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IMF-035-02-0001-en	Why does active bacterial growth matter for killing by wall-active drugs?	Wall-active drugs weaken the peptidoglycan structure as it expands, so active growth is important for killing.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0002-en	How can porin changes in Gram-negative bacteria combine with beta-lactamases to create substantial resistance?	Porins restrict drug entry by size and chemistry, so their loss or alteration reduces entry while periplasmic enzymes further reduce intracellular drug exposure.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0003-en	Why is encapsulated bloodstream infection particularly dangerous when splenic function is absent?	Capsules and surface polysaccharides inhibit complement deposition and phagocytosis, so efficient clearance depends on opsonising antibody, which is less effective without splenic function.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0004-en	Why can infection relapse from a protected site even when the laboratory reported the organism as susceptible?	The result came from rapidly growing cells, but persister cells survive as transient phenotypic survivors without genetic resistance, and their descendants may again be susceptible.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0005-en	Why can source control or device removal be decisive in biofilm infection?	The matrix limits immune access and diffusion, so antibiotics may suppress planktonic shedding without sterilising the adherent reservoir.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0006-en	When fever or bacteraemia persists during antibiotic treatment, what should be reassessed before changing the drug, and why?	An uncontrolled source and drug delivery, because drainage, relief of obstruction or debridement may be needed rather than a different drug.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0007-en	Why must negative-sense RNA viruses carry or produce an RNA-dependent RNA polymerase, unlike many positive-sense viruses?	Positive-sense RNA can often function directly as messenger RNA, whereas negative-sense RNA cannot, so the polymerase is needed to produce messenger RNA.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0008-en	Why does receptor presence alone not guarantee productive viral infection of a tissue?	A receptor may permit attachment, but intracellular factors, temperature, polarity, innate responses and access route determine productive infection.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0009-en	Why does viral evolution not guarantee reduced virulence over time?	Evolution has no intention: selection enriches variants that reproduce and transmit, and severity results from replication, transmission route, host immunity and ecological opportunity.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0010-en	Why is yeast recovered from blood interpreted differently from yeast in a non-sterile specimen?	Yeast in a non-sterile specimen may represent colonisation, whereas recovery from blood is usually significant.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0011-en	Why is blood-stage treatment alone incomplete for some malaria species?	Some species leave dormant liver forms capable of relapse, which blood-stage treatment does not address.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0012-en	Why should exposure history be taken before immune therapy in people from endemic settings?	Strongyloides can maintain infection through autoinfection for decades, and corticosteroid or other immunosuppression can trigger accelerated dissemination and secondary bacterial sepsis.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0013-en	Why does a minimum inhibitory concentration not predict eradication at every infection site?	It measures growth inhibition under standard laboratory conditions, not eradication in biofilm, abscess, cerebrospinal fluid, urine or intracellular tissue, where inoculum, binding and immunity alter outcome.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending
IMF-035-02-0014-en	What findings strengthen the case that a detected microbe is causing disease rather than merely present?	Finding it at the diseased site, burden fitting the syndrome, tissue invasion or characteristic injury, aligned host risk and timing, and weaker alternative causes.	Integrated Medical Foundations; chapter 35, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a447f3780b898fe4f8dddae4dabd493442c6d6a534f410528ccd6220da0dbb98; editorial review pending	imf lang::en chapter::035 module::035-02 review::pending