Midlife periodic health exam in the primary care practice

The periodic exam for the healthy midlife patient (age 45 to 65) includes blood pressure testing, cholesterol screening, and a baseline ECG. Counseling is appropriate for proper diet, exercise, and smoking cessation Screening tests are indicated for colon cancer for men and women, and for breast and cervical cancer for women. A check of immunization status can detect a need for recommended vaccines, including tetanus-diphtheria. Question patients about hearing problems, and test as needed. Counsel women about risk factors for osteoporosis and the need for adequate calcium and vitamin D intake. Ask about symptoms of urinary incontinence and sexual problems. Screen women for thyroid disease.