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IMF-058-01-0001-en	Why should immune care identify the defective pathway and prevent complications before starting suppression?	Immune failure can cause allergy, autoimmunity, immunodeficiency, infection, rejection or malignancy, and immune-modifying treatments themselves cause infection, cancer, metabolic, haematological and organ toxicities.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0002-en	How does an allergen trigger immediate hypersensitivity at the cellular level?	It cross-links immunoglobulin E bound to mast cells and basophils, releasing histamine, tryptase, leukotrienes, prostaglandins and cytokines.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0003-en	How do released mast-cell mediators produce urticaria, bronchospasm and shock?	They cause vasodilation, capillary leak, smooth-muscle contraction, mucus, itch and sensory activation, which together produce urticaria, angioedema, bronchospasm, gastrointestinal symptoms and shock.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0004-en	What distinguishes antibody-mediated cytotoxic, immune-complex and delayed hypersensitivity reactions?	Cytotoxic antibodies target cells or matrix, activate complement or alter receptors; immune complexes deposit and inflame vessels, glomeruli, joints and skin; delayed reactions are T-cell mediated and appear hours to days after exposure.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0005-en	Why must a reaction history distinguish true allergy from intolerance, toxicity or vasovagal episodes?	An inaccurate allergy label can deny first-line therapy and increase complications, so adverse effects, intolerance, toxicity, vasovagal episodes and coincidence must be separated from allergy.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0006-en	Why should skin-prick and specific immunoglobulin E tests target plausible triggers rather than broad panels?	They detect sensitisation, which does not always mean clinical allergy, so broad food panels create false positives; results alter probability but not reaction severity.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0007-en	Why should anaphylaxis be treated without waiting for skin signs or laboratory confirmation?	It is a rapidly evolving reaction threatening airway, breathing or circulation, and skin or mucosal features are sometimes absent, so these signs after a likely trigger warrant immediate treatment.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0008-en	How should a patient with anaphylaxis be positioned, and why is sudden standing avoided?	Supine with legs elevated when tolerated, lateral in pregnancy and in the recovery position if unconscious, because sudden standing can precipitate collapse.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0009-en	Why do bronchodilators, antihistamines and corticosteroids not replace adrenaline in anaphylaxis?	A bronchodilator treats only persistent bronchospasm, antihistamines relieve only skin symptoms, and corticosteroids have no reliable immediate life-saving effect.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0010-en	What changes in refractory anaphylaxis, and why may glucagon be considered?	An experienced team gives monitored intravenous adrenaline infusion, further fluid and airway planning, and seeks alternative or additional shock; glucagon can be considered because beta blockade may blunt the response.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0011-en	Why is observation after anaphylaxis individualised, and what should discharge provide?	Biphasic symptoms can recur, so observation follows severity, treatment needed, comorbidity, trigger and access to help; discharge provides trigger referral, autoinjectors when indicated, technique and an action plan.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0012-en	Why is chronic spontaneous urticaria not usually pursued as a hidden food allergy, and how is it treated?	It is commonly autoimmune rather than an undiscovered food allergy; second-generation antihistamines are first-line and may be increased under guidance, and resistant disease can receive biologic therapy.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0013-en	What distinguishes bradykinin-mediated from histamine-mediated angioedema clinically and therapeutically?	Bradykinin-mediated angioedema from angiotensin-converting enzyme inhibitors or hereditary complement-regulator defects lacks urticaria and responds poorly to adrenaline or antihistamine, so airway protection and cause-specific inhibitors are used.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0014-en	Why do allergic rhinitis, asthma, eczema and food allergy cluster, and what is the limit of oral immunotherapy?	They share epithelial-barrier and type-two immune pathways; oral immunotherapy raises the reaction threshold for selected foods but is not risk-free permission for unrestricted intake.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0015-en	Which features suggest a primary immunodeficiency rather than ordinary infection susceptibility?	Unusually severe, recurrent, persistent, opportunistic or anatomically unusual infection, plus clues such as poor growth, deep abscesses, autoimmunity or live-vaccine reactions; common infections alone do not establish deficiency.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0016-en	Why must immune test results in suspected primary immunodeficiency be interpreted in context?	Timing, age, medicines, protein loss and acute illness affect the results, so tests are selected and read according to phenotype; genetic diagnosis can then guide treatment and family counselling.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0017-en	How does the type of primary immunodeficiency shape vaccination and definitive treatment?	Selected antibody failure receives immunoglobulin replacement, live vaccines are avoided in defined cellular defects, and severe disorders may need haematopoietic stem-cell transplantation or gene therapy.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0018-en	How does the pattern of acquired immune impairment predict the likely infections?	Neutropenia favours bacterial and fungal invasion, impaired T-cell function permits viral, fungal, mycobacterial and protozoal disease, and antibody failure promotes encapsulated bacterial infection.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0019-en	Why is combination antiretroviral therapy started promptly in human immunodeficiency virus infection?	The virus depletes CD4 T cells and causes chronic immune activation, and prompt combination therapy can achieve durable suppression, immune recovery and prevention of sexual transmission.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0020-en	Why should prolonged glucocorticoid therapy not be stopped abruptly?	Among their many toxicities, glucocorticoids cause adrenal suppression, so withdrawal must consider adrenal recovery; the lowest effective exposure is used throughout.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0021-en	How does the mechanism of an immune-modifying drug predict its toxicity? Give examples.	Tumour-necrosis-factor blockade can reactivate tuberculosis and hepatitis B, B-cell depletion impairs antibody responses, complement blockade raises meningococcal risk, and checkpoint inhibitors can inflame almost any organ.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0022-en	How is febrile neutropenia managed, and why is antibiotic treatment not delayed for a source?	It is an emergency: cultures are taken and immediate broad antipseudomonal antibiotics given without waiting for a source, and rectal procedures that disrupt mucosa are avoided.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0023-en	How do hyperacute, acute and chronic graft rejection differ in timing and injury?	Hyperacute antibody rejection occurs within minutes to hours, acute cellular or antibody rejection over days to months, and chronic rejection causes progressive vascular and interstitial injury.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending
IMF-058-01-0024-en	What double-edged effect do allogeneic cells have after stem-cell transplantation?	They provide a graft-versus-tumour benefit but can cause graft-versus-host disease of skin, gut, liver, lung and other organs.	Integrated Medical Foundations; chapter 58, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 0a47403e91ab83dccf1a380458c792710f9135e79cd53357bb5f775f7694cab0; editorial review pending	imf lang::en chapter::058 module::058-01 review::pending