← all publishers

dromlakhani

@dromlakhani source repo

Report this profile Claim this profile

• 872 skills
• 0 followers
• 10 repo stars
• 3 weeks ago last updated

1. ▌
   Icsm Target Mid Normal Testosterone · dromlakhani

   Aims to correct serum total testosterone to the mid-normal reference range for young men during testosterone therapy. Triggers when a clinician monitors treatment and wonders what testosterone level should I aim for or is the patient's T in the target zone.
   10 repo stars
2. ▌
   Ata Ppgl Gi Symptom Management · dromlakhani

   Manages gastrointestinal symptoms from catecholamine excess in pheochromocytoma and paraganglioma, addressing constipation, paralytic ileus, megacolon, or intestinal pseudo-obstruction/perforation. Triggered by clinician queries about treating GI symptoms in PPGL patients with constipation, abdominal distension, or nausea/vomiting.
   10 repo stars
3. ▌
   Ppgl Pregnancy Surgical Timing · dromlakhani

   Determines optimal timing for surgical tumor removal in pregnant PPGL patients to balance maternal and fetal risks. Triggered by PPGL diagnosed in pregnant patient, assessing surgical feasibility during pregnancy, or planning intervention for PPGL in gestation.
   10 repo stars
4. ▌
   Ata Postop Pituitary Axis Surveillance · dromlakhani

   Recommends retesting all pituitary axes starting at 6 weeks after pituitary surgery and periodically to monitor development or resolution of pituitary deficiencies. Use when managing postoperative pituitary surgery patient; triggers include postoperative pituitary surgery patient needing longitudinal hormone monitoring.
   10 repo stars
5. ▌
   Endo Serial Mri Pegvisomant Tumor Size · dromlakhani

   This skill suggests serial MRI imaging to assess tumor size in patients receiving pegvisomant therapy for acromegaly. Use when initiating pegvisomant or during follow‑up to monitor for tumor growth.
   10 repo stars
6. ▌
   Endo Against 25ohd Test Under 50 · dromlakhani

   The skill advises against routine 25(OH)D testing in asymptomatic adults younger than 50 years who lack established indications for vitamin D assessment. It is triggered when a clinician considers ordering a 25(OH)D test for preventive screening in this age group.
   10 repo stars
7. ▌
   Endo Against Vit D Supp Under 50 · dromlakhani

   Recommends against empiric vitamin D supplementation beyond the Dietary Reference Intake (DRI) in adults younger than 50 years. Use when a clinician considers vitamin D supplementation for non‑pregnant adults under 50 without established indications for treatment.
   10 repo stars
8. ▌
   Endo Vitd Supplementation Over75 · dromlakhani

   Suggests empiric vitamin D supplementation to lower mortality risk in adults aged 75 years and older. Triggered by clinician questions such as “Should I prescribe vitamin D to this elderly patient?” or “Is vitamin D supplementation indicated for patients over 75?”
   10 repo stars
9. ▌
   Constipation Defecatory Disorder · dromlakhani

   Step-wise management of constipation caused by defecatory disorder (pelvic floor dysfunction, dyssynergia, outlet obstruction) using the WGO cascade framework. Trigger when a patient strains excessively even with soft stools, uses manual manoeuvres to defecate, has difficult defecation with a feeling of blockage, is suspected of having pelvic floor dyssynergia, anorectal dyssynergia, obstructed defecation, or rectocele causing constipation.
   10 repo stars
10. ▌
    Genryzon Igf1 Titration · dromlakhani

    Titrate Genryzon (somatrogon, weekly long-acting growth hormone) dose in a paediatric GHD patient using serum IGF-1 SDS. Encodes the mandatory 4-days-post-dose sampling rule, the target SDS window, the 15% dose-reduction trigger, and the oral estrogen adjustment. Use when a clinician asks how to titrate somatrogon, when to sample IGF-1 on Genryzon, target IGF-1 SDS on weekly GH, what to do if IGF-1 is too high on somatrogon, IGF-1 rising on Genryzon, how to adjust GH dose in a girl started on oral OCP, or presents a paediatric GHD case on somatrogon with an IGF-1 value to interpret. Grounded in the Pfizer India Product Monograph (Genryzon LPD, 2022 — PfLEET 2022-0081166).
    10 repo stars
11. ▌
    Enda Add Antihypertensive Uncontrolled Bp · dromlakhani

    This skill suggests initiating antihypertensive treatment while continuing fludrocortisone when blood pressure remains uncontrolled after fludrocortisone dose reduction. Trigger phrases include "BP remains uncontrolled," "persistent hypertension," or "elevated BP despite fludrocortisone adjustment."
    10 repo stars
12. ▌
    Enda Adjust Glucocorticoid Stress Illness · dromlakhani

    Suggests adjusting glucocorticoid dose according to severity of illness or magnitude of the stressor in patients with primary adrenal insufficiency. Use when patient with PAI has intercurrent illness, fever, or stress.
    10 repo stars
13. ▌
    Enda Alternative Glucocorticoid Emergency · dromlakhani

    This skill suggests using prednisolone as an alternative glucocorticoid when hydrocortisone is unavailable for emergency treatment of adrenal crisis. Dexamethasone is the least-preferred option and should only be administered if no other glucocorticoid is available.
    10 repo stars
14. ▌
    Enda Annual Screening Autoimmune Diseases · dromlakhani

