Blood pressure, blood sugar, lung function test and cholesterol testing

1. Health screening
services
By
Kiran Sharma
12/10/2013
Kiran Sharma, Assistant
Professor
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2. 
Health as a state of complete physical,
mental and social well-being and not
merely the absence of disease or infirmity.

Health is the extent to which an individual
or group is able on one hand, to realize
aspirations and satisfy needs and on the
other hand to change or cope with the
environment
HEALTH
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3. 
Screening refers to examination of a group of
usually asymptomatic individuals to detect
those with a high probability of having a
given disease, typically by means of an
inexpensive diagnostic test.

Monitoring refers to the act of observation
and in some cases intervention generally
referring to monitoring of a condition after
diagnosis to assess and improve outcomes.
SCREENING
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4. 
Health screening services are the services
provided by the health care professionals
to screen the health status of individuals
with or without positive sign and
symptoms.
HEALTH SCREENING SERVICES
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6. 
Early detection can make a difference between
relatively simple courses of treatment or lifethreatening complications

Health screenings save lives by early detection of
conditions such as hypertension or elevated
blood sugar and can help prevent serious
diseases

Many cases of disease exist and remain
undiagnosed that seriously affect our quality of
life. Many of these conditions can be corrected or
improved through a simple course of treatment if
once it has been discovered by health screening
IMPORTANCE OF HEALTH
SCREENING
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7. 
One of the additional benefits of a health
screen is peace of mind and reassurance.

Health Screening Services contributes to
economic burden of the patient by early
diagnosis and prevention.

For many people, the diagnosis comes when
they make contact with the health system for
other reasons for example when admitted or
visited to hospital with minor illness or
injuries.
The longer, people are undiagnosed, the
more likely it is the complication of the
disease

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8. 
Health screenings are convenient (readily
available), affordable (inexpensive),
comprehensive, very reliable with few
false negatives and flexible. Also it is
painless, noninvasive and inexpensive
tests.
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9. 
Based on composition of Health screen, it
is classified into three types. They are

STANDARD HEALTH SCREEN

PREMIUM HEALTH SCREEN

EXECUTIVE HEALTH SCREEN
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10. 
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Consultation with health professional
Blood glucose test (marker for diabetes)
Blood cholesterol test (total Cholesterol level)
Blood pressure measurement and evaluation
Body mass indexing (measures height weight
ratio)
Cardiac risk assessment
Comprehensive urine analysis (tests for
elevation of protein, blood etc in urine)
STANDARD HEALTH SCREEN
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11. 
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Consultation with health professional
Blood glucose test (marker for diabetes)
Blood cholesterol test (total Cholesterol level)
Blood pressure measurement and evaluation
Body mass indexing (measures height weight
ratio)
Cardiac risk assessment
Pulmonary function tests (lung capacity, and
screens for possible disease)
Liver function tests (for abnormal liver function)
Comprehensive urine analysis (tests for protein,
blood in the urine and possible kidney disease
infection)
PREMIUM HEALTH SCREEN
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12. Comprehensive one to one consultation
 Blood glucose test (marker for diabetes)
 Blood cholesterol test (total Cholesterol levels)
 Blood pressure measurement and evaluation
 Body mass indexing (measures height and
weight ratio)
 12 lead ECG (measures the electrical conduction
of the heart)
 Cardiac risk assessment
 Renal profile (blood test to check kidney
functions)

EXECUTIVE HEALTH SCREEN
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13. Bone profile (blood test for measure calcium,
phosphate)
 Full blood count (measures red cells, white cells,
hemoglobin etc.)
 Ferritin blood test (can detect hereditary
conditions such as haemochromatosis)
 Pulmonary function tests (lung capacity, and
screens for possible disease)
 Liver function tests (for abnormal liver function)
 Comprehensive urine analysis (tests for protein,
blood in the urine and possible kidney disease
infection)
 Healthy body fat % range

EXECUTIVE HEALTH SCREEN(contd.)
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14. 
Blood pressure (BP), sometimes
referred to as arterial blood pressure,
is the pressure exerted by circulating
blood upon the walls of blood vessels

During each heartbeat, blood pressure
varies between a maximum (systolic) and
a minimum (diastolic) pressure
BLOOD PRESSURE
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15. Physiology
There are many physical factors that influence
arterial pressure
Amount of blood
Viscosity of blood
Flow of blood
Elasticity of blood vessels
Flexibility of walls of blood12/10/2013 Kiran Sharma, Assistant
vessels
Professor
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16. During exercise
 During tension, fear
 During sleeping
 Excitement

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17. PULSE PRESSURE
average 40 mm Hg
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18. 
It is alternate expansion and elastic recoil
of an artery with each systole.

