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PREFACE ACKNOWLEDGMENTS

CONTRIBUTORS

1 Defining Primary Care

Jan M. Kriebs

Midwifery Scope of Practice

Women’s Health as Primary Care Practice

The Clinical Scope of Primary Care

Chronic Diseases and Cause of Death

Disparities in Health Care

Cultural Competence in Practice

Conclusion

References

2 General Health Examination

Barbara K. Hackley

Annual Health Exam

Screening Tests

Criteria for Successful Screening Programs

Accuracy of Screening Tests

Impact of Disease Prevalence

Biases in Screening Tests

Recommendations of Various Organizations

Immunizations

Immune Response

Types of Vaccinations

Vaccine Safety

Principles of Vaccination

Commonly Used Adult Vaccines

HPV Vaccines

Influenza Vaccines

Measles, Mumps, Rubella (MMR) Vaccines

Meningococcal Vaccine

Pneumococcal Vaccines

Tetanus, Diphtheria, Acellular Pertussis (Tdap) Vaccine

Varicella and Zoster Vaccines

Immunization in Special Populations

References

3 Environmental Health

Katie Huffling

Why Women’s Healthcare Professionals?

Scope of the Issue

Clinical Care

Presentations of Mental Illness Through the Life Cycle

Essential History, Physical, and Laboratory

Evaluation

History

Physical Examination

Laboratory Studies

Mental Disorders Commonly Seen in Primary Care

Mood Disorders

Anxiety Disorders

Stress Disorders

Adjustment Disorders

Eating Disorders

Personality Disorders

Substance-Related Disorders

Female Gender–Associated Mental Disorders

Menstrual Disorders

Perinatal Mood Disorders

Depression and/or Anxiety During Pregnancy

Postpartum Mood Disorders

Adjunctive Therapies for Mental Illness

Referral and Consultation with Mental Health

Clinicians

Conclusion

Online Resources

References

6 Substance Use

Christine L. Savage, Deborah Finnell

Substance Use Across the Continuum

Level of Risk

Types of Psychoactive Substances

Epidemiology of Substance Use in Women

Tobacco: Prevalence, Attributable Mortality

Alcohol: Prevalence, Attributable Mortality

Illicit Drugs: Prevalence, Attributable Mortality

Substance Use in Women by Age and Ethnicity

Emerging Issues

Nonprescription Use of Controlled Substances

Methamphetamine

Legalization of Marijuana

Neurobiologic Bases of Substance Use

The Brain Reward System

Genetics and Epigenetics

Application to Practice

Women-Specific Issues

Documentation

Danger Assessment and Safety Planning

Working with Survivors of Abuse

Trauma-Informed Care

Abuse During Pregnancy

Sequelae

Prevention of IPV

Elder Abuse

Incarcerated Women

Health Concerns

Women’s Health Care

Programs Addressing These Challenges

A Final Note for Clinicians

References

8 Neurology

Lynn C. Simko

Introduction

Common Symptoms

General Approach to Investigating Neurologic

Problems

History

Abbreviated Neurologic Exam

Neurologic and Laboratory Testing

Headache

Essential History, Physical, and Laboratory

Assessment

Tension Headache

Migraine Headache

Chronic Headache

Cluster Headache

Syncope

History

Physical Examination

Laboratory

Management of Syncope

Complementary/Alternative Therapies

Patient Instructions

During Pregnancy and Lactation

Vertigo and Dizziness

Numbness and Paresthesia—Peripheral Neuropathy

History

Physical

Laboratory and Clinical Testing

Management of Numbness/Tingling/Paresthesia

Weakness

History

Physical

Laboratory

Diagnostic Clues

Specific Conditions

Outer Ear Conditions: Otitis Externa, Foreign Bodies, and Earwax

Middle Ear Condition: Otitis Media with Effusion

Inner Ear Conditions: Sensorineural Hearing Loss and Vertigo

Retrocochlear Condition: Vestibular Schwannoma

References

11 Oral Health

Barbara K. Hackley

Preventive Health Care

Personal Dental Health Practices

Screening and Early Treatment of Dental Health Conditions

Recognizing Dental Disease

Clinical Presentation

Essential History, Physical, and Laboratory

Evaluation

Management of Common Conditions

Caries

Abscess

Gingivitis and Periodontal Disease

Tooth Loss

