Medical Council Malta Statutory Exam flashcards

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

Septic shock haemodynamic definition

Sepsis with persisting hypotension requiring vasopressors to maintain mean arterial pressure of at least 65 mmHg, together with a serum lactate above 2 mmol/L despite adequate volume resuscitation.

STEMI reperfusion window

Primary percutaneous coronary intervention is preferred if it can be delivered within 120 minutes of first medical contact; otherwise fibrinolysis is given, ideally within 30 minutes of diagnosis in eligible patients.

Stroke thrombolysis time limit

Intravenous thrombolysis may be given within 4.5 hours of symptom onset in ischaemic stroke, after imaging has excluded intracranial haemorrhage and contraindications have been reviewed.

DKA potassium rule

In diabetic ketoacidosis, insulin infusion is deferred while serum potassium is below 3.3 mmol/L; potassium is replaced first because insulin drives potassium into cells and can precipitate dangerous arrhythmia.

Anaphylaxis adrenaline dose

Adults receive 0.5 mg intramuscular adrenaline (0.5 mL of 1:1000 solution) into the anterolateral thigh, repeated every five minutes as needed; this is the first-line treatment.

Life-threatening asthma features

Silent chest, cyanosis, poor respiratory effort, exhaustion, hypotension, bradycardia or a normal or rising carbon dioxide level indicate life-threatening asthma and demand immediate senior and critical care involvement.

Chronic hyponatraemia correction rate

Chronic hyponatraemia should be corrected by no more than roughly 8 to 10 mmol/L in 24 hours, because faster correction risks osmotic demyelination syndrome.

Variceal bleed initial management

Suspected variceal upper gastrointestinal bleeding is managed with resuscitation, a vasoactive agent such as terlipressin, prophylactic antibiotics, and urgent endoscopic band ligation.

Cockcroft-Gault clearance use

Cockcroft-Gault estimates creatinine clearance from age, weight, sex and serum creatinine and is the formula most often used to set renal dose-adjustment thresholds in drug labelling.

Acute coronary syndrome dual therapy

Acute coronary syndrome typically requires dual antiplatelet therapy plus parenteral anticoagulation, with aspirin continued long term and the second antiplatelet agent duration set by stent type and bleeding risk.

Sepsis-3 organ dysfunction marker

Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection, operationalised as an acute rise in the SOFA score of at least two points.

Hypoglycaemia treatment in adults

Conscious adults receive oral fast-acting carbohydrate; unconscious or unsafe-swallow patients receive intravenous glucose or intramuscular glucagon, followed by a longer-acting carbohydrate source and review of the cause.

Acute upper GI bleed resuscitation order

Secure airway and circulation with large-bore intravenous access and blood products before endoscopy; restrictive transfusion thresholds are generally preferred in non-exsanguinating patients.

Meningococcal rash significance

A non-blanching petechial or purpuric rash in a febrile patient suggests meningococcal disease and warrants immediate parenteral antibiotics, without waiting for lumbar puncture or imaging.

Therapeutic index meaning

The ratio between a drug's toxic dose and its effective dose; drugs with a narrow index, such as digoxin, warfarin and lithium, require therapeutic drug monitoring to avoid toxicity.

Elements of valid consent

Valid consent requires the patient to have capacity, to be given sufficient information about the proposed treatment and alternatives, and to decide voluntarily without coercion.

Test of decision-making capacity

A person lacks capacity for a decision if unable to understand, retain, weigh and communicate relevant information; capacity is specific to that decision and that moment.

Refusal by competent adult

A competent adult may refuse any treatment, including life-sustaining treatment, and that refusal must be respected; treating against such a refusal can constitute assault.

Medical Council Malta function

The statutory regulator under the Health Care Professions Act that maintains registers of medical practitioners and investigates complaints and fitness-to-practice concerns.

Requirement to hold registration

Practising medicine in Malta requires current registration with the Medical Council Malta; practising while unregistered or while suspended is a statutory offence and a disciplinary matter.

Permitted confidentiality disclosures

Patient information may be disclosed without consent where required by law, ordered by a court, or where necessary to prevent a serious and imminent risk of harm that cannot otherwise be averted.

Duty of candour after harm

Following a patient safety incident the clinician should promptly explain what happened, apologise and describe remedial action; the apology does not by itself create legal liability.

Professional indemnity expectation

Registered practitioners are expected to hold adequate professional indemnity cover; civil compensation claims for negligent harm are handled separately from Council disciplinary proceedings.

Controlled drug prescription requirements

Prescriptions for controlled drugs must be legible, dated, signed and state the drug, form, strength, dose and quantity; record-keeping is subject to statutory controls and inspection.

Conflict of interest declaration

Clinicians must declare financial or personal interests that could influence patient care, referral decisions or research, and should withdraw from decisions where a material conflict exists.

Gifts from patients or industry

Gifts of trivial value may be accepted, but anything that could create an expectation of preferential treatment or influence prescribing must be declined or declared to the employer.

Reporting impaired colleagues

A clinician who believes a colleague's health, conduct or performance poses a risk to patients must raise the concern locally and, where required, notify the Medical Council Malta.

Consent in emergencies

Where a patient lacks capacity and the intervention is immediately necessary to save life or prevent serious harm, treatment may proceed under the doctrine of necessity, limited to that need.

Records retention and access

Patients have a right of access to their medical records; records must be accurate, contemporaneous, kept securely and retained for the period required by law and professional guidance.

Delegation and supervision limits

A doctor may delegate tasks only to someone competent and adequately supervised, remains accountable for the overall care, and must not delegate duties reserved to registered practitioners.

Boundaries of the doctor-patient relationship

Sexual or exploitative relationships with current patients are prohibited; personal or financial relationships that could distort clinical judgement must be avoided or formally declared.