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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.

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。

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).

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。

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.

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。

Recommends potassium supplementation for hypokalemia management in PA patients who are pregnant or planning pregnancy. Triggered when a pregnant PA patient presents with low serum potassium and asks 'How should I treat hypokalemia?' or when electrolytes are reviewed.

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。

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。

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.

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。

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。

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.

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。

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。

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。

Selects the aldosterone-to-renin ratio (ARR) method over hypokalemia for screening hypertensive patients for primary aldosteronism. Use when a clinician asks what test to use for screening hypertensive patients with resistant hypertension or unexplained hypokalemia for PA.

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。

Determines whether to add a mineralocorticoid receptor antagonist (e.g., spironolactone or eplerenone) to glucocorticoid therapy in glucocorticoid-remediable aldosteronism when blood pressure fails to normalize with glucocorticoid alone. Triggered by persistent hypertension or inadequate BP control despite optimized glucocorticoid dosing in GRA patients.

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。

Determines whether to screen a patient with hypertension for primary aldosteronism based solely on the presence of hypertension. Use when a clinician asks whether to screen a hypertensive patient for PA, triggered by phrases such as "should we screen for aldosteronism" or "evaluate for secondary hypertension".

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。

Calculates the lowest effective glucocorticoid dose (dexamethasone or prednisone) to normalize blood pressure and serum potassium in glucocorticoid-remediable aldosteronism (GRA/FH-I) by titrating to biochemical and clinical targets. Indicated when initiating medical treatment for confirmed GRA, triggered by findings such as early-onset hypertension, family history of stroke before age 40, spontaneous hypokalemia, or suppressed plasma renin activity with elevated aldosterone.

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。

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.

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。

Determines when adrenal venous sampling may be skipped in primary aldosteronism. Applies to patients <35 years with spontaneous hypokalemia, marked aldosterone excess, and unilateral adrenal lesions suggestive of cortical adenoma 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。

Determines whether adrenal venous sampling (AVS) is needed in addition to CT for lateralizing primary aldosteronism before surgery. Trigger phrases include "patient with primary aldosteronism considering surgery", "unilateral adrenal adenoma on CT", "surgical candidate", and "age <35 with hypokalemia and >1‑cm adenoma".

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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.

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。

Helps distinguish unilateral from bilateral adrenal disease based on 18-oxocortisol levels, which are typically higher in aldosterone-producing adenoma than idiopathic adrenal hyperplasia. Use when evaluating 18-oxocortisol results during PA workup to guide subtype classification after a positive ARR.

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。

In patients with primary aldosteronism receiving mineralocorticoid receptor antagonist therapy, the guideline recommends titrating the MRA dose upward to raise renin when blood pressure remains uncontrolled and renin is suppressed. Consider this step when hypertension is not at goal despite MRA therapy and plasma renin activity (or direct renin concentration) is low.

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。

Recommends using mineralocorticoid receptor antagonists rather than epithelial sodium-channel inhibitors for medical treatment of primary aldosteronism. Use when a clinician asks whether to use an MRA or ENaC inhibitor for medical treatment of PA.

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。

Differentiates aldosterone-producing adenoma from idiopathic adrenal hyperplasia based on 18-hydroxycorticosterone levels, with APA patients generally having levels >100 ng/dL at 8:00 a.m. and IAH patients usually having levels <100 ng/dL. Use when reviewing 18-OHB test results to help subtype PA; triggers include 18-OHB >100 ng/dL (suggesting APA) or <100 ng/dL (suggesting IAH).

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。

Evaluates likelihood of primary aldosteronism by measuring plasma aldosterone suppression after oral captopril; normal suppression ≥30% makes PA unlikely, while lack of suppression with persistently suppressed plasma renin activity suggests PA. Use when assessing captopril challenge test (CCT) results for PA diagnosis in patients with positive aldosterone-to-renin ratio.

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。

Determines when to avoid aldosterone suppression testing in hypertensive patients with a positive PA screen who have normokalemia and suppressed aldosterone below assay‑specific cutoffs (<11 ng/dL immunoassay or <8 ng/dL LC‑MS/MS), indicating low likelihood of primary aldosteronism. Use when a clinician asks whether to skip confirmatory suppression testing based on low pretest probability.

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。