Menu
Skills in this repository
SkillsMP has collected 858 skills from dromlakhani/MD2SKILL. Open a skill to review its source and details.
dromlakhani/MD2SKILLShowing 40 of 858 collected skills.
This skill interprets SDHx and fumarate hydratase gene variants to assess metastasis risk in pheochromocytoma and paraganglioma patients. Triggered by identification of SDHB pathogenic variant (or negative SDHB immunostaining), FH variant, or other SDHx…
Indicates and performs genetic testing for pheochromocytoma and paraganglioma when a clinician questions whether to order testing for a PPGL patient, using triggers such as any PPGL diagnosis, family history of PPGL, young age at onset (<50 years), bilateral…
This skill selects a treatment algorithm for pheochromocytoma and paraganglioma based on identified germline pathogenic variants, enabling personalized management per syndrome-specific guidelines. It is triggered when a clinician identifies RET, VHL, NF1, or…
Manages gastrointestinal symptoms from catecholamine excess in pheochromocytoma and paraganglioma, addressing constipation, paralytic ileus, megacolon, or intestinal pseudo-obstruction/perforation. Triggered by clinician queries about treating GI symptoms in…
This skill confirms pheochromocytoma and paraganglioma (PPGL) diagnosis on histopathology by requiring immunostaining positive for Chromogranin A and negative for cytokeratin in tumor tissue, with SDHB negativity indicating SDHx pathogenic variants that…
Applies histopathological scoring systems (GAPP, COPPS, PASS) to estimate metastasis risk in pheochromocytoma and paraganglioma. Used when a clinician asks 'What is the metastasis risk based on this pheochromocytoma pathology report?' and triggered by…
Administers intravenous phentolamine followed by infusion, then transitions to oral doxazosin after the acute phase resolves, while avoiding β-blockers before α-blockade. Indicated for severe hypertension (>180/110 mmHg) with headache, palpitations, or…
Selects the initial imaging modality (CT, MRI, 123I-MIBG scintigraphy, or 18F-FDG PET) for suspected pheochromocytoma and paraganglioma based on clinical question (tumor localization vs metastasis detection) and patient factors. Triggered by biochemical…
Initiates and adjusts medical treatment for functional pheochromocytoma and paraganglioma. Starts with selective α-blocker for catecholamine excess hypertension or symptoms, adds calcium antagonists or metyrosine if BP control insufficient, and adds…
Assesses metastasis risk in pheochromocytoma and paraganglioma using age at diagnosis, tumor size, catecholamine secretion pattern, timing of metastatic lesion diagnosis, tumor localization, disease type, histopathological findings, SDHB gene pathogenic…
Coordinates multidisciplinary treatment with palliative care unit for pain management while avoiding medications that risk inducing hypertensive crisis (e.g., metoclopramide, certain antidepressants) in PPGL patients. Triggered by reports of pain in PPGL…
Manages perioperative volume for pheochromocytoma and paraganglioma by initiating a normal salt diet (9 g/day) on day 3 of α‑blocker therapy, titrating intake to blood pressure and orthostatic changes, and administering 1–2 L saline pre‑operatively. Triggered…
Determines that α-blockers are generally unnecessary when catecholamine overproduction is unclear in suspected pheochromocytoma or paraganglioma, but requires comprehensive assessment of clinical findings before prescribing α-blockers before surgery. Use when…
The skill selects 131I-MIBG therapy for pheochromocytoma or paraganglioma with positive 123I-MIBG scintigraphy that reduces excess catecholamines, or 177Lu-DOTATATE therapy for lesions with positive somatostatin receptor scintigraphy, both modalities covered…
Chooses the initial screening test for suspected pheochromocytoma and paraganglioma when evaluating hypertension with paroxysmal symptoms, adrenal incidentaloma, or family history of PPGL. Selects among random urinary fractionated metanephrines (creatinine…
Selects surgical approach for pheochromocytoma and paraganglioma resection based on tumor size, invasion suspicion, metastatic status, and familial bilateral risk when a clinician asks 'What surgical approach should I use for this pheochromocytoma patient?'…
This skill determines postoperative surveillance intensity for pheochromocytoma and paraganglioma based on hereditary status, catecholamine phenotype, tumor size, and location. Use when a clinician asks 'How long and how often should I follow up this…
The skill recommends administering potassium iodide (50–150 mg/day) or Lugol's solution (5–10 drops/day) for three days prior to and continuing through the day of 123I-MIBG scintigraphy to reduce thyroid radiation exposure and prevent medullary thyroid cancer…
Manage pheochromocytoma and paraganglioma in pregnancy by preferring ultrasound or MRI for imaging (avoiding CT/123I-MIBG unless benefits outweigh radiation risks), using selective α-blockers as first-line medical therapy (adding calcium antagonists if needed…
Determines when to use 123I-MIBG scintigraphy for PPGL diagnosis and whether thyroid blockade is required. Triggers include: need functional imaging to confirm PPGL origin, evaluating for metastatic PPGL or PGL, preparing for 131I-MIBG therapy requires…
