Family Medicine Part 1 Exam Review - HK

Bordetella pertussis

The pathogen causing whooping cough, a notifiable disease characterized by mechanical complications such as urinary incontinence, rib fractures, and subconjunctival hemorrhage.

Shingrix

A recombinant, non-live zoster vaccine used for the prevention of shingles.

Hep B booster for Healthcare Workers

If anti-HBs titre is $<10$ after 3 doses, give 1 booster dose and test in 1 month; if it remains low, give 2 more doses.

Pneumococcal Vaccination (>65 without high risk)

A single dose of 23PPV is recommended for patients over 65 with no high-risk factors.

Pneumococcal Vaccination (>65 with high risk)

Administer 1 dose of PCV15 followed by 1 dose of 23PPV after 1 year (includes DM, Chronic Kidney Disease, and BMI $\geq 30$).

Hypertension Emergency

Blood pressure $>180/120$ with evidence of end-organ damage, such as Grade 4 fundoscopy changes (papilledema), managed with IV labetalol.

Malignant Hypertension

Hypertension associated with grade 4 fundoscopy changes, specifically papilledema.

Thiazide diuretics side effects

Hyperglycemia, hyperuricemia, hypercalcemia, hypokalemia, and hyponatremia.

Surgical 3rd Nerve Palsy

Presents with a fixed and dilated pupil (ptosis, mydriasis, 'down and out' gaze) due to posterior communicating artery aneurysm or uncal herniation.

Medical 3rd Nerve Palsy

Often caused by DM or Giant Cell Arteritis, characterized by pupil sparing despite 'down and out' gaze and ptosis.

HBV Antenatal management

For HBsAg positive mothers, start Tenofovir at 24-28 weeks; infant receives HBIG and HBV vaccine within 12 hours of birth.

Edinburgh Postnatal Depression Scale (EPDS)

Screening tool at 6 weeks postpartum where a score $\geq 10$ or $12$ suggests depression, and Question 10 screens for suicidal ideation.

Pre-eclampsia High Risk criteria

History of pre-eclampsia, Hypertension, Chronic Kidney Disease, SLE, or DM, requiring low-dose aspirin from 12-36 weeks (no later than 16 weeks).

HELLP Syndrome

A severe form of pre-eclampsia characterized by Hemolysis (elevated LDH), deranged LFTs, and Low Platelets.

Nitrofurantoin in UTI

$100\,mg$ BD for 7 days; must be avoided at term to prevent hemolytic anemia due to G6PD deficiency.

Intrahepatic Cholestasis of Pregnancy

Pruritus over palms and soles in 2nd-3rd trimester with bile acid $>40$; managed with ursodeoxycholic acid and induction at 36-37+6 weeks.

GDM Screening (HK Guideline)

$75\,g$ OGTT results: Fasting Glucose $\geq 5.1\,mmol/L$, 1-hour $\geq 10\,mmol/L$, or 2-hour $\geq 8.5\,mmol/L$.

Mentzer Index

$\frac{MCV}{RBC} < 13$, suggesting Beta-Thalassemia when HbA2 is $>3.5\%$.

Post-menopausal Bleeding (PMB) investigation

TVS to measure endometrial thickness; a threshold of $\geq 4\,mm$ requires endometrial biopsy or hysteroscopy.

Mirena (Levonorgestrel-releasing IUS)

Used for contraception and menorrhagia; risks include 5% device expulsion and increased uterine perforation risk during breastfeeding.

Fitz-Hugh-Curtis Syndrome

Perihepatitis following PID, presenting with RUQ pain radiating to the right shoulder and pleuritic chest pain with normal LFTs.

Rotterdam Criteria

Diagnostic criteria for PCOS needing 2 out of 3: oligo/anovulation, hyperandrogenism (hirsutism/acne), or $>12$ antr