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dromlakhani/MD2SKILLعرض ٤٠ من أصل ٨٥٨ skills مجمعة.
Image the adrenal glands with CT and the ovaries with transvaginal ultrasound when biochemical evaluation suggests an androgen‑secreting tumor, such as markedly elevated DHEAS or testosterone, rapid progression of hirsutism, or virilization. Trigger phrases…
لغة النص الأصلي: الإنجليزية
Assesses the adrenal response to cosyntropin stimulation by measuring 17-hydroxyprogesterone and other steroid precursors to exclude rare forms of congenital adrenal hyperplasia in women with hirsutism. Triggered when evaluating hyperandrogenic patients with…
لغة النص الأصلي: الإنجليزية
Assess for Cushing syndrome, thyroid dysfunction, acromegaly, or hyperprolactinemia when clinical features suggestive of these disorders are present in a woman with hirsutism. Trigger phrases include "Cushingoid features," "hypothyroidism signs," "acromegalic…
لغة النص الأصلي: الإنجليزية
Assess urinary corticoid metabolites by mass spectrometry to exclude apparent cortisone reductase deficiency. Indicated when a woman presents with moderate/severe hirsutism or mild hirsutism accompanied by clinical evidence of a hyperandrogenic endocrine…
لغة النص الأصلي: الإنجليزية
Guidance to avoid antiandrogen monotherapy unless adequate contraception is in place. Trigger phrases include patient-important hirsutism despite cosmetic measures, sexually active status, inadequate contraception, desire for pregnancy, permanent…
لغة النص الأصلي: الإنجليزية
The clinician avoids GnRH agonist therapy for hirsutism unless the patient has severe hyperandrogenemia (e.g., ovarian hyperthecosis) and has demonstrated a suboptimal response to combined oral contraceptives plus an antiandrogen. Trigger phrases include…
لغة النص الأصلي: الإنجليزية
This skill advises against using insulin‑lowering drugs (e.g., metformin, thiazolidinediones) solely to treat hirsutism in premenopausal women. Apply when evaluating patient‑important hirsutism despite cosmetic measures or when insulin‑lowering therapy is…
لغة النص الأصلي: الإنجليزية
The skill recommends against testing for elevated androgen levels in eumenorrheic women with only unwanted local hair growth and no abnormal hirsutism score. Trigger phrases include statements like, “She only has stray facial hair but regular periods; do we…
لغة النص الأصلي: الإنجليزية
The skill advises clinicians to avoid prescribing topical antiandrogen agents (e.g., spironolactone or finasteride cream) for hirsutism in premenopausal women. Trigger phrases include “patient wants a topical cream for facial hair,” “considering eflornithine…
لغة النص الأصلي: الإنجليزية
Consider oral contraceptive‑antiandrogen combination therapy for severe hirsutism causing emotional distress or after inadequate response to OC monotherapy. Avoid using this combination as first‑line treatment; reserve for patients with severe distress or…
لغة النص الأصلي: الإنجليزية
Perform dexamethasone suppression testing to evaluate functional adrenal androgen excess in women with hirsutism. Trigger phrases include “moderate/severe hirsutism with normal total testosterone,” “clinical evidence of hyperandrogenic disorder despite normal…
لغة النص الأصلي: الإنجليزية
For a premenopausal woman presenting with mild hirsutism (Ferriman–Gallwey score 8–15) and no clinical evidence of an endocrine disorder (eumenorrheic menses, absence of hyperandrogenic signs), the clinician should consider either pharmacologic therapy or…
لغة النص الأصلي: الإنجليزية
Recommend lifestyle changes for obese women with PCOS who present with hirsutism and seek improvement of androgen-related symptoms. Trigger phrases include BMI ≥30, PCOS diagnosis, hirsutism (Ferriman–Gallwey score ≥8), and desire for non-pharmacologic…
لغة النص الأصلي: الإنجليزية
This skill guides selection of a low‑dose estrogen oral contraceptive combined with a low‑risk progestin for premenopausal women with hirsutism who are at increased venous thromboembolism risk (e.g., obesity or age >39 years). It triggers when a patient…
لغة النص الأصلي: الإنجليزية
Measure serum androstenedione or other steroid intermediates in premenopausal women with hirsutism when atypical features raise suspicion for adrenal pathology, such as rapid progression, virilization, or high-risk ethnicity for nonclassic congenital adrenal…
لغة النص الأصلي: الإنجليزية
Measure early morning serum DHEAS to screen for adrenal hyperandrogenism in women with hirsutism and normal total/free testosterone but clinical signs of androgen excess. Consider testing when there is suspicion of nonclassic congenital adrenal hyperplasia or…
لغة النص الأصلي: الإنجليزية
The clinician orders early morning serum total and free testosterone when total testosterone is normal but the patient presents with moderate to severe hirsutism or mild hirsutism accompanied by signs of hyperandrogenism such as menstrual irregularity or lack…
لغة النص الأصلي: الإنجليزية
For women with patient-important hirsutism despite cosmetic measures who have suboptimal response after ≥6 months of oral contraceptive monotherapy, consider adding an antiandrogen; no preference among antiandrogens but avoid flutamide due to its…
لغة النص الأصلي: الإنجليزية
This skill guides clinicians to initiate oral combined estrogen–progestin contraceptives as initial therapy for premenopausal women with patient-important hirsutism despite cosmetic measures who are not seeking fertility. It emphasizes that no specific OC…
لغة النص الأصلي: الإنجليزية
Suggest oral combined estrogen–progestin contraceptives as initial therapy for most premenopausal women with patient‑important hirsutism who are not seeking fertility. Consider this approach when hirsutism persists despite cosmetic measures (shaving,…
