All Skills

Determines when adrenal venous sampling may be skipped in primary aldosteronism. Applies to patients <35 years with spontaneous hypokalemia, marked aldosterone excess, and unilateral adrenal lesions suggestive of cortical adenoma on CT.

Interprets the aldosterone-to-renin ratio using active renin concentration (ARC) to screen for primary aldosteronism. Triggered when a clinician has PAC and ARC results and asks 'How do I interpret this ARR using active renin concentration?'

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 overweight patient?' or 'Should I initiate lifestyle changes for a patient with BMI 26?'.

Recommends low-dose GH replacement in patients with cured acromegaly and documented GHD in the absence of known contraindications. Triggers include managing a cured acromegaly patient with documented growth hormone deficiency.

Manages suspected mild central hypothyroidism in patients with pituitary disease and low-normal free thyroxine (fT4). Initiates levothyroxine (L-T4) when suggestive symptoms are present or when serial fT4 shows a decrease of 20% or more.

Decide when and how to assess minimal residual disease (MRD) in multiple myeloma — bone marrow MRD by next-generation flow (NGF) or sequencing (NGS), plus imaging MRD by PET-CT — and how to act on the result. Trigger when a clinician asks "how to assess MRD in myeloma", "MRD-negative complete response", "PET-CT for MRD", "is bone marrow MRD enough", "when to test for MRD", "next-generation flow for myeloma", or "myeloma sustained MRD negativity". Based on EHA-ESMO 2021.

Classifies a patient's dizziness into one of four categories — vestibular/vertigo, presyncope, disequilibrium, or nonspecific — using history, timing, triggers, and associated symptoms. Use when a patient presents with dizziness, giddiness, lightheadedness, feeling off-balance, spinning, or nearly blacking out and you need to determine the type before further workup.

Diagnose monogenic and syndromic obesity in children and adolescents using a structured step-by-step algorithm. Use this skill whenever a clinician suspects a genetic cause of obesity, asks about leptin deficiency, MC4R mutation, POMC deficiency, PCSK1 deficiency, leptin receptor deficiency, Bardet-Biedl syndrome, Prader-Willi syndrome, Alström syndrome, or any case of early-onset severe obesity with hyperphagia. Also trigger for questions about targeted pharmacotherapy including setmelanotide or metreleptin, or when to order a genomic obesity panel. Cross-references the NHS Genomic Test Finder skill to surface the relevant R-code once a diagnosis is reached.

Initiates a 6‑month trial of DHEA replacement in women with primary adrenal insufficiency (PAI) who have persistent low libido, depressive symptoms, or low energy despite otherwise optimized glucocorticoid and mineralocorticoid therapy. If the patient does not report a sustained beneficial effect after 6 months, discontinue DHEA.

Administer Hydrocortisone Stress Dosing During Active Phase of Labor

In patients with primary aldosteronism receiving mineralocorticoid receptor antagonist therapy, the guideline recommends titrating the MRA dose upward to raise renin when blood pressure remains uncontrolled and renin is suppressed. Consider this step when hypertension is not at goal despite MRA therapy and plasma renin activity (or direct renin concentration) is low.

Assess pharmacotherapy eligibility based on BMI/comorbidity

Evaluates central hypothyroidism (CH) patients for adrenal insufficiency (AI) prior to initiating levothyroxine (L‑T4) replacement. Triggers include consideration of L‑T4 start in central hypothyroidism needing thyroid replacement.

Manage diabetes insipidus with desmopressin

Suggests testing HPA axis functionality before and after starting GH replacement in patients not receiving glucocorticoid replacement with apparently normal pituitary-adrenal function. Triggers include initiating GH replacement in a GHD patient who is not on glucocorticoids and has normal adrenal function.

Recommends confirmatory testing with corticotropin stimulation test in patients presenting with clinical symptoms or signs suggesting PAI (e.g., fatigue, hypotension, hyponatremia, hyperpigmentation) when the patient's condition permits safe testing. Use when a clinician identifies suggestive features and circumstances allow outpatient stimulation testing without imminent need for emergency glucocorticoids.

Selects spironolactone as first-line mineralocorticoid receptor antagonist for bilateral primary aldosteronism, with eplerenone as an alternative when spironolactone–related adverse effects are problematic. Trigger phrases include 'confirmed bilateral PA on AVS', 'idiopathic adrenal hyperplasia', 'bilateral adrenal hyperplasia', 'glucocorticoid-remediable aldosteronism', and 'initiating medical therapy for bilateral adrenal disease'.

Determines whether to recommend adrenalectomy or mineralocorticoid receptor antagonists for primary aldosteronism based on PA subtype and patient/surgical factors. Triggered after subtype confirmation when clinicians ask “Should this patient have surgery or medical treatment?” or discuss treatment options with the patient.

