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Claude Skills by dromlakhani
github.com/dromlakhani875 skills0 installs1,377 views
- Ata Male Testosterone Replacement IndicationsRecommends testosterone replacement for adult males with central hypogonadism and no contraindications to prevent anemia related to T deficiency; reduce fat mass; and improve BMD, libido, sexual function, energy levels, sense of well-being, and muscle mass and strength. Triggers include consideration of testosterone replacement in males with central hypogonadism (e.g., low serum testosterone with symptoms of deficiency).Votes: 0GitHub stars: 12
- Ata Premenopausal Women Gonadal Hormone TreatmentRecommends gonadal hormone treatment for premenopausal women with central hypogonadism when no contraindications exist. Triggered when evaluating hormonal replacement in a premenopausal woman with oligomenorrhea or amenorrhea suggestive of central hypogonadism.Votes: 0GitHub stars: 12
- Endo Androgen Deficiency Diagnosis AgainstRecommends against diagnosing androgen deficiency syndrome in healthy women because there is no well-defined syndrome and no data linking androgen levels to specific signs or symptoms. Triggered when a clinician considers diagnosing androgen deficiency in a woman without known pituitary, adrenal, or gonadal disease.Votes: 0GitHub stars: 12
- Endo Dhea Generalized Use AgainstRecommends against routine use of dehydroepiandrosterone in women because indications are inadequate and evidence of efficacy and long-term safety is lacking. Triggers include a clinician considering DHEA supplementation for general well‑being, adrenal insufficiency, or other non‑specific indications.Votes: 0GitHub stars: 12
- Endo Fha Avoid Bisphosphonates Denosumab Testosterone LeptinThis skill recommends against using bisphosphonates, denosumab, testosterone, or leptin to improve bone mineral density in adolescents and women with functional hypothalamic amenorrhea (FHA) due to insufficient evidence and potential risks. Use when a clinician asks, 'Should we give her denosumab for low BMD?' or encounters language such as 'Avoid bisphosphonates in FHA' or 'Do not use leptin or testosterone or leptin for bone health'.Votes: 0GitHub stars: 12
- Endo Fha Avoid Kisspeptin Leptin InfertilityThis skill recommends against using kisspeptin or leptin to treat infertility in patients with functional hypothalamic amenorrhea (FHA) except within research or closely monitored trials due to limited evidence. Use when a clinician states, “Let’s not prescribe kisspeptin for her infertility,” or encounters triggers such as “Avoid kisspeptin outside trials” or “Do not use leptin for ovulation induction.”Votes: 0GitHub stars: 12
- Endo Fha Avoid Ocps Menses BmdThis skill advises against prescribing oral contraceptive pills solely to induce menstruation or enhance bone mineral density in patients with functional hypothalamic amenorrhea (FHA). Use when a clinician considers, 'Should I give her OCPs to get her period back?' or encounters statements such as 'Don’t use OCPs just for menses' or 'Avoid OCPs as a sole BMD strategy'.Votes: 0GitHub stars: 12
- Endo Fha Baseline Bmd TimingThis skill advises obtaining a baseline bone mineral density (BMD) measurement by dual‑energy X‑ray absorptiometry (DXA) for any adolescent or woman with six or more months of amenorrhea, and earlier when severe nutritional deficiency, other energy deficit states, or skeletal fragility are suspected. Trigger phrases include 'Get BMD after six months of amenorrhea' or 'Order DXA early due to suspected malnutrition'.Votes: 0GitHub stars: 12
- Endo Fha Bmd Pcos FhaThis skill recommends obtaining a baseline BMD measurement by DXA in adolescents or women with functional hypothalamic amenorrhea (FHA) and concurrent polycystic ovary syndrome (PCOS) who have six or more months of amenorrhea, and earlier if there is history or suspicion of severe nutritional deficiency, other energy deficit states, or skeletal fragility. Use when a clinician states, “She has PCOS and no periods for seven months—let’s get a DXA,” or similar triggers such as “Check BMD in PCOS...Votes: 0GitHub stars: 12
- Endo Fha Brain Mri IndicationsThis skill recommends obtaining a brain MRI with pituitary slices and contrast in adolescents or women with presumed functional hypothalamic amenorrhea (FHA) who have severe/persistent headaches, non-self-induced vomiting, changes in vision/thirst/urination, lateralizing neurologic signs, or clinical/laboratory evidence of pituitary hormone deficiency or excess. Triggers include phrases such as “MRI for persistent headache and vomiting” or “Get pituitary MRI if there are neuro signs”.Votes: 0GitHub stars: 12
