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SkillsMP has collected 858 skills from dromlakhani/MD2SKILL. Open a skill to review its source and details.
dromlakhani/MD2SKILLShowing 40 of 858 collected skills.
Suggests initial therapy for diabetes insipidus utilizes short-acting aqueous ADH, allowing safer use in the vast majority of cases where DI resolves spontaneously. Triggers include: new diabetes insipidus diagnosis requiring initial therapy, use when…
Determines levothyroxine dosing for central hypothyroidism to achieve serum free T4 in the mid to upper half of the reference range. Triggers include confirmed central hypothyroidism requiring thyroid hormone replacement when initiating L‑4 therapy.
Manages suspected mild central hypothyroidism in patients with pituitary disease and low-normal free thyroxine (fT4). Initiates levothyroxine (L-T4) when suggestive symptoms are present or when serial fT4 shows a decrease of 20% or more.
Recommends against prescheduled desmopressin (DDAVP) dosing in the first week after pituitary surgery due to hyponatremia risk from transient diabetes insipidus resolution and syndrome of inappropriate antidiuretic hormone secretion occurring 7–10 days…
Suggests women on oral estrogen replacement receive higher GH doses compared to eugonadal females or males. Triggers when managing GH replacement in a woman on oral estrogen requiring GH therapy (e.g., "female on oral estrogen needing GH replacement").
Administers glucocorticoid coverage in patients with pituitary apoplexy to prevent adrenal crisis while awaiting definitive laboratory diagnosis. Triggers include managing a pituitary apoplexy patient needing glucocorticoid coverage until laboratory…
Recommends testing for acute pituitary insufficiency in all patients with pituitary apoplexy. Use when managing pituitary apoplexy patient; triggers include pituitary apoplexy diagnosis.
Monitors for diabetes insipidus development after glucocorticoid replacement in cured acromegaly patients; recommends adrenal insufficiency testing if diabetes insipidus improves without an adrenal insufficiency diagnosis. Triggered when managing a cured…
Recommend continuing glucocorticoid replacement until hypothalamic-pituitary-adrenal (HPA) axis recovery after surgical resection of ACTH-secreting pituitary tumors. Use when managing postoperative patients following ACTH-secreting tumor surgery to prevent…
Retest thyroid and GH axes after curative surgery for Cushing's disease before initiating hormone replacement. Use when managing postoperative Cushing's disease patient; triggers include postoperative Cushing's surgery patient needing hormone reassessment.
Diagnoses gonadotrope dysfunction in postmenopausal women by confirming absent high serum FSH and LH when not on hormone replacement therapy. Use when evaluating a postmenopausal woman for hypogonadism; triggers include postmenopausal woman with suspected…
Recommends that clinicians monitor pituitary axes in pituitary apoplexy patients treated with surgical decompression or conservative management because hypopituitarism may develop over time. Use when managing pituitary apoplexy patient; triggers include…
Recommends retesting all pituitary axes starting at 6 weeks after pituitary surgery and periodically to monitor development or resolution of pituitary deficiencies. Use when managing postoperative pituitary surgery patient; triggers include postoperative…
Measures free T4 6–8 weeks after pituitary surgery in patients with intact preoperative thyroid function to detect central hypothyroidism. Triggers include postoperative patient needing thyroid function assessment and postoperative patient with intact…
This skill guides perioperative levothyroxine management for adults with preoperative central hypothyroidism undergoing non-emergency surgery. Trigger phrases include "preoperative central hypothyroidism patient requiring non-emergency surgery" and "use when…
Recommends reassessing all pituitary axes in patients with macroprolactinoma and central hypogonadism who have had successful dopamine agonist treatment. Use when managing a macroprolactinoma patient after dopamine agonist treatment with normalized prolactin…
Recommends against using serum TSH levels to guide levothyroxine dose adjustments in patients with central hypothyroidism. Triggers include evaluating a central hypothyroidism patient on levothyroxine who requires dose adjustment.
This skill recommends adding pegvisomant or cabergoline to ongoing somatostatin receptor ligand (SRL) therapy when a patient exhibits an inadequate biochemical response, defined as failure to achieve age‑normalized IGF‑1 or random GH <1 µg/L despite maximally…
Recommends annual GH and IGF-1 reassessment following medication withdrawal to assess the efficacy of radiation therapy in patients with acromegaly. Use during long-term follow-up after radiotherapy when evaluating biochemical control after a planned…
Recommends annual hormonal testing of patients following radiotherapy to monitor for hypopituitarism and other delayed radiation effects. Use in survivorship care after RT when patients have received pituitary or hypothalamic RT/SRT.
