diff --git a/public/css/assistant.css b/public/css/assistant.css
index 7f630b8a..b699cc5b 100644
--- a/public/css/assistant.css
+++ b/public/css/assistant.css
@@ -121,8 +121,11 @@
 /* Sources: a full-page right column; the panel fills the height and scrolls */
 .assistant-side { display:flex; flex-direction:column; gap:12px; height:100%; min-height:0; }
 .assistant-side .card { flex:1 1 auto; display:flex; flex-direction:column; min-height:0; }
-.assistant-generated-image { display:grid; gap:8px; }
-.assistant-generated-image img { width:100%; border-radius:10px; border:1px solid var(--g200); background:white; }
+.assistant-generated-image { display:grid; gap:8px; justify-items:start; }
+/* Thumbnail in the transcript; Preview (or clicking it) opens full resolution. */
+.assistant-generated-image img { width:auto; max-width:min(100%,320px); max-height:240px; object-fit:contain; border-radius:10px; border:1px solid var(--g200); background:white; cursor:zoom-in; }
+.assistant-generated-image img:focus-visible { outline:2px solid var(--blue); outline-offset:2px; }
+@media (max-width:960px) { .assistant-generated-image img { max-width:100%; max-height:200px; } }
 .assistant-image-actions { display:flex; gap:8px; flex-wrap:wrap; }
 .assistant-image-preview-open { overflow:hidden; }
 .assistant-image-modal { position:fixed; inset:0; z-index:9999; background:rgba(15,23,42,.82); display:flex; align-items:center; justify-content:center; padding:24px; }
diff --git a/public/js/assistant/citations.js b/public/js/assistant/citations.js
index c33db861..1d873979 100644
--- a/public/js/assistant/citations.js
+++ b/public/js/assistant/citations.js
@@ -82,7 +82,7 @@ export function renderAssistantMarkdown(md, sources, options) {
   return typeof opts.sanitize === 'function' ? opts.sanitize(html) : html;
 }
 
-function wrapTables(html) {
+export function wrapTables(html) {
   return String(html || '')
     .replace(/<table(\s[^>]*)?>/g, '<div class="assistant-table-scroll" tabindex="0" role="region" aria-label="Scrollable table"><table$1>')
     .replace(/<\/table>/g, '</table></div>');
diff --git a/public/js/assistant/images.js b/public/js/assistant/images.js
index 171675e3..36e25987 100644
--- a/public/js/assistant/images.js
+++ b/public/js/assistant/images.js
@@ -10,7 +10,10 @@ export function createAssistantImageStore() {
   function renderGeneratedImage(src, alt, downloadUrl) {
     var id = 'img-' + (++generatedImageSeq);
     generatedImages[id] = { src: src, downloadUrl: downloadUrl || (assetPath(src) ? src + '?download=1' : '') };
-    return '<div class="assistant-generated-image"><img src="' + escapeAttr(src) + '" alt="' + escapeAttr(alt || 'Generated image') + '">' +
+    // The in-chat image is a thumbnail; full resolution is one click away, so a
+    // long answer is not pushed off the screen by the picture that illustrates it.
+    return '<div class="assistant-generated-image"><img src="' + escapeAttr(src) + '" alt="' + escapeAttr(alt || 'Generated image') +
+      '" data-assistant-open-image="' + escapeAttr(id) + '" title="Click to view full resolution" tabindex="0" role="button">' +
       '<div class="assistant-image-actions">' +
       '<button type="button" class="btn-sm btn-ghost" data-assistant-open-image="' + escapeAttr(id) + '"><i class="fas fa-expand"></i> Preview</button>' +
       '<button type="button" class="btn-sm btn-ghost" data-assistant-download-image="' + escapeAttr(id) + '"><i class="fas fa-download"></i> Download</button>' +
diff --git a/public/js/clinicalAssistant.js b/public/js/clinicalAssistant.js
index 846c131d..3bf0cca1 100644
--- a/public/js/clinicalAssistant.js
+++ b/public/js/clinicalAssistant.js
@@ -4,7 +4,7 @@
 // server can call native MCP directly without routing through mcpo.
 // ============================================================
 import { EMPTY_PROMPT_SETS } from './assistant/data.js';
-import { escapeAttr, escapeHtml, renderAssistantMarkdown, renderCitationLinks, safeImageUrl } from './assistant/citations.js';
+import { escapeAttr, escapeHtml, renderAssistantMarkdown, renderCitationLinks, safeImageUrl, wrapTables } from './assistant/citations.js';
 import { renderSourcesList } from './assistant/sources.js';
 import { createAssistantExporter } from './assistant/export.js';
 import { createAssistantImageStore } from './assistant/images.js';
@@ -1506,13 +1506,24 @@ import {
 
