Claude Skills by dromlakhani

Recommends assessing 10-year atherosclerotic cardiovascular disease risk using the Pooled Cohort Equations to guide lipid-lowering therapy initiation in adults with obesity. Triggers include obese patient needing lipid-lowering therapy decision, assessing when to start statin in obesity, and using risk score to guide treatment in obesity.

Recommends conducting cardiovascular risk assessment by evaluating traditional risk factors and calculating 10-year atherosclerotic cardiovascular disease risk using the Pooled Cohort Equations. Use when a clinician asks about cardiovascular risk stratification in a patient with endocrine disorder.

This skill advises assessing cardiovascular risk using guidelines for nontransgender adults in transgender patients receiving gender-affirming hormone therapy. Trigger phrases include "Transgender patient on hormone therapy", "CV risk assessment in gender-affirming hormone treatment", and "Applying standard risk calculators to transgender individuals".

This skill suggests assessment and treatment of lipids and other cardiovascular risk factors in adults receiving chronic glucocorticoid therapy above replacement levels due to increased cardiovascular disease risk. Clinical triggers include "Patient on long-term glucocorticoids", "Assessing lipid impact of steroid therapy", and "CV risk evaluation in chronic glucocorticoid use".

Recommends assessment and treatment of lipids and other cardiovascular risk factors in women who enter menopause early (<40 to 45 years old), with atherosclerotic cardiovascular disease risk calculated and followed after menopause. Clinical triggers include: "Woman with early menopause (<45 years)", "Assessing CV risk in premature ovarian failure", "Lipid evaluation in early menopausal transition".

Suggests assessment and treatment of lipids and other cardiovascular risk factors in adults with growth hormone deficiency associated with hypopituitarism. Trigger phrases include: "GHD with hypopituitarism needing lipid management", "Assessing cardiovascular risk in combined pituitary hormone deficiency", "Lipid evaluation in GHD-hypopituitarism".

Suggests measuring coronary artery calcium to inform shared decision-making when statin treatment decisions are uncertain in adults with endocrine disorders at borderline or intermediate ASCVD risk. Triggers include patient has 10-year ASCVD risk between 5-19.9%, uncertain about statin initiation, and borderline or intermediate cardiovascular risk.

Advises clinical or biochemical investigation for anabolic steroid abuse when encountering isolated low HDL‑C (<30 mg/dL) without elevated triglycerides. Typical triggers include a patient with HDL‑C <30 mg/dL and normal TG, suspected anabolic steroid use with isolated low HDL, or investigating drug abuse during a dyslipidemia workup.

Suggests considering thyroxine treatment to reduce LDL-C in patients with subclinical hypothyroidism (TSH <10 mIU/L) and associated hyperlipidemia. Trigger phrases include "Patient with SCH and hyperlipidemia", "TSH between 4-10 mIU/L with elevated lipids", "Considering thyroid treatment for lipid abnormality in mild hypothyroidism".

The guideline recommends that cardiovascular risk assessment and management in adults with cured Cushing syndrome follow the same approach as in the general population. Clinical triggers include evaluating a patient with cured Cushing syndrome, performing post-treatment cardiovascular risk assessment in Cushing, and planning long-term follow-up for cured endocrine disorders.

The guideline suggests adding eicosapentaenoic acid ethyl ester 4 g/day to reduce cardiovascular disease risk in adults on statins with persistent triglyceride levels 150–499 mg/dL who have either established atherosclerotic cardiovascular disease or type 2 diabetes plus ≥2 additional risk factors. Typical triggers are “Patient on statin with TG 150-499 mg/dL”, “Statin-treated patient with ASCVD or diabetes plus 2 risk factors”, and “Moderate hypertriglyceridemia despite statin therapy”.

Suggests adding eicosapentaenoic acid ethyl ester 4 g/day to reduce cardiovascular risk in adults with type 2 diabetes on a statin at LDL goal with residual triglycerides over 150 mg/dL and two additional traditional or risk-enhancing factors. Triggers include: "T2D patient on statin at LDL goal", "Residual TG >150 mg/dL despite statin", "T2D with statin plus 2 additional risk factors".

