Periodic Health Exam

THE PERIODIC HEALTH
EXAM
PERIODIC HEALTH EXAM
• Is a package of services and procedures, including
screening, couseling, chemoprophylaxis, and vaccination
offered to patients to prevent diseases or their
complications.
• It gives greater value to cost-effectiveness and scientific

evidence in the selection of examinations for preventive
care.
• It covers the full range of preventive services from

primary to tertiary levels.
• Based on the identification and assessment of risk

factors that ay be present in the patient.
RISK ASSESSMENT
• RISK FACTOR: defined by the WHO as any attribute or
exposure of an individual that increases the likelihood of
developing a disease or injury.
• Diseases prioritized when doing preventive care include

those that can cause mortality and disability.
• WHO estimates that with the reduction of exposure to

just 8 major risk factors, global health expectancy is
estimated to increase in 5 years.
• These factors include alcohol and tobacco use, high BP,

high BMI, high choloesterol, high blood sugar, low fruit
and vegetable intake, and physical inactivity.
TOP 10 LEADING CAUSES OF
MORTALITY
RISK ASSESSMENT
• In all consultations, risk assessment begins with

obtaining the patient''s relevant information from a good
clinical history.
MEDICAL HISTORY
• Diseases vcan be risk factors for other diseases (e.g.,

Obesity has strong associations with the development of
DM, diabetics in turn are prone to have elevated BP)
• Existing diseases, thus, place patients on a high-risk

category where more exams may be required.
FAMILY HISTORY
• Family history is best assessed by drawing a 3-generation
genogram that must be updated in every visit.
• Diseases in the family are important determinants in the selection of

screening exams (Gout, Breast, colon and prostate CA)
• The general population is advised to undergo mammography, FOBT,

PSA at 50 years old.
• Infectious diseases, while non-hereditary, may be considered

familial.
• Presence of diseases like TB and Hep B in an index patient is an

indication that other family members should be screened as well.
DIET AND NUTRITION
• nutrition history has always been an important part of
pediatric history.
• an increasing number of adults are obses and DIET is

one of the major risk factors identified by WHO.
• a family physician can do a simple evaluation by asking

for a 24- hr food recall to get and idea of the quality and
quantity of food eaten by the patient.
• the healthy eating plate provides an easy guide to

measure nutrient intake which in turn may be used to
help patients in the modification of their daily diet.
TOBACCO
• It is the single most preventable cause of disease.
• It is called the most potent carcinogen due to its

association with cacers of the respiratory tract, bladder,
cervix, and pancreas.
• Every consultation must be used as an opportunity to

motivate patients to stop smoking.
• Information regarding tobacco is documented in "pack

years" (obtained by multpyling the # of years of smoking
by the # of sticks consumed)
ALCOHOL
• it has been linked to a number of diseases like
unintentional injuries, mental illness, liver cirrhosis and
pancreatitis, especially when taken in excess.
• the amount of alcohol present in common beverages

taken into the body is measured in terms of the number
of drinks.
• STANDARD DRINK: 12-oz regular beer, 8-oz malt liqiou,

5-oz table wine, 3.4-oz fortified wine, or 1.5-oz 80-proof
liquor.
• hazardous or risk drinking is set for MEN at >/= 4 drinks

at one time or >14 drinks weekly, and for WOMEN at >/=
3 drinks at one time or > 7 drinks weekly.
ALCOHOL
• Comprehensive assessment in patients suspected of

alcohol abuse includes: alcohol use, including a history
of consumption from the patient and a significant other,
any alcohol-related problems, other drug misuse,
including over-the-counter medications, any co-existing
physical, mental, or social health problems and the
current readiness and belief in the ability to change.
EXERCISE & PHYSICAL ACTIVITIES
• WHO identified physical inactivity and a sedentary
lifestyle as one of the 4 major behaviors linked with non-
communicable diseases.
• A simple exercise prescription during a visit includes the

type of exercise, duration, frequency, and the target
heart rate ( calculated by getting the maximum HR,
equivalent to 220 minus the person's age)
• for endurance tarining and general aerobic conditioning,

beginners should target 50% to 65% of their max HR;
60% to 75% for intermediate level exercicers; and 70%
to 85% for established aerobic exercisers.
OCCUPATIONAL & ENVIRONMENTAL
HISTORY
• Information about the nature af present and previous
jobs, the length of time the job was held, its exact nature,
and other data like exposure to fumes, dust, solvents,
chemicals, vibration, loud noise, and repetitive motion
are all pertinent in assessment of
risks(Pneumoconioses, musco-skeletal injuries, hearing
loss and burns)
• Questions about the living condition of the patient matter

in planning for health maintenance.
• Congestion, like when living in urban slums or beside

factories or industries, suggests the nedd for
investigation on infectious diseases as well as diseases
due to environmental pollutants
SEXUAL HISTORY
• Information on sexual activities past and present;

partners amd types of partner, history of STD, or multiple
partners by the partner, homosexual or heterosexual
relations; sexual practices, the use of condoms or oral
contraceptives, the use of alcohol or drugs during sexual
activities, and the patient's sexual orientation is
necessary.
• A non-judgmental attitude is essential