    Suggests periodic screening for autoimmune diseases known to be more prevalent in PAI patients in whom autoimmune origin of PAI has not been excluded; optimal frequency unknown but can be done annually. Use when determining screening schedule for PAI patient with uncertain autoimmune origin.
    10 repo stars
15. ▌
    Malignancy Hypercalcemia Workup · dromlakhani

    Work up Malignancy-Associated Hypercalcemia (MAH) — distinguish humoral hypercalcemia of malignancy (HHM, PTHrP-driven), local osteolytic hypercalcemia, 1,25(OH)2D-mediated lymphoma hypercalcemia, ectopic PTH secretion, and multiple myeloma — and pick the right confirmatory tests and therapy direction. Trigger when a clinician asks "is this hypercalcemia from cancer", "PTHrP positive what now", "hypercalcemia in lung cancer / breast cancer / lymphoma / myeloma", "humoral hypercalcemia of malignancy", "MAH workup", or any hypercalcemia case with suppressed PTH and a known or suspected malignancy.
    10 repo stars
16. ▌
    Es Cushing Against Treatment No Diagnosis · dromlakhani

    This skill recommends against initiating cortisol-lowering treatment when there is no established diagnosis of Cushing's syndrome. It is triggered when a clinician considers treating suspected CS based only on borderline biochemical abnormalities or nonspecific signs without confirmatory testing; examples include "suspected CS", "borderline UFC", "no confirmed diagnosis", "consider empiric ketoconazole".
    10 repo stars
17. ▌
    Pdm Glucose Monitoring T2dm · dromlakhani

    Suggests either continuous glucose monitor (CGM) or self-monitoring of blood glucose (SMBG) for pregnant individuals with type 2 diabetes. Triggers include decisions about glucose monitoring methods for pregnant patients with T2DM needing a monitoring strategy.
    10 repo stars
18. ▌
    Pdm Metformin Insulin Avoid · dromlakhani

    Recommends against routine addition of metformin to insulin for pregnant individuals with type 2 diabetes already on insulin. Triggered when considering adding metformin to an insulin regimen in pregnancy for patients with type 2 diabetes.
    10 repo stars
19. ▌
    Es Cgm Contraindication Check · dromlakhani

    This skill checks for contraindications or sources of inaccuracy that may affect continuous glucose monitoring (CGM) reliability in hospitalized adults. It is triggered when clinicians ask, “Are there factors that could make CGM unreliable?” or when assessing for skin infection, hypoperfusion, hypovolemia, vasoactive/pressor therapy, or medications such as acetaminophen >4 g/day, dopamine, vitamin C, or hydroxyurea.
    10 repo stars
20. ▌
    Es Pump Basal Rate Adaptation · dromlakhani

    Considers adapting the basal insulin rate at hospital admission for patients using insulin pump therapy. Triggered by clinician questions such as "Should we adjust the basal rate upon admission for pump therapy?" or when evaluating pump continuation versus transition to scheduled subcutaneous insulin.
    10 repo stars
21. ▌
    Es Pump Supplies Availability · dromlakhani

    Verify that insulin pump supplies (provided by patient or family) will be available throughout the hospitalization to support continued pump use. Triggered by questions such as "Do we have sufficient pump supplies for the hospital stay?"
    10 repo stars
22. ▌
    Glp1 Gi Ae Symptom Advisor · dromlakhani

    Provide symptom-specific dietary and lifestyle advice for a patient on a GLP-1 receptor agonist who has developed nausea, vomiting, diarrhoea, or constipation. Use when a clinician asks "what to advise for nausea/vomiting/diarrhoea/constipation on semaglutide/liraglutide/tirzepatide", or any GLP-1 patient with a specific GI symptom needs targeted non-pharmacological advice. Outputs a focused do/avoid list per symptom, grounded in the Gorgojo-Martínez 2023 consensus (Figure 2).
    10 repo stars
23. ▌
    Mounjaro Prescribing Guide · dromlakhani

    Bedside prescribing reference for Mounjaro (tirzepatide) — indications, dose escalation, missed-dose rule, KwikPen vs prefilled pen differences, contraindications, warnings, storage, and monitoring. Use when a clinician asks how to start tirzepatide, how to titrate Mounjaro, how to handle a missed weekly dose, Mounjaro storage, Mounjaro contraindications, Mounjaro pregnancy/MTC warnings, or needs a quick Mounjaro monograph lookup. Grounded in the Canadian Product Monograph (Eli Lilly Canada, April 2026).
    10 repo stars
24. ▌
    Endo T Baseline Followup Measurement · dromlakhani

    Recommends measuring testosterone levels at baseline and after 3–6 weeks of initial treatment to assess for patient overuse or excessive dosing. Triggered when initiating testosterone therapy in women with hypoactive sexual desire disorder (HSDD) to verify levels remain within physiological range and avoid supratherapeutic dosing.
    10 repo stars
25. ▌
    Endo T Measurement Diagnosis Against · dromlakhani

    The guideline recommends against routinely measuring testosterone in women for diagnostic purposes due to the lack of a reliable correlation between symptoms and testosterone levels. This recommendation is triggered when a clinician orders a testosterone test to assess fatigue, low libido, or mood symptoms without evidence of underlying endocrine pathology.
    10 repo stars
26. ▌
    Es Ghc Hypoglycemia Safeguards · dromlakhani

    This skill guides clinicians to apply safeguards—including frequent point-of-care glucose monitoring and insulin dose adjustments—to prevent hypoglycemia when tapering or discontinuing glucocorticoids in hospitalized patients. Use when encountering triggers such as "Glucocorticoid being tapered, how to avoid hypoglycemia?" or "Stopping steroids, need to avoid low blood sugar."
    10 repo stars
27. ▌
    Es Scheduled Insulin Preferred · dromlakhani

