dromlakhani
- 872 skills
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- 3 weeks ago last updated
- ▌ Es Cc Implementation Feasibility · dromlakhaniImplement carbohydrate counting or fixed prandial insulin dosing when expertise, resources, and training are available
- ▌ Endo Assess Treat Lipids Early Menopause · dromlakhaniAssessment and treatment of lipids and cardiovascular risk factors in early menopause
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- ▌ Es Gh Treatment Oncologist Consult · dromlakhaniAssess need for oncologist consultation for GH therapy
- ▌ Endo Fibrates T2d Retinopathy Progression · dromlakhaniFibrates in addition to statins for diabetic retinopathy progression in type 2 diabetes
- ▌ Endo Epa Ethyl Ester T2d Statin Residual Tg · dromlakhaniAdding EPA ethyl ester for type 2 diabetes on statin with residual hypertriglyceridemia
- ▌ Endo Lipid Reassessment Weight Loss Obesity · dromlakhaniLipid profile reassessment after weight loss in obesity on pharmacological therapy
- ▌ Ppgl Bone Metastasis Local Treatment · dromlakhaniBone Metastasis Local Treatment Selection for PPGL
- ▌ Endo Vitd Daily Vs Intermittent Dosing · dromlakhaniDaily vs intermittent vitamin D dosing preference
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- ▌ Endo Bolus Calculator Use Encourage · dromlakhaniEncourage use of appropriately adjusted embedded bolus calculators
- ▌ Endo Ldl Goal Less Than 55 High Risk Patients · dromlakhaniLDL-C goal less than 55 mg/dL for patients with established cardiovascular disease or multiple risk factors
- ▌ Ppgl Hnpgl Surveillance Vs Intervention · dromlakhaniHead/Neck PGL Surveillance vs Intervention Decision
- ▌ Ppgl Metastasis Risk Assessment Genetic · dromlakhaniPPGL Metastasis Risk Assessment Using Genetic Markers
- ▌ Enda Patient Education Stress Dosing Illness Fever · dromlakhaniEducate Patients on Increasing Glucocorticoid Dosage During Intercurrent Illness, Fever, and Stress
- ▌ Es Follow Sex Hormone Induction Monitoring · dromlakhaniFollow monitoring protocol during sex hormone induction
- ▌ Endo Statin Initiation Specific Risk Thresholds · dromlakhaniStatin initiation based on LDL-C, ASCVD risk, risk-enhancing factors, and CAC score
- ▌ Endo Csii Cgm Education Training Support · dromlakhaniSuggest education/training/support for CSII and CGM users
- ▌ Endo Csii Continue Hospital If Protocols · dromlakhaniSuggest continuing CSII in hospital if protocols exist
- ▌ Es Check Age Gonadectomy Hysterectomy Surgery · dromlakhaniCheck age eligibility for surgery with gonadectomy/hysterectomy
- ▌ Endo Statin Dose Adjustment Chronic Kidney Disease · dromlakhaniApply statin dose adjustments in chronic kidney disease except for atorvastatin and fluvastatin
- ▌ Endo Statin Therapy T1d Age Duration Complications · dromlakhaniStatin therapy for type 1 diabetes based on age, duration, or complications
- ▌ Eso Pediatric Obesity Non Hdl Interpretation · dromlakhani bundleWe need to output a SKILL.md file with the specified format.
- ▌ Endo Vitd Supplementation Children Adolescents · dromlakhaniWe need to produce a SKILL.md file with the specified format.