Recommends obtaining a fasting screening lipid panel at diagnosis to assess cardiovascular risk in women with polycystic ovary syndrome. Triggers include: "New PCOS diagnosis", "Initial lipid assessment in ovarian disorder", "Baseline cardiovascular risk evaluation in PCOS".

Suggests fibrates in addition to statins to reduce retinopathy progression in adults with type 2 diabetes and diabetic retinopathy. Triggers include: "Patient with T2D and diabetic retinopathy", "Considering fibrate for retinopathy protection", "Assessing retinopathy progression prevention in diabetes".

Recommends choosing high-intensity statins in patients with atherosclerotic cardiovascular disease, or those with risk factors for atherosclerotic cardiovascular disease or risk-enhancing factors. Trigger phrases include: "Patient with established ASCVD", "Assessing need for high-intensity statin in high-risk patient", "Selecting statin intensity based on risk profile".

Recommends LDL-C goal <55 mg/dL in patients with established ASCVD or multiple risk factors to reduce cardiovascular risk. Triggers include: patient with established ASCVD, high-risk patient needing aggressive lipid lowering, assessing LDL-C target in secondary prevention.

Recommends lowering LDL-C to <70 mg/dL in adults with type 2 diabetes and cardiovascular risk factors to reduce ASCVD risk. Consider when encountering a patient with T2D and CV risk factors, LDL-C >70 mg/dL requiring treatment, or when assessing lipid-lowering therapy goals in diabetes.

Suggests lifestyle measures as first-line treatment for obese patients with elevated triglycerides to lower cardiovascular and pancreatitis risk. Applies when considering first-line therapy for obesity-related hypertriglyceridemia or a non-pharmacological approach to obesity lipid management.

Recommends lipid profile measurement after bariatric surgery to assess cardiovascular risk in patients with obesity (BMI >40 or >35 kg/m2 with comorbidities). Clinical triggers include: patient post-bariatric surgery needing lipid assessment, assessing cardiovascular risk after bariatric procedure, lipid check following weight loss surgery.

Recommends obtaining a lipid panel to assess triglyceride levels and calculate LDL-C for initial screening in adults with endocrine disorders. Triggered when a clinician requests initial lipid assessment in a patient with known endocrine disorder such as diabetes, thyroid disease, or obesity.

Reassesses lipid profile after 5% weight loss in obese patients on pharmacological weight loss therapy to evaluate cardiovascular disease and pancreatitis risk.

Defines lipoprotein(a) ≥50 mg/dL (125 nmol/L) as a cardiovascular risk-enhancing factor for atherosclerotic cardiovascular disease. Triggered by Lp(a) measurement showing ≥50 mg/dL, assessing Lp(a)'s contribution to CVD risk, or using the Lp(a) threshold for risk stratification.

Suggests measuring lipoprotein(a) to inform decision-making about short-term and lifetime ASCVD risk and need to intensify LDL-C-lowering therapy in adult patients with family history of premature ASCVD, personal history of ASCVD, or family history of high lipoprotein(a). Triggers include family history of premature heart disease, personal history of atherosclerotic cardiovascular disease, and family history of high lipoprotein(a).

Suggests measurement of the usual lipid profile before and after treatment of growth hormone excess in adults with acromegaly. Triggers include: patient with acromegaly starting treatment, assessing lipid changes after GH suppression therapy, lipid monitoring in acromegaly management.

Advises assessment of metabolic syndrome components and body fat distribution to accurately determine cardiovascular disease risk in individuals with obesity. Trigger phrases include "Patient with obesity needing CVD risk assessment", "Evaluating metabolic syndrome in obese patient", and "Assessing body fat distribution for cardiovascular risk".

