97.2 📚 國考版醫垫國考 / PGY OSCE

97.2.0.1 📌 Cram Sheet

97.2.0.1.1 🔥 高 yield 8
  1. CUP ~ 3% all cancer; adenocarcinoma 70%
  2. 8 favorable subsets (treat as that cancer)
  3. Female axillary LN adeno = occult breast
  4. Female peritoneal serous = occult ovarian
  5. Cervical squamous LN = H&N
  6. Mid-line + young + β-hCG/AFP = germ cell
  7. NGS + IHC essential
  8. Tumor agnostic: pembro MSI-H/TMB-H, larotrectinib NTRK, BRAF V600E dabrafenib + trametinib, RET selpercatinib, HER2 T-DXd
97.2.0.1.2 🔢 必背
IHC Suggests
CK7+/CK20− Lung, breast, uterus, pancreas
CK7−/CK20+ CRC
CK7+/CK20+ Urothelial, pancreatic, gastric
CK7−/CK20− HCC, RCC, prostate
TTF-1 Lung adeno, thyroid
PAX8 Thyroid, kidney, ovary, endometrial
GATA3 Breast, urothelial
HepPar1 HCC
PSA, NKX3.1 Prostate

97.2.0.2 ⭐ 高 yield

97.2.0.2.1 Tumor Agnostic Drugs
Mutation Drug
MSI-H / dMMR Pembrolizumab
TMB-H ≥ 10 Pembrolizumab
NTRK fusion Larotrectinib, entrectinib
BRAF V600E Dabrafenib + trametinib
RET fusion Selpercatinib, pralsetinib
ROS1 Repotrectinib
HER2 Trastuzumab + T-DXd

97.2.0.3 🎯 自我檢枬

  1. CUP %? → ~ 3%
  2. CUP histology most? → Adenocarcinoma 70%
  3. Female axillary LN adeno? → Occult breast (favorable)
  4. Female peritoneal serous? → Occult ovarian
  5. Cervical squamous LN? → H&N source
  6. Mid-line young β-hCG/AFP+? → Germ cell pattern
  7. CK7+/CK20−? → Lung, breast, uterus
  8. CK7−/CK20+? → CRC
  9. TTF-1+? → Lung adeno, thyroid
  10. MSI-H tumor agnostic? → Pembrolizumab
  11. NTRK fusion? → Larotrectinib
  12. BRAF V600E? → Dabrafenib + trametinib

⚠ AI 草皿。