「primary」の検索結果

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。

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。

This skill recommends computed tomography (CT) as the initial imaging modality for primary aldosteronism (PA) evaluation in Japan, citing its accessibility and comparable performance to MRI. It is triggered when a clinician orders imaging for suspected PA and asks 'What imaging should I start with?' or seeks a cost-effective initial evaluation.

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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.

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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.

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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'.

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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.

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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.

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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).

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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。

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?'

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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.

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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.

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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.

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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。

Determines when to test for germline KCNJ5 mutations indicating familial hyperaldosteronism type III in very young patients with primary aldosteronism. Triggered by severe early-onset hypertension with hypokalemia in infants or young children (<20 years) with confirmed PA.

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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.

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Recommends equipping every patient with primary adrenal insufficiency (PAI) with a glucocorticoid injection kit for emergency self‑administration and providing training on its use. Trigger when preparing a PAI patient for stress dosing, adrenal crisis prevention, or when prescribing glucocorticoid replacement and needing to ensure emergency preparedness.

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Suggests genetic counseling for patients with primary adrenal insufficiency (PAI) when a monogenic disorder is suspected. Use when PAI patient presents with early-onset disease, syndromic features, consanguinity, family history, or negative autoimmune antibodies.

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Determines follow‑up interval for patients with primary adrenal insufficiency (PAI) based on age: annual visits for adults and children, and every 3–4 months for infants. Triggered when establishing routine endocrine care after PAI diagnosis or during stable management.

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Recommends initiating fludrocortisone 50–100 µg daily for mineralocorticoid replacement in adults with confirmed aldosterone deficiency (e.g., low aldosterone, elevated renin) and no salt restriction. Use when aldosterone deficiency is confirmed in a patient with primary adrenal insufficiency (PAI) presenting with salt craving or postural hypotension.

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Recommends fludrocortisone 100 µg daily for children with primary adrenal insufficiency and confirmed aldosterone deficiency; for infants under 12 months, adds sodium chloride supplementation. Triggered by PAI with aldosterone deficiency, evidenced by salt craving, hyponatremia, hyperkalemia, or elevated renin with low 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。

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.

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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.

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。