Common Cases in Women's Primary Care Clinics

Preface
Contents
Part I: Introduction
	Chapter 1: Introduction to Women’s Primary Care
		1.1 Introduction
			1.1.1 A Brief History of Primary Care
			1.1.2 A Primer on Women’s Health
			1.1.3 An Overview of this Book
		Suggested Reading
	Chapter 2: History and Physical Examination of a Woman
		2.1 Short Introduction
		2.2 Case Presentation
		2.3 Discussion
			2.3.1 Approach to this Patient: History of Present Illness
			2.3.2 Approach to this Patient: Past Medical and Surgical History
			2.3.3 Approach to this Patient: Family History
			2.3.4 Approach to this Patient: Social History
			2.3.5 Approach to this Patient: Gynecologic History
			2.3.6 Approach to this Patient: Physical Exam
		2.4 Conclusion
		Suggested Reading
	Chapter 3: Procedures in Women’s Primary Care Clinic
		3.1 Case Study
		3.2 Introduction
		3.3 Women’s Health Primary Care Clinic Model
		3.4 Primary Care Outpatient Procedures
			3.4.1 Gynecological Procedures
				Our Case
					Patient Comfort and Procedural Preparation
					Sterility and Disinfection
					Aftercare Instructions and Follow-Up
					Billing and Coding
						Diagnostic(screening) Procedures
						Therapeutic (prevention)
