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Recommends prostate-specific antigen (PSA) testing and digital rectal examination (DRE) to monitor prostate health during testosterone therapy, following evidence-based guidelines for prostate cancer surveillance. Use when managing a patient on testosterone…
لغة النص الأصلي: الإنجليزية
This skill advises caution when using ADAM, AMS, or MMAS questionnaires for hypogonadism screening due to good sensitivity but low specificity limiting diagnostic utility. Triggered when a clinician wonders whether a questionnaire can reliably detect…
لغة النص الأصلي: الإنجليزية
Conducts regular monitoring for testosterone therapy response and adverse events. Triggered when testosterone therapy is initiated and the clinician plans follow‑up, asking when to check symptom improvement or what to monitor for side effects.
لغة النص الأصلي: الإنجليزية
Recommends repeating total testosterone measurement on at least two separate occasions when the initial result is below 12 nmol/L before starting testosterone therapy. Triggered when a clinician finds a low total testosterone (<12 nmol/L) and questions…
لغة النص الأصلي: الإنجليزية
States that testosterone therapy should be restricted to investigational protocols in patients with biochemical recurrence or metastatic prostate cancer due to unknown long-term risks. Triggers when a clinician encounters a patient with rising PSA after…
لغة النص الأصلي: الإنجليزية
This skill recommends screening men with obesity, type 2 diabetes mellitus, or metabolic syndrome for hypogonadism given the high comorbidity between these insulin‑resistant conditions and low testosterone. It is triggered when a clinician encounters a…
لغة النص الأصلي: الإنجليزية
Guides selection among hCG, recombinant FSH, aromatase inhibitors, SERMs, combined testosterone/hCG, or intranasal testosterone for men on or after testosterone therapy who wish to preserve fertility. Triggers when a clinician manages a man requesting sperm…
لغة النص الأصلي: الإنجليزية
Guides shared decision-making for testosterone therapy selection by discussing formulation, route, safety, efficacy, tolerability, availability, preference, and cost with the patient. Triggers when a clinician has decided to treat hypogonadism and asks,…
لغة النص الأصلي: الإنجليزية
Aims to correct serum total testosterone to the mid-normal reference range for young men during testosterone therapy. Triggers when a clinician monitors treatment and wonders what testosterone level should I aim for or is the patient's T in the target zone.
لغة النص الأصلي: الإنجليزية
This skill outlines the monitoring schedule for testosterone therapy, detailing baseline, 3‑month, 6‑month, and yearly assessments of symptoms, adverse events, total testosterone, hematocrit, PSA, and DRE. Use it when a patient is receiving testosterone and…
لغة النص الأصلي: الإنجليزية
This skill applies a total testosterone threshold of less than 12 nmol/L (3.5 ng/mL) to diagnose late-onset hypogonadism. It is triggered when a clinician evaluates a testosterone result and questions whether the level is low enough to diagnose hypogonadism…
لغة النص الأصلي: الإنجليزية
Testosterone therapy is more effective than placebo at correcting anemia in middle-aged and older men with confirmed hypogonadism. Consider this approach when evaluating a hypogonadal man with anemia and questioning whether testosterone will improve…
لغة النص الأصلي: الإنجليزية
Recommends initiating testosterone therapy in symptomatic men with total testosterone less than 12 nmol/L (350 ng/dL). Triggers when patients present with low libido, erectile dysfunction, fatigue, or decreased vigor and have confirmed low T levels.
لغة النص الأصلي: الإنجليزية
Reserve testosterone monotherapy for men with mild erectile dysfunction and an absolute demonstration of hypogonadism; otherwise combine testosterone therapy with a PDE5 inhibitor. Triggered when a clinician managing erectile dysfunction asks whether…
لغة النص الأصلي: الإنجليزية
Recommends adding testosterone therapy to phosphodiesterase‑type‑5 inhibitor (PDE5i) for men with erectile dysfunction who do not respond to PDE5i monotherapy. Triggered when a patient reports inadequate response to sildenafil, tadalafil, or vardenafil and…
لغة النص الأصلي: الإنجليزية
Drug-interaction and co-medication adjustment reference for a child on Genryzon (somatrogon, weekly long-acting growth hormone). Covers glucocorticoids, insulin and oral hypoglycaemics, thyroxine, oral estrogen, and CYP3A4-metabolised drugs (sex steroids,…
لغة النص الأصلي: الإنجليزية
Titrate Genryzon (somatrogon, weekly long-acting growth hormone) dose in a paediatric GHD patient using serum IGF-1 SDS. Encodes the mandatory 4-days-post-dose sampling rule, the target SDS window, the 15% dose-reduction trigger, and the oral estrogen…
لغة النص الأصلي: الإنجليزية
Bedside prescribing reference for Genryzon (somatrogon, Pfizer India) — the once-weekly long-acting growth hormone for paediatric growth hormone deficiency. Use when a clinician asks how to start Genryzon, how to dose somatrogon in a child, how to switch a…
لغة النص الأصلي: الإنجليزية
Pretreatment screening checklist before starting Genryzon (somatrogon, weekly long-acting growth hormone) in a child with confirmed paediatric growth hormone deficiency. Ensures thyroid, adrenal, glucose, ocular, tumour, and Prader-Willi status are checked…
لغة النص الأصلي: الإنجليزية
Red-flag safety scan for a child on Genryzon (somatrogon, weekly long-acting growth hormone) — recognise and act on the treatment-emergent adverse events that require holding, investigating, or stopping the drug. Covers benign intracranial hypertension,…
لغة النص الأصلي: الإنجليزية
Decide when to stop Genryzon (somatrogon, weekly long-acting growth hormone) in a paediatric GHD patient — the three physiological gates (epiphyseal closure, height velocity <2 cm/year, bone age >14 in girls or >16 in boys) plus the safety-driven stops…
لغة النص الأصلي: الإنجليزية
Performs corticotropin stimulation test to diagnose adrenal insufficiency when morning cortisol is indeterminate (3-15 µg/dL). Triggers include morning cortisol 3-15 µg/dL requiring further AI testing.