    In most adult patients with hyperglycemia (with or without known type 2 diabetes) hospitalized for noncritical illness, scheduled insulin therapy is preferred over noninsulin agents for glycemic management. Clinicians should consider this when they ask, "Patient has hyperglycemia, should we start insulin or try a noninsulin drug?"
    10 repo stars
28. ▌
    Endo Statin Contraindication Pregnancy · dromlakhani

    Recommends against using statins in women who are pregnant or trying to become pregnant. Trigger phrases include "Female patient of childbearing potential needing lipid therapy", "Assessing medication safety in pregnancy", "Considering statin for lipid disorder in pregnancy".
    10 repo stars
29. ▌
    Endo Statin Therapy T1d Ckd Stages 1 4 · dromlakhani

    This skill suggests statin therapy irrespective of cardiovascular risk score to reduce cardiovascular risk in adults with type 1 diabetes and chronic kidney disease stages 1-4. Clinical triggers include "Patient with T1D and CKD stages 1-4", "Assessing statin need in type 1 diabetic kidney disease", and "T1D with renal impairment".
    10 repo stars
30. ▌
    Endo Statin Therapy T2d Ckd Stages 1 4 · dromlakhani

    This skill suggests statin therapy irrespective of cardiovascular risk score to reduce cardiovascular risk in adults with type 2 diabetes and CKD stages 1-4 or postrenal transplant. Consider when encountering phrases such as "Patient with T2D and CKD stages 1-4", "T2D with renal transplant", or "Assessing statin need in diabetic kidney disease".
    10 repo stars
31. ▌
    Endo Paget Hearing Loss Prevention · dromlakhani

    Suggests treatment with a potent bisphosphonate to prevent worsening of a hearing deficit in patients with Paget's disease involving the temporal bone. Triggers include detected or suspected hearing loss thought to be related to Paget's disease.
    10 repo stars
32. ▌
    Endo Paget Zoledronate Choice Dose · dromlakhani

    Suggests a single 5‑mg intravenous dose of zoledronate as the treatment of choice in patients with active Paget’s disease who have no contraindication to IV zoledronate. Triggered when initiating pharmacologic therapy for Paget’s disease and confirming absence of renal impairment or other contraindications.
    10 repo stars
33. ▌
    Ata Ppgl Thyroid Block For Mibg · dromlakhani

    The skill recommends administering potassium iodide (50–150 mg/day) or Lugol's solution (5–10 drops/day) for three days prior to and continuing through the day of 123I-MIBG scintigraphy to reduce thyroid radiation exposure and prevent medullary thyroid cancer in patients undergoing evaluation for pheochromocytoma or paraganglioma. It is triggered when a clinician questions whether to give a thyroid blocking agent for a 123I-MIBG scan, such as when ordering 123I-MIBG scintigraphy for PPGL evaluation.
    10 repo stars
34. ▌
    Endo Avoid Gh Igf1 Monitoring Pregnancy · dromlakhani

    This skill advises against measuring GH or IGF-1 in pregnant patients with acromegaly because placental GH variant interferes with assay interpretation. Use when evaluating hormone testing in a pregnant acromegaly patient.
    10 repo stars
35. ▌
    Endo Discontinue Pegvisomant If Lftgt3x · dromlakhani

    Consider discontinuing pegvisomant when alanine aminotransferase (ALT) or aspartate aminotransferase (AST) exceeds three times the upper limit of normal (ULN) during routine monthly liver function testing. This trigger applies to patients receiving pegvisomant for acromegaly who demonstrate transaminase elevations >3× ULN on LFT monitoring.
    10 repo stars
36. ▌
    Endo Trial Cabergoline Modest Igf1 Mild · dromlakhani

    Suggests a trial of a dopamine agonist, usually cabergoline, as initial adjuvant therapy in patients with only modest IGF-1 elevations and mild GH excess symptoms after surgery. Use when postoperative IGF-1 is mildly elevated and symptoms of GH excess are mild.
    10 repo stars
37. ▌
    Endo Against 25ohd Test Pregnancy · dromlakhani

    Recommends against routine 25(OH)D testing during pregnancy. Use when a clinician considers ordering 25(OH)D tests for pregnant patients lacking established indications such as hypocalcemia or malabsorption.
    10 repo stars
38. ▌
    T1d Islet Autoantibody Screening Confirmation · dromlakhani

    Order and confirm islet autoantibody screening for early-stage type 1 diabetes — which antibodies to test (GAD65, IAA, IA2, ZnT8), sample types (capillary dried blood spot, venous), the mandatory two-sample two-method confirmation protocol, and how to interpret a positive, negative, or single-antibody result. Use when a clinician asks how to screen for early T1D, which islet autoantibodies to order, how to confirm a positive T1D antibody screen, is one autoantibody enough for T1D diagnosis, GAD antibody positive what next, or is running a general population or family-history T1D screening program. Grounded in Hussain et al 2026 (Diabetes, Obesity and Metabolism, IDF Europe consensus, DOI 10.1111/dom.70569).
    10 repo stars
39. ▌
    T1d Progression Risk And Monitoring Frequency · dromlakhani

