All Skills

Prompt for generating an AGENTS.md file for a repository

Convert Markdown files to HTML similar to `marked.js`, `pandoc`, `gomarkdown/markdown`, or similar tools; or writing custom script to convert markdown to html and/or working on web template systems like `jekyll/jekyll`, `gohugoio/hugo`, or similar web templating systems that utilize markdown documents, converting them to html. Use when asked to "convert markdown to html", "transform md to html", "render markdown", "generate html from markdown", or when working with .md files and/or web a templating system that converts markdown to HTML output. Supports CLI and Node.js workflows with GFM, CommonMark, and standard Markdown flavors.

Generate a language translation for a mkdocs documentation stack.

Diátaxis Documentation Expert. An expert technical writer specializing in creating high-quality software documentation, guided by the principles and structure of the Diátaxis technical documentation authoring framework.

Update a markdown file section with an index/table of files from a specified folder.

Complete bedside prescribing reference for Mirago (mirabegron, beta-3 adrenoceptor agonist) for overactive bladder — covering contraindications, safety screening, drug interactions, dose selection in special populations, titration, and administration. Use when a clinician asks how to start mirabegron, what dose to use in renal or hepatic impairment, is mirabegron safe in this patient, mirabegron drug interactions, or Mirago for OAB.

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 choosing an AED or what information to provide on weight effects of specific agents such as valproate versus lamotrigine.

Determines when to pursue genetic testing for glucocorticoid-remediable aldosteronism (FH-I/GRA) in patients with confirmed primary aldosteronism (PA). Indicated when PA onset is before age 20 or there is a family history of PA or stroke before age 40.

Determines when to test for germline KCNJ5 mutations indicating familial hyperaldosteronism type III in very young patients with primary aldosteronism. Triggered by severe early-onset hypertension with hypokalemia in infants or young children (<20 years) with confirmed PA.

We need to output a SKILL.md file with the specified format.

Determines whether to add a mineralocorticoid receptor antagonist (e.g., spironolactone or eplerenone) to glucocorticoid therapy in glucocorticoid-remediable aldosteronism when blood pressure fails to normalize with glucocorticoid alone. Triggered by persistent hypertension or inadequate BP control despite optimized glucocorticoid dosing in GRA patients.

This skill guides perioperative levothyroxine management for adults with preoperative central hypothyroidism undergoing non-emergency surgery. Trigger phrases include "preoperative central hypothyroidism patient requiring non-emergency surgery" and "use when managing preoperative CH patient".

Uses BMI-specific cutoffs to interpret peak GH values during stimulation testing. Use when interpreting GH stimulation test results; triggers include GH stimulation test requiring BMI-adjusted interpretation.

Calculates the initial growth hormone (GH) replacement dose based on patient age for adults with proven growth hormone deficiency (GHD). Triggers include initiating GH replacement in patients with proven GHD requiring GH replacement.

Clinicians educate adrenal insufficiency patients taking nondexamethasone glucocorticoids who initiate enzyme-inducing antiepileptic drugs about early signs of adrenal insufficiency. Trigger when an AI patient on nondexamethasone GC starts an enzyme-inducing AED such as phenytoin, carbamazepine, or oxcarbazepine.

Determines unilateral vs bilateral aldosterone excess based on cortisol-corrected aldosterone ratios from adrenal venous sampling, with ratio >4:1 indicating unilateral excess, ratio 3:1 suggestive of bilateral hypersecretion, and interpretation dependent on cosyntropin stimulation protocol used during sampling. Use when analyzing AVS results to guide surgical vs medical treatment decisions; triggers include 'AVS lateralization ratio', 'cosyntropin-stimulated AVS', 'aldosterone-to-cortisol ratio >4:1', and 'ratio 3:1 suggestive of bilateral disease'.

Evaluates likelihood of primary aldosteronism by measuring plasma aldosterone suppression after oral captopril; normal suppression ≥30% makes PA unlikely, while lack of suppression with persistently suppressed plasma renin activity suggests PA. Use when assessing captopril challenge test (CCT) results for PA diagnosis in patients with positive aldosterone-to-renin ratio.

Guides choice among spironolactone, eplerenone, and esaxerenone for primary aldosteronism based on comparative efficacy, safety, and patient-specific factors. Triggers include when initiating MRA therapy and asking 'Which MRA should I prescribe?' or considering switching agents due to adverse effects, cost, or need for potassium supplementation.