   // ── Patient take home: plain-language summary + copy/export/email ────
   var takehomeBusy = false;
-  var takehomeText = '';          // canonical original, never overwritten
-  var takehomeTranslated = '';    // current translation, '' when showing the original
+  var takehomeText = '';            // canonical original markdown, never overwritten
+  var takehomeTranslatedHtml = '';  // translated HTML, '' when showing the original
   var takehomeLang = '';
 
-  // Copy / Export / Email must hand over what the parent is actually reading.
+  // The take home is translated as HTML for the same reason chat messages are:
+  // LibreTranslate's text mode destroys tables and emphasis markers.
+  function takehomeVisibleHtml() {
+    return takehomeTranslatedHtml
+      ? wrapTables(sanitize(takehomeTranslatedHtml))
+      : renderMarkdown(takehomeText, [], {});
+  }
+
+  // Copy / Export / Email must hand over what the caregiver is actually reading.
   function takehomeVisibleText() {
-    return takehomeTranslated || takehomeText;
+    if (!takehomeTranslatedHtml) return takehomeText;
+    var holder = document.createElement('div');
+    holder.innerHTML = sanitize(takehomeTranslatedHtml);
+    return String(holder.textContent || '').replace(/\n{3,}/g, '\n\n').trim();
   }
 
   function openPatientTakehome() {
@@ -1524,7 +1535,7 @@ import {
     closePatientTakehomeModal();
     takehomeBusy = true;
     takehomeText = '';
-    takehomeTranslated = '';
+    takehomeTranslatedHtml = '';
     takehomeLang = '';
     var modal = document.createElement('div');
     modal.className = 'assistant-takehome-modal';
@@ -1560,7 +1571,7 @@ import {
       if (result) {
         // Same universal markdown renderer as chat bubbles; raw text stays
         // canonical for Copy/Export/email.
-        result.innerHTML = renderMarkdown(takehomeText, [], {});
+        result.innerHTML = takehomeVisibleHtml();
         result.classList.remove('hidden');
       }
       if (actions) actions.classList.remove('hidden');
@@ -1584,7 +1595,7 @@ import {
 
   function renderTakehomeBody() {
     var result = document.querySelector('#assistant-takehome-modal .assistant-takehome-result');
-    if (result) result.innerHTML = renderMarkdown(takehomeVisibleText(), [], {});
+    if (result) result.innerHTML = takehomeVisibleHtml();
   }
 
   function translateTakehome(target) {
@@ -1592,16 +1603,16 @@ import {
     if (!takehomeText) return;
     if (!target) { // back to the original
       takehomeLang = '';
-      takehomeTranslated = '';
+      takehomeTranslatedHtml = '';
       renderTakehomeBody();
       return;
     }
     if (select) select.disabled = true;
-    translateAssistantMessage(takehomeText, target, translateProvider, 'text')
+    translateAssistantMessage(simplifyHtmlForTranslation(renderMarkdown(takehomeText, [], {})), target, translateProvider, 'html')
       .then(function(data) {
         if (!data.success) throw new Error(data.error || 'Translation failed');
         takehomeLang = target;
-        takehomeTranslated = String(data.translated || '');
+        takehomeTranslatedHtml = String(data.translated || '');
         renderTakehomeBody();
       })
       .catch(function(err) {
@@ -1621,7 +1632,7 @@ import {
       return;
     }
     assertSharingOwner(owner);
-    var html = renderMarkdown(takehomeVisibleText(), [], {});
+    var html = takehomeVisibleHtml();
     doc.document.write('<!DOCTYPE html><html><head><meta charset="utf-8"><title>Patient Take Home</title>' +
       '<style>body{font-family:Arial,sans-serif;color:#111827;line-height:1.6;margin:32px;max-width:720px}' +
       'h1{color:#0f766e;font-size:24px;margin:0 0 4px;border-bottom:2px solid #0f766e;padding-bottom:8px}' +
@@ -1635,7 +1646,7 @@ import {
   function closePatientTakehomeModal() {
     var modal = document.getElementById('assistant-takehome-modal');
     if (modal) modal.remove();
-    takehomeTranslated = '';
+    takehomeTranslatedHtml = '';
     takehomeLang = '';
   }
 
