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IMF-087-03-0001-en	Why does deficiency of a vitamin-derived cofactor impair several pathways at once?	The cofactor serves multiple enzymes sharing the same chemical task, so deficiency affects them all rather than one isolated pathway.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0002-en	Why does thiamine deficiency particularly harm brain and heart and cause lactic acidosis?	Thiamine pyrophosphate is needed by pyruvate dehydrogenase and other oxidative enzymes; these organs depend on continuous oxidative metabolism, and impaired pyruvate use causes lactic acidosis.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0003-en	How do the roles of NAD and NADP differ?	NAD generally carries electrons from catabolic reactions toward energy production, whereas NADP provides reducing power for biosynthesis and antioxidant defence.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0004-en	Why should biotin supplementation be considered when an immunoassay result seems implausible?	Supplemental biotin can interfere with assays using biotin–streptavidin technology, producing falsely high or low results with potentially serious consequences.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0005-en	Why can folate improve anaemia in vitamin B twelve deficiency yet leave the patient at risk?	B twelve deficiency traps folate in a form unavailable for nucleotide synthesis, causing megaloblastic change; folate can improve the anaemia but not B twelve-related nervous-system damage.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0006-en	Why are transport, storage, insertion and excretion of transition metals tightly controlled?	Free transition metals are potentially toxic because they drive inappropriate redox chemistry.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0007-en	Why can a pathway measured in vitro appear normal while the pathway fails in vivo?	The in-vitro measurement uses saturating substrate, whereas in vivo flux may be limited by defective transport or physiological substrate supply.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0008-en	What does reciprocal regulation of opposing pathways achieve?	It prevents opposing pathways from running strongly together, which would waste energy.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0009-en	Why can you not infer a protein's activity simply from knowing it is phosphorylated?	A modification has no universal meaning: phosphorylation can activate one protein and inhibit another.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0010-en	Why is the slowest isolated reaction not necessarily the rate-limiting step of a living pathway?	Control is distributed across the network, as control coefficients quantify, and it can shift with feeding, exercise, disease, or drug treatment.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0011-en	How can an immunoassay be precise yet systematically wrong, and how is this resolved?	Cross-reacting molecules, heterophile antibodies, autoantibodies, high-dose hook effects, or biotin can distort results; dilution, another platform, or mass spectrometry can confirm.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0012-en	How can pre-analytical handling alter potassium and glucose results?	Haemolysis releases intracellular potassium into the sample, and ongoing cellular metabolism consumes glucose unless samples are handled promptly.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0013-en	Why is a result outside the reference interval not in itself a reason to treat?	Intervals contain a central proportion of a reference population, so healthy people fall outside by chance, more so with many tests; decision limits relate to outcomes.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending
IMF-087-03-0014-en	What does a normal baseline with an abnormal response on a dynamic test suggest?	Dynamic tests probe regulation rather than static concentration, so this pattern suggests failure of reserve or of feedback.	Integrated Medical Foundations; chapter 87, TTS module 3; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 35b2e75c47aeb46e7e96f1b26e26e3e368717ba777da5d46f0711afab2198e9d; editorial review pending	imf lang::en chapter::087 module::087-03 review::pending