How do I install the Pheo Screening Strategy skill?

Run npx skillmds@latest add dromlakhani/pheo-screening-strategy 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 Pheo Screening Strategy safe to use?

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Which AI agents work with Pheo Screening Strategy?

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 Pheo Screening Strategy free to use?

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

Who published Pheo Screening Strategy?

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

Pheo Screening Strategy by dromlakhani

Name: Pheo Screening Strategy
Rating: 4.2 (5 reviews)
Author: dromlakhani

Pheo Screening Strategy

First-line screening logic to identify patients who require biochemical testing for Pheochromocytoma or Paraganglioma. Trigger when a clinician asks "who to screen for pheo", "evaluation of adrenal incidentaloma", or "workup for paroxysmal hypertension."

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Pheochromocytoma Screening Strategy

This skill provides the clinical decision criteria for initiating biochemical screening for pheochromocytoma and paraganglioma based on the Endocrine Society Clinical Practice Guidelines.

Step 1 — Identification of High-Risk Clinical Features

Screen for pheochromocytoma if any of the following are present:

Paroxysmal Symptoms ("The Spell"):
- Triad of: Episodic headache, sweating, and palpitations.
- Note: The presence of all three in a hypertensive patient has high specificity (>90%).
Refractory or Early-Onset Hypertension:
- Drug-resistant hypertension (uncontrolled on ≥3 agents).
- Marked blood glucose lability or paradoxically worsening BP with beta-blockers.
- Hypertension onset at age <20 years.
Adrenal Incidentaloma:
- Any adrenal mass discovered on imaging, especially if the unenhanced CT attenuation is >10 Hounsfield Units (HU).
Genetic Predisposition:
- Personal or family history of MEN2, NF1, or von Hippel-Lindau (VHL).
- Personal history of a previous glomus tumor or paraganglioma.

Step 2 — Decision: To Screen or Not to Screen?

Finding Present?	Action
YES to any above	Move to Biochemical Testing (Plasma or 24h Urinary Metanephrines).
NO	Pheochromocytoma is unlikely; manage as primary hypertension unless other secondary features emerge.

Clinical Guardrails

Do NOT proceed to imaging first. Always obtain biochemical proof before ordering CT or MRI. Imaging first leads to false positives and unnecessary surgeries.
Beta-Blocker Warning: Never start a beta-blocker (e.g., Propranolol, Atenolol) before establishing alpha-blockade if pheo is suspected, as this can trigger a hypertensive crisis due to unopposed alpha-stimulation.
Medication Interference: Many drugs (TCAs, Levodopa, Decongestants) can cause false-positive metanephrine elevations. Review the med list before testing.

Source: Lenders JW, et al. Pheochromocytoma and Paraganglioma: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2014;99(6):1915-42. doi: 10.1210/jc.2014-1498

---name: pheo-screening-strategydescription: First-line screening logic to identify patients who require biochemical testing for Pheochromocytoma or Paraganglioma. Trigger when a clinician asks "who to screen for pheo", "evaluation of adrenal incidentaloma", or "workup for paroxysmal hypertension."---# Pheochromocytoma Screening StrategyThis skill provides the clinical decision criteria for initiating biochemical screening for pheochromocytoma and paraganglioma based on the Endocrine Society Clinical Practice Guidelines.---## Step 1 — Identification of High-Risk Clinical FeaturesScreen for pheochromocytoma if **any** of the following are present:1. **Paroxysmal Symptoms ("The Spell"):** - Triad of: Episodic headache, sweating, and palpitations. - Note: The presence of all three in a hypertensive patient has high specificity (>90%).2. **Refractory or Early-Onset Hypertension:** - Drug-resistant hypertension (uncontrolled on ≥3 agents). - Marked blood glucose lability or paradoxically worsening BP with beta-blockers. - Hypertension onset at age <20 years.3. **Adrenal Incidentaloma:** - Any adrenal mass discovered on imaging, especially if the unenhanced CT attenuation is >10 Hounsfield Units (HU).4. **Genetic Predisposition:** - Personal or family history of MEN2, NF1, or von Hippel-Lindau (VHL). - Personal history of a previous glomus tumor or paraganglioma.---## Step 2 — Decision: To Screen or Not to Screen?| Finding Present? | Action ||---|---|| **YES** to any above | Move to **Biochemical Testing** (Plasma or 24h Urinary Metanephrines). || **NO** | Pheochromocytoma is unlikely; manage as primary hypertension unless other secondary features emerge. |---## Clinical Guardrails- **Do NOT proceed to imaging first.** Always obtain biochemical proof before ordering CT or MRI. Imaging first leads to false positives and unnecessary surgeries.- **Beta-Blocker Warning:** Never start a beta-blocker (e.g., Propranolol, Atenolol) before establishing alpha-blockade if pheo is suspected, as this can trigger a hypertensive crisis due to unopposed alpha-stimulation.- **Medication Interference:** Many drugs (TCAs, Levodopa, Decongestants) can cause false-positive metanephrine elevations. Review the med list before testing.---**Source:** Lenders JW, et al. Pheochromocytoma and Paraganglioma: An Endocrine Society Clinical Practice Guideline. *J Clin Endocrinol Metab*. 2014;99(6):1915-42. doi: 10.1210/jc.2014-1498

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