This skill recommends obtaining an oncology consultation to direct treatment of the underlying malignancy causing hypercalcemia of malignancy. It is triggered when a clinician diagnoses HCM and seeks guidance on coordinating cancer‑directed therapy.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
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.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
This skill recommends follow-up morning cortisol and/or ACTH stimulation tests or insulin-induced hypoglycemia to assess HPA axis recovery in postoperative Cushing's syndrome patients with at least one intact adrenal gland. Triggers include postoperative remission (morning cortisol <5 µg/dL or UFC <28–56 nmol/d) and the need to evaluate HPA recovery before glucocorticoid discontinuation.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
Screen a hypercalcemic patient for medication- and supplement-induced causes — thiazides, lithium, vitamin D, vitamin A/retinoids, antiestrogens, theophylline, milk-alkali, SGLT2 inhibitors, immune checkpoint inhibitors, denosumab rebound, teriparatide/abaloparatide, foscarnet, ketogenic diet, aluminium. Trigger when a clinician asks "is this hypercalcemia drug-induced", "thiazide hypercalcemia", "lithium hypercalcemia", "denosumab rebound hypercalcemia", "vitamin D toxicity", "milk-alkali syndrome", "SGLT2 hypercalcemia", or any new hypercalcemia where medication review is needed.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
This skill recommends measuring late-night salivary or serum cortisol to screen for Cushing's disease recurrence in patients with eucortisolism after transsphenoidal surgery, including cases where eucortisolism was established by medical treatment prior to surgery. Use when postoperative follow-up shows eucortisolism (normal morning cortisol/UFC) but concern for recurrence exists.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
This skill recommends transsphenoidal selective adenomectomy (TSS) by an experienced pituitary surgeon as the optimal treatment for Cushing's disease in pediatric and adult patients. Use when a patient with ACTH-dependent Cushing syndrome is a surgical candidate; triggers include overt Cushing's syndrome, elevated UFC or late-night salivary cortisol, and pituitary MRI showing an adenoma.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
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.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
This skill recommends lifelong biochemical testing for recurrence in all patients with Cushing's syndrome after adrenalectomy, except those with resected adrenal adenoma showing CT density <10 Hounsfield units. Use when determining long‑term follow‑up strategy for a post‑adrenalectomy CS patient; triggers include “post‑adrenalectomy Cushing’s syndrome”, “CT density <10 HU”, and “adrenal adenoma resection”.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
This skill suggests targeted therapies (somatostatin analogs or tyrosine kinase inhibitors) to treat ectopic ACTH syndrome when ectopic ACTH secretion is confirmed or strongly suspected. Use when triggers include occult or metastatic ectopic ACTH secretion, very severe ACTH‑dependent disease uncontrolled by medical therapy, or when surgery is not possible or noncurative.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
This skill recommends lifelong follow-up tests for cardiac myxoma and associated disease (testicular tumors, acromegaly, thyroid lesions) in patients with Carney complex. Use when managing a Cushing’s syndrome patient with a confirmed or suspected Carney complex diagnosis (e.g., spotty skin lentigines, cardiac myxoma, endocrine tumors).
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
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.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
This skill provides a shared decision-making framework for selecting second-line therapies in patients with ACTH-dependent Cushing's syndrome who have persistent hypercortisolism after transsphenoidal surgery or for whom surgery is not feasible. Clinical triggers include "failed TSS", "non-curative pituitary surgery", "persistent UFC elevation post-op", and "surgery contraindicated".
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
This skill suggests medical therapy to block aberrant hormone receptors for bilateral macronodular adrenal hyperplasia (BMAH) when surgery is not preferred or feasible. Consider this approach in patients with confirmed BMAH and evidence of aberrant hormone receptor expression (e.g., GIP, LH/hCG, serotonin) driving cortisol excess.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
This skill recommends urgent treatment (within 24–72 hours) of hypercortisolism when life‑threatening complications of Cushing's syndrome such as infection, pulmonary thromboembolism, cardiovascular events, or acute psychosis are present. Trigger phrases include sepsis, PE, chest pain with hemodynamic instability, new‑onset psychosis, or delirium in a patient with known or suspected Cushing's.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
This skill recommends bilateral adrenalectomy for occult or metastatic ectopic ACTH secretion or as a life-preserving emergency treatment in patients with very severe ACTH‑dependent Cushing’s syndrome who cannot be promptly controlled by medical therapy. It is triggered by life‑threatening complications of uncontrolled hypercortisolism such as infection, pulmonary thromboembolism, cardiovascular catastrophe, or acute psychosis.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
This skill recommends unilateral resection by an experienced adrenal surgeon for all cases of benign unilateral disease causing Cushing's syndrome. Trigger when a CS patient has a unilateral adrenal lesion confirmed benign via imaging and biochemical assessment.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
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."
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
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.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
This skill suggests perioperative prophylaxis for venous thromboembolism in patients with Cushing's syndrome undergoing surgery. Use when preparing a CS patient for any surgical procedure; triggers include "CS patient pre-op", "Cushing's syndrome surgery", "perioperative VTE prophylaxis CS".
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
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".
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
Work up a patient with confirmed hypercalcemia using the PTH-dependent vs. PTH-independent algorithm — order the right second-tier tests (PTHrP, 25(OH)D, 1,25(OH)2D, SPEP/UPEP, urinary calcium/creatinine clearance ratio, TSH) to reach a diagnosis. Trigger when a clinician asks "what's causing this hypercalcemia", "how to work up high calcium", "what tests to order for hypercalcemia", "PTH is normal what next", "differential diagnosis of hypercalcemia", or shares a confirmed hypercalcemia and asks for the workup.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
Provides a checklist of five evidence-based measures to enhance the technical success of adrenal venous sampling procedures. Triggers include when preparing for AVS and asking 'How can I maximize success rate?' or troubleshooting failed attempts.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
Determines when to pursue genetic testing for glucocorticoid-remediable aldosteronism (FH-I/GRA) in patients with confirmed primary aldosteronism (PA). Indicated when PA onset is before age 20 or there is a family history of PA or stroke before age 40.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新
Determines age- and body weight-appropriate glucocorticoid dosage for pediatric patients with primary aldosteronism, particularly glucocorticoid-remediable aldosteronism (GRA), to avoid over-treatment. Use when prescribing glucocorticoids to children with confirmed or suspected PA; triggers include pediatric PA, GRA, or need to dose glucocorticoid based on age and weight.
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。
dromlakhani/MD2SKILL☆ 142026年10月5日 更新