Executive Checkup Checklist

LABORATORY PROCEDURES (Blood Chemistry)

1. Fasting for 10-12 hours.

2. Nothing by mouth.(food, water, alcoholic drinks, smoking, even candies) before blood extraction.

STRESS TEST (TREADMILL)

1. Bring extrashirt, jogging pants or shorts and rubber shoes.

PAPSMEAR

1. Should be done 7 days after last day of menstruation.

2. Don’t douche or have sexual intercourse 24 hours prior to procedure.

ULTRASOUND:

AORTA/ LIVER/ GALLBLADDER/ PANCREAS/ SPLEEN/ HBT/ WHOLE ABDOMEN

1. Light, fat-free evening meal at 7pm

2. Take 2 Dulcolax tablets before bedtime

* No food by mouth for 12 hours the night before theprocedure. No breakfast. Water allowed.

IVP: INTRAVENOUS PYELOGRAPHY

1. Secure creatinine result

2. Light, fat-free evening meal before the examination

3. Take 2 Dulcolax tablets and/or Castor Oil (mixed with orange juice) after dinner.

*No food and drinks by mouth after midnight. No breakfast or water.

***PLS. CALL FORTMED FOR APPOINTMENT***

KUB / PROSTATE / PELVIC

1. Drink 4-6 glasses of water 30minutes before ultrasound

2. Do not urinate before the examination

MAMMOGRAPHY / SONOMAMMOGRAM

1. Procedure to be done on the 10thto 12thday from the first day of menstruation

TRANSRECTAL ULTRASOUND

1. Light, fat-freeevening meal

2. Take 2 Dulcolax tablets before bedtime

3. Take light breakfast only.

4. Then, insert 1 suppository

BARIUM ENEMA

1. Light, fat-free evening meal

2. Take 2 Dulcolax tablets after dinner

3. Insert 1 Dulcolax Suppository at 5am

*No food and drinks by mouth after midnight

****SCHEDULE OF BARIUM ENEMA: TUESDAY: 11-1PM ****

PLS. CALL FORTMED FOR APPOINTMENT

PREPARATION FOR TRANSRECTAL ULTRASOUND

Light meal the evening before the examination

Take 2 Dulcolax tablets after dinner

NPO after midnight. No breakfast.

Insert 1 Dulcolax suppository at 5am.