91.2 📚 國考版醫垫國考 / PGY OSCE

91.2.0.1 📌 Cram Sheet

91.2.0.1.1 🔥 高 yield 10
  1. TCC 90% (urothelial)
  2. Painless gross hematuria classic 80%
  3. Smoking 50% risk
  4. Schistosoma → SCC
  5. Cyclophosphamide → hemorrhagic cystitis + CA
  6. NMIBC: TURBT + BCG (high-grade) / MMC (low-grade)
  7. BCG-unresponsive: pembrolizumab / nadofaragene
  8. MIBC: neoadj cisplatin → radical cystectomy + adjuvant nivolumab
  9. Metastatic 1st line 22E: EV + pembrolizumab (EV-302)
  10. Erdafitinib for FGFR3/2
91.2.0.1.2 🔢 必背
項目 æ•žå­—
TCC % 90%
Smoking RR 50% bladder CA
Hematuria classic Painless gross
Tis CIS
T1 Lamina propria
T2 Muscularis propria
BCG induction 6 weekly

91.2.0.2 ⭐ 高 yield

91.2.0.2.1 Drug Quick
Drug Mechanism Use
BCG Live attenuated TB → immune NMIBC high-grade
Mitomycin C Alkylating Low-grade NMIBC
Gemcitabine Antimetabolite Intravesical alt + systemic
Cisplatin (DDMVAC, GC) Platinum chemo Neoadjuvant + metastatic
Avelumab Anti-PD-L1 1st line maintenance
Pembrolizumab Anti-PD-1 BCG-unresponsive + metastatic
Nivolumab Anti-PD-1 Adjuvant post-cystectomy
Atezolizumab Anti-PD-L1 Metastatic
Enfortumab vedotin Nectin-4 ADC EV-302 1st line combo
Erdafitinib FGFR3/2 inhibitor FGFR-altered
Sacituzumab govitecan TROP2 ADC Refractory
Nadofaragene firadenovec Intravesical IFNα gene therapy BCG-unresponsive Tis
Disitamab vedotin HER2 ADC HER2+
91.2.0.2.2 Trials
  • EV-302 (enfortumab vedotin + pembrolizumab): 1st line metastatic urothelial
  • JAVELIN Bladder 100 (avelumab maintenance): post-cisplatin
  • CheckMate 274 (nivolumab adjuvant): MIBC post-cystectomy
  • KEYNOTE-057 (pembrolizumab): BCG-unresponsive
  • PURE-01 (pembrolizumab neoadjuvant): MIBC
91.2.0.2.3 Special Subtypes
  • Squamous (Schistosoma)
  • Adenocarcinoma (urachal)
  • Small cell (aggressive; treat like SCLC)
  • Sarcomatoid (aggressive)

91.2.0.3 🎯 自我檢枬

  1. TCC %? → 90%
  2. Smoking RR? → 50% of bladder CA
  3. Schistosoma type? → SCC
  4. Cyclophosphamide? → Hemorrhagic cystitis + CA
  5. NMIBC stages? → Tis, Ta, T1
  6. MIBC stages? → T2+
  7. NMIBC high-grade? → TURBT + BCG
  8. BCG-unresponsive treatment? → Pembrolizumab / nadofaragene / cystectomy
  9. MIBC standard? → Neoadj cisplatin + cystectomy + adjuvant nivolumab
  10. Metastatic 1st line 22E? → EV + pembrolizumab (EV-302)
  11. Erdafitinib? → FGFR3/2
  12. Avelumab role? → Maintenance post-cisplatin (JAVELIN Bladder 100)
  13. Adjuvant after cystectomy? → Nivolumab (CheckMate 274)
  14. Sacituzumab govitecan? → TROP2 ADC for refractory
  15. Disitamab vedotin? → HER2 ADC

⚠ AI 草皿。