- Endo Fha Correct Energy ImbalanceThis skill recommends increasing caloric intake, improving nutrition, and/or decreasing exercise activity to restore energy balance and reactivate the hypothalamic–pituitary–ovarian axis in functional hypothalamic amenorrhea. It is triggered when a clinician states, 'We need to fix her energy deficit to bring back her periods,' or hears phrases like 'Increase calories and reduce exercise' or 'Focus on nutritional rehabilitation and weight gain'.Votes: 0GitHub stars: 12
- Endo Fha Diagnosis Exclude OrganicThis skill guides clinicians to confirm that anatomic or organic causes of amenorrhea have been ruled out before labeling the condition as functional hypothalamic amenorrhea. Triggers include statements such as “We need to exclude organic causes first” or “Before calling it FHA, let’s get an MRI and prolactin level.”Votes: 0GitHub stars: 12
- Endo Fha Diagnostic Evaluation Cycle LengthThis skill directs clinicians to initiate a diagnostic workup for functional hypothalamic amenorrhea (FHA) when menstrual cycles persistently exceed 45 days or amenorrhea lasts three months or longer. Trigger phrases include 'cycle longer than 45 days' or 'three months of no menses warrants evaluation'.Votes: 0GitHub stars: 12
- Endo Fha Educate Ocps MaskingThis skill involves educating patients with functional hypothalamic amenorrhea who use oral contraceptive pills for contraception that the pills may conceal the return of spontaneous menses and that bone loss can persist if an energy deficit remains. Use when a clinician says, “Let’s explain how OCPs might hide her recovery,” or when hearing triggers such as “Warn her OCPs can mask menses” or “Tell her bone loss may persist despite OCPs if she stays underweight.”Votes: 0GitHub stars: 12
- Endo Fha Endocrine LabsThis skill guides clinicians to obtain an initial endocrine laboratory evaluation for functional hypothalamic amenorrhea, measuring serum TSH, free T4, prolactin, LH, FSH, estradiol, and AMH, with addition of total testosterone and DHEA-S if hyperandrogenism is present and 8 AM 17-hydroxyprogesterone if late-onset CAH is suspected. Use when a clinician states, “We need a full endocrine panel to assess thyroid, gonadal, and adrenal function,” or uses trigger phrases such as “Check TSH, prolact...Votes: 0GitHub stars: 12
- Endo Fha Fertility Cbt Trial ConceptionThis skill suggests considering a trial of cognitive behavioral therapy (CBT) to restore ovulation and fertility in women with functional hypothalamic amenorrhea (FHA) who desire pregnancy, based on a small study showing efficacy with minimal harm. Clinicians may use this when they hear phrases such as "Try CBT to improve fertility" or "Consider psychotherapy before medical ovulation induction".Votes: 0GitHub stars: 12
- Endo Fha Fertility Clomiphene Citrate Trial EstrogenThis skill suggests a trial of clomiphene citrate for ovulation induction in women with functional hypothalamic amenorrhea (FHA) who have an adequate endogenous estrogen level, as determined by baseline estradiol measurement. Use when a clinician asks, 'Her estrogen is measurable—should we try clomiphene?' Triggers include language like 'If E2 is sufficient, try clomiphene' or 'Consider clomiphene after confirming estrogen production'.Votes: 0GitHub stars: 12
- Endo Fha Fertility Gonadotropin Therapy CautiousThis skill advises exercising caution when using gonadotropin therapy (FSH/LH) for ovulation induction in patients with functional hypothalamic amenorrhea (FHA), particularly monitoring for ovarian hyperresponse and multiple gestations. It is triggered when a clinician states, “We’ll use gonadotropins but watch for overstimulation,” or phrases such as “Use gonadotropins cautiously” or “Monitor estradiol and follicle count during gonadotropin therapy”.Votes: 0GitHub stars: 12
- Endo Fha Fertility Pulsatile Gnrh First LineThis skill recommends initiating fertility treatment with pulsatile GnRH as the first-line approach to induce ovulation in women with functional hypothalamic amenorrhea (FHA) who desire pregnancy, followed by gonadotropin therapy if GnRH is unavailable. Use when a clinician states, 'She wants to conceive—let’s start with pulsatile GnRH.' Triggers include language like 'First try pulsatile GnRH for ovulation' or 'Use GnRH pump before gonadotropins'.Votes: 0GitHub stars: 12
