Primary Care
Core concepts
Midwives provide primary care across the lifespan, so know health maintenance intervals, immunization schedules, and screening thresholds. Cervical cancer screening starts at 21 (cytology every 3 years) with co-testing or primary HPV testing from 30 to 65; mammography is recommended biennially from 40 to 74; colorectal screening runs 45–75; osteoporosis screening starts at 65 for women or earlier with risk factors. Screen adults-including pregnant and postpartum people-for depression, and screen for intimate partner violence and tobacco use.
Chronic disease management matters: hypertension thresholds and pregnancy implications, diabetes screening and glycemic targets, thyroid disease, asthma, obesity, and lipid management. Know when to treat and when to refer. Contraception, STI screening, and preconception counseling are core primary care, not separate topics.
Traps
Questions test age cutoffs and intervals, not just test names. USPSTF grades differ from society guidelines; know which is being referenced. Do not start a teratogen without pregnancy assessment, and do not attribute fatigue or palpitations to stress before checking thyroid, anemia, and glucose.
Worked example
A 52-year-old with fatigue, weight gain, and heavy menses: check CBC, ferritin, and TSH; treat iron deficiency anemia and evaluate abnormal uterine bleeding rather than presuming perimenopause.
Rule of thumb
Screen by age and risk, confirm abnormal results before treating, and always ask about pregnancy potential before prescribing.