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IMF-056-01-0001-en	Why can minor swelling or infection in the ear, nose, pharynx, larynx and upper airway become dangerous quickly?	Sensory, respiratory, swallowing, speech and immune functions are concentrated in a small region, so minor swelling can obstruct airflow and infection can spread to orbit, skull base, deep neck or brain.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0002-en	How does the cochlea turn vibration into auditory nerve signals, and where are high and low frequencies represented?	Basilar membrane movement bends hair-cell stereocilia, converting mechanical energy into nerve signals; high frequencies map near the stiff base and low frequencies near the apex.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0003-en	What distinguishes conductive from sensorineural hearing loss in where the fault lies?	Conductive loss impairs transmission in the external or middle ear, whereas sensorineural loss reflects the cochlea, auditory nerve or central pathways.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0004-en	Why is sudden sensorineural hearing loss developing over hours to days handled as an otological emergency?	Corticosteroid treatment is time-sensitive, so after alternatives are considered it needs urgent audiometry and specialist assessment.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0005-en	What can Weber and Rinne tuning-fork tests contribute, and why do they not replace audiometry?	They help classify asymmetry, but only formal audiometry quantifies air and bone thresholds and speech discrimination.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0006-en	In otitis externa, which findings suggest invasive skull-base infection, and how does management change?	Diabetes or immune suppression with severe persistent pain, granulation, cranial neuropathy or systemic illness; it requires urgent imaging and systemic antipseudomonal therapy rather than topical care alone.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0007-en	In acute otitis media, what supports the diagnosis, and what decides whether antibiotics are given?	A bulging inflamed membrane with middle-ear effusion supports it; analgesia is central, and antibiotics depend on age, severity, certainty, complications and follow-up.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0008-en	Why does persistent middle-ear effusion matter in a child?	It causes conductive hearing loss, which can affect speech development.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0009-en	Why is cholesteatoma dangerous, and why is its definitive management usually surgical?	Keratinising epithelium keeps expanding in middle ear or mastoid, eroding bone and causing facial palsy, labyrinthine fistula or intracranial infection.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0010-en	Which tinnitus features warrant targeted investigation, and what may pulsatile tinnitus reflect?	Unilateral tinnitus, asymmetric hearing loss, pulsatile sound or focal neurology; pulsatile tinnitus may reflect vascular flow or raised intracranial pressure.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0011-en	How does a cochlear implant differ from a hearing aid, and when is it used?	A hearing aid amplifies according to the hearing profile, whereas a cochlear implant directly stimulates the auditory nerve in severe loss when conventional aids are insufficient.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0012-en	What distinguishes the motion detected by the semicircular canals from that detected by the utricle and saccule?	The canals detect angular acceleration, while the utricle and saccule detect linear acceleration and gravity; vestibular nuclei integrate these with vision and proprioception to stabilise gaze and posture.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0013-en	What mechanism underlies brief attacks of vertigo triggered by head movement, and how are they confirmed and treated?	Displaced otoconia cause benign paroxysmal positional vertigo; positional testing provokes characteristic delayed, fatigable nystagmus, and canalith repositioning treats it.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0014-en	How do hearing symptoms distinguish vestibular neuritis, labyrinthitis and Meniere disease?	Vestibular neuritis gives prolonged acute vertigo without hearing loss, labyrinthitis adds cochlear symptoms, and Meniere disease gives episodic vertigo with fluctuating hearing loss, tinnitus and aural pressure.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0015-en	Why is bedside head impulse, nystagmus and skew testing useful yet hazardous in suspected stroke with vertigo?	In continuous acute vestibular syndrome, done by trained examiners, it may outperform early imaging, but misuse outside that syndrome or expertise is unsafe.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0016-en	Why should vestibular suppressants be limited to brief use in acute vertigo?	Prolonged use delays vestibular compensation and increases falls, whereas early mobilisation and vestibular rehabilitation support recovery.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0017-en	What adverse effects limit topical and oral decongestants in rhinitis?	Repeated topical decongestants cause rebound congestion, and oral sympathomimetics can raise blood pressure and heart rate.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0018-en	Which features in acute rhinosinusitis suggest orbital or intracranial spread, and what do they require?	Unilateral swelling, severe frontal headache, eye pain or restricted movement, reduced vision, proptosis, neurological change or toxicity; they need emergency imaging and treatment.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0019-en	How is anterior epistaxis controlled initially, and why does posterior bleeding need a specialist?	Sit forward, pinch the soft nose continuously, clear airway risk and assess haemodynamics and antithrombotics; posterior bleeding can be brisk and needs specialist control.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0020-en	In infectious mononucleosis, why is contact risk avoided, and what does a rash after an aminopenicillin imply?	The spleen may be enlarged and vulnerable; an aminopenicillin-associated rash can occur without true penicillin allergy.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0021-en	Why does Ludwig angina demand early airway security, and what else is done?	Spreading floor-of-mouth cellulitis, often dental, elevates the tongue and threatens the airway; secure it early with experienced help, give intravenous antibiotics, image when stable and drain or remove the source.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0022-en	When does hoarseness require laryngoscopy rather than reassurance?	When it persists or comes with a neck mass, haemoptysis, dysphagia, ear pain, weight loss, tobacco or alcohol exposure, or stridor, because cancer and vocal-fold paralysis are among its causes.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0023-en	What does the phase of stridor suggest about the level of obstruction, and what are the first steps?	Inspiratory stridor suggests extrathoracic obstruction and biphasic sound glottic or subglottic narrowing; keep the patient calm, give oxygen, call airway expertise and avoid distressing examination.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending
IMF-056-01-0024-en	Why can a bedside swallowing screen not exclude aspiration, and what is needed instead?	It only estimates risk and misses silent aspiration, which requires instrumental assessment by fibreoptic endoscopic or videofluoroscopic study.	Integrated Medical Foundations; chapter 56, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 4e0a1546281d515378caffabfa86fdba4093cdcb682d3f85317bb98968a9591e; editorial review pending	imf lang::en chapter::056 module::056-01 review::pending