    For a person with confirmed islet autoantibodies (early-stage type 1 diabetes), state the numerical progression risk to Stage 3 T1D by stage and age, set the age-stratified monitoring frequency (metabolic and HbA1c), apply the ≥10% longitudinal HbA1c rise → OGTT rule, and give the standard risk-modifier and communication framing. Use when a clinician asks how often should I monitor this Stage 1 child, what's the risk of this teenager progressing to insulin, adult with GAD positive what's the 5-year risk, my patient's HbA1c has risen 12% is that important, single autoantibody how often to retest, or how to counsel a family about progression risk. Grounded in Phillip et al. Diabetologia 2024 international staging and monitoring consensus, cross-referenced with Hussain et al 2026 IDF Europe roadmap.
    10 repo stars
40. ▌
    Dbd Diabetes Hypertension Donor Eligibility · dromlakhani

    Decide whether a kidney from a brain-dead deceased donor (DBD) with diabetes mellitus and/or hypertension is suitable for transplantation, using the ISOT 2025 Delphi consensus and Table 4 eligibility checklist. Trigger when a clinician asks "can I use a kidney from a diabetic deceased donor", "is this DBD with HTN/DM acceptable", "ECD donor with diabetes — accept or decline", "DBD eligibility for hypertensive donor", or shares a deceased donor with diabetes or hypertension and needs an accept/borderline/decline decision.
    10 repo stars
41. ▌
    Enda Glucocorticoid Injection Kit Training · dromlakhani

    Recommends equipping every patient with primary adrenal insufficiency (PAI) with a glucocorticoid injection kit for emergency self‑administration and providing training on its use. Trigger when preparing a PAI patient for stress dosing, adrenal crisis prevention, or when prescribing glucocorticoid replacement and needing to ensure emergency preparedness.
    10 repo stars
42. ▌
    Enda Increase Hc Pregnancy Third Trimester · dromlakhani

    Recommends increasing hydrocortisone dose in pregnant patients with primary adrenal insufficiency based on individual clinical course, especially during the third trimester. Trigger phrases include "fatigue, postural hypotension, weight loss, or hyperglycemia in pregnant PAI patient" and "need for glucocorticoid dose adjustment in third trimester."
    10 repo stars
43. ▌
    Enda Monitor Mineralocorticoid Replacement · dromlakhani

    This skill outlines monitoring of mineralocorticoid replacement in primary adrenal insufficiency, focusing on clinical assessment of salt craving, postural hypotension, or edema alongside serum electrolyte measurements. It is initiated when evaluating patients on fludrocortisone therapy to ensure adequate dosing and avoid over- or under-replacement.
    10 repo stars
44. ▌
    Es Cushing Multidisciplinary Team Approach · dromlakhani

    This skill recommends that a multidisciplinary team, including an experienced endocrinologist, incorporates patient values and preferences while providing education about treatment options for Cushing’s syndrome. Use when planning treatment for a CS patient requiring coordinated care; triggers include persistent hypercortisolism after transsphenoidal surgery, consideration of bilateral adrenalectomy, radiotherapy, or medical therapy, and need for shared decision‑making.
    10 repo stars
45. ▌
    Endo Assess Cgm Data Diff Smbg · dromlakhani

    Assesses patient’s understanding of how CGM data (trends, rates of change) differ from discrete SMBG fingerstick values. Triggered when clinicians hear requests to explain lag and trend arrows on CGM or teach the difference between CGM glucose and fingerstick glucose.
    10 repo stars
46. ▌
    Endo Assess Emergency Supplies · dromlakhani

    Assesses whether the patient has emergency supplies such as glucagon, ketone strips, and backup insulin readily available. Triggered when clinicians verify the patient carries a glucagon kit or ensure backup insulin and supplies are accessible.
    10 repo stars
47. ▌
    Es Rtcgm Adip Vs Mdis Smbg T1d · dromlakhani

    This skill suggests using real-time continuous glucose monitoring (CGM) and algorithm-driven insulin pumps (ADIPs) rather than multiple daily injections (MDIs) with self-monitoring of blood glucose (SMBG) three or more times daily for adults and children with type 1 diabetes (T1D). Trigger phrases include "Should I use RT-CGM+ADIP or MDI+SMBG for this T1D patient?" or "Is intensive pump therapy indicated for this patient?"
    10 repo stars
48. ▌
    Noveltreat Storage Handling · dromlakhani

    Storage, handling, and disposal of the Noveltreat pre-filled semaglutide injection pen (0.25 / 0.5 / 1 / 2.4 mg, Sun Pharma) — fridge rules, 28-day out-of-fridge limit, single-use, pen-lock mechanism, light and freeze precautions, biomedical-waste disposal. Use when a clinician, pharmacist, or patient asks how to store Noveltreat, whether the pen can be kept outside the fridge, how long Noveltreat is stable at room temperature, how to dispose of a used Noveltreat pen, or what to do with an accidentally frozen / dropped / exposed pen. Grounded in Sun Pharmaceutical Industries Ltd. Product Monograph — Diabetes and Obesity (2026).
    10 repo stars
49. ▌
    Endo Hirsutism Screen Nccah High Risk · dromlakhani

    This skill screens high‑risk patients for nonclassic congenital adrenal hyperplasia (NCCAH) by measuring 17‑OHP even when total and free testosterone are normal. Use when a clinician says, "She has a family history of CAH; should we still screen despite normal androgens?" or notes positive family history or high‑risk ethnic group.
    10 repo stars
50. ▌
    Icsm Avoid Testosterone Acute Illness · dromlakhani

    Advises against obtaining testosterone levels during acute illness as results may be unreliable. Triggers when a patient is febrile, infected, or otherwise acutely unwell and the clinician questions whether to draw testosterone now or delay testing until recovery.
    10 repo stars
51. ▌
    Icsm Avoid Tt For Diabetes Prevention · dromlakhani

