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IMF-050-01-0001-en	Why is body size alone a misleading guide to whether a person is malnourished?	Malnutrition includes inflammatory catabolism and excess adiposity with poor nutrient quality, so a person with obesity can still lose muscle and become severely malnourished.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0002-en	Why does prolonged negative energy balance consume muscle and organ protein?	The body stores glycogen and triglyceride but has no inert protein reserve, so protein must come from functioning muscle and organs.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0003-en	How does the hormonal response to fasting mobilise fuel, and what limits protein loss?	Falling insulin with glucagon and stress hormones promotes glycogenolysis, lipolysis, gluconeogenesis, and ketone production; brain use of ketones limits but does not prevent protein loss.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0004-en	Why can feeding alone not reverse catabolism in sepsis, burns, or cancer, and what still helps?	Inflammatory catabolism proceeds despite feeding until the underlying disease is controlled, but adequate protein and mobilisation help preserve function.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0005-en	Why must a change in body weight be interpreted cautiously in suspected malnutrition?	Weight change may reflect tissue, fluid, or both, and ascites or oedema can conceal real weight loss.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0006-en	What distinguishes malnutrition screening from diagnosis?	Screening tools only identify risk; diagnosis integrates a phenotype of weight loss, muscle loss, or low body mass with a cause such as reduced intake, malabsorption, or inflammatory disease.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0007-en	Why is a low serum albumin not diagnostic of malnutrition?	No single blood test diagnoses malnutrition, and albumin falls mainly with inflammation, capillary leak, dilution, liver dysfunction, and renal loss.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0008-en	How can severe acute illness cause important malnutrition even when weight appears stable?	It can produce rapid muscle loss that stable body weight does not reveal.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0009-en	What distinguishes sarcopenia from frailty?	Sarcopenia is low muscle strength and quantity associated with ageing or disease, whereas frailty is a broader vulnerability across multiple physiological systems.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0010-en	What should be improved before escalating the route of support, and how should oral supplements be used?	Improve eating environment, symptom control, assistance, texture, timing, fortification, and culturally suitable food; supplements add energy and protein but should not displace preferred meals.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0011-en	Why should rigid calorie targets be avoided, and what does the dietitian check beyond the prescription?	Rigid targets ignore fluid limits, kidney or liver disease, metabolic tolerance, and goals of care; dietitians calculate individual needs and monitor whether delivery actually occurs.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0012-en	Why should iron deficiency prompt investigation rather than indefinite replacement?	The deficiency has a cause, such as bleeding, menstrual loss, low intake, malabsorption, or increased demand, that replacement alone leaves unexplained.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0013-en	Why can ferritin mislead in suspected iron deficiency, and how is it interpreted?	Ferritin reflects stores but rises with inflammation, so it is read together with transferrin saturation and the clinical context.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0014-en	When is intravenous iron chosen over oral iron?	Oral iron works when absorbed and tolerated; intravenous iron is used when rapid replacement, severe intolerance, ongoing losses, or poor absorption justify it.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0015-en	Why is giving folate alone dangerous when vitamin B twelve deficiency is possible?	Folate can improve the megaloblastic anaemia while B twelve neurological injury, which can occur even without anaemia, continues to progress.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0016-en	Why is thiamine given before or with carbohydrate in high-risk patients, and what must not be delayed?	Thiamine is required for oxidative carbohydrate metabolism, and deficiency can cause Wernicke encephalopathy; emergency glucose for hypoglycaemia must still not be delayed.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0017-en	How do deficiencies of vitamins C, D, and K each produce their clinical effects?	Vitamin C deficiency impairs collagen, causing bleeding and poor healing; vitamin D deficiency contributes to osteomalacia and weakness; vitamin K deficiency impairs coagulation.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0018-en	What happens physiologically when insulin-driven refeeding follows prolonged undernutrition?	Phosphate, potassium, and magnesium move into cells, thiamine demand increases, sodium and water are retained, and metabolism expands, which can cause arrhythmia, heart failure, and respiratory weakness.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0019-en	How is feeding started safely in a patient at high risk of refeeding syndrome?	Identify risk first, give thiamine and multivitamins, correct and closely monitor electrolytes, begin energy cautiously, manage fluid and sodium, and increase delivery progressively with clinical review.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0020-en	Why is refeeding syndrome a risk whichever feeding route is chosen?	It is driven by the insulin response to renewed energy supply, so it can occur by oral, enteral, parenteral, or intravenous glucose routes.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0021-en	Why is enteral feeding generally preferred to parenteral nutrition when the gut functions?	It supports the gastrointestinal mucosa and carries fewer bloodstream and metabolic complications than parenteral nutrition.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0022-en	Why should diarrhoea during enteral feeding not be blamed on the formula first?	It more often results from antibiotics, infection, sorbitol-containing medicines, or excessive delivery than from the formula itself.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0023-en	Why does parenteral nutrition require a dedicated aseptic line and daily review?	Catheter infection and thrombosis can be fatal, so line care and the ongoing need for the line are reviewed every day.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending
IMF-050-01-0024-en	What does metabolic surgery demand after the operation, and what risks does rapid weight loss bring?	It requires lifelong nutrition, micronutrient monitoring, and psychosocial follow-up; rapid loss can increase gallstones and expose sarcopenia.	Integrated Medical Foundations; chapter 50, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 308fe366bb1fe0edbe34a5b176f98c8ad346791691a4ae20579eed17016239a8; editorial review pending	imf lang::en chapter::050 module::050-01 review::pending