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Sample Wellness Medical Physical Exam FCSN HANDS-ON PHYSICAL EXAMINATION 1 Vital Signs Head neck eyes ears nose and throat 1 Cardiovascular Inspection auscultation percussion and palpation 1 Pulmonary Inspection auscultation percussion and palpation 1 Gastrointestinal Inspection auscultation percussion and palpation 1 Genitourinary Hernia exam see cancer screening 1 Lymph Nodes The examination of organ systems must be supplemented with an evaluation of lymph nodes in the cervical auxiliary and inguinal regions. 1 Neurological The neurologic exam for uniformed personnel must include a general mental status evaluation and general assessment of the major cranialperipheral nerves motor sensory reflexes. 1 Musculoskeletal Includes an overall assessment of range of motion ROM of all joints. Additionally observation of the personnel performing certain standard office exercises or functions is helpful in assessing joint mobility and function. BLOOD ANALYSIS The following are components of the blood analysis. At a minimum laboratory services must provide these components in their automated chemistry panel SMAC 20 and complete blood count CBC protocols 1 White Blood Cell Count Differential Red Blood Cell Count Hematocrit and Platelet Count 1 Liver Function Tests which includes SGOTAST SGPTALT LDH Alkaline Phosphatase and Bilirubin 1 C-Reactive Protein and Triglycerides 1 Cholesterol which includes Total Cholesterol Low Density Lipoprotein LDL-C level High Density Lipoprotein HDL-C level and Total Cholesterol HDL Ratio 1 Glucose if over 120 then HbA1c 1 Blood Urea Nitrogen Creatinine Sodium Potassium Carbon Dioxide Total Protein Albumin and Calcium URINALYSIS 1 Dip Stick Includes pH Glucose Ketones Protein Blood and Bilirubin 1 Microscopic Includes WBC RBC WBC Casts RBC Casts and Crystals VISION TESTS Assessment of vision must include evaluation of distance near peripheral and color vision. Evaluate for common visual disorders. PULMONARY SPIROGRAM 1 Every year for smokers 1 Every three years for nonsmoker CHEST X-RAY 1 Every five years STRESS EKG WITH VO2 VALUE CALCULATED 1 Members 30-years-old and under will be tested on treadmill every third year. 1 Those 30 to 39-years-old will be tested on treadmill every other year. 1 Those 40 and older will be tested yearly. Abnormal Cardiac Follow-up Electron Beam Tomography EBT ONCOLOGY SCREENING ELEMENTS 1 Prostate Specific Antigen PSA fecal occult blood testing and skin exam 1 Additional screenings based on need or at the request of the patient may also be provided during the base-line exam. CANCER SCREENING 1 Digital rectal exam 1 Testicular exam 1 Clinical breast examination 1 Pap smear IMMUNIZATIONS AND INFECTIOUS DISEASE SCREENING 1 Tuberculosis Screen Annual PPD 1 Hepatitis C Virus Screen 1 Hepatitis B Virus Vaccine 1 TetanusDiphtheria Vaccine Booster 1 Measles Mumps Rubella Vaccine MMR 1 Measles Vaccine Mumps Vaccine 1 Rubella Vaccine Polio Vaccine Hepatitis A Vaccine 1 Varicella Vaccine Influenza Vaccine 1 HIV Screening required to be offered HEAVY METAL AND SPECIAL EXPOSURE SCREENING AS NEEDED Arsenic urine Mercury urine Lead urine Lead blood Aluminum Antimony Bismuth Cadmium Chromium Copper Nickel Zinc - Organophosphates RBC cholinesterase Polychlorinated Biphenyls blood iA work history and medical history with special attention to skin respiratory and gastrointestinal systems and those nonspecific symptoms such as headache nausea vomiting dizziness weakness or other central nervous system dysfunctions that may be associated with acute or chronic exposure to AN. ii A physical examination giving particular attention to central nervous system gastrointestinal system respiratory system skin and thyroid. iii A 14 x 17 posteroanterior chest x-ray. iv Further tests of the intestinal tract including fecal occult blood screening and proctosigmoidoscopy for all workers 40 years of age or older and for any other affected employees for whom in the opinion of the physician such testing is appropriate. APPENDIXC 3 2