#separator:Tab
#html:false
#tags column:5
IMF-023-01-0001-en	Why can a hormone concentration not be read simply as a measure of gland activity?	It reflects secretion, distribution, binding, metabolism and clearance, not gland activity alone, so interpretation needs paired hormones, physiological context and dynamic response.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0002-en	How do peptide and steroid hormones differ in synthesis, storage and site of action?	Peptides are made as precursors, stored in vesicles, released by exocytosis and act on membrane receptors; steroids derive from cholesterol, are usually made on demand, cross membranes and regulate transcription via intracellular receptors.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0003-en	Why can pregnancy or liver disease distort a total hormone measurement without changing hormone action?	Only unbound hormone is readily available to tissues and clearance, so changes in binding proteins alter total concentration without changing free biological activity.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0004-en	How do trophic hormone levels distinguish primary gland failure from central failure?	Both give low peripheral hormone, but primary failure has high trophic drive, whereas central failure has an inappropriately low or normal trophic hormone.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0005-en	Why must gonadotropin-releasing hormone be delivered intermittently?	Intermittent pulses sustain gonadotropin secretion, whereas continuous exposure suppresses the axis.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0006-en	Why can a single hormone value be misleading?	Many hormones are pulsatile or circadian, for example growth hormone pulsing in sleep and cortisol peaking near waking, and meals, exercise, stress, posture, menstrual stage and acute illness also alter results.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0007-en	What distinct questions do suppression tests and stimulation tests answer?	Suppression tests ask whether autonomous secretion can be restrained; stimulation tests ask whether reserve can respond. Each should answer a defined question, not compensate for indiscriminate screening.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0008-en	How does hypothalamic control of prolactin differ from control of the other anterior pituitary hormones?	The other hormones are driven by releasing hormones, but dopamine tonically inhibits prolactin, although thyrotropin-releasing hormone can also stimulate it.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0009-en	In what ways can a pituitary mass cause disease, and what do upward and lateral extension damage?	It can secrete hormone, compress normal tissue, or both; upward extension compresses the optic chiasm, classically impairing temporal fields, and lateral invasion affects ocular motor nerves and sympathetic fibres.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0010-en	Why is sudden haemorrhage or infarction within a pituitary tumour dangerous beyond its effect on vision?	Besides severe headache, visual loss and ophthalmoplegia, it can cause altered consciousness and acute adrenal insufficiency.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0011-en	What stimuli release vasopressin, and how do they differ?	Osmoreceptors respond sensitively to rising effective osmolality, while substantial volume depletion provides a powerful non-osmotic stimulus.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0012-en	How does vasopressin reduce water excretion?	Acting at renal V2 receptors, it inserts aquaporin water channels into collecting ducts; its V1 effects include vasoconstriction.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0013-en	Why is diabetes insipidus most dangerous when water access is limited?	Deficient vasopressin secretion or renal resistance causes large volumes of dilute urine, so without free water intake hypernatraemic dehydration develops.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0014-en	How do treatment approaches differ between central and nephrogenic diabetes insipidus, and what can mimic both?	Central disease responds to desmopressin; nephrogenic disease needs correction of cause and less solute and urine load. Primary polydipsia can mimic the pattern, so plasma and urine concentration are compared under supervision.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0015-en	In inappropriate antidiuresis, why does treatment depend on symptom severity and duration?	Water retention lowers sodium while urine stays inappropriately concentrated, and overly rapid correction of chronic hyponatraemia can cause osmotic demyelination.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0016-en	Why is insulin-like growth factor one useful for screening growth hormone status, and what limits it?	It integrates growth hormone secretion over time, but nutrition, liver disease, kidney disease, pregnancy and age also influence it.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0017-en	What determines whether growth hormone excess causes gigantism or acromegaly, and how is excess confirmed?	Excess before epiphyseal closure causes gigantism and after closure acromegaly; diagnosis uses insulin-like growth factor one and failure of glucose to suppress growth hormone, then pituitary imaging.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0018-en	Why does diagnosing growth hormone deficiency usually require stimulation testing?	Symptoms are non-specific and a random growth hormone value is unhelpful, so other axes are assessed and reserve is tested by stimulation.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0019-en	How do suckling and delivery enable lactation?	Suckling reduces hypothalamic dopamine and so increases prolactin secretion, while falling sex steroids after delivery permit lactation in a breast prepared by pregnancy.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0020-en	How does hyperprolactinaemia cause infertility and bone loss, and why is galactorrhoea an unreliable sign?	High prolactin suppresses gonadotropin-releasing hormone, causing menstrual disturbance, infertility, sexual dysfunction and reduced bone protection; galactorrhoea is neither required nor specific.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0021-en	Why must a prolactinoma be distinguished from medication effect or stalk compression before treatment?	The same prolactin elevation has different implications: dopamine agonists suppress secretion and usually shrink prolactinomas, whereas drug effect or stalk interruption has a different cause to address.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0022-en	Why is adrenocorticotropic deficiency immediately dangerous, and which replacement must come first?	Cortisol support is lost, though aldosterone is usually kept by the renin-angiotensin system; cortisol is replaced before thyroid hormone, since thyroid replacement first can precipitate crisis.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0023-en	What distinguishes the presentation of thyroid-stimulating and gonadotroph pituitary tumours?	Thyroid-stimulating tumours cause central hyperthyroidism with non-suppressed thyroid-stimulating hormone, whereas gonadotroph tumours are often clinically non-functioning and present through mass effect.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending
IMF-023-01-0024-en	Why should pituitary imaging usually follow biochemical reasoning rather than precede it?	Incidental pituitary abnormalities are common and do not prove secretion, while very small functional lesions may not be obvious on imaging.	Integrated Medical Foundations; chapter 23, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 515b35431b6db8672ab382f7eedf09986c7fdb497d1b1749bc9d38b85db02130; editorial review pending	imf lang::en chapter::023 module::023-01 review::pending