dromlakhani/MD2SKILL - 第 11 页

es-preop-bg-only-target

If achieving preoperative HbA1c <8% is not feasible, target preoperative blood glucose concentrations of 100 to 180 mg/dL instead. Trigger phrase: "Cannot meet HbA1c goal, what glucose target should we use preoperatively?"

原文语言：英语

es-preop-bg-timing

The clinician verifies that blood glucose concentrations are within the targeted range of 100 to 180 mg/dL during the 1 to 4 hours preceding surgery. A common trigger is the question, "Is the patient's BG in target range shortly before surgery?"

原文语言：英语

es-preop-hba1c-factors

Consider factors that may affect hemoglobin A1c when interpreting preoperative levels for adults with diabetes undergoing elective surgery. Triggered by questions such as "Are there conditions that might make HbA1c unreliable for this patient?" when anemia,…

原文语言：英语

es-preop-target-hba1c-bg

For adult patients with diabetes undergoing elective surgical procedures, aim for preoperative hemoglobin A1c below 8% and blood glucose concentrations between 100 to 180 mg/dL. Triggered by questions such as "What preoperative glycemic targets should we set…

原文语言：英语

es-rapid-acting-analog-vs-regular-insulin-bolus

This skill suggests using rapid-acting insulin analogs instead of regular human insulin for prandial bolus dosing in basal-bolus therapy for patients at high risk of hypoglycemia. It is triggered by clinician questions such as "Should I use rapid-acting…

原文语言：英语

es-scheduled-insulin-preferred

In most adult patients with hyperglycemia (with or without known type 2 diabetes) hospitalized for noncritical illness, scheduled insulin therapy is preferred over noninsulin agents for glycemic management. Clinicians should consider this when they ask,…

原文语言：英语

es-structured-education-vs-unstructured-advice-insulin-treated

Recommends structured diabetes education with follow-up over unstructured advice for insulin-treated type 1 or type 2 diabetes outpatients at high risk for hypoglycemia. Trigger phrases include "Should I provide structured diabetes education or unstructured…

原文语言：英语

ata-gc-overreplacement-osteoporosis

Individually assesses glucocorticoid replacement to avoid over-replacement and reduce osteoporosis risk by suggesting low-dose hydrocortisone to increase bone formation and promote positive bone-remodeling balance. Triggered when managing patients on…

原文语言：英语

ata-lt4-overreplacement-fracture

Monitors levothyroxine (L-T4) replacement in hypopituitarism to prevent over-replacement and associated fracture risk. Triggered when managing L-T4 therapy, especially when levothyroxine dose adjustment is needed to avoid overdose.

原文语言：英语

gc-overreplacement-fracture-risk

Recommends vertebral fracture assessment (baseline spinal x-ray or DXA) to identify unsuspected vertebral fractures in men over-replaced with glucocorticoids and at fracture risk. Use when evaluating a male hypopituitarism patient on glucocorticoids with…

原文语言：英语

endo-ace-arb-ccb-htn

Recommends ACE inhibitors, ARBs, or calcium channel blockers as first-line hypertension therapy rather than β‑adrenergic blockers in obese patients with type 2 diabetes. Triggers include when a clinician asks, 'What antihypertensive should I start for this…

原文语言：英语

endo-antidiabetic-weightloss

Recommends adding a glucose‑lowering agent that promotes weight loss (GLP‑1 agonist or SGLT‑2 inhibitor) to metformin for overweight or obese patients with type 2 diabetes. Triggered when a clinician asks which drug to add to metformin for weight loss in an…

原文语言：英语

endo-avoid-offlabel-weightloss

Advises against using medications approved for other indications solely for weight loss, except in research contexts or by providers with weight‑management expertise managing well‑informed patients. Common triggers include questions such as 'Is it appropriate…

原文语言：英语

endo-avoid-sympathomimetic-cvd

Recommends using non‑sympathomimetic agents (lorcaserin, orlistat) for pharmacological weight loss in patients with cardiovascular disease. Triggers include clinician questions such as “What weight‑loss medication is safest for this patient with coronary…

原文语言：英语

endo-avoid-sympathomimetic-htn

Recommends against using sympathomimetic agents (phentermine, diethylpropion) in patients with uncontrolled hypertension or a history of heart disease. Triggers include clinician questions such as “Is it safe to prescribe phentermine for this patient with…

原文语言：英语

endo-bariatric-eligibility

Determines if a patient is a candidate for bariatric surgery using BMI thresholds: BMI ≥35 kg/m2 with comorbidity or BMI ≥40 kg/m2 regardless of comorbidities. Triggers include when a clinician asks, 'Is this patient eligible for bariatric surgery given their…

原文语言：英语

endo-comorbidities-evaluation

The skill evaluates all patients with acromegaly for hypertension, diabetes mellitus, cardiovascular disease, osteoarthritis, and sleep apnea at initial assessment. It is triggered by a new diagnosis of acromegaly or when a patient presents for baseline…

原文语言：英语

endo-comorbidities-longitudinal-monitoring

This skill recommends longitudinal monitoring and rigorous management of identified comorbidities—such as hypertension, diabetes mellitus, cardiovascular disease, osteoarthritis, and sleep apnea—in patients with acromegaly. Apply throughout follow‑up when…

原文语言：英语

endo-dose-escalation

Guides dose escalation for obesity pharmacotherapy based on efficacy and tolerability while staying within approved upper dose limits. Triggers include clinician questions like "How should I titrate naltrexone/bupropion if the starting dose is tolerated?" or…

原文语言：英语

endo-efficacy-5pct

This skill guides clinicians to assess whether a patient has achieved ≥5% weight loss at 3 months while on a weight‑loss medication and to determine continuation versus discontinuation based on efficacy and safety. It is triggered when a clinician asks, 'Has…