@@ -1709,9 +1720,26 @@ import {
     cards.forEach(function(card) { bubble.appendChild(card); });
   }
 
+  // LibreTranslate mangles markdown syntax in text mode: table pipes come back as
+  // "←", the |---| delimiter row is translated as prose, and "**bold**" returns as
+  // "** bold**", which no longer renders. Its html mode leaves tags — and bare
+  // [n] markers — completely intact, so rendered HTML is what gets translated.
+  function simplifyHtmlForTranslation(html) {
+    if (typeof DOMParser === 'undefined') return String(html || '');
+    var doc = new DOMParser().parseFromString(String(html || ''), 'text/html');
+    // Rendered maths and UI chrome are not prose; flatten them to their text so
+    // the translator cannot rearrange markup it does not own.
+    doc.body.querySelectorAll('.katex, mjx-container, .assistant-code-copy, .assistant-table-actions, .assistant-msg-actions, .assistant-image-card, script, style')
+      .forEach(function(el) { el.replaceWith(doc.createTextNode(el.textContent || '')); });
+    doc.body.querySelectorAll('.assistant-table-scroll').forEach(function(el) {
+      var table = el.querySelector('table');
+      if (table) el.replaceWith(table); // re-wrapped after translation
+    });
+    return doc.body.innerHTML;
+  }
+
   // Citation markers must survive the round trip so the translated answer keeps
-  // its clickable [n] chips. Markdown itself is sent unchanged: the old scrub
-  // deleted ordered-list numbers, flattened tables and ate underscores.
+  // its clickable [n] chips.
   function citationNumbersIn(text) {
     var found = [];
     String(text || '').replace(/\[((?:\d+\s*,\s*)*\d+)\]/g, function(match, cluster) {
@@ -1736,35 +1764,48 @@ import {
     if (!bubble.assistantOriginalHtml) bubble.assistantOriginalHtml = bubble.innerHTML;
     var sources = Array.isArray(bubble.assistantSources) ? bubble.assistantSources : [];
     var expected = citationNumbersIn(raw);
-    translateAssistantMessage(raw, target, provider, 'text')
+
+    function showTranslation(translated) {
+      // Sanitize what the service returned, THEN turn the surviving [n] markers
+      // into the usual chips bound to this message's sources, then restore the
+      // scroll wrapper the simplification removed.
+      var html = wrapTables(renderCitationLinks(sanitize(String(translated || '')), sources, {}));
+      var lost = expected.filter(function(n) { return citationNumbersIn(translated).indexOf(n) === -1; });
+      if (lost.length) {
+        // Keep dropped evidence reachable rather than letting it disappear.
+        html += '<div class="assistant-translated-sources"><strong>' +
+          escapeHtml('Sources not carried into the translation') + '</strong>' +
+          renderCitationLinks(lost.map(function(n) { return '[' + n + ']'; }).join(' '), sources, {}) +
+          '</div>';
+      }
+      bubble.innerHTML = html +
+        '<button type="button" class="btn-sm btn-ghost" data-assistant-msg-show-original><i class="fas fa-undo"></i> Show original</button>';
+      reattachImageCards(bubble, imageCards); // same nodes — status polling continues
+      renderEmbeddedBlocks(bubble);
+    }
+
+    // [n] markers are left unlinked here (empty sources) so they cross as plain
+    // text and can be re-linked after translation.
+    var sourceHtml = simplifyHtmlForTranslation(renderMarkdown(raw, [], {}));
+    translateAssistantMessage(sourceHtml, target, provider, 'html')
       .then(function(data) {
         if (!data.success) throw new Error(data.error || 'Translation failed');
-        var translated = String(data.translated || '');
-        // Same renderer as the original bubble: headings, lists and tables come
-        // back, and [n] markers become the usual clickable .assistant-cite chips
-        // bound to this message's sources.
-        var kept = citationNumbersIn(translated);
-        var lost = expected.filter(function(n) { return kept.indexOf(n) === -1; });
-        var html = renderMarkdown(translated, sources, {});
-        if (lost.length) {
-          // The translator dropped markers; keep the evidence reachable rather
-          // than letting the citations disappear with the formatting.
-          html += '<div class="assistant-translated-sources"><strong>' +
-            escapeHtml('Sources not carried into the translation') + '</strong>' +
-            renderCitationLinks(lost.map(function(n) { return '[' + n + ']'; }).join(' '), sources, {}) +
-            '</div>';
-        }
-        bubble.innerHTML = html +
-          '<button type="button" class="btn-sm btn-ghost" data-assistant-msg-show-original><i class="fas fa-undo"></i> Show original</button>';
-        reattachImageCards(bubble, imageCards); // same nodes — status polling continues
-        renderEmbeddedBlocks(bubble);
+        showTranslation(data.translated);
       })
-      .catch(function(err) {
-        // Put the message back exactly as it was, images included.
-        bubble.innerHTML = bubble.assistantOriginalHtml;
-        reattachImageCards(bubble, imageCards);
-        renderEmbeddedBlocks(bubble);
-        if (typeof showToast === 'function') showToast(err && err.message ? err.message : 'Translation failed', 'error');
+      .catch(function() {
+        // Some LibreTranslate builds reject html mode. Plain text loses tables
+        // and emphasis, but an unformatted translation beats none.
+        return translateAssistantMessage(raw, target, provider, 'text')
+          .then(function(data) {
+            if (!data.success) throw new Error(data.error || 'Translation failed');
+            showTranslation(renderMarkdown(String(data.translated || ''), [], {}));
+          })
+          .catch(function(err) {
+            bubble.innerHTML = bubble.assistantOriginalHtml;
+            reattachImageCards(bubble, imageCards);
+            renderEmbeddedBlocks(bubble);
+            if (typeof showToast === 'function') showToast(err && err.message ? err.message : 'Translation failed', 'error');
+          });
       });
   }
 