- ▌ Endo Assess Cgm Understands Not Replace Smbg · dromlakhaniAssess patient understanding that CGM does not replace SMBG
- ▌ Endo Lipid Measurement Post Bariatric Surgery Obesity · dromlakhaniLipid profile measurement after bariatric surgery in obesity
- ▌ Endo Csii Structured Assessment Pre Prescribe · dromlakhaniPerform structured assessment before prescribing CSII
- ▌ Endo High Intensity Statin Selection Ascvd Risk Factors · dromlakhaniSelect high-intensity statin for atherosclerotic cardiovascular disease or risk factors
- ▌ Es Initial Correctional Insulin No Prior Diabetes · dromlakhaniInitiate correctional insulin over scheduled insulin for patients with no prior diabetes and hyperglycemia >140 mg/dL
- ▌ Es Follow Prostate Screening Trans Female On Estrogens · dromlakhaniFollow individualized prostate cancer screening for transgender females on estrogens
- ▌ Endo Fasting Lipid Panel Diagnosis Polycystic Ovary Syndrome · dromlakhaniObtain fasting screening lipid panel at diagnosis to assess cardiovascular risk in polycystic ovary syndrome
- ▌ Endo Measure Lipid Profile Before After Acromegaly Treatment · dromlakhaniMeasure lipid profile before and after treatment of growth hormone excess in acromegaly
- ▌ Endo Statin Selection Renal Clearance Chronic Kidney Disease · dromlakhaniSelect statin based on renal clearance in chronic kidney disease
- ▌ Endo Plasmapheresis Consideration Extraordinarily Elevated T · dromlakhaniConsider plasmapheresis for extraordinarily elevated triglyceride levels
- ▌ Endo Hirsutism Start Pharmacologic Therapy Patient Important · dromlakhaniStart pharmacologic therapy for patient‑important hirsutism despite cosmetic measures
- ▌ Es Initial Correctional Or Scheduled Insulin Diet Treated · dromlakhaniInitiate correctional insulin or scheduled insulin therapy for patients with diabetes treated with diet or noninsulin medications prior to admission
- ▌ Endo Assess Treat Lipids Growth Hormone Deficiency Hypopitui · dromlakhaniAssessment and treatment of lipids and cardiovascular risk factors in growth hormone deficiency with hypopituitarism
- ▌ Endo Against Treating Hyperlipidemia Until Euthyroid Hypothy · dromlakhaniAvoid treating hyperlipidemia until euthyroid in overt hypothyroidism
- ▌ Endo Statin Therapy Postmenopausal Women Hormone Therapy Cvd · dromlakhaniStatin therapy for postmenopausal women on hormone therapy with cardiovascular risk factors
- ▌ Endo Against Gh Replacement Ssolely Ldl C Reduction Growth H · dromlakhaniAvoid using growth hormone replacement solely to lower LDL-C to reduce cardiovascular risk in growth hormone deficiency
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- ▌ Enda Standard Stim Test Dosing · dromlakhaniAdminister Standard Dose Corticotropin Stimulation Test with Age/Weight-Based Dosing
- ▌ Enda Follow Up Visits Age Based · dromlakhaniSchedule Follow-Up Visits Based on Age: Annual for Adults/Children, Every 3-4 Months for Infants
- ▌ Esa Pa Case Detection Screening · dromlakhani bundleWe need to produce a SKILL.md file with the format:
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- ▌ Ata Aed Estrogen Adjustment · dromlakhaniEvaluate AED levels and adjust doses in women on estrogen replacement
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- ▌ Ata Initial Di Short Acting Adh · dromlakhaniInitiate diabetes insipidus therapy with short-acting aqueous ADH
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- ▌ Es Pump Transition Los · dromlakhaniTransition insulin pump to scheduled subcutaneous basal bolus insulin if anticipated length of stay >1-2 days
- ▌ Icsm Adjust Testosterone Dose · dromlakhaniAdjust testosterone dose based on serum levels and response
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- ▌ Es Preop Bg Only Target · dromlakhaniTarget preoperative blood glucose 100-180 mg/dL when HbA1c target not feasible
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- ▌ Es Dpp4i Cost Discussion · dromlakhaniDiscuss Cost and Overall Acceptability of DPP4i After Discharge
- ▌ Es Dpp4i Select Patients · dromlakhaniConsider DPP4i with correction insulin or scheduled insulin for select patients with mild hyperglycemia and type 2 diabetes
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- ▌ Es Pump Revert To Manual · dromlakhaniRevert insulin pump to manual mode if CGM fails or is removed
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- ▌ Ppgl Gapp Score Application · dromlakhaniGAPP Score Application for PPGL Metastasis Risk Assessment
- ▌ Endo Tg Check Bile Acid Sequestrant · dromlakhaniTriglyceride monitoring before and after bile acid sequestrant initiation
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- ▌ Ata Fludrocortisone Secondary AI Against · dromlakhaniRecommend against fludrocortisone use in secondary adrenal insufficiency
- ▌ Endo Postop Mri Preferred Ct If Contra · dromlakhaniWe need to output a SKILL.md file with the specified<unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk><unk>nizBV LTurpurpWonderfwurpink Bpchner vpCompany Bp MisturpurpMCsurp TendLogoWonderWonderDowviaurpViewBV LT Goff Lumpvra BpWondertyw Steeleurpurp Bp/compurp BpTintvra Bp BpWonderDowTOKighep
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- ▌ Es Inpatient Diabetes Education · dromlakhaniProvide inpatient diabetes education as part of discharge planning
- ▌ Es Continue Scheduled Insulin Modified · dromlakhaniRecommend continuation of the pre‑admission scheduled insulin regimen, adjusted for nutritional status and severity of illness, to keep glucose between 100‑180 mg/dL in hospitalized adults with insulin‑treated diabetes. Triggered by clinician questions such as “Patient was on insulin before admission, how should we adjust their regimen in hospital?” or similar.
