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Claude Skills by dromlakhani
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- Pheo Biochemical ConfirmationAlgorithm for interpreting metanephrine results and handling borderline elevations in suspected Pheochromocytoma. Trigger when a clinician asks "how to interpret metanephrines", "metanephrine units", or "borderline metanephrine result".Votes: 0GitHub stars: 12
- Pheo Preoperative Alpha BlockadePre-operative preparation protocol for Pheochromocytoma, focusing on alpha-blockade titration and volume expansion. Trigger when a clinician asks "prep for pheo surgery", "alpha blockade vs beta blockade", or "doxazosin titration".Votes: 0GitHub stars: 12
- Pheo Screening StrategyFirst-line screening logic to identify patients who require biochemical testing for Pheochromocytoma or Paraganglioma. Trigger when a clinician asks "who to screen for pheo", "evaluation of adrenal incidentaloma", or "workup for paroxysmal hypertension."Votes: 0GitHub stars: 12
- Ppgl 123i Mibg IndicationDetermines when to use 123I-MIBG scintigraphy for PPGL diagnosis and whether thyroid blockade is required. Triggers include: need functional imaging to confirm PPGL origin, evaluating for metastatic PPGL or PGL, preparing for 131I-MIBG therapy requires baseline scintigraphy.Votes: 0GitHub stars: 12
- Ppgl 18f Fdg Pet IndicationThis skill identifies when 18F-FDG PET is indicated for detecting metastatic pheochromocytoma/paraganglioma (PPGL), especially in patients with known SDHx pathogenic variants or negative 123I-MIBG scintigraphy. Clinical triggers include suspected metastatic PPGL with negative MIBG, evaluating PPGL with known SDHx variant, and assessing treatment response in metastatic PPGL.Votes: 0GitHub stars: 12
- Ppgl 68ga Dotatate Pet IndicationDetermines when to use 68Ga-DOTATATE PET for diagnosing primary head and neck paragangliomas irrespective of genetic variants. Triggers include suspected head/neck PGL requiring sensitive detection, evaluating for SSTR-positive neuroendocrine tumor, and pre-assessment for 177Lu-DOTATATE therapy in HNPGL.Votes: 0GitHub stars: 12
- Ppgl Alpha Blocker Add On IndicationDetermines when to add calcium antagonists or metyrosine to an alpha-blocker regimen for inadequate blood pressure control in pheochromocytoma and paraganglioma (PPGL). Indications include blood pressure uncontrolled on maximal alpha-blocker dose, significant side effects from alpha-blocker monotherapy, or development of vasospastic angina during preoperative management, with metyrosine initiated at 0.5 g/day and titrated to a maximum of 4 g/day.Votes: 0GitHub stars: 12
- Ppgl Alpha Blocker TitrationTitrates preoperative alpha-blocker dose based on blood pressure response to achieve target hemodynamics (<130/80 mmHg sitting). Increases dose (e.g., doxazosin) every 2‑3 days until target BP is reached, monitoring for orthostatic hypotension and adjusting accordingly; triggers include 'Patient on preoperative alpha-blocker needs dose adjustment,' 'Blood pressure not at target despite current alpha-blocker dose,' 'Assessing need for alpha-blocker titration during preoperative period.'Votes: 0GitHub stars: 12
- Ppgl Asymptomatic Carrier Surveillance AgeDetermines the appropriate age to initiate surveillance for asymptomatic genetic carriers of PPGL pathogenic variants. Indicated for a child of a PPGL patient with a known pathogenic variant, identification of an at‑risk relative for PPGL genetic screening, or initiation of surveillance in a pediatric genetic carrier.Votes: 0GitHub stars: 12
- Ppgl Asymptomatic Carrier Surveillance FrequencyEstablishes surveillance frequency for asymptomatic genetic carriers of PPGL pathogenic variants after an initial negative genetic screen. It guides clinicians in determining long-term monitoring plans and follow-up schedules for PPGL mutation carriers, recommending annual clinical evaluation, biennial fractionated metanephrines evaluation, and triennial MRI of head/neck/chest/abdomen/pelvis.Votes: 0GitHub stars: 12