لغة النص الأصلي: الإنجليزية
Perform pelvic ultrasonography to detect ovarian neoplasm in patients with severe or progressive hyperandrogenism, triggered by moderate/severe hirsutism, virilization, or rapid hair growth despite therapy. Third-person guidance for clinicians to gather data,…
لغة النص الأصلي: الإنجليزية
In patients with known hyperandrogenemia undergoing hair removal (laser, photoepilation, or electrolysis), add pharmacologic therapy to minimize hair regrowth. Trigger phrases include "known hyperandrogenemia," "post-laser hair regrowth," and "persistent…
لغة النص الأصلي: الإنجليزية
This skill guides clinicians to select photoepilation for patients with dark (auburn/brown/black) terminal hair and electrolysis for those with light (blonde/white) hair when considering direct hair removal for hirsutism. Trigger phrases include…
لغة النص الأصلي: الإنجليزية
Performs a urine or serum pregnancy test in premenopausal women presenting with amenorrhea and hirsutism to exclude pregnancy before initiating androgen evaluation or teratogenic therapies. Trigger phrases include "amenorrhea", "hirsutism", "rule out…
لغة النص الأصلي: الإنجليزية
Orders early morning 17‑hydroxyprogesterone to screen for nonclassic congenital adrenal hyperplasia due to 21‑hydroxylase deficiency in hyperandrogenemic women with amenorrhea or infrequent menses. Triggered by menstrual irregularity with hirsutism and a…
لغة النص الأصلي: الإنجليزية
This skill screens high‑risk patients for nonclassic congenital adrenal hyperplasia (NCCAH) by measuring 17‑OHP even when total and free testosterone are normal. Use when a clinician says, "She has a family history of CAH; should we still screen despite…
لغة النص الأصلي: الإنجليزية
For premenopausal women with patient-important hirsutism despite cosmetic measures, clinicians should initiate pharmacologic therapy and maintain the same regimen for at least six months before considering any dose change, medication switch, or addition of…
لغة النص الأصلي: الإنجليزية
Initiates oral contraceptives or other pharmacologic agents as first‑line treatment for women with hirsutism that causes sufficient distress to seek additional treatment despite shaving, plucking, or waxing. Trigger phrase: "She’s tried shaving and waxing but…
لغة النص الأصلي: الإنجليزية
Measures serum total and/or free testosterone in women with an abnormal Ferriman–Gallwey hirsutism score to evaluate for hyperandrogenemia. Triggered when a clinician wonders whether to check androgen levels because the patient's hirsutism score exceeds the…
لغة النص الأصلي: الإنجليزية
For women of color with facial hirsutism seeking photoepilation, suggest long‑wavelength laser (Nd:YAG or diode) with skin cooling and warn about paradoxical hypertrichosis, especially in Mediterranean or Middle Eastern backgrounds. Consider electrolysis or…
لغة النص الأصلي: الإنجليزية
Suggests a 3- to 6‑month trial of testosterone dosing to achieve a mid‑normal premenopausal value in a reference assay for postmenopausal women with properly diagnosed HSDD and no contraindications. Triggered when a postmenopausal woman requests therapy for…
لغة النص الأصلي: الإنجليزية
This skill advises against routinely treating women with low androgen levels due to hypopituitarism, adrenal insufficiency, surgical menopause, pharmacological glucocorticoid administration, or other associated conditions because of insufficient efficacy and…
لغة النص الأصلي: الإنجليزية
Suggests oral contraceptives over injectable contraceptives for women with BMI ≥27 kg/m2 with comorbidities or BMI ≥30 kg/m2 seeking contraception, provided they are well‑informed and oral contraceptives are not contraindicated. Triggers include clinician…
لغة النص الأصلي: الإنجليزية
Recommends measuring testosterone levels at baseline and after 3–6 weeks of initial treatment to assess for patient overuse or excessive dosing. Triggered when initiating testosterone therapy in women with hypoactive sexual desire disorder (HSDD) to verify…
لغة النص الأصلي: الإنجليزية
Recommends discontinuing testosterone therapy in women with hypoactive sexual desire disorder (HSDD) who show no symptomatic improvement after a 6‑month trial. Triggers include a clinician reviewing lack of response at follow‑up and considering continuation…
لغة النص الأصلي: الإنجليزية
This skill recommends discontinuing testosterone therapy in women with hypoactive sexual desire disorder (HSDD) when there is no clinical improvement in desire or sexual satisfaction after six months of treatment. Clinical triggers include a reassessment…
لغة النص الأصلي: الإنجليزية
The guideline recommends against generalized testosterone use for indications such as infertility, sexual dysfunction other than HSDD, cognitive, cardiovascular, metabolic, bone health, or general well-being due to insufficient evidence of benefit and lacking…
لغة النص الأصلي: الإنجليزية
Advises against using testosterone preparations formulated for men or compounded by pharmacies in women due to lack of efficacy and safety data specific to female physiology. Triggers include a clinician considering a transdermal patch, gel, or injectable…
لغة النص الأصلي: الإنجليزية
The guideline recommends against routinely measuring testosterone in women for diagnostic purposes due to the lack of a reliable correlation between symptoms and testosterone levels. This recommendation is triggered when a clinician orders a testosterone test…
لغة النص الأصلي: الإنجليزية
This skill recommends monitoring serum testosterone levels 3–6 weeks after initiating therapy and every 6 months thereafter to detect overuse or signs of androgen excess. It is triggered when a clinician manages a woman on testosterone therapy requiring early…
لغة النص الأصلي: الإنجليزية