How do I install the Endo Pa Lateralization Imaging skill?

Run npx skillmds@latest add dromlakhani/endo-pa-lateralization-imaging 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 Pa Lateralization Imaging safe to use?

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

Which AI agents work with Endo Pa Lateralization Imaging?

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 Pa Lateralization Imaging free to use?

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Who published Endo Pa Lateralization Imaging?

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

Endo Pa Lateralization Imaging by dromlakhani

Name: Endo Pa Lateralization Imaging
Rating: 4.666666666666667 (3 reviews)
Author: dromlakhani

Endo Pa Lateralization Imaging

Determines whether adrenal venous sampling (AVS) is needed in addition to CT for lateralizing primary aldosteronism before surgery. Trigger phrases include "patient with primary aldosteronism considering surgery", "unilateral adrenal adenoma on CT", "surgical candidate", and "age <35 with hypokalemia and >1‑cm adenoma".

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Determine need for adrenal venous sampling in addition to CT for PA lateralization

STEP 1 — Gather Information

Confirm primary aldosteronism diagnosis via elevated ARR, assess surgical candidacy and desire for adrenalectomy, review CT adrenal morphology (size, laterality), note patient age, presence of hypokalemia, and exclude familial hyperaldosteronism syndromes.

STEP 2 — Rule In / Rule Out

Is the patient a surgical candidate who desires adrenalectomy?

No → recommend medical therapy; stop.
Yes → proceed to classify CT findings.

STEP 3 — Classify or Stratify

Evaluate CT for unilateral adenoma >1 cm in patients <35 years with marked PA and hypokalemia.

If all present → high probability lateralizing PA; AVS may be unnecessary.
Otherwise → AVS indicated.

STEP 4 — Decide

If AVS unnecessary → proceed with CT‑guided surgical planning.
If AVS indicated → perform CT with adrenal venous sampling prior to deciding medical vs surgical treatment.

Clinical Guardrails / Mimics / Pitfalls

Relying on CT alone can misclassify bilateral disease or nonfunctioning adenomas; AVS requires experienced interventional radiologist and adequate cortisol/aldosterone assays; avoid AVS in familial hyperaldosteronism types I‑IV, bilateral macronodular hyperplasia, or uncontrolled hypertension; ensure renin suppressed and potassium normal before AVS to prevent false‑lateralization.

Concrete Clinical Example

A 32‑year‑old woman with hypertension, spontaneous hypokalemia, ARR 45, CT shows 1.3 cm left adrenal adenoma, desires surgery, no family history. Age <35, marked PA, hypokalemia, >1 cm adenoma → AVS may be omitted; she undergoes left laparoscopic adrenalectomy and is cured.

Source: Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2025, https://doi.org/10.1210/clinem/dgaf284

TODO: consider adding scripts/calc.py for the endo-pa-lateralization-imaging calculator

---name: endo-pa-lateralization-imagingdescription: Determines whether adrenal venous sampling (AVS) is needed in addition to CT for lateralizing primary aldosteronism before surgery. Trigger phrases include "patient with primary aldosteronism considering surgery", "unilateral adrenal adenoma on CT", "surgical candidate", and "age <35 with hypokalemia and >1‑cm adenoma".---# Determine need for adrenal venous sampling in addition to CT for PA lateralization## STEP 1 — Gather InformationConfirm primary aldosteronism diagnosis via elevated ARR, assess surgical candidacy and desire for adrenalectomy, review CT adrenal morphology (size, laterality), note patient age, presence of hypokalemia, and exclude familial hyperaldosteronism syndromes.## STEP 2 — Rule In / Rule OutIs the patient a surgical candidate who desires adrenalectomy? - No → recommend medical therapy; stop. - Yes → proceed to classify CT findings.## STEP 3 — Classify or StratifyEvaluate CT for unilateral adenoma >1 cm in patients <35 years with marked PA and hypokalemia. - If all present → high probability lateralizing PA; AVS may be unnecessary. - Otherwise → AVS indicated.## STEP 4 — DecideIf AVS unnecessary → proceed with CT‑guided surgical planning. If AVS indicated → perform CT with adrenal venous sampling prior to deciding medical vs surgical treatment.## Clinical Guardrails / Mimics / PitfallsRelying on CT alone can misclassify bilateral disease or nonfunctioning adenomas; AVS requires experienced interventional radiologist and adequate cortisol/aldosterone assays; avoid AVS in familial hyperaldosteronism types I‑IV, bilateral macronodular hyperplasia, or uncontrolled hypertension; ensure renin suppressed and potassium normal before AVS to prevent false‑lateralization.## Concrete Clinical ExampleA 32‑year‑old woman with hypertension, spontaneous hypokalemia, ARR 45, CT shows 1.3 cm left adrenal adenoma, desires surgery, no family history. Age <35, marked PA, hypokalemia, >1 cm adenoma → AVS may be omitted; she undergoes left laparoscopic adrenalectomy and is cured.**Source:** Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2025, https://doi.org/10.1210/clinem/dgaf284> **TODO:** consider adding scripts/calc.py for the endo-pa-lateralization-imaging calculator

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