This skill advises against measuring GH or IGF-1 in pregnant patients with acromegaly because placental GH variant interferes with assay interpretation. Use when evaluating hormone testing in a pregnant acromegaly patient.
The guideline recommends against routine preoperative medical therapy (e.g., somatostatin receptor ligands) solely to improve postoperative biochemical control in acromegaly. Consider this when planning transsphenoidal surgery and evaluating whether to…
Recommends against using random GH levels to diagnose acromegaly because of pulsatile secretion. Use when a clinician considers ordering a random GH test to evaluate for acromegaly in a patient with suggestive features.
This skill advises against routine abdominal ultrasound to screen for gallstone disease in patients receiving somatostatin receptor ligands (SRLs) such as octreotide LAR or lanreotide autogel. Consider this recommendation when planning surveillance imaging…
Suggests screening for colon neoplasia with colonoscopy at the time of acromegaly diagnosis to establish baseline colorectal cancer risk. Trigger when a patient receives a new diagnosis of acromegaly (elevated IGF‑1 with lack of GH suppression after oral…
Recommends confirming acromegaly in patients with elevated or equivocal IGF-1 by demonstrating lack of GH suppression to <1 µg/L after an oral glucose load. Triggers include equivocal IGF-1 results requiring diagnostic certainty before proceeding to imaging.
This skill guides discontinuation of long-acting somatostatin receptor ligands (SRLs) and pegvisomant approximately two months before conception attempts in patients with acromegaly, substituting short-acting octreotide as needed for disease control. Trigger…
Consider discontinuing pegvisomant when alanine aminotransferase (ALT) or aspartate aminotransferase (AST) exceeds three times the upper limit of normal (ULN) during routine monthly liver function testing. This trigger applies to patients receiving…
Recommends applying standard acromegaly treatment approaches to normalize GH and IGF-1 in patients with pituitary gigantism. Use when evaluating a child or adolescent with excessive linear growth prior to epiphyseal closure, elevated IGF-1, and nonsuppressed…
Recommends assessing for hypopituitarism and replacing hormone deficits in patients with acromegaly at diagnosis and during follow‑up. Triggered by confirmed elevated IGF‑1, post‑surgical or post‑radiation evaluation, or emergence of symptoms such as fatigue,…
This skill suggests measuring serum IGF-1 in patients who lack typical acromegaly features but present with associated comorbidities such as sleep apnea, type 2 diabetes, debilitating arthritis, carpal tunnel syndrome, hyperhidrosis, or hypertension. It is…
Recommends measuring serum IGF-1 to exclude acromegaly in any patient discovered to have a pituitary mass on imaging. Triggers include incidental pituitary lesion found on MRI/CT for unrelated reasons.
Recommends measuring serum IGF-1 to screen for acromegaly in patients presenting with typical acral and facial manifestations such as enlarging ring or shoe size, macroglossia, or frontal bossing. Trigger phrases include “acral enlargement,” “facial…
This skill suggests initiating either a somatostatin receptor ligand (SRL) or pegvisomant as adjuvant medical therapy in patients with moderate-to-severe signs and symptoms of GH excess and no local mass effects following transsphenoidal surgery. Clinical…
This skill outlines monitoring of liver function tests (LFTs) during pegvisomant therapy for acromegaly. It recommends obtaining LFTs monthly for the first 6 months and then every 6 months, with consideration of discontinuing pegvisomant if transaminases…
This skill recommends performing an imaging study to assess tumor size, appearance, and parasellar extent once biochemical diagnosis of acromegaly is confirmed. Trigger when IGF-1 is elevated and GH fails to suppress to <0.4 µg/L during an oral glucose…
Measures serum IGF-1 and a random GH level at 12 weeks or later after transsphenoidal surgery for acromegaly to evaluate biochemical remission. Trigger phrases: “postoperative follow‑up at 12 weeks”, “assess remission after surgery”, “check IGF‑1 and random…
Recommends performing an imaging study at least 12 weeks after transsphenoidal surgery for acromegaly to visualize residual tumor and adjacent structures, with MRI as the preferred modality. Use this skill when assessing surgical outcomes once adequate…
Suggests measuring a nadir GH level after an oral glucose load in patients with a postoperative random GH greater than 1 µg/L. Use to further evaluate GH suppression when baseline GH is elevated postoperatively.
This skill suggests preoperative somatostatin receptor ligand (SRL) therapy to reduce anesthetic risk in acromegaly patients with severe pharyngeal thickness, obstructive sleep apnea, or high-output heart failure. It is triggered when assessing preoperative…