70.2 📚 國考版醫垫國考 / PGY OSCE

70.2.0.1 📌 Cram Sheet

70.2.0.1.1 🔥 高 yield 10
  1. Generalized LAP = CHICAGO
  2. Localized: 看郚䜍 + drainage
  3. Virchow’s left supraclavicular = gastric/abdominal ca
  4. B symptoms = lymphoma (fever + night sweats + weight loss)
  5. Excisional > FNA for suspected lymphoma
  6. Mono triad: pharyngitis + atypical lymph + LAP / HSM
  7. Massive spleno 4 病: CML, MF, lymphoma, kala-azar
  8. Howell-Jolly = asplenia
  9. Asplenia vaccine: pneumo + Hib + meningococcus
  10. EBV + amoxicillin = morbilliform rash (not allergy)
70.2.0.1.2 🔢 必背
項目 æ•žå­—
LAP biopsy threshold > 1-2 cm + > 4 wk
Massive spleno > 8 cm below costal
B symptom weight loss > 10%
Mono atypical lymph > 10%

70.2.0.2 ⭐ 高 yield

70.2.0.2.1 CHICAGO Generalized LAP
  • Cancer (lymphoma, leukemia, mets)
  • Hypersensitivity (DRESS, drug)
  • Infection (HIV, EBV, CMV, TB, syph, toxo)
  • CTD (SLE, RA, Still’s)
  • Atypical lymphoproliferative (Castleman)
  • Granulomatous (sarcoid)
  • Other (Kikuchi, Rosai-Dorfman)
70.2.0.2.2 Reed-Sternberg cell = Hodgkin
  • Owl-eye appearance
  • CD15 + CD30 +
  • Subtypes: nodular sclerosis (most common), mixed cellularity, lymphocyte-rich, lymphocyte-depleted
70.2.0.2.3 NHL
  • B-cell most common (DLBCL, follicular, MCL, MZL, Burkitt)
  • T-cell less common
70.2.0.2.4 CLL
  • Smudge cells
  • Bilateral painless LAP + lymphocytosis
  • Flow: CD5+ B cells (CD19+, CD20+)
70.2.0.2.5 Splenomegaly Workup
  • Imaging confirms size
  • BM biopsy if heme suspicion
  • Smear (atypical lymph, hairy cell, schistocyte)
70.2.0.2.6 Splenectomy + Vaccines
  • Pneumococcus (PCV20 + PPSV23)
  • H. influenzae type b
  • Meningococcus (ACWY + B)
  • Annual flu
  • 兒童 antibiotic prophylaxis

70.2.0.3 🎯 自我檢枬

  1. CHICAGO? → Cancer/Hyper/Infection/CTD/Atypical/Granuloma/Other
  2. Virchow’s? → Left supraclavicular, gastric ca
  3. RS cell? → Hodgkin
  4. Mono triad? → Pharyngitis + LAP + atypical lymph
  5. Massive spleno? → CML, MF, lymphoma, kala-azar
  6. Asplenia smear? → Howell-Jolly
  7. Asplenia vaccines? → Pneumo + Hib + meningo
  8. Excisional vs FNA for lymphoma? → Excisional
  9. CLL flow markers? → CD5+, CD19+, CD20+
  10. Kikuchi disease? → Asian young female, self-limited cervical LAP + fever

⚠ AI 草皿。