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

1. ▌
   Ata Thyroid Fna Decision · dromlakhani

   Decides whether a thyroid nodule needs FNA biopsy using the ATA 2015 sonographic pattern classification (high/intermediate/low/very low/benign) and nodule size thresholds. Use when a clinician asks "does this thyroid nodule need a biopsy", "should I FNA this nodule", "what size threshold for thyroid FNA", "is this nodule suspicious enough for biopsy", or describes a thyroid ultrasound finding and wants a biopsy recommendation. Distinct from EU-TIRADS — uses the ATA 5-pattern system.
   10 repo stars
2. ▌
   Es Gh Treatment Timing · dromlakhani

   This skill determines the appropriate timing for initiating growth hormone (GH) therapy in childhood cancer survivors, recommending to wait until 1 year disease‑free after completion of malignant disease treatment to minimize risks. Triggers include clinician questions such as “When can I start GH therapy after cancer treatment completion?” or “How long should I wait to initiate growth hormone post‑remission?”
   10 repo stars
3. ▌
   Ata Cortisol Cutoff AI Diagnosis · dromlakhani

   Applies serum cortisol cutoffs (<3 μg/dL indicates central adrenal insufficiency; >15 μg/dL likely excludes it) when evaluating morning cortisol for suspected adrenal insufficiency. Triggers include morning cortisol measurement in suspected AI and use when interpreting morning cortisol levels for adrenal insufficiency workup.
   10 repo stars
4. ▌
   Ata Dexamethasone Aed Adjustment · dromlakhani

   In patients with adrenal insufficiency receiving dexamethasone replacement, the guideline suggests increasing the dexamethasone dose when enzyme-inducing antiepileptic drugs are co-administered. Trigger phrases include "AI patient on dexamethasone starts enzyme-inducing antiepileptic drug" or "AI patient on dexamethasone requiring enzyme-inducing AED".
   10 repo stars
5. ▌
   Enda Adult Glucocorticoid Dosing · dromlakhani

   Suggests using hydrocortisone 15–25 mg or cortisone acetate 20–35 mg daily in two or three divided oral doses for adult primary adrenal insufficiency (PAI) patients initiating glucocorticoid replacement. The highest dose is given upon awakening, with the second dose either early afternoon (≈2 h after lunch) or split into lunch and afternoon doses; consider total daily dose calculation based on chosen formulation and frequency.
   10 repo stars
6. ▌
   Enda Emergency Hc Adrenal Crisis · dromlakhani

   Recommends immediate IV hydrocortisone stress dosing for patients with suspected adrenal crisis presenting with severe adrenal insufficiency symptoms such as hypotension, hyponatremia, hyperkalemia, or acute abdominal pain. Use when clinician observes signs of adrenal crisis (e.g., syncope, delirium, marked abdominal tenderness) prior to diagnostic test results.
   10 repo stars
7. ▌
   Endo Pa Repeat Screen Medication · dromlakhani

   Recommends withdrawing interfering medications and repeating aldosterone-to-renin ratio screening when initial screen is negative but clinical suspicion remains due to hypokalemia or medication interference. Trigger phrases include "initial screen negative", "hypokalemia", "resistant hypertension", and use of MRAs, ACE inhibitors, ARBs, beta-blockers, clonidine, or alpha-methyldopa.
   10 repo stars
8. ▌
   Esa Pa Skip Confirmatory Testing · dromlakhani

   This skill determines whether confirmatory testing can be omitted after a positive aldosterone-to-renin ratio (ARR) in patients with suspected primary aldosteronism. It is applied when a patient exhibits spontaneous hypokalemia, undetectable renin, and a plasma aldosterone concentration ≥20 ng/dL (550 pmol/L).
   10 repo stars
9. ▌
   Es Hcm Dose Calcitonin · dromlakhani

   Calculates salmon calcitonin dose based on patient weight for rapid calcium lowering in hypercalcemia of malignancy. Triggered when a clinician considers rapid calcium lowering and asks about weight‑based calcitonin dosing.
   10 repo stars
10. ▌
    Carelink Interpreter · dromlakhani

    Systematically interpret a Medtronic CareLink or MiniMed 780G Daily Review download in a structured 6-step clinical workflow — covering Time in Range, insulin delivery, day/night patterns, hypo and hyperglycemia root causes, and a prioritised action plan. Trigger when a clinician uploads or shares a CareLink report, MiniMed download, 780G Daily Review, pump download, or asks to review a patient's CGM or insulin pump data.
    10 repo stars
11. ▌
    Icsm Avoid Tt For Fathering · dromlakhani

    This skill advises against initiating testosterone therapy in men who express a desire for future fathering, as exogenous testosterone suppresses spermatogenesis and can lead to infertility. It is triggered when a patient reports wanting children and the clinician contemplates prescribing testosterone, raising the question of whether testosterone therapy is safe for future fertility or should be avoided.
    10 repo stars
12. ▌
    Icsm Prostate Monitoring Tt · dromlakhani

