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IMF-061-02-0001-en	What should escalating pain despite increasing analgesia prompt, and why should analgesia not be withheld for diagnosis?	It can signal compartment syndrome, ischaemia, perforation, infection, or a treatment complication; analgesia should enable repeated examination rather than be withheld as if pain were diagnostically useful.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0002-en	Why is an opioid-sparing regimen useful only if the replacement is itself safe?	Stacking gabapentinoids, sedatives, and muscle relaxants may worsen falls and ventilation, so each addition needs a defined benefit and review point.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0003-en	Why does an acute pain plan state the difference between preventive regular dosing and rescue dosing, and when the next dose is due?	So the plan is not read as an instruction to add more medicine whenever pain increases.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0004-en	Why do non-steroidal drugs cause harm beyond the site of pain, and does topical use remove this risk?	Reducing prostaglandins also removes gastric, renal, platelet, and vascular protection; topical treatment lowers systemic exposure, but absorption is not zero.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0005-en	Why are long-acting opioid preparations unsuitable for initial titration in opioid-naive patients?	Their accumulation outlasts reassessment, so the effect of a dose cannot be judged before more drug has built up.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0006-en	Why can respiratory rate alone miss opioid ventilatory impairment?	A sedated patient may take apparently regular shallow breaths with rising carbon dioxide, while supplemental oxygen preserves saturation.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0007-en	What is the target when titrating naloxone, and when may an infusion be needed?	Titrate to adequate breathing rather than full painful withdrawal, and consider an infusion when the opioid lasts longer than naloxone.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0008-en	Why is abrupt involuntary discontinuation of long-term opioids dangerous, and what is preferred?	It can trigger withdrawal, illicit substitution, and suicide risk, so taper collaboratively unless immediate toxicity demands faster action, and offer agonist therapy for opioid-use disorder.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0009-en	How do vasoconstrictor and patient factors change the safe total dose of local anaesthetic?	Vasoconstrictor in suitable sites prolongs local exposure and reduces systemic absorption; the total of every infiltration and block is adjusted for weight, pregnancy, low cardiac output, liver dysfunction, acidosis, and protein binding.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0010-en	Why can a patient arrest immediately after an anatomically successful intubation?	Induction removes airway tone and sympathetic support and positive-pressure ventilation reduces venous return, so severe hypovolaemia, tamponade, tension pneumothorax, pulmonary hypertension, or metabolic acidosis can decompensate unless physiology is prepared.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0011-en	Why can neuromuscular paralysis conceal awareness during general anaesthesia?	Paralysis produces neither unconsciousness nor analgesia, so depth and drug delivery must be cross-checked, especially during low-dose emergency anaesthesia.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0012-en	Why is temperature an unreliable early sign of malignant hyperthermia, and what appears first?	This skeletal muscle calcium regulation crisis first shows an unexplained rapid carbon dioxide rise, tachycardia, rigidity, acidosis, and hyperkalaemia, while the temperature rise can be late.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0013-en	How does a high neuraxial block cause profound bradycardia and shock?	Sympathetic blockade causes vasodilation and reduced venous return, and a high block also impairs cardiac accelerator fibres, intercostal function, arms, and consciousness.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending
IMF-061-02-0014-en	Why is recovery after sedation a distinct high-risk phase?	Procedural stimulation ends while sedative absorption and active metabolites continue, so procedural success includes safe recovery, not only completing the intervention.	Integrated Medical Foundations; chapter 61, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: dc246066115f251cfe7859a0258aabd26d450c4c39ea3b0a2f77cbc73a1bc1de; editorial review pending	imf lang::en chapter::061 module::061-02 review::pending