Recommends mineralocorticoid receptor antagonists for all primary aldosteronism patients to prevent target organ damage, irrespective of blood pressure control or serum potassium levels. Triggered when a clinician encounters a PA patient with well‑controlled…
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dromlakhani/MD2SKILL - Page 16
SkillsMP has collected 858 skills from dromlakhani/MD2SKILL. Open a skill to review its source and details.
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Guides choice among spironolactone, eplerenone, and esaxerenone for primary aldosteronism based on comparative efficacy, safety, and patient-specific factors. Triggers include when initiating MRA therapy and asking 'Which MRA should I prescribe?' or…
Provides evidence-based guidelines for preoperative optimization and postoperative monitoring in patients with primary aldosteronism undergoing adrenalectomy. Triggers include when planning surgery or starting treatment and asking 'What perioperative care is…
Identifies safe antihypertensive options for hypertensive disorders in pregnancy applicable to PA patients, with gestational age restrictions. Triggers include when managing hypertension in a pregnant or pregnancy-planning PA patient and asking 'What BP meds…
Recommends potassium supplementation for hypokalemia management in PA patients who are pregnant or planning pregnancy. Triggered when a pregnant PA patient presents with low serum potassium and asks 'How should I treat hypokalemia?' or when electrolytes are…
Suggests considering mineralocorticoid receptor antagonists when benefits outweigh risks in pregnant or preconception PA patients with uncontrolled hypertension and hypokalemia. Triggered when standard therapy fails and clinicians ask 'Should I consider MRAs…
Interprets the aldosterone-to-renin ratio using active renin concentration (ARC) to screen for primary aldosteronism. Triggered when a clinician has PAC and ARC results and asks 'How do I interpret this ARR using active renin concentration?'
Determines if PAC/PRA ratio and PAC levels indicate positive or provisionally positive screening for primary aldosteronism. Triggered when a clinician has PAC and PRA results and asks “Is this screening test positive for PA?” or needs to interpret borderline…
Determines whether a hypertensive patient should be screened for primary aldosteronism based on clinical features associated with higher PA prevalence. Triggered when a clinician asks 'Should I screen this hypertensive patient for PA?' or observes spontaneous…
Recommends switching specific anti-hypertensive medications to reduce false-positive and false-negative screening results for primary aldosteronism. Triggered when a clinician notes 'The patient is on ACE inhibitors/ARBs' or suspects medication interference…
Recommends antihypertensive therapy including mineralocorticoid receptor antagonists (MRAs) for patients with a positive primary aldosteronism (PA) screening test who decline confirmatory testing. Triggers include when a patient has positive screening but…
Provides guidance on acceptable blood sampling conditions for primary aldosteronism screening when ideal early‑morning supine fasting conditions cannot be met. Triggers include when a clinician says “The patient wasn’t fasting/supine” or questions whether…
Determines whether to recommend adrenalectomy or mineralocorticoid receptor antagonists for primary aldosteronism based on PA subtype and patient/surgical factors. Triggered after subtype confirmation when clinicians ask “Should this patient have surgery or…
Guidance for clinicians managing pregnant individuals with preexisting diabetes mellitus (PDM) who are evaluating daily carbohydrate intake; consider a carbohydrate-restricted diet (<175 g/day) or usual diet (>175 g/day) based on patient factors. Trigger when…
This skill advises against using a single 24-hour CGM target <140 mg/dL when managing glucose in pregnancy for patients with preexisting diabetes. Trigger when a clinician is determining CGM-based glucose targets for pregnant individuals with type 1 or type 2…
Recommends contraception when pregnancy is not desired for individuals with diabetes who could become pregnant. Triggered by discussions about pregnancy planning, contraception needs, or when pregnancy is not desired.
Recommends early delivery based on individualized risk assessment rather than expectant management for pregnant patients with preexisting diabetes mellitus (PDM). Consider when evaluating delivery timing in the presence of diabetes‑related complications,…
Recommends discontinuation of GLP-1RA before conception rather than between start of pregnancy and end of first trimester for individuals with type 2 diabetes who are planning pregnancy. Trigger when clinician considers stopping GLP-1RA therapy in a patient…
Suggests either continuous glucose monitor (CGM) or self-monitoring of blood glucose (SMBG) for pregnant individuals with type 2 diabetes. Triggers include decisions about glucose monitoring methods for pregnant patients with T2DM needing a monitoring…
Recommends use of hybrid closed-loop pump rather than insulin pump with CGM (without algorithm) or multiple daily injections with CGM for pregnant individuals with type 1 diabetes. Triggered when deciding on insulin delivery methods for pregnant patients with…
Recommends against routine addition of metformin to insulin for pregnant individuals with type 2 diabetes already on insulin. Triggered when considering adding metformin to an insulin regimen in pregnancy for patients with type 2 diabetes.