    Recommends prostate-specific antigen (PSA) testing and digital rectal examination (DRE) to monitor prostate health during testosterone therapy, following evidence-based guidelines for prostate cancer surveillance. Use when managing a patient on testosterone and questioning whether prostate checks are needed or when PSA/DRE are due.
    10 repo stars
13. ▌
    Icsm Tt Monotherapy Mild Ed · dromlakhani

    Reserve testosterone monotherapy for men with mild erectile dysfunction and an absolute demonstration of hypogonadism; otherwise combine testosterone therapy with a PDE5 inhibitor. Triggered when a clinician managing erectile dysfunction asks whether testosterone alone is sufficient or a PDE5 inhibitor should be added.
    10 repo stars
14. ▌
    Es Ghc Nph Bbi Choice · dromlakhani

    Select either NPH-based insulin regimen or basal bolus insulin regimen for glycemic management in patients receiving glucocorticoids. Triggered by clinician questions such as "Which insulin regimen should we use for steroid-induced hyperglycemia?"
    10 repo stars
15. ▌
    Endo Less Sedating Antihistamine · dromlakhani

    Recommends selecting antihistamines with reduced central nervous system activity (less sedation) to minimize weight‑gain risk. Triggers include clinician questions such as “Which antihistamine is least likely to cause weight gain for this patient with allergies?” or “Should I prefer a non‑sedating antihistamine over diphenhydramine for this obese patient?"
    10 repo stars
16. ▌
    Ata Prolactinoma Axis Reassess · dromlakhani

    Recommends reassessing all pituitary axes in patients with macroprolactinoma and central hypogonadism who have had successful dopamine agonist treatment. Use when managing a macroprolactinoma patient after dopamine agonist treatment with normalized prolactin and tumor shrinkage.
    10 repo stars
17. ▌
    Endo Avoid Random Gh Diagnosis · dromlakhani

    Recommends against using random GH levels to diagnose acromegaly because of pulsatile secretion. Use when a clinician considers ordering a random GH test to evaluate for acromegaly in a patient with suggestive features.
    10 repo stars
18. ▌
    Endo Visual Field Optic Chiasm · dromlakhani

    Suggests performing formal visual field testing when imaging reveals tumor abutting the optic chiasm to evaluate for visual pathway compression. Trigger phrases include MRI or CT showing tumor-chiasm contact.
    10 repo stars
19. ▌
    Es Gh Treatment Regimen · dromlakhani

    This skill selects the appropriate growth hormone treatment regimen for childhood cancer survivors with confirmed growth hormone deficiency. It advises using the same dosing and monitoring strategies as for individuals with GHD from the noncancer population, triggered by questions such as “What GH dose and schedule should I use for this survivor?” or “How do I determine growth hormone therapy parameters in childhood cancer?”
    10 repo stars
20. ▌
    Pediatric Obesity Etiology Screener · dromlakhani

    Screen a child with obesity for red flags suggesting monogenic, syndromic, or secondary endocrine causes — distinguishing atypical from typical exogenous obesity. Trigger when a clinician asks whether obesity could be genetic or hormonal, suspects Prader-Willi syndrome, Cushing disease, hypothyroidism, ROHHAD, Bardet-Biedl syndrome, leptin deficiency, or craniopharyngioma, or when a child has early-onset severe obesity, short stature with obesity, hyperphagia, hypotonia, dysmorphic features, or developmental delay with weight gain.
    10 repo stars
21. ▌
    Pediatric Obesity Surgical Screener · dromlakhani

    Screen a child aged 13+ with obesity for eligibility for bariatric surgery (laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass) using the CMAJ 2025 guideline. Trigger when a clinician asks whether a child qualifies for weight loss surgery, bariatric surgery in adolescents, sleeve gastrectomy in a teenager, or when to refer for surgical management of pediatric obesity.
    10 repo stars
22. ▌
    Ata Acth Stim Test Interpretation · dromlakhani

    Performs corticotropin stimulation test to diagnose adrenal insufficiency when morning cortisol is indeterminate (3-15 µg/dL). Triggers include morning cortisol 3-15 µg/dL requiring further AI testing.
    10 repo stars
23. ▌
    Endo Pa Repeat Screen Hypokalemia · dromlakhani

    Recommends correcting serum potassium to the laboratory reference range and repeating aldosterone-to-renin ratio (ARR) screening when the initial screen is negative in a hypertensive patient with hypokalemia. Use when a clinician encounters a negative PA screen in a hypertensive patient with hypokalemia and wonders whether to repeat testing after potassium repletion.
    10 repo stars
24. ▌
    Jes Pa Avs Subtype Classification · dromlakhani

    This skill provides criteria to distinguish unilateral from bilateral primary aldosteronism using adrenal venous sampling results, including lateralization index, contralateral ratio, and clinical factors. It is triggered after AVS when clinicians analyze results and ask 'Is this unilateral or bilateral PA?' or need to guide treatment decisions.
    10 repo stars
25. ▌
    Es Hcm Dose Pamidronate · dromlakhani