This skill identifies when 18F-FDG PET is indicated for detecting metastatic pheochromocytoma/paraganglioma (PPGL), especially in patients with known SDHx pathogenic variants or negative 123I-MIBG scintigraphy. Clinical triggers include suspected metastatic…
Determines when to use 68Ga-DOTATATE PET for diagnosing primary head and neck paragangliomas irrespective of genetic variants. Triggers include suspected head/neck PGL requiring sensitive detection, evaluating for SSTR-positive neuroendocrine tumor, and…
Determines when to add calcium antagonists or metyrosine to an alpha-blocker regimen for inadequate blood pressure control in pheochromocytoma and paraganglioma (PPGL). Indications include blood pressure uncontrolled on maximal alpha-blocker dose, significant…
Titrates preoperative alpha-blocker dose based on blood pressure response to achieve target hemodynamics (<130/80 mmHg sitting). Increases dose (e.g., doxazosin) every 2‑3 days until target BP is reached, monitoring for orthostatic hypotension and adjusting…
Determines the appropriate age to initiate surveillance for asymptomatic genetic carriers of PPGL pathogenic variants. Indicated for a child of a PPGL patient with a known pathogenic variant, identification of an at‑risk relative for PPGL genetic screening,…
Establishes surveillance frequency for asymptomatic genetic carriers of PPGL pathogenic variants after an initial negative genetic screen. It guides clinicians in determining long-term monitoring plans and follow-up schedules for PPGL mutation carriers,…
Determines the appropriate timing for initiating beta-blocker therapy in patients with pheochromocytoma/paraganglioma (PPGL) to prevent hypertensive crisis. Indicated for tachycardia/tachyarrhythmia, myocardial damage, heart failure, or ischemic heart disease…
Applies specific cutoff values to interpret biochemical test results for PPGL diagnosis. Uses >3x upper limit of normal for screening tests (random urinary fractionated metanephrines corrected for creatinine, blood fractionated catecholamines, plasma-free…
Selects between external radiation therapy and surgical intervention for bone metastases in PPGL based on lesion characteristics and patient factors. Triggers include: PPGL patient with confirmed bone metastasis, assessing local treatment options for osseous…
Determines when to use bone-modifying agents (e.g., zoledronic acid, denosumab) for skeletal-related event prevention in PPGL bone metastases. Considers BMA as an option for preventing pathological fractures, spinal cord compression, and hypercalcemia, using…
Selects the appropriate functional confirmation test after a positive PPGL screening test to establish biochemical diagnosis. Triggered by statements such as 'Screening test positive for PPGL,' 'Need to confirm PPGL diagnosis before imaging,' or 'Biochemical…
Applies the COPPS score to predict metastasis risk in PPGL by integrating tumor size, necrosis, vascular invasion, and SDHB/S100 immunostaining. Triggered when a PPGL pathology specimen is available for scoring, when calculating metastatic risk index from…
Applies the GAPP score to assess metastasis risk in PPGL based on histopathological features. Triggers include: 'PPGL tumor requiring histopathological risk assessment,' 'Evaluating tumor grade for metastatic potential,' 'Determining follow-up intensity based…
Selects specific genes to test for PPGL based on clinical presentation and phenotypic characteristics. Indications include abdominal/PGL with metastasis risk (test SDHB), head/neck PGL (test SDHD), bilateral PCC or pancreatic lesions (test VHL), and…
Determines when to suggest genetic testing for PPGL and educates patients about hereditary PPGL prevalence and testing significance, recommending testing for all PPGL patients per international guidelines while informing about the 20-40% hereditary rate and…
Manages gastrointestinal symptoms (constipation, paralytic ileus, mega-colon) in pheochromocytoma and paraganglioma (PPGL) using intravenous phentolamine and oral metyrosine to improve intestinal peristalsis. Indicated for PPGL patients with severe…
Assesses specific clinical indications warranting surgical resection or radiation therapy for head and neck paraganglioma. Recommends intervention for tympanic PGL with hearing loss, jugular bulb PGL with pulsatile tinnitus, significant skull base…
Decides between surveillance therapy and active intervention for head and neck paraganglioma based on symptomology and tumor behavior. Prefers surveillance for asymptomatic, slow-growing tumors; advises surgical resection or radiation therapy for symptomatic,…
Executes the hypertensive crisis management algorithm for PPGL by administering intravenous phentolamine infusion followed by oral doxazosin, with addition of oral beta‑blocker for tachycardia after alpha‑blockade is established. It is triggered by clinical…
Selects the first-line imaging modality to localize a PPGL tumor after biochemical confirmation. Common triggers are 'Biochemical tests confirm PPGL, need to localize tumor,' 'Planning surgical approach requires anatomical localization,' and 'Positive…