202.2 📚 國考版

202.2.0.1 必背 — Smallpox

• Eradicated 1980 (last natural Somalia 1977)
• Bioterror Category A
• Stockpiles CDC + Russia

202.2.0.2 必背 — Smallpox vs Chickenpox

• Smallpox: synchronous progression, centrifugal (face/extremities dense), severe systemic
• Chickenpox: successive crops, centripetal (trunk), mild systemic

202.2.0.3 必背 — Mpox

• 2022-2024 global outbreak Clade IIb (W African, MSM sexual)
• 2024 Clade Ib outbreak (DRC + neighboring, more severe)
• Reservoir: rodents (not monkeys)
• Synchronous lesion progression
• LAP prominent (distinguishes from smallpox)

202.2.0.4 必背 — Mpox Treatment

• Tecovirimat (TPOXX) — 2024 STOMP trial NEGATIVE for Clade I efficacy
• May still use compassionate / severe / immunocompromise
• Supportive

202.2.0.5 必背 — JYNNEOS Vaccine

• Modified vaccinia Ankara (MVA-BN, non-replicating)
• 2 doses 4 weeks apart
• PrEP for high-risk MSM
• PEP within 4 days (≤ 14)
• Safe in immunocompromise

202.2.0.6 必背 — Mpox + HIV

• Uncontrolled HIV CD4 < 200 → severe disease
• Mortality 5-15% in this group
• ART critical + IRIS monitoring

202.2.0.7 必背 — Molluscum Contagiosum

• Pearly papules with central umbilication
• Children: contact, fomites
• Adults: anogenital sexual
• HIV: extensive / atypical
• Self-limited; cryotherapy / curettage if treatment

---