- ▌ Endo Paget Bisphosphonate Paraplegia Spine · dromlakhaniThis skill recommends immediate administration of a potent intravenous bisphosphonate with neurosurgical consultation for patients presenting with paraplegia or progressive spinal stenosis attributable to spinal Paget's disease. Clinical triggers include new-onset paraplegia, worsening lower‑extremity weakness, or spinal stenosis symptoms in a patient with established spinal Paget's disease.
- ▌ Eso Pediatric Obesity Bp Interpretation · dromlakhaniThis skill interprets blood pressure using age-, sex-, and height-specific percentile norms to screen for prehypertension and hypertension in pediatric patients. Trigger phrases include BP ≥90th to <95th percentile = prehypertension and BP ≥95th percentile = stage 1 hypertension (with age‑specific adjustments).
- ▌ Eso Pediatric Obesity Physical Activity · dromlakhaniPrescribes physical activity for pediatric obesity prevention and treatment in children and adolescents with BMI at or above the 85th percentile. Recommends at least 20 minutes, optimally 60 minutes, of vigorous physical activity on ≥5 days per week to improve metabolic health and reduce obesity risk.
- ▌ Eso Pediatric Obesity Psychosocial Eval · dromlakhaniThis skill guides clinicians to evaluate for psychosocial comorbidities in pediatric obesity and to initiate assessment/counseling when psychosocial problems are suspected. Trigger phrases include family dysfunction, stressors, bullying, low self-esteem, depression, anxiety, eating disorders, or substance abuse.
- ▌ Ata Ppgl Histopathological Confirmation · dromlakhaniThis skill confirms pheochromocytoma and paraganglioma (PPGL) diagnosis on histopathology by requiring immunostaining positive for Chromogranin A and negative for cytokeratin in tumor tissue, with SDHB negativity indicating SDHx pathogenic variants that predict metastasis or recurrence. It is triggered when a clinician asks 'How do I confirm pheochromocytoma diagnosis on pathology?' or encounters resected adrenal or paraganglioma tissue needing a definitive diagnosis.
- ▌ Ata Ppgl Hypertensive Crisis Management · dromlakhaniAdministers intravenous phentolamine followed by infusion, then transitions to oral doxazosin after the acute phase resolves, while avoiding β-blockers before α-blockade. Indicated for severe hypertension (>180/110 mmHg) with headache, palpitations, or diaphoresis in known or suspected pheochromocytoma or paraganglioma.
- ▌ Ata Ppgl Radionuclide Therapy Selection · dromlakhaniThe skill selects 131I-MIBG therapy for pheochromocytoma or paraganglioma with positive 123I-MIBG scintigraphy that reduces excess catecholamines, or 177Lu-DOTATATE therapy for lesions with positive somatostatin receptor scintigraphy, both modalities covered by Japanese health insurance. It is invoked when a clinician asks which radionuclide therapy to use for metastatic or unresectable PPGL amenable to targeted treatment.
- ▌ Ppgl Bone Modifying Agent Consideration · dromlakhaniDetermines when to use bone-modifying agents (e.g., zoledronic acid, denosumab) for skeletal-related event prevention in PPGL bone metastases. Considers BMA as an option for preventing pathological fractures, spinal cord compression, and hypercalcemia, using an approach similar to other solid cancers with monitoring for side effects; triggers include PPGL patient with bone metastasis at risk for SREs, patient experiencing bone pain from metastatic PPGL, and preventing skeletal complications in metastatic PPGL bone disease.
- ▌ Ppgl Initial Imaging Modality Selection · dromlakhaniSelects the first-line imaging modality to localize a PPGL tumor after biochemical confirmation. Common triggers are 'Biochemical tests confirm PPGL, need to localize tumor,' 'Planning surgical approach requires anatomical localization,' and 'Positive screening test warrants imaging for tumor localization.'