    The guideline recommends against using testosterone therapy alone to prevent or treat diabetes in men with hypogonadism. Clinicians should consider this recommendation when contemplating testosterone to improve HbA1c or insulin resistance and questioning whether testosterone can replace glucose-lowering therapy or be used for diabetes management.
    10 repo stars
52. ▌
    Icsm Choose Testosterone Assay Method · dromlakhani

    Recommends mass spectrometry for research purposes and good-quality immunoassays for routine clinical diagnosis when standardized against an international reference range. Triggers when a clinician orders a testosterone test and asks "which assay should I use?" or questions "is this immunoassay reliable enough?"
    10 repo stars
53. ▌
    Icsm Defer Tt Elevated Psa Or Nodules · dromlakhani

    Recommends postponing testosterone initiation and pursuing MRI or biopsy when PSA is elevated or a prostate nodule is detected on digital rectal examination; if evaluation shows no cancer, testosterone therapy may be considered. Triggered by clinician findings of elevated PSA (>4 ng/mL) or a palpable prostate nodule during DRE, prompting the question of whether to hold testosterone until prostate cancer is ruled out.
    10 repo stars
54. ▌
    Icsm Morning Testosterone Measurement · dromlakhani

    Recommends measuring total testosterone in the morning fasting state (07:00–11:00) using a reliable assay for patients suspected of hypogonadism. Triggered when a clinician orders a testosterone test and questions whether the sample should be drawn fasting and in the morning.
    10 repo stars
55. ▌
    Icsm Physical Exam Hypogonadism Signs · dromlakhani

    Advises checking for smaller testes, decreased body hair, and gynecomastia as physical clues to hypogonadism. Triggered when evaluating a man with suspected testosterone deficiency who asks what physical exam findings support the diagnosis or whether any exam signs suggest hypogonadism.
    10 repo stars
56. ▌
    Icsm Testosterone Monitoring Schedule · dromlakhani

    This skill outlines the monitoring schedule for testosterone therapy, detailing baseline, 3‑month, 6‑month, and yearly assessments of symptoms, adverse events, total testosterone, hematocrit, PSA, and DRE. Use it when a patient is receiving testosterone and the clinician asks what labs and checks are needed today or when the next monitoring visit should occur.
    10 repo stars
57. ▌
    Es Basal Insulin Dose Reduction · dromlakhani

    Consider reducing basal insulin dose by 10% to 20% at hospitalization for patients on basal heavy insulin regimens (≥0.6–1.0 units/kg/day) to prevent over‑coverage of meal‑related glucose excursions. Trigger phrases include “Patient on high basal insulin dose, should we reduce it during hospital stay?” and “Basal insulin dose ≥0.6 U/kg/day, consider reduction on admission.”
    10 repo stars
58. ▌
    Endo Statin Therapy T2d Cv Risk Factors · dromlakhani

    Recommends statin therapy in addition to lifestyle modification to reduce cardiovascular risk in adults with type 2 diabetes and additional cardiovascular risk factors such as hypertension, dyslipidemia, smoking, or family history of premature ASCVD. Use when managing a patient with type 2 diabetes who has concomitant hypertension, LDL‑C >70 mg/dL, or other risk‑enhancing factors.
    10 repo stars
59. ▌
    Ata Gc Overreplacement Osteoporosis · dromlakhani

    Individually assesses glucocorticoid replacement to avoid over-replacement and reduce osteoporosis risk by suggesting low-dose hydrocortisone to increase bone formation and promote positive bone-remodeling balance. Triggered when managing patients on long-term glucocorticoid therapy requiring osteoporosis risk assessment.
    10 repo stars
60. ▌
    Endo Comorbidities Longitudinal Monitoring · dromlakhani

    This skill recommends longitudinal monitoring and rigorous management of identified comorbidities—such as hypertension, diabetes mellitus, cardiovascular disease, osteoarthritis, and sleep apnea—in patients with acromegaly. Apply throughout follow‑up when comorbidities are present to mitigate morbidity and mortality risk.
    10 repo stars
61. ▌
    Ata Ppgl Chemotherapy Indication · dromlakhani

    Recommends CVD chemotherapy as first-line systemic treatment for unresectable pheochromocytoma/paraganglioma with rapid progression or when radionuclide therapy is not applicable. Considers disease progression rate and feasibility to choose between CVD chemotherapy and radionuclide therapy in patients with positive nuclear imaging when progression is slow and radionuclide therapy feasible.
    10 repo stars
62. ▌
    Pheo Preoperative Alpha Blockade · dromlakhani

    Pre-operative preparation protocol for Pheochromocytoma, focusing on alpha-blockade titration and volume expansion. Trigger when a clinician asks "prep for pheo surgery", "alpha blockade vs beta blockade", or "doxazosin titration".
    10 repo stars
63. ▌
    Ppgl Confirmation Test Selection · dromlakhani

    Selects the appropriate functional confirmation test after a positive PPGL screening test to establish biochemical diagnosis. Triggered by statements such as 'Screening test positive for PPGL,' 'Need to confirm PPGL diagnosis before imaging,' or 'Biochemical test results exceed screening thresholds.'
    10 repo stars
64. ▌
    Ppgl Lifelong Follow Up Duration · dromlakhani