		3.5 Our Case
		3.6 Summary
		Suggested Reading
Part II: Non Infection Medical Condition in Women
	Chapter 4: Pelvic Pain
		4.1 Case
		4.2 Introduction
		4.3 Differential Diagnosis
			4.3.1 Reproductive Organs
			4.3.2 Musculoskeletal or Myofascial Pain
			4.3.3 Gastrointestinal
			4.3.4 Urinary
			4.3.5 Central Pain Disorders
		4.4 Evaluation
		4.5 Case
		4.6 Treatment
		4.7 Summary
		Suggested Reading
	Chapter 5: Vaginitis
		5.1 Introduction
		5.2 Case Presentation
		5.3 Discussion of Case
			5.3.1 Bacterial Vaginosis
			5.3.2 Vulvovaginal Candidiasis
			5.3.3 Trichomoniasis
			5.3.4 Non-infectious Vaginitis
		5.4 Conclusion
		Suggested Reading
	Chapter 6: Menstrual Bleeding Disorders
		6.1 Introduction
		6.2 Normal Menstrual Cycle
		6.3 Case
		6.4 Conclusion
		Suggested Reading
	Chapter 7: Breast Complaints
		7.1 Introduction
		7.2 Epidemiology for Breast Cancer
		7.3 Case 1:Guidance and Management of Clinically Suspicious Breast Lump
			7.3.1 Patient Case
			7.3.2 Workup of a Breast Mass
		7.4 Case 2: Appropriate Screening Intervals, Risk Assessment, Managing Modifiable Risk Factors)
		7.5 Patient Case
		7.6 Introduction of Breast Cancer Risk Assessment Models and Assessment Tools
		7.7 Clinical Trials and Task Force Committees on the Evidence for Breast Cancer Screening
		7.8 Management of Breast Cancer for Primary Care: What Risk Factors Can We Mitigate?
		7.9 Conclusion
		Suggested Reading
	Chapter 8: Diagnosis and Management of Urinary Incontinence
		8.1 Introduction
		8.2 Case 1
		8.3 Treatments
			8.3.1 Case 1 Conclusion
		8.4 Case 2
		8.5 Discussion
		Suggested Reading
	Chapter 9: Intimate Partner Violence in Primary Care: Screening, Recognition, and Contingency Planning
		9.1 Introduction
		9.2 Epidemiology
		9.3 Case 1
		9.4 Morbidity and Mortality
		9.5 Case 1B
			9.5.1 Screening for IPV
			9.5.2 Screening Tools
		9.6 Case 2
			9.6.1 Validation and Listening
		9.7 Evaluating for Risk of Immediate Harm
		9.8 Case 2B
			9.8.1 High Risk Planning
			9.8.2 Mandatory Reporting
			9.8.3 Safety Planning
		9.9 Case 2c
		9.10 Conclusion
		Suggested Reading
	Chapter 10: Women and the Immune System
		10.1 Introduction
		10.2 Case 1
		10.3 Case 1 Discussion
		10.4 Case 2
		10.5 Case 2 Discussion
		10.6 Conclusion
		Suggested Reading
	Chapter 11: Cardiovascular Disease in Women
		11.1 Introduction
		11.2 Case 1
		11.3 Discussion
			11.3.1 Risk Factors for Atherosclerotic Cardiovascular Disease
			11.3.2 Management of Cardiovascular Risk Factors
			11.3.3 Aspirin in Primary Prevention
			11.3.4 Management of Blood Pressure
			11.3.5 Management of Disorders of Cholesterol
			11.3.6 Management of Diabetes Mellitus in Cardiovascular Disease
			11.3.7 Psychosocial Stressors and Mental Health
			11.3.8 Hormone Therapy and ASCVD
		11.4 Conclusion
		Suggested Reading
	Chapter 12: Birth Control
		12.1 Introduction
		12.2 Clinical Case
		12.3 Discussion
			12.3.1 Tubal Occlusion
			12.3.2 Long-Acting Reversible Contraception
		12.4 Copper IUD
		12.5 LNG-IUD
		12.6 Subdermal Etonogestrel Implant
			12.6.1 Progestin-Only Injections
			12.6.2 Progestin-Only Pills
			12.6.3 Combination Hormonal Contraception
			12.6.4 Barrier Contraception
			12.6.5 Fertility Awareness
			12.6.6 Conclusion
		Suggested Reading
	Chapter 13: Non-Ob Treatment of the Pregnant Patient
		13.1 Conclusion
		Suggested Reading
	Chapter 14: Menopause
		14.1 Case Presentation
		14.2 Introduction
		14.3 Physiology of Menopause
			14.3.1 Endocrine Characteristics of Menopausal Transition (Perimenopause)
				Ovarian
				Pituitary
				Adrenals
		14.4 Clinical Implications
			14.4.1 Presentation
				Classic Symptoms
				Other Symptoms Associated with Menopause
				Body Changes Reported with Menopause Transition
			14.4.2 Evaluation
			14.4.3 Our Case
			14.4.4 Clinical Issues
				Subfecundity and Fertility
				Abnormal Uterine Bleeding
				Vasomotor Symptoms of Menopause
				Genitourinary Syndrome of Menopause
				Sleep Disturbances
				Sexual Health
				Neuropsychological Health
				Metabolic Changes
				Osteoporosis
		14.5 Our Case
		14.6 Management
			14.6.1 Lifestyle Prescription
			14.6.2 Pharmacological Therapy
				Menopausal Hormonal Therapy
				Menopausal Non-Hormonal Therapy
			14.6.3 Alternative and Complementary Therapy
		14.7 Summary
		Suggested Reading
	Chapter 15: Eating Disorders in Women’s Health Primary Care Practice
		15.1 Introduction
		15.2 Case 1
		15.3 Discussion
			15.3.1 Screening
			15.3.2 Eating Disorders
				Anorexia Nervosa
				Bulimia Nervosa
				Binge Eating Disorder
				Avoidant/Restrictive Food Intake Disorder
				Other Specified Feeding and Eating Disorders
			15.3.3 Evaluation
			15.3.4 Comprehensive Treatment Plan
				Identification of Level of Care
				Non-Pharmacological Interventions
