「ace」の検索結果

This skill confirms whether a hospital has the necessary policies and expertise to support inpatient insulin pump therapy, including informed consent, standardized order sets, and device management guidance for imaging and surgical procedures. Triggered by questions such as "Are hospital policies and expertise in place for insulin pump use?" to ensure safe continuation of pump therapy in noncritical illness.

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Calculates initial and escalating dose for pubertal induction hormone therapy based on patient weight or body surface area. Triggers include patient eligible for sex hormone treatment, ready to start hormones.

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This skill guides postoperative management after Cushing's syndrome surgery by classifying patients into hypocortisolism, hypercortisolism, or eucortisolism based on serum cortisol levels. Use when postoperative cortisol is <5 µg/dL (hypocortisolism), >20 µg/dL (hypercortisolism), or 5-20 µg/dL (eucortisolism) to direct glucocorticoid replacement, further treatment, or monitoring.

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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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This skill outlines monitoring glucocorticoid replacement in children with primary adrenal insufficiency (PAI) using clinical assessment of growth velocity, weight, blood pressure, and energy levels. Trigger when evaluating a child with PAI for adequacy of glucocorticoid therapy during routine follow-up.

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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.

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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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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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Suggests reducing the fludrocortisone dose in patients who develop new-onset hypertension while on fludrocortisone replacement for primary adrenal insufficiency. Consider dose reduction when hypertension arises alongside signs of mineralocorticoid excess such as edema, weight gain, or hypokalemia.

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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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Suggests that pregnant patients with primary adrenal insufficiency be monitored for clinical signs of glucocorticoid over- or under-replacement such as normal weight or gain, fatigue, postural hypotension or hypertension, and hyperglycemia, with at least one review each trimester. Use when managing a pregnant patient with PAI to assess glucocorticoid dosing adequacy.

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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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Suggests avoiding synthetic, long-acting glucocorticoids (e.g., prednisolone, dexamethasone) in children with primary adrenal insufficiency (PAI). Use when selecting glucocorticoid replacement for a child with PAI to prevent Cushingoid side effects and dose titration difficulties.

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Calculate and interpret the PREVENT-ASCVD risk score (10-year and 30-year) for primary prevention of atherosclerotic cardiovascular disease per the 2026 ACC/AHA multisociety dyslipidaemia guideline. Covers inputs required, risk-category thresholds (low <3%, borderline 3–<5%, intermediate 5–<10%, high ≥10%), when to use the 30-year calculation (adults 30–59), and how PREVENT differs from the older Pooled Cohort Equations (lower risk estimates by 40–50%, race-agnostic). Use when a clinician asks what the 10-year ASCVD risk is, how to calculate PREVENT, PCE vs PREVENT, risk category for this patient, does my patient need a statin, 30-year risk calculation, primary prevention risk assessment. Grounded in the 2026 ACC/AHA multisociety dyslipidaemia guideline.

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Diagnose monogenic and syndromic obesity in children and adolescents using a structured step-by-step algorithm. Use this skill whenever a clinician suspects a genetic cause of obesity, asks about leptin deficiency, MC4R mutation, POMC deficiency, PCSK1 deficiency, leptin receptor deficiency, Bardet-Biedl syndrome, Prader-Willi syndrome, Alström syndrome, or any case of early-onset severe obesity with hyperphagia. Also trigger for questions about targeted pharmacotherapy including setmelanotide or metreleptin, or when to order a genomic obesity panel. Cross-references the NHS Genomic Test Finder skill to surface the relevant R-code once a diagnosis is reached.

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Suggests using longer-acting glucocorticoids when standard hydrocortisone regimens are impractical due to nonavailability, poor adherence, or need for once-daily dosing. Triggers include glucocorticoid replacement therapy decisions where patients report difficulty with multiple daily doses, lack of access to hydrocortisone, or preference for simplified regimens.

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In patients with adrenal insufficiency receiving dexamethasone replacement, the guideline suggests increasing the dexamethasone dose when enzyme-inducing antiepileptic drugs are co-administered. Trigger phrases include "AI patient on dexamethasone starts enzyme-inducing antiepileptic drug" or "AI patient on dexamethasone requiring enzyme-inducing AED".

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Recommends using the lowest tolerable hydrocortisone dose to potentially decrease risks of metabolic and cardiovascular disease in central adrenal insufficiency. Triggers include managing a patient with central adrenal insufficiency requiring glucocorticoid replacement.

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Recommends against dexamethasone for glucocorticoid replacement in primary adrenal insufficiency (PAI) due to risk of Cushingoid side effects from difficult dose titration. Use when selecting a glucocorticoid for PAI management to avoid iatrogenic Cushing syndrome.

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Standard operating procedure for producing a documentation page end to end — gather source material, classify, draft against the measured corpus profile, then run the reader-level and humanizer passes and both gates. Use for any page on a documentation surface, or when rewriting a page that reads as machine-written. Orchestrates technical-writing, reader-level and humanizer in a fixed order.

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Read-only release + backlog recap. Reports the last release, commits-since-tag classified by conventional-commit type with the semver bump they trigger and pushed-vs-origin state, the backlog bucketed (open/picked-up/dropped with epic parent→child nesting), the roadmap epics with their per-task tallies, and condensed open questions — then recommends the next pickup. One `cli.mjs recap` call returns all six recap keys. Invoke any time (on demand) to plan a release or choose the next thing to build; a compact form is also surfaced at session start. Not a workflow phase; never writes CHANGELOG; never starts or commits work.

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Workflow Phase 10 — orchestrator for documentation work. Surveys the diff, routes any page on a documentation surface through `technical-writer`, standalone technical reference through the `documentation` skill, tutorials through `technical-tutorials`, and all other prose body work (inline docs, README updates, user-facing copy) through the `prose` skill (which mandates `humanizer` and conditionally `copywriting`). Verifies completeness and marks phase done.

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Capture what someone actually said without contaminating it with your own inference. Invoke when eliciting intent in conversation (design discussion, requirement interview, decision surfacing) and when turning a conversation into a durable record (ADR, decision node, memory entry, spec `## Decisions` row). Enforces quote-before-critique, keeps illustration separate from commitment, and holds interpretation subordinate to verbatim. Prevents the failure where unspecified space is filled by the recorder and then evaluated as if the speaker had specified it.

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Preflight a spec draft without saving. Runs the same checks as the write-boundary hooks — PlantUML syntax, required diagram presence, AC-to-sequence traceability, Design calls quality floor, and System delta row resolution — and prints a compact pass/fail table. Use while iterating so the hooks don't bite on save.

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。