98.2 📚 國考版醫垫國考 / PGY OSCE

98.2.0.1 📌 Cram Sheet

98.2.0.1.1 🔥 高 yield 12
  1. SIADH most common paraneoplastic endo: SCLC dominant
  2. PTHrP: squamous lung, H&N, breast, RCC (most common HyperCa malignancy)
  3. Osteolytic HyperCa: MM, breast bone mets
  4. 1,25-D HyperCa: lymphoma (Hodgkin)
  5. Ectopic ACTH (Cushing): SCLC, carcinoid, MTC, pheo
  6. NICTH (IGF-2): HCC, sarcoma — large tumor; low insulin/C-peptide
  7. Erythrocytosis (EPO): RCC, HCC, hepatic adenoma, hemangioblastoma
  8. Trousseau: pancreatic > GI; LMWH preferred
  9. DIC: APL (M3 t(15;17)) + ATRA + arsenic
  10. AIHA: warm (Hodgkin/CLL); cold (lymphoma)
  11. PRCA + thymoma
  12. Granulocytosis (G-CSF): lung, GI
98.2.0.1.2 🔢 必背
Syndrome Cancer
SIADH SCLC #1
PTHrP Squamous lung/H&N/breast/RCC
Osteolytic MM, breast
1,25-D Lymphoma
Ectopic ACTH SCLC, carcinoid
NICTH (IGF-2) HCC, sarcoma
EPO RCC, HCC
Trousseau Pancreas
DIC APL (M3), mucin-adeno
MAHA Mucin-secreting adeno
PRCA Thymoma
AIHA warm Hodgkin, CLL
AIHA cold Lymphoma (lymphoplasmacytic)

98.2.0.2 ⭐ 高 yield

98.2.0.2.1 Hypercalcemia of Malignancy
Type % Cancer
PTHrP 80% Squamous lung, H&N, breast, RCC
Osteolytic 15% MM, breast bone mets
1,25-D 5% Lymphoma, granulomatous
Ectopic PTH rare —
98.2.0.2.2 Treatment Quick
Syndrome Acute Tx
SIADH Fluid restriction + tolvaptan + 3% saline if severe
HyperCa IV NS + calcitonin + zoledronic + denosumab + steroid (1,25-D)
Ectopic ACTH Steroidogenesis inhibitor (osilodrostat, ketoconazole)
NICTH Steroid + glucagon + GH bridge; tumor resection
Trousseau LMWH long-term (DOAC evolving)
DIC + APL ATRA + arsenic + supportive
AIHA Steroid + rituximab + tumor therapy

98.2.0.3 🎯 自我檢枬

  1. SIADH most? → SCLC
  2. PTHrP cancers 4? → Squamous lung/H&N/breast/RCC
  3. 1,25-D cancers? → Lymphoma
  4. Ectopic ACTH cancers? → SCLC, carcinoid
  5. NICTH mechanism? → IGF-2 from large tumor (HCC, sarcoma)
  6. EPO ↑ cancers? → RCC, HCC, hepatic adenoma, hemangioblastoma
  7. Trousseau cancer? → Pancreatic
  8. Trousseau anticoagulation? → LMWH preferred
  9. APL = M3 = ? → t(15;17), DIC, ATRA + arsenic
  10. PRCA + which cancer? → Thymoma
  11. AIHA warm? → Hodgkin, CLL
  12. MAHA cancer? → Mucin-secreting adeno (gastric, pancreatic)
  13. Granulocytosis (ectopic G-CSF)? → Lung, GI
  14. Thrombocytosis cancers? → Pancreatic, ovarian, lung, GI
  15. Cold agglutinin? → Lymphoplasmacytic lymphoma

⚠ AI 草皿。