HKMLE Part I flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Medical Registration Ordinance Cap. 161

Hong Kong statute establishing the Medical Council of Hong Kong, provisional and full registration categories, disciplinary powers, and the legal basis for practising medicine in the territory.

Provisional registration period

A doctor registered provisionally must serve a specified period of approved internship or supervised practice in Hong Kong before becoming eligible for full registration under the Ordinance.

Informed consent elements

Valid consent requires patient capacity, adequate disclosure of material risks and alternatives, comprehension, and voluntariness; a signed form alone does not create valid consent.

Best interests decision

For an adult lacking capacity, treatment decisions are made in the patient's best interests, weighing clinical benefit, prior expressed wishes, and the least restrictive option.

Confidentiality statutory exceptions

Disclosure without consent is permitted where required by law, such as notifiable disease reporting, or where necessary to prevent serious harm to an identifiable person.

Notifiable diseases Hong Kong

Statutory notification to the Centre for Health Protection covers diseases including tuberculosis, cholera, dengue fever, measles, and severe acute respiratory syndrome, enabling surveillance and outbreak control.

Sensitivity and specificity

Sensitivity is the proportion of true cases correctly identified as positive; specificity is the proportion of true non-cases correctly identified as negative. Both are intrinsic to the test.

Positive predictive value

PPV is the probability that a person with a positive test truly has the disease; unlike sensitivity, it depends on disease prevalence in the tested population.

Number needed to treat

NNT equals one divided by the absolute risk reduction. It estimates how many patients must be treated for one additional favourable outcome compared with control.

Relative risk versus odds ratio

Relative risk compares outcome incidence between exposed and unexposed groups in cohort studies; odds ratio approximates it in case-control studies, especially for rare outcomes.

Incidence versus prevalence

Incidence measures new cases per population at risk per unit time; prevalence measures all existing cases at a point or period. Prevalence rises with longer disease duration.

Dangerous Drugs Ordinance Cap. 134

Hong Kong legislation controlling narcotics and other dangerous drugs, requiring registration, secure storage, and record-keeping for prescribing, supply, and possession by healthcare professionals.

Antimicrobial stewardship principle

Prescribe antibiotics only for likely bacterial infection, choose the narrowest effective agent, use correct dose and duration, and review culture results to de-escalate therapy.

Tuberculosis notification and management

Tuberculosis is statutorily notifiable in Hong Kong; suspected cases require prompt notification, sputum testing, contact tracing, and directly observed therapy through chest clinics.

Anion gap calculation

Anion gap equals measured sodium minus the sum of chloride and bicarbonate; a raised gap suggests unmeasured anions such as lactate, ketones, or toxins.

Metabolic acidosis compensation

Compensation is respiratory hyperventilation lowering PaCO2; expected PaCO2 approximates 1.5 times bicarbonate plus 8, with deviation indicating a mixed disorder.

Renal clearance concept

Clearance is the volume of plasma completely cleared of a substance per unit time; inulin clearance approximates glomerular filtration rate, while PAH clearance estimates renal plasma flow.

Cranial nerve lesion patterns

Facial nerve palsy affects all ipsilateral facial muscles including the forehead; upper motor neuron lesions spare the forehead because of bilateral cortical innervation.

Dermatome landmark levels

Key dermatomes: C5 shoulder, C6 thumb, C7 middle finger, T4 nipple, T10 umbilicus, L1 groin, L4 medial malleolus, L5 dorsum of foot, S1 lateral foot.

Enzyme kinetics Michaelis-Menten

Reaction velocity depends on substrate concentration; Km is the substrate concentration at half maximal velocity, and competitive inhibitors raise apparent Km without altering Vmax.

Pharmacokinetic half-life

Half-life is the time for plasma concentration to halve; roughly four to five half-lives are needed to reach steady state during constant-rate dosing.

First-pass metabolism

Orally absorbed drugs pass through portal circulation and liver before systemic circulation, reducing bioavailability; routes avoiding this include intravenous and sublingual administration.

Cell injury reversible versus irreversible

Reversible injury shows cellular swelling and fatty change; irreversible injury is marked by membrane rupture, mitochondrial damage, and nuclear changes such as pyknosis and karyolysis.

Hypersensitivity types

Type I is IgE-mediated immediate allergy; type II is antibody against fixed antigens; type III is immune-complex deposition; type IV is T-cell mediated delayed hypersensitivity.

Gram stain interpretation

Gram-positive organisms retain crystal violet and appear purple due to thick peptidoglycan; gram-negative organisms decolourise and counterstain pink with safranin.

Koch postulates limitations

The classical postulates require the organism in all cases and reproducible disease in animals; they fail for unculturable agents, carriers, and diseases with multifactorial causation.

Outbreak investigation steps

Confirm the diagnosis, define and count cases, describe by person place and time, form hypotheses, test with analytical studies, then implement control measures and communicate findings.

Screening test criteria

A suitable screening test targets an important condition with detectable preclinical phase, acceptable sensitivity and specificity, and available effective treatment with acceptable cost.

Lead-time bias

Apparent survival gain from screening because diagnosis occurs earlier without changing the time of death; mortality outcome measures avoid this distortion.

Randomised trial allocation concealment

Concealing the upcoming allocation sequence from recruiters prevents selection bias; it is distinct from blinding, which conceals treatment from participants or assessors.

Professional boundary rule

Doctors must not exploit the power imbalance in the clinical relationship; sexual or financial relationships with current patients are prohibited by the Code of Professional Conduct.

Duty to report impairment

A doctor with a health condition or substance misuse that may endanger patients has a professional duty to seek help and, where required, report to the Medical Council.