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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。

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。

Determines the appropriate IV pamidronate dose (60‑90 mg) and infusion duration (2‑24 h) for adults with hypercalcemia of malignancy based on renal function. Triggered when a clinician orders pamidronate and asks how to adjust for kidney dysfunction (eGFR < 60 mL/min/1.73 m²).

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.

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 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。

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.

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。

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。

Recommends initiating hydrocortisone replacement at a total starting dose of 8 mg/m2 body surface area per day, given in three or four divided doses, for children with confirmed primary adrenal insufficiency (PAI). Use when starting glucocorticoid therapy in pediatric PAI patients, adjusting the dose according to individual clinical response, growth, and need for stress coverage.

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。

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.

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。

Teaches AI patients about stress-dosing and emergency glucocorticoid administration; instructs to obtain emergency card/bracelet/necklace and kit with injectable high-dose GC. Triggers when counseling any patient with adrenal insufficiency (e.g., "Use when counseling patient with adrenal insufficiency...").

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。

Recommends hydrocortisone replacement dosing of 15–20 mg total daily, administered as a single dose or divided doses with the highest dose given in the morning upon awakening and the second dose in the afternoon (two-dose regimen) or second and third doses at lunch and late afternoon (three-dose regimen). Use when initiating glucocorticoid replacement for adrenal insufficiency; triggers include diagnosing adrenal insufficiency requiring 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。

Guides individualised HbA1c target-setting and identifies the correct intensification trigger for adults with type 2 diabetes using the NICE NG28 (2026) framework, covering standard targets, hypoglycaemia-risk adjustment, indications for target relaxation, and appropriate monitoring frequency.

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。

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.

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。

Screen a child with obesity for red flags suggesting monogenic, syndromic, or secondary endocrine causes — distinguishing atypical from typical exogenous obesity. Trigger when a clinician asks whether obesity could be genetic or hormonal, suspects Prader-Willi syndrome, Cushing disease, hypothyroidism, ROHHAD, Bardet-Biedl syndrome, leptin deficiency, or craniopharyngioma, or when a child has early-onset severe obesity, short stature with obesity, hyperphagia, hypotonia, dysmorphic features, or developmental delay with weight gain.

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。

Order and interpret lipoprotein(a) [Lp(a)] measurement at least once in a lifetime, apply the risk-enhancer threshold (≥125 nmol/L or ≥50 mg/dL), and run cascade screening of first-degree relatives for premature ASCVD, familial hypercholesterolaemia, or elevated Lp(a) per the 2026 ACC/AHA multisociety dyslipidaemia guideline. Covers the Class 1 lifetime measurement, how elevated Lp(a) affects LLT initiation and intensification, the cascade screening indications, the interaction of Lp(a) with ASCVD risk estimation, and current therapeutic limitations. Use when a clinician asks when to check Lp(a), how often to repeat Lp(a), elevated Lp(a) what next, treatment for high Lp(a), should I screen my patient's family, Lp(a) and statins, cascade screening indications. Grounded in the 2026 ACC/AHA multisociety dyslipidaemia guideline.

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。

Decide whether a kidney from a brain-dead deceased donor (DBD) with diabetes mellitus and/or hypertension is suitable for transplantation, using the ISOT 2025 Delphi consensus and Table 4 eligibility checklist. Trigger when a clinician asks "can I use a kidney from a diabetic deceased donor", "is this DBD with HTN/DM acceptable", "ECD donor with diabetes — accept or decline", "DBD eligibility for hypertensive donor", or shares a deceased donor with diabetes or hypertension and needs an accept/borderline/decline decision.

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。

Calculate the Maryland Aggregate Pathology Index (MAPI) on a deceased donor procurement kidney biopsy to predict graft survival and decide single vs dual vs discard allocation. Trigger when a clinician asks "what's the MAPI score", "interpret donor kidney biopsy", "should I use this marginal kidney", "MAPI cutoff for transplant", "procurement biopsy scoring", or has histology results from a deceased donor kidney and needs an objective grading.

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。

Suggests adjusting glucocorticoid dose according to severity of illness or magnitude of the stressor in patients with primary adrenal insufficiency. Use when patient with PAI has intercurrent illness, fever, or stress.

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。

Set absolute LDL-C, non-HDL-C, and ApoB treatment goals, PLUS percent LDL-C reduction, for a primary-prevention patient on lipid-lowering therapy per the re-introduced treatment goals in the 2026 ACC/AHA multisociety dyslipidaemia guideline. Covers goals by PREVENT-ASCVD category (low / borderline / intermediate / high), by CAC score, in severe hypercholesterolaemia / FH, in diabetes with multiple ASCVD risk factors, and the ApoB targets once LDL-C and non-HDL-C goals are met. Use when a clinician asks what LDL goal to aim for, LDL target for intermediate risk, non-HDL goal, ApoB target, dual goals on statin, patient at goal or not, how low should LDL go, statin not enough what next. Grounded in the 2026 ACC/AHA multisociety dyslipidaemia guideline.

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。

Guides comorbidity-stratified selection of initial and further glucose-lowering medicines for adults with type 2 diabetes using the NICE NG28 (2026) framework, covering six clinical profiles: no relevant comorbidity, heart failure, atherosclerotic cardiovascular disease, early onset, obesity, chronic kidney disease, and frailty.

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。

Contract document for the binding test verdict file at .claude/state/last_test_result. Format spec for callers (integrate, simplify, chore, the verify-tick worker) that inline the four mechanical operations. Not Skill-tool-invocable.

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。

Write technical documentation that matches the measured profile of professionally-written docs. Carries the craft rules derived from 114k words of pre-2022 documentation (SQLite, PostgreSQL, Python, Django, Rust, Go, Pro Git, nginx), the per-Diátaxis-type numeric targets, and the copywriting register for page leads. Use when drafting or rewriting any documentation prose, or when a page is factually right but reads as machine-written.

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。

Workflow Phase 6 — TDD coordinator. Decides the scenario recipe and the implementation contract in main context, writes them to a state file, seeds per-worker tasks (scenario, implement, verify-tick, design-ui-tick) into the TaskList, and yields with harness_state continue so the harness invokes each worker as its own tick. No subagent delegation; no nested Skill calls.

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。

Decompose an approved spec into a dependency-ordered swarm plan — one task per component, each with an explicit write_set. Produces `.claude/state/swarm/<slug>.json` with tasks + waves. The wave scheduler guarantees pairwise-disjoint write_sets within each wave so parallel dispatch is provably conflict-free.

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。