Recommends monitoring the lipid profile at diagnosis and periodically thereafter to identify dyslipidemia in adult patients with Cushing syndrome. Triggered by phrases such as "Patient diagnosed with Cushing syndrome", "Assessing for lipid abnormalities in endocrine disorder", or "Screening for dyslipidemia in cortisol excess".

Recommends obtaining a lipid profile at diagnosis to assess for dyslipidemia in adults with growth hormone deficiency. Trigger phrases include "New diagnosis of GHD", "Initial lipid assessment in growth hormone disorder", and "Baseline lipid profile in hypopituitarism".

Recommends pharmacologic treatment as adjunct to diet and exercise to prevent pancreatitis in adults with fasting triglyceride levels >500 mg/dL. Triggered when evaluating a patient with an endocrine disorder who presents with fasting TG >500 mg/dL (severe hypertriglyceridemia) and no contraindication to pharmacologic therapy.

Suggests plasmapheresis may be useful in patients who do not respond to conventional triglyceride-lowering methods, such as those with triglyceride levels over 10,000 mg/dL or in extremely high-risk situations like pregnancy. Triggers include: "TG >10,000 mg/dL unresponsive to conventional therapy", "Considering plasmapheresis for severe hypertriglyceridemia", "Pregnant patient with extreme TG elevation".

Recommends re-evaluating the lipid panel after a hyperthyroid patient becomes euthyroid, as LDL-C changes can appear as early as 3 months post-euthyroid. Trigger phrases include "Hyperthyroid patient becoming euthyroid", "Assessing lipid changes after thyroid treatment", "Lipid panel follow-up in thyroid disease management".

Recommends repeating a fasting lipid panel in adults with endocrine disorders when triglyceride levels are elevated or genetic dyslipidemia is suspected. Triggers include initial non-fasting lipid panel showing elevated TG, suspected genetic lipid disorder, and need to confirm lipid abnormality with a fasting sample.

Rules out hypothyroidism as a secondary cause of hyperlipidemia prior to initiating lipid-lowering therapy. Triggered by patient presentation with hyperlipidemia, consideration of starting lipid-lowering medication, or assessment of secondary causes of dyslipidemia.

Advises that continuation or initiation of statin treatment in patients over 75 years depends on atherosclerotic cardiovascular disease risk, prognosis, potential interacting medications, polypharmacy, mental health, and patient wishes. Common clinical triggers for using this skill are 'Elderly patient needing statin assessment', 'Statins in octogenarian with lipid disorder', and 'Balancing risks/benefits of statin in advanced age'.

Recommends against using statins in women who are pregnant or trying to become pregnant. Trigger phrases include "Female patient of childbearing potential needing lipid therapy", "Assessing medication safety in pregnancy", "Considering statin for lipid disorder in pregnancy".

Recommends dose adjustments for statins in chronic kidney disease, except for atorvastatin and fluvastatin which do not require dose adjustment. Triggers include: "Patient with CKD prescribed statin", "Assessing statin dosing in renal impairment", "Adjusting medication for kidney function".

This skill advises initiation of statin as adjunct to diet and exercise after discussion of risks/benefits when LDL-C >70 mg/dL and 10-year ASCVD risk >7.5%, or ASCVD risk 5% to 7.4% plus 1+ risk-enhancing factors, or CAC score >75th percentile for age/sex/race, or CAC score >100. Trigger phrases include: "LDL-C >70 mg/dL with high ASCVD risk", "Intermediate risk plus risk-enhancing factors", "Elevated CAC score indicating need for statin".

The guideline recommends statin therapy over hormone therapy for dyslipidemia management in postmenopausal women. Consider this approach when encountering a postmenopausal woman with dyslipidemia, choosing between statin and hormone therapy, or assessing first-line lipid treatment in menopause.

Recommends considering renal clearance when selecting a statin in chronic kidney disease, preferring pitavastatin, pravastatin, and rosuvastatin which have partial kidney clearance over atorvastatin, fluvastatin, lovastatin, and simvastatin which are cleared via the liver. Triggers include: Patient with CKD needing statin selection, Assessing statin safety in renal impairment, Choosing appropriate statin for kidney function.

