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IMF-038-02-0001-en	Why does safe sepsis care run two processes in parallel, and why is repeated examination central?	Neither suspected infection nor organ dysfunction is specific, so reversible threats are treated while evidence for infection, source, and alternatives is built; each response to intervention changes probability.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0002-en	How can effective arterial volume fall in sepsis even when total body water is increased?	Inflammatory mediators reduce vascular tone and increase endothelial permeability, so fluid leaves the effective circulation while total body water rises.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0003-en	Why might the same low blood pressure warrant different responses in two septic patients?	An alert, warm patient with preserved urine and improving perfusion differs physiologically from one with mottling and confusion, so the number alone does not define the needed treatment.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0004-en	Why do trajectory and reserve matter more than a single organ-dysfunction score in sepsis?	Failure of one organ increases the demand on others, so the direction of change and remaining reserve predict course better than one snapshot.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0005-en	Why can lactate rise even when oxygen is present, and why is forcing its normalisation with fluid harmful?	Adrenergic stimulation accelerates glycolysis and lactate production regardless of oxygen; chasing normal values with repeated fluid can cause pulmonary oedema and abdominal or venous congestion.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0006-en	Why is initial fluid framed as a therapeutic trial, and why may a fluid-responsive patient still not need fluid?	Each amount is tested against stroke volume, perfusion, and congestion; responsiveness is not need if perfusion is already adequate or pulmonary risk outweighs benefit.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0007-en	What makes passive leg raising more useful than static central venous pressure for predicting fluid responsiveness?	Passive leg raising gives a reversible internal volume challenge when paired with a responsive output marker, whereas static central venous pressure poorly predicts responsiveness.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0008-en	Why should a rising vasopressor requirement not be read as simple underdosing?	It may signal ongoing haemorrhage, tamponade, tension pneumothorax, pulmonary embolism, adrenal insufficiency, a persisting infective source, or acidaemia, each needing specific reassessment.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0009-en	How do poorly filled blood culture bottles and contamination each cause harm, and what does diagnostic stewardship mean?	Underfilling reduces sensitivity and contamination increases unnecessary therapy; diagnostic stewardship means taking the right specimen before treatment when safe, not withholding tests indiscriminately.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0010-en	Why does delayed source control allow sepsis to progress despite adequate serum antibiotic levels, and why take deep samples?	An undrained focus sustains microbial growth, toxin production, and inflammatory signalling; deep operative samples are taken because superficial swabs can misdirect therapy.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0011-en	In what sense does stewardship protect the treated patient first, beyond limiting resistance?	Avoiding unnecessary antimicrobials reduces allergy, kidney and liver injury, cytopenia, cardiac effects, interactions, C. difficile disease, and microbiota disruption in that patient.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0012-en	Why do pyuria and cloudy or odorous urine not justify treating bacteriuria in a catheterised patient?	Bacteria commonly inhabit catheterised tracts without disease, pyuria is common, and urine appearance is nonspecific; treatment without compatible symptoms causes adverse effects and resistance.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0013-en	What distinguishes the protective role of a surgical mask from that of a respirator?	Surgical masks chiefly provide source control and droplet protection, whereas respirators reduce inhalation when correctly selected and fit-tested.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending
IMF-038-02-0014-en	Why do critical, semicritical, and noncritical devices need different processing?	Risk follows contact: devices entering sterile tissue need sterilisation, those contacting mucosa need validated high-level processing, and those touching intact skin need lower-level disinfection.	Integrated Medical Foundations; chapter 38, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: a5142afa8b3587a3475d3e62cbb13cb20c18751cfc4eb09ec6adba5c1b9e0676; editorial review pending	imf lang::en chapter::038 module::038-02 review::pending