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概要と使いどころ

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

Determines whether to recommend unilateral laparoscopic adrenalectomy or medical therapy with a mineralocorticoid receptor antagonist for patients with confirmed unilateral PA (aldosterone-producing adenoma or unilateral adrenal hyperplasia). Triggered when discussing treatment options after confirming unilateral PA in a hypertensive patient with hypokalemia or resistant 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。

dromlakhani/MD2SKILL142026年10月5日 更新

Adjusts intravenous bisphosphonate dosing and infusion duration for patients with hypercalcemia of malignancy and renal insufficiency (creatinine clearance <60 mL/min). Triggered when a clinician encounters renal impairment and asks how to modify zoledronic acid or pamidronate infusion rates.

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

Determines whether a hypertensive patient should be screened for primary aldosteronism based on clinical features associated with higher PA prevalence. Triggered when a clinician asks 'Should I screen this hypertensive patient for PA?' or observes spontaneous hypokalemia, resistant hypertension, hypertension onset before age 40, adrenal tumor, young-onset stroke, or sleep apnea syndrome.

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 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。

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

Recommends initiating intravenous isotonic saline hydration as initial management for hypercalcemia of malignancy (HCM) while awaiting antiresorptive therapy, with fluid rate adjusted according to cardiac function. Triggered when a clinician encounters a patient with HCM (e.g., serum calcium >12 mg/dL, symptoms of hypercalcemia) and seeks immediate measures before specific drugs are available.

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 initiating intravenous bisphosphonate or denosumab for adults with hypercalcemia of malignancy compared with no treatment. Use when a clinician asks about first‑line pharmacologic therapy for HCM or when deciding to start antiresorptive agents.

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 the appropriate zoledronic acid dose (3‑4 mg IV) and infusion duration based on renal function. Triggered when a clinician prepares to prescribe zoledronic acid for hypercalcemia of malignancy and asks about renal‑adjusted administration.

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 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。

dromlakhani/MD2SKILL142026年10月5日 更新

Calculates salmon calcitonin dose based on patient weight for rapid calcium lowering in hypercalcemia of malignancy. Triggered when a clinician considers rapid calcium lowering and asks about weight‑based calcitonin dosing.

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 denosumab rather than an intravenous bisphosphonate for adults with hypercalcemia of malignancy. It is triggered when a clinician questions which antiresorptive to choose first or seeks guidance on drug selection 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

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。

dromlakhani/MD2SKILL142026年10月5日 更新

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.

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 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.

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

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.

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 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。

dromlakhani/MD2SKILL142026年10月5日 更新

Determines whether to perform adrenal venous sampling (AVS) to lateralize aldosterone excess in patients with confirmed primary aldosteronism (PA) who are being evaluated for surgical treatment. Indicated when surgery is feasible and desired by the patient, or when subtype workup is planned for a surgical candidate, especially in those younger than 35 years with spontaneous hypokalemia, marked aldosterone excess, and unilateral adrenal lesions 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

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。

dromlakhani/MD2SKILL142026年10月5日 更新

Recommends performing a dexamethasone suppression test to evaluate for autonomous cortisol secretion in patients with primary aldosteronism and adrenal adenoma. Triggered when a clinician considers whether to perform a dexamethasone suppression test in a patient with PA and adrenal adenoma.

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 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.

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 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。

dromlakhani/MD2SKILL142026年10月5日 更新