diff --git a/src/routes/clinicalAssistant.js b/src/routes/clinicalAssistant.js
index 7f1d1f06..5965c33d 100644
--- a/src/routes/clinicalAssistant.js
+++ b/src/routes/clinicalAssistant.js
@@ -315,7 +315,7 @@ router.post('/clinical-assistant/chat', async function(req, res) {
     var ai = await callAI(prepared.messages, assistantGenerationOptions({
       model: prepared.chatModel || undefined,
       temperature: 0.15,
-      tools: imageTool.tools,
+      tools: prepared.withholdImageTool ? undefined : imageTool.tools,
       maxTokens: 2600,
       images: prepared.images
     }));
@@ -382,7 +382,7 @@ router.post('/clinical-assistant/chat/stream', async function(req, res) {
     var ai = await callAIStream(prepared.messages, assistantGenerationOptions({
       model: prepared.chatModel || undefined,
       temperature: 0.15,
-      tools: imageTool.tools,
+      tools: prepared.withholdImageTool ? undefined : imageTool.tools,
       maxTokens: 2600,
       images: prepared.images
     }), function(delta) {
@@ -436,6 +436,41 @@ function isExplicitImageRequest(message) {
   return IMAGE_REQUEST_PATTERN.test(String(message || ''));
 }
 