    Determines the appropriate IV pamidronate dose (60‑90 mg) and infusion duration (2‑24 h) for adults with hypercalcemia of malignancy based on renal function. Triggered when a clinician orders pamidronate and asks how to adjust for kidney dysfunction (eGFR < 60 mL/min/1.73 m²).
    10 repo stars
26. ▌
    Es Hcm Treat Bp Or Dmab · dromlakhani

    Recommends initiating intravenous bisphosphonate or denosumab for adults with hypercalcemia of malignancy compared with no treatment. Use when a clinician asks about first‑line pharmacologic therapy for HCM or when deciding to start antiresorptive agents.
    10 repo stars
27. ▌
    Pdm Delivery Timing · dromlakhani

    Recommends early delivery based on individualized risk assessment rather than expectant management for pregnant patients with preexisting diabetes mellitus (PDM). Consider when evaluating delivery timing in the presence of diabetes‑related complications, suboptimal glycemia, abnormal fetal growth, or maternal comorbidities that may increase perinatal risk beyond 38 weeks gestation.
    10 repo stars
28. ▌
    Ata Male Hypogonadism Timing · dromlakhani

    Recommends performing hormonal testing for central hypogonadism in males in the absence of acute/subacute illness, before 10 AM after an overnight fast, combined with serum prolactin measurement. Use when scheduling hormonal tests for male hypogonadism; triggers include preparing to order hypogonadism labs in male patients.
    10 repo stars
29. ▌
    Endo Fha Baseline Bmd Timing · dromlakhani

    This skill advises obtaining a baseline bone mineral density (BMD) measurement by dual‑energy X‑ray absorptiometry (DXA) for any adolescent or woman with six or more months of amenorrhea, and earlier when severe nutritional deficiency, other energy deficit states, or skeletal fragility are suspected. Trigger phrases include 'Get BMD after six months of amenorrhea' or 'Order DXA early due to suspected malnutrition'.
    10 repo stars
30. ▌
    Endo Fha Progestin Challenge · dromlakhani

    This skill involves administering a progestin challenge (e.g., medroxyprogesterone acetate 5–10 mg daily for 5–10 days) to induce withdrawal bleeding, which indicates adequate estrogen exposure and evaluates outflow tract integrity. Use when a clinician states, “Let’s do a progestin challenge to see if she bleeds,” or gives orders such as “Give 10 mg medroxyprogesterone for 10 days and check for bleed” or “Use progestin challenge to assess endometrial estrogen effect”.
    10 repo stars
31. ▌
    Icsm Repeat Testosterone Low · dromlakhani

    Recommends repeating total testosterone measurement on at least two separate occasions when the initial result is below 12 nmol/L before starting testosterone therapy. Triggered when a clinician finds a low total testosterone (<12 nmol/L) and questions whether confirmation is needed prior to treatment.
    10 repo stars
32. ▌
    Es Cc Policy Expertise · dromlakhani

    This skill ensures the hospital has a policy to guide carbohydrate counting for prandial insulin dosing and confirms availability of healthcare professionals knowledgeable in diabetes management. It is triggered when clinicians ask, "Do we have a hospital policy and expertise for carbohydrate counting?" to standardize insulin dosing and improve glycemic safety.
    10 repo stars
33. ▌
    Es No Preop Cho Fluids · dromlakhani

    Do not administer carbohydrate-containing oral fluids preoperatively to adult patients with diabetes undergoing planned elective surgical procedures. Triggered when clinicians ask, "Should we give this patient a carbohydrate drink before surgery?"
    10 repo stars
34. ▌
    Es Preop Hba1c Factors · dromlakhani

    Consider factors that may affect hemoglobin A1c when interpreting preoperative levels for adults with diabetes undergoing elective surgery. Triggered by questions such as "Are there conditions that might make HbA1c unreliable for this patient?" when anemia, hemoglobinopathies, chronic renal failure, alcoholism, drugs, or large blood glucose variations are present.
    10 repo stars
35. ▌
    Endo Ldl Goal Less Than 70 T2d · dromlakhani

    Recommends lowering LDL-C to <70 mg/dL in adults with type 2 diabetes and cardiovascular risk factors to reduce ASCVD risk. Consider when encountering a patient with T2D and CV risk factors, LDL-C >70 mg/dL requiring treatment, or when assessing lipid-lowering therapy goals in diabetes.
    10 repo stars
36. ▌
    Pheo Screening Strategy · dromlakhani

    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."
    10 repo stars
37. ▌
    Ata Gh Elderly Low Igf1 Against · dromlakhani

    Recommends against administering growth hormone to elderly adults who have age-adjusted low IGF-1 levels and no history of pituitary or hypothalamic disease. Triggered when considering GH replacement in an elderly patient with low IGF-1 (e.g., 'elderly patient with low IGF-1 considering GH replacement').
    10 repo stars
38. ▌
    Endo Lft Monitoring Pegvisomant · dromlakhani