    Determines appropriate postoperative follow-up duration for PPGL based on hereditary status, catecholamine phenotype, tumor size, and location to guide surveillance intensity. Recommends lifelong follow-up for hereditary PPGL and at least 10 years for sporadic PPGL with noradrenaline dominance, tumor ≥5 cm, or extra‑adrenal/PGL location; triggers include 'Post-op PPGL patient requiring follow-up plan,' 'Assessing need for extended surveillance in PPGL survivor,' 'Determining follow-up duration for cured PPGL patient.'
    10 repo stars
65. ▌
    Ppgl Pediatric Surgical Approach · dromlakhani

    Determines surgical approach for PPGL in children considering tumor size, suspected pathogenic gene variants, and hereditary tumor syndromes. Chooses between laparotomy and endoscopic surgery based on child's size and genetic risk; incorporates family history and genetic testing results in decision-making, with triggers such as 'Child diagnosed with PPGL requiring surgery,' 'Need to select surgical approach for pediatric PPGL,' and 'Evaluating surgical options in child with genetic syndrome.'
    10 repo stars
66. ▌
    Ppgl Pregnancy Imaging Selection · dromlakhani

    Selects safe imaging modalities for PPGL evaluation in pregnancy to minimize fetal radiation exposure, preferring ultrasound or MRI and reserving CT or 123I-MIBG scintigraphy for cases where diagnostic benefits outweigh radiation risks after informed consent. Triggered by phrases such as 'Pregnant patient with suspected PPGL symptoms,' 'Need imaging for PPGL in pregnant patient,' or 'Evaluating PPGL while minimizing fetal radiation risk.'
    10 repo stars
67. ▌
    Ppgl Surgical Approach Selection · dromlakhani

    This skill selects the surgical approach (laparoscopic/robot-assisted vs open adrenalectomy) for pheochromocytoma and paraganglioma (PPGL) based on tumor size and suspected organ invasion. It is triggered when imaging shows PPGL tumor size approaching 6 cm, suspected tumor invasion into adjacent structures on imaging, or when determining the surgical approach for a confirmed PPGL.
    10 repo stars
68. ▌
    Ata Postmenopausal Gonadotrope Diagnosis · dromlakhani

    Diagnoses gonadotrope dysfunction in postmenopausal women by confirming absent high serum FSH and LH when not on hormone replacement therapy. Use when evaluating a postmenopausal woman for hypogonadism; triggers include postmenopausal woman with suspected hypogonadism.
    10 repo stars
69. ▌
    Ata Postop Pituitary Apoplexy Monitoring · dromlakhani

    Recommends that clinicians monitor pituitary axes in pituitary apoplexy patients treated with surgical decompression or conservative management because hypopituitarism may develop over time. Use when managing pituitary apoplexy patient; triggers include pituitary apoplexy patient needing longitudinal monitoring.
    10 repo stars
70. ▌
    Endo Repeat Surgery Residual Intrasellar · dromlakhani

    Suggests considering repeat surgery in patients with residual intrasellar disease after initial surgical resection. Consider when postoperative imaging demonstrates persistent intrasellar tumor.
    10 repo stars
71. ▌
    Es Short Stature High Risk Screen · dromlakhani

    This skill identifies childhood cancer survivors at high risk for short adult height based on cranial/spinal/total body irradiation at a young age or a history of inadequate weight gain or prolonged steroid requirement. It is triggered by questions such as "Does this survivor need growth monitoring?" or "Is this patient high-risk for growth impairment?"
    10 repo stars
72. ▌
    Enda Fludrocortisone Aldosterone Deficiency · dromlakhani

    Recommends initiating fludrocortisone 50–100 µg daily for mineralocorticoid replacement in adults with confirmed aldosterone deficiency (e.g., low aldosterone, elevated renin) and no salt restriction. Use when aldosterone deficiency is confirmed in a patient with primary adrenal insufficiency (PAI) presenting with salt craving or postural hypotension.
    10 repo stars
73. ▌
    Enda Pediatric Fludrocortisone Infants Nacl · dromlakhani

    Recommends fludrocortisone 100 µg daily for children with primary adrenal insufficiency and confirmed aldosterone deficiency; for infants under 12 months, adds sodium chloride supplementation. Triggered by PAI with aldosterone deficiency, evidenced by salt craving, hyponatremia, hyperkalemia, or elevated renin with low aldosterone.
    10 repo stars
74. ▌
    Es Hcm Ugps1 Iv Fluids First Line · dromlakhani

    Recommends initiating intravenous isotonic saline hydration as initial management for hypercalcemia of malignancy (HCM) while awaiting antiresorptive therapy, with fluid rate adjusted according to cardiac function. Triggered when a clinician encounters a patient with HCM (e.g., serum calcium >12 mg/dL, symptoms of hypercalcemia) and seeks immediate measures before specific drugs are available.
    10 repo stars
75. ▌
    Hypercalcemia Severity Classifier · dromlakhani

    Classify the severity of hypercalcemia at the bedside — mild, moderate, or severe — by combining the corrected/ionized calcium level with the acuity and symptom pattern, and decide whether the patient needs urgent therapy. Trigger when a clinician asks "is this hypercalcemia severe", "how bad is this calcium level", "when to admit for hypercalcemia", "is this hypercalcemic crisis", "how to grade hypercalcemia", or shares a calcium level and asks how worried to be.
    10 repo stars
76. ▌
    Es Cushing Against Treatment Borderline Hpa · dromlakhani

    This skill recommends against initiating treatments aimed at normalizing cortisol or its action when only borderline biochemical abnormalities of the hypothalamic-pituitary-adrenal (HPA) axis are present without specific signs of Cushing's syndrome. Use when encountering borderline urinary free cortisol, late-night salivary cortisol, or dexamethasone suppression test results without classic Cushingoid features; triggers include borderline UFC (1-2× ULN), equivocal late-night salivary cortisol, or nondiagnostic low-dose DST.
    10 repo stars
77. ▌
    Es Cushing Initial Resection Recommendation · dromlakhani

