62.2 📚 國考版醫垫國考 / PGY OSCE

62.2.0.1 📌 Cram Sheet

62.2.0.1.1 🔥 高 yield 10
  1. PV intra-epidermal / BP subepidermal
  2. PV Nikolsky+ / BP Nikolsky−
  3. PV Dsg3 / BP BP180-BP230
  4. DIF fish-net = PV / Linear BMZ = BP
  5. PV first-line = Rituximab + steroid22E
  6. DH IgA papillae = celiac → gluten-free + dapsone
  7. Linear IgA disease = vancomycin most common drug
  8. Behçet’s pathergy + HLA-B51 + 口/生/県䞉聯
  9. Lupus skin: acute / subacute / chronic / profundus
  10. Cicatricial pemphigoid scarring (eye, mouth)
62.2.0.1.2 🔢 必背
病 抗原 DIF
PV Dsg3 (mucosa) / Dsg1 (skin) fish-net
BP BP180, BP230 linear BMZ
DH tTG granular IgA papillae
Linear IgA LAD-1 linear IgA BMZ
Bullous SLE Type VII collagen linear BMZ IgG/IgA

62.2.0.2 ⭐ 高 yield

62.2.0.2.1 Antibodies
  • Anti-Dsg3 = mucosal-dominant PV
  • Anti-Dsg3 + Dsg1 = mucocutaneous PV
  • Anti-Dsg1 only = pemphigus foliaceus
  • Anti-BP180/230 = BP
62.2.0.2.2 Treatment
病 First-line
PV Rituximab + steroid (22E first-line)
BP mild Topical clobetasol
BP moderate-severe Pred + steroid-sparing
DH Gluten-free + dapsone
Linear IgA Stop drug + dapsone
Lupus discoid Topical steroid + HCQ
Behçet’s Colchicine, apremilast, TNF-α
62.2.0.2.3 Behçet’s Criteria
  • Recurrent oral ulcers + 2 of:
    • Genital ulcers
    • Eye lesions (uveitis)
    • Skin lesions
    • Pathergy +
62.2.0.2.4 Vasculitis Skin
  • IgA vasculitis (HSP): 兒童 + palpable purpura + GI + 關節
  • Cryoglobulinemic: HCV
  • ANCA-associated: GPA, MPA, EGPA

62.2.0.3 🎯 自我檢枬

  1. PV vs BP Nikolsky? → PV+, BP−
  2. PV intra/sub epidermal? → Intra
  3. PV first-line 22E? → Rituximab + steroid
  4. BP mild Tx? → Topical clobetasol
  5. DH IgA in? → Dermal papillae
  6. Linear IgA most common drug? → Vancomycin
  7. Behçet’s pathergy +?
  8. DIF for PV? → Fish-net intercellular IgG

⚠ AI 草皿。