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概要と使いどころ

Save a project fact, decision or gotcha so your next session already knows it.

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。

ToruAI/toru-claude-agents152026年7月26日 更新

This skill indicates the need for periodic prolactin monitoring in transgender females undergoing estrogen therapy. Clinical triggers include a transgender female patient receiving estrogen treatment.

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 real-time continuous glucose monitoring (CGM) and algorithm-driven insulin pumps (ADIPs) rather than multiple daily injections (MDIs) with self-monitoring of blood glucose (SMBG) three or more times daily for adults and children with type 1 diabetes (T1D). Trigger phrases include "Should I use RT-CGM+ADIP or MDI+SMBG for this T1D patient?" or "Is intensive pump therapy indicated for this 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 determines whether testicular volume should be used as the primary or sole indicator of sexual development in male childhood cancer survivors who have received gonadotoxic treatments such as alkylating agents or testicular radiotherapy. Triggers include clinician questions like “Can I use testicular volume to assess puberty in this male survivor after chemotherapy?” or “Is testis size reliable for sexual maturity evaluation post‑radiation?”

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 adolescent meets criteria for GnRH agonist treatment to suppress pubertal development. Triggers include adolescent requesting to suppress puberty, adolescent with gender dysphoria seeking pubertal blockade, or clinician noting Tanner G2/B2 with request for hormone suppression.

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 real-time continuous glucose monitoring (RT-CGM) for adult patients with type 1 diabetes mellitus (T1DM) whose hemoglobin A1C is above individualized target. Consider when clinician notes 'T1DM A1C above goal, consider RT-CGM' or 'Patient willing to wear CGM daily, A1C elevated'.

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

Assesses the patient’s ability to prevent, detect, and treat hypoglycemia, including recognition of symptoms, appropriate carbohydrate treatment, and use of emergency glucagon. Triggered when clinicians review the hypoglycemia action plan or check whether the patient recognizes low symptoms and treatment steps.

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

Suggests CSII with good adherence to monitoring and dosing for adults with type 2 diabetes mellitus who have poor glycemic control despite intensive insulin therapy, oral agents, other injectable therapy, and lifestyle modifications. Trigger phrases include 'T2DM on multiple injectables still uncontrolled' and 'Consider pump for insulin-requiring T2DM failing other therapies'.

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 guides clinicians to reassess glucose monitoring frequency when discontinuing continuous subcutaneous insulin infusion (CSII) or transitioning to multiple daily injections (MDI). It is triggered by phrases such as 'Plan for glucose monitoring after pump stop' or 'Determine SMBG/CGM frequency post-pump' to ensure individualized glycemic goals are met.

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 continuing a patient’s personal continuous glucose monitor (CGM) in the hospital with or without algorithm-driven insulin pump (ADIP) therapy rather than discontinuing it for individuals already using CGM outpatient. Use when deciding whether to maintain personal CGM during admission or when a patient requests to keep their device, particularly in those at high risk for hypoglycemia.

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

The skill suggests using real-time continuous glucose monitoring (CGM) combined with algorithm-driven insulin pumps (ADIPs) rather than multiple daily injections (MDIs) with self-monitoring of blood glucose (SMBG) three or more times daily for adults and children with type 1 diabetes (T1D) to lower hypoglycemia incidence. Clinical triggers include discussions about insulin pump therapy, CGM use, or reducing hypoglycemia in T1D patients on intensive insulin regimens.

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 use of hybrid closed-loop pump rather than insulin pump with CGM (without algorithm) or multiple daily injections with CGM for pregnant individuals with type 1 diabetes. Triggered when deciding on insulin delivery methods for pregnant patients with type 1 diabetes.

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 recommends regularly evaluating for corticotroph tumor progression using pituitary MRIs and ACTH levels in patients with known Cushing's disease who underwent bilateral adrenalectomy and in patients undergoing this procedure for presumed occult ectopic ACTH secretion. Triggers include postoperative follow‑up after bilateral adrenalectomy, rising ACTH levels, or new pituitary lesion on MRI suggestive of tumor progression.

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 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.

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 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/MD2SKILL142026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/MD2SKILL142026年10月5日 更新

This skill recommends re-evaluating the need for treatment of other pituitary hormone deficiencies in the postoperative period following surgical intervention for Cushing's syndrome. It is triggered when assessing a post-op CS patient for ongoing pituitary function, evaluating for hypopituitarism, or checking HPA axis recovery with morning cortisol/ACTH stimulation tests and pituitary MRI within 1–3 months.

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 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/MD2SKILL142026年10月5日 更新

Recommends additional treatments for patients with persistent overt hypercortisolism after initial surgical intervention for Cushing's syndrome. Trigger phrases include "post-op CS patient shows ongoing hypercortisolism," "persistent overt hypercortisolism after TSS," and "elevated UFC or midnight salivary cortisol following surgery."

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

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。

dromlakhani/MD2SKILL142026年10月5日 更新

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

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 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

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