Family Medicine: Continuity, Prevention, and Shared Decisions
Family medicine tests breadth and pragmatism. Questions emphasize preventive care, chronic disease management, and the biopsychosocial context. Expect items on screening intervals, immunization, smoking cessation, contraception, and common primary care presentations.
Core content
Know screening recommendations for hypertension, diabetes, cervical and colorectal cancer, and lipid disorders, including when to start and stop. Understand the difference between screening and diagnostic testing. Manage chronic conditions with a stepwise, guideline-aligned approach: lifestyle first where appropriate, then pharmacotherapy, with attention to adherence and cost. Learn the approach to common symptoms - cough, headache, low back pain, fatigue, and dyspepsia - using red flags to decide who needs referral or imaging.
Traps
- Over-testing: stems often include a reassuring presentation where watchful waiting is correct.
- Red flags: weight loss, night sweats, focal neurologic deficits, or age over 50 with new symptoms change the pathway.
- Screening age: questions test the exact thresholds and intervals; do not extrapolate.
- Polypharmacy: consider drug interactions and deprescribing in older adults.
Rule of thumb
In primary care, the best answer is often the least invasive one that safely addresses the patient's concern, coupled with appropriate follow-up. When a stem offers both a test and a reassurance-and-review option, look for red flags to decide.
Worked example
A healthy 45-year-old with acute low back pain and no red flags does not need imaging. Recommend activity, analgesia, and review; imaging is reserved for red flags, trauma, or persistent symptoms.