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IMF-064-01-0001-en	Why should a test be ordered only when its result would change action?	A test changes uncertainty but does not replace reasoning, and it carries harms such as pain, anaemia, radiation, contrast injury, incidental findings, cascades and delay.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0002-en	Why can the same test have different predictive values in different settings?	Predictive values vary with prevalence, so the meaning of a positive or negative result depends on how common the target condition is in the population tested.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0003-en	When does the shortcut that a sensitive negative test excludes disease fail?	It holds only in the validated context; it fails when timing, technique, disease spectrum or cut-off differ from those in which performance was established.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0004-en	Why can action be justified at a lower probability for some diseases than for others?	Thresholds reflect consequences: a dangerous but treatable disease justifies acting at a lower probability because missing it costs more.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0005-en	Why do healthy people fall outside reference intervals, and why does ordering more tests make abnormal results more likely?	Reference intervals commonly contain ninety-five per cent of a selected healthy population, so some healthy values lie outside, and each extra test adds another chance abnormality.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0006-en	How can specimen handling produce misleading potassium, glucose or coagulation results?	Haemolysis raises potassium and enzymes, delay changes glucose and blood gases, and an underfilled citrate tube distorts coagulation tests.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0007-en	How should an unexpected critical result that might be a specimen error be handled?	Assess the patient and check units, previous values, specimen comments and plausibility, repeating urgently where error could harm, but never simply dismiss the critical result.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0008-en	Why can mean cell volume be normal in a patient with nutritional anaemia?	Mean cell volume classifies anaemia only broadly, and mixed deficiencies can combine to give an apparently normal value.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0009-en	Why does a normal platelet count not establish that bleeding risk is low?	Platelet number does not measure function, and bleeding risk also depends on vessels, coagulation, drugs, kidney or liver disease and the procedure planned.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0010-en	Why does serum sodium need volume state and osmolality to be interpreted?	Sodium mainly reflects water balance rather than body sodium content, so volume state, glucose, osmolality and urine studies are needed to explain it.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0011-en	How is confirming an unexpected hyperkalaemia balanced against treating it?	Unexpected hyperkalaemia is confirmed, but when severe or accompanied by electrical change an electrocardiogram is obtained and treatment starts immediately.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0012-en	Why can creatinine misrepresent filtration early in acute kidney injury?	Creatinine reflects filtration imperfectly and lags acute injury, and it also varies with muscle, diet, secretion, age and drugs.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0013-en	Why can a normal osmolar gap or anion gap not exclude dangerous poisoning?	The osmolar gap varies with timing and other solutes and the anion gap needs albumin and baseline context, so neither can independently exclude poisoning.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0014-en	Why does a very high aminotransferase level not necessarily indicate worse liver function than a modest one?	Aminotransferases indicate hepatocyte injury, not synthetic function, and in advanced failure enzymes may be only modestly raised.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0015-en	What distinguishes an elevated troponin from a diagnosis of myocardial infarction?	Troponin indicates myocardial injury from many causes such as sepsis or embolism; infarction requires a rise or fall plus clinical evidence of ischaemia.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0016-en	Why can glycated haemoglobin misrepresent prior glycaemia?	It estimates prior glycaemia through red cells, so altered red-cell survival, haemoglobin variants, transfusion, pregnancy and kidney disease distort it.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0017-en	Why do a normal prothrombin time and activated partial thromboplastin time not exclude a bleeding disorder?	They sample selected pathways and miss platelet dysfunction, von Willebrand disease, factor thirteen deficiency and direct anticoagulant effect.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0018-en	Why does a positive blood culture need interpretation before it is treated as infection?	It may represent a pathogen, colonisation or a contaminant, so organism, number of sets, time to positivity, host, device and syndrome must be weighed.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0019-en	How do polymerase chain reaction and serology each mislead about current infection?	Polymerase chain reaction detects nucleic acid and may stay positive after viable organisms disappear; serology reflects immune response and may be negative early.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0020-en	Why does a normal chest radiograph not exclude early infection, embolism or small pneumothorax?	Plain radiography is limited because overlapping structures hide disease, so comparison with priors and knowledge of view and position matter.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0021-en	How is cumulative radiation risk weighed in children and pregnancy when imaging is needed?	Radiation accumulates, especially in children and pregnancy, but concern about it should not delay or withhold necessary life-saving imaging.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0022-en	Why can radiotracer imaging mislead when evaluating cancer?	Radiotracers map physiology, so inflammation can mimic cancer and tumours with low metabolic activity may be missed.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0023-en	Why do false positives and overdiagnosis matter more in screening than in diagnosis?	Screening tests asymptomatic populations where prevalence is low, so false positives and overdiagnosis carry great weight relative to true disease found.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending
IMF-064-01-0024-en	Why is a test without a responsible reviewer described as unfinished care?	Pending and incidental results can be lost at transitions, so ownership must be assigned at every transition for the result to lead to action.	Integrated Medical Foundations; chapter 64, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 9e4cd9326d94359ec934e1d02558d5b20bd403170b0d734861027c9ff4dfc514; editorial review pending	imf lang::en chapter::064 module::064-01 review::pending