41.3 🩺 內科專科考前版

41.3.0.1 📌 䞀頁重點

  • 22Ebronchial artery embolization 匷化、ECMO bridge for severe
  • NTM + bronchiectasis emerging cause
  • TaiwanTB endemic、lung cancer 高

41.3.0.2 💊 進階治療

41.3.0.2.1 Bronchial Artery Embolization
  • Success > 90%
  • Recurrence ~20%
  • Complications: spinal cord ischemia (rare), bronchial necrosis
41.3.0.2.2 ECMO bridge
  • Severe massive hemoptysis with respiratory failure
  • Bridge to definitive treatment
41.3.0.2.3 Vasculitis
  • Steroid + cyclophosphamide / rituximab
  • Plasmapheresis for severe (anti-GBM, severe ANCA)

41.3.0.3 🌟 Pearls (8)

  1. 「Bleeding-side down」 during transport
  2. Bronchoscopy + IR embolization:栞心 management
  3. TB cavitary = consider 持續 contagiousness
  4. NTM 老人 + bronchiectasis 倚
  5. Aspergilloma in cavity → recurrent hemoptysis
  6. GPA sinus + lung + kidney triad
  7. Anticoagulation caveat in PE with hemoptysis
  8. CT chest > CXR for cause identification

41.3.0.4 📍 台灣 Context

  • TB high incidence
  • Lung cancer 第 1 cancer death
  • IR embolization 普及
  • 健保 bronchoscopy

41.3.0.5 🎓 內專重點

  1. Massive 定矩 + 急救
  2. 5 倧病因
  3. Pulmonary-renal syndrome
  4. Bronchial artery embolization
  5. NTM + bronchiectasis

⚠ AI 草皿。