💡
Take home Message
前言
- 當住院醫師最討人厭的地方，每個月都要做報告
- 使用AI來快速製作報告，讓更多心力留在臨床還有耍廢XD
步驟1 - 使用 Claude
Claude 可以容納的Token數較多，使用GPT可能太多文字的內容無法
javascriptPrompt: I'm working on a PowerPoint presentation and need assistance in structuring the content. Summarized in bullet point, formatted in markdown The presentation should encompass 20 pages
AI 回覆
Slide 1: Title Page
Slide 2: Outline
- Introduction & Terminology
- Epidemiology
- Clinical Manifestations
- Diagnosis
- Imaging
- Colonoscopy
- Pathology
- Staging
- Treatment
- Initial Surgery
- Localized Disease
- Disseminated Disease
- Additional Treatment Based on Pathology
- Post-Treatment Surveillance
- Prognosis
- Summary
Slide 3: Introduction and Terminology
- Definition of appendiceal mucocele and mucinous lesions
- Classification systems
- Non-neoplastic vs neoplastic
- PSOGI consensus (serrated polyps, LAMN, HAMN, mucinous carcinoma)
- Differentiation between lesions
- Pseudomyxoma peritonei (PMP)
- Definition
- Caused by rupture of mucinous lesions
- Abundant mucin production
Slide 4: Non-Neoplastic Lesions
- Simple mucoceles/retention cysts
- Due to obstruction → cystic dilation, mucin secretion
- Normal epithelium ± flattening
- No predisposition to neoplasia
- Can extrude mucin into tissue
Slide 5: Neoplastic Lesions
- Serrated polyps
- Unique architecture, ± dysplasia
- Considered hyperplasia previously
- Molecular features different than colon
Slide 6: Neoplastic Lesions (Cont.)
- LAMN
- Dysplastic epithelium
- Expansile growth
- No infiltrative invasion
- Low-grade atypia
- HAMN
- Only distinguishable by high-grade atypia
- More aggressive than LAMN?
- Mucinous adenocarcinoma
- Invasive growth pattern
- Marked desmoplastic reaction
- Well, moderately, poorly differentiated
Slide 7: Pseudomyxoma Peritonei
- Clinical syndrome caused by appendiceal mucinous neoplasm rupture
- Intraperitoneal spread of mucin and/or neoplastic mucinous epithelium
- Prognosis depends on cellularity in mucin
Slide 8: Epidemiology
- 35000 cases annually in US
- Slight female predominance
- Peak incidence 50s-60s
- Increased risk with complicated appendicitis
Slide 9: Clinical Manifestations
- Usually incidental finding
- Can cause:
- RLQ pain
- Mass
- Intestinal/GU obstruction
- Perforation/rupture → PMP
- ± Anemia, ↑ tumor markers
Slide 10: Diagnosis – Imaging
- CT: low attenuation RLQ cystic mass
- Size >2 cm, wall thickening/calcification: higher risk neoplasm
- MRI, US can also diagnose
Slide 11: Diagnosis - Colonoscopy
- Smooth cecal indentation
- Normal overlying mucosa
- Can't get diagnostic biopsy
Slide 12: Diagnosis – Pathology
- Need whole specimen
- Simple mucoceles
- Flattened/effaced epithelium
- Mucin pools – no epithelium
- No atypia/dysplasia
- Serrated lesions
- Epithelium in sawtooth pattern
- ± dysplasia
Slide 13: Diagnosis – Pathology (Cont.)
- LAMN
- Dysplastic epithelium
- Pushing border
- Mucin dissection without invasion
- HAMN
- Only distinguished by ↑ grade dysplasia
- Mucinous adenocarcinoma
- Budding, irregular glands
- Stromal desmoplasia
- Well, moderately, poorly differentiated
Slide 14: Staging – AJCC 8th Edition
- Guidelines for LAMN and adenocarcinoma
- LAMN
- Confined: Tis
- Acellular mucin outside: T4a
- Cellular mucin outside: M1a
- Adenocarcinoma
- Invasion patterns dictate T stage
- Mucin deposits classified as peritoneal mets
Slide 15: Initial Surgery – Localized
- Standard appendectomy
- Open/laparoscopic
- Strive for cecal cuff
- Intact removal critical
- More if cecal/adjacent organ involvement
Slide 16: Initial Surgery – Ruptured Lesions
- Careful handling imperative
- Place in retrieval bag before extraction
- Limited surgery for containment
- Hemicolectomy
- Irrigation to minimize spillage
- Defer extensive CRS to specialized centers
Slide 17: Initial Surgery – Disseminated Disease
- Often diagnosed by peritoneal biopsy
- Defer appendectomy unless appendicitis
Slide 18: Additional Treatment – Pathology
- Simple/serrated → None
- Completely resected LAMN/HAMN → Observe
- Ruptured T4a → Yearly imaging X 10 years
- M1 LAMN/HAMN → Refer for CRS/HIPEC
- Adenocarcinoma → CRS/HIPEC for mets
Slide 19: Additional Treatment – Concurrent Lesions
- High rate of synchronous tumors
- Need colonoscopy ± ovaries exam
Slide 20: Post-Treatment Surveillance
- Dictated by pathology & resection completeness
- Yearly imaging x 10 years: T4a LAMN or HAMN
- More frequent: adenocarcinoma
Slide 21: Prognosis
- Excellent: simple, serrated
- Good: LAMN, especially if intact
- HAMN likely similar
- Adenocarcinoma: grade/stage dependent
Slide 22: Summary
- Classify appendiceal mucinous lesions
- Surgical resection + pathology dictates need for added treatment
- Imaging surveillance for high-risk cases
- Prognosis depends on histology
Slide 23: References
Let me know if you would like me to modify or add anything to this outline. I aimed to provide a comprehensive overview with enough details to generate approximately 20 slides.
步驟2 - 使用 GPTs
使用我製作的 報告救星 GPTs
將 md 檔案直接放入，將會使用 python-ppt 直接製造出簡報
- 製作出的簡報範例
後話
- 簡單兩步驟，快速製作醫學簡報，拯救你的疲累臨床生涯
- 當中還是需要小修，注意：還是要看PAPER，這只能減少你的時間，要報告多詳細還是得靠你自己
聯絡我
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