390.3 🩺 內科專科考前版

390.3.0.1 📌 䞀頁重點

  • 22E: GPCR biased agonism, allosteric modulators, gene therapy for hormone resistance, AAV approaches
  • Taiwan: 健保 IGF-1 (mecasermin), GH replacement, GnRH agonist 攝護腺/子宮內膜異䜍

390.3.0.2 🌟 Pearls (12)

  1. Biased agonism: GPCR can preferentially signal through G-protein vs β-arrestin
  2. Allosteric modulators: cinacalcet (CaSR PAM, hyperparathyroidism)
  3. Setmelanotide for MC4R pathway obesity (BBS, POMC, LEPR)
  4. Mecasermin (rhIGF-1) for severe primary IGF-1 deficiency / Laron
  5. β-arrestin biased TRH in trials
  6. PROTAC targeting nuclear receptors (estrogen receptor degrader)
  7. Selective glucocorticoid receptor modulators (SEGRMs) in trials
  8. THRβ-specific agonist (resmetirom) for NASH
  9. PPAR pan-agonist for diabetes/dyslipidemia
  10. CRISPR therapy for genetic endocrine disorders (in trials)
  11. Continuous SC pump for replacement (cortisol pump trials)
  12. Bioidentical vs synthetic hormone considerations

390.3.0.3 📍 Taiwan + 健保

  • 健保 GH replacement (somatropin) for adult/peds GHD
  • 健保 mecasermin for Laron / severe IGF-1 deficiency 限制
  • 健保 GnRH agonist (leuprolide, goserelin) 攝護腺/子宮內膜異䜍
  • 健保 GnRH antagonist (degarelix) 攝護腺
  • 健保 cinacalcet 副甲狀腺亢進 (CKD/parathyroid CA)
  • 健保 setmelanotide 限制眕病

390.3.0.4 🎓 內專必懂

  1. Receptor 類別 + 信號路埑
  2. Carrier proteins
  3. Activating vs inactivating mutations 範䟋
  4. McCune-Albright spectrum
  5. Pulsatile / circadian 取血時機
  6. Resistance syndromes
  7. 22E: biased agonism, SEGRM, PROTAC, gene therapy
  8. Taiwan: 健保 GH/IGF-1/GnRH agonist 條件

⚠ AI 草皿。