    Recommends initial surgical resection of the primary lesion(s) causing Cushing's syndrome when surgery is feasible and likely to significantly reduce glucocorticoid excess. Trigger phrases include overt Cushing's syndrome, ACTH-dependent CS, ectopic ACTH secretion, adrenal adenoma, bilateral macronodular adrenal hyperplasia, and persistent hypercortisolism.
    10 repo stars
78. ▌
    Es Cushing Serum Sodium Monitoring Post Tss · dromlakhani

    This skill recommends measuring serum sodium several times during the first 5–14 days after transsphenoidal surgery to detect and manage electrolyte disturbances such as postoperative hyponatremia and diabetes insipidus. Use when managing a post-TSS Cushing’s syndrome patient in the early recovery phase; triggers include postoperative day 5–10 hyponatremia, polyuria, fluid intake‑output imbalance, or suspected diabetes insipidus.
    10 repo stars
79. ▌
    Pdm Postpartum Endocrine Care · dromlakhani

    Recommends postpartum endocrine care (diabetes management) in addition to usual obstetric care for individuals with preexisting diabetes (including those with pregnancy loss or termination). Triggered by postpartum care planning for patients with diabetes after delivery.
    10 repo stars
80. ▌
    Endo Assess Cgm Alarms Settings · dromlakhani

    Assesses that CGM low- and high-glucose alarm thresholds are individualized to optimize patient benefit and minimize alarm fatigue. Triggered by clinician prompts to 'Review low-glucose alarm thresholds' or 'Ensure alarms are individualized and not excessive'.
    10 repo stars
81. ▌
    Glp1 Candidacy Myths Checker · dromlakhani

    Decide whether commonly-excluded patients (eating disorders, elderly ≥75, upper GI disease) can actually receive a GLP-1 receptor agonist. Use when a clinician asks "can I give semaglutide to a patient with binge eating disorder / anorexia / bulimia", "is liraglutide safe in an 80-year-old", "GLP-1 with GERD or chronic gastritis", "GLP-1 in sarcopenic elderly", or anytime a patient is being ruled out for GLP-1 therapy based on a perceived contraindication. Grounded in Gorgojo-Martínez 2023 §6 (Myths or Reality).
    10 repo stars
82. ▌
    Glp1 Gi Ae Patient Education · dromlakhani

    Counsel a patient before starting a GLP-1 receptor agonist (semaglutide, liraglutide, dulaglutide, exenatide, lixisenatide, oral semaglutide) on how to prevent GI adverse events — nausea, vomiting, diarrhoea, constipation. Use when a clinician asks for patient-education material, a GLP-1 starter handout, pre-initiation counselling, or "what should I tell my patient before starting Ozempic/Wegovy/Rybelsus/Victoza/Saxenda/Trulicity." Produces a structured patient-facing brief grounded in the Gorgojo-Martínez 2023 multidisciplinary consensus.
    10 repo stars
83. ▌
    Noveltreat Prescribing Guide · dromlakhani

    Bedside prescribing reference for Noveltreat (Sun Pharma semaglutide 0.25/0.5/1/1.7/2.4 mg pre-filled pen) for chronic weight management — adult indication criteria, 5-step dose escalation, missed-dose rule, contraindications, warnings, drug interactions, and red-flag stop signals. Use when a clinician asks how to start Noveltreat, how to titrate semaglutide 2.4 mg, Noveltreat missed dose, Noveltreat contraindications, Noveltreat drug interactions, or when a patient on Noveltreat needs a monograph-level clinical decision. Grounded in Sun Pharmaceutical Industries Ltd. Product Monograph — Diabetes and Obesity (2026).
    10 repo stars
84. ▌
    Wegovy Pediatric Eligibility · dromlakhani

    Check whether an adolescent aged 12 to under 18 years qualifies for Wegovy (semaglutide 2.4 mg) using BMI age-sex 95th-percentile cutoff, weight above 60 kg threshold, and secondary-obesity exclusion. Use when a clinician asks "is my teenager eligible for Wegovy", "Wegovy in adolescents", "pediatric semaglutide 2.4 mg indication", or needs to screen a 12 to 17 year-old with obesity before initiation. Grounded in the Wegovy Canadian Product Monograph (Novo Nordisk, March 2024).
    10 repo stars
85. ▌
    Endo Fha Inpatient Evaluation Criteria · dromlakhani

    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.”
    10 repo stars
86. ▌
    Endo Fha Rpth Delayed Fracture Low Bmd · dromlakhani

    This skill suggests that short-term recombinant parathyroid hormone 1-34 (rPTH) may be considered in rare adult functional hypothalamic amenorrhea (FHA) cases with delayed fracture healing and markedly reduced bone mineral density. Use when a clinician notes, 'Her fracture isn’t healing and her Z-score is -3—could rPTH help?' or considers rPTH for poor fracture healing or teriparatide in severe osteoporosis with FHA.
    10 repo stars
87. ▌
    Endo Hirsutism Screen Nccah Amenorrhea · dromlakhani

    Orders early morning 17‑hydroxyprogesterone to screen for nonclassic congenital adrenal hyperplasia due to 21‑hydroxylase deficiency in hyperandrogenemic women with amenorrhea or infrequent menses. Triggered by menstrual irregularity with hirsutism and a clinical request to rule out adrenal hyperplasia.
    10 repo stars
88. ▌
    Icsm Avoid Tt For Depressive Disorders · dromlakhani