    This skill outlines monitoring of liver function tests (LFTs) during pegvisomant therapy for acromegaly. It recommends obtaining LFTs monthly for the first 6 months and then every 6 months, with consideration of discontinuing pegvisomant if transaminases exceed three times the upper limit of normal.
    10 repo stars
39. ▌
    Endo Target Age Normalized Igf1 · dromlakhani

    Suggests a biochemical treatment goal of age-normalized serum IGF-1 value to indicate disease control in acromegaly. Use when setting therapeutic targets after initiating medical therapy or surgery, e.g., post-op IGF-1 at 12 weeks or random GH >1 µg/L.
    10 repo stars
40. ▌
    Endo Vit D Supp Pregnancy · dromlakhani

    The guideline 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. Consider this when a clinician inquires about vitamin D supplementation for pregnant patients to reduce pregnancy complications.
    10 repo stars
41. ▌
    Movicol Prescribing Guide · dromlakhani

    Complete bedside prescribing reference for Movicol (macrogol 3350 + electrolytes) covering dosing for chronic constipation and faecal impaction, special population adjustments, contraindications, warnings, and drug interactions. Trigger when a clinician asks how to dose Movicol, how many sachets to prescribe, how to use Movicol for faecal impaction, whether Movicol is safe in pregnancy or renal failure, or what the contraindications to Movicol are.
    10 repo stars
42. ▌
    Enda Monitor Pregnant Pai Patients · dromlakhani

    Suggests that pregnant patients with primary adrenal insufficiency be monitored for clinical signs of glucocorticoid over- or under-replacement such as normal weight or gain, fatigue, postural hypotension or hypertension, and hyperglycemia, with at least one review each trimester. Use when managing a pregnant patient with PAI to assess glucocorticoid dosing adequacy.
    10 repo stars
43. ▌
    Enda Renin Aldosterone Measurement · dromlakhani

    This skill recommends simultaneous measurement of plasma renin and aldosterone in patients with primary adrenal insufficiency (PAI) to determine the presence of mineralocorticoid deficiency. It is triggered when assessing for mineralocorticoid deficiency in PAI, such as in patients with unexplained hyponatremia, hyperkalemia, or salt craving despite glucocorticoid replacement.
    10 repo stars
44. ▌
    Enda Test Pai Acutely Ill Symptoms · dromlakhani

    Recommends diagnostic testing to exclude primary adrenal insufficiency (PAI) in acutely ill patients presenting with otherwise unexplained volume depletion, hypotension, hyponatremia, hyperkalemia, fever, abdominal pain, hyperpigmentation, or hypoglycemia (especially in children). Use when clinical suspicion arises from these suggestive signs or symptoms suggestive of PAI.
    10 repo stars
45. ▌
    Jes Pa Avs Catheterization Success · dromlakhani

    Determines successful catheterization in adrenal venous sampling by applying selectivity index cut‑offs with and without ACTH stimulation. Triggered during AVS when measuring cortisol levels and asking “Is the catheter properly positioned?” or when reviewing results for technical adequacy.
    10 repo stars
46. ▌
    Jes Pa Confirmatory Test Selection · dromlakhani

    Guides selection of the optimal confirmatory test (CCT, SIT, FUT, OSLT) for primary aldosteronism based on patient safety and feasibility. Triggers include when a clinician asks “Which confirmatory test should I use?” or evaluates patient comorbidities before testing.
    10 repo stars
47. ▌
    Jes Pa Pregnancy Mra Consideration · dromlakhani

    Suggests considering mineralocorticoid receptor antagonists when benefits outweigh risks in pregnant or preconception PA patients with uncontrolled hypertension and hypokalemia. Triggered when standard therapy fails and clinicians ask 'Should I consider MRAs despite pregnancy?' or when assessing risk‑benefit of MRA use.
    10 repo stars
48. ▌
    Es Cgm Vs Smbg T1d Mdi · dromlakhani

    Recommends CGM over SMBG for type 1 diabetes patients on multiple daily injections to reduce hypoglycemia risk. Triggered by clinician questions such as "Should I use CGM or SMBG for this T1D patient on MDI?" or "Is CGM preferred for glucose monitoring in this patient?"
    10 repo stars
49. ▌
    Es Assess Gd Dsm5 Criteria · dromlakhani

    This skill determines whether an adolescent or adult patient meets DSM-5 criteria for gender dysphoria (gender incongruence) by evaluating the presence of at least two of six specified criteria over a minimum 6-month duration, accompanied by clinically significant distress or impairment. It is triggered when a clinician queries whether the patient's reported symptoms align with gender dysphoria, such as persistent incongruence between experienced/expressed gender and designated gender.
    10 repo stars
50. ▌
    Endo Fha Educate Ocps Masking · dromlakhani

    This skill involves educating patients with functional hypothalamic amenorrhea who use oral contraceptive pills for contraception that the pills may conceal the return of spontaneous menses and that bone loss can persist if an energy deficit remains. Use when a clinician says, “Let’s explain how OCPs might hide her recovery,” or when hearing triggers such as “Warn her OCPs can mask menses” or “Tell her bone loss may persist despite OCPs if she stays underweight.”
    10 repo stars
51. ▌
    Endo T Ongoing Monitoring 6mo · dromlakhani

