#separator:Tab
#html:false
#tags column:5
IMF-010-01-0001-en	What defines shock, and why can blood pressure be normal in a shocked patient?	Shock is acute circulatory failure causing inadequate tissue perfusion and cellular oxygen use; pressure may be low, normal, or temporarily maintained.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0002-en	State the determinants of oxygen delivery as the manuscript gives them.	Oxygen delivery equals cardiac output multiplied by arterial oxygen content, and cardiac output equals heart rate times stroke volume.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0003-en	Why can a patient have a normal oxygen saturation yet inadequate oxygen delivery?	Arterial oxygen content depends mainly on haemoglobin concentration as well as saturation, so anaemia or low cardiac output can leave delivery insufficient.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0004-en	What happens to oxygen consumption once delivery falls beyond the critical point?	Increased extraction no longer compensates, consumption becomes supply-dependent, anaerobic metabolism increases, and lactate may rise.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0005-en	Why is lactate a severity and trend marker rather than a direct meter of tissue hypoxia?	It also rises from adrenergic stimulation, reduced clearance, mitochondrial dysfunction, seizures, or drugs.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0006-en	Why can an organ be poorly perfused despite an apparently adequate arterial pressure?	Effective perfusion also depends on local resistance, venous pressure, autoregulation, microcirculation, and baseline disease, so a congested organ perfuses poorly.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0007-en	In hypovolaemic shock, what lowers stroke volume, and why may the expected signs be absent?	Reduced venous return lowers stroke volume; medicines, age, pregnancy, or neurogenic states can alter the tachycardia, vasoconstriction, and cool skin.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0008-en	What is characteristic of filling pressures in cardiogenic shock, and what follows from that?	Filling pressures are often high, producing pulmonary or systemic congestion, although right-sided and left-sided patterns differ.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0009-en	Which four processes does sepsis combine as the common example of distributive shock?	Vasodilation, increased permeability, myocardial depression, and microvascular dysfunction.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0010-en	How can neurogenic shock present differently from other shock states?	Loss of sympathetic tone may produce bradycardia with warm skin rather than tachycardia with cool peripheries.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0011-en	Name the causes of obstructive shock and the treatment principle that follows from them.	Massive pulmonary embolism, cardiac tamponade, tension pneumothorax, and dynamic hyperinflation; the obstruction must be relieved rather than escalating fluid or vasopressor doses.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0012-en	Trace the mechanism by which tamponade produces pulsus paradoxus during spontaneous inspiration.	Greater right-sided venous return displaces the shared septum leftward within the restricted pericardium, left-ventricular filling and stroke volume fall, and systolic pressure drops excessively on inspiration.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0013-en	In tamponade, what is the anatomical problem, and why can contraction still look vigorous?	Filling is restricted from outside the heart rather than contraction failing, so a vigorously contracting but underfilled ventricle still delivers little blood.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0014-en	Why does the volume of a pericardial effusion alone not establish its haemodynamic effect?	Accumulation rate and pericardial compliance also determine whether filling is restricted.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0015-en	Which other condition can produce pulsus paradoxus, and what does that imply for its interpretation?	Severe obstructive airway disease can produce it, so the sign must be connected with filling mechanics and the overall clinical state before a cause is assigned.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0016-en	Why does a single normal blood pressure reading not exclude shock?	Compensated shock can preserve pressure, and warm vasodilated shock may even show bounding pulses early, so perfusion must be examined directly.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0017-en	What does a fluid bolus test, and against which observations is the response judged?	It tests whether increasing stressed intravascular volume improves output; response is judged by pressure, pulse, perfusion, urine output, lung findings, and dynamic measures when available.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0018-en	Why does only a fraction of an infused crystalloid remain intravascular?	Crystalloid solutions distribute through the whole extracellular fluid compartment.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0019-en	List the harms of excess fluid in resuscitation.	Pulmonary oedema, tissue oedema, impaired oxygen diffusion, raised abdominal pressure, delayed healing, and venous congestion of the kidneys and liver.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0020-en	Why are large crystalloid volumes harmful in haemorrhagic shock?	They dilute clotting factors, worsen hypothermia, and disrupt clots, so bleeding control and blood-component resuscitation are needed instead.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0021-en	Why is noradrenaline (norepinephrine) commonly first-line in septic vasodilatory shock?	Alpha effects predominate, raising vascular tone and pressure, with useful beta support.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0022-en	When is an inotrope indicated, and what can dobutamine cause?	When low output persists despite adequate filling and pressure; dobutamine stimulates beta receptors but may cause tachyarrhythmia or hypotension.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0023-en	What is the immediate treatment of anaphylaxis, and what cannot substitute for it?	Immediate intramuscular adrenaline (epinephrine) with airway planning, positioning, fluid, and adjuncts; antihistamines do not replace adrenaline.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending
IMF-010-01-0024-en	Why can sedation and positive-pressure ventilation precipitate collapse in shock?	Both reduce venous return, which a preload-dependent patient cannot tolerate.	Integrated Medical Foundations; chapter 10, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 8c4b6ae8ec2b79fdfddc7832f2f7746365085dba762d52a6a2968ddb720a6dbb; editorial review pending	imf lang::en chapter::010 module::010-01 review::pending