HKMLE Part III key terms

The local statute that governs registration of doctors, licensing, discipline, and professional conduct in Hong Kong, forming the legal basis for what a registered medical practitioner may lawfully do.

The statutory body that maintains the register of medical practitioners, sets ethical standards, and hears disciplinary inquiries into allegations of professional misconduct or unfitness to practise.

Conduct falling short of the standards expected of a registered doctor, judged by peer professional opinion, which may lead to disciplinary sanctions rather than only civil or criminal liability.

A patient's voluntary agreement to an investigation or treatment after receiving adequate information about its nature, benefits, material risks, and reasonable alternatives, given by a person with capacity.

A risk that a reasonable person in the patient's position would attach significance to, or that the particular patient would consider important, and which therefore must be disclosed during consent discussions.

A person's ability to understand, retain, and weigh relevant information and communicate a decision; assessed functionally for the specific decision rather than assumed from diagnosis alone.

The standard used to make treatment decisions for a patient lacking capacity, weighing clinical benefit, the patient's known wishes and values, and the least restrictive option available.

A statement made by a person with capacity setting out preferences or refusals for future medical treatment, to be applied if they later lose the capacity to decide.

The professional duty to protect patient information from unauthorised disclosure, subject to lawful exceptions such as consent, statutory reporting, or overriding public interest in serious harm.

Hong Kong legislation regulating the collection, holding, use, security, and access of personal data, including health records, and setting out data protection principles that doctors must observe.

Structured ongoing learning and audit activity required of practising doctors to maintain and update competence, commonly counted in credits for the purposes of periodic practice review.

A quality improvement cycle that compares current practice against agreed standards, identifies gaps, implements change, and re-measures to confirm improvement in patient care.

The framework through which healthcare organisations are accountable for continuously improving quality and safeguarding standards, covering safety, audit, risk management, and staff competence.

A structured retrospective method for investigating a serious adverse event to identify underlying system failures, rather than blaming individuals, and to generate preventive recommendations.

A serious, largely preventable patient safety incident, such as wrong-site surgery or retained instrument, that should not occur if recognised safeguards are followed and which triggers mandatory review.

A standardised team briefing performed before induction, before incision, and before the patient leaves theatre to confirm identity, site, procedure, allergies, and equipment readiness.

Life-threatening organ dysfunction caused by a dysregulated host response to infection, requiring early recognition, cultures, antibiotics, and fluid resuscitation within the first hour.

Sepsis with persisting hypotension requiring vasopressors to maintain mean arterial pressure and persisting hyperlactataemia despite adequate fluid resuscitation, carrying high mortality.

A bedside screening score using respiratory rate, systolic blood pressure, and altered mentation; two or more criteria in a patient with suspected infection prompt escalation of care.

A set of six early actions in suspected sepsis: oxygen if needed, blood cultures, intravenous antibiotics, intravenous fluids, lactate measurement, and urine output monitoring.

A spectrum of conditions caused by acute myocardial ischaemia, including ST-elevation infarction, non-ST-elevation infarction, and unstable angina, managed according to ECG and troponin findings.

A cardiac muscle protein released into blood when myocytes are damaged; high-sensitivity assays detect small rises and serial measurement distinguishes acute from chronic elevation.

Emergency balloon dilatation and stenting of the culprit coronary artery during ST-elevation myocardial infarction, preferred when it can be delivered promptly by an experienced team.

The interval from a patient's arrival at hospital to inflation of the balloon during primary angioplasty, used as a key performance measure of timely reperfusion in infarction care.

Acute focal neurological deficit due to vascular causes, either ischaemic or haemorrhagic; urgent imaging is needed to distinguish them because treatment pathways differ markedly.

Intravenous clot-dissolving therapy for selected ischaemic stroke patients within a defined time window, given after imaging excludes haemorrhage and contraindications are checked.

The National Institutes of Health Stroke Scale, a standardised 15-item clinical score quantifying neurological deficit severity and guiding treatment decisions and monitoring after stroke.

A hyperglycaemic emergency with ketonaemia, metabolic acidosis, and dehydration, treated with fluids, insulin infusion, potassium replacement, and treatment of the precipitating cause.

Marked hyperglycaemia with high serum osmolality and profound dehydration but minimal ketosis, typically in older type 2 diabetes patients, managed with careful fluid and insulin therapy.

The difference between measured cations and anions in serum, calculated as sodium minus chloride and bicarbonate, used to classify metabolic acidosis and monitor its cause.

A blood test measuring pH, partial pressures of oxygen and carbon dioxide, bicarbonate, and lactate, used to assess acid-base status and adequacy of ventilation and oxygenation.

Respiratory failure with low arterial oxygen and raised carbon dioxide, reflecting inadequate alveolar ventilation; controlled oxygen and non-invasive ventilation may be required.

Persistent airflow obstruction with respiratory symptoms caused by airway and alveolar abnormalities, usually from tobacco exposure, managed with bronchodilators, smoking cessation, and pulmonary rehabilitation.

A pulmonary function test measuring forced expiratory volume and forced vital capacity; a reduced post-bronchodilator ratio confirms obstructive lung disease.

A chronic inflammatory airway disorder with variable airflow obstruction, wheeze, and cough, managed with inhaled corticosteroids and relievers, with acute attacks treated by systemic steroids.

The maximum speed of forced expiration measured by a portable meter, useful for monitoring variability in asthma and assessing severity of an acute exacerbation.

An abrupt decline in renal function with rising creatinine or falling urine output, classified by cause as prerenal, intrinsic, or postrenal and managed by treating the cause and complications.

A severity classification based on the magnitude of creatinine rise and duration of reduced urine output, guiding urgency of investigation, fluid management, and consideration of renal replacement.

A raised serum potassium concentration that risks fatal cardiac arrhythmia; emergency treatment includes calcium to stabilise the myocardium, insulin-dextrose, and removal of potassium.

A surface recording of cardiac electrical activity used to detect arrhythmia, ischaemia, conduction block, and electrolyte disturbance, and interpreted by rate, rhythm, axis, and waveform.

An irregularly irregular supraventricular rhythm with absent P waves, carrying stroke risk; management addresses rate or rhythm control and anticoagulation based on assessed thromboembolic risk.

A clinical tool estimating stroke risk in atrial fibrillation from factors including heart failure, hypertension, age, diabetes, prior stroke, vascular disease, and sex, guiding anticoagulation decisions.

Coordinated efforts to use antimicrobials appropriately, choosing the right drug, dose, route, and duration to optimise outcomes while limiting resistance and healthcare-associated infection.

The ability of microorganisms to survive exposure to drugs that would normally kill them, driven by selective pressure from unnecessary or incomplete courses and spread between hosts.

Infection control measures, including contact, droplet, or airborne precautions, applied to reduce transmission from patients with known or suspected transmissible infections.

Percutaneous exposure to blood or body fluid through a contaminated sharp, requiring immediate washing, risk assessment, post-exposure prophylaxis, and source testing.

The concurrent use of multiple medicines, often five or more, which increases the risk of interactions, adverse effects, and non-adherence and warrants structured medication review.

A harmful or unintended response to a medicine at normal doses, classified as predictable or unpredictable, and which should be documented and reported to the pharmacovigilance system.

A preventable mistake in ordering a medicine, such as wrong drug, dose, route, frequency, or omission, which may or may not reach the patient and cause harm.

The statutory and professional duty to recognise and act on suspected abuse or neglect of a child, including referral to social services and documentation of findings.

The professional obligation to be open and honest with patients when something goes wrong in their care, including apologising, explaining what happened, and describing what will be done.