跳到正文
cccskills
免费在 GitHub 公开

es-cushing-educate-patients-families-clinical-features-remission

This skill recommends educating patients and families about the clinical features of remission in Cushing's syndrome when a patient achieves biochemical remission after treatment. Use when a CS patient has postoperative normal cortisol levels, reports symptom improvement, and requires guidance on long-term expectations and monitoring for recurrence.

中文简介正在准备中。当前显示原文说明。

dromlakhani/MD2SKILL

实测评分 未实测

查看安装方法

包含的文件（1）

  • SKILL.md2.7 KB

SKILL.md（原文）

安装前可以查看交给 AI 代理的指令内容。

Educating Patients and Families About the Clinical Features of Remission in Cushing's Syndrome

STEP 1 — Gather Information

Confirm remission status by reviewing postoperative serum cortisol, late-night salivary cortisol, or UFC; assess resolution of CS symptoms (weight, hypertension, glucose, mood); review comorbidities and current medications.

STEP 2 — Rule In / Rule Out

Rule in remission if postoperative serum cortisol <5 µg/dL (or UFC normal) with normal diurnal rhythm; rule out persistent hypercortisolism if cortisol remains elevated or symptoms persist, and rule out hypocortisolism if cortisol is low with signs of adrenal insufficiency.

STEP 3 — Classify or Stratify

Stratify remission state as eucortisolism (normal cortisol), hypocortisolism (low cortisol needing glucocorticoid replacement), or hypercortisolism (persistent excess requiring further treatment).

STEP 4 — Decide

For eucortisolism, provide education on expected clinical improvements, timeline for symptom resolution, importance of lifelong monitoring for recurrence, and management of residual comorbidities; for hypocortisolism, educate on glucocorticoid replacement and stress dosing; for hypercortisolism, advise additional treatments per guideline.

Clinical Guardrails / Mimics / Pitfalls

Do not confuse glucocorticoid withdrawal symptoms (fatigue, nausea, weight loss) with disease recurrence; avoid premature discontinuation of replacement therapy before HPA axis recovery; do not rely solely on symptoms for remission confirmation—use biochemical testing; monitor for Nelson’s syndrome after bilateral adrenalectomy.

Concrete Clinical Example

A 42-year-old woman with Cushing’s disease undergoes transsphenoidal adenomectomy; postoperative morning cortisol is 1.2 µg/dL and late-night salivary cortisol is normal. She reports improved energy and weight loss. Educate her and her family that symptoms will continue to improve over 6–12 months, that lifelong annual screening with late-night salivary cortisol is needed to detect recurrence, and that she may experience temporary glucocorticoid withdrawal requiring stress dosing during illness.

Source: Treatment of Cushing’s Syndrome: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2015, DOI:10.1210/jc.2015-1818

评价

还没有评价。欢迎分享你的使用感受。

评论

无需登录即可发表。欢迎分享使用感受、提问，或说明在哪些环境下无法运行。

还没有评论。来写第一条吧。

提交后会立即公开。请勿填写邮箱、电话等个人信息。URL 最多 2 个。

0 / 1000 字

此表单受 reCAPTCHA 保护，适用 Google 的隐私权政策和服务条款。

同一仓库的技能

780g-pump-adjustment

免费

Guide pump setting adjustments for the MiniMed 780G system based on CareLink data, using Medtronic's 3-step follow-up workflow. Use when a clinician has CareLink data for a 780G patient and wants to know what to change — which setting, by how much, and how to program it. Triggers include: "what do I adjust", "how to fix high TIR", "how to reduce hypos", "adjust ICR/ISF/basal", "SmartGuard settings", "780G pump settings review", or any question about optimising 780G therapy after reviewing a download.

中文简介正在准备中。当前显示原文说明。

dromlakhani/MD2SKILL142026年10月20日 更新

ata-acth-stim-test-interpretation

免费

Performs corticotropin stimulation test to diagnose adrenal insufficiency when morning cortisol is indeterminate (3-15 µg/dL). Triggers include morning cortisol 3-15 µg/dL requiring further AI testing.

中文简介正在准备中。当前显示原文说明。

dromlakhani/MD2SKILL142026年10月20日 更新

ata-adrenal-crisis-treatment

免费

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.

中文简介正在准备中。当前显示原文说明。

dromlakhani/MD2SKILL142026年10月20日 更新

ata-aed-ai-education

免费

Clinicians educate adrenal insufficiency patients taking nondexamethasone glucocorticoids who initiate enzyme-inducing antiepileptic drugs about early signs of adrenal insufficiency. Trigger when an AI patient on nondexamethasone GC starts an enzyme-inducing AED such as phenytoin, carbamazepine, or oxcarbazepine.

中文简介正在准备中。当前显示原文说明。

dromlakhani/MD2SKILL142026年10月20日 更新

ata-aed-lt4-monitoring

免费

In central hypothyroidism patients receiving levothyroxine who initiate enzyme‑inducing antiepileptic drugs, the guideline recommends checking free T4 at least 6 weeks after AED start and increasing the levothyroxine dose if free T4 falls below the target range. Triggers include: central hypothyroidism patient on levothyroxine starting antiepileptic drug such as phenytoin, carbamazepine, or oxcarbazepine.

中文简介正在准备中。当前显示原文说明。

dromlakhani/MD2SKILL142026年10月20日 更新

ata-cortisol-cutoff-ai-diagnosis

免费

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.

中文简介正在准备中。当前显示原文说明。

dromlakhani/MD2SKILL142026年10月20日 更新

查看 dromlakhani 的全部技能

报告此技能的问题