- Endo Fha Gonadotropin Hyperresponse MonitoringThis skill advises close monitoring for an exaggerated ovarian response when using exogenous gonadotropins for ovulation induction in patients with functional hypothalamic amenorrhea (FHA) who also have underlying polycystic ovary syndrome (PCOS). Use when a clinician remarks, 'She’s on gonadotropins and has PCOS—watch for overstimulation,' or notes phrases such as 'Monitor for hyperresponse to gonadotropins' or 'Check estradiol frequently during gonadotropin therapy in PCOS'.Votes: 0GitHub stars: 12
- Endo Fha Inpatient Evaluation CriteriaThis skill guides clinicians to assess patients with functional hypothalamic amenorrhea (FHA) for hospital admission when they exhibit severe bradycardia, hypotension, orthostasis, or significant electrolyte abnormalities. Use when a clinician says, “Her heart rate is 40 and she’s dizzy—should we admit her?” or notes phrases like “Admit for hypotension and bradycardia” or “Check for orthostatic vitals and electrolytes.”Votes: 0GitHub stars: 12
- Endo Fha Mullerian Anomalies Primary AmenorrheaThis skill guides clinicians to evaluate congenital or acquired Müllerian tract anomalies in patients with primary amenorrhea using physical exam, progestin challenge test, and imaging. Trigger phrases include 'Rule out imperforate hymen with exam' or 'Consider ultrasound for Müllerian anomalies'.Votes: 0GitHub stars: 12
- Endo Fha Ovulation Induction Bmi ThresholdThis skill states that ovulation induction should be pursued only in women with functional hypothalamic amenorrhea (FHA) who have a body mass index (BMI) of at least 18.5 kg/m² and only after attempts to correct the underlying energy deficit. Use when a clinician asks, 'Her BMI is 18.2—should we hold off on ovulation drugs?' or hears triggers such as 'Wait until BMI is at least 18.5' or 'Don’t induce ovulation until weight is normalized'.Votes: 0GitHub stars: 12
- Endo Fha Patient Education Menstrual PatternsThis skill involves informing patients that irregular menses during recovery from functional hypothalamic amenorrhea do not require immediate evaluation and that menstrual irregularity does not prevent conception. It is used when a clinician says, 'Let’s explain what to expect as her cycles return,' or when statements like 'Tell her irregular periods are okay' or 'Reassure her she can still conceive while cycles normalize' are made.Votes: 0GitHub stars: 12
- Endo Fha Personal Family HistoryThis skill guides clinicians to obtain a detailed personal and family history focusing on diet, eating disorders, exercise, weight, sleep, stressors, mood, menstrual pattern, fractures, substance abuse, and familial endocrine/reproductive disorders when evaluating suspected functional hypothalamic amenorrhea. Use when clinicians state they need to know about her exercise routine, diet, and family history of eating disorders, or when they ask about weight fluctuations, sleep, and stressors, or...Votes: 0GitHub stars: 12
- Endo Fha Physical Exam Organic ExclusionThis skill directs clinicians to conduct a thorough physical exam, including external and selected bimanual gynecologic exam, to identify signs of anatomic or organic causes of amenorrhea. Use when clinicians state, 'Let’s check for thyroid enlargement, galactorrhea, or pelvic masses,' or 'Perform bimanual to rule out outflow tract anomalies' or 'Look for hirsutism, acne, or signs of androgen excess'.Votes: 0GitHub stars: 12
- Endo Fha Progestin ChallengeThis skill involves administering a progestin challenge (e.g., medroxyprogesterone acetate 5–10 mg daily for 5–10 days) to induce withdrawal bleeding, which indicates adequate estrogen exposure and evaluates outflow tract integrity. Use when a clinician states, “Let’s do a progestin challenge to see if she bleeds,” or gives orders such as “Give 10 mg medroxyprogesterone for 10 days and check for bleed” or “Use progestin challenge to assess endometrial estrogen effect”.Votes: 0GitHub stars: 12
- Endo Fha Psychological Support CbtThis skill suggests offering psychological support, particularly cognitive behavioral therapy, to address stress and maladaptive coping mechanisms in patients with functional hypothalamic amenorrhea. Trigger phrases include “Recommend CBT for anxiety and perfectionism” or “Consider psychotherapy to improve coping”.Votes: 0GitHub stars: 12
