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cccskills

「dr」の検索結果

1.4万 件 ・ 関連度順

概要と使いどころ

Recommends combination of calcitonin and an intravenous bisphosphonate or denosumab as initial treatment for severe hypercalcemia (serum calcium >14 mg/dL). Indicated when a clinician notes severe HCM or seeks rapid calcium lowering in symptomatic 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。

dromlakhani/MD2SKILL142026年10月5日 更新

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。

dromlakhani/MD2SKILL142026年10月5日 更新

The guideline suggests checking serum magnesium and phosphate levels and repleting if low in patients receiving antiresorptive therapy for hypercalcemia of malignancy. Clinicians should consider this when they note electrolyte abnormalities or inquire about supportive care during bisphosphonate or denosumab 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

Computes albumin‑adjusted (corrected) serum calcium using total calcium and albumin to adjust for hypo‑ or hyperalbuminemia. Triggered when a clinician notes hypoalbuminemia and requests corrected calcium to assess true hypercalcemia of malignancy severity.

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 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

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。

dromlakhani/MD2SKILL142026年10月5日 更新

Identifies patients with a positive aldosterone-to-renin ratio screening who may proceed directly to subtype testing without confirmatory testing based on specific clinical criteria. Triggers include spontaneous hypokalemia, baseline plasma aldosterone concentration >100 pg/mL (CLEIA), renin suppression, or a clinician questioning the need for a confirmatory test after a positive screen.

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

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 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

The skill suggests adding a calcimimetic for hypercalcemia of malignancy due to parathyroid carcinoma that persists after intravenous bisphosphonate or denosumab therapy. It is triggered when a clinician notes refractory HCM despite antiresorptive therapy and considers adding a calcimimetic.

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

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

Recommends adding intravenous bisphosphonate or denosumab when hypercalcemia due to parathyroid carcinoma is not adequately controlled with a calcimimetic. Consider this adjunct when a clinician notes persistent HCM despite calcimimetic therapy and asks about next-step 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 checking and managing vitamin D according to Endocrine Society guidelines to avoid hypocalcemia in patients receiving bisphosphonates or denosumab for hypercalcemia of malignancy. Use when a clinician notes risk factors for hypocalcemia (e.g., low 25‑OH vitamin D, renal insufficiency) and asks about baseline labs before antiresorptive start.

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 confirmatory testing with corticotropin stimulation test in patients presenting with clinical symptoms or signs suggesting PAI (e.g., fatigue, hypotension, hyponatremia, hyperpigmentation) when the patient's condition permits safe testing. Use when a clinician identifies suggestive features and circumstances allow outpatient stimulation testing without imminent need for emergency glucocorticoids.

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 interprets the oral sodium loading test for primary aldosteronism by evaluating 24‑hour urinary aldosterone excretion after a high‑sodium diet. Use when reviewing results of an "oral sodium loading test" for PA diagnosis; trigger phrases include "urinary aldosterone excretion ≤10 g/24 h" (PA unlikely) or "≥12 g/24 h (Mayo) / ≥14 g/24 h (Cleveland)" (PA highly likely).

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

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。

dromlakhani/MD2SKILL142026年10月5日 更新

Interprets the postural stimulation test to detect angiotensin II‑unresponsive aldosterone‑producing adenoma (APA) or familial hyperaldosteronism type I (FH‑I) when aldosterone fails to rise with upright posture. Triggered by clinical cues such as “postural stimulation test shows no aldosterone increase”, “suspected APA with non‑responsive aldosterone”, or “evaluating FH‑I in young patients with early‑onset hypertension and hypokalemia”.

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

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。

dromlakhani/MD2SKILL142026年10月5日 更新

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。

dromlakhani/MD2SKILL142026年10月5日 更新

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。

dromlakhani/MD2SKILL142026年10月5日 更新

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。

dromlakhani/MD2SKILL142026年10月5日 更新