This skill suggests statin therapy as adjunct to lifestyle modification to reduce cardiovascular risk in adults with persistent endogenous Cushing syndrome, irrespective of cardiovascular risk score. Trigger phrases include "Patient with persistent Cushing syndrome", "Assessing statin need in cortisol excess", and "Cardiovascular risk reduction in Cushing syndrome".

Recommends statin therapy to reduce cardiovascular risk in postmenopausal women on hormone therapy who have additional cardiovascular risk factors. Trigger phrases include: "Postmenopausal woman on HRT with CVD risk factors", "Assessing statin need in hormone-treated menopause", "Evaluating cardiovascular protection in hormone therapy users".

This skill suggests statin therapy, irrespective of cardiovascular risk score, to reduce cardiovascular risk in adults with type 1 diabetes who are age 40 years or older, have diabetes duration >20 years, or have microvascular complications. Clinical triggers include: 'T1D patient age 40+', 'T1D with diabetes duration >20 years', 'T1D with microvascular complications'.

This skill suggests statin therapy irrespective of cardiovascular risk score to reduce cardiovascular risk in adults with type 1 diabetes and chronic kidney disease stages 1-4. Clinical triggers include "Patient with T1D and CKD stages 1-4", "Assessing statin need in type 1 diabetic kidney disease", and "T1D with renal impairment".

Suggests statin therapy, irrespective of the cardiovascular risk score, to reduce cardiovascular risk in adults with type 1 diabetes and diabetic retinopathy. Trigger phrases include "Patient with T1D and diabetic retinopathy", "Considering statin for T1D with retinopathy", "Assessing cardiovascular risk in T1D with eye complications".

Suggests statin therapy, irrespective of the cardiovascular risk score, to reduce cardiovascular risk in adults with type 1 diabetes who have obesity or who have high triglycerides and low HDL-C. Clinical triggers include "T1D patient with obesity", "T1D with high TG and low HDL-C", and "Assessing statin need in T1D with metabolic syndrome features".

This skill suggests statin therapy irrespective of cardiovascular risk score to reduce cardiovascular risk in adults with type 2 diabetes and CKD stages 1-4 or postrenal transplant. Consider when encountering phrases such as "Patient with T2D and CKD stages 1-4", "T2D with renal transplant", or "Assessing statin need in diabetic kidney disease".

Recommends statin therapy in addition to lifestyle modification to reduce cardiovascular risk in adults with type 2 diabetes and additional cardiovascular risk factors such as hypertension, dyslipidemia, smoking, or family history of premature ASCVD. Use when managing a patient with type 2 diabetes who has concomitant hypertension, LDL‑C >70 mg/dL, or other risk‑enhancing factors.

This skill recommends checking triglyceride levels before and after starting a bile acid sequestrant in patients with elevated triglycerides (150-499 mg/dL). Clinical triggers include: triglyceride level 150-499 mg/dL, consideration of bile acid sequestrant for hypertriglyceridemia, and monitoring of therapeutic response to bile acid sequestrant.

Individually assesses glucocorticoid replacement to avoid over-replacement and reduce osteoporosis risk by suggesting low-dose hydrocortisone to increase bone formation and promote positive bone-remodeling balance. Triggered when managing patients on long-term glucocorticoid therapy requiring osteoporosis risk assessment.

Monitors levothyroxine (L-T4) replacement in hypopituitarism to prevent over-replacement and associated fracture risk. Triggered when managing L-T4 therapy, especially when levothyroxine dose adjustment is needed to avoid overdose.

Suggests the use of analgesics as adjunctive therapy for mild-to-moderate joint pain due to joint cartilage deterioration in patients with Paget's disease adjacent to the painful joint. Triggered when a patient reports joint pain attributable to adjacent Paget's involvement.