    Recommends reviewing serum testosterone levels every 6 months during ongoing therapy to monitor for excessive use and signs of androgen excess such as hirsutism or acne. It is indicated when a clinician manages a woman receiving long-term testosterone therapy and needs to evaluate for adverse effects or consider dose adjustment.
    10 repo stars
52. ▌
    Endo T Trial Baseline Nonoral · dromlakhani

    Recommends checking baseline testosterone level and using an approved non-oral preparation (such as transdermal patch, gel, or cream) when initiating a testosterone trial for hypoactive sexual desire disorder (HSDD) in women. Triggered when a clinician plans to start a T trial for HSDD and needs to confirm baseline levels and select an appropriate delivery method.
    10 repo stars
53. ▌
    Icsm Avoid Tt For Weight Loss · dromlakhani

    The skill advises against using testosterone therapy alone for weight loss or cardio-metabolic improvement. It triggers when a clinician considers prescribing testosterone for obesity or diabetes and questions whether testosterone alone will aid weight loss or improve metabolic parameters.
    10 repo stars
54. ▌
    Icsm Hematocrit Monitoring Tt · dromlakhani

    This skill guides clinicians to maintain hematocrit below 54% before and during testosterone therapy, with particular attention to high-altitude populations to mitigate polycythemia risk. It is triggered when reviewing labs and asking, "Is the hematocrit safe or do I need to adjust or hold testosterone due to high Hct?"
    10 repo stars
55. ▌
    Icsm Treat Symptomatic Low Tt · dromlakhani

    Recommends initiating testosterone therapy in symptomatic men with total testosterone less than 12 nmol/L (350 ng/dL). Triggers when patients present with low libido, erectile dysfunction, fatigue, or decreased vigor and have confirmed low T levels.
    10 repo stars
56. ▌
    Es Cc Or Fixed Prandial · dromlakhani

    For adult patients with type 1 diabetes or insulin-treated type 2 diabetes hospitalized for noncritical illness who require prandial insulin, suggest either carbohydrate counting or fixed prandial insulin dosing. Triggered by clinician queries such as "Patient is T1D or insulin-treated T2D, how should we dose prandial insulin?"
    10 repo stars
57. ▌
    Es No Cc Noninsulin T2d · dromlakhani

    In adult patients with noninsulin-treated type 2 diabetes hospitalized for noncritical illness who require prandial insulin therapy, the guideline suggests avoiding carbohydrate counting for prandial insulin dosing. Consider this approach when clinicians ask, "Patient is noninsulin-treated T2D needing prandial insulin, should we use carb counting?"
    10 repo stars
58. ▌
    Gcih Patient Classifier · dromlakhani

    Classify a hospitalised patient on glucocorticoids as established diabetic (Group 1) or new glucocorticoid-induced hyperglycemia without prior DM (Group 2), then determine whether background basal-bolus insulin is needed and at what starting dose based on HbA1c. Trigger when a clinician asks "does this steroid patient need background insulin", "starting insulin dose for steroid-induced diabetes", "how to manage GCIH in a known diabetic vs new hyperglycemia", "background insulin for prednisolone patient", or any question about initiating insulin in a patient receiving glucocorticoids.
    10 repo stars
59. ▌
    Ata Ppgl Avoid Fna Hnpgl · dromlakhani

    Recommends against fine needle cytology for pathological diagnosis of head and neck paraganglioma due to its low accuracy and risk of misdiagnosis. Use when a clinician asks 'Should I perform fine needle cytology for suspected head and neck paraganglioma?' — triggers include suspicion of head and neck paraganglioma requiring pathological confirmation.
    10 repo stars
60. ▌
    Ppgl Beta Blocker Timing · dromlakhani

    Determines the appropriate timing for initiating beta-blocker therapy in patients with pheochromocytoma/paraganglioma (PPGL) to prevent hypertensive crisis. Indicated for tachycardia/tachyarrhythmia, myocardial damage, heart failure, or ischemic heart disease only after adequate alpha-blockade; contraindicated before alpha-blocker initiation, and triggered by clinician statements such as “Patient develops tachycardia on alpha-blocker therapy,” “Need to control heart rate in PPGL with cardiac comorbidities,” or “Assessing safety of adding beta-blocker to current regimen.”
    10 repo stars
61. ▌
    Ata Gh Pregnancy Discontinuation · dromlakhani

    Suggests discontinuing growth hormone (GH) replacement during pregnancy due to lack of clear evidence for efficacy or safety and placental GH production. Triggers include managing a pregnant patient on GH replacement.
    10 repo stars
62. ▌
    Ata No Prescheduled Ddavp Postop · dromlakhani

    Recommends against prescheduled desmopressin (DDAVP) dosing in the first week after pituitary surgery due to hyponatremia risk from transient diabetes insipidus resolution and syndrome of inappropriate antidiuretic hormone secretion occurring 7–10 days postoperatively. Use when managing a postoperative diabetes insipidus patient in the first week after surgery.
    10 repo stars
63. ▌
    Endo Avoid Preop Medical Therapy · dromlakhani

