Annual physical exam checklist by age

First Steps at an Annual Physical

An annual checkup starts with your doctor going over your health history. They'll ask how you feel and whether you've had any symptoms. The doctor might also ask about your family's health history.

Then you'll have a physical exam, where your doctor:

• Measures your weight, height, and body mass index (BMI)
• Checks vital signs like your temperature and heart rate
• Looks into your eyes, ears, nose, and throat
• Presses on different areas of your body to feel the size of your organs and feel for pain or any lumps or other changes
• Checks your reflexes with a small rubber hammer
• Listens to your heart and lungs with a stethoscope

The doctor may look more closely at certain areas of your body, based on what symptoms you report and your gender.

Tests to Expect During Your Checkup

Complete blood count. This test measures the number of red blood cells, white blood cells, and platelets in a sample of your blood. It can find problems like infections, anemia, bleeding disorders, and blood cancer.

Blood pressure check . Everyone age 40 and older needs to have a blood pressure check once a year.  In this test, a doctor or nurse will wrap a cuff around your arm and inflate it. The device measures the pressure in your arteries when your heart pumps.

Cholesterol screening . Everyone age 20 and older should get a cholesterol blood test once every 4 to 6 years. When you're over 40, your doctor will calculate your 10-year risk for heart disease or stroke. Depending on this risk, you might need more frequent cholesterol checks.

Diabetes screening. Anyone age 50 to 70 who is overweight or obese should have a diabetes test. Your doctor can check you for diabetes with a test that measures your blood sugar level after you've fasted for 8 to 12 hours, or an A1c test that looks at your blood sugar average over the last 2 to 3 months.

Urine tests. A test called a urinalysis used to be a routine part of checkups. Today, your doctor might not ask for a sample of your urine unless you have symptoms of a problem like a urinary tract infection (UTI) or kidney disease.

Your doctor might also ask whether you're up to date on other health screenings, including:

Colon cancer. You'll need regular screenings for this cancer once you reach age 45, or younger if you're at higher risk.. You can get a colonoscopy once every 10 years if you're not at high risk for colon cancer. Other tests, like flexible sigmoidoscopy or stool tests, are done at different intervals based on your age and colon cancer risk.

Hepatitis C. If you haven't already been tested, your doctor might give you a blood test to look for this infection.

Checkups in Men and Women

Some tests you might have during an annual checkup are different for men and women.

Men. When you're over 50, you should talk to your doctor about prostate cancer screening. They can check you for this cancer with these two tests:

• Prostate specific antigen (PSA) test measures the level of a protein in the blood that rises in some men who have prostate cancer.
• Traditionally a digital rectal exam (DRE) has been used to screen for prostate cancer. It is generally not used for screening now.

Women. When you're 65 and older, you need bone mineral density screenings to look for weak bones that could lead to fractures. Ask your doctor when, and how often, you should have this test. Postmenopausal women younger than 65 years of age with risk factors for fracture will also need a bone mineral density screening.

To look for breast cancer, your doctor may do a breast exam, where they check your breasts for lumps or other changes. A checkup is also the time to talk about scheduling a mammogram, which you need every 1 or 2 years starting at age 50. Depending on an individual woman’s risk factors, screening may be more often or may start at an earlier age

Until you turn 65, your doctor may do a Pap test and a human papillomavirus (HPV) test for cervical cancer every 5 years or only a Pap test every 3 years.The decision to discontinue screening in average-risk woman depends on their prior results, life expectancy, and preferences in a shared decision-making discussion.

Are You Up to Date on Your Vaccines?

At each checkup, your doctor should also make sure that you've had all your recommended vaccines, which include a:

• Flu vaccine every fall
• Shingles vaccine (two doses once you're 50 or older)
• Pneumococcal polysaccharide vaccine (PPSV23) to protect you against pneumonia, meningitis, and bloodstream infections -- one dose once you're 65 and older, or at 50 or older if you have certain health conditions
• Tetanus and diphtheria (Td) booster shot once every 10 years

You may also need additional vaccines if you have a health condition like diabetes, heart disease, or lung disease. Ask your doctor which vaccines you should get.

It's important to also talk about your mental health, too. Tell your doctor if you've had any anxiety, depression, or other mental issues since your last visit.

Use your checkup to let your doctor know everything that's been going on with your health. And take the time to prepare for the checkup so you can fill your doctor in on your symptoms and get all your questions answered.