HKCFP Conjoint MCQ cheat sheet

Consultation models: the Calgary–Cambridge guide organises the interview into initiating the session, gathering information, physical examination, explanation and planning, closing the session, and building the relationship across all stages.

Screening in asymptomatic adults: hypertension from 18 years (BP each visit or at least every 2 years if normal), cervical cytology from 25 years (Hong Kong programme), colorectal cancer screening 50–75 years by FIT or colonoscopy, and breast screening by mammography in the 40–70 range depending on local programme.

Cardiovascular risk: estimate 10-year risk with a validated tool (Framingham or QRISK); statin therapy is generally offered when 10-year risk is ≥10% alongside lifestyle advice, with lower thresholds if diabetes or familial hypercholesterolaemia is present.

Diabetes diagnosis: fasting plasma glucose ≥7.0 mmol/L, 2-hour OGTT ≥11.1 mmol/L, HbA1c ≥6.5%, or random glucose ≥11.1 mmol/L with symptoms; without symptoms a repeat confirmatory test is required.

Hypertension diagnosis: clinic BP ≥140/90 mmHg on repeated occasions; ambulatory or home monitoring (daytime average ≥135/85 mmHg) confirms or excludes white-coat hypertension before starting lifelong therapy.

Lipid targets in established atherosclerotic disease: LDL-C below 1.8 mmol/L is the usual secondary-prevention goal, with intensification if not achieved on maximally tolerated statin.

Antibiotic stewardship: most acute upper respiratory infections, acute bronchitis, and uncomplicated rhinosinusitis are viral; delayed or no antibiotic prescribing reduces resistance without increasing complications in low-risk patients.

Childhood immunisation follows the local schedule; live vaccines are contraindicated in significant immunosuppression and pregnancy, and anaphylaxis to a vaccine component is an absolute contraindication to that vaccine.

Multimorbidity: apply the rule of halves - screen for depression and anxiety in chronic disease, review polypharmacy at each care-plan review, and deprescribe agents whose time-to-benefit exceeds life expectancy.

Asthma versus COPD: asthma shows variable airflow obstruction with reversibility (FEV1 improvement ≥12% and ≥200 mL after bronchodilator); COPD shows persistent post-bronchodilator FEV1/FVC <0.70.

Diabetic foot screening annually: monofilament and vibration sensation, pedal pulses, skin and footwear review; any ulcer with loss of sensation or absent pulses warrants urgent referral to a multidisciplinary foot service.

Depression: use a validated scale (PHQ-9); mild cases may respond to guided self-help and structured exercise, moderate-to-severe cases to psychotherapy and/or SSRI, with response reviewed at 2–4 weeks and full effect at 6–8 weeks.

Contraception counselling: combined hormonal methods are contraindicated with migraine with aura, uncontrolled hypertension, smoking over 15 cigarettes daily at age ≥35, and a history of venous thromboembolism.

Palliative care: opioid dosing for cancer pain follows stepwise titration with breakthrough doses at 10–17% of the total daily dose; constipation prophylaxis with a stimulant laxative is started with any regular opioid.

Health behaviour change: the 5A model (ask, advise, assess, assist, arrange) and brief motivational interviewing outperform simple advice for smoking cessation and alcohol reduction.

Safeguarding: a child or elder with injuries inconsistent with the explanation, delayed presentation, or repeated attendances triggers documentation and referral under local child or adult protection procedures.