- Endo Fha Rpth Delayed Fracture Low BmdThis skill suggests that short-term recombinant parathyroid hormone 1-34 (rPTH) may be considered in rare adult functional hypothalamic amenorrhea (FHA) cases with delayed fracture healing and markedly reduced bone mineral density. Use when a clinician notes, 'Her fracture isn’t healing and her Z-score is -3—could rPTH help?' or considers rPTH for poor fracture healing or teriparatide in severe osteoporosis with FHA.Votes: 0GitHub stars: 12
- Endo Fha Screening LabsThis skill recommends obtaining initial screening laboratory tests for functional hypothalamic amenorrhea (FHA) to rule out pregnancy and systemic illness. Use when a clinician states, 'Let’s get basic labs to rule out pregnancy and systemic illness,' or similar phrases such as 'Order a chem panel and pregnancy test' or 'Check CBC and metabolic panel'.Votes: 0GitHub stars: 12
- Endo Fha Short Term Transdermal E2 ProgestinThis skill recommends a short course of transdermal estradiol combined with cyclic oral progestin (not oral contraceptives) for adolescents and women with functional hypothalamic amenorrhea who have not resumed menses after a reasonable trial of nutritional, psychological, and/or modified exercise interventions. It is triggered when a clinician states, 'She’s tried diet and CBT but still no periods—let’s try transdermal E2,' or similar phrases such as 'Consider transdermal estrogen after life...Votes: 0GitHub stars: 12
- Endo Hirsutism Add Antiandrogen After 6monthsThis skill guides clinicians to add an antiandrogen after six months of monotherapy with an oral contraceptive when patient‑important hirsutism shows an inadequate response. Trigger phrases include “patient‑important hirsutism”, “6 months of OC monotherapy”, and “suboptimal hirsutism response”.Votes: 0GitHub stars: 12
- Endo Hirsutism Add Direct Hair Removal Cosmetic BenefitSuggests adding electrolysis or laser/photoepilation after pharmacologic therapy when the patient desires additional cosmetic improvement beyond medication alone. Triggered by clinician statements such as "She’s improved on the pill but wants smoother skin; should we add laser?"Votes: 0GitHub stars: 12
- Endo Hirsutism Add Eflornithine PhotoepilationAdd eflornithine 13.9% cream to photoepilation for faster hirsutism reduction in women with patient-important hirsutism who desire a quicker cosmetic response. Trigger when the patient reports inadequate speed of hair reduction after initiating laser or intense pulsed light therapy.Votes: 0GitHub stars: 12
- Endo Hirsutism Adrenal Ct Ovarian Us If Tumor SuspectedImage the adrenal glands with CT and the ovaries with transvaginal ultrasound when biochemical evaluation suggests an androgen‑secreting tumor, such as markedly elevated DHEAS or testosterone, rapid progression of hirsutism, or virilization. Trigger phrases include “sudden‑onset hirsutism,” “virilization (clitoromegaly, deepening voice),” “DHEAS > 700 µg/dL,” “testosterone in male range,” or “progressive hirsutism despite therapy.”Votes: 0GitHub stars: 12
- Endo Hirsutism Assess Cosyntropin ResponseAssesses the adrenal response to cosyntropin stimulation by measuring 17-hydroxyprogesterone and other steroid precursors to exclude rare forms of congenital adrenal hyperplasia in women with hirsutism. Triggered when evaluating hyperandrogenic patients with high-risk features (e.g., positive family history, high-risk ethnicity) despite normal baseline androgens.Votes: 0GitHub stars: 12
- Endo Hirsutism Assess Cushing Thyroid Acromegaly HyperprolactinemiaAssess for Cushing syndrome, thyroid dysfunction, acromegaly, or hyperprolactinemia when clinical features suggestive of these disorders are present in a woman with hirsutism. Trigger phrases include "Cushingoid features," "hypothyroidism signs," "acromegalic changes," or "galactorrhea/menstrual disturbance."Votes: 0GitHub stars: 12
- Endo Hirsutism Assess Urinary Corticoid MetabolitesAssess urinary corticoid metabolites by mass spectrometry to exclude apparent cortisone reductase deficiency. Indicated when a woman presents with moderate/severe hirsutism or mild hirsutism accompanied by clinical evidence of a hyperandrogenic endocrine disorder such as menstrual disturbance, progression despite therapy, or signs of virilization.Votes: 0GitHub stars: 12
- Endo Hirsutism Avoid Antiandrogen Monotherapy Unless ContraceptionGuidance to avoid antiandrogen monotherapy unless adequate contraception is in place. Trigger phrases include patient-important hirsutism despite cosmetic measures, sexually active status, inadequate contraception, desire for pregnancy, permanent sterilization, or long-acting reversible contraception.Votes: 0GitHub stars: 12
