菜单
Recommends treating central hypothyroidism before performing GH stimulation testing because CH may impair accurate diagnosis of GHD. Use when preparing for GH stimulation testing; triggers include patient requiring GH stimulation test with possible CH.
默认使用会先检查来源的 Prompt；你也可以切换为直接命令，或下载本地副本。
决定是否安装前，请先阅读 SKILL.md，以及 SkillsMP 当前展示的配套文件。
用 Codex 或 Claude 帮你安装 复制这段 Prompt，粘贴到 Codex、Claude 或其他助手里，让它检查 Skill 页面并帮你完成安装。
直接命令不会经过审查 Prompt；运行前请先检查来源。
npx skills add https://github.com/dromlakhani/MD2SKILL --skill ata-ch-before-gh-stim命令会保持在同一行。复制前请横向滚动并检查完整内容。
想先保存到本地？可下载 SkillsMP 当前能够提供的文件。
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
正在显示 SKILL.md
| name | ata-ch-before-gh-stim |
| description | Recommends treating central hypothyroidism before performing GH stimulation testing because CH may impair accurate diagnosis of GHD. Use when preparing for GH stimulation testing; triggers include patient requiring GH stimulation test with possible CH. |
Order serum free T4 (fT4) and TSH; assess for hypothyroid symptoms (fatigue, cold intolerance, weight gain, dry skin); confirm pituitary disease context (known pituitary lesion, surgery, radiation, or other hormone deficiencies).
If fT4 is below the laboratory reference range with a low, normal, or mildly elevated TSH in the setting of pituitary disease, rule in central hypothyroidism (CH); otherwise rule out CH.
If CH is ruled in, proceed to treatment; if CH is ruled out, proceed directly to GH stimulation testing.
If CH present, initiate levothyroxine (L-T4) replacement at ~1.6 µg/kg/d, adjust dose to maintain fT4 in the mid‑upper reference range, monitor fT4 every 6–8 weeks, and perform GH stimulation testing once euthyroid; if CH absent, proceed directly to GH stimulation testing.
Do not rely on TSH alone to diagnose or monitor CH; do not start GH stimulation testing without evaluating for CH; do not use L-T3, thyroid extracts, or other thyroid hormone formulations for CH; do not adjust L-T4 dosing based on TSH levels in CH; avoid overtreatment that may suppress TSH excessively and precipitate adrenal insufficiency if glucocorticoids are deficient.
A 50‑year‑old man with a non‑functioning pituitary adenoma undergoes evaluation for suspected GHD. Prior to GH stimulation testing, fT4 is 0.8 ng/dl (low) and TSH is 4.2 µIU/ml (mildly elevated). He is diagnosed with CH, started on L-T4 100 µg daily, and after 8 weeks fT4 rises to 1.2 ng/dl (mid‑reference). GH stimulation testing is then performed, showing a peak GH of 3.1 µg/L, confirming GHD.
Source: Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI: 10.1210/jc.2016-2118