How do I install the Endo Comorbidities Evaluation skill?

Run npx skillmds@latest add dromlakhani/endo-comorbidities-evaluation in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Endo Comorbidities Evaluation safe to use?

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Which AI agents work with Endo Comorbidities Evaluation?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Endo Comorbidities Evaluation free to use?

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Who published Endo Comorbidities Evaluation?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Endo Comorbidities Evaluation by dromlakhani

Name: Endo Comorbidities Evaluation
Rating: 4.666666666666667 (3 reviews)
Author: dromlakhani

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 endocrine workup.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Evaluate comorbidities in all acromegaly patients

STEP 1 — Gather Information

Confirm acromegaly diagnosis (elevated IGF-1 with lack of GH suppression after glucose load). Collect history: blood pressure, diabetic symptoms, cardiovascular symptoms (chest pain, dyspnea), joint pain/stiffness, snoring, daytime somnolence. Perform exam: BP, BMI, joint inspection, neck circumference. Order labs: fasting glucose/HbA1c, lipid panel, basic metabolic panel.

STEP 2 — Rule In / Rule Out

Is acromegaly biochemically confirmed?

Yes → Proceed to comorbidity evaluation.
No → Consider alternative diagnoses; do not apply this comorbidity pathway.

STEP 3 — Classify or Stratify

Screen results for each comorbidity:

Hypertension: BP ≥130/80 mmHg or on treatment.
Diabetes: HbA1c ≥6.5% or fasting glucose ≥126 mg/dL.
Cardiovascular disease: history of MI, stroke, or abnormal stress test/echo.
Osteoarthritis: joint pain with crepitus or radiographic changes.
Sleep apnea: STOP-BANG ≥3 or witnessed apneas; refer for polysomnography.

STEP 4 — Decide

For each identified comorbidity, initiate guideline-directed management:

Hypertension: start ACEi/ARB, lifestyle.
Diabetes: metformin ± other agents.
CVD: cardiology referral, aspirin/statin as indicated.
Osteoarthritis: acetaminophen/NSAID, PT, weight loss.
Sleep apnea: CPAP titration after sleep study.

Clinical Guardrails / Mimics / Pitfalls

Do not attribute all symptoms to acromegaly without evaluating comorbidities separately. Manage each comorbidity per disease-specific guidelines; do not delay definitive acromegaly therapy while completing screening. Avoid assuming normal labs exclude disease in early stages.

Concrete Clinical Example

A 48-year-old with newly diagnosed acromegaly (IGF-1 450 ng/mL, no GH suppression) presents for initial workup. Screening shows BP 152/94 mmHg, HbA1c 7.1%, triglycerides 210 mg/dL, bilateral knee crepitus, and spouse-reported snoring with apneas. Diagnoses: hypertension, type 2 diabetes, hyperlipidemia, osteoarthritis, probable OSA. Treatment: lisinopril, metformin, atorvastatin, NSAID PRN, and sleep study with CPAP if OSA confirmed.

Source: Acromegaly: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2014, DOI:10.1210/jc.2014-2700

---name: endo-comorbidities-evaluationdescription: 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 endocrine workup.---# Evaluate comorbidities in all acromegaly patients## STEP 1 — Gather InformationConfirm acromegaly diagnosis (elevated IGF-1 with lack of GH suppression after glucose load). Collect history: blood pressure, diabetic symptoms, cardiovascular symptoms (chest pain, dyspnea), joint pain/stiffness, snoring, daytime somnolence. Perform exam: BP, BMI, joint inspection, neck circumference. Order labs: fasting glucose/HbA1c, lipid panel, basic metabolic panel.## STEP 2 — Rule In / Rule OutIs acromegaly biochemically confirmed? - Yes → Proceed to comorbidity evaluation. - No → Consider alternative diagnoses; do not apply this comorbidity pathway.## STEP 3 — Classify or StratifyScreen results for each comorbidity: - Hypertension: BP ≥130/80 mmHg or on treatment. - Diabetes: HbA1c ≥6.5% or fasting glucose ≥126 mg/dL. - Cardiovascular disease: history of MI, stroke, or abnormal stress test/echo. - Osteoarthritis: joint pain with crepitus or radiographic changes. - Sleep apnea: STOP-BANG ≥3 or witnessed apneas; refer for polysomnography.## STEP 4 — DecideFor each identified comorbidity, initiate guideline-directed management: - Hypertension: start ACEi/ARB, lifestyle. - Diabetes: metformin ± other agents. - CVD: cardiology referral, aspirin/statin as indicated. - Osteoarthritis: acetaminophen/NSAID, PT, weight loss. - Sleep apnea: CPAP titration after sleep study.## Clinical Guardrails / Mimics / PitfallsDo not attribute all symptoms to acromegaly without evaluating comorbidities separately. Manage each comorbidity per disease-specific guidelines; do not delay definitive acromegaly therapy while completing screening. Avoid assuming normal labs exclude disease in early stages.## Concrete Clinical ExampleA 48-year-old with newly diagnosed acromegaly (IGF-1 450 ng/mL, no GH suppression) presents for initial workup. Screening shows BP 152/94 mmHg, HbA1c 7.1%, triglycerides 210 mg/dL, bilateral knee crepitus, and spouse-reported snoring with apneas. Diagnoses: hypertension, type 2 diabetes, hyperlipidemia, osteoarthritis, probable OSA. Treatment: lisinopril, metformin, atorvastatin, NSAID PRN, and sleep study with CPAP if OSA confirmed.**Source:** Acromegaly: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2014, DOI:10.1210/jc.2014-2700

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