinomas of the lung, gastric, biliary and colonic.

HSV II IgG (Herpes Simplex Type II IgG)
Herpes Simplex Type II infection is classified as sexually transmitted disease. HSV Type I which is not sexually transmitted may cause false positive result due to cross reactivity.

HAV IgG (Hepatitis A IgG)
Presence of antibody are protective and persists for life.

Anti HIV I & II
HIV (Human Immunodeficiency Virus) is the causative agent of AIDS (Acquired Immunodeficiency Syndrome). Common strains of virus are type I and II.
Serologic diagnosis and initial screening of HIV infection is achieved by detection of antibodies (Anti HIV I & II). Initial reactive result is confirmed with Western Blot. A person with negative Anti HIV I & II does not mean that he is totally free of HIV, as during the window period of the disease, the test will give false negative results.

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