不属于以上分类的技能（1.2万 个）
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.
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Recommends against using fludrocortisone for mineralocorticoid replacement in patients with secondary adrenal insufficiency. Trigger phrases include: considering mineralocorticoid replacement for secondary adrenal insufficiency and secondary adrenal insufficiency patient needing mineralocorticoid replacement.
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Suggests using hydrocortisone 15–25 mg or cortisone acetate 20–35 mg daily in two or three divided oral doses for adult primary adrenal insufficiency (PAI) patients initiating glucocorticoid replacement. The highest dose is given upon awakening, with the second dose either early afternoon (≈2 h after lunch) or split into lunch and afternoon doses; consider total daily dose calculation based on chosen formulation and frequency.
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Administers immediate parenteral injection of 50–100 mg hydrocortisone for suspected adrenal crisis secondary to adrenal insufficiency. Triggers include hypotension, hypoglycemia, or acute illness in a patient with known adrenal insufficiency.
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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.
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Complete bedside prescribing reference for Mirago (mirabegron, beta-3 adrenoceptor agonist) for overactive bladder — covering contraindications, safety screening, drug interactions, dose selection in special populations, titration, and administration. Use when a clinician asks how to start mirabegron, what dose to use in renal or hepatic impairment, is mirabegron safe in this patient, mirabegron drug interactions, or Mirago for OAB.
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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.
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Decide when to order coronary artery calcium (CAC) scoring in a primary-prevention patient and interpret the result per the 2026 ACC/AHA multisociety dyslipidaemia guideline. Covers the Class 1 indication (men ≥40 / women ≥45, borderline / intermediate PREVENT-ASCVD risk, uncertainty about LLT), CAC score interpretation (0, 1–99, 100–299, ≥300, ≥1000), how CAC modifies LDL and non-HDL goals, when to repeat CAC, and pitfalls (incidental CAC on non-cardiac CT, radiation, cost). Use when a clinician asks should I order a CAC score, CAC indications, what does CAC 150 mean, treatment goals with CAC score, repeat CAC frequency, CAC in a smoker, CAC vs CCTA, is CAC useful in intermediate risk. Grounded in the 2026 ACC/AHA multisociety dyslipidaemia guideline.
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Screen a child aged 13+ with obesity for eligibility for bariatric surgery (laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass) using the CMAJ 2025 guideline. Trigger when a clinician asks whether a child qualifies for weight loss surgery, bariatric surgery in adolescents, sleeve gastrectomy in a teenager, or when to refer for surgical management of pediatric obesity.
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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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Guide pre-endoscopy management decisions for patients on GLP-1 receptor agonists (semaglutide, tirzepatide, liraglutide etc.), deciding whether to proceed, delay, or modify the approach based on GI symptoms, fasting status, and indication. Trigger when a clinician asks about GLP-1 RA and endoscopy, semaglutide before colonoscopy, Ozempic before procedure, or whether to hold a GLP-1 agonist before endoscopy.
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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.
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Accounts for estrogen-induced elevation of total serum cortisol via increased corticosteroid-binding globulin (CBG) when evaluating adrenal reserve or hydrocortisone replacement adequacy. Triggered when assessing glucocorticoid adequacy in patients receiving estrogen therapy (e.g., oral estrogen replacement) or interpreting cortisol levels in estrogen-exposed individuals.
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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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This skill guides annual evaluation of patients with primary adrenal insufficiency (PAI) for symptoms and signs of glucocorticoid and mineralocorticoid over- or under-replacement. Use during annual follow-up when assessing for weight changes, blood pressure abnormalities, edema, or symptoms such as fatigue, insomnia, or salt craving.
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Recommends adjusting glucocorticoid doses on the day of surgery based on illness severity and magnitude of surgical stress. Triggers when managing a patient requiring surgery needing perioperative glucocorticoid management, such as "patient on HC for central AI undergoing major abdominal surgery" or "patient with hypopituitarism scheduled for minor procedure".
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Administers 100-mg hydrocortisone IV bolus followed by continuous IV infusion of 200 mg HC per 24 hours (alternatively 50 mg IV every 6 hours) for patients undergoing major surgical stress. Use when managing patient with major surgical stress; triggers include patient undergoing major surgery.
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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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Applies serum cortisol cutoffs (<3 μg/dL indicates central adrenal insufficiency; >15 μg/dL likely excludes it) when evaluating morning cortisol for suspected adrenal insufficiency. Triggers include morning cortisol measurement in suspected AI and use when interpreting morning cortisol levels for adrenal insufficiency workup.
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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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Select the right treatment tier for a child with obesity — behavioural, pharmacologic, or surgical — using the CMAJ 2025 pediatric obesity guideline. Trigger when a clinician asks what to do for a child with obesity, which intervention to start, whether to escalate treatment, or when to consider medication or surgery for pediatric obesity.
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This skill suggests initiating antihypertensive treatment while continuing fludrocortisone when blood pressure remains uncontrolled after fludrocortisone dose reduction. Trigger phrases include "BP remains uncontrolled," "persistent hypertension," or "elevated BP despite fludrocortisone adjustment."
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This skill suggests using prednisolone as an alternative glucocorticoid when hydrocortisone is unavailable for emergency treatment of adrenal crisis. Dexamethasone is the least-preferred option and should only be administered if no other glucocorticoid is available.
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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.
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