- Ppgl Beta Blocker TimingDetermines the appropriate timing for initiating beta-blocker therapy in patients with pheochromocytoma/paraganglioma (PPGL) to prevent hypertensive crisis. Indicated for tachycardia/tachyarrhythmia, myocardial damage, heart failure, or ischemic heart disease only after adequate alpha-blockade; contraindicated before alpha-blocker initiation, and triggered by clinician statements such as “Patient develops tachycardia on alpha-blocker therapy,” “Need to control heart rate in PPGL with cardiac ...Votes: 0GitHub stars: 12
- Ppgl Biochemical Cutoff ApplicationApplies specific cutoff values to interpret biochemical test results for PPGL diagnosis. Uses >3x upper limit of normal for screening tests (random urinary fractionated metanephrines corrected for creatinine, blood fractionated catecholamines, plasma-free fractionated metanephrines) and >2x upper limit of normal for 24-hour urinary fractionated catecholamines confirmation; triggers include interpreting urinary metanephrine screening results, evaluating 24-hour catecholamine excretion for conf...Votes: 0GitHub stars: 12
- Ppgl Bone Metastasis Local TreatmentSelects between external radiation therapy and surgical intervention for bone metastases in PPGL based on lesion characteristics and patient factors. Triggers include: PPGL patient with confirmed bone metastasis, assessing local treatment options for osseous PPGL lesions, determining radiation vs surgery for spinal PPGL metastasis.Votes: 0GitHub stars: 12
- Ppgl Bone Modifying Agent ConsiderationDetermines when to use bone-modifying agents (e.g., zoledronic acid, denosumab) for skeletal-related event prevention in PPGL bone metastases. Considers BMA as an option for preventing pathological fractures, spinal cord compression, and hypercalcemia, using an approach similar to other solid cancers with monitoring for side effects; triggers include PPGL patient with bone metastasis at risk for SREs, patient experiencing bone pain from metastatic PPGL, and preventing skeletal complications i...Votes: 0GitHub stars: 12
- Ppgl Confirmation Test SelectionSelects the appropriate functional confirmation test after a positive PPGL screening test to establish biochemical diagnosis. Triggered by statements such as 'Screening test positive for PPGL,' 'Need to confirm PPGL diagnosis before imaging,' or 'Biochemical test results exceed screening thresholds.'Votes: 0GitHub stars: 12
- Ppgl Copps Score ApplicationApplies the COPPS score to predict metastasis risk in PPGL by integrating tumor size, necrosis, vascular invasion, and SDHB/S100 immunostaining. Triggered when a PPGL pathology specimen is available for scoring, when calculating metastatic risk index from histology, or when determining need for adjuvant therapy based on tumor biology.Votes: 0GitHub stars: 12
- Ppgl Gapp Score ApplicationApplies the GAPP score to assess metastasis risk in PPGL based on histopathological features. Triggers include: 'PPGL tumor requiring histopathological risk assessment,' 'Evaluating tumor grade for metastatic potential,' 'Determining follow-up intensity based on histological scoring.'Votes: 0GitHub stars: 12
- Ppgl Genetic Test SelectionSelects specific genes to test for PPGL based on clinical presentation and phenotypic characteristics. Indications include abdominal/PGL with metastasis risk (test SDHB), head/neck PGL (test SDHD), bilateral PCC or pancreatic lesions (test VHL), and MEN2-associated mucosal neuromas or medullary thyroid cancer (test RET).Votes: 0GitHub stars: 12
- Ppgl Genetic Testing IndicationDetermines when to suggest genetic testing for PPGL and educates patients about hereditary PPGL prevalence and testing significance, recommending testing for all PPGL patients per international guidelines while informing about the 20-40% hereditary rate and implications for family screening. Triggers include: 'Newly diagnosed PPGL patient,' 'Discussing hereditary risk with PPGL patient,' 'Considering genetic testing for PPGL patient and family.'Votes: 0GitHub stars: 12
- Ppgl Gi Symptom ManagementManages gastrointestinal symptoms (constipation, paralytic ileus, mega-colon) in pheochromocytoma and paraganglioma (PPGL) using intravenous phentolamine and oral metyrosine to improve intestinal peristalsis. Indicated for PPGL patients with severe constipation or ileus, GI symptoms suspected due to catecholamine excess, or when improving intestinal motility is needed.Votes: 0GitHub stars: 12
