413.2 📚 國考版醫垫國考 / PGY OSCE

413.2.0.1 📌 Cram Sheet

413.2.0.1.1 🔥 高 yield 10
  1. LGBTQIA+ 定矩: lesbian, gay, bisexual, trans, queer, intersex, asexual+
  2. Sex vs gender vs orientation distinction
  3. Trans women (MTF): estradiol + spironolactone
  4. Trans men (FTM): testosterone IM/gel
  5. WPATH SOC 8 (2022) — current standard
  6. MSM PrEP: TDF/FTC daily; cabotegravir IM q2mo; lenacapavir SC q6mo (22E)
  7. PEP within 72 h × 28 d
  8. Trans man with cervix: still Pap
  9. Trans woman on E long-term: mammography
  10. Mental health disparities: depression, anxiety, suicide 4-5x higher
413.2.0.1.2 🔢 必背
項目 æ•žå­—
Trans man T cypionate 50-100 mg q1-2 wk
Trans woman estradiol oral 2-6 mg/d
Spironolactone for MTF 100-200 mg/d
PEP duration 28 d
PEP within 72 h
Cabotegravir PrEP Q2 mo IM
Lenacapavir Q6 mo SC (22E)
Suicide trans youth 4-5x cisgender
Adolescent puberty blocker Tanner II/III + persistent dysphoria

413.2.0.2 ⭐ 高 yield

413.2.0.2.1 Trans Hormone Monitoring
Drug Monitor
Estradiol E2 level (target 100-200 pg/mL); LFT; lipid; K (if spiron); thyroid (TBG up); DVT
Spironolactone K, Cr
Testosterone T (mid-normal); Hct (avoid > 54%); lipid; LFT; sleep apnea
413.2.0.2.2 PrEP Options
  • Truvada (TDF/FTC) daily
  • Descovy (TAF/FTC) daily (renal-safer)
  • Cabotegravir IM Q2 mo (PEP not effective)
  • Lenacapavir SC Q6 mo (newest, 22E)
413.2.0.2.3 MSM STI Screening
  • HIV
  • Syphilis
  • 3-site gonorrhea: pharynx + urethra + rectum
  • 3-site chlamydia
  • HSV (selected)
  • HBV/HCV (esp. injectable drug)
  • HPV-related anal CA (DRE / HRA / Pap-anus in high-risk)
413.2.0.2.4 Anatomy-Based Cancer Screening
Organ Present Screening
Cervix Pap/HPV (any genital identity)
Breast Mammography (per duration estrogen if MTF; per cisgender if FTM not surgery)
Prostate PSA SDM (trans women still have prostate after vaginoplasty)
Anus + HPV+ HRA (high-resolution anoscopy) high-risk
413.2.0.2.5 Adolescent Gender Considerations
  • WPATH SOC 8 (2022)
  • Multidisciplinary team
  • Mental health assessment
  • Parental support
  • Puberty blocker (GnRH agonist) Tanner II/III with persistent dysphoria
  • Cross-sex hormones (gradual after puberty blocker)
  • Surgery considerations (later, with team)

413.2.0.3 🎯 自我檢枬

  1. LGBTQIA+ definitions? → Lesbian/gay/bi/trans/queer/intersex/asexual+
  2. Sex vs gender? → Sex = anatomy at birth; gender = identity
  3. Trans woman hormone? → Estradiol + spironolactone
  4. Trans man hormone? → Testosterone IM/gel
  5. WPATH SOC current? → 8 (2022)
  6. PrEP options 3? → Daily TDF/FTC, cabotegravir IM, lenacapavir SC (22E)
  7. PEP duration? → 28 d within 72 h
  8. Trans man cervix screen? → Yes (still Pap)
  9. Trans woman breast screen? → Yes (per duration E)
  10. Suicide trans youth? → 4-5x cisgender
  11. Adolescent puberty blocker? → GnRH agonist Tanner II/III
  12. MSM STI 3-site? → Pharynx, urethra, rectum
  13. Mpox vaccine for? → MSM high-risk
  14. Trans women prostate? → Yes (still after vaginoplasty)
  15. WSW HPV/cervix? → Same risk; needs Pap

⚠ AI 草皿。