原文语言：英语

endo-followup-assessment

Advises assessing efficacy and safety at least monthly for the first 3 months, then at least every 3 months for all patients prescribed weight‑loss medications. Triggers include clinician questions such as “How often should I check progress after starting…

原文语言：英语

endo-less-sedating-antihistamine

Recommends selecting antihistamines with reduced central nervous system activity (less sedation) to minimize weight‑gain risk. Triggers include clinician questions such as “Which antihistamine is least likely to cause weight gain for this patient with…

原文语言：英语

endo-lifestyle-mod-bmi25

Recommends that diet, exercise, and behavioral modification be included in all obesity management approaches for patients with a BMI of 25 kg/m2 or higher. Triggered when clinicians ask, 'What foundational non-pharmacologic therapy should I start for this…

原文语言：英语

endo-monitor-weight-waist-art

Recommends regular monitoring of weight and waist circumference in patients receiving antiretroviral therapy due to unavoidable weight gain, redistribution, and associated cardiovascular risk. Triggered when a clinician asks, 'How often should I check weight…

原文语言：英语

endo-pharmaco-eligibility

Determines if a patient is a candidate for pharmacotherapy based on BMI thresholds: BMI ≥27 kg/m2 with at least one obesity-related comorbidity or BMI ≥30 kg/m2 regardless of comorbidities. Triggered when a clinician asks, “Does this patient qualify for…

原文语言：英语

endo-prefer-nsaid-dmard

Recommends using NSAIDs or DMARDs instead of glucocorticoids for chronic inflammatory disease (e.g., rheumatoid arthritis) to limit weight gain. Triggered when clinicians ask, “What anti‑inflammatory should I choose for this RA patient to avoid weight gain?”…

原文语言：英语

endo-sdm-aed

This skill guides clinicians in sharing decision‑making when selecting an antiepileptic drug (AED) by providing quantitative estimates of each drug’s expected weight effect. It is triggered when a clinician asks how to discuss weight‑change risks when…

原文语言：英语

endo-sdm-antidepressant

Recommends a shared decision‑making process that provides patients with quantitative estimates of the expected weight effect of antidepressants to inform drug choice, also considering expected treatment length. Triggers include clinician questions such as…

原文语言：英语

endo-sdm-antipsychotic

Recommends using weight‑neutral antipsychotic alternatives when possible and employing shared decision‑making that provides quantitative estimates of expected weight effect to guide drug choice. Triggered when a clinician asks, “How do I involve this patient…

原文语言：英语

endo-weightloss-maint

This skill suggests using approved weight‑loss medication over no pharmacological therapy to ameliorate comorbidities and improve physical activity in adults with BMI ≥30 kg/m² or BMI ≥27 kg/m² with at least one comorbid condition. It is triggered when a…

原文语言：英语

endo-weightneutral-t2dm

Recommends weight‑losing and weight‑neutral medications as first‑ and second‑line agents for managing overweight/obese patients with type 2 diabetes. Triggers include when a clinician asks, 'Which diabetes medications will not worsen weight in this obese…

原文语言：英语

eso-pediatric-obesity-alt-interpretation

Interprets ALT levels to screen for NAFLD in pediatric patients with obesity. Triggered when evaluating overweight/obese youth (BMI ≥85th percentile) and considering liver enzyme testing.

原文语言：英语

eso-pediatric-obesity-bariatric-surgery-contraindication

Assesses contraindications for bariatric surgery in adolescents, recommending against the procedure in pre‑adolescent children, pregnant or breast‑feeding teens, and those who have not mastered healthy dietary and activity habits or have unresolved substance…

原文语言：英语

eso-pediatric-obesity-bariatric-surgery-eligibility

Assesses eligibility for bariatric surgery in adolescents with obesity. Trigger phrases include Tanner 4-5 pubertal development, BMI ≥40 kg/m2 or BMI ≥35 kg/m2 with significant comorbidities, failed lifestyle modification, and need for psychological stability.

原文语言：英语

eso-pediatric-obesity-bmi-classification

Determines if a child ≥2 years is overweight, obese, or extremely obese using BMI percentile and extreme obesity thresholds. Triggers include BMI ≥85th percentile (overweight), ≥95th percentile (obese), or ≥120% of the 95th percentile or ≥35 kg/m2 (extremely…

原文语言：英语

eso-pediatric-obesity-bmi-monitoring

The skill calculates, plots, and reviews a child's BMI percentile at least once per year during well-child or sick-child visits. It triggers when a pediatric patient presents for routine health supervision or acute care, prompting BMI assessment and…

原文语言：英语

eso-pediatric-obesity-bp-interpretation

This skill interprets blood pressure using age-, sex-, and height-specific percentile norms to screen for prehypertension and hypertension in pediatric patients. Trigger phrases include BP ≥90th to <95th percentile = prehypertension and BP ≥95th percentile =…

原文语言：英语

eso-pediatric-obesity-comorbidity-trigger

This skill recommends evaluating children and adolescents with a BMI at or above the 85th percentile for age and sex for potential obesity-related comorbidities. Clinical triggers include overweight or obese classification by BMI percentile.

原文语言：英语

eso-pediatric-obesity-endocrine-lab-trigger

Recommends against routine laboratory evaluation for endocrine etiologies of pediatric obesity unless the patient exhibits attenuated stature or decreased height velocity relative to genetic/familial potential and pubertal stage. Clinical trigger phrases…

原文语言：英语

eso-pediatric-obesity-fasting-glucose-interpretation

Interprets fasting plasma glucose to screen for prediabetes and diabetes in children and adolescents with BMI ≥85th percentile (overweight/obese). Trigger phrases include 'overweight or obese', 'BMI ≥85th percentile', 'screening for comorbidities', and…

原文语言：英语