+// Any noun that means "a picture", in the languages the assistant is used in.
+// Latin roots cover most; the Cyrillic/CJK/Arabic forms are listed because the
+// assistant is translated into them.
+const IMAGE_NOUN_PATTERN = /\b(image|imagen|imagem|immagine|bild|picture|photo|foto|visual|illustration|ilustraci|illustrazione|diagram|diagrama|diagramm|figure|figura|figur|flowchart|infographic|infograf|chart|graphic|poster|schema|schéma)/i;
+const IMAGE_NOUN_NON_LATIN = /(изображени|картинк|рисунок|схем|диаграмм|иллюстра|图|图像|画像|イラスト|صورة|رسم)/i;
+// Words that mean "do that again" — a real, if terse, request for another image.
+// \b is ASCII-only, so the non-Latin forms are matched without word boundaries.
+const IMAGE_REPEAT_PATTERN = /\b(again|another|one more|redo|repeat|regenerate|otra|otro|encore|nochmal|wieder)\b/i;
+const IMAGE_REPEAT_NON_LATIN = /(ещё|еще|снова|заново|もう一度|再来|مرة أخرى)/i;
+
+function mentionsImage(message) {
+  var text = String(message || '');
+  return IMAGE_NOUN_PATTERN.test(text) || IMAGE_NOUN_NON_LATIN.test(text) ||
+    IMAGE_REPEAT_PATTERN.test(text) || IMAGE_REPEAT_NON_LATIN.test(text);
+}
+
+// "Окей" / "Nice" / "👍" after an image turn is an acknowledgement, not a request
+// for a second image. Recognising acknowledgements in every language is not
+// possible, so the rule is inverted and language-independent: a SHORT follow-up
+// that says nothing about a picture never gets the image tool. The worst case is
+// that a terse question is answered in text, which is what it asked for anyway.
+function withholdImageTool(message, history) {
+  var text = String(message || '').trim();
+  if (!text || mentionsImage(text)) return false;
+  var words = text.split(/\s+/).filter(Boolean);
+  if (words.length > 3 || text.length > 32) return false;
+  var turns = Array.isArray(history) ? history : [];
+  for (var i = turns.length - 1; i >= 0; i--) {
+    if (turns[i] && turns[i].role === 'assistant') {
+      return isExplicitImageRequest(String(turns[i].content || ''));
+    }
+  }
+  return false;
+}
+
 async function dispatchImageRequestFallback(ai, prepared, req) {
   if (!ai || ai.imageToolHandled || (ai.toolCalls && ai.toolCalls.length)) return ai;
   if (!isExplicitImageRequest(prepared.message)) return ai;
@@ -581,6 +616,7 @@ async function prepareAssistantChat(body) {
     message: message,
     images: images,
     imageContext: generatedImages.imageContext(message, history),
+    withholdImageTool: withholdImageTool(message, history),
     chatModel: chatModel,
     imageModel: imageModel,
     sources: sources,
diff --git a/test/assistant-image-intent.test.js b/test/assistant-image-intent.test.js
index e61bae4e..f39a6df6 100644
--- a/test/assistant-image-intent.test.js
+++ b/test/assistant-image-intent.test.js
@@ -18,3 +18,69 @@ test('assistant image intent still handles explicit visual requests', async () =
   assert.equal(isImageRequest('show me the diagram'), true);
   assert.equal(isImageRequest('create an infographic for asthma'), true);
 });
+
+// A run of image turns used to make every acknowledgement produce another image:
+// the model saw its own "I'll generate an educational image…" in the history and
+// repeated it for "Окей" and "Nice". The tool is withheld for short follow-ups
+// that say nothing about a picture, which does not depend on recognising an
+// acknowledgement in any particular language.
+function imageToolGuard() {
+  const fs = require('node:fs');
+  const src = fs.readFileSync(path.join(__dirname, '..', 'src/routes/clinicalAssistant.js'), 'utf8');
+  const start = src.indexOf('const IMAGE_REQUEST_PATTERN');
+  const end = src.indexOf('async function dispatchImageRequestFallback');
+  assert.ok(start > 0 && end > start, 'image guard block located');
+  return new Function(src.slice(start, end) + '; return { withholdImageTool, mentionsImage };')();
+}
+
+const afterImage = [
+  { role: 'user', content: 'Can you illustrate with an image' },
+  { role: 'assistant', content: "I'll generate an educational image illustrating the imaging findings of periventricular leukomalacia." }