				Medical Management and Pharmacotherapy
				Complications and Management
				Gynecological Health
				Bone Health
				Pregnancy and Eating Disorders
		15.4 Conclusion
		Suggested Reading
	Chapter 16: Osteoporosis
		16.1 Introduction
			16.1.1 Pathophysiology and Presentation
		16.2 Case Presentation
			16.2.1 Initial Presentation
			16.2.2 Initial Testing and Management
			16.2.3 Follow-Up and Initiation of Pharmacological Therapy
			16.2.4 Monitoring After Initiation of Therapy
			16.2.5 Transition of Therapy
			16.2.6 Follow-Up on Teriparatide
		16.3 Discussion
			16.3.1 Definition and Diagnosis
			16.3.2 Screening for Osteoporosis
			16.3.3 Management of Osteoporosis
				Bisphosphonates
				Denosumab
				Anabolic Agents
				Selective Estrogen Receptor Modulators
			16.3.4 Monitoring After Treatment
		16.4 Conclusion
		Suggested Reading
Part III: Common Infections in Women
	Chapter 17: Urinary Tract Infection
		17.1 Introduction
			17.1.1 Case
		17.2 Definitions
			17.2.1 Continuation of Case
		17.3 Uncomplicated Urinary Tract Infections
			17.3.1 Continuation of Case
			17.3.2 Continuation of Case
			17.3.3 Continuation of Case
		17.4 Complicated Urinary Tract Infections
			17.4.1 Continuation of Case
		17.5 Recurrent Urinary Tract Infections
			17.5.1 Continuation of Case
			17.5.2 Non-antibiotic Prophylaxis
			17.5.3 Antibiotic Prophylaxis
		17.6 Asymptomatic Bacteriuria
			17.6.1 Continuation of Case
		17.7 Special Circumstances
			17.7.1 Continuation of Case
		17.8 Conclusion
		Suggested Reading
	Chapter 18: A Primary Care Clinician’s Focus on Sexually Transmitted Infections in the Female Gender
		18.1 Introduction
		18.2 Case 1
		18.3 Discussion
			18.3.1 Understanding Sexually Transmitted Infections
			18.3.2 Chlamydial Infections
				Introduction
				Diagnostic Considerations
				Treatment Approach
				Management of Sex Partners and Other Considerations
				Follow-Up Testing
			18.3.3 Gonococcal Infections
				Introduction
				Diagnostic Considerations
				Treatment Approach
				Management of Sex Partners and Other Considerations
				Follow-Up Testing
			18.3.4 Trichomonas Infections
				Introduction
				Diagnostic Considerations
				Treatment Approach
				Management of Sex Partners and Other Considerations
				Follow-Up Testing
			18.3.5 Syphilitic Infections
				Introduction
				Diagnostic Considerations
				Treatment Approach
				Management of Sex Partners and Other Considerations
			18.3.6 Herpes Simplex Virus
				Introduction
				Diagnostic Considerations
				Treatment Approach
			18.3.7 Severe Disease
			18.3.8 Hepatitis
				Management of Sex Partners and Other Considerations
			18.3.9 Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)
				Introduction
				Diagnostic Considerations
				Treatment Approach
				Management of Sex Partners and Other Considerations
		18.4 Hepatitis B Virus (HBV)
			18.4.1 Introduction
			18.4.2 Diagnostic Considerations
			18.4.3 Treatment Approach
			18.4.4 Management of Sex Partners and Other Considerations
		18.5 Hepatitis C Virus (HCV)
			18.5.1 Introduction
			18.5.2 Diagnostic Considerations
			18.5.3 Treatment Approach
			18.5.4 Management of Sex Partners and Other Considerations
		18.6 Human Papillomavirus (HPV)
			18.6.1 Introduction
			18.6.2 Diagnostic Considerations
			18.6.3 Treatment Approach
			18.6.4 Management of Sex Partners and Other Considerations
		18.7 Mycoplasma Genitalium
			18.7.1 Introduction
			18.7.2 Diagnostic Considerations
			18.7.3 Treatment Approach
			18.7.4 Management of Sex Partners and Other Considerations
		18.8 Ectoparasitic Infections
			18.8.1 Pediculosis Pubis (Pubic Lice)
				Introduction
				Diagnostic Considerations
				Treatment Approach
				Management of Sex Partners and Other Considerations
		18.9 Scabies
			18.9.1 Introduction
			18.9.2 Diagnostic Considerations
			18.9.3 Treatment Approach
			18.9.4 Management of Sex Partners and Other Considerations
		18.10 STI Prevention Counseling
		18.11 STI Prevention Tips
		18.12 Conclusion
		Suggested Reading
Part IV: Heath Maintenance
	Chapter 19: Mammography/Cervical Cancer Screening
		19.1 Case
		19.2 Breast Cancer Screening
			19.2.1 Introduction
			19.2.2 Risk Factors for Breast Cancer
				Case Continued
			19.2.3 Risk Assessment Tools
			19.2.4 Screening Modalities
				Case Continued
				Average Risk Patients
				High-Risk Patients
				Special Considerations
			19.2.5 Screening Recommendations
				Average Risk Patients
				High-Risk Patients
			19.2.6 Benefits and Harms of Screening
		19.3 Cervical Cancer
			19.3.1 Introduction
			19.3.2 Risk Factors for Cervical Cancer
			19.3.3 Screening Methodologies
				Special Considerations
			19.3.4 Screening Recommendations
			19.3.5 Benefits and Harms of Screening
			19.3.6 Summary
		Suggested Reading
Index