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IMF-045-01-0001-en	Why must psychiatric assessment include physical and neurological assessment rather than rely on the story and mental state alone?	Symptoms can arise not only from primary mental illness but from drugs, withdrawal, infection, neurological disease, endocrine disturbance, trauma, sleep loss, or severe stress.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0002-en	When does collateral information become essential, and how can it be obtained while respecting confidentiality?	When cognition, psychosis, intoxication, communication, or risk limits the history; consent is sought where possible, and clinicians may receive information without disclosing confidential details.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0003-en	What distinguishes mood from affect in the mental state examination?	Mood is the sustained subjective emotion the person reports, while affect is the observed range, intensity, stability, reactivity, and congruence, and the two can differ.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0004-en	What makes a belief a delusion rather than an unusual belief, and how should the clinician explore it?	A delusion is a fixed false belief held outside the person's cultural context, and its certainty is explored respectfully.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0005-en	Which cognitive findings point towards delirium in the mental state examination?	Inattention and fluctuation suggest delirium, which is why arousal and attention are assessed alongside orientation, memory, language, visuospatial and executive function.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0006-en	How do insight and judgement differ, and why does neither mean agreeing with the clinician?	Insight is awareness and interpretation of one's condition, while judgement is demonstrated decision-making; both are judged on the person's awareness and reasoning, so neither means agreement with the clinician.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0007-en	What distinguishes a formulation from a list of diagnostic labels?	It summarises predisposing, precipitating, perpetuating, and protective factors across biological, psychological, and social domains to explain this person's presentation and guide care.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0008-en	Why are tests for medical causes targeted to features such as sudden onset or focal neurology rather than run as broad screening?	Features like sudden or late onset, fluctuating attention, focal signs, fever, or medication change direct which causes to exclude, whereas routine broad screening can produce incidental findings.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0009-en	Why is decision-making capacity assessed for a specific decision at a specific time, and which abilities are tested?	Capacity can fluctuate and differ between simple and complex decisions; the person must understand, retain, use or weigh the information, and communicate a choice.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0010-en	Why does neither an apparently unwise choice nor the presence of a delusion prove incapacity?	Capacity concerns the decision-making process; a delusion matters only if it prevents understanding or weighing the specific decision.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0011-en	If capacity is absent, what guides the decision and what must be documented?	Emergency necessity, advance directives, substitute decision-makers, best-interest standards, and local law, using the least restrictive alternative and documenting evidence, support offered, reasoning, and review plan.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0012-en	Why should clinicians ask directly and calmly about suicidal thoughts rather than avoid the topic?	Asking does not implant the idea, and direct questions reveal plans, intent, preparation, access to means, what stopped action, and whether risk is changing.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0013-en	Why can suicide risk not be reduced to a score or low-medium-high label, and what is formulated instead?	A label says nothing about why or how risk may change, so clinicians formulate dynamic and enduring factors, foreseeable scenarios, protective resources, access to lethal means, and ability to seek help.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0014-en	What distinguishes a safety plan from a no-suicide contract?	A safety plan is collaborative and specific, identifying warning signs, internal coping, social distraction, trusted contacts, professional services, and means restriction, rather than being a promise.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0015-en	Why is psychiatric diagnosis a weaker guide to violence risk than other factors?	Most people with mental illness are not violent; substance use, past behaviour, situational factors, and access often predict violence more strongly than diagnosis.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0016-en	How is de-escalation carried out with an agitated person?	With a calm voice, space, choices, reduced stimulation, and clear limits, while attending to pain, fear, intoxication, and communication needs.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0017-en	Grief and adversity can cause intense distress. How does this bear on the diagnosis of major depression?	Distress can occur without a disorder, yet the presence of an understandable context does not exclude major depression.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0018-en	Why are cognitive behavioural and exposure therapies preferred to long-term benzodiazepines in anxiety disorders?	Cognitive behavioural and exposure therapies reduce avoidance, whereas long-term benzodiazepines cause tolerance, dependence, falls, and cognitive impairment.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0019-en	What distinguishes mania from hypomania?	Mania causes marked impairment or psychosis, whereas hypomania is less severe and causes neither.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0020-en	Which factors promote lithium toxicity, and which organ systems does it affect?	Dehydration and interacting drugs promote toxicity, which is gastrointestinal, neurological, and cardiac.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0021-en	Why can schizophrenia-spectrum illness not be diagnosed at a first psychotic episode on symptoms alone?	First-episode diagnosis requires longitudinal exclusion of mood, substance, neurological, autoimmune, endocrine, infectious, and developmental causes.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0022-en	Why must catatonia be recognised urgently, and why can antipsychotics be a problem?	Dehydration, thrombosis, pressure injury, malnutrition, and malignant deterioration occur; benzodiazepine challenge and ECT are key treatments, while antipsychotics can worsen some cases.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0023-en	Why does a positive toxicology result not prove current impairment?	Toxicology has detection windows, so a positive result shows exposure within that window rather than present impairment.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending
IMF-045-01-0024-en	Why should a personality disorder diagnosis not be made from a single crisis presentation?	Diagnosis requires longitudinal context and should not become pejorative shorthand; in crisis, clinicians validate distress, keep consistent boundaries, and avoid splitting care teams.	Integrated Medical Foundations; chapter 45, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 39fea89ec338123253bc6971649649fef91980bb87ad913cad3367e8de2f964e; editorial review pending	imf lang::en chapter::045 module::045-01 review::pending