Pulse rate 70-90 per minute ( same as
heart rate)
Tachycardia- rapid pulse rate
 Bradycardia – slow pulse rate

PULSE
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20.  HIGH
BLOOD PRESSURE
(hypertension)


It is a condition in which the arteries
have persistently elevated blood
pressure.
Every time the human heart beats, it
pumps blood to the whole body through
the arteries.
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21. 
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Smoking
Obesity or being overweight
Being obese/overweight as a child - a research team
at the Indiana University School of Medicine found
that obese/overweight children are much more likely
to suffer from hypertension during adulthood.
Diabetes
Lack of physical activity
Pregnancy
Causes of hypertension
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22.  High levels
 Insufficient
of salt intake (sodium sensitivity).
calcium, potassium, and magnesium
consumption
 Vitamin D deficiency
 High levels of alcohol consumption
 Stress
 Aging
 Medicines such as birth control pills
 Genetics and a family history of hypertension
 Chronic kidney disease
 Adrenal and thyroid problems or tumors
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23. 
Hypertension is classified as either primary
(essential) hypertension or secondary
hypertension; about 90–95% of cases are
categorized as "primary hypertension" which
means high blood pressure with no obvious
underlying medical cause.[2] The remaining
5–10% of cases (secondary hypertension)
are caused by other conditions that affect the
kidneys, arteries, heart or endocrine system.
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24. 
Low blood pressure means that your
blood pressure is lower than normal
Low blood pressure
( hypotension)
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25. Some of the causes of low blood pressure
include:
 Not drinking enough fluids (dehydration).
 Medicines, such as high blood pressure
medicine or other heart medicines.
 Health problems such as thyroid disease, severe
infection, bleeding in the intestines, or heart
problems.
 Trauma, such as major bleeding or severe burns.
 Depreession
 Fasting
 emotions
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26. Measuring BLOOD PRESSURE
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28. Sitting position while measuring BP
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31. 
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Make sure you place the round end of the stethoscope
'under' the blood pressure cuff.
You inflate the sphygmomanometer (blood pressure cuff)
to a little above 180 mm Hg.This collapses the major
arteries to the arm (that's why it is uncomfortable).
Then you slowly release air by gently turning the air
valve, and watch the pressure drop.When you first hear a
sound, that will be the Systolic blood pressure.
The sound you hear is the blood now flowing in the
artery of the arm. This means that the systolic pressure is
now greater than the pressure in the blood pressure cuff.
As you continue to watch the pressure drop, when you no
longer hear any sounds, that will
be the Diastolic blood pressure.
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32. 
The blood sugar concentration or blood glucose level
is the amount of glucose (sugar) present in the blood of a
human.

The body naturally tightly regulates blood glucose levels
as a part of metabolic homeostasis.

Blood sugar levels outside the normal range may be an
indicator of a medical condition. A persistently high level
is referred to as hyperglycemia; low levels are referred to
as hypoglycemia
BLOOD SUGAR
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33. 
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The international standard way of measuring blood
glucose levels are in terms of a molar concentration,
measured in mmol/L (millimoles per litre; or millimolar,
abbreviated mM).
In the United States, mass concentration is measured in
mg/dL (milligrams per decilitre)
A body's homeostatic mechanism, when operating
normally, restores the blood sugar level to a narrow range
of about 4.4 to 6.1 mmol/L (79.2 to 110 mg/dL) (as
measured by a fasting blood glucose test)
Normal values
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34. High blood sugar (hyperglycemia)
 Long-term hyperglycemia causes many of the long-term
health problems including heart disease, eye, kidney, and
nerve damage.
 The most common cause of hyperglycemia is diabetes.
Low blood sugar(hypoglycemia)
 If blood sugar levels drop too low, a potentially fatal
condition called hypoglycemia develops.
 Symptoms may include lethargy, impaired mental
functioning; irritability; shaking, twitching, weakness in
arm and leg muscles; pale complexion; paranoid or
aggressive mentality and loss of consciousness.
Abnormality in blood sugar levels
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35. Glucose is measured in whole blood, plasma or
serum.
 Historically, blood glucose values were given in
terms of whole blood, but most laboratories now
measure and report plasma or serum glucose levels.

Glucose measurement
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36. Collection of blood in clot tubes for serum chemistry analysis
permits the metabolism of glucose in the sample by blood cells until
separated by centrifugation.
 Red blood cells, for instance, do not require insulin to intake
glucose from the blood. Higher than normal amounts of white or
red blood cell counts can lead to excessive glycolysis in the sample,
with substantial reduction of glucose level if the sample is not
processed quickly. Ambient temperature at which the blood sample
is kept prior to centrifuging and separation of plasma/serum also
affects glucose levels.
 At refrigerator temperatures, glucose remains relatively stable for
several hours in a blood sample. Loss of glucose can be prevented
by using Fluoride tubes (i.e., gray-top) since fluoride inhibits
glycolysis. However, these should only be used when blood will be
transported from one hospital laboratory to another for glucose
measurement. Red-top serum separator tubes also preserve glucose
in samples after being centrifuged isolating the serum from cells.