    The guideline recommends against routine preoperative medical therapy (e.g., somatostatin receptor ligands) solely to improve postoperative biochemical control in acromegaly. Consider this when planning transsphenoidal surgery and evaluating whether to initiate medical pretreatment.
    10 repo stars
64. ▌
    Endo Confirm Gh Suppression Ogtt · dromlakhani

    Recommends confirming acromegaly in patients with elevated or equivocal IGF-1 by demonstrating lack of GH suppression to <1 µg/L after an oral glucose load. Triggers include equivocal IGF-1 results requiring diagnostic certainty before proceeding to imaging.
    10 repo stars
65. ▌
    Endo Igf1 Pituitary Mass Ruleout · dromlakhani

    Recommends measuring serum IGF-1 to exclude acromegaly in any patient discovered to have a pituitary mass on imaging. Triggers include incidental pituitary lesion found on MRI/CT for unrelated reasons.
    10 repo stars
66. ▌
    Endo Igf1 Typical Manifestations · dromlakhani

    Recommends measuring serum IGF-1 to screen for acromegaly in patients presenting with typical acral and facial manifestations such as enlarging ring or shoe size, macroglossia, or frontal bossing. Trigger phrases include “acral enlargement,” “facial coarsening,” “prognathism,” or “spade‑like hands” prompting IGF-1 measurement.
    10 repo stars
67. ▌
    Dfi Antibiotic Selector · dromlakhani bundle

    Select the correct empiric antibiotic regimen for a diabetic foot infection based on infection grade and MRSA risk, using the IWGDF/IDSA 2023 framework. Trigger when a clinician asks which antibiotic to use for a diabetic foot infection, DFI, or DFU, or asks about empiric treatment, antibiotic choice, or antibiotic duration for a foot wound in a diabetic patient.
    10 repo stars
68. ▌
    Dfi Severity Classifier · dromlakhani bundle

    Classify the severity of a Diabetes-related Foot Infection (DFI) using the IWGDF/IDSA 2023 step-by-step framework. Use this skill whenever a clinician presents a diabetic foot case and wants to know if it's infected, how severe it is, whether osteomyelitis is present, and what to do next. Trigger on mentions of diabetic foot ulcer, DFI, DFU with signs of infection, foot wound in diabetes, or requests to "classify" or "grade" a foot infection.
    10 repo stars
69. ▌
    Es Male Cpp Hormone Test · dromlakhani

    This skill determines whether serum testosterone (preferably via LC-MS/MS) and luteinizing hormone levels should be obtained before 10:00 AM to support clinical evaluation of male childhood cancer survivors suspected of or at risk for central precocious puberty after gonadotoxic exposure. It is triggered by clinician questions such as "Should I check testosterone and LH for this boy at risk for early puberty after chemo?" or "Is morning hormone testing needed for CPP evaluation in males with gonadotoxic history?"
    10 repo stars
70. ▌
    Enda Glucocorticoid Therapy All Pai · dromlakhani

    Recommends initiating glucocorticoid therapy in all patients with confirmed primary adrenal insufficiency (PAI). Use when PAI diagnosis is confirmed by subnormal cortisol response to ACTH stimulation test or elevated ACTH with low cortisol.
    10 repo stars
71. ▌
    Enda Preliminary Cortisol Acth Test · dromlakhani

    Suggests using morning cortisol ≤140 nmol/L (5 µg/dL) in combination with ACTH as a preliminary test suggestive of primary adrenal insufficiency when a corticotropin stimulation test is not feasible. Use when patients present with indicative symptoms such as hypotension, hyponatremia, hyperkalemia, or fatigue and corticotropin stimulation testing cannot be performed.
    10 repo stars
72. ▌
    Jes Pa Screening Positive Treatment · dromlakhani

    Recommends antihypertensive therapy including mineralocorticoid receptor antagonists (MRAs) for patients with a positive primary aldosteronism (PA) screening test who decline confirmatory testing. Triggers include when a patient has positive screening but refuses additional tests and asks "What should I treat with?" or initiates empiric therapy, with preference for MRAs in typical PA presentations (e.g., spontaneous hypokalemia, resistant hypertension, adrenal tumor on CT).
    10 repo stars
73. ▌
    Es Cushing Patient Family Education · dromlakhani

    This skill provides structured education to patients and families about Cushing's syndrome pathophysiology, treatment options, and post-remission expectations. It is triggered when a clinician encounters a new Cushing's syndrome patient or family needing disease information, such as at initial diagnosis or before treatment initiation.
    10 repo stars
74. ▌
    Es Cushing Treatment Goals Overt Cs · dromlakhani

