73.2 📚 國考版醫垫國考 / PGY OSCE

73.2.0.1 📌 Cram Sheet

73.2.0.1.1 🔥 高 yield 10
  1. Tissue confirmation 必須
  2. TNM staging + Stage 0-IV
  3. ECOG 0-5 / Karnofsky 100-0
  4. PS ≥ 3 䞍適 intensive chemo
  5. MDT 是 cancer care 暙準
  6. SPIKES for bad news
  7. Paraneoplastic: SIADH (SCLC) / PTHrP (squamous) / LEMS (SCLC) / Trousseau (pancreatic)
  8. Lymphoma → excisional biopsy
  9. Molecular markers: HER2/ER/PR/EGFR/ALK/PD-L1/MSI/BRAF/KRAS
  10. Cancer emergencies 7: SCC / SVCS / TLS / HyperCa / FN / 心包 tamponade / ICP
73.2.0.1.2 🔢 必背
項目 æ•žå­—
ECOG range 0-5
Karnofsky range 0-100
PS chemo cutoff ≥ 3 䞍適
TLS hyperK threshold > 6
Hospice prognosis < 6 月

73.2.0.2 ⭐ 高 yield

73.2.0.2.1 TNM 範䟋
  • T1-4tumor size/extent
  • N0-3regional lymph nodes
  • M0/M1metastasis
73.2.0.2.2 Paraneoplastic Syndromes
系統 症候矀 癌皮
Endocrine SIADH SCLC
Endocrine Cushing’s (ectopic ACTH) SCLC, carcinoid
Endocrine Hypercalcemia (PTHrP) Squamous (lung, H/N, breast)
Endocrine Hypoglycemia (IGF-2) HCC, sarcoma
Neuro LEMS (anti-VGCC) SCLC
Neuro Cerebellar (anti-Yo) Ovarian
Neuro Limbic encephalitis (anti-Hu) SCLC
Neuro Anti-NMDA-R Ovarian teratoma
Hemato Trousseau Pancreatic, lung, GI
Hemato DIC APL (M3)
Derma AN (sudden) Gastric
Derma Dermatomyositis Ovarian, lung, GI, breast
73.2.0.2.3 Molecular Markers
Marker Cancer Drug
HER2 Breast, gastric Trastuzumab
ER/PR Breast Tamoxifen, AI
EGFR Lung adeno Osimertinib, gefitinib
ALK Lung adeno Alectinib, crizotinib
BRAF V600E Melanoma, CRC, hairy cell Dabrafenib + trametinib
KRAS G12C NSCLC, CRC Sotorasib
MSI-H CRC, endometrial Pembrolizumab
PD-L1 Multiple Pembrolizumab, nivolumab

73.2.0.3 🎯 自我檢枬

  1. ECOG range? → 0-5
  2. PS ≥ 3 chemo? → 䞍適 intensive
  3. Lymphoma biopsy? → Excisional
  4. SCLC paraneoplastic 3? → SIADH, LEMS, Cushing’s
  5. Trousseau syndrome? → Migratory thrombophlebitis, 倚 pancreatic
  6. PTHrP cancers? → Squamous (lung, H/N, breast)
  7. SPIKES 6 字? → Setting/Perception/Invitation/Knowledge/Emotions/Strategy
  8. HER2 drug? → Trastuzumab
  9. EGFR L858R drug? → Osimertinib
  10. MSI-H drug? → Pembrolizumab

⚠ AI 草皿。