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IMF-026-01-0001-en	Beyond recognising physiology and pairing hormones, what must endocrine diagnosis separate gland disease from?	From the effects of medication, illness, pregnancy, binding proteins and assay interference, because each can alter hormone results without disease of the gland itself.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0002-en	Why should an endocrine history clarify what a weight change actually reflects?	Weight change may reflect fat, fluid, muscle, intake, malabsorption or catabolism, and each points toward a different mechanism.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0003-en	How should symptoms such as fatigue or weight gain be weighed in endocrine assessment?	They are weak in isolation but become meaningful when they appear as part of a coherent cluster of symptoms.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0004-en	Why must the medication history include injected, inhaled, topical, non-prescribed and complementary agents?	Agents such as glucocorticoids, thyroid hormone, amiodarone, lithium, opioids, sex steroids and biotin supplements can create or conceal endocrine syndromes.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0005-en	How is proximal weakness tested at the bedside?	By asking the patient to rise from a chair or lift the arms against resistance, which loads the proximal muscle groups.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0006-en	Why does a rounded face, obesity or sparse hair carry little diagnostic weight on its own?	These features are common outside hormone disease, so no single feature proves an endocrine diagnosis.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0007-en	What makes a finding such as broad violaceous striae or persistent hyperpigmentation more discriminatory?	Its combination with other signs: striae with proximal weakness and bruising, or hyperpigmentation with postural hypotension, carry more weight than common isolated features.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0008-en	Why can a retrosternal goitre cause pressure symptoms despite little palpable enlargement?	Extension behind the sternum lies beyond reach of palpation, so compression can occur even when the neck feels small.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0009-en	Which assessments does Graves orbitopathy require, and what finding makes review urgent?	Visual acuity, fields, colour vision, pupils, ocular movement and corneal exposure; suspected optic neuropathy requires urgent review.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0010-en	Which presentation accompanying headache suggests pituitary apoplexy?	Headache with sudden visual or ocular-motor change, vomiting, hypotension or altered consciousness.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0011-en	How is protective sensation tested in diabetic foot assessment?	With a calibrated monofilament at recommended sites, adding vibration or other modalities when useful.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0012-en	Why should diabetic foot risk classification not end with documentation?	Its purpose is to trigger action: education, footwear, podiatry, vascular review and follow-up.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0013-en	In reproductive history, why must anatomy, fertility or pregnancy risk not be inferred from identity or relationship status?	Identity and relationship status do not determine anatomy, fertility, sexual activity or pregnancy risk, so each must be asked about directly using the patient's own terms.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0014-en	Why should an abnormal semen result lead to repetition rather than a conclusion?	Semen varies substantially, so a single abnormal result may not represent the man's usual state.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0015-en	Which conditions must be in place before an intimate examination, and what can the patient do during it?	Clinical indication, explicit consent, privacy, explanation, appropriate exposure and a chaperone by preference and policy; the patient may pause or stop at any time.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0016-en	What limits the diagnostic value of bimanual examination?	Although it assesses tenderness, uterine characteristics, adnexal masses and cervical excitation, it has limited sensitivity for many disorders.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0017-en	Why should suspected testicular torsion go to immediate surgical assessment rather than further testing?	Sudden severe pain with a high or abnormal testis suggests torsion, and delaying for low-value testing costs time the testis may not have.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0018-en	Why is a target hormone measured together with its regulator?	The pair shows whether the axis is responding appropriately; a regulator within range can still be abnormal when physiology demands elevation or suppression.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0019-en	Which assay problems can distort hormone results, and what should be done when results conflict with the phenotype?	Biotin, heterophile antibodies, macrohormones, cross-reactivity and hook effects at extreme concentrations; the laboratory should be contacted.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0020-en	What does interpretation of a dynamic endocrine test require beyond the result itself?	Pretest probability and thresholds validated for the assay used, since each test has protocol-specific preparation and hazards.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0021-en	Why should a single chorionic gonadotropin value not be interpreted alone in early pregnancy?	Serial concentrations and transvaginal ultrasound help only when read in gestational context, not from one isolated number.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0022-en	What distinguishes screening from diagnostic testing in reproductive and prenatal care?	Screening estimates risk, whereas diagnostic testing establishes or excludes a defined condition, with different certainty and procedural consequences.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0023-en	Before attributing symptoms to an incidental lesion, which questions must be answered?	Whether it secretes, compresses, appears malignant or is growing, because an incidental lesion may be unrelated to the symptoms.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending
IMF-026-01-0024-en	In time-critical endocrine and obstetric syndromes, how are treatment and diagnostic sampling ordered?	Stabilisation and targeted empirical treatment may precede definitive confirmation, with critical samples taken only when this causes no meaningful delay.	Integrated Medical Foundations; chapter 26, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ac0e49f310d62821ecef03570dfb40be4867939478ed7c34c143f83b9502c7db; editorial review pending	imf lang::en chapter::026 module::026-01 review::pending