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 obese patient with T2DM to avoid weight gain?' or 'Should I avoid β‑blockers in this patient with diabetes and hypertension?'

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 "What is the maximum liraglutide dose I can use?"

Recommends using mineralocorticoid receptor antagonists rather than epithelial sodium-channel inhibitors for medical treatment of primary aldosteronism. Use when a clinician asks whether to use an MRA or ENaC inhibitor for medical treatment of PA.

Determines whether to perform adrenal venous sampling (AVS) to lateralize aldosterone excess in patients with confirmed primary aldosteronism (PA) who are being evaluated for surgical treatment. Indicated when surgery is feasible and desired by the patient, or when subtype workup is planned for a surgical candidate, especially in those younger than 35 years with spontaneous hypokalemia, marked aldosterone excess, and unilateral adrenal lesions on CT.

Determines when adrenal venous sampling (AVS) is indicated for functional subtyping of primary aldosteronism (PA) when surgical treatment is feasible and desired by the patient. Triggered when a clinician confirms PA diagnosis and asks 'Do I need AVS for subtyping?' or evaluates surgical candidacy.

Recommends that all diabetes insipidus patients wear an emergency bracelet or necklace to alert clinicians to their condition if incapacitated. Use when establishing care for a diabetes insipidus patient; triggers include diabetes insipidus diagnosis.

Monitor free T4 and adjust levothyroxine after starting antiepileptic drugs in central hypothyroidism

Differentiates aldosterone-producing adenoma from idiopathic adrenal hyperplasia based on 18-hydroxycorticosterone levels, with APA patients generally having levels >100 ng/dL at 8:00 a.m. and IAH patients usually having levels <100 ng/dL. Use when reviewing 18-OHB test results to help subtype PA; triggers include 18-OHB >100 ng/dL (suggesting APA) or <100 ng/dL (suggesting IAH).

Advises against testosterone therapy in men with biochemical recurrence after prostate cancer treatment due to very limited data and potential risk of progression. Consider when a patient has a rising PSA after definitive therapy and the clinician evaluates testosterone for hypogonadism, questioning whether TTh is safe in BCR.

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 in choosing an antipsychotic with minimal weight gain?” or “What resources show weight‑change projections for risperidone vs aripiprazole?”.

Monitors euthyroid adults with growth hormone deficiency (GHD) who are initiating GH replacement therapy for the development of central hypothyroidism (CH). Initiates levothyroxine (L-T4) if free thyroxine (fT4) falls below the laboratory reference range; triggers include GHD patient starting GH replacement.

Calculates the lowest effective glucocorticoid dose (dexamethasone or prednisone) to normalize blood pressure and serum potassium in glucocorticoid-remediable aldosteronism (GRA/FH-I) by titrating to biochemical and clinical targets. Indicated when initiating medical treatment for confirmed GRA, triggered by findings such as early-onset hypertension, family history of stroke before age 40, spontaneous hypokalemia, or suppressed plasma renin activity with elevated aldosterone.

Recommends mineralocorticoid receptor antagonists for all primary aldosteronism patients to prevent target organ damage, irrespective of blood pressure control or serum potassium levels. Triggered when a clinician encounters a PA patient with well‑controlled BP and normal K and wonders, 'Do I still need to treat with MRA?' or considers stopping therapy.

Perform digital rectal examination (DRE) in all men before initiating testosterone therapy to exclude prostate abnormalities or support suspicion of hypogonadism when prostate volume is reduced. Triggered when a clinician considers starting testosterone and questions whether a prostate exam is needed first or whether to check the prostate before prescribing TTh.

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 patient?' or 'Should I avoid sulfonylureas in this patient with T2DM and obesity due to weight gain risk?'

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.

This skill recommends performing an imaging study to assess tumor size, appearance, and parasellar extent once biochemical diagnosis of acromegaly is confirmed. Trigger when IGF-1 is elevated and GH fails to suppress to <0.4 µg/L during an oral glucose tolerance test.

Bedside prescribing reference for Bemdec (bempedoic acid / NEXLETOL) — indication check, dose, statin co-prescribing safety caps, monitoring plan, warnings for hyperuricemia and tendon rupture, and special population guidance. Use when a clinician asks "can I start bempedoic acid", "Bemdec indication", "is bempedoic acid safe with my statin", "patient on Nexletol has joint pain or high uric acid", "bempedoic acid in CKD or liver disease or pregnancy", or any prescribing or monitoring question about bempedoic acid.