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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.
Recommends transsphenoidal surgery as the primary therapeutic option for most patients with biochemically confirmed acromegaly. Consider this recommendation when evaluating a newly diagnosed patient with elevated IGF-1 and/or clinical features suggestive of…
Suggests considering repeat surgery in patients with residual intrasellar disease after initial surgical resection. Consider when postoperative imaging demonstrates persistent intrasellar tumor.
Suggests radiation therapy for residual tumor mass after surgery when medical therapy is unavailable, unsuccessful, or not tolerated. Trigger phrases include "residual tumor mass following surgery", "medical therapy unavailable", "medical therapy…
The skill advises maintaining the same GH and IGF-1 assay throughout a patient's management to ensure comparable serial measurements. Trigger when ordering serial hormone tests for acromegaly monitoring, such as before and after therapy changes or during…
This skill suggests serial MRI imaging to assess tumor size in patients receiving pegvisomant therapy for acromegaly. Use when initiating pegvisomant or during follow‑up to monitor for tumor growth.
Recommends serial visual field testing during pregnancy for patients with acromegaly who harbor a macroadenoma to monitor for neurologic deterioration. Trigger when a pregnant acromegaly patient has a known pituitary macroadenoma.
Recommends initiating a somatostatin receptor ligand (SRL) as primary medical therapy for acromegaly when curative surgery is not possible. Consider this approach in patients with extensive cavernous sinus invasion, absence of chiasmal compression, or those…
Recommends stereotactic radiotherapy (SRT) over conventional radiotherapy for acromegaly when adjuvant radiation is indicated after surgery or failed medical therapy, unless SRT is unavailable, there is significant residual tumor burden, or the tumor’s…
This skill suggests surgical debulking for parasellar disease when total resection is unlikely due to extensive extrasellar extension seen on imaging, aiming to improve subsequent response to medical therapy. Trigger phrases include parasellar disease,…
Suggests a biochemical treatment goal of age-normalized serum IGF-1 value to indicate disease control in acromegaly. Use when setting therapeutic targets after initiating medical therapy or surgery, e.g., post-op IGF-1 at 12 weeks or random GH >1 µg/L.
Suggests using a random GH level <1.0 µg/L as a therapeutic goal to assess biochemical control of acromegaly during follow‑up after surgery or medical therapy. Use when evaluating post‑treatment response, particularly when random GH is measured alongside…
Suggests a trial of a dopamine agonist, usually cabergoline, as initial adjuvant therapy in patients with only modest IGF-1 elevations and mild GH excess symptoms after surgery. Use when postoperative IGF-1 is mildly elevated and symptoms of GH excess are…
Recommend performing abdominal ultrasound when a patient on somatostatin receptor ligand (SRL) therapy develops signs or symptoms suggestive of gallstone disease. Trigger phrases include biliary colic, postprandial right upper quadrant pain, Murphy's sign, or…
Recommends utilizing short-acting octreotide subcutaneous injections for disease control while awaiting conception after discontinuing long-acting somatostatin receptor ligands or pegvisomant. Trigger phrases include “preconception window,” “discontinuing…
Suggests performing formal visual field testing when imaging reveals tumor abutting the optic chiasm to evaluate for visual pathway compression. Trigger phrases include MRI or CT showing tumor-chiasm contact.
