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This skill guides individualized prostate cancer screening for transgender females receiving estrogen therapy based on personal risk. Trigger phrase: transgender female receiving estrogens.
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npx skills add https://github.com/dromlakhani/MD2SKILL --skill es-follow-prostate-screening-trans-female-on-estrogensコマンドは1行のまま表示されます。コピー前に横へスクロールして全体を確認してください。
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For a person with confirmed islet autoantibodies (early-stage type 1 diabetes), state the numerical progression risk to Stage 3 T1D by stage and age, set the age-stratified monitoring frequency (metabolic and HbA1c), apply the ≥10% longitudinal HbA1c rise → OGTT rule, and give the standard risk-modifier and communication framing. Use when a clinician asks how often should I monitor this Stage 1 child, what's the risk of this teenager progressing to insulin, adult with GAD positive what's the 5-year risk, my patient's HbA1c has risen 12% is that important, single autoantibody how often to retest, or how to counsel a family about progression risk. Grounded in Phillip et al. Diabetologia 2024 international staging and monitoring consensus, cross-referenced with Hussain et al 2026 IDF Europe roadmap.
Order and confirm islet autoantibody screening for early-stage type 1 diabetes — which antibodies to test (GAD65, IAA, IA2, ZnT8), sample types (capillary dried blood spot, venous), the mandatory two-sample two-method confirmation protocol, and how to interpret a positive, negative, or single-antibody result. Use when a clinician asks how to screen for early T1D, which islet autoantibodies to order, how to confirm a positive T1D antibody screen, is one autoantibody enough for T1D diagnosis, GAD antibody positive what next, or is running a general population or family-history T1D screening program. Grounded in Hussain et al 2026 (Diabetes, Obesity and Metabolism, IDF Europe consensus, DOI 10.1111/dom.70569).
Classify a person with a positive islet autoantibody screen into a specific stage of type 1 diabetes (At Risk / Stage 1 / Stage 2a / Stage 2b / Stage 3a / Stage 3b / Stage 4) using the international consensus staging framework based on autoantibody count and glycaemic status. Use when a clinician asks how to stage a positive autoantibody screen, what stage of T1D is this, is this early-stage T1D, does this child need insulin yet, is this presymptomatic T1D, does this qualify for teplizumab, or presents a person with any combination of islet autoantibodies + glucose data. Applies across paediatric and adult populations. Grounded in Hussain et al 2026 (Diabetes, Obesity and Metabolism, IDF Europe consensus, DOI 10.1111/dom.70569).
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SKILL.md を表示中
| name | es-follow-prostate-screening-trans-female-on-estrogens |
| description | This skill guides individualized prostate cancer screening for transgender females receiving estrogen therapy based on personal risk. Trigger phrase: transgender female receiving estrogens. |
Collect demographic data (age, race/ethnicity), personal and family history of prostate cancer (especially first‑degree relatives), known genetic risk factors (BRCA1/2, HOXB13), and confirm current estrogen therapy regimen and duration.
Determine if the patient is a transgender female receiving estrogen therapy; if not, this skill does not apply, otherwise proceed to risk assessment.
Stratify personal risk into average (no first‑degree relative with prostate cancer before age 65, no known genetic mutation) versus increased (first‑degree relative diagnosed <65 years, multiple relatives, or known pathogenic mutation).
For average risk, engage in shared decision‑making about initiating PSA screening at age 50 per general population guidelines; for increased risk, consider earlier initiation (age 40‑45) and discuss frequency based on individualized risk.
A 55‑year‑old transgender female on oral estradiol 4 mg daily for 10 years reports her father was diagnosed with prostate cancer at age 62; she is classified as increased risk and opts to begin PSA screening at age 45 with repeat testing every 2 years after discussion of risks and benefits.
Source: Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons, Endocrine Society, 2017, DOI:10.1210/jc.2017-01658