    This skill defines the treatment goals for patients with overt Cushing's syndrome, focusing on normalizing cortisol levels or action to eliminate symptoms and treat comorbidities. Use when a clinician asks about treatment objectives for a newly diagnosed overt Cushing's syndrome patient; triggers include "overt CS," "treatment goals for overt Cushing's," and "normalize cortisol in overt CS."
    10 repo stars
75. ▌
    Pdm Contraception Use · dromlakhani

    Recommends contraception when pregnancy is not desired for individuals with diabetes who could become pregnant. Triggered by discussions about pregnancy planning, contraception needs, or when pregnancy is not desired.
    10 repo stars
76. ▌
    Ata Female Hypogonadism Workup · dromlakhani

    This skill guides the workup of females with oligomenorrhea or amenorrhea to evaluate for central hypogonadism by measuring serum estradiol, FSH, and LH while excluding pregnancy, hyperprolactinemia, hyperandrogenism, and thyroid disease. Use when evaluating a female with menstrual irregularities suggesting hypogonadism (e.g., oligomenorrhea/amenorrhea with low estrogen and inappropriately low or normal gonadotropins).
    10 repo stars
77. ▌
    Endo Fha Avoid Ocps Menses Bmd · dromlakhani

    This skill advises against prescribing oral contraceptive pills solely to induce menstruation or enhance bone mineral density in patients with functional hypothalamic amenorrhea (FHA). Use when a clinician considers, 'Should I give her OCPs to get her period back?' or encounters statements such as 'Don’t use OCPs just for menses' or 'Avoid OCPs as a sole BMD strategy'.
    10 repo stars
78. ▌
    Endo Fha Brain Mri Indications · dromlakhani

    This skill recommends obtaining a brain MRI with pituitary slices and contrast in adolescents or women with presumed functional hypothalamic amenorrhea (FHA) who have severe/persistent headaches, non-self-induced vomiting, changes in vision/thirst/urination, lateralizing neurologic signs, or clinical/laboratory evidence of pituitary hormone deficiency or excess. Triggers include phrases such as “MRI for persistent headache and vomiting” or “Get pituitary MRI if there are neuro signs”.
    10 repo stars
79. ▌
    Endo T Generalized Use Against · dromlakhani

    The guideline recommends against generalized testosterone use for indications such as infertility, sexual dysfunction other than HSDD, cognitive, cardiovascular, metabolic, bone health, or general well-being due to insufficient evidence of benefit and lacking long-term safety data. Consider this recommendation when a clinician contemplates prescribing testosterone for any indication other than confirmed hypoactive sexual desire disorder in postmenopausal women.
    10 repo stars
80. ▌
    Endo Basal Insulin Trial · dromlakhani

    In obese patients with type 2 diabetes mellitus requiring insulin, a preferential trial of basal insulin is recommended before initiating premixed or combination insulin therapy. Consider this approach when clinicians ask, 'Should I try basal insulin alone before moving to premixed insulin in this patient?' or 'Is a basal‑only trial appropriate before initiating combination insulin therapy?'.
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81. ▌
    Es Preop Target Hba1c Bg · dromlakhani

    For adult patients with diabetes undergoing elective surgical procedures, aim for preoperative hemoglobin A1c below 8% and blood glucose concentrations between 100 to 180 mg/dL. Triggered by questions such as "What preoperative glycemic targets should we set for this surgical patient?"
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82. ▌
    Ata Post Acromegaly Di Monitoring · dromlakhani

    Monitors for diabetes insipidus development after glucocorticoid replacement in cured acromegaly patients; recommends adrenal insufficiency testing if diabetes insipidus improves without an adrenal insufficiency diagnosis. Triggered when managing a cured acromegaly patient receiving glucocorticoid replacement.
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83. ▌
    Ata Postop Thyroid Function Check · dromlakhani

    Measures free T4 6–8 weeks after pituitary surgery in patients with intact preoperative thyroid function to detect central hypothyroidism. Triggers include postoperative patient needing thyroid function assessment and postoperative patient with intact preoperative thyroid function.
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84. ▌
    Endo Therapeutic Goal Random Gh 1 · dromlakhani

    Suggests using a random GH level <1.0 µg/L as a therapeutic goal to assess biochemical control of acromegaly during follow‑up after surgery or medical therapy. Use when evaluating post‑treatment response, particularly when random GH is measured alongside IGF‑1 to determine if disease is controlled.
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85. ▌
    Endo Us Gallstones If Symptomatic · dromlakhani

    Recommend performing abdominal ultrasound when a patient on somatostatin receptor ligand (SRL) therapy develops signs or symptoms suggestive of gallstone disease. Trigger phrases include biliary colic, postprandial right upper quadrant pain, Murphy's sign, or suspected cholecystitis.
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86. ▌
    Endo Vitd No Testing 50to74 · dromlakhani

    This skill recommends against routine 25(OH)D testing in asymptomatic adults aged 50–74 years. It is triggered by questions such as "Should I order a vitamin D level for this patient aged 50-74?" or "Is vitamin D testing indicated for asymptomatic middle-aged adults?"
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87. ▌
    Endo Vitd No Testing Over75 · dromlakhani