STRESSORS & COPING MECHANISM
• Stress, especislly when chronically experienced, has
been known to cause significant morbidities.
• Questions on domestic violence and other forms of

abuse must be included in the assessment of stressors
at home
• Coping mechanisms may also be a cause of ilness

rather than a solution.
• Healthy choices include talking with friends, family, or

more formally with counselors. Harmful coping
mechanisms lead to addiction suck as smoking,
alcoholism, gambling and overeating.
SUPPORT SYSTEM
• The family is cited as the strongest support system.
• As therapeutic partners, they lighen the load of family

physicians.
• Once all risk factors have been identified adn analyzed,

the fa,mily physician can then discuss with the patient
the recommendations for preventive care based on
current medical evidence.
COMPONENTS OF PHE
• Lifesyle Counseling
• Screening
• Vaccination
• Chemoprophylaxis
LIFESTYLE COUNSELING
• Lifestyle is define as consistently practiced behaviors.
• Entails both affirming the health-promoting behaviors as

well as motivating patients to modify those that lead to
illness.
SCREENING
• All Filipino children and adults must have their height and weight checked
annually.
• Adults from 20 yrs old onwards must also have their BP taken regularly.
• Nenoates aat 24-48 hrs of life need to un dergo newborn screening.
• Pegnant women must be tested for urinalysis, VDRL, RPR, Hep B antigen
• Adults who ar 50 yrs old and above can bebefit from FBS and FOBT.
• Examination for visual acuity and functional reach are recommended

annually for those 60 yrs old and above.
• For special populations, PAP smear, mammogram for women, EKGsfor bus
drivres, and HIV and STD screening for sexually promiscuous and their
partners.
VACCINATION
• Expanded Program of Immunixation by the DOH (BCG,

DPT, OPV, measles, Hepatitis B) and also Hib, Varicella,
MMR, Hepatitis A, and Influenza for children 0-19 yrs
old.
• These days, there are more people traveling from one

place to another. thus, vaccination for travelers is
increasingly becoming imperative.
• Preexposure rabies vaccination should be considered for

travelers who plan a prolonged duration of stay in a
rmeote area or who engage in activities that might
involve working near animals or that could attract
animals.
CHOMEPREVENTION &
CHEMOPROPHYLAXIS
• Chemoprevention is the use of drugs to prevent ore
delay the occurence of a disease.
• SERMS for Breast CA, NSAIDS, Selenium and Calcium

for Colon CA, Long term oral contaceptive use for
Ovarian CA, Vitamin supplementation such as Folic acid
during pregnancy to guard against Neural tube defects.
• Chemoprophylaxis is also given to those who are in

close contact with patients having serious infectious
conditions (e.g.,Meningococcal disease: Coprofloxacin
or Rifampicin)
THANK YOU!

Periodic Health Exam

Uploaded by

Copyright:

Available Formats

Periodic Health Exam

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Periodic Health Exam

Uploaded by

Copyright:

Available Formats

THE PERIODIC HEALTH

• It gives greater value to cost-effectiveness and scientific

• It covers the full range of preventive services from

• Based on the identification and assessment of risk

• Diseases prioritized when doing preventive care include

• WHO estimates that with the reduction of exposure to

• These factors include alcohol and tobacco use, high BP,

• In all consultations, risk assessment begins with

• Diseases vcan be risk factors for other diseases (e.g.,

• Existing diseases, thus, place patients on a high-risk

• Diseases in the family are important determinants in the selection of

• The general population is advised to undergo mammography, FOBT,

• Infectious diseases, while non-hereditary, may be considered

• Presence of diseases like TB and Hep B in an index patient is an

• an increasing number of adults are obses and DIET is

• a family physician can do a simple evaluation by asking

• the healthy eating plate provides an easy guide to

• It is called the most potent carcinogen due to its

• Every consultation must be used as an opportunity to

• Information regarding tobacco is documented in "pack

• the amount of alcohol present in common beverages

• STANDARD DRINK: 12-oz regular beer, 8-oz malt liqiou,

• hazardous or risk drinking is set for MEN at >/= 4 drinks

• Comprehensive assessment in patients suspected of

• A simple exercise prescription during a visit includes the

• for endurance tarining and general aerobic conditioning,

• Questions about the living condition of the patient matter

• Congestion, like when living in urban slums or beside

• Information on sexual activities past and present;

• A non-judgmental attitude is essential

• Questions on domestic violence and other forms of

• Coping mechanisms may also be a cause of ilness

• Healthy choices include talking with friends, family, or

• The family is cited as the strongest support system.

• As therapeutic partners, they lighen the load of family

• Once all risk factors have been identified adn analyzed,

• Lifestyle is define as consistently practiced behaviors.

• Entails both affirming the health-promoting behaviors as

• Nenoates aat 24-48 hrs of life need to un dergo newborn screening.

• Examination for visual acuity and functional reach are recommended

• Expanded Program of Immunixation by the DOH (BCG,

• These days, there are more people traveling from one

• Preexposure rabies vaccination should be considered for

• SERMS for Breast CA, NSAIDS, Selenium and Calcium

• Chemoprophylaxis is also given to those who are in

You might also like