209.2 📚 國考版

209.2.0.1 必背 — Measles Triad

  • 3 C’s (Cough, Coryza, Conjunctivitis) + fever in prodrome
  • Koplik spots = pathognomonic (buccal mucosa, before rash)
  • Maculopapular rash starts face → cephalocaudal spread; confluent

209.2.0.2 必背 — Measles Complications

  • Pneumonia #1 cause death
  • Otitis media, diarrhea, croup
  • SSPE (5-15 yr post-infection, fatal)
  • Immune amnesia (lymphocyte memory depletion)

209.2.0.3 必背 — Vitamin A in Measles

  • 200,000 IU PO × 1, repeat 24 hr
  • WHO recommendation
  • Reduces mortality

209.2.0.4 必背 — Mumps Parotitis + Complications

  • Parotid swelling (uni or bilateral)
  • Orchitis (~ 20% post-pubertal males); infertility rare
  • Aseptic meningitis 10%
  • Pancreatitis, encephalitis, hearing loss rare

209.2.0.5 必背 — Rubella + CRS

  • 1st trimester maternal infection = catastrophic
  • CRS: hearing loss + cataracts + cardiac (PDA) + microcephaly + ID
  • “Blueberry muffin baby”
  • Vaccinate pre-pregnancy

209.2.0.6 必背 — MMR Schedule

  • 12-15 mo + 4-6 yr (2-dose series)
  • Live attenuated; contraindicated in pregnancy + severe immunocompromise

209.2.0.7 必背 — MMR Efficacy

  • Measles + Rubella: 97% after 2 doses
  • Mumps: 88% after 2 doses

209.2.0.8 必背 — 2024-2025 Outbreaks

  • USA + Europe + Asia rising
  • Vaccine hesitancy major driver
  • Pediatric deaths reported

209.2.0.9 必背 — Post-Exposure Prophylaxis

  • MMR within 72 hr for susceptibles
  • Measles IG within 6 days for high-risk (pregnant, immunocompromise, infants)