Temporomandibular Disorders

Dental Trauma

Care of the Pregnant and Breastfeeding

Woman

References

12 Diabetes

Allison A. Vorderstrasse

Epidemiology

Course of Disease

Evaluation for Diabetes

History and Physical

Laboratory Testing

Differential Diagnosis

Management

Type 1 Diabetes

Type 2 Diabetes

Patient Education

Prevention of Type 2 Diabetes

Impact of Pregnancy and Breastfeeding

References

13 Thyroid and Other Endocrine Disorders

Barbara K. Hackley, Jan M. Kriebs

Thyroid Disease

Screening Recommendations

Common Respiratory Symptoms

Rhinitis

Fever

Wheeze

Cough

Physiologic Changes in Pregnancy

Management of Specific Respiratory Conditions

Common Cold

Essential History, Physical, and Laboratory

Assessment

Management

Influenza

Essential History, Physical, and Laboratory

Assessment

Management

Pneumonia

Essential History, Physical, and Laboratory

Assessment

Management

Allergies

Essential History, Physical, and Laboratory

Evaluation

Management

Patient Instructions

Rhinosinusitis

Essential History, Physical, and Laboratory Evaluation

Management

Chronic Rhinosinusitis

Management

Acute Bronchitis

Essential History, Physical, and Laboratory Evaluation

Management

Asthma

Essential History, Physical, and Laboratory Evaluation

Management

Chronic Obstructive Pulmonary Disease

Essential History, Physical, and Laboratory

Testing

Management of Stable COPD

Management of Exacerbations of Chronic Bronchitis and/or COPD

Tuberculosis

Essential History, Physical, and Laboratory Testing

Management of Tuberculosis

References

Clinical Presentation

Essential History, Physical, and Laboratory

Findings

History

Physical

Laboratory/Imaging Testing

Cardiac Symptoms and Physical Findings

Chest Pain

Palpitations

Heart Murmur

Management of Cardiovascular Conditions

Hypertension

Physiology

Management

Management Issues Specific to Women

Alternative Therapies in the Management of Hypertension

Dyslipidemia

Physiology

Management

Medication Management

Alternative Therapies

Metabolic Syndrome

Dyslipidemia and Pregnancy

Venous Thromboembolism

Physiology

Assessment

Treatment

Pregnancy and Postpartum

Hypercoagulable States

Varicose Veins

References

17 Gastrointestinal

Diseases

Barbara K. Hackley, Elaine Leigh

Clinical Presentation

Nausea and Vomiting

Diarrhea

Dyspepsia and Heartburn

Dysphagia

Abdominal Pain

Constipation

Rectal Bleeding

Essential History, Physical, and Laboratory

Evaluation

History

Physical Examination

Laboratory Evaluation

Imaging/Diagnostic Procedures

Management of Common Gastrointestinal

Conditions

Conditions Associated with Nausea, Vomiting, and/or Diarrhea

Conditions Associated with Nausea and Vomiting

Conditions Associated with Diarrhea

Conditions Characterized Primarily by Dyspepsia and Heartburn

Conditions Characterized Primarily by Dysphagia

Conditions Characterized Primarily by Abdominal Pain

Conditions Characterized by Constipation

Conditions Characterized Primarily by Rectal Bleeding

Miscellaneous

References

18 Obesity and Weight Management

Diane Berry

Pathophysiology of Obesity

Office-Based Obesity Care

Measurement of Obesity

Associated Disease Risks

Management of Obesity

Dietary Interventions

Behavioral Modification Interventions

Nonproliferative Changes

Proliferative Lesions Without Atypia

Proliferative Lesions with Atypia— Hyperplasia and Carcinoma In Situ

Other Symptoms and Conditions

Breast Cancer Screening

Risk Factors for Breast Cancer

Imaging in Breast Cancer Screening

Prevention of Breast Cancer

Invasive Breast Cancer

Hormone Receptor Status and Prognosis

Less Common Cancers

Psychosocial Aspects of Breast Cancer

Missed Diagnoses and Liability

Conclusion

References

Appendix 19-A: Breast Examination

Procedure for Breast Examination

References

20 Urinary System

Megan Sapp Madsen, Jan M. Kriebs

Basics of Anatomy and Physiology

Essential History, Physical Examination, and

Laboratory

History

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