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This skill recommends measuring serum cortisol or urine free cortisol off-medication at 6- to 12-month intervals to assess radiation therapy effect in patients with Cushing's syndrome undergoing or post-radiotherapy. It is also indicated when patients on stable medical therapy develop new adrenal insufficiency symptoms such as fatigue, weight loss, or hypotension.

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This skill directs lifelong treatment of cardiovascular risk factors, osteoporosis, and psychiatric symptoms in all patients with Cushing's syndrome until biochemical resolution of hypercortisolism. Use when managing any CS patient for long‑term comorbidity control; triggers include persistent hypertension, dyslipidemia, low bone density, depression, anxiety, or cognitive changes in the setting of known or suspected CS.

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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.

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Initiates a 6‑month trial of DHEA replacement in women with primary adrenal insufficiency (PAI) who have persistent low libido, depressive symptoms, or low energy despite otherwise optimized glucocorticoid and mineralocorticoid therapy. If the patient does not report a sustained beneficial effect after 6 months, discontinue DHEA.

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The Endocrine Society recommends a standard-dose corticotropin (ACTH) stimulation test to confirm primary adrenal insufficiency when clinical suspicion arises from symptoms such as hypotension, hyponatremia, hyperkalemia, or unexplained fatigue. Dosing is weight/age based: 250 µg for adults and children ≥2 years, 15 µg/kg for infants, and 125 µg for children <2 years.

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Educates patients with primary adrenal insufficiency on increasing glucocorticoid dosage during intercurrent illness, fever (≥38°C), or physiological stress, including recognition of precipitating symptoms (e.g., fever, vomiting, trauma) and actions to prevent impending adrenal crisis. Trigger phrases: fever, intercurrent illness, stress, vomiting, inability to tolerate oral meds, need for parenteral glucocorticoid.

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Suggests monitoring DHEA replacement in women with primary adrenal insufficiency (PAI) by measuring morning serum DHEAS levels before the daily dose, targeting the mid‑normal range. Consider when evaluating low libido, depressive symptoms, or low energy despite optimized glucocorticoid and mineralocorticoid replacement.

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Recommends confirmatory testing with corticotropin stimulation test in patients presenting with clinical symptoms or signs suggesting PAI (e.g., fatigue, hypotension, hyponatremia, hyperpigmentation) when the patient's condition permits safe testing. Use when a clinician identifies suggestive features and circumstances allow outpatient stimulation testing without imminent need for emergency glucocorticoids.

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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.

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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.

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Guide pre-endoscopy management decisions for patients on GLP-1 receptor agonists (semaglutide, tirzepatide, liraglutide etc.), deciding whether to proceed, delay, or modify the approach based on GI symptoms, fasting status, and indication. Trigger when a clinician asks about GLP-1 RA and endoscopy, semaglutide before colonoscopy, Ozempic before procedure, or whether to hold a GLP-1 agonist before endoscopy.

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Trace bugs backward to their origin, not just symptoms

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Find the first batch of foreign-trade prospect companies from public web, LinkedIn, and user-authorized data sources such as customs exports, trade show lists, association directories, CRM/Excel files, or historical customer data, then output a conservative, structured candidate list ready for lead screening.

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Control Philips Hue lights, scenes, rooms via OpenHue CLI.

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Generate architecture and design documents for implemented code changes with risk-based depth selection. Automatically evaluates risk signals, layer spread, and change magnitude to choose documentation level (A/B/C). Use after completing a feature, before merging a PR that touches multiple layers or sensitive areas (auth, infra, migrations, payments), or when an implemented change needs a design record or ADR.

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Finalize documentation changes for production readiness by discovering existing conventions, verifying code-doc alignment, reviewing format/terminology/tone consistency, verifying branch/worktree intent, and structuring clean commits with a post-publish branch/worktree cleanup decision. Counterpart of finalize-and-commit for documentation projects.

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Diagnose and fix CJK (Korean, Japanese, Chinese) text-wrapping issues in web UIs. Systematically traces mid-syllable breaks, orphaned glyphs, and awkward line splits through a layered fix strategy covering global CSS cascade, component-library overrides, headline balancing, and translation-level phrase binding. Produces an evidence-based diagnosis and verification report before any code change is applied.

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Format and publish rich Notion documents with structured sections, code blocks, tables, callouts, quotes, mermaid diagrams, and emojis. Use when the user asks to organize, write, or save content to Notion (e.g., "notion에 정리해줘", "notion에 저장해줘"), or when invoked with /notion-format. Detects content type (tech-doc, meeting-notes, analysis, tutorial, bug-report) and applies the appropriate formatting template automatically.

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Finalize code changes for production readiness by removing duplicate logic, auditing hardcoded values, verifying branch/worktree intent, verifying build integrity, structuring clean commits with Conventional Commits format, and forcing a post-publish branch/worktree cleanup decision.

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Ship an already-committed Git branch through GitHub: verify branch/worktree intent, push, create or mark a pull request ready for review, optionally wait for CI, optionally address review comments automatically, and merge with explicit safety gates. Use when a solo developer repeatedly asks to publish committed work, register a ready PR, handle PR feedback, and complete merge.

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Research and compare how competing products implement a similar feature at the UX and interaction level. Provides structured comparison tables and strategic differentiation recommendations.

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Re-audit code changes to identify side effects, regression risks, and unhandled edge cases before merging or deploying. Use after a change is complete and before merging to a shared branch, before deploying a hotfix, after complex multi-module refactoring, or when a previous review may have missed side effects in async, state-mutating, or security-sensitive code paths.

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Continuously detect recurring UI/UX concepts during frontend discussions, track conversation-wide recurrence, and register repeated concepts as structured knowledge assets in a Notion database via MCP. Activates when UI/UX principles, heuristics, laws, or design patterns recur during frontend work, or on manual @ux commands (@ux save, @ux skip, @ux link).

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Sync reusable frontend decisions into persistent project documentation after UI work. Use when frontend changes introduce or modify component APIs, variants, design-system tokens, styling conventions, layout behavior, accessibility rules, interaction patterns, responsive behavior, or agent operating instructions; when the user asks to reflect decisions in components.md, design system docs, AGENTS.md, CLAUDE.md, GEMINI.md, or similar project memory files; or before finalizing frontend work where future consistency depends on decisions made during implementation.

日本語の概要は準備中です。原文の説明を表示しています。