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IMF-025-02-0001-en	Why must gonadotropin-releasing hormone be pulsatile, and how is continuous exposure used therapeutically?	Pulsatility sustains luteinising and follicle-stimulating hormone secretion; continuous exposure desensitises pituitary receptors, which is used therapeutically after an initial stimulatory phase.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0002-en	What is functional hypothalamic amenorrhoea, and why does it matter beyond fertility?	It is adaptive suppression of hypothalamic drive when energy or stress signals are unsuitable for reproduction; gonadotropins and oestradiol fall, affecting fertility, bone, cardiovascular physiology and wellbeing.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0003-en	What distinguishes central precocious puberty from early puberty due to peripheral sex-steroid exposure?	Central precocious puberty follows early hypothalamic activation of pulsatile signalling, whereas peripheral sex-steroid exposure bypasses central drive.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0004-en	What does an ovarian reserve result estimate, and why must it not be presented as a fertility prognosis?	It estimates the remaining follicular pool and response to stimulation; it does not guarantee natural fertility or oocyte quality, so a probability marker must not become a deterministic prognosis.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0005-en	Why does exogenous androgen reduce sperm production rather than improve fertility?	It suppresses gonadotropins and therefore intratesticular testosterone, which is much higher than blood levels and required for spermatogenesis, sometimes causing azoospermia.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0006-en	Since many drugs cross the placenta, why is treating maternal disease often better for the fetus than withholding therapy?	The placenta is not an impermeable shield: maternal hypoxaemia, anaemia, hypotension, vascular disease and inflammation themselves reduce fetal delivery, so treating the mother often benefits the fetus more.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0007-en	How does inadequate spiral-artery remodelling lead to maternal disease?	High-resistance vessels are not converted to high-flow channels, causing placental ischaemia and release of factors that produce maternal endothelial dysfunction, with hypertension, proteinuria and organ injury.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0008-en	Why can pregnancy unmask stenotic valves, pulmonary hypertension or cardiomyopathy?	Cardiac output rises through stroke volume and heart rate and plasma volume expands substantially, a load that a limited heart or valve may not accommodate.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0009-en	Why can a carbon dioxide value that is normal for a non-pregnant adult indicate inadequate ventilation in pregnancy?	Progesterone normally increases ventilation and lowers carbon dioxide, with renal compensation lowering bicarbonate, so a non-pregnant normal value means ventilation has fallen short.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0010-en	Why can glycosuria occur in pregnancy at a lower blood glucose?	Increased renal blood flow and filtration change the filtered load and tubular handling of glucose.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0011-en	Why does gestational diabetes warrant postpartum reassessment even when glucose normalises after delivery?	It shows that insulin resistance exceeded beta-cell reserve and predicts future metabolic risk for both parent and child.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0012-en	Why is prostaglandin therapy used in some newborns with cardiac lesions?	Some lesions require the ductus arteriosus to remain open for pulmonary or systemic flow, and prostaglandin can preserve it while definitive assessment occurs.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0013-en	Postpartum haemorrhage is organised by tone, tissue, trauma and thrombin. How does each cause bleeding?	Atony leaves the uterus uncontracted, retained placenta prevents contraction, genital trauma bleeds despite a firm uterus, and coagulation failure worsens every source.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending
IMF-025-02-0014-en	Why must pregnancy laboratory values be judged neither against non-pregnant ranges alone nor simply explained away as physiological?	Volume, filtration, binding proteins, clotting factors and acid-base change physiologically, yet this must not conceal pathological hypertension, haemolysis, low platelets or liver injury; stage, symptoms, baseline and rate of change decide.	Integrated Medical Foundations; chapter 25, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9dc43d642a9cf7dfba91f17523d19172a6b86f3f6d811fb7e5c20df7501c205b; editorial review pending	imf lang::en chapter::025 module::025-02 review::pending