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IMF-058-02-0001-en	Why is it often difficult to tell whether a patient has too much or too little immunity?	Fever, rash, lung infiltrates, diarrhoea, cytopenia and organ dysfunction can represent either, so the failed defensive or regulatory function must be localised.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0002-en	Explain, by receptor action, why intramuscular adrenaline is first-line in anaphylaxis.	Alpha-one vasoconstriction reverses vasodilation and oedema, beta-one activity supports the heart, and beta-two activity bronchodilates and reduces mediator release.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0003-en	Why can sudden sitting or standing be fatal during anaphylaxis?	With low venous return, an abrupt move to sitting or standing can precipitate empty-ventricle arrest, so the patient stays supine with legs elevated or in a supported position needed for breathing.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0004-en	How should a normal serum tryptase after suspected anaphylaxis be interpreted?	Tryptase supports mast-cell activation when sampled at appropriate acute and baseline times, but sensitivity varies by trigger, so a normal result does not exclude anaphylaxis.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0005-en	What infection patterns point to neutrophil defects, terminal-complement deficiency or absent spleen?	Neutrophil defects cause deep bacterial and fungal abscesses, impaired pus or unusual catalase-positive infection; terminal-complement deficiency predisposes to invasive Neisseria; asplenia impairs clearance of encapsulated organisms and red-cell parasites.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0006-en	Why should prophylaxis follow a patient's integrated immune state rather than one drug name?	Combinations alter several compartments at once: a patient on corticosteroid, B-cell depletion and chemotherapy may have T-cell dysfunction, poor antibody, neutropenia, mucosal injury and a central line together.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0007-en	Why should a patient without a functioning spleen who develops fever be assessed immediately rather than told to return if it persists?	Sepsis from encapsulated bacteria such as pneumococcus, meningococcus and Haemophilus influenzae progresses rapidly from mild prodromal symptoms, so antibiotics follow cultures without delay.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0008-en	Why can inflammation from an opportunistic infection worsen soon after antiretroviral therapy starts, and what does it usually signify?	Early immune recovery can unmask or worsen inflammation against an existing infection, an immune-reconstitution syndrome; it does not usually mean treatment failure, but timing and management vary by pathogen.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0009-en	What two problems can abrupt withdrawal of prolonged glucocorticoids cause at once, and what should the plan specify?	It can precipitate adrenal crisis even as the treated inflammatory disease relapses; the plan specifies taper, infection and bone prophylaxis, glucose monitoring and stress-dose considerations.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0010-en	What specific vulnerabilities do B-cell depletion, complement inhibition and Janus-kinase inhibition create?	B-cell depletion lowers new antibody responses and can cause prolonged hypogammaglobulinaemia or viral reactivation; complement inhibition raises meningococcal risk even after vaccination; Janus-kinase inhibition can increase zoster and thrombosis.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0011-en	Why must suspected checkpoint-inhibitor immune-related adverse events be distinguished from infection before immunosuppression?	Varied symptoms, sometimes lagging well behind a dose, can be immune-related events but also infection, tumour progression or drug toxicity, and immunosuppression given while an infection is missed is itself dangerous.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0012-en	Why are vaccines timed before immunosuppression, and why may inactive vaccine responses be rechecked?	Live vaccines may later be unsafe and need a sufficient interval before suppression starts; inactive vaccines cannot cause infection but responses may be inadequate, so repeat immunisation or antibody assessment is arranged.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0013-en	Why is empirically increasing immunosuppression for solid-organ graft dysfunction dangerous?	Thrombosis, obstruction, leak, recurrence, dehydration, calcineurin toxicity and infection can mimic rejection, so drug levels, imaging, microbiology, donor-specific antibodies and biopsy must first exclude infection.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending
IMF-058-02-0014-en	Why must a calcineurin-inhibitor trough level be interpreted in clinical context?	The window is narrow: too little risks rejection and too much causes renal vasoconstriction, hyperkalaemia and neurotoxicity, while interactions and diarrhoea shift levels, so timing, adherence and graft state matter.	Integrated Medical Foundations; chapter 58, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d758bc34da93f813abc9a45955092454ea800e62b7296dae96d43b70fa74e654; editorial review pending	imf lang::en chapter::058 module::058-02 review::pending