This skill determines the appropriate screening and dynamic testing procedures (e.g., insulin tolerance test, standard or high-dose ACTH stimulation) for diagnosing adrenocorticotropic hormone deficiency in childhood cancer survivors, recommending the same…
This skill outlines the essential patient education points for childhood cancer survivors with adrenocorticotropic hormone deficiency (ACTHD), covering stress‑dose glucocorticoid instructions, emergency injectable glucocorticoid administration, and the need…
This skill determines whether screening for adrenocorticotropic hormone deficiency (ACTHD) is indicated in childhood cancer survivors with hypothalamic‑pituitary axis radiation exposure between 24‑30 Gy. Screening is recommended when the survivor is >10 years…
This skill identifies childhood cancer survivors who require lifelong annual screening for adrenocorticotropic hormone deficiency (ACTHD) based on hypothalamic-pituitary tumor history or radiation exposure ≥30 Gy. It is triggered by clinician questions such…
This skill identifies the appropriate glucocorticoid replacement regimen for childhood cancer survivors with adrenocorticotropic hormone deficiency (ACTHD), recommending hydrocortisone dosing and stress coverage strategies identical to those used in the…
This skill determines if formal diagnostic testing for growth hormone deficiency is required in childhood cancer survivors who already have three or more confirmed anterior pituitary hormone deficiencies, as retesting may not change management. Triggers…
This skill determines whether to use growth hormone-releasing hormone (GHRH) alone or with arginine for diagnosing growth hormone deficiency (GHD) after hypothalamic-pituitary axis radiation exposure. It addresses clinician questions such as "Is the…
This skill determines whether serum insulin-like growth factor-1 (IGF-I) levels alone can be used to diagnose growth hormone deficiency (GHD) in childhood cancer survivors exposed to hypothalamic-pituitary axis radiotherapy. Triggers include questions such as…
This skill guides selection of an appropriate provocative test for growth hormone deficiency (GHD) diagnosis in childhood cancer survivors when clinicians ask, "What test should I use to diagnose GHD in this survivor?" or "Which provocative test is…
This skill identifies adult childhood cancer survivors with isolated growth hormone deficiency and prior hypothalamic‑pituitary axis radiation exposure who require retesting to confirm persistence of GHD. Triggers include clinician questions such as “Should I…
This skill identifies childhood cancer survivors who require lifelong periodic assessment for growth hormone deficiency based on hypothalamic-pituitary tumor history or cranial/spinal radiation exposure ≥18 Gy. It is triggered by questions such as "Does this…
This skill determines whether spontaneous growth hormone secretion sampling (e.g., 12-hour overnight) is appropriate for diagnosing growth hormone deficiency in childhood cancer survivors. It is triggered by clinician questions such as "Can I use overnight GH…
This skill determines the appropriate diagnostic strategy for luteinizing hormone/follicle-stimulating hormone deficiency (LH/FSHD) in childhood cancer survivors, recommending the use of the same diagnostic methods (e.g., GnRH stimulation test) as in the…
This skill identifies childhood cancer survivors who require screening for luteinizing hormone/follicle-stimulating hormone deficiency based on hypothalamic-pituitary axis radiation exposure ≥30 Gy or history of tumors/surgery affecting the HP region.…
This skill identifies the appropriate treatment approach for luteinizing hormone/follicle-stimulating hormone deficiency (LH/FSHD) in childhood cancer survivors. It is triggered by clinician questions such as "How should I treat LH/FSHD in this survivor?" or…
This skill determines the appropriate biochemical tests (e.g., free T4, TSH) for screening thyroid-stimulating hormone deficiency (TSHD) in childhood cancer survivors. It recommends using the same assays and reference ranges as in the noncancer population…
This skill determines whether serum triiodothyronine, thyroid-stimulating hormone surge analysis, or thyrotropin-releasing hormone stimulation should be used to diagnose thyroid-stimulating hormone deficiency in childhood cancer survivors. Triggers include:…
This skill identifies childhood cancer survivors who require lifelong annual screening for thyroid-stimulating hormone deficiency (TSHD) based on hypothalamic-pituitary tumor history or radiation exposure ≥30 Gy. It is triggered by clinician questions such as…
This skill determines the appropriate treatment approach for thyroid-stimulating hormone deficiency (TSHD) in childhood cancer survivors. It recommends using the same levothyroxine dosing and monitoring strategies (e.g., target free T4 levels) as in the…
Recommends daily lower-dose vitamin D over intermittent high-dose dosing for adults aged 50 years and older who have indications for vitamin D supplementation. Trigger phrases include: "Should I prescribe daily or intermittent vitamin D for this patient?" and…
The guideline recommends against routine 25(OH)D screening and subsequent vitamin D treatment in adults with dark complexion who lack established indications for testing. Consider this recommendation when clinicians ask, "Should I screen for vitamin D…
Recommends against routine 25(OH)D screening and subsequent vitamin D treatment in healthy adults without established indications. Triggered by clinician questions such as "Should I screen for vitamin D deficiency in this healthy adult?" or "Is vitamin D…
This skill recommends against routine 25-hydroxyvitamin D [25(OH)D] screening and subsequent vitamin D supplementation in adults with obesity when no established indication exists. It is triggered by clinician questions such as “Should I screen for vitamin D…
Recommends against routine vitamin D supplementation beyond the Dietary Reference Intake in adults aged 50-74 years without established indications for vitamin D treatment. Triggers include clinician questions such as "Should I prescribe vitamin D to this…
Recommends against empiric vitamin D supplementation beyond the Dietary Reference Intake in adults younger than 50 years. Triggered by questions such as "Should I prescribe vitamin D to this young adult?" or "Is vitamin D supplementation needed for patients…