    Testosterone monotherapy is not an effective treatment for clinical depressive disorders in hypogonadal men and should not be used for that purpose. Consider this when a patient presents with depressive mood and low testosterone, questioning whether testosterone will improve depression or if depression should be treated separately.
    10 repo stars
89. ▌
    Es Discharge Planning Components · dromlakhani

    This skill outlines the core components to include in comprehensive diabetes discharge planning for hospitalized adults. It is triggered by questions such as "What should be included in diabetes discharge planning?" and ensures education on survival skills, referral for outpatient DSMES, follow-up scheduling, and medication/supply access.
    10 repo stars
90. ▌
    Endo Pharmacologic Treatment Tg Over 500 · dromlakhani

    Recommends pharmacologic treatment as adjunct to diet and exercise to prevent pancreatitis in adults with fasting triglyceride levels >500 mg/dL. Triggered when evaluating a patient with an endocrine disorder who presents with fasting TG >500 mg/dL (severe hypertriglyceridemia) and no contraindication to pharmacologic therapy.
    10 repo stars
91. ▌
    Endo Statin Considerations Over 75 Years · dromlakhani

    Advises that continuation or initiation of statin treatment in patients over 75 years depends on atherosclerotic cardiovascular disease risk, prognosis, potential interacting medications, polypharmacy, mental health, and patient wishes. Common clinical triggers for using this skill are 'Elderly patient needing statin assessment', 'Statins in octogenarian with lipid disorder', and 'Balancing risks/benefits of statin in advanced age'.
    10 repo stars
92. ▌
    Endo Paget Early Response Assessment · dromlakhani

    This skill outlines using short-term changes in bone resorption markers (e.g., serum CTx or urine NTx) before and shortly after bisphosphonate therapy to predict an adequate therapeutic response. It is triggered when there is urgency to control severe symptoms or when Paget’s disease is highly active, prompting rapid efficacy assessment.
    10 repo stars
93. ▌
    Endo Paget Remission Target Turnover · dromlakhani

    Suggests reducing bone turnover below the midpoint of the reference range for the chosen monitoring bone turnover marker to maximize the duration of remission. Triggered when aiming to sustain long-term remission after treatment and the marker exceeds the midpoint.
    10 repo stars
94. ▌
    Eso Pediatric Obesity Screen Time · dromlakhani

    Recommends limiting non-academic screen time to 1-2 hours per day and decreasing other sedentary behaviors. Trigger phrases include "excessive screen time," "digital activities," and "sedentary behaviors."
    10 repo stars
95. ▌
    Ata Ppgl Screening Test Selection · dromlakhani

    Chooses the initial screening test for suspected pheochromocytoma and paraganglioma when evaluating hypertension with paroxysmal symptoms, adrenal incidentaloma, or family history of PPGL. Selects among random urinary fractionated metanephrines (creatinine corrected), blood fractionated catecholamines, or plasma-free fractionated metanephrines.
    10 repo stars
96. ▌
    Ppgl 68ga Dotatate Pet Indication · dromlakhani

    Determines when to use 68Ga-DOTATATE PET for diagnosing primary head and neck paragangliomas irrespective of genetic variants. Triggers include suspected head/neck PGL requiring sensitive detection, evaluating for SSTR-positive neuroendocrine tumor, and pre-assessment for 177Lu-DOTATATE therapy in HNPGL.
    10 repo stars
97. ▌
    Ata Pituitary Apoplexy Gc Until Diagnosis · dromlakhani

    Administers glucocorticoid coverage in patients with pituitary apoplexy to prevent adrenal crisis while awaiting definitive laboratory diagnosis. Triggers include managing a pituitary apoplexy patient needing glucocorticoid coverage until laboratory confirmation of pituitary function.
    10 repo stars
98. ▌
    Endo Vitd No Supplementation 50to74 · dromlakhani

    Recommends against routine vitamin D supplementation beyond the Dietary Reference Intake in adults aged 50-74 years without established indications for vitamin D treatment. Triggers include clinician questions such as "Should I prescribe vitamin D to this middle-aged adult?" or "Is vitamin D supplementation needed for patients aged 50-74?"
    10 repo stars
99. ▌
    Endo Vitd Supplementation Pregnancy · dromlakhani

    Suggests empiric vitamin D supplementation during pregnancy to lower the risk of preeclampsia, intra-uterine mortality, preterm birth, small-for-gestational-age birth, and neonatal mortality. Triggered by clinician questions such as "Should I prescribe vitamin D to this pregnant patient?" or "Is vitamin D supplementation indicated for pregnant patients?"
    10 repo stars
100. ▌
     Genryzon Drug Interactions · dromlakhani

     Drug-interaction and co-medication adjustment reference for a child on Genryzon (somatrogon, weekly long-acting growth hormone). Covers glucocorticoids, insulin and oral hypoglycaemics, thyroxine, oral estrogen, and CYP3A4-metabolised drugs (sex steroids, corticosteroids, anticonvulsants, ciclosporin). Use when a clinician asks about drug interactions with Genryzon or somatrogon, prescribing another drug in a child on GH, girl on Genryzon starting OCP, diabetic child starting GH, adjusting hydrocortisone on GH, or CYP3A4 concerns with somatrogon. Grounded in the Pfizer India Product Monograph (Genryzon LPD, 2022 — PfLEET 2022-0081166).
     10 repo stars