- Endo Hirsutism Avoid Gnrh Agonist Except SevereThe clinician avoids GnRH agonist therapy for hirsutism unless the patient has severe hyperandrogenemia (e.g., ovarian hyperthecosis) and has demonstrated a suboptimal response to combined oral contraceptives plus an antiandrogen. Trigger phrases include "severe hyperandrogenemia," "suboptimal response to OC/antiandrogen," and "ovarian hyperthecosis."Votes: 0GitHub stars: 12
- Endo Hirsutism Avoid Insulin Lowering DrugsThis skill advises against using insulin‑lowering drugs (e.g., metformin, thiazolidinediones) solely to treat hirsutism in premenopausal women. Apply when evaluating patient‑important hirsutism despite cosmetic measures or when insulin‑lowering therapy is considered for hyperandrogenism without other indications.Votes: 0GitHub stars: 12
- Endo Hirsutism Avoid Test Androgen Local HairThe skill recommends against testing for elevated androgen levels in eumenorrheic women with only unwanted local hair growth and no abnormal hirsutism score. Trigger phrases include statements like, “She only has stray facial hair but regular periods; do we need androgen labs?”Votes: 0GitHub stars: 12
- Endo Hirsutism Avoid Topical AntiandrogenThe skill advises clinicians to avoid prescribing topical antiandrogen agents (e.g., spironolactone or finasteride cream) for hirsutism in premenopausal women. Trigger phrases include “patient wants a topical cream for facial hair,” “considering eflornithine for hirsutism,” or “requests antiandrogen topical therapy.”Votes: 0GitHub stars: 12
- Endo Hirsutism Consider Combo Therapy Severe DistressConsider oral contraceptive‑antiandrogen combination therapy for severe hirsutism causing emotional distress or after inadequate response to OC monotherapy. Avoid using this combination as first‑line treatment; reserve for patients with severe distress or prior OC failure.Votes: 0GitHub stars: 12
- Endo Hirsutism Dexamethasone Suppression TestPerform dexamethasone suppression testing to evaluate functional adrenal androgen excess in women with hirsutism. Trigger phrases include “moderate/severe hirsutism with normal total testosterone,” “clinical evidence of hyperandrogenic disorder despite normal androgens,” or “progression of hirsutism despite therapy.”Votes: 0GitHub stars: 12
- Endo Hirsutism Either Approach Mild No EndocrineFor a premenopausal woman presenting with mild hirsutism (Ferriman–Gallwey score 8–15) and no clinical evidence of an endocrine disorder (eumenorrheic menses, absence of hyperandrogenic signs), the clinician should consider either pharmacologic therapy or direct hair removal as initial management options. Choose pharmacologic therapy (e.g., combined oral contraceptive) or direct hair removal (laser/photoepilation or electrolysis) based on patient preference, contraceptive needs, and hair char...Votes: 0GitHub stars: 12
- Endo Hirsutism Lifestyle Changes Obese PcosRecommend lifestyle changes for obese women with PCOS who present with hirsutism and seek improvement of androgen-related symptoms. Trigger phrases include BMI ≥30, PCOS diagnosis, hirsutism (Ferriman–Gallwey score ≥8), and desire for non-pharmacologic management.Votes: 0GitHub stars: 12
- Endo Hirsutism Low Dose Oc Vte RiskThis skill guides selection of a low‑dose estrogen oral contraceptive combined with a low‑risk progestin for premenopausal women with hirsutism who are at increased venous thromboembolism risk (e.g., obesity or age >39 years). It triggers when a patient presents with patient‑important hirsutism requiring pharmacologic therapy and has VTE risk factors without estrogen contraindications.Votes: 0GitHub stars: 12
- Endo Hirsutism Measure Androstenedione AtypicalMeasure serum androstenedione or other steroid intermediates in premenopausal women with hirsutism when atypical features raise suspicion for adrenal pathology, such as rapid progression, virilization, or high-risk ethnicity for nonclassic congenital adrenal hyperplasia. This step follows a normal total and free testosterone but persistent clinical evidence of hyperandrogenism.Votes: 0GitHub stars: 12
- Endo Hirsutism Measure Dheas Adrenal ScreenMeasure early morning serum DHEAS to screen for adrenal hyperandrogenism in women with hirsutism and normal total/free testosterone but clinical signs of androgen excess. Consider testing when there is suspicion of nonclassic congenital adrenal hyperplasia or adrenal tumor, especially in patients with high-risk ethnicity, family history, or progressive hirsutism despite normal ovarian androgen levels.Votes: 0GitHub stars: 12