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IMF-061-01-0001-en	Why must anaesthesia and sedation be combined with preparation, monitoring, and rescue planning?	They alter consciousness, sensation, reflexes, or movement and can rapidly create airway and haemodynamic emergencies.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0002-en	How is a nociceptive signal modified between the primary afferent and the conscious experience of pain?	It is amplified or inhibited in the spinal cord before ascending through thalamic and cortical networks, and descending pathways, attention, expectation, fear, sleep, mood, and social context further modulate it.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0003-en	What distinguishes neuropathic pain from nociplastic pain?	Neuropathic pain results from lesion or disease of somatosensory pathways, whereas nociplastic pain reflects altered processing without sufficient ongoing tissue injury or an identifiable neural lesion.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0004-en	How should pain be assessed in a patient with dementia, critical illness, or impaired communication?	A scale alone cannot replace observation and function, so combine behavioural signs, physiological context, caregiver knowledge, and therapeutic trials, then reassess benefit and adverse effects.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0005-en	What principle underlies multimodal analgesia, and what does regional anaesthesia contribute to it?	Treat the cause where possible and combine non-drug and drug methods acting through different pathways; regional anaesthesia adds powerful relief that spares opioids.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0006-en	Why must the total paracetamol dose across combination products be checked, and why does suspected overdose need prompt antidote assessment?	Combination products hide additional paracetamol, and overdose can cause silent early hepatic injury that is not revealed by early symptoms.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0007-en	How does the mechanism of non-steroidal anti-inflammatory drugs explain both their benefit and their harms?	Inhibiting cyclooxygenase and prostaglandin synthesis helps inflammatory and acute musculoskeletal pain but can cause ulceration, bleeding, kidney injury, sodium retention, hypertension, bronchospasm, and cardiovascular events.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0008-en	How do opioids act on neurons, and which patient and drug factors increase their risk?	Opioid receptors reduce neurotransmitter release and neuronal excitability; risk rises with sleep apnoea, frailty, kidney or liver dysfunction, opioid naivety, high dose, and concurrent alcohol or other sedatives.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0009-en	When are small intravenous opioid doses used rather than oral treatment, and why are long-acting preparations wrong for opioid-naive acute pain?	Monitored small intravenous doses suit a need for rapid effect, oral treatment is safer for stable pain, and long-acting preparations cannot be titrated rapidly.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0010-en	Why can oxygen saturation be falsely reassuring in opioid respiratory depression?	Supplemental oxygen can keep saturation deceptively normal while rate, depth, arousal, and ventilation are falling.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0011-en	How is opioid respiratory depression managed, and why must the patient be observed after naloxone?	Stimulate, open the airway, ventilate, stop the opioid, and titrate naloxone to adequate breathing; naloxone may wear off before the opioid.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0012-en	What distinguishes opioid dependence from addiction, and how does this shape discontinuation?	Dependence is expected adaptation, whereas addiction is impaired control despite harm; abrupt discontinuation is avoided unless there is immediate danger, and evidence-based opioid-use-disorder treatment is offered when indicated.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0013-en	Why are neuropathic pain medicines started low and reviewed, especially when combined with other sedatives?	They can cause dizziness, falls, anticholinergic effects, cardiac risk, oedema, sedation, and misuse, and combining sedatives increases respiratory risk.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0014-en	What advantage does ketamine offer at subanaesthetic doses, and what adverse effects limit it?	As an N-methyl-D-aspartate receptor antagonist it gives analgesia with relative preservation of breathing, but causes dissociation, hypertension, nausea, salivation, and emergence phenomena.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0015-en	How does local anaesthetic systemic toxicity present, and how is it managed?	Sodium channel blockade causes circumoral symptoms, tinnitus, seizure, conduction delay, ventricular dysrhythmia, and collapse; stop injection, get help, manage airway and seizure, modify resuscitation, and give lipid emulsion by protocol.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0016-en	Why must every pre-anaesthetic airway plan include rescue options up to front-of-neck access?	No single examination finding predicts difficulty, so preparation covers ventilation, device, intubation, and front-of-neck rescue.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0017-en	Why is excessive fasting avoided, and why can a fasted patient still aspirate?	Excessive fasting causes dehydration and discomfort, and obstruction, pregnancy, diabetes, severe pain, opioids, and some metabolic medicines delay gastric emptying despite fasting.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0018-en	How is tracheal tube placement confirmed, and what takes priority when oxygenation fails?	Placement is confirmed by sustained exhaled carbon dioxide rather than chest movement, and a rehearsed algorithm prioritises oxygenation over repeated traumatic attempts.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0019-en	Why is antithrombotic timing critical in spinal and epidural anaesthesia?	Neuraxial puncture can cause spinal haematoma, and correct timing of antithrombotic drugs is what prevents it.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0020-en	Why must a sedation team be able to rescue one level deeper than intended, and who should monitor?	Sedation is a continuum and patients can unexpectedly go deeper, so for moderate or deep sedation a trained clinician whose primary role is monitoring, not performing the procedure, is allocated.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0021-en	Why is capnography especially valuable during sedation with supplemental oxygen?	It detects hypoventilation before desaturation, which supplemental oxygen otherwise delays.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0022-en	What airway risks distinguish benzodiazepine-opioid combinations, propofol, and ketamine in procedural sedation?	Benzodiazepine with opioid synergistically depresses breathing, propofol rapidly causes apnoea and hypotension with no reversal agent, and ketamine preserves reflexes yet can still cause obstruction, laryngospasm, apnoea, or emesis.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0023-en	How do perioperative anaphylaxis and malignant hyperthermia differ in presentation and specific treatment?	Anaphylaxis causes sudden hypotension, bronchospasm, or difficult ventilation, possibly without rash, and needs adrenaline; malignant hyperthermia causes rising carbon dioxide, rigidity, acidosis, hyperkalaemia, and heat, and needs dantrolene.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending
IMF-061-01-0024-en	Beyond stable physiology, what does discharge after sedation require?	Mobility, an escort when indicated, written advice with driving, alcohol, decision, and activity restrictions, and escalation instructions for bleeding, infection, respiratory depression, or block complications.	Integrated Medical Foundations; chapter 61, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 31c9ae9a171f9fabace053ab51c7f9fb189c9f68f4620b729cebff2cd63752d6; editorial review pending	imf lang::en chapter::061 module::061-01 review::pending