    Recommends against routine 25(OH)D testing in adults aged 75 years and older. Triggered by questions such as "Should I order a vitamin D level for this patient over 75?" or "Is vitamin D testing indicated for asymptomatic elderly adults?"
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88. ▌
    Enda Low Dose Stim Test Short Supply · dromlakhani

    Suggests using a low-dose (1 µg) corticotropin stimulation test to diagnose primary adrenal insufficiency when the standard 250 µg corticotropin is unavailable due to drug shortage. Consider this approach when clinicians encounter a corticotropin shortage or when the standard dose cannot be obtained.
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89. ▌
    Esa Pa Interpret Oral Sodium Loading · dromlakhani

    This skill interprets the oral sodium loading test for primary aldosteronism by evaluating 24‑hour urinary aldosterone excretion after a high‑sodium diet. Use when reviewing results of an "oral sodium loading test" for PA diagnosis; trigger phrases include "urinary aldosterone excretion ≤10 g/24 h" (PA unlikely) or "≥12 g/24 h (Mayo) / ≥14 g/24 h (Cleveland)" (PA highly likely).
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90. ▌
    Es Hcm Prefer Dmab Over Bp · dromlakhani

    This skill suggests using denosumab rather than an intravenous bisphosphonate for adults with hypercalcemia of malignancy. It is triggered when a clinician questions which antiresorptive to choose first or seeks guidance on drug selection for HCM.
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91. ▌
    Es Hcm Refractory Use Dmab · dromlakhani

    Recommends denosumab for adults with refractory or recurrent hypercalcemia of malignancy who have persistent or relapsed hypercalcemia despite intravenous bisphosphonate therapy. Triggered when a clinician observes recurrent hypercalcemia after bisphosphonate treatment or considers next‑line agents for HCM.
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92. ▌
    Endo Cgm Vs Smbg T1d Mdi · dromlakhani

    Recommends using continuous glucose monitoring instead of fingerstick self-monitoring for type 1 diabetes patients on multiple daily injections to reduce hypoglycemia risk. Use when a clinician evaluates glucose monitoring options for T1D on MDIs or manages hypoglycemia-prone T1D patients.
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93. ▌
    Endo Hirsutism No Preference Oc · dromlakhani

    This skill guides clinicians to initiate oral combined estrogen–progestin contraceptives as initial therapy for premenopausal women with patient-important hirsutism despite cosmetic measures who are not seeking fertility. It emphasizes that no specific OC formulation is preferred, as all appear equally effective for hirsutism with low side‑effect risk.
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94. ▌
    Endo T Male Formulation Against · dromlakhani

    Advises against using testosterone preparations formulated for men or compounded by pharmacies in women due to lack of efficacy and safety data specific to female physiology. Triggers include a clinician considering a transdermal patch, gel, or injectable testosterone product that is labeled or compounded for male use.
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95. ▌
    Endo T Monitoring Early And 6mo · dromlakhani

    This skill recommends monitoring serum testosterone levels 3–6 weeks after initiating therapy and every 6 months thereafter to detect overuse or signs of androgen excess. It is triggered when a clinician manages a woman on testosterone therapy requiring early safety assessment and ongoing surveillance for adverse effects.
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96. ▌
    Icsm Testosterone Threshold Loh · dromlakhani

    This skill applies a total testosterone threshold of less than 12 nmol/L (3.5 ng/mL) to diagnose late-onset hypogonadism. It is triggered when a clinician evaluates a testosterone result and questions whether the level is low enough to diagnose hypogonadism or what cutoff defines low T.
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97. ▌
    Es Dces Credentials Check · dromlakhani

    Verify that a diabetes care and education specialist (DCES) involved in inpatient diabetes education holds Certified Diabetes Care and Education Specialist (CDE) or Board Certified-Advanced Diabetes Management (BC-ADM) credentials, or is actively working toward such certification. Triggered by questions like "Does the DCES have required credentials?" to ensure qualified education delivery.
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98. ▌
    Es Dces Resource Training · dromlakhani

    When diabetes care and education specialist (DCES) availability is limited, availability is limited, the DCES serves as a resource to train healthcare providers (e.g., staff nurses, pharmacists, dietitians) to deliver inpatient diabetes education. Trigger phrases include "DCES scarce, how to still provide diabetes education?"
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99. ▌
    Endo Paget Bisphosphonate Chf · dromlakhani

    This skill suggests treatment with a bisphosphonate in patients with Paget's disease who also have symptomatic congestive heart failure. Triggers include the presence of Paget's disease alongside signs or symptoms of congestive heart failure such as dyspnea, orthopnea, or elevated jugular venous pressure.
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100. ▌
     Ppgl Gi Symptom Management · dromlakhani

     Manages gastrointestinal symptoms (constipation, paralytic ileus, mega-colon) in pheochromocytoma and paraganglioma (PPGL) using intravenous phentolamine and oral metyrosine to improve intestinal peristalsis. Indicated for PPGL patients with severe constipation or ileus, GI symptoms suspected due to catecholamine excess, or when improving intestinal motility is needed.
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