80.2 📚 國考版醫垫國考 / PGY OSCE

80.2.0.1 📌 Cram Sheet

80.2.0.1.1 🔥 高 yield 12
  1. 8 倧急症: SCC / SVCS / TLS / HyperCa / FN / Tamponade / ICP / Hyperviscosity (+ hyperleukocytosis, DIC, SIADH, adrenal)
  2. SCC: 任䜕 cancer + back pain → MRI + dexa stat
  3. SVCS: lung CA #1; stent + chemo/RT
  4. TLS Cairo-Bishop: K↑ PO4↑ UA↑ Ca↓
  5. TLS prophylaxis: hydration + allopurinol / rasburicase
  6. Rasburicase G6PD contraindicated
  7. HyperCa: NS + zoledronic + denosumab + calcitonin
  8. PTHrP = squamous lung/H&N/breast/RCC
  9. Tamponade: Beck triad + pericardiocentesis
  10. Brain mets: dexa + RT
  11. Hyperviscosity Waldenström/MM: plasmapheresis
  12. Hyperleukocytosis: leukapheresis + hydroxyurea
80.2.0.1.2 🔢 必背
項目 æ•žå­—
SCC dexa 10 mg IV → 4 mg q6h
TLS K threshold ≥ 6
TLS PO4 ≥ 4.5
TLS UA ≥ 8
TLS Ca ≀ 7
HyperCa Zol dose 4 mg IV
Hyperleukocytosis AML > 50K
Hyperleukocytosis ALL > 100K
Pulsus paradoxus > 10 mmHg

80.2.0.2 ⭐ 高 yield

80.2.0.2.3 Hypercalcemia Algorithm
  1. IV NS → 200-300 mL/h
  2. Calcitonin SC for rapid (24-48 h)
  3. Zoledronic acid for sustained (4 mg IV, peak 4-7 d)
  4. Denosumab if renal failure or refractory bisphos (120 mg SC)
  5. Steroid if lymphoma/granulomatous (Vit D-mediated)
  6. Hemodialysis for Ca > 18 / severe symptoms
80.2.0.2.4 SVCS — When to Get Tissue Dx First?
  • Almost always (chemosensitive tumors → chemo > RT)
  • Exception: imminent airway compromise / cerebral edema → temporize with steroid + stent

80.2.0.3 🎯 自我檢枬

  1. Cancer back pain workup? → MRI + dexa
  2. SCC steroid dose? → Dex 10 mg IV → 4 mg q6h
  3. TLS Cairo-Bishop 4? → K↑ PO4↑ UA↑ Ca↓
  4. Rasburicase contraindication? → G6PD deficiency
  5. HyperCa rapid drug? → Calcitonin SC (24-48h)
  6. HyperCa sustained drug? → Zoledronic / denosumab
  7. PTHrP cancers? → Squamous (lung, H&N), breast, RCC
  8. SVCS most common cancer? → Lung
  9. Tamponade triad? → Hypotension + JVD + muffled
  10. Hyperleukocytosis WBC AML? → > 50K
  11. Hyperviscosity treat? → Plasmapheresis
  12. Brain mets steroid? → Dex 10 mg IV

⚠ AI 草皿。