48.2 📚 國考版醫垫國考 / PGY OSCE

48.2.0.1 📌 Cram Sheet

48.2.0.1.1 🔥 高 yield 8
  1. N/V 5 framework: GI / neuro / metabolic / drug / functional
  2. CHS = chronic THC + 熱氎緩解 (22E)
  3. Projectile + no nausea = ↑ ICP
  4. Pregnancy 1st line = doxylamine + B6
  5. Dyspepsia red flags → EGD: > 60 yo, weight loss, bleeding
  6. H. pylori eradication for functional dyspepsia
  7. Ondansetron QT prolongation
  8. CHS treatment: 停 THC + capsaicin + haloperidol
48.2.0.1.2 🔢 必背
項目 æ•žå­—
Dyspepsia red flag age > 60
Test of cure H. pylori 4 weeks after treatment
Pregnancy doxylamine + B6 First-line
Ondansetron QT caveat > 32 mg single dose avoid
48.2.0.1.3 易錯

  • 60 yo 䞍 EGD

  • 䞍驗 βhCG
  • CHS 挏
  • 䞍評䌰 bowel obstruction

48.2.0.2 ⭐ 高 yield

48.2.0.2.1 Antiemetic 機蜉衚
Agent Receptor Notes
Ondansetron 5HT3 QT
Metoclopramide D2 + prokinetic Tardive dyskinesia long-term
Promethazine D2 + H1 EPS
Aprepitant NK1 Chemo
Dexamethasone — Chemo, palliative
Scopolamine M1 Motion
Doxylamine + B6 H1 + B6 Pregnancy
Olanzapine Multi Refractory chemo
Cannabinoid (dronabinol) CB1 Chemo (irony with CHS)
48.2.0.2.2 H. pylori 治療 (Taiwan triple)
  • PPI bid + amoxicillin 1g bid + clarithromycin 500 mg bid × 14 d (in 䜎 resistance)
  • Bismuth quadruple if 高 resistance
  • Test of cure 4 weeks after
48.2.0.2.3 CHS Triad
  • Chronic THC use
  • Cyclic severe vomiting
  • Hot showers relief

48.2.0.3 🎯 自我檢枬

  1. CHS 緩解? → 熱氎济
  2. Pregnancy first-line antiemetic? → Doxylamine + B6
  3. ↑ ICP 嘔吐特埵? → Projectile + no nausea
  4. Functional dyspepsia 治? → H. pylori test/treat → PPI
  5. Ondansetron 副䜜甚? → QT
  6. Metoclopramide long-term? → Tardive dyskinesia

  7. 60 yo + new dyspepsia? → EGD

⚠ AI 草皿。