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37. 
Two major methods have been used to measure glucose.

The first, still in use in some places, is a chemical method
exploiting the nonspecific reducing property of glucose in a
reaction with an indicator substance that changes color when
reduced. Since other blood compounds also have reducing
properties (e.g., urea, which can be abnormally high in uremic
patients), this technique can produce erroneous readings in
some situations (5 to 15 mg/dL has been reported).

The more recent technique, using enzymes specific to glucose,
is less susceptible to this kind of error. The two most common
employed enzymes are glucoseoxidase and hexokinase.
MEASUREMENT
TECHNIQUES
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38. Measurement techniques
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40. 1.
2.
3.
4.
5.
6.
7.
8.
Fasting blood sugar (i.e., glucose) test (FBS)
Two-hr postprandial blood sugar test (2-h PPBS)
Oral glucose tolerance test (OGTT)
Intravenous glucose tolerance test (IVGTT)
Glycosylated hemoglobin (HbA1C)
Self-monitoring of glucose level via patient testing
Random blood sugar (RBS)
Average blood glucose may be estimated by
measuring glycated hemoglobin (HbA1c)
Blood glucose laboratory tests
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41. Clinical correlation
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42. 
Lung function tests, also called pulmonary function
tests, measure how well your lungs work.

Comparing the measured values for pulmonary function tests
obtained on a patient at any particular point with normal
values derived from population studies.

The percentage of predicted normal is used to grade the
severity of the abnormality.
LUNG FUNCTION TEST
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43. 
Spirometry - This test measures how much air you can breathe in
and out. It also measures how fast you can blow air out.

Body plethysmography - This test measures how much air is
present in your lungs when you take a deep breath. It also measures
how much air remains in your lungs after you breathe out fully.

Lung diffusion capacity. This test measures how well oxygen passes
from your lungs to your bloodstream.
Lung volumes
Arterial blood gas, shunt fraction measurement, dead space
Airway resistance
Inspiratory/expiratory muscle pressures
Airway reactivity (methacholine/exercise challenge)
Cardiopulmonary exercise test
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Pulmonary Function Tests
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44. VT: tidal volume - air inhaled during quiet
breathing
 IRV: inspiratory reserve volume maximal volume inhaled from quiet
breathing
 ERV: expiratory reserve volume - maximal
volume exhaled from quiet breathing
 RV: residual volume - volume remaining
after maximal exhalation

Primary Lung Volumes
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45. TLC: total lung capacity - sum of 4
primary volumes
 VC: vital capacity - volume exhaled from
maximal inspiration to maximal expiration
 FRC: functional residual capacity –
resting, end-expiratory volume
 IC: maximal volume inhaled from FRC

Lung Capacities = Sum of Primary
Lung Volumes
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46. 
Measurement of the pattern of air movement into and out
of the lungs during controlled ventilatory maneuvers.

You will be asked to breathe through a mouthpiece while
wearing a nose clip. The tester will coach you to take in
as big a breath as possible. You will then blast the air out
as fast as you can until your lungs are completely empty.
You may then be asked to take another deep breath in
again. You will do this three times or more to make sure
the results are accurate.
Spirometry
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47. The Spirogram
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48. A total cholesterol blood test is a blood
test to check the cholesterol and
triglyceride in the blood.
 Total cholesterol testing is necessary to
check the level of cholesterol in the blood.

Cholesterol Test
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49. 
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Cholesterol - Cholesterol is used by the body to produce hormones
and build cells. Excess cholesterol in the blood can clog artery walls
and form plaque. Too much of plaque can increase the risk of heart
disease.
HDL cholesterol - This is good cholesterol that binds with fat in the
blood and helps to remove it from the body.
LDL cholesterol - Known as 'bad cholesterol', LDL cholesterol can
increase the risk of heart disease.
VLDL - This lipoprotein distributes the triglyceride that is created
by the liver. Excessive VLDL can increase the chances of a stroke
and heart disease.
Triglycerides - Triglycerides are fat that is stored in the body as
energy.
Cholesterol attaches itself to a protein and travels through
blood. This package is known as a lipoprotein. A Lipid profile
test is done to check the level of total cholesterol,
triglycerides, HDL cholesterol, and LDL cholesterol.
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50. This is done to screen for a lipid disorder.
 This test is done to check how a person is responding
to treatment for lipid disorders.
 A test like this can determine if you are at a risk of
getting heart disease.
 This test might be done to screen for diseases that
cause high cholesterol in people.

Reasons Why It is Conducted
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51. REPORTABLE RANGE
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52. THANKS
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