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cccskills

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概要と使いどころ

Selects spironolactone as first-line mineralocorticoid receptor antagonist for bilateral primary aldosteronism, with eplerenone as an alternative when spironolactone–related adverse effects are problematic. Trigger phrases include 'confirmed bilateral PA on AVS', 'idiopathic adrenal hyperplasia', 'bilateral adrenal hyperplasia', 'glucocorticoid-remediable aldosteronism', and 'initiating medical therapy for bilateral adrenal disease'.

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/MD2SKILL142026年10月5日 更新

Recommends mineralocorticoid receptor antagonists for all primary aldosteronism patients to prevent target organ damage, irrespective of blood pressure control or serum potassium levels. Triggered when a clinician encounters a PA patient with well‑controlled BP and normal K and wonders, 'Do I still need to treat with MRA?' or considers stopping 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/MD2SKILL142026年10月5日 更新

This skill suggests treatment with either a calcimimetic or an intravenous bisphosphonate/denosumab for hypercalcemia due to parathyroid carcinoma. Triggered when a clinician diagnoses parathyroid carcinoma-associated hypercalcemia of malignancy and inquires about initial medical management options.

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/MD2SKILL142026年10月5日 更新

Guides choice among spironolactone, eplerenone, and esaxerenone for primary aldosteronism based on comparative efficacy, safety, and patient-specific factors. Triggers include when initiating MRA therapy and asking 'Which MRA should I prescribe?' or considering switching agents due to adverse effects, cost, or need for potassium supplementation.

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/MD2SKILL142026年10月5日 更新

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.

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/MD2SKILL142026年10月5日 更新

Provides evidence-based guidelines for preoperative optimization and postoperative monitoring in patients with primary aldosteronism undergoing adrenalectomy. Triggers include when planning surgery or starting treatment and asking 'What perioperative care is needed?' or managing complications such as resistant hypertension, hypokalemia, or suspected cortisol co-secretion.

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/MD2SKILL142026年10月5日 更新

Establishes age- and gender-specific blood pressure goals for pediatric patients with primary aldosteronism (PA) using published normative data to assess treatment adequacy and avoid over-treatment. Use when managing hypertension in children with PA to evaluate if BP is adequately controlled; triggers include pediatric PA hypertension, BP not normalized with glucocorticoid therapy, and need for age‑specific BP targets.

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/MD2SKILL142026年10月5日 更新

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.

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/MD2SKILL142026年10月5日 更新

Identifies safe antihypertensive options for hypertensive disorders in pregnancy applicable to PA patients, with gestational age restrictions. Triggers include when managing hypertension in a pregnant or pregnancy-planning PA patient and asking 'What BP meds are safe?' or reviewing medications.

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/MD2SKILL142026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/MD2SKILL142026年10月5日 更新

Interprets the aldosterone-to-renin ratio using active renin concentration (ARC) to screen for primary aldosteronism. Triggered when a clinician has PAC and ARC results and asks 'How do I interpret this ARR using active renin concentration?'

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/MD2SKILL142026年10月5日 更新

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.

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/MD2SKILL142026年10月5日 更新

Determines if PAC/PRA ratio and PAC levels indicate positive or provisionally positive screening for primary aldosteronism. Triggered when a clinician has PAC and PRA results and asks “Is this screening test positive for PA?” or needs to interpret borderline results.

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/MD2SKILL142026年10月5日 更新

Determines whether a hypertensive patient should be screened for primary aldosteronism based on clinical features associated with higher PA prevalence. Triggered when a clinician asks 'Should I screen this hypertensive patient for PA?' or observes spontaneous hypokalemia, resistant hypertension, hypertension onset before age 40, adrenal tumor, young-onset stroke, or sleep apnea syndrome.

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/MD2SKILL142026年10月5日 更新

Recommends switching specific anti-hypertensive medications to reduce false-positive and false-negative screening results for primary aldosteronism. Triggered when a clinician notes 'The patient is on ACE inhibitors/ARBs' or suspects medication interference with screening results.

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/MD2SKILL142026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/MD2SKILL142026年10月5日 更新

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).

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/MD2SKILL142026年10月5日 更新

Provides guidance on acceptable blood sampling conditions for primary aldosteronism screening when ideal early‑morning supine fasting conditions cannot be met. Triggers include when a clinician says “The patient wasn’t fasting/supine” or questions whether non‑ideal sampling affects screening validity.

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/MD2SKILL142026年10月5日 更新

Determines whether to recommend adrenalectomy or mineralocorticoid receptor antagonists for primary aldosteronism based on PA subtype and patient/surgical factors. Triggered after subtype confirmation when clinicians ask “Should this patient have surgery or medical treatment?” or discuss treatment options with the patient.

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/MD2SKILL142026年10月5日 更新

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.

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/MD2SKILL142026年10月5日 更新

Identifies young patients with classic primary aldosteronism features who may proceed directly to unilateral adrenalectomy without adrenal venous sampling based on high probability of unilateral disease. Triggered when a clinician sees a patient <35 years with hypokalemia, unilateral adrenal tumor on CT, and high plasma aldosterone concentration and asks whether AVS can be bypassed.

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/MD2SKILL142026年10月5日 更新

Recommends adding intravenous bisphosphonate or denosumab in adults with hypercalcemia of malignancy due to tumors with high calcitriol levels (e.g., lymphoma) who remain severe or symptomatic despite glucocorticoid therapy. Use when managing lymphoma‑related HCM on steroids and considering escalation of antiresorptive 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/MD2SKILL142026年10月5日 更新

This skill advises regular visual examination of the mouth to monitor for osteonecrosis of the jaw and other dental issues in patients receiving antiresorptive agents. Trigger phrases include initiating bisphosphonate or denosumab therapy and requesting preventive dental care guidance.

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/MD2SKILL142026年10月5日 更新

Identifies patients with normokalemia and no adrenal tumors on CT who likely have bilateral PA and may proceed directly to medical therapy without AVS. Triggers include when a clinician notes normokalemia and clean adrenal CT and asks 'Is AVS necessary if I suspect bilateral disease?'

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/MD2SKILL142026年10月5日 更新