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IMF-053-02-0001-en	Why is a positive pregnancy test without a confirmed intrauterine pregnancy followed as a pregnancy of unknown location?	It should not be dismissed as too early; haemodynamics, pain, bleeding, transvaginal ultrasound, and the human chorionic gonadotropin trend are integrated, since no single value proves normality.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0002-en	Why does unreliable follow-up change the choice between medical, expectant, and surgical management of a possible ectopic pregnancy?	The safety of each option depends on stability, imaging, hormone values, contraindications, and reliable capacity to return, so safety changes when follow-up cannot be assured.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0003-en	Why does gonadotropin drive increase in the early follicular phase?	Falling progesterone and oestradiol release gonadotropin suppression, allowing follicle-stimulating hormone to recruit follicles.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0004-en	What sequence of vascular and inflammatory events sheds the functional layer when implantation fails?	Luteal regression withdraws hormones, spiral arterioles constrict, inflammatory mediators activate, and the functional layer sheds.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0005-en	Why does a normal haemoglobin not settle the impact of heavy menstrual bleeding?	A normal-looking haemoglobin does not exclude depleted iron stores, so iron deficiency must be assessed directly.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0006-en	How does anovulation produce irregular bleeding?	Without ovulation, unopposed oestrogen exposure is prolonged and the unstable endometrium then sheds irregularly.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0007-en	How do tranexamic acid and hormonal regimens each act in acute heavy uterine bleeding?	Tranexamic acid reduces fibrinolysis, while hormonal regimens stabilise the endometrium when appropriate.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0008-en	Why may hysteroscopy be needed even when endometrial biopsy has been performed?	Hysteroscopy directly visualises focal cavity lesions that blind biopsy may miss.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0009-en	Why does adnexal torsion produce ovarian oedema before infarction?	The twisted vascular pedicle obstructs venous outflow before arterial inflow, so the ovary swells and then infarcts.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0010-en	Why do negative nucleic-acid tests not exclude pelvic inflammatory disease?	They identify important sexually transmitted pathogens but cannot exclude polymicrobial upper-tract infection, and the diagnosis is kept clinical to prevent tubal injury.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0011-en	Why does endometriosis pain severity track poorly with visible lesion volume?	Pain reflects lesion location, nerve involvement, central sensitisation, pelvic-floor response, inflammation, and psychosocial burden more than visible volume.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0012-en	In amenorrhoea with low oestradiol, how do gonadotropin levels localise the problem?	High gonadotropins indicate primary ovarian insufficiency, whereas low or normal gonadotropins suggest hypothalamic or pituitary suppression.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0013-en	Why is withdrawal bleeding on combined hormonal pills misleading in functional hypothalamic amenorrhoea?	The pill creates withdrawal bleeding without correcting the energy deficit, while low oestradiol continues to compromise bone, cardiovascular physiology, fertility, and genital tissue.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending
IMF-053-02-0014-en	Why is repeated empirical treatment for presumed candidiasis risky in persistent vulval symptoms?	It can delay recognition of lichen sclerosus, contact dermatitis, herpes, pre-cancerous change, and cancer, so the skin is inspected and persistent lesions are biopsied.	Integrated Medical Foundations; chapter 53, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: ee2fc2a4d6acc664e626b49e100a41d62057e57aa5ac1f7abcfa5614d192a49f; editorial review pending	imf lang::en chapter::053 module::053-02 review::pending