+];
+const afterText = [
+  { role: 'user', content: 'periventricular leukomalacia' },
+  { role: 'assistant', content: 'PVL is a disorder of the periventricular white matter.' }
+];
+
+test('acknowledgements after an image turn do not get the image tool, in any language', () => {
+  const { withholdImageTool } = imageToolGuard();
+  for (const ack of ['ok', 'okay', 'Nice', 'Perfect', 'thanks!', 'Окей', 'bien', 'ç', '👍', 'got it']) {
+    assert.equal(withholdImageTool(ack, afterImage), true, JSON.stringify(ack) + ' must not trigger another image');
+  }
+});
+
+test('real image follow-ups keep the tool, including terse repeat requests', () => {
+  const { withholdImageTool } = imageToolGuard();
+  for (const ask of ['again', 'another one', 'ещё', 'redo', 'make it bigger with labels',
+    'now show the MRI diagram', 'can you add a figure for the cystic phase']) {
+    assert.equal(withholdImageTool(ask, afterImage), false, JSON.stringify(ask) + ' is a real image request');
+  }
+});
+
+test('the guard only applies after an image turn and never blocks a first request', () => {
+  const { withholdImageTool } = imageToolGuard();
+  assert.equal(withholdImageTool('Nice', afterText), false, 'no preceding image turn, nothing to repeat');
+  assert.equal(withholdImageTool('Окей', []), false, 'an empty conversation cannot be repeating an image');
+  assert.equal(withholdImageTool('draw me a diagram of the airway', afterText), false);
+  assert.equal(withholdImageTool('Explain the pathophysiology of PVL in preterm infants', afterImage), false,
+    'a substantive question is not a short acknowledgement');
+});
+
+test('the in-chat image is a clickable thumbnail, not a full-width picture', async () => {
+  const fs = require('node:fs');
+  const root = path.join(__dirname, '..');
+  const { createAssistantImageStore } = await import(pathToFileURL(path.join(root, 'public/js/assistant/images.js')).href);
+  const store = createAssistantImageStore({});
+  const html = store.renderGeneratedImage('/api/generated-images/synthetic.png', 'Generated teaching visual');
+  assert.match(html, /<img[^>]*data-assistant-open-image="img-\d+"/, 'the image itself opens the full-resolution preview');
+  assert.match(html, /<img[^>]*role="button"[^>]*>/, 'and announces itself as activatable');
+  assert.match(html, /data-assistant-open-image="img-\d+"><i class="fas fa-expand"><\/i> Preview/, 'the Preview button still works');
+
+  const css = fs.readFileSync(path.join(root, 'public/css/assistant.css'), 'utf8');
+  const rule = css.split('\n').find(line => line.startsWith('.assistant-generated-image img {'));
+  assert.ok(rule, 'the generated-image rule exists');
+  assert.doesNotMatch(rule, /width:100%/, 'no longer stretched to the bubble width');
+  assert.match(rule, /max-width:min\(100%,320px\)/, 'capped to a thumbnail');
+  assert.match(rule, /max-height:240px/);
+  assert.match(rule, /cursor:zoom-in/, 'the thumbnail invites the click');
+});
diff --git a/test/assistant-translate.test.js b/test/assistant-translate.test.js
index bc271ef6..814741c1 100644
--- a/test/assistant-translate.test.js
+++ b/test/assistant-translate.test.js
@@ -181,8 +181,8 @@ test('per-message translate picker offers a provider choice and leaves the raw t
   const sent = JSON.parse(translateCalls[0].options.body);
   assert.equal(sent.target, 'es');
   assert.equal(sent.provider, 'libretranslate');
-  assert.equal(sent.format, 'text');
-  assert.equal(sent.message, 'Chest pain in a four year old.');
+  assert.equal(sent.format, 'html', 'html mode is what preserves tables and emphasis');
+  assert.equal(sent.message, '<p>Chest pain in a four year old.</p>\n');
   const bubble = row.querySelector('.assistant-bubble');
   assert.match(bubble.textContent, /Traducción de "Chest pain in a four year old/);
   assert.equal(c.messages[0].content, 'Chest pain in a four year old.', 'canonical transcript unchanged');
@@ -231,9 +231,14 @@ test('a translated answer keeps its citation chips, headings, lists and tables',
   await new Promise(r => setImmediate(r));
 
