93.2 📚 國考版醫垫國考 / PGY OSCE

93.2.0.1 📌 Cram Sheet

93.2.0.1.1 🔥 高 yield 10
  1. 15-35 yr 男 most common cancer
  2. Cryptorchidism 5-10x risk (orchiopexy reduces 䞍消陀)
  3. Pure seminoma: AFP normal; β-hCG normal/mild
  4. NSGCT: AFP / β-hCG / LDH elevated
  5. Pure seminoma + AFP elevated = 䞍是 pure (yolk sac/embryonal)
  6. Inguinal radical orchiectomy (NOT trans-scrotal!)
  7. BEP (bleomycin + etoposide + cisplatin) cure > 90%
  8. Stage I active surveillance option
  9. Sperm cryopreservation pre-chemo
  10. Salvage: TIP / VeIP + high-dose + autoHSCT
93.2.0.1.2 🔢 必背
Tumor β-hCG AFP
Pure seminoma ~10% mild NEVER ↑
Embryonal ↑ ↑
Yolk sac − ↑↑
Choriocarcinoma ↑↑↑ −
Teratoma − −
項目 æ•žå­—
15-35 yr cancer rank #1
Cure stage I > 95%
Cure stage III > 70%
Bleomycin lifetime < 400 units
BEP cycles 3-4

93.2.0.2 ⭐ 高 yield

93.2.0.2.1 IGCCCG Risk
Risk Criteria
Good Testicular/RP primary + no non-pulm visceral + low markers
Intermediate Visceral mets present OR markers higher
Poor Mediastinal primary OR very high markers
93.2.0.2.2 Treatment by Stage
Stage Seminoma NSGCT
I Surveillance / carboplatin × 1 / RT Surveillance / RPLND / BEP × 1
IIA-B RT or BEP BEP × 3-4 + RPLND
IIC-III BEP × 3-4 BEP × 3-4
93.2.0.2.3 Salvage
  • TIP (paclitaxel + ifosfamide + cisplatin)
  • VeIP (vinblastine + ifosfamide + cisplatin)
  • High-dose chemo + autologous HSCT (carboplatin + etoposide)

93.2.0.3 🎯 自我檢枬

  1. Most common cancer 15-35 男? → Testicular
  2. Cryptorchidism RR? → 5-10x
  3. Pure seminoma AFP? → Normal (NEVER ↑)
  4. Yolk sac marker? → AFP
  5. Choriocarcinoma marker? → β-hCG (↑↑↑)
  6. Surgery 1st step? → Inguinal radical orchiectomy
  7. Trans-scrotal? → 犁忌
  8. BEP regimen? → Bleomycin + etoposide + cisplatin
  9. Cure rate Stage III? → > 70%
  10. Pre-chemo? → Sperm cryopreservation
  11. Salvage chemo? → TIP, VeIP
  12. High-dose + autoHSCT for? → Refractory
  13. Bleomycin SE? → Lung toxicity (cumulative)
  14. Etoposide SE? → Secondary AML
  15. Stage I seminoma options? → Surveillance / carboplatin / RT

⚠ AI 草皿。