Family Medicine blog
Clinical teaching and practical ideas for your next study session.
Febrile Prostatitis With a Weak Stream: When to Escalate for Retention
A febrile man with dysuria, perineal pain, a weak dribble, and a palpable bladder may need more than outpatient antibiotics. Learn how to check for acute retention, decide on urgent escalation, and frame bladder drainage without assuming one catheter route fits every patient.
Mental Capacity Act MCQs: Apply the Two-Stage Test to Finances
For Mental Capacity Act questions about finances, start with the specific decision and assess ability with practicable support. Then link any inability to an impairment; diagnosis or an unwise choice alone is not enough.
Necrotizing Otitis Externa: Pseudomonas Is Likely; Escalation Is the Skill
Pseudomonas aeruginosa is the most commonly isolated organism in necrotizing otitis externa, but naming it does not prevent delayed diagnosis. Learn primary-care red flags and when persistent ear-canal infection needs urgent escalation.
Fishy Discharge, Positive BV Wet Prep: Why STI Testing Still Matters
A bedside pattern can support bacterial vaginosis, but it does not answer whether a patient also has an STI. In a 24-year-old with a new partner, separate the vaginitis diagnosis from the decisions to test for chlamydia, gonorrhea, trichomoniasis, and HIV.
Population Health Risk Stratification: Why 40/30/20/10 Is Not a Patient Score
The familiar 40/30/20/10 shorthand is a historical population-health figure, not an individual risk score. Review its five-part breakdown, why the percentages are not precise causal weights, and how to turn a panel flag into person-centered care.
LNG-IUD Contraindications: Why a Negative Pregnancy Test May Not Clear Insertion
A negative urine pregnancy test does not always clear a patient for same-day LNG-IUD insertion. Learn how the pregnancy checklist distinguishes actual pregnancy, temporary uncertainty that calls for deferral, and true category 4 conditions.
New-Onset Heavy Menstrual Bleeding: When to Test for VWD
In new-onset heavy menstrual bleeding, the lifetime pattern—not a bruising question or routine PT/aPTT alone—helps decide when to test for von Willebrand disease while continuing uterine evaluation.
Unconscious After Choking: The CPR-First Board Priority
Learn why severe adult choking followed by unresponsiveness triggers compression-first CPR regardless of whether a pulse is present—and how to distinguish this FBAO pathway from general adult BLS.
Stable Chest Pain: Why CAD Risk-Factor Counts Aren’t a Diagnostic Score
A risk-factor list and a pain description answer different questions. Learn how to separate long-term cardiovascular prevention from estimating whether stable chest symptoms reflect obstructive coronary disease.
PID Follow-Up at 72 Hours: When Persistent Pelvic Pain Needs a New Workup
A follow-up after outpatient PID is a diagnostic checkpoint, not just an adherence check. Learn which findings should improve, how to judge the clinical trajectory, and when persistent pain calls for urgent reassessment.
Chlamydia and Gonorrhea Screening in Women: Separate Who to Test From What to Collect
For asymptomatic women, board reasoning has two parts: decide whether screening is indicated, then choose the specimen. Learn why a vaginal NAAT—often self-collected—is the preferred urogenital strategy, when urine remains reasonable, and when exposure history may call for additional site-specific testing. CDC’s cervix-based screening recommendations also apply to transgender men and gender-diverse people with a cervix.
ACE Inhibitor Monitoring After Initiation: Expected Creatinine Rise or AKI?
A creatinine rise after starting an ACE inhibitor may reflect the intended reduction in intraglomerular pressure—or an emerging kidney injury. Learn how to monitor blood pressure, creatinine, eGFR, and potassium, then distinguish an expected hemodynamic change from volume depletion, drug interactions, hyperkalemia, or AKI that requires action.