Recommends postpartum endocrine care (diabetes management) in addition to usual obstetric care for individuals with preexisting diabetes (including those with pregnancy loss or termination). Triggered by postpartum care planning for patients with diabetes…
This skill screens for pregnancy intention in individuals with preexisting diabetes at every reproductive, diabetes, primary care, and urgent care/ER visit when clinically appropriate. Trigger phrases include reproductive planning, preconception care, or…
Recommends real-time CGM with confirmatory bedside POC-BG monitoring for insulin dosing adjustments rather than POC-BG testing alone in adults with insulin-treated diabetes at high risk of hypoglycemia. Consider this approach for patients aged ≥65 years, BMI…
Recommends using continuous glucose monitoring instead of fingerstick self-monitoring for type 1 diabetes patients on multiple daily injections to reduce hypoglycemia risk. Use when a clinician evaluates glucose monitoring options for T1D on MDIs or manages…
The skill suggests using real-time continuous glucose monitoring (CGM) combined with algorithm-driven insulin pumps (ADIPs) rather than multiple daily injections (MDIs) with self-monitoring of blood glucose (SMBG) three or more times daily for adults and…
Suggests real-time CGM over no CGM for outpatients with type 2 diabetes who use insulin and/or sulfonylureas and are at high risk for hypoglycemia to detect and prevent low glucose events. Consider when initiating CGM in T2D patients on insulin/SU with a…
Suggests testosterone therapy as symptomatically indicated for low testosterone levels, and not for improving dyslipidemia or cardiovascular disease risk. Trigger phrases include "Patient with low testosterone symptomatic", "Considering testosterone for…
Recommends either carbohydrate counting or fixed prandial insulin dosing for adults with type 1 diabetes or insulin‑treated type 2 diabetes hospitalized for noncritical illness who require prandial insulin. Triggered when a clinician asks about mealtime…
Recommends initiating correctional insulin alone for hospitalized adults without prior diabetes who develop hyperglycemia (blood glucose >140 mg/dL). If hyperglycemia persists (≥2 point‑of‑care glucose values ≥180 mg/dL within 24 hours while on correctional…
Recommends either a dipeptidyl peptidase-4 inhibitor with correction insulin or scheduled insulin therapy for select adult patients with mild hyperglycemia and type 2 diabetes hospitalized for noncritical illness. Consider when HbA1c <7.5%, blood glucose <180…
Recommends using glucagon preparations that do not require reconstitution (e.g., nasal, autoinjector) over those needing reconstitution for treating outpatient severe hypoglycemia to ensure prompt, correct dosing. Triggered when prescribing glucagon for type…
Suggests initial therapy with correctional insulin or scheduled insulin to maintain glucose targets 100–180 mg/dL for adults treated with diet or noninsulin medications before admission; add scheduled insulin if hyperglycemia persists (≥2 POC‑BG ≥180 mg/dL in…
This skill recommends providing inpatient diabetes education as part of a comprehensive discharge-planning process for adults with diabetes hospitalized for noncritical illness, rather than omitting education. Use when planning discharge for a diabetic…
Recommends implementing inpatient glycemic surveillance and management programs that leverage EHR data to identify and mitigate hypoglycemia risk versus standard care. Triggered by establishing hypoglycemia reduction programs, using EHR alerts for glucose…
Recommends long-acting insulin analogs over human NPH insulin for basal therapy in adults and children at high hypoglycemia risk to reduce nocturnal hypoglycemia. Consider when selecting basal insulin for patients with type 1 or type 2 diabetes who have a…
Recommends avoiding carbohydrate counting for prandial insulin dosing in adults with noninsulin‑treated type 2 diabetes who require mealtime insulin during noncritical illness hospitalization. Trigger phrases include “initiating prandial insulin in a diet‑ or…
Recommends avoiding carbohydrate‑containing oral fluids preoperatively in adults with type 1, type 2, or other diabetes undergoing elective surgery. Consider when a clinician questions preoperative fluids for a diabetic patient, especially if orders include…
Recommends neutral protamine Hagedorn–based or basal bolus insulin regimens for managing hyperglycemia in adults receiving enteral nutrition with diabetes-specific or nonspecific formulations during noncritical illness. Trigger phrases include hyperglycemia…
Suggests glycemic management with either NPH-based insulin or basal bolus insulin regimens for adults experiencing hyperglycemia while receiving glucocorticoids in noncritical illness. Triggers include hyperglycemia during glucocorticoid therapy such as…