43.2 📚 國考版醫垫國考 / PGY OSCE

43.2.0.1 📌 Cram Sheet

43.2.0.1.1 🔥 高 yield 8
  1. Starling forces: hydrostatic, oncotic, permeability, lymphatic
  2. Pitting: HF / cirrhosis / nephrotic / drugs
  3. Non-pitting: lymphedema / myxedema
  4. Single leg = DVT until ruled out
  5. Periorbital: nephrotic / myxedema / angioedema
  6. CCB-induced edemaamlodipine 等
  7. Stemmer’s sign + = lymphedema
  8. ACEI angioedema → 換 ARB
43.2.0.1.2 🔢 必背
項目 æ•žå­—
Albumin to swell < 2.5
Spironolactone:furosemide for cirrhosis 100:40 (~2.5:1)
Salt restriction < 2 g/d
Nephrotic protein > 3.5 g/d
Anasarca generalized edema

43.2.0.2 ⭐ 高 yield

43.2.0.2.1 Edema Causes by Pattern
Pattern DDx
Bilateral lower HF, cirrhosis, nephrotic, CKD, venous insufficiency, drugs
Unilateral leg DVT, cellulitis, lymphedema, Baker’s cyst
Periorbital Nephrotic, myxedema, angioedema
Anasarca Severe HF, cirrhosis, nephrotic, PLE
Ascites Cirrhosis, CHF, malignancy, TB
Pulmonary Cardiogenic vs ARDS
43.2.0.2.2 Drug-Induced Edema
  • CCB (amlodipine, nifedipine)
  • NSAID
  • Steroid
  • Glitazones (pioglitazone)
  • Hormones (estrogen, progesterone)
  • Fludrocortisone
  • Pregabalin / gabapentin
43.2.0.2.3 Angioedema
  • ACEI (bradykinin)
  • Hereditary (C1 esterase def)
  • Allergic (mast cell)
  • Treatment: epinephrine, antihistamine, steroid; HAE → C1 inh, icatibant, ecallantide
43.2.0.2.4 Lymphedema
  • Stemmer’s sign +
  • Post-cancer surgery
  • Filariasis
  • Congenital (Milroy)
  • Compression + pneumatic + microsurgery
43.2.0.2.5 Venous Insufficiency
  • Brown stasis dermatitis + ulceration (medial malleolus)
  • Compression stocking
43.2.0.2.6 Nephrotic vs Nephritic
  • Nephrotic: proteinuria > 3.5 + albumin ↓ + edema + lipiduria
  • Nephritic: hematuria + HTN + AKI + RBC casts + 范少 edema
43.2.0.2.7 Cirrhosis Ascites
  • Spironolactone + furosemide ratio
  • Paracentesis (large volume + albumin replacement)
  • TIPS for refractory

43.2.0.3 🎯 自我檢枬

  1. ACEI angioedema 機蜉? → Bradykinin
  2. Stemmer’s sign +? → Lymphedema
  3. Pitting edema 4 病? → HF, cirrhosis, nephrotic, drugs
  4. CCB edema åžž? → Amlodipine
  5. HAE 急救? → C1 inhibitor, icatibant, ecallantide
  6. Cirrhosis spironolactone:furosemide? → ~2.5:1
  7. Single leg edema 必查? → Doppler DVT

⚠ AI 草皿。