لغة النص الأصلي: الإنجليزية
Administers immediate parenteral injection of 50–100 mg hydrocortisone for suspected adrenal crisis secondary to adrenal insufficiency. Triggers include hypotension, hypoglycemia, or acute illness in a patient with known adrenal insufficiency.
لغة النص الأصلي: الإنجليزية
Clinicians educate adrenal insufficiency patients taking nondexamethasone glucocorticoids who initiate enzyme-inducing antiepileptic drugs about early signs of adrenal insufficiency. Trigger when an AI patient on nondexamethasone GC starts an enzyme-inducing…
لغة النص الأصلي: الإنجليزية
In central hypothyroidism patients receiving levothyroxine who initiate enzyme‑inducing antiepileptic drugs, the guideline recommends checking free T4 at least 6 weeks after AED start and increasing the levothyroxine dose if free T4 falls below the target…
لغة النص الأصلي: الإنجليزية
Applies serum cortisol cutoffs (<3 μg/dL indicates central adrenal insufficiency; >15 μg/dL likely excludes it) when evaluating morning cortisol for suspected adrenal insufficiency. Triggers include morning cortisol measurement in suspected AI and use when…
لغة النص الأصلي: الإنجليزية
In patients with adrenal insufficiency receiving dexamethasone replacement, the guideline suggests increasing the dexamethasone dose when enzyme-inducing antiepileptic drugs are co-administered. Trigger phrases include "AI patient on dexamethasone starts…
لغة النص الأصلي: الإنجليزية
Recommends measuring serum cortisol levels at 8–9 AM as the first-line test for diagnosing central adrenal insufficiency. Use when starting diagnostic workup for suspected adrenal insufficiency; triggers include suspected adrenal insufficiency requiring…
لغة النص الأصلي: الإنجليزية
Accounts for estrogen-induced elevation of total serum cortisol via increased corticosteroid-binding globulin (CBG) when evaluating adrenal reserve or hydrocortisone replacement adequacy. Triggered when assessing glucocorticoid adequacy in patients receiving…
لغة النص الأصلي: الإنجليزية
Recommends against using fludrocortisone for mineralocorticoid replacement in patients with secondary adrenal insufficiency. Trigger phrases include: considering mineralocorticoid replacement for secondary adrenal insufficiency and secondary adrenal…
لغة النص الأصلي: الإنجليزية
Recommends hydrocortisone replacement dosing of 15–20 mg total daily, administered as a single dose or divided doses with the highest dose given in the morning upon awakening and the second dose in the afternoon (two-dose regimen) or second and third doses at…
لغة النص الأصلي: الإنجليزية
Suggests testing HPA axis functionality before and after starting GH replacement in patients not receiving glucocorticoid replacement with apparently normal pituitary-adrenal function. Triggers include initiating GH replacement in a GHD patient who is not on…
لغة النص الأصلي: الإنجليزية
Recommends performing biochemical testing for HPA axis at least 18-24 hours after last hydrocortisone dose or longer for synthetic glucocorticoids. Use when scheduling HPA axis testing in glucocorticoid-treated patient needing assessment of adrenal reserve.
لغة النص الأصلي: الإنجليزية
Suggests using longer-acting glucocorticoids when standard hydrocortisone regimens are impractical due to nonavailability, poor adherence, or need for once-daily dosing. Triggers include glucocorticoid replacement therapy decisions where patients report…
لغة النص الأصلي: الإنجليزية
Recommends using the lowest tolerable hydrocortisone dose to potentially decrease risks of metabolic and cardiovascular disease in central adrenal insufficiency. Triggers include managing a patient with central adrenal insufficiency requiring glucocorticoid…
لغة النص الأصلي: الإنجليزية
Administers 100-mg hydrocortisone IV bolus followed by continuous IV infusion of 200 mg HC per 24 hours (alternatively 50 mg IV every 6 hours) for patients undergoing major surgical stress. Use when managing patient with major surgical stress; triggers…
لغة النص الأصلي: الإنجليزية
Suggests administering 25-75 mg hydrocortisone per 24 hours for 1-2 days in patients with adrenal insufficiency undergoing minor to moderate surgical stress. Triggers include patient undergoing minor to moderate surgery with known or suspected adrenal…
لغة النص الأصلي: الإنجليزية
In patients with normal preoperative adrenal function, suggests an individualized clinical approach for postoperative glucocorticoid administration until HPA axis evaluation can be performed. Triggers include managing postoperative patient with normal…
لغة النص الأصلي: الإنجليزية
Recommends administering stress-dose glucocorticoids before surgery and tapering after surgery in patients with adrenal insufficiency before repeat testing. Triggers include preoperative planning for surgery in a patient with known or suspected adrenal…
لغة النص الأصلي: الإنجليزية
Recommends against using a random cortisol level to diagnose adrenal insufficiency. Triggers when considering a random cortisol test for AI evaluation (e.g., "random cortisol measurement being considered for AI diagnosis").
لغة النص الأصلي: الإنجليزية