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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.
This skill indicates the need for periodic prolactin monitoring in transgender females undergoing estrogen therapy. Clinical triggers include a transgender female patient receiving estrogen treatment.
This skill guides clinicians to inform and counsel individuals seeking gender-affirming medical treatment about fertility preservation options before initiating puberty suppression in adolescents or before starting hormonal therapy in adolescents and adults.…
In women who have started estrogen replacement, suggests evaluating AED levels and adjusting AED doses as required. Triggers include: woman on estrogen replacement requiring AED management.
This skill guides the workup of females with oligomenorrhea or amenorrhea to evaluate for central hypogonadism by measuring serum estradiol, FSH, and LH while excluding pregnancy, hyperprolactinemia, hyperandrogenism, and thyroid disease. Use when evaluating…
This skill guides ordering initial labs (serum testosterone, FSH, and LH) to evaluate suspected central hypogonadism in adult males. Use when a male presents with low libido, fatigue, decreased energy, or other signs suggestive of gonadal deficiency.
Recommends performing hormonal testing for central hypogonadism in males in the absence of acute/subacute illness, before 10 AM after an overnight fast, combined with serum prolactin measurement. Use when scheduling hormonal tests for male hypogonadism;…
Recommends testosterone replacement for adult males with central hypogonadism and no contraindications to prevent anemia related to T deficiency; reduce fat mass; and improve BMD, libido, sexual function, energy levels, sense of well-being, and muscle mass…
Recommends gonadal hormone treatment for premenopausal women with central hypogonadism when no contraindications exist. Triggered when evaluating hormonal replacement in a premenopausal woman with oligomenorrhea or amenorrhea suggestive of central…
Recommends against diagnosing androgen deficiency syndrome in healthy women because there is no well-defined syndrome and no data linking androgen levels to specific signs or symptoms. Triggered when a clinician considers diagnosing androgen deficiency in a…
Recommends against routine use of dehydroepiandrosterone in women because indications are inadequate and evidence of efficacy and long-term safety is lacking. Triggers include a clinician considering DHEA supplementation for general well‑being, adrenal…
This skill recommends against using bisphosphonates, denosumab, testosterone, or leptin to improve bone mineral density in adolescents and women with functional hypothalamic amenorrhea (FHA) due to insufficient evidence and potential risks. Use when a…
This skill recommends against using kisspeptin or leptin to treat infertility in patients with functional hypothalamic amenorrhea (FHA) except within research or closely monitored trials due to limited evidence. Use when a clinician states, “Let’s not…
This skill advises against prescribing oral contraceptive pills solely to induce menstruation or enhance bone mineral density in patients with functional hypothalamic amenorrhea (FHA). Use when a clinician considers, 'Should I give her OCPs to get her period…
This skill advises obtaining a baseline bone mineral density (BMD) measurement by dual‑energy X‑ray absorptiometry (DXA) for any adolescent or woman with six or more months of amenorrhea, and earlier when severe nutritional deficiency, other energy deficit…
This skill recommends obtaining a baseline BMD measurement by DXA in adolescents or women with functional hypothalamic amenorrhea (FHA) and concurrent polycystic ovary syndrome (PCOS) who have six or more months of amenorrhea, and earlier if there is history…
This skill recommends obtaining a brain MRI with pituitary slices and contrast in adolescents or women with presumed functional hypothalamic amenorrhea (FHA) who have severe/persistent headaches, non-self-induced vomiting, changes in vision/thirst/urination,…
This skill recommends increasing caloric intake, improving nutrition, and/or decreasing exercise activity to restore energy balance and reactivate the hypothalamic–pituitary–ovarian axis in functional hypothalamic amenorrhea. It is triggered when a clinician…
This skill guides clinicians to confirm that anatomic or organic causes of amenorrhea have been ruled out before labeling the condition as functional hypothalamic amenorrhea. Triggers include statements such as “We need to exclude organic causes first” or…
This skill directs clinicians to initiate a diagnostic workup for functional hypothalamic amenorrhea (FHA) when menstrual cycles persistently exceed 45 days or amenorrhea lasts three months or longer. Trigger phrases include 'cycle longer than 45 days' or…
This skill involves educating patients with functional hypothalamic amenorrhea who use oral contraceptive pills for contraception that the pills may conceal the return of spontaneous menses and that bone loss can persist if an energy deficit remains. Use when…
