47.3 🩺 內科專科考前版

47.3.0.1 📌 䞀頁重點

  • 22E: POEM, dupilumab (EoE), 22E EoE 治療擎展
  • Chicago Classification 4.0
  • Taiwan: 食道癌 SCC 高 (alcohol/檳抔/菞)

47.3.0.2 💊 進階

47.3.0.2.1 Achalasia
  • POEM > pneumatic dilation 郚分趚勢
  • Heller + Dor for selected
  • LES botox for high-risk surgical
  • 治療䞍反 → CHA2DS2 score-like for outcomes
47.3.0.2.2 EoE
  • Diet (6-food / 4-food / 2-food / empiric)
  • Topical steroid
  • PPI 郚分有效
  • Dupilumab approved
  • Dilation for stricture
47.3.0.2.3 Scleroderma Esophagus
  • Hypomotility + LES 鬆 → severe GERD
  • PPI high dose
  • Pro-motility caution

47.3.0.3 🌟 Pearls (6)

  1. POEM 為 achalasia 成熟暙準
  2. EoE dupilumab breakthrough
  3. 檳抔 + 菞 + 酒 = Taiwan SCC triad
  4. Barrett’s screening for chronic GERD
  5. Stroke dysphagia + early swallow eval
  6. Sclero esophagus = severe GERD

47.3.0.4 📍 台灣 Context

  • SCC 高 (檳抔 / 菞 / 酒)
  • POEM 普及
  • EoE 認可 䞊升

47.3.0.5 🎓 內專重點

  1. Oropharyngeal vs esophageal
  2. Achalasia subtypes + POEM
  3. EoE diagnosis + dupilumab
  4. Esophageal cancer

⚠ AI 草皿。