#separator:Tab
#html:false
#tags column:5
IMF-059-02-0001-en	Why must observation after poisoning follow expected kinetics rather than one reassuring examination?	A patient can look well while a delayed-release formulation is still being absorbed or a toxic metabolite is accumulating.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0002-en	How can an apparently first-order decline turn into prolonged or nonlinear toxicity?	Toxic effect depends on dose reaching the target over time, and saturation, enterohepatic cycling, bezoars and ongoing release can prolong that exposure beyond simple first-order decline.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0003-en	What dose estimate should the toxicological history seek, and which sources may be more reliable than a tablet count?	It seeks the maximum plausible dose, not an average; packaging, dispensing records, witnesses, emergency personnel and scene evidence may be more reliable than tablet count.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0004-en	How do muscarinic and nicotinic effects combine in cholinergic poisoning?	Muscarinic effects flood secretions and increase bronchial tone, while nicotinic effects cause fasciculation followed by weakness.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0005-en	Why is the electrocardiogram an early toxicology test, and why is it repeated?	It reveals sodium-channel blockade, potassium-channel delay, bradyarrhythmia, ischaemia and conduction disease, and serial tracings are needed because absorption and metabolites evolve.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0006-en	Why is acidaemia dangerous in salicylate poisoning, and why must potassium be corrected during alkalinisation?	Acidaemia increases entry of non-ionised salicylate into brain, and urinary alkalinisation with sodium bicarbonate only works when potassium is corrected.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0007-en	Why is intubating a salicylate-poisoned patient hazardous, and what general principle does it illustrate?	Even brief apnoea or ordinary ventilator settings let carbon dioxide and acidity rise abruptly; a physiological adaptation that looks abnormal may be keeping the patient alive.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0008-en	In methanol or ethylene glycol poisoning, why is a normal osmolar gap late in the course not reassuring?	Both become toxic after alcohol-dehydrogenase metabolism; the osmolar gap may be high early and fall as the anion gap rises, so a late normal gap can accompany serious toxicity.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0009-en	Why can the total digoxin concentration usually not be interpreted after digoxin-specific antibody fragments?	The measured total includes antibody-bound drug, so management instead follows electrolytes and serial electrocardiograms.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0010-en	What guides the decision to dialyse in lithium toxicity, and why is activated charcoal not relied on?	Dialysis rests on neurological features, kidney function, ingestion pattern and change over time, not concentration alone; activated charcoal does not adsorb lithium.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0011-en	Why may both ordinary pulse oximetry and a later carboxyhaemoglobin level underestimate carbon monoxide poisoning?	Ordinary pulse oximetry reads carboxyhaemoglobin as oxygenated, and a low level measured after oxygen or delay underestimates the peak burden.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0012-en	When do oximes help in organophosphate poisoning, and why is prolonged respiratory surveillance needed?	For selected compounds, oximes reactivate acetylcholinesterase before enzyme ageing; weakness can emerge after cholinergic symptoms improve, so breathing is watched for longer.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0013-en	Why does an ingested button battery need emergency removal and continued surveillance afterwards?	It produces rapid oesophageal necrosis through local current, and fistula and vascular erosion can still develop after removal.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending
IMF-059-02-0014-en	Why does temporary improvement after an antidote not justify discharge?	The causative agent may act for longer, so discharge requires evidence that the predicted peak has passed and that serial clinical, electrocardiographic and needed laboratory checks are safe.	Integrated Medical Foundations; chapter 59, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d3a60f0e5ca9fbc8ac36d4ec3898da1619abc766b9326fd09421299d83aca50; editorial review pending	imf lang::en chapter::059 module::059-02 review::pending