412.2 📚 國考版醫垫國考 / PGY OSCE

412.2.0.1 📌 Cram Sheet

412.2.0.1.1 🔥 高 yield 10
  1. CV #1 mortality men
  2. Lung CA #1 cancer death (PSA SDM 55-69)
  3. CRC 45-75 USPSTF
  4. BPH 50% age 60, 80% age 80
  5. BPH α-blocker (tamsulosin) + 5α-RI (finasteride/dutasteride)
  6. Tadalafil 5 mg daily for BPH + ED
  7. Andropause / LOH: confirm low T × 2 + symptomatic
  8. TRAVERSE 2023: TRT non-inferior CV
  9. Suicide 4x women
  10. ED window CV (3-5 yr precedes MI)
412.2.0.1.2 🔢 必背
項目 æ•žå­—
Heart disease men rank #1
Lung CA men rank #1 cancer death
BPH histologic 60 yr 50%
BPH histologic 90 yr 90%
AUA IPSS mild 0-7
AUA IPSS moderate 8-19
AUA IPSS severe 20-35
Total T cutoff < 264-300 ng/dL
Suicide F:M 4x more men
Lifetime prostate CA ~ 1/8
PSA SDM age 55-69

412.2.0.2 ⭐ 高 yield

412.2.0.2.1 BPH Treatment Quick
Drug Mechanism
Tamsulosin α1A selective (less BP)
Alfuzosin α1
Terazosin / doxazosin α1 (also BP)
Finasteride 5α-reductase (Type 2)
Dutasteride 5α-reductase (Type 1+2)
Tadalafil PDE5 daily for BPH+ED
Mirabegron β3 agonist for OAB component
Anticholinergic OAB symptoms
412.2.0.2.2 Surgery for BPH
  • TURP (transurethral resection prostate) — gold standard
  • Laser (HoLEP, GreenLight)
  • Prostatic urethral lift (UroLift)
  • Water vapor (Rezum)
  • Open prostatectomy (very large)
  • Indications: severe LUTS refractory, retention, recurrent UTI, hematuria, stone, renal failure
412.2.0.2.3 Cancer Screening Men
Cancer Recommendation
Lung USPSTF 50-80 + 20 PY + quit < 15 yr
Prostate SDM 55-69 (PSA + DRE)
CRC 45-75 (FIT/colonoscopy)
Skin Self-exam ABCDE; high-risk q1y
Testicular Self-exam (no formal screening)
412.2.0.2.4 Mental Health Men-Specific
  • Depression less recognized (anger, substance, withdrawal)
  • Suicide 4x rate
  • ECT for severe + refractory
  • SSRI/SNRI standard
412.2.0.2.5 Health Maintenance Men
  • Vaccines: Tdap, flu, pneumococcal, shingles, COVID, HPV (≀ 26 yr)
  • Lifestyle: exercise, diet, weight, smoking cessation
  • Cancer + CV + mental health screening

412.2.0.3 🎯 自我檢枬

  1. CV men rank? → #1 mortality
  2. Lung CA men rank? → #1 cancer death
  3. PSA SDM age? → 55-69
  4. CRC USPSTF age? → 45-75
  5. BPH α-blocker 1st? → Tamsulosin
  6. BPH 5α-RI? → Finasteride / dutasteride
  7. Tadalafil 5 mg daily? → BPH + ED
  8. AUA IPSS severe? → 20-35
  9. Andropause T cutoff? → < 264-300
  10. TRAVERSE result? → TRT non-inferior CV
  11. Suicide F:M? → 4x more men
  12. ED CV window? → 3-5 yr
  13. PSA elevation workup? → BPH/prostatitis/CA, MRI prostate, biopsy
  14. Pediatric LDCT? → No (adult criteria)
  15. HPV vaccine men? → ≀ 26 yr (ACIP); some up to 45

⚠ AI 草皿。