- Ppgl Hnpgl Intervention IndicationAssesses specific clinical indications warranting surgical resection or radiation therapy for head and neck paraganglioma. Recommends intervention for tympanic PGL with hearing loss, jugular bulb PGL with pulsatile tinnitus, significant skull base compression, catecholamine production, rapid growth, or metastasis; triggers include 'HNPGL patient develops neurological symptoms,' 'Tumor shows rapid growth on serial imaging,' 'Functional testing reveals catecholamine overproduction in HNPGL'.Votes: 0GitHub stars: 12
- Ppgl Hnpgl Surveillance Vs InterventionDecides between surveillance therapy and active intervention for head and neck paraganglioma based on symptomology and tumor behavior. Prefers surveillance for asymptomatic, slow-growing tumors; advises surgical resection or radiation therapy for symptomatic, rapidly growing, or functionally active tumors. Triggers include: 'Newly diagnosed head/neck PGL patient,' 'Assessing management options for HNPGL,' 'Determining if HNPGL requires intervention or observation.'Votes: 0GitHub stars: 12
- Ppgl Hypertensive Crisis ManagementExecutes the hypertensive crisis management algorithm for PPGL by administering intravenous phentolamine infusion followed by oral doxazosin, with addition of oral beta‑blocker for tachycardia after alpha‑blockade is established. It is triggered by clinical phrases such as 'Patient presents with hypertensive crisis suspected PPGL etiology,' 'Sudden severe hypertension with headache/palpitations,' or 'Intraoperative hypertensive surge during PPGL manipulation.'Votes: 0GitHub stars: 12
- Ppgl Initial Imaging Modality SelectionSelects the first-line imaging modality to localize a PPGL tumor after biochemical confirmation. Common triggers are 'Biochemical tests confirm PPGL, need to localize tumor,' 'Planning surgical approach requires anatomical localization,' and 'Positive screening test warrants imaging for tumor localization.'Votes: 0GitHub stars: 12
- Ppgl Initial Screening Test SelectionSelects the initial biochemical screening test for pheochromocytoma and paraganglioma based on test availability and clinical context. Triggers include patient presenting with palpitations, headaches, or hypertension; need to screen for PPGL in an incidentally discovered adrenal mass; or initial biochemical workup for suspected PPGL.Votes: 0GitHub stars: 12
- Ppgl Lifelong Follow Up DurationDetermines appropriate postoperative follow-up duration for PPGL based on hereditary status, catecholamine phenotype, tumor size, and location to guide surveillance intensity. Recommends lifelong follow-up for hereditary PPGL and at least 10 years for sporadic PPGL with noradrenaline dominance, tumor ≥5 cm, or extra‑adrenal/PGL location; triggers include 'Post-op PPGL patient requiring follow-up plan,' 'Assessing need for extended surveillance in PPGL survivor,' 'Determining follow-up duratio...Votes: 0GitHub stars: 12
- Ppgl Metastasis Risk Assessment ClinicalAssesses metastasis risk in PPGL using clinical factors such as age at diagnosis, tumor size, catecholamine secretion pattern, and tumor location. Indicated for newly diagnosed PPGL patients requiring risk stratification, evaluating metastatic potential, or pre-treatment assessment of aggressiveness.Votes: 0GitHub stars: 12
- Ppgl Metastasis Risk Assessment GeneticDetermines metastasis risk in PPGL using SDHB immunohistochemistry and genetic testing; integrates SDHB loss with tumor size, necrosis, vascular invasion, and S100 loss into COPPS score. Triggers include: 'PPGL tumor tissue available for immunohistochemistry,' 'Genetic testing reveals SDHB variant,' 'Assessing metastatic potential from genetic profile.'Votes: 0GitHub stars: 12
- Ppgl Metastasis Risk Assessment HistopathologicalEvaluates metastasis risk in pheochromocytoma and paraganglioma (PPGL) using histopathological scoring systems such as PASS and GAPP. Triggered when a pathology specimen is available from PPGL resection, when assessing tumor malignant potential on histology, or when determining the need for intensified follow-up based on pathology.Votes: 0GitHub stars: 12