   const sent = JSON.parse(app.calls.filter(x => x.url === '/api/clinical-assistant/translate')[0].options.body);
-  assert.equal(sent.message, raw, 'raw markdown goes to the translator — no lossy pre-scrub');
-  assert.match(sent.message, /^1\. Give amoxicillin/m, 'ordered-list numbering survives to the wire');
-  assert.match(sent.message, /\| Amoxicillin \| 90 mg\/kg\/day \|/, 'table pipes survive to the wire');
+  // Rendered HTML, not markdown: LibreTranslate's text mode turns table pipes
+  // into "←" and "**bold**" into "** bold**"; html mode leaves tags intact.
+  assert.equal(sent.format, 'html');
+  assert.match(sent.message, /<table>/, 'the table crosses the wire as a real table');
+  assert.match(sent.message, /<ol>/, 'ordered steps cross as an ordered list');
+  assert.match(sent.message, /<strong>90 mg\/kg\/day<\/strong>/, 'emphasis crosses as a tag');
+  assert.match(sent.message, /\[1\]/, 'citation markers cross as bare text so they can be re-linked');
+  assert.doesNotMatch(sent.message, /assistant-cite/, 'they are NOT pre-linked, which the translator would mangle');
 
   const bubble = row.querySelector('.assistant-bubble');
   const chips = bubble.querySelectorAll('.assistant-cite');
diff --git a/test/patient-takehome.test.js b/test/patient-takehome.test.js
index 2c12d162..74512a74 100644
--- a/test/patient-takehome.test.js
+++ b/test/patient-takehome.test.js
@@ -205,7 +205,7 @@ function client(t, options = {}) {
     fetchSavedAssistantChats: async () => ({ success: true, chats: [] }),
     saveAssistantChat: async () => ({ success: true }),
     fetchAssistantStatus: async () => ({ success: true, translateProvider: 'libretranslate' }),
-    translateAssistantMessage: (message, target, provider) => apiFetch('/api/clinical-assistant/translate', { method: 'POST', headers: {}, body: JSON.stringify({ message, target, provider }), failTranslate: options.failTranslate }).then(r => r.json()),
+    translateAssistantMessage: (message, target, provider, format) => apiFetch('/api/clinical-assistant/translate', { method: 'POST', headers: {}, body: JSON.stringify({ message, target, provider, format: format || 'text' }), failTranslate: options.failTranslate }).then(r => r.json()),
     getAuthHeaders: () => ({ 'X-Synthetic': '1' }),
     fetchSavedAssistantChat: async id => ({ success: true, chat: { id, payload: { version: 2, messages: [{ role: 'user', content: 'Old question' }] } } }),
     openAssistantStream: async (payload) => {
@@ -359,7 +359,8 @@ test('translating the take home rerenders it and carries into Copy, Export and E
 
   const sent = JSON.parse(app.calls.find(c => c.url === '/api/clinical-assistant/translate').options.body);
   assert.equal(sent.target, 'es');
-  assert.match(sent.message, /Rest\*\* and drink fluids/, 'the generated take-home text is what gets translated');
+  assert.equal(sent.format, 'html', 'html mode keeps emphasis and tables intact');
+  assert.match(sent.message, /<strong>Rest<\/strong>/, 'the generated take-home is what gets translated');
   const result = modal.querySelector('.assistant-takehome-result');
   assert.match(result.textContent, /\[es\]/, 'the modal shows the translation');
   assert.ok(result.querySelector('strong'), 'still rendered as markdown, not escaped text');