99.2 📚 國考版醫垫國考 / PGY OSCE

99.2.0.1 📌 Cram Sheet

99.2.0.1.1 🔥 高 yield 12
  1. Anti-Hu (ANNA-1): SCLC; sensory neuronopathy + encephalomyelitis
  2. Anti-Yo (PCA-1): ovary/breast; cerebellar degeneration
  3. Anti-Ri (ANNA-2): breast/SCLC; opsoclonus-myoclonus
  4. Anti-Ma2: testicular germ cell; limbic + brainstem
  5. Anti-VGCC: SCLC; LEMS
  6. Anti-amphiphysin: SCLC/breast; stiff person syndrome
  7. Anti-Tr: Hodgkin; cerebellar
  8. Anti-NMDA-R: ovarian teratoma; psychosis + dyskinesia + seizure
  9. Anti-LGI1: thymoma; FBDS + hypoNa + limbic
  10. Anti-CASPR2: thymoma; Morvan
  11. ICI-induced neuro irAE: encephalitis, MG, myositis (often + myocarditis)
  12. Subacute neuro + cancer screen mandatory
99.2.0.1.2 🔢 必背
Antibody Cancer Syndrome
Anti-Hu SCLC, neuroblastoma Sensory neuronopathy, encephalomyelitis
Anti-Yo Ovary, breast Cerebellar
Anti-Ri Breast, SCLC Opsoclonus-myoclonus
Anti-Ma2 Testicular germ cell Limbic + brainstem
Anti-VGCC SCLC LEMS
Anti-amphiphysin SCLC, breast Stiff person
Anti-Tr Hodgkin Cerebellar
Anti-NMDA-R Ovarian teratoma Psychosis + dyskinesia + seizure
Anti-LGI1 Thymoma FBDS + hypoNa + limbic
Anti-CASPR2 Thymoma Morvan

99.2.0.2 ⭐ 高 yield

99.2.0.2.1 LEMS vs MG
LEMS MG
Antibody Anti-VGCC Anti-AChR / MuSK
Cancer SCLC 60-80% Thymoma 10%
Weakness Proximal Variable, ocular bulbar
Reflexes ↓ (areflexia) Normal/↓
Autonomic Yes (dry mouth) No
RNS Incremental at high freq Decremental
Post-tetanic Improvement Decrement
Treatment 3,4-DAP, immunotherapy Pyridostigmine, immunotherapy
99.2.0.2.2 AE Mnemonic
  • “NMDA = Neurology of teen Nihilism” (psychosis, dyskinesia)
  • “LGI1 = Low Na + Limbic + Lips/face seizure”
99.2.0.2.3 ICI Neurologic irAE
  • Encephalitis
  • Myasthenia gravis
  • Myositis (often + myocarditis = severe)
  • Aseptic meningitis
  • GBS-like
  • Optic neuritis
  • Treatment: high-dose steroid + IVIG + plasma exchange

99.2.0.3 🎯 自我檢枬

  1. Anti-Hu cancer? → SCLC
  2. Anti-Yo cancer? → Ovary, breast
  3. Anti-VGCC syndrome? → LEMS
  4. LEMS cancer? → SCLC
  5. Anti-NMDA-R cancer? → Ovarian teratoma
  6. Anti-LGI1 features? → FBDS + hypoNa + limbic
  7. Anti-Ma2 cancer? → Testicular germ cell
  8. Anti-Tr cancer? → Hodgkin
  9. Stiff person syndrome Ab? → Anti-amphiphysin (or anti-GAD)
  10. LEMS RNS? → Incremental at high freq
  11. MG RNS? → Decremental
  12. ICI MG + myositis + myocarditis combo? → High mortality
  13. Anti-NMDA treatment? → Tumor + IVIG + rituximab + cyclophosphamide
  14. Subacute cerebellar in young woman? → Anti-Yo (ovary/breast)
  15. Opsoclonus-myoclonus? → Anti-Ri (adult); neuroblastoma (peds)

⚠ AI 草皿。