- Ppgl Metastatic Treatment SelectionSelects between CVD chemotherapy and radionuclide therapy as first-line systemic treatment for metastatic PPGL based on disease progression and imaging results. Triggers include PPGL with distant metastases requiring systemic therapy, assessing first-line treatment options for metastatic PPGL, and determining CVD chemo vs radionuclide therapy for progressive disease.Votes: 0GitHub stars: 12
- Ppgl Pain Management Medication SelectionSelects analgesic medications for PPGL pain management while avoiding agents that may provoke hypertensive crisis. Triggers include metastatic PPGL patient requiring pain management, assessing safe analgesic options in PPGL, and managing pain while preventing hypertensive crisis.Votes: 0GitHub stars: 12
- Ppgl Partial Adrenalectomy IndicationThis skill assesses whether partial adrenalectomy is indicated for pheochromocytoma and paraganglioma (PPGL) to preserve adrenal function in patients with familial PPGL syndrome, imaging showing bilateral adrenal tumors or high-risk genetics, or young PPGL patients desiring adrenal function preservation. Indication is considered for familial PCC, tumors ≤5 cm, or high risk of future contralateral adrenal lesions, requiring surgical expertise and informed consent regarding recurrence risk.Votes: 0GitHub stars: 12
- Ppgl Pass Score ApplicationThis skill applies the PASS score to evaluate malignant behavior in PPGL specimens as a reference tool for metastasis risk assessment. It is triggered by histopathological evaluation requiring PASS scoring, assessment of tumor malignant potential on histology, or determination of need for additional risk stratification based on PASS, noting the weak correlation between PASS scores and metastasis, low inter-observer agreement, and the need for use alongside other markers with validation for lo...Votes: 0GitHub stars: 12
- Ppgl Pediatric Investigation TriggerThis skill identifies when to investigate pediatric pheochromocytoma and paraganglioma (PPGL) in children presenting with hypertension accompanied by symptoms such as headache, sweating, palpitations, or reduced growth rate. It triggers investigation when blood pressure measurement confirms hypertension in a child with any of these associated symptoms.Votes: 0GitHub stars: 12
- Ppgl Pediatric Surgical ApproachDetermines surgical approach for PPGL in children considering tumor size, suspected pathogenic gene variants, and hereditary tumor syndromes. Chooses between laparotomy and endoscopic surgery based on child's size and genetic risk; incorporates family history and genetic testing results in decision-making, with triggers such as 'Child diagnosed with PPGL requiring surgery,' 'Need to select surgical approach for pediatric PPGL,' and 'Evaluating surgical options in child with genetic syndrome.'Votes: 0GitHub stars: 12
- Ppgl Postoperative Follow Up TimingThis skill initiates postoperative follow-up timing for pheochromocytoma and paraganglioma (PPGL) after surgical resection based on biochemical and imaging protocols. It is triggered by events such as the patient completing PPGL surgical resection, entering the post-op period requiring surveillance initiation, or needing to establish a postoperative monitoring timeline.Votes: 0GitHub stars: 12
- Ppgl Pregnancy Imaging SelectionSelects safe imaging modalities for PPGL evaluation in pregnancy to minimize fetal radiation exposure, preferring ultrasound or MRI and reserving CT or 123I-MIBG scintigraphy for cases where diagnostic benefits outweigh radiation risks after informed consent. Triggered by phrases such as 'Pregnant patient with suspected PPGL symptoms,' 'Need imaging for PPGL in pregnant patient,' or 'Evaluating PPGL while minimizing fetal radiation risk.'Votes: 0GitHub stars: 12
- Ppgl Pregnancy Medical ManagementManages PPGL medically in pregnancy by initiating selective alpha‑blockers at diagnosis and adding calcium antagonists (nifedipine or amlodipine) if blood pressure control is insufficient before delivery. Triggers include: 'Pregnant patient diagnosed with PPGL,' 'Requiring blood pressure control in pregnant PPGL patient,' and 'Medical management of PPGL throughout pregnancy.'Votes: 0GitHub stars: 12
