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IMF-068-01-0001-en	Why does recognising that a patient is dying not amount to abandonment?	Recognising dying shifts effort toward comfort and communication rather than withdrawing care.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0002-en	What does asking whether the team would be surprised by the patient's death within months achieve, and what is it not?	It identifies unmet planning needs, but it is a prompt for planning rather than a prognosis.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0003-en	How do the illness trajectories of cancer, organ failure, and frailty or dementia differ?	Cancer may decline predictably, organ failure fluctuates with crises, and frailty or dementia declines slowly with acute interruptions.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0004-en	How can hope change during serious illness without becoming false reassurance?	Hope can shift from cure toward achievable priorities, such as returning home, attending an event, or relieving pain.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0005-en	What must a time-limited trial define for it to test benefit against the patient's goals?	The intervention, objective markers of benefit, the duration, and what happens if benefit is absent.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0006-en	Why should prognosis be described as scenarios rather than a date?	Prognosis is a range, so best, worst, and likely scenarios with broad time frames convey it, with uncertainty stated.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0007-en	What does conflict over treatment often reflect, and how should the team respond?	It often reflects differences in facts, values, grief, or trust; name shared goals, summarise disagreement, and seek second opinion or palliative, ethics, or mediation support.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0008-en	When is examination or investigation justified in holistic palliative symptom assessment?	Only when findings will change management; reversible contributors are considered, but burdensome tests that cannot improve outcomes are avoided.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0009-en	Why may preventive drugs be stopped in palliative care, and what must simplification avoid?	Their delayed benefit may no longer match prognosis; stopping must avoid withdrawal from corticosteroids, benzodiazepines, anticonvulsants, opioids, and other dependence-producing therapy.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0010-en	Why identify the type of pain rather than relying on opioids alone?	Specific pains may respond to targeted treatment such as corticosteroids, bisphosphonates, radiotherapy, or nerve blocks; opioids are central for severe pain but not the only treatment.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0011-en	Why are transdermal opioid systems unsuitable for rapidly escalating pain?	They adjust slowly, so dosing cannot keep pace with rapidly rising need.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0012-en	Why is the calculated dose reduced when converting from one opioid to another?	Conversion tables are only estimates and cross-tolerance is incomplete, so the dose is reduced and specialist advice sought.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0013-en	Why must tolerance and dependence be distinguished from addiction when treating terminal pain?	Confusing them feeds fear of addiction, and that fear should not leave terminal pain untreated.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0014-en	When does oxygen relieve breathlessness, and when does it add little?	It helps breathlessness with hypoxaemia, but often adds little for a patient who is not hypoxaemic.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0015-en	How does low-dose systemic opioid relieve refractory breathlessness?	It alters central perception and the ventilatory response, and is therefore titrated carefully.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0016-en	Why must the purpose and stopping plan of non-invasive ventilation be made explicit?	It can either relieve symptoms or prolong life, so which aim it serves and when it stops must be clear.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0017-en	Why does constipation matter beyond bowel discomfort, and when are rectal measures avoided?	It causes pain, nausea, overflow, retention, and delirium; rectal measures are avoided with neutropenia, thrombocytopenia, mucosal injury, or refusal.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0018-en	Why do antimuscarinic drugs have limited value for noisy respiratory secretions near death?	They may reduce new secretion but do not remove fluid already present, and they can cause dry mouth or delirium.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0019-en	What might terminal agitation signal, and how does that shape its treatment?	It may signal pain, bladder distension, fear, withdrawal, or spiritual distress, so causes are treated alongside proportionate sedation.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0020-en	What might a desire for hastened death express, and how should the clinician respond?	It may express uncontrolled symptoms, loss of autonomy, family burden, depression, spiritual suffering, or a stable request under local law; respond with curiosity and safety assessment.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0021-en	Why may a standard antidepressant fail a depressed patient with a short prognosis?	Antidepressant onset may take longer than the remaining prognosis, so specialists may consider faster options.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0022-en	Why does raising calorie intake not reverse cancer cachexia, and what may matter more?	Inflammatory cancer cachexia is not reversed by calories alone, so preferred foods and social eating may matter more than calorie targets.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0023-en	Why are withholding and withdrawing treatment ethically equivalent, and how does proportionate symptom medication differ from intending death?	Both decisions rest on benefit and goals; proportionate symptom medication treats symptoms and is distinct from intending death.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending
IMF-068-01-0024-en	How does bereavement follow-up find those needing help without medicalising normal sorrow?	It accepts yearning, anger, guilt, and relief as possibly normal while looking for suicide risk, severe impairment, persistent disabling grief, depression, trauma, and practical needs.	Integrated Medical Foundations; chapter 68, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 142e84d61d2b1bba054854eae934a7b21260f8cd9c391fdc519a2d81b45b827a; editorial review pending	imf lang::en chapter::068 module::068-01 review::pending