Office Practice / Primary Care
Core concepts
This domain blends preventive care with common ambulatory problems. Expect questions on health maintenance: mammography, cervical and colorectal cancer screening, osteoporosis screening, and immunizations (including Tdap in pregnancy and HPV). Know the evaluation of common symptoms - abnormal bleeding, pelvic pain, dysuria, vaginal discharge, and breast complaints - and the difference between empiric and targeted treatment. Be comfortable with thyroid disease in pregnancy, anemia workup, and the management of uncomplicated hypertension and diabetes as they intersect with obstetric and gynecologic care. Mental health screening (depression, intimate partner violence) and contraception counseling are recurring themes. Also review menopause management, including hormone therapy indications and risks.
Traps
Questions frequently test when not to act: not treating asymptomatic bacteriuria with the wrong agent, not ordering imaging for uncomplicated low back pain, not starting antibiotics for viral URI. Watch for screening interval errors (mammography every 1-2 years, cervical screening every 3-5 years depending on modality) and for contraindications to hormone therapy (e.g., history of breast cancer, VTE). Another trap: attributing symptoms to menopause when a structural cause must be excluded first.
Worked example / rule of thumb
A 52-year-old presents with hot flashes and no contraindications. Hormone therapy is appropriate for vasomotor symptoms at the lowest effective dose for the shortest duration, with annual reassessment. Rule of thumb: treat symptoms, not a lab value - menopause is a clinical diagnosis, and FSH testing is rarely needed in women over 45 with typical symptoms.