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IMF-045-02-0001-en	Why is "hearing a voice" described in detail before a syndrome is assigned?	It may be a hallucination, intrusive thought, dissociation, misheard sound, sleep-transition phenomenon, trauma memory, or delirium; precise phenomenology improves diagnosis and rapport.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0002-en	How do circumstantial and tangential speech differ, and how does flight of ideas differ from loosening of associations?	Circumstantial speech reaches the point through excessive detail while tangential speech never returns; flight of ideas has rapid understandable links, whereas loosening makes links hard to follow.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0003-en	What distinguishes an obsession from a delusion?	An obsession is an unwanted intrusive thought usually recognised as arising in one's own mind, whereas a delusion is held with pathological conviction despite counterevidence and outside shared culture.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0004-en	Why are arousal and attention tested before memory when screening cognition?	Tasks such as months backward, digit span, or a multistep command reveal inattention that orientation questions miss, and impaired attention with acute change and fluctuation suggests delirium.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0005-en	Why can a person have capacity to accept food but not to manage a complex high-risk discharge?	Capacity is a functional assessment of a defined decision, not a global label, so it depends on the information that decision requires and can return once reversible barriers are treated.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0006-en	A patient refuses a recommended operation to preserve a particular function. Why can this still show capacity?	The reasoning process, not agreement with clinicians, is decisive; valuing a function over survival probability can be a rational weighing of the decision.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0007-en	In a capacity assessment record, why is a diagnosis or cognitive test score not a conclusion, and how is fluctuating capacity handled?	The record must show the person's understanding and weighing of the specific decision; when capacity fluctuates, important decisions move to the best time of day and non-urgent ones wait.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0008-en	Why is labelling someone "low risk" less useful than a risk formulation?	The label falsely implies certainty and specifies no action, whereas a formulation states the current state relative to baseline, scenarios, triggers, means, supports, and interventions that change probability.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0009-en	Why does the existence of family not settle discharge safety, and why is early contact arranged after discharge?	Having family does not show support is available, so their role is confirmed directly; the period after discharge stays highly changeable even when acute risk has fallen.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0010-en	What is checked before emergency medication and monitored afterwards?	Before: substances, current medicines, allergy, pregnancy, corrected QT, respiratory and neuromuscular disease; after: airway, breathing, oxygenation, blood pressure, rhythm, consciousness, and temperature.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0011-en	Why is recognising bipolar depression important when treating a depressive syndrome?	Antidepressant monotherapy may destabilise some patients with bipolar depression.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0012-en	How does the reduced need for sleep in mania differ from insomnia?	In mania the person sleeps less yet feels rested, whereas insomnia is an inability to sleep.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0013-en	Why are weight, waist, blood pressure, glucose, lipids, and movement findings recorded before antipsychotic treatment starts?	A baseline allows later drug harm to be distinguished from change in the disease itself.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending
IMF-045-02-0014-en	How does refeeding cause electrolyte and fluid disturbance in severe malnutrition?	Rising insulin drives phosphate, potassium, and magnesium into cells while sodium and water are retained, and thiamine deficiency and cardiac failure can follow.	Integrated Medical Foundations; chapter 45, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4682a1b6c75d67e96a9c17dc8ea720eb30df888df1426af19c7cd6ed8ec726d9; editorial review pending	imf lang::en chapter::045 module::045-02 review::pending