- Ppgl Pregnancy Surgical TimingDetermines optimal timing for surgical tumor removal in pregnant PPGL patients to balance maternal and fetal risks. Triggered by PPGL diagnosed in pregnant patient, assessing surgical feasibility during pregnancy, or planning intervention for PPGL in gestation.Votes: 0GitHub stars: 12
- Ppgl Preoperative Alpha Blocker SelectionSelects preoperative alpha-blocker therapy and establishes initial dosing regimen for PPGL blood pressure control. Triggered by biochemically confirmed PPGL requiring surgery, patient needs preoperative blood pressure control, or preparing for adrenalectomy in PPGL patient.Votes: 0GitHub stars: 12
- Ppgl Preoperative Salt Saline ProtocolImplements preoperative salt loading and saline infusion to prevent orthostatic hypotension and hemodynamic instability during PPGL surgery. Initiates normal salt diet (9 g/day) on day 3 of alpha-blockers and administers 1-2 L saline infusion from evening before surgery until surgery for patients scheduled for PPGL surgical resection, completing preoperative alpha-blocker titration, or preventing intraoperative hypotension in PPGL surgery.Votes: 0GitHub stars: 12
- Ppgl Radionuclide Therapy SelectionSelects between 131I-MIBG and 177Lu-DOTATATE radionuclide therapy for PPGL based on imaging results. Triggers include PPGL patient requires radionuclide therapy, positive 123I-MIBG scintigraphy indicating MIBG-avid tumor, and positive somatostatin receptor scintigraphy for SSTR-avid tumor.Votes: 0GitHub stars: 12
- Ppgl Surgical Approach SelectionThis skill selects the surgical approach (laparoscopic/robot-assisted vs open adrenalectomy) for pheochromocytoma and paraganglioma (PPGL) based on tumor size and suspected organ invasion. It is triggered when imaging shows PPGL tumor size approaching 6 cm, suspected tumor invasion into adjacent structures on imaging, or when determining the surgical approach for a confirmed PPGL.Votes: 0GitHub stars: 12
- Ata Acromegaly Gh DoseRecommends low-dose GH replacement in patients with cured acromegaly and documented GHD in the absence of known contraindications. Triggers include managing a cured acromegaly patient with documented growth hormone deficiency.Votes: 0GitHub stars: 12
- Ata Adipsic Di TitrationRecommends careful DDAVP and fluid intake titration including frequent weighing and serum sodium level monitoring for adipsic diabetes insipidus. Use when managing adipsic DI requiring fluid balance management.Votes: 0GitHub stars: 12
- Ata Aed Ddavp MonitoringThis skill recommends monitoring desmopressin (DDAVP) doses and adjusting them as needed in patients who have recently started antiepileptic drugs (AEDs). It is triggered when a patient initiates AED therapy and requires DDAVP management for diabetes insipidus.Votes: 0GitHub stars: 12
- Ata Ch Ai Screening Lt4Evaluates central hypothyroidism (CH) patients for adrenal insufficiency (AI) prior to initiating levothyroxine (L‑T4) replacement. Triggers include consideration of L‑T4 start in central hypothyroidism needing thyroid replacement.Votes: 0GitHub stars: 12
- Ata Ch Before Gh StimRecommends treating central hypothyroidism before performing GH stimulation testing because CH may impair accurate diagnosis of GHD. Use when preparing for GH stimulation testing; triggers include patient requiring GH stimulation test with possible CH.Votes: 0GitHub stars: 12
- Ata Ch Diagnosis AlgorithmThis skill confirms central hypothyroidism when serum free T4 is below the laboratory reference range with low, normal, or mildly elevated TSH in the setting of pituitary disease. Use when assessing thyroid function in pituitary disease; triggers include pituitary disease with suspected thyroid dysfunction.Votes: 0GitHub stars: 12
- Ata Ch Treatment Formulations AgainstRecommend against using levotriiodothyronine (L-T3), thyroid extracts, or other thyroid hormone formulations for central hypothyroidism. Triggered when evaluating thyroid hormone replacement in central hypothyroidism (e.g., 'considering thyroid hormone replacement for central hypothyroidism' or 'central hypothyroidism requiring thyroid hormone replacement').Votes: 0GitHub stars: 12