MOH GP Competitive Appointment Exam flashcards

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

Wells score DVT

Clinical prediction rule for deep vein thrombosis; ≥2 points indicates DVT likely, prompting ultrasound; includes signs like leg swelling, tenderness, and risk factors.

Centor criteria

Clinical score for streptococcal pharyngitis: tonsillar exudate, tender nodes, fever, absence of cough; each 1 point; score ≥3 suggests testing or treatment.

Ottawa ankle rules

Decision rule for ankle X-ray after injury: pain in malleolar zone plus bone tenderness at posterior lateral or medial malleolus, or inability to bear weight.

CURB-65

Pneumonia severity score: confusion, urea >7 mmol/L, respiratory rate ≥30, low blood pressure, age ≥65; each 1 point; score ≥2 consider admission.

Hypertension diagnosis threshold

Clinic blood pressure ≥140/90 mmHg on two occasions; home or ambulatory monitoring threshold ≥135/85 mmHg; confirms diagnosis and guides treatment.

Acute gout management

Treat with NSAIDs, colchicine, or corticosteroids; do not start or stop urate-lowering therapy during attack; target serum urate <360 µmol/L.

Sore throat red flags

Drooling, stridor, trismus, muffled voice, or unilateral swelling suggest peritonsillar abscess or epiglottitis; require urgent referral.

Low back pain red flags

Age >50 with new pain, trauma, fever, weight loss, night pain, neurological deficits, bowel/bladder dysfunction, or saddle anesthesia; urgent imaging or referral.

HbA1c target

For most adults with type 2 diabetes, target HbA1c <7%; less stringent <8% for elderly or comorbid; <6.5% if achievable without hypoglycemia.

Diabetic retinopathy screening

Annual dilated eye exam; if no retinopathy for two consecutive years, consider less frequent screening; pregnancy may worsen retinopathy.

Lipid targets high risk

For established cardiovascular disease, LDL-C <1.8 mmol/L or ≥50% reduction; for very high risk, LDL-C <1.4 mmol/L.

Singapore cancer screening

Cervical Pap every 3 years ages 25-69; mammogram every 2 years ages 50-69; colorectal FIT annually ages 50-69; consider colonoscopy every 10 years.

Childhood immunisation schedule

Singapore schedule: BCG at birth; Hepatitis B at birth, 1, 6 months; DTaP-IPV-Hib at 2, 4, 6, 18 months; MMR at 12 and 15-18 months; varicella at 12-15 months.

Adult vaccinations

Influenza annually for ≥65, chronic disease, pregnancy; pneumococcal for ≥65 or high-risk; Tdap every 10 years; zoster vaccine for ≥50.

CKD staging

eGFR stages G1 ≥90, G2 60-89, G3a 45-59, G3b 30-44, G4 15-29, G5 <15; albuminuria A1 <3, A2 3-30, A3 >30 mg/mmol.

Asthma control GINA

Controlled if daytime symptoms ≤2/week, no night waking, reliever use ≤2/week, no activity limitation, and normal lung function.

Cardiovascular risk assessment

Use validated charts like Framingham or Singapore Coronary Risk Calculator; statins recommended if 10-year risk ≥20% or diabetes with additional risk factors.

SMC practising certificate

All doctors must hold valid annual practising certificate from Singapore Medical Council; renewal requires meeting CPD requirements, e.g., 50 CME points per year.

SMC Ethical Code

ECEG 2016 core principles: patient welfare, respect for patient autonomy, social justice; mandatory reporting of impairment or misconduct.

Controlled drugs regulations

Under Poisons Act and Medicines Act, controlled drugs like opioids and benzodiazepines require special record-keeping, secure storage, and prescription restrictions.

Infectious Diseases Act

Mandatory notification of specified diseases (e.g., measles, tuberculosis, dengue, chickenpox, hand-foot-mouth disease) to MOH within specified timeframes.

MediShield Life CHAS

National health insurance and Community Health Assist Scheme provide subsidies for chronic conditions and selected screenings; doctors must follow claim rules.

PDPA patient data

Personal Data Protection Act requires consent for collection, use, disclosure of patient data; exceptions for emergency care and mandatory reporting; protect confidentiality.

Telemedicine guidelines

SMC guidelines: ensure appropriate modality, verify patient identity, obtain informed consent, document, and prescribe only when safe and within competence.

Clinic licensing

Under Private Hospitals and Medical Clinics Act, clinics must meet standards for premises, equipment, staff qualifications, and record-keeping; regular audits.

Informed consent

Disclose diagnosis, procedure nature, risks, benefits, alternatives, and consequences of refusal; document discussion; patient must have capacity and voluntariness.

SPIKES protocol

Six-step framework for breaking bad news: Setting, Perception, Invitation, Knowledge, Emotions, Strategy/Summary; structures difficult conversations.

Medical error disclosure

Duty to be open and honest when harm occurs; explain what happened, apologize, outline prevention steps; document in notes.

Confidentiality exceptions

Do not disclose patient information without consent unless required by law (e.g., infectious disease reporting, court order) or in public interest; share on need-to-know basis.

Prescribing safety

Check allergies, interactions, renal/hepatic function, pregnancy status; use clear handwriting or electronic prescribing; avoid abbreviations; provide written instructions.

WHO 5 moments

Hand hygiene before touching patient, before clean/aseptic procedure, after body fluid exposure, after touching patient, after touching patient surroundings.

Consent for minors

Age of consent for medical treatment in Singapore is 18; under 18, parent/guardian consent generally required, but mature minor doctrine may apply.