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IMF-059-01-0001-en	Why does the toxicological approach stabilise physiology before the poison is identified?	Histories are incomplete and products may be mixed, so staff are protected, exposure is stopped and airway, breathing, circulation, temperature, glucose and seizures are stabilised before toxidromes, tests and antidotes are pursued.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0002-en	How should a contaminated patient be handled before and during irrigation so that rescuers are not harmed?	Nobody enters contamination without protection; clothing is removed and dry chemicals brushed off before skin and eyes are irrigated generously, and inhalational cases are moved to fresh air without exposing rescuers.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0003-en	Why do normal early findings not exclude serious poisoning?	Delayed-release formulations, toxic metabolites and hepatic toxicity can declare themselves later, so a normal early assessment cannot rule them out.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0004-en	In deliberate self-poisoning, why should a report of low intent not lessen the medical response, and when is psychosocial assessment done?	Low intent does not reduce the dose taken, so the medical risk is judged on the exposure; psychosocial safety assessment follows stabilisation.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0005-en	Sympathomimetic and antimuscarinic toxicity both cause agitation and mydriasis. What distinguishes them?	Sympathomimetic toxicity causes sweating, whereas antimuscarinic toxicity gives dry flushed skin with reduced bowel sounds and urinary retention.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0006-en	How do serotonin toxicity and neuroleptic malignant syndrome differ in tempo, trigger and neuromuscular signs?	Serotonin toxicity shows hyperreflexia and clonus with mental change, autonomic activation and heat, while neuroleptic malignant syndrome evolves more slowly after dopamine blockade with rigidity.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0007-en	What distinguishes malignant hyperthermia from the other hyperthermic toxidromes?	It is an anaesthetic-triggered crisis marked by rising carbon dioxide, rigidity, acidosis, hyperkalaemia and heat.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0008-en	Why is a paracetamol concentration measured after possible overdose even when the patient has no symptoms?	Early paracetamol poisoning may cause only mild symptoms while a reactive metabolite injures the liver, so absent symptoms cannot exclude a toxic ingestion.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0009-en	What does each of QRS widening and QT prolongation signify on the electrocardiogram of a poisoned patient?	QRS widening suggests sodium-channel blockade, while QT prolongation increases the risk of polymorphic ventricular tachycardia.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0010-en	Why should management not be driven by a urine drug screen?	Screens give false results, have long detection windows and correlate poorly with impairment, so the clinician treats the patient, not the screen.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0011-en	Under what conditions is activated charcoal useful, and what limits its use?	It adsorbs many substances if given early to a cooperative patient with a protected airway; otherwise aspiration can be catastrophic, and it binds alcohols, metals, corrosives and some small ions poorly.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0012-en	When is whole-bowel irrigation considered, in contrast to gastric lavage and induced vomiting?	It is selected under specialist guidance for sustained-release drugs, substances charcoal does not bind, or body packing, whereas lavage is rarely appropriate and vomiting should not be induced.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0013-en	How does paracetamol overdose injure the liver, and how does N-acetylcysteine counter this?	Saturated conjugation lets a reactive metabolite deplete glutathione and injure liver; N-acetylcysteine replenishes glutathione, is highly effective early and remains useful after injury.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0014-en	When can a paracetamol concentration be interpreted on the treatment nomogram?	Only for a single immediate-release ingestion with a known time and a correctly timed concentration; staggered, delayed, massive or uncertain ingestion needs specialist protocols.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0015-en	Why can salicylate toxicity worsen while the serum concentration is falling?	The drug moves into tissues, so clinical toxicity can progress despite a falling serum level; salicylate concentrations are therefore interpreted serially.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0016-en	Why is naloxone titrated to adequate breathing, and why must patients still be observed afterwards?	Ventilation is the priority, so the target is breathing rather than painful withdrawal; naloxone may act for less time than the opioid, so recurrent toxicity needs observation or infusion.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0017-en	Why is flumazenil reserved for carefully selected benzodiazepine overdoses?	It can precipitate seizure or withdrawal in dependent patients or mixed overdose, whereas benzodiazepine sedation usually needs only supportive care.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0018-en	How does fast sodium-channel blockade by tricyclic antidepressants present, and what treats the cardiovascular toxicity?	It causes hypotension, QRS widening, ventricular dysrhythmia and seizure, alongside antimuscarinic signs; sodium bicarbonate treats the cardiovascular toxicity.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0019-en	Why do antipyretics fail in stimulant-induced hyperthermia, and what is done instead?	The heat is toxin-driven muscle heat, which antipyretics do not correct; benzodiazepines reduce central activation and severe elevation is treated with rapid external cooling and sedation.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0020-en	What distinguishes the toxicity of methanol from that of ethylene glycol?	Methanol causes visual and basal-ganglia toxicity through formic acid, whereas ethylene glycol causes acidosis, kidney injury and calcium oxalate deposition.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0021-en	Why does cyanide poisoning cause profound lactic acidosis, and how should suspicion be acted on?	Cyanide blocks mitochondrial electron transport, producing profound lactic acidosis and cardiovascular collapse after smoke or industrial exposure, so an appropriate antidote is given promptly when suspected.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0022-en	In organophosphate poisoning, what endpoint guides atropine dosing, and what can follow apparent recovery?	Atropine is repeated, sometimes in large doses, until bronchial secretions and perfusion improve, not by pupil size; intermediate neuromuscular weakness can follow apparent recovery.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0023-en	How do acid and alkali injuries differ, and what does the oropharyngeal appearance reveal about the oesophagus?	Acids cause coagulative injury while alkalis penetrate deeply through liquefaction, and oropharyngeal appearance does not predict oesophageal damage.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending
IMF-059-01-0024-en	What distinguishes heat stroke from heat exhaustion, and why must cooling not wait?	Heat exhaustion is dehydration and cardiovascular strain without central neurological dysfunction; heat stroke adds encephalopathy and organ injury and needs immediate rapid cooling, not delayed for transport or tests.	Integrated Medical Foundations; chapter 59, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3103f21e16fcc374acd6b221dcad3f5f47f73882e6c20f1050d3a53aa3b3f256; editorial review pending	imf lang::en chapter::059 module::059-01 review::pending