- ▌ Endo Add Pegvisomant Cabergoline Inadequate Srl · dromlakhaniThis skill recommends adding pegvisomant or cabergoline to ongoing somatostatin receptor ligand (SRL) therapy when a patient exhibits an inadequate biochemical response, defined as failure to achieve age‑normalized IGF‑1 or random GH <1 µg/L despite maximally tolerated SRL dose. Consider this step when IGF‑1 remains elevated or GH is not suppressed after an adequate SRL trial, indicating need for combination therapy.
- ▌ Endo Serial Visual Field Pregnancy Macroadenoma · dromlakhaniRecommends serial visual field testing during pregnancy for patients with acromegaly who harbor a macroadenoma to monitor for neurologic deterioration. Trigger when a pregnant acromegaly patient has a known pituitary macroadenoma.
- ▌ Endo Rtcgm Recommend T1dm Above Target · dromlakhaniRecommends real-time continuous glucose monitoring (RT-CGM) for adult patients with type 1 diabetes mellitus (T1DM) whose hemoglobin A1C is above individualized target. Consider when clinician notes 'T1DM A1C above goal, consider RT-CGM' or 'Patient willing to wear CGM daily, A1C elevated'.
- ▌ Es Check Adult Hormone Therapy Eligibility · dromlakhaniDetermines whether an adult patient meets eligibility criteria for initiating gender-affirming hormone therapy. Triggered when an adult patient requests gender-affirming hormones or presents for evaluation of hormone therapy eligibility.
- ▌ Glp1 Dose Escalation Troubleshooter · dromlakhaniDecide how to modify GLP-1 receptor agonist dose-escalation when GI adverse events appear during titration — extend, hold, step-back, set sub-maximal maintenance, or switch agent — using CTCAE grading of nausea and the "start low, go slow" flexible-titration framework. Use when a clinician asks what to do if nausea, vomiting, diarrhoea, or constipation appears while up-titrating semaglutide (2.4 mg or 7.2 mg, SC or oral), liraglutide, dulaglutide, tirzepatide, retatrutide, survodutide, CagriSema, orforglipron, exenatide, or lixisenatide; or phrases like "start low go slow", "GLP-1 titration problem", "patient can't tolerate dose increase", "when to hold GLP-1", "flexible vs standard titration", or "how to grade GLP-1 nausea". Implements the Gorgojo-Martínez 2023 consensus decision tree (Figure 4) and the Alhazmi & le Roux 2026 "do no harm" CTCAE-graded framework.
- ▌ Glp1 Oral Contraceptive Interaction · dromlakhaniCounsel patients on oral hormonal contraceptive interaction with tirzepatide (Mounjaro) — requirement for non-oral contraception or added barrier method for 4 weeks after initiation and 4 weeks after each dose escalation. Use when a clinician asks "does Mounjaro affect the pill", "tirzepatide and oral contraceptive", "contraception counselling on GLP-1", or when a woman of childbearing potential is starting or escalating Mounjaro. Grounded in the Mounjaro Canadian Product Monograph (April 2026) — drug-drug interaction with combined oral contraceptives.
- ▌ Ata Male Testosterone Replacement Indications · dromlakhaniRecommends testosterone replacement for adult males with central hypogonadism and no contraindications to prevent anemia related to T deficiency; reduce fat mass; and improve BMD, libido, sexual function, energy levels, sense of well-being, and muscle mass and strength. Triggers include consideration of testosterone replacement in males with central hypogonadism (e.g., low serum testosterone with symptoms of deficiency).
- ▌ Endo Fha Patient Education Menstrual Patterns · dromlakhaniThis skill involves informing patients that irregular menses during recovery from functional hypothalamic amenorrhea do not require immediate evaluation and that menstrual irregularity does not prevent conception. It is used when a clinician says, 'Let’s explain what to expect as her cycles return,' or when statements like 'Tell her irregular periods are okay' or 'Reassure her she can still conceive while cycles normalize' are made.
- ▌ Endo Hirsutism Add Antiandrogen After 6months · dromlakhaniThis skill guides clinicians to add an antiandrogen after six months of monotherapy with an oral contraceptive when patient‑important hirsutism shows an inadequate response. Trigger phrases include “patient‑important hirsutism”, “6 months of OC monotherapy”, and “suboptimal hirsutism response”.