How do I install the Endo Fha Inpatient Evaluation Criteria skill?

Run npx skillmds@latest add dromlakhani/endo-fha-inpatient-evaluation-criteria 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 Fha Inpatient Evaluation Criteria safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: docs only. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Endo Fha Inpatient Evaluation Criteria?

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 Fha Inpatient Evaluation Criteria free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Endo Fha Inpatient Evaluation Criteria?

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

Endo Fha Inpatient Evaluation Criteria by dromlakhani

Name: Endo Fha Inpatient Evaluation Criteria
Rating: 4.2 (5 reviews)
Author: dromlakhani

Endo Fha Inpatient Evaluation Criteria

This skill guides clinicians to assess patients with functional hypothalamic amenorrhea (FHA) for hospital admission when they exhibit severe bradycardia, hypotension, orthostasis, or significant electrolyte abnormalities. Use when a clinician says, “Her heart rate is 40 and she’s dizzy—should we admit her?” or notes phrases like “Admit for hypotension and bradycardia” or “Check for orthostatic vitals and electrolytes.”

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Evaluate for inpatient treatment based on vital signs and electrolyte instability

STEP 1 — Gather Information

Collect heart rate, blood pressure (supine and standing after 3 minutes), respiratory rate, temperature, weight, and symptoms (dizziness, syncope, fatigue). Obtain basic metabolic panel (sodium, potassium, chloride, bicarbonate, BUN, creatinine) and consider magnesium, phosphate if refeeding risk.

STEP 2 — Rule In / Rule Out

Rule in inpatient evaluation if any of the following are present: heart rate <50 beats/min, systolic blood pressure <90 mmHg, orthostatic systolic drop ≥20 mmHg or diastolic drop ≥10 mmHg, or heart rate increase ≥30 bpm upon standing; or electrolyte abnormality such as potassium <3.0 mmol/L, sodium <130 mmol/L, or glucose <60 mg/dL. Otherwise, rule out need for immediate admission based on vitals/labs.

STEP 3 — Classify or Stratify

Classify as high risk for inpatient admission if any severe vital sign or electrolyte criterion from Step 2 is met; classify as low risk if vitals are stable and electrolytes are within normal limits.

STEP 4 — Decide

For high‑risk patients, admit to a monitored inpatient setting for cardiac telemetry, electrolyte repletion, and initiation of a structured refeeding plan under dietitian supervision. For low‑risk patients, arrange outpatient multidisciplinary follow‑up (nutrition, psychotherapy, endocrinology) with close safety net instructions.

Clinical Guardrails / Mimics / Pitfalls

Do not attribute bradycardia solely to athletic training without excluding FHA; hypotension may mimic sepsis or dehydration—check volume status and consider infection. Orthostatic vitals can be falsely normal if measured too early; ensure 3‑minute standing. Avoid missing refeeding syndrome by checking phosphate and magnesium before starting nutrition. Do not delay admission for isolated mild electrolyte changes if symptomatic.

Concrete Clinical Example

An 18‑year‑old woman with known FHA presents with HR 42 bpm, supine BP 88/52 mmHg, standing BP 70/48 mmHg after 3 min (orthostatic drop 18/4), and serum potassium 2.8 mmol/L. She reports light‑headedness. Meeting bradycardia, hypotension, orthostasis, and hypokalemia criteria, she is admitted for telemetry, potassium replacement, and supervised refeeding.

Source: Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline, Gordon et al., 2017, doi:10.1210/jc.2017-00131

---name: endo-fha-inpatient-evaluation-criteriadescription: This skill guides clinicians to assess patients with functional hypothalamic amenorrhea (FHA) for hospital admission when they exhibit severe bradycardia, hypotension, orthostasis, or significant electrolyte abnormalities. Use when a clinician says, “Her heart rate is 40 and she’s dizzy—should we admit her?” or notes phrases like “Admit for hypotension and bradycardia” or “Check for orthostatic vitals and electrolytes.”---# Evaluate for inpatient treatment based on vital signs and electrolyte instability## STEP 1 — Gather InformationCollect heart rate, blood pressure (supine and standing after 3 minutes), respiratory rate, temperature, weight, and symptoms (dizziness, syncope, fatigue). Obtain basic metabolic panel (sodium, potassium, chloride, bicarbonate, BUN, creatinine) and consider magnesium, phosphate if refeeding risk.## STEP 2 — Rule In / Rule Out**Rule in** inpatient evaluation if any of the following are present: heart rate <50 beats/min, systolic blood pressure <90 mmHg, orthostatic systolic drop ≥20 mmHg or diastolic drop ≥10 mmHg, or heart rate increase ≥30 bpm upon standing; or electrolyte abnormality such as potassium <3.0 mmol/L, sodium <130 mmol/L, or glucose <60 mg/dL. Otherwise, **rule out** need for immediate admission based on vitals/labs.## STEP 3 — Classify or StratifyClassify as **high risk** for inpatient admission if any severe vital sign or electrolyte criterion from Step 2 is met; classify as **low risk** if vitals are stable and electrolytes are within normal limits.## STEP 4 — DecideFor high‑risk patients, admit to a monitored inpatient setting for cardiac telemetry, electrolyte repletion, and initiation of a structured refeeding plan under dietitian supervision. For low‑risk patients, arrange outpatient multidisciplinary follow‑up (nutrition, psychotherapy, endocrinology) with close safety net instructions.## Clinical Guardrails / Mimics / PitfallsDo not attribute bradycardia solely to athletic training without excluding FHA; hypotension may mimic sepsis or dehydration—check volume status and consider infection. Orthostatic vitals can be falsely normal if measured too early; ensure 3‑minute standing. Avoid missing refeeding syndrome by checking phosphate and magnesium before starting nutrition. Do not delay admission for isolated mild electrolyte changes if symptomatic.## Concrete Clinical ExampleAn 18‑year‑old woman with known FHA presents with HR 42 bpm, supine BP 88/52 mmHg, standing BP 70/48 mmHg after 3 min (orthostatic drop 18/4), and serum potassium 2.8 mmol/L. She reports light‑headedness. Meeting bradycardia, hypotension, orthostasis, and hypokalemia criteria, she is admitted for telemetry, potassium replacement, and supervised refeeding.**Source:** Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline, Gordon et al., 2017, doi:10.1210/jc.2017-00131

Frequently asked questions