菜单
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.
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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).
基于 SOC 职业分类
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| name | ata-male-hypogonadism-labs |
| description | 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. |
Collect history of hypogonadism symptoms (low libido, erectile dysfunction, fatigue, decreased muscle mass, reduced beard growth). Ensure no acute/subacute illness and obtain sample before 10 AM after overnight fast. Review medications that suppress testosterone (glucocorticoids, opiates, ketoconazole, etc.) and assess for other pituitary hormone deficiencies.
Measure morning total testosterone, FSH, and LH. If testosterone is low and FSH/LH are low or inappropriately normal (not elevated), central hypogonadism is suggested; if testosterone is low with elevated FSH/LH, primary hypogonadism is likely and central hypogonadism is ruled out.
Classify as central hypogonadism when testosterone is below the laboratory reference range and FSH/LH are not elevated. Consider concomitant hyperprolactinemia (prolactinoma) or other pituitary deficits (TSH, cortisol, GH) to further characterize the hypopituitarism pattern.
If central hypogonadism is confirmed, evaluate for testosterone replacement contraindications (prostate cancer, elevated hematocrit, untreated sleep apnea) and initiate replacement if appropriate. Simultaneously assess for other pituitary hormone deficiencies and obtain pituitary MRI to identify structural lesions.
Do not diagnose central hypogonadism based on a random or non‑fasting testosterone sample; avoid testing during acute illness or steroid use. Do not start testosterone replacement without evaluating prostate safety (PSA, exam) and hematocrit. Do not overlook elevated prolactin as a cause of hypogonadotropic hypogonadism. Do not assume normal FSH/LH excludes central hypogonadism if testosterone is low.
A 45‑year‑old man reports 3 months of decreased libido and fatigue. Morning total testosterone is 200 ng/dL (low), FSH 2 mIU/mL (low‑normal), LH 1.5 mIU/mL (low‑normal). No acute illness. Results indicate central hypogonadism; proceed to evaluate for other pituitary deficits and order pituitary MRI.
Source: Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI:10.1210/jc.2016-2118