This skill recommends obtaining a baseline BMD measurement by DXA in adolescents or women with functional hypothalamic amenorrhea (FHA) and concurrent polycystic ovary syndrome (PCOS) who have six or more months of amenorrhea, and earlier if there is history or suspicion of severe nutritional deficiency, other energy deficit states, or skeletal fragility. Use when a clinician states, “She has PCOS and no periods for seven months—let’s get a DXA,” or similar triggers such as “Check BMD in PCOS+FHA after six months amenorrhea” or “Order DXA sooner due to low weight.”

Suggests oral contraceptives over injectable contraceptives for women with BMI ≥27 kg/m2 with comorbidities or BMI ≥30 kg/m2 seeking contraception, provided they are well‑informed and oral contraceptives are not contraindicated. Triggers include clinician questions such as “Which contraceptive method is less likely to cause weight gain in this obese patient?” or “Should I recommend oral pills instead of depot injection for this patient with BMI 29 and hypertension?”.

This skill recommends monitoring desmopressin (DDAVP) doses and adjusting them as needed in patients who have recently started antiepileptic drugs (AEDs). It is triggered when a patient initiates AED therapy and requires DDAVP management for diabetes insipidus.

Recommends against performing dynamic GnRH stimulation testing in the evaluation of hypogonadism, as it provides no additional diagnostic information beyond baseline gonadotropins and sex steroids. Consider this recommendation when evaluating hypogonadism and contemplating GnRH testing.

This skill identifies adult childhood cancer survivors with isolated growth hormone deficiency and prior hypothalamic‑pituitary axis radiation exposure who require retesting to confirm persistence of GHD. Triggers include clinician questions such as “Should I retest for GHD in this adult survivor with childhood GHD and radiation history?” or “Is repeat GHD evaluation indicated in this patient?”

Decide whether a newly-diagnosed multiple myeloma (NDMM) patient is eligible for high-dose melphalan + autologous stem cell transplantation (ASCT) as part of front-line therapy, using the EHA-ESMO 2021 criteria. Trigger when a clinician asks "is this myeloma patient fit for transplant", "ASCT eligibility for myeloma", "transplant-eligible NDMM", "should I refer for stem cell transplant", "high-dose melphalan candidate", or any decision about whether a newly-diagnosed myeloma patient should go to upfront ASCT.

BPPV Differential Diagnosis Checker

Dizziness Red Flag Screener

Determines age- and body weight-appropriate glucocorticoid dosage for pediatric patients with primary aldosteronism, particularly glucocorticoid-remediable aldosteronism (GRA), to avoid over-treatment. Use when prescribing glucocorticoids to children with confirmed or suspected PA; triggers include pediatric PA, GRA, or need to dose glucocorticoid based on age and weight.

Determines whether to recommend unilateral laparoscopic adrenalectomy or medical therapy with a mineralocorticoid receptor antagonist for patients with confirmed unilateral PA (aldosterone-producing adenoma or unilateral adrenal hyperplasia). Triggered when discussing treatment options after confirming unilateral PA in a hypertensive patient with hypokalemia or resistant hypertension.

Recommends ACTH stimulation during AVS to improve success rate of bilateral selective catheterization, acknowledging unclear impact on diagnostic accuracy for laterality. Triggers include when setting up AVS and asking 'Should I administer ACTH?' or considering procedural optimization.

Comprehensive toolkit for protein language models including ESM3 (generative multimodal protein design across sequence, structure, and function) and ESM C (efficient protein embeddings and representations). Use this skill when working with protein sequences, structures, or function prediction; designing novel proteins; generating protein embeddings; performing inverse folding; or conducting protein engineering tasks. Supports both local model usage and cloud-based Forge API for scalable inference.

Google Workspace CLI for Gmail, Calendar, Drive, Contacts, Sheets, and Docs.

Material-UI v7 component library patterns including sx prop styling, theme integration, responsive design, and MUI-specific hooks. Use when working with MUI components, styling with sx prop, theme customization, or MUI utilities.

Optimize for search engine visibility and ranking. Use when asked to "improve SEO", "optimize for search", "fix meta tags", "add structured data", "sitemap optimization", or "search engine optimization".

This skill should be used for time series machine learning tasks including classification, regression, clustering, forecasting, anomaly detection, segmentation, and similarity search. Use when working with temporal data, sequential patterns, or time-indexed observations requiring specialized algorithms beyond standard ML approaches. Particularly suited for univariate and multivariate time series analysis with scikit-learn compatible APIs.

Quantum computing framework for building, simulating, optimizing, and executing quantum circuits. Use this skill when working with quantum algorithms, quantum circuit design, quantum simulation (noiseless or noisy), running on quantum hardware (Google, IonQ, AQT, Pasqal), circuit optimization and compilation, noise modeling and characterization, or quantum experiments and benchmarking (VQE, QAOA, QPE, randomized benchmarking).

Comprehensive document creation, editing, and analysis with support for tracked changes, comments, formatting preservation, and text extraction. When Claude needs to work with professional documents (.docx files) for: (1) Creating new documents, (2) Modifying or editing content, (3) Working with tracked changes, (4) Adding comments, or any other document tasks