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IMF-046-01-0001-en	At first contact, why does a normal blood pressure not exclude shock, and what should guide recognition instead?	Patterns and trends, not a single reading, guide recognition of physiological threat; a normal pressure does not exclude shock.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0002-en	Why should the patient's pre-intervention state be recorded before treatment starts?	Because the response to treatment helps distinguish between mechanisms, and that comparison depends on knowing the state before intervention.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0003-en	What does a problem representation compress into one sentence, and when should negative findings be included in it?	It compresses context, tempo, syndrome, severity and discriminating findings; negatives are included only when they are reliable and discriminating.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0004-en	How is an active problem list ranked, and how are duplicate entries handled?	Problems are ranked by physiological threat, reversibility, time sensitivity and patient priority; duplicates are merged while preserving causal relationships.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0005-en	What should a focused differential for an unresolved syndrome include, and why is a long unranked list not safer?	Built from anatomy, mechanism and tempo, it includes likely causes, dangerous alternatives and diagnoses plausible from this patient's exposures or comorbidity; a short reasoned list is at least as safe.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0006-en	When can time spent on diagnosis be therapeutic, and when is immediate empirical action required instead?	When the patient is stable, diagnostic time can itself be therapeutic; when delay risks irreversible harm, immediate empirical action is needed.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0007-en	What should be predicted before ordering a test, and what follows if no result would change the plan?	Predict how each possible result would change action; if none would, the test should be reconsidered.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0008-en	Why should a treatment plan specify drug, indication, dose, route, interval, review date, monitoring and stop conditions?	So that another clinician can continue it safely; treatment is written around goals and mechanisms, not as an isolated order.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0009-en	What does a therapeutic trial require, and what may a lack of response reflect?	A defined target, time frame and alternative explanation; lack of response may reflect wrong diagnosis, inadequate delivery, advanced irreversible disease or insufficient time.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0010-en	Why may preventing hypoglycaemia matter more than intensive glucose control during an acute admission?	Benefits are balanced over different time horizons: intensive control may not help the acute admission, whereas preventing hypoglycaemia does.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0011-en	What does medication reconciliation compare, and how is each difference classified?	It compares medicines actually used before admission with current orders and the intended discharge regimen, classifying each difference as intentional or unintentional.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0012-en	Why must a held medicine be documented with its reason and restart criteria?	A discharge list without explanation transfers ambiguity to the patient and the next clinician.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0013-en	During daily ward review, how should staff concern be weighed against a reassuring observation score?	Concern overrides a reassuring score, and the review specifies observation frequency, treatment limits, whom to call and trigger thresholds.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0014-en	How should an escalation call be structured, and what should happen if the patient remains unsafe?	State urgency first, then concise context, findings, actions, response and a specific request; persist through the hierarchy if the patient remains unsafe.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0015-en	How should uncertainty be documented and safety-netted while avoiding both false reassurance and defensive overtesting?	Record what is known, likely, possible but dangerous, and currently unsupported, then safety-net through observation, repeat examination, trigger thresholds and planned follow-up.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0016-en	Which cognitive processes commonly underlie diagnostic error, and what questions does a deliberate pause ask?	Anchoring, premature closure, framing, availability and failure to integrate discordant data; the pause asks what else it could be, what does not fit, what to expect next, and whether treatment changed probability.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0017-en	What makes a handover task actionable for the next clinician?	Each task states what, why, when, owner, expected result and response to an abnormal result, confirmed by closed-loop questions and restatement.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0018-en	What must clinical notes keep distinct, and how should a patient's behaviour be recorded?	Notes distinguish observation, reports and inference, and describe behaviour without judgement; copied text is reviewed and errors are corrected transparently.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0019-en	When does discharge planning begin, and what does stability mean for discharge?	It begins at admission with baseline function, environment and supports; stability means the patient can be managed safely outside current monitoring.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0020-en	How should competing recommendations be resolved in a patient with multimorbidity?	Prioritise treatments with meaningful benefit, acceptable burden and alignment with goals, and coordinate specialists so one organ's plan does not destabilise another.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0021-en	Why are rehabilitation and social support part of disease treatment after sepsis, surgery or critical illness?	Recovery can involve weakness, cognitive problems, pain, anxiety and financial strain, so function and quality of life must be tracked and treated alongside biomarkers.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0022-en	What does a resuscitation decision cover, and what should goals-of-care documentation record?	It addresses cardiopulmonary arrest, not all treatment; record which interventions remain appropriate, who participated, the patient's reasoning and values, and when to review.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0023-en	How should recognising that cure is unlikely change the care a patient receives?	It should intensify comfort and coordination rather than signal abandonment, with palliative care running alongside disease-directed treatment.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending
IMF-046-01-0024-en	After harm, why are standardisation and design preferred to education alone, and how does a just culture judge individual actions?	They are stronger than education alone; a just culture distinguishes human error, risky shortcuts and reckless conduct while preserving accountability.	Integrated Medical Foundations; chapter 46, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: b621ddebbe1a94b463d1d54f1b533eb4fe9da7bb33f4a4edc02f9ac3847edfea; editorial review pending	imf lang::en chapter::046 module::046-01 review::pending