101.2 📚 國考版醫垫國考 / PGY OSCE

101.2.0.1 📌 Cram Sheet

101.2.0.1.1 🔥 高 yield 10
  1. HSC = CD34+ CD38− Lin−
  2. Sources: BM / PBSC (G-CSF) / cord / haplo (PTCy)
  3. Auto-HSCT: MM, lymphoma rescue
  4. Allo-HSCT: AML/MDS/SAA/SCD/SCID
  5. Conditioning: MAC vs RIC vs NMA
  6. GVHD acute: skin + GI + liver (< 100 d)
  7. GVHD chronic: multiorgan (sclerodermic, BOS, sicca)
  8. GVHD 1st: high-dose steroid; refractory: ruxolitinib
  9. VOD: defibrotide (only FDA-approved)
  10. Exa-cel (Casgevy CRISPR) for SCD + β-thal (FDA 2023)
101.2.0.1.2 🔢 必背
項目 æ•žå­—
HSC marker CD34+ CD38− Lin−
G-CSF mobilization 10 ÎŒg/kg × 5 d
Neutrophil engraft ANC > 500 × 3 d
Plt engraft > 20K untransfused × 7 d
GVHD acute cutoff < 100 d
GVHD steroid 1-2 mg/kg pred

101.2.0.2 ⭐ 高 yield

101.2.0.2.1 Cytokines
Cytokine Lineage
EPO Erythroid
TPO Megakaryocyte
G-CSF Granulocyte
GM-CSF Granulocyte + monocyte
IL-3 Multilineage
IL-7 Lymphoid
SCF HSC + multilineage
101.2.0.2.2 CAR-T Drugs Quick
Drug Target Indication
Tisagenlecleucel CD19 ALL pediatric, DLBCL
Axicabtagene CD19 DLBCL, follicular
Brexucabtagene CD19 MCL, ALL adult
Lisocabtagene CD19 DLBCL, CLL
Idecabtagene BCMA MM
Ciltacabtagene BCMA MM
101.2.0.2.3 CRS Grading + Treatment
Grade Sx Tx
1 Fever Supportive
2 Fever + hypoxia/hypoTN Tocilizumab ± steroid
3 More severe Tocilizumab + steroid
4 Vasopressor + ventilator Tocilizumab + high-dose steroid + ICU
101.2.0.2.4 ICANS (Neurotoxicity)
  • Encephalopathy, seizure, cerebral edema
  • Treat: dexamethasone (high-dose), supportive
  • Tocilizumab does NOT cross BBB → use steroid
101.2.0.2.5 Gene Therapy
  • Exa-cel (Casgevy): CRISPR BCL11A edit (FDA 2023); SCD + β-thal
  • Lovo-cel (Lyfgenia): lentiviral βA-T87Q for SCD
  • Beti-cel (Zynteglo): β-thal transfusion-dependent

101.2.0.3 🎯 自我檢枬

  1. HSC immunophenotype? → CD34+ CD38− Lin−
  2. PBSC mobilization? → G-CSF 10 ÎŒg/kg × 5 d
  3. Auto vs allo? → Auto = self (rescue); allo = donor
  4. Haplo GVHD prevention? → PTCy
  5. GVHD acute organs 3? → Skin, GI, liver
  6. GVHD treatment 1st? → 1-2 mg/kg pred
  7. GVHD refractory? → Ruxolitinib
  8. VOD treatment? → Defibrotide
  9. CRS treatment? → Tocilizumab + steroid
  10. ICANS treatment? → Dexamethasone (steroid; tocilizumab no BBB)
  11. Exa-cel mechanism? → CRISPR BCL11A
  12. Conditioning 3 types? → MAC, RIC, NMA
  13. Cord blood downside? → Slower engraftment + lower cell dose
  14. Engraftment ANC criterion? → > 500 × 3 d
  15. Late infection > 100 d? → Encapsulated bacteria, VZV

⚠ AI 草皿。