100.2 📚 國考版醫垫國考 / PGY OSCE

100.2.0.1 📌 Cram Sheet

100.2.0.1.1 🔥 高 yield 10
  1. Survivorship Care Plan (SCP) = standard
  2. Anthracycline cumulative > 450 mg/m² → 5% HF
  3. Trastuzumab cardiomyopathy often reversible
  4. Bleomycin > 400 units → pulmonary fibrosis
  5. Hodgkin survivors: 2nd breast CA (post-mediastinal RT), thyroid, lung, CV
  6. Tamoxifen → endometrial CA
  7. ADT → osteoporosis + CV + DM
  8. RT → secondary solid tumors in field (10-30 yr latency)
  9. Etoposide → AML (MLL); alkylating → MDS/AML (5-10 yr)
  10. Pediatric survivors: 5-10x 2nd cancer risk
100.2.0.1.2 🔢 必背
Therapy Late Effect
Doxorubicin Cardiomyopathy (cumulative > 450 mg/m²)
Trastuzumab Cardiomyopathy (reversible)
Bleomycin Pulmonary fibrosis (> 400 units)
Cisplatin Nephrotoxicity, neuropathy, ototoxicity
Tamoxifen Endometrial CA, DVT
AI Osteoporosis, arthralgia
ADT Osteoporosis, CV, DM, hot flashes
Mediastinal RT CAD, valve, pericarditis, breast CA
Neck RT Hypothyroidism, secondary cancer
Cranial RT Hypopituitarism, cognitive
Pelvic RT Bowel, fertility, secondary cancers

100.2.0.2 ⭐ 高 yield

100.2.0.2.1 Surveillance Quick
  • Cancer-specific NCCN guidelines
  • Q3-6 mo first 2-3 yr
  • Q6-12 mo years 2-5
  • Annual > 5 yr
  • Tumor markers per cancer
  • Mammography (Hodgkin from 25)
  • TSH annually neck RT
  • Echo periodically anthracycline/trastuzumab
100.2.0.2.2 Multidisciplinary Survivorship
  • Oncology
  • Primary care (transition)
  • Cardio-onc (anthracycline)
  • Endocrine (multi-axis)
  • Mental health
  • Sexual health
  • Nutrition / exercise
  • Social work / financial
100.2.0.2.3 High-Risk Survivors
  • Pediatric / adolescent
  • Hodgkin lymphoma
  • Bone marrow transplant
  • HSCT
  • Breast CA (long-term hormonal)

100.2.0.3 🎯 自我檢枬

  1. Anthracycline cumulative limit? → 450 mg/m²
  2. Bleomycin lifetime? → < 400 units
  3. Tamoxifen second cancer risk? → Endometrial
  4. Hodgkin post-mediastinal RT? → Breast CA + thyroid + CV
  5. ADT bone? → Osteoporosis + DEXA
  6. AI bone? → Osteoporosis
  7. Etoposide AML? → MLL rearrangement (1-3 yr)
  8. Alkylating MDS/AML? → 5-10 yr
  9. Cisplatin neuro? → Peripheral neuropathy
  10. SCP includes? → Treatment summary, surveillance, late effects, lifestyle, psychosocial
  11. Pediatric survivor 2nd cancer? → 5-10x baseline
  12. Cardio-onc clinic? → Anthracycline + trastuzumab
  13. Mediastinal RT mammography? → Start age 25
  14. Survivor depression %? → 15-25%
  15. ICI myocarditis severity? → Combo with myasthenia + myositis = high mortality

⚠ AI 草皿。