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IMF-047-02-0001-en	Why does the absence of coughing not establish swallowing safety in oropharyngeal dysphagia?	Aspiration can be silent, so voice, breathing, oxygenation, and fatigue after the meal are also observed.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0002-en	Why is texture modification for dysphagia reviewed rather than prescribed indefinitely?	It may reduce aspiration but also reduces hydration and pleasure, so its balance must be reassessed.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0003-en	Why does tube feeding not make mouth care unnecessary?	Tube feeding does not entirely prevent aspiration of oral secretions or reflux, and mouth care reduces the bacterial load that is aspirated.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0004-en	Why are proton-pump inhibitors most effective when taken before meals?	Meals activate the proton pumps, and the drugs work best when timed to meet activated pumps.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0005-en	How do non-steroidal drugs and Helicobacter pylori each injure gastric mucosa, and why does their combination matter?	Non-steroidal drugs injure systemically through cyclooxygenase inhibition and topically, while Helicobacter causes chronic active inflammation in the mucus niche; together they markedly increase ulcer risk.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0006-en	Why can the initial haemoglobin be normal in acute upper gastrointestinal haemorrhage?	Whole blood has been lost before equilibration, so the first value can be preserved; shock, perfusion, and ongoing output are assessed instead.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0007-en	Why is transfusion in upper gastrointestinal bleeding individualised rather than driven by one threshold?	Excessive transfusion can raise portal pressure, while inadequate oxygen delivery harms heart and brain.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0008-en	How does fasting help distinguish osmotic from secretory diarrhoea?	Osmotic diarrhoea falls with fasting because poorly absorbed solute retains water, whereas secretory diarrhoea continues through active ion secretion or impaired absorption.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0009-en	Why are plain water and very concentrated sweet drinks poor choices for rehydration?	Water alone does not replace sodium loss, and very concentrated sweet drinks can worsen osmotic diarrhoea.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0010-en	Why is a positive nucleic-acid test for Clostridioides difficile not sufficient proof of disease?	It is sensitive for toxigenic organisms but does not prove active toxin injury, so only unformed stool from a compatible syndrome is tested and results are read with multistep algorithms and clinical probability.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0011-en	What can faecal calprotectin show in suspected inflammatory bowel disease, and what can it not?	It reflects neutrophilic intestinal inflammation but cannot distinguish infection from immune disease.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0012-en	In acute severe ulcerative colitis, why is surgical input sought early rather than after drug treatment fails?	Response must be judged within days, and delaying surgery in toxic megacolon, perforation, uncontrolled bleeding, or worsening systemic toxicity increases mortality.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0013-en	How does mechanical obstruction cause harm beyond pain?	Fluid and gas accumulate upstream, causing vomiting, third-space loss, electrolyte disturbance, bacterial translocation, and aspiration risk.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending
IMF-047-02-0014-en	Why is improvement in pain or stool frequency not taken as recovery?	Weight, intake, anaemia, inflammation, or organ function may still be deteriorating, and symptom control must be distinguished from a threatened bowel or nutritional state.	Integrated Medical Foundations; chapter 47, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 48ab4f6464ce31b82dbcac3ceee2275c3640a4b1a0da78d5f8d4a1f23944cf21; editorial review pending	imf lang::en chapter::047 module::047-02 review::pending