This skill guides clinicians to obtain an initial endocrine laboratory evaluation for functional hypothalamic amenorrhea, measuring serum TSH, free T4, prolactin, LH, FSH, estradiol, and AMH, with addition of total testosterone and DHEA-S if hyperandrogenism…
This skill suggests considering a trial of cognitive behavioral therapy (CBT) to restore ovulation and fertility in women with functional hypothalamic amenorrhea (FHA) who desire pregnancy, based on a small study showing efficacy with minimal harm. Clinicians…
This skill suggests a trial of clomiphene citrate for ovulation induction in women with functional hypothalamic amenorrhea (FHA) who have an adequate endogenous estrogen level, as determined by baseline estradiol measurement. Use when a clinician asks, 'Her…
This skill advises exercising caution when using gonadotropin therapy (FSH/LH) for ovulation induction in patients with functional hypothalamic amenorrhea (FHA), particularly monitoring for ovarian hyperresponse and multiple gestations. It is triggered when a…
This skill recommends initiating fertility treatment with pulsatile GnRH as the first-line approach to induce ovulation in women with functional hypothalamic amenorrhea (FHA) who desire pregnancy, followed by gonadotropin therapy if GnRH is unavailable. Use…
This skill advises close monitoring for an exaggerated ovarian response when using exogenous gonadotropins for ovulation induction in patients with functional hypothalamic amenorrhea (FHA) who also have underlying polycystic ovary syndrome (PCOS). Use when a…
This skill guides clinicians to assess patients with functional hypothalamic amenorrhea (FHA) for hospital admission when they exhibit severe bradycardia, hypotension, orthostasis, or significant electrolyte abnormalities. Use when a clinician says, “Her…
This skill guides clinicians to evaluate congenital or acquired Müllerian tract anomalies in patients with primary amenorrhea using physical exam, progestin challenge test, and imaging. Trigger phrases include 'Rule out imperforate hymen with exam' or…
This skill states that ovulation induction should be pursued only in women with functional hypothalamic amenorrhea (FHA) who have a body mass index (BMI) of at least 18.5 kg/m² and only after attempts to correct the underlying energy deficit. Use when a…
This skill involves informing patients that irregular menses during recovery from functional hypothalamic amenorrhea do not require immediate evaluation and that menstrual irregularity does not prevent conception. It is used when a clinician says, 'Let’s…
This skill guides clinicians to obtain a detailed personal and family history focusing on diet, eating disorders, exercise, weight, sleep, stressors, mood, menstrual pattern, fractures, substance abuse, and familial endocrine/reproductive disorders when…
This skill directs clinicians to conduct a thorough physical exam, including external and selected bimanual gynecologic exam, to identify signs of anatomic or organic causes of amenorrhea. Use when clinicians state, 'Let’s check for thyroid enlargement,…
This skill involves administering a progestin challenge (e.g., medroxyprogesterone acetate 5–10 mg daily for 5–10 days) to induce withdrawal bleeding, which indicates adequate estrogen exposure and evaluates outflow tract integrity. Use when a clinician…
This skill suggests offering psychological support, particularly cognitive behavioral therapy, to address stress and maladaptive coping mechanisms in patients with functional hypothalamic amenorrhea. Trigger phrases include “Recommend CBT for anxiety and…
This skill suggests that short-term recombinant parathyroid hormone 1-34 (rPTH) may be considered in rare adult functional hypothalamic amenorrhea (FHA) cases with delayed fracture healing and markedly reduced bone mineral density. Use when a clinician notes,…
This skill recommends obtaining initial screening laboratory tests for functional hypothalamic amenorrhea (FHA) to rule out pregnancy and systemic illness. Use when a clinician states, 'Let’s get basic labs to rule out pregnancy and systemic illness,' or…
This skill recommends a short course of transdermal estradiol combined with cyclic oral progestin (not oral contraceptives) for adolescents and women with functional hypothalamic amenorrhea who have not resumed menses after a reasonable trial of nutritional,…
This skill guides clinicians to add an antiandrogen after six months of monotherapy with an oral contraceptive when patient‑important hirsutism shows an inadequate response. Trigger phrases include “patient‑important hirsutism”, “6 months of OC monotherapy”,…
Suggests adding electrolysis or laser/photoepilation after pharmacologic therapy when the patient desires additional cosmetic improvement beyond medication alone. Triggered by clinician statements such as "She’s improved on the pill but wants smoother skin;…
Add eflornithine 13.9% cream to photoepilation for faster hirsutism reduction in women with patient-important hirsutism who desire a quicker cosmetic response. Trigger when the patient reports inadequate speed of hair reduction after initiating laser or…