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IMF-043-02-0001-en	Why are baseline function and speed of change treated as diagnostic vital signs in older people?	Narrowed reserve lets acute illness cross several thresholds at once, so it presents as a fall, confusion, immobility, poor intake, or new dependence rather than a textbook organ syndrome.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0002-en	How can frailty and comorbidity dissociate in an individual patient?	Frailty is reduced multidimensional reserve with impaired recovery after stress, so a person can have several stable diseases without frailty, or substantial frailty with a short diagnosis list.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0003-en	How can a minor procedure or urinary infection lead to institutional dependence, and how is this cascade prevented?	It can trigger delirium, immobility, deconditioning, incontinence, and pressure injury; prevention uses early mobilisation, own clothes, meals out of bed, glasses and hearing aids, sleep protection, and rehabilitation from day one.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0004-en	Why is the single word "independent" inadequate for establishing baseline, and what determines discharge destination?	Baseline needs specific questions about transfers, walking, stairs, bathing, cooking, medicines, and finances; destination follows recovery trajectory, housing, support, and goals, not current function alone.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0005-en	Why does protein and energy supplementation alone not rebuild function in sarcopenia?	Nutrition supports training but cannot rebuild function without mechanical stimulus, so resistance exercise must be progressively loaded rather than reduced to token movement.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0006-en	How does the heart-rate response on standing distinguish neurogenic orthostatic hypotension from volume depletion?	In neurogenic hypotension the heart-rate rise is disproportionately small for the pressure fall; in volume depletion it is greater than usual, though beta blockers and a pacemaker alter interpretation.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0007-en	Why may drug dosing in frail older people require more than an estimated filtration equation?	Low muscle mass makes little creatinine and equations fail in frailty, amputation, oedema, or changing function, so trends, cystatin estimates, measured clearance, and clinical toxicity may be needed.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0008-en	Why is pharmacodynamic vulnerability often more important than altered kinetics in older adults?	Drugs such as benzodiazepines, opioids, anticholinergics, insulin, and anticoagulants can cause disproportionate delirium, falls, retention, hypoglycaemia, bleeding, or syncope beyond what kinetics predict.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0009-en	Why does medication reconciliation ask what is actually taken rather than reading the list?	Non-prescription analgesics, antihistamines, sleep products, supplements, patches, inhalers, eye drops, borrowed medicines, and intentionally skipped doses are otherwise missed.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0010-en	Why is deprescribing made in stages, and how is its success measured?	Changing many medicines at once obscures the cause of benefit or harm; success is improvement in alertness, mobility, continence, symptoms, and treatment burden, not just fewer medicines.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0011-en	Why does inability to rise after a fall matter, and why does walking not exclude fracture?	Prolonged time on the floor causes pressure injury, hypothermia, dehydration, rhabdomyolysis, kidney injury, and fear; pain may be muted, so occult hip, pelvic, or vertebral fracture can be missed.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0012-en	Why should an acute decline in a person with dementia, or a quietly sleeping patient, prompt assessment for delirium?	Dementia strongly predisposes to delirium but does not explain an acute decline, and a quiet sleeping patient may have hypoactive delirium rather than benign fatigue.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0013-en	What does it mean that capacity is not all or nothing, and on what basis does a substitute decision-maker act?	A person may manage simple everyday decisions yet find a complex high-risk operation difficult to judge; a substitute acts on the person's known values and best interests, not their own preference.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending
IMF-043-02-0014-en	How does goal-concordant geriatric care differ from simply offering less treatment because a person is old?	It offers proportionate care informed by reserve, reversibility, burden, and what makes the outcome worthwhile, discussing best, worst, and most likely functional outcomes.	Integrated Medical Foundations; chapter 43, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 5ad9f95c96b9591d3ef18920f29e2510fb8f11de82a6efa6b1609a30c335576d; editorial review pending	imf lang::en chapter::043 module::043-02 review::pending