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10 questions Flashcards

1
Q

10 questions (one hot day)

A
  1. hot/cold
  2. sweat
  3. thirst
  4. urination
  5. bowels/digestion
  6. ribs/abdomen
  7. head/face ENT
  8. pain
  9. sleep
  10. gyn/sexual function
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2
Q

EXTERIOR

HOT/COLD

A

acute

rapid onset

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3
Q

INTERIOR

HOT/COLD

A

chronic

gradual onset

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4
Q

HOT

HOT/COLD

A

fever/chills

  • fever predominant: WIND HEAT
  • fever only: INTERIOR HEAT (can be EXCESS/VACUOUS)
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5
Q

INTERIOR HEAT EXCESS

HOT/COLD

A

INTERIOR HEAT - EXCESS:

  • big thirst (gulps)
  • forceful (P)
  • thick/darkred (T) with yellow coat
  • 4 BIGS
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6
Q

INTERIOR HEAT VACUITY

HOT/COLD

A

INTERIOR HEAT - VACUOUS:

  • big thirst (sips)
  • forceless (P)
  • thin/red (T) with no coat
  • NIGHTSWEATS
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7
Q

COLD

HOT/COLD

A

FEVER/CHILLS

  • chills predominant: WIND COLD
  • chills only: INTERIOR COLD (can be EXCESS/VACUOUS)
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8
Q

INTERIOR COLD EXCESS

HOT/COLD

A

INTERIOR COLD - EXCESS:

  • intense pain (worse with pressure)
  • forceful/slow (P: tight/wiry/deep/confined)
  • bluish/pale (T)
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9
Q

INTERIOR COLD VACUITY

HOT/COLD

A

INTERIOR COLD - VACUOUS:

  • cock’s crow diarrhea (yang vacuity)
  • undigested diarrhea/lethargy (SP T&T fail)
  • profuse sweating without exertion
  • forceless (P)
  • bluish/pale (T) wet/thick/swollen
  • bright white complexion
  • T&T FAILURE
  • most often overweight (obesity = yang vacuity)
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10
Q

THIRST progression

THIRST/APPETITE/TASTES

A

yin vac > heat > fire

* yin is always vacuous

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11
Q

BIG THIRST

THIRST/APPETITE/TASTES

A

drink in gulps

  • excess, interior heat
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12
Q

LITTLE THIRST

THIRST/APPETITE/TASTES

A

drink in sips

  • yin vacuity + vacuity heat
  • starting to dry, but not hot yet
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13
Q

THIRST, NO DESIRE

THIRST/APPETITE/TASTES

A

drink in sips (because it’s hot; no desire)

  • due to damp-heat (excess yin)
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14
Q

THIRST, WARM FLUIDS

THIRST/APPETITE/TASTES

A

cold (interior cold)
can be excess/vacuous

  • usually due to exterior cold invasion
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15
Q

SWEAT

A

ask about abnormal varieties:

  • sweating without exertion
  • sweating when it’s not hot outside
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16
Q

EXCESS SWEATING

SWEAT

A

excess heat
big sweat
running hot
excess yang

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17
Q

VACUOUS SWEATING - YIN

SWEAT

A

YIN VAC

  • night/tidal sweating
  • 5-centered heat
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18
Q

VACUOUS SWEATING - YANG

SWEAT

A

YANG VAC

- spontaneous/profuse sweating without exertion; worse during day

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19
Q

VACUOUS SWEATING - QI

SWEAT

A

ZHONG QI VAC

  • sweaty palms/feet (SP T&T fail)
  • damp to wet depending on SP’s vacuity

WEI QI VAC

  • leaking qi, moist
  • pores not closed
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20
Q

MIXED SWEATING

SWEAT

A

(EXCESS/VACUITY)

  • damp accumulation
  • superficially moist
  • usually excess pathology; rises from vacuity pathology
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21
Q

LACK OF SWEATING

SWEAT

A

abnormal variety
something’s blocking surface
excess cold = no sweat (block)
unsurfaced dampness

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22
Q

NORMAL BOWELS

BOWELS

A

1 to 3x daily

  • well-formed (not loose/hard; - no undigested food)
  • no blood/pus
  • not much odor
  • easily evacuated (no straining; sense of completion)
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23
Q

CONSTIPATION

BOWELS

A

less than 1x daily

  • dry bowels (due to EXCESS/VACUOUS HEAT)
  • common in yin deficient, elderly patients
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24
Q

TYPES OF CONSTIPATION

BOWELS

A
  • cold LI (excess heat; rare)
  • binding LI (damp-heat; not enough fiber)
  • LV qi stagnation (little pellets)
  • SP qi vacuity (pencil shape)
  • qi vacuity (cc is not constipation; 7-8 days; lack of energy to move bowel, although reasonable diet; just diminished peristalsis function)
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25
VACUITY | BOWELS
exhaustion after evacuation | - downward pressure qi doesn't hold up)
26
EXCESS | BOWELS
feeling better after evacuation | - damp-heat remnants; fudgy, pungent aroma
27
YANG VACUITY | BOWELS
pain (due to vacuity cold)
28
DIARRHEA | BOWELS
more than 3x daily | - loose, unformed
29
DIARRHEA - YANG VACUITY | BOWELS
"cock's crow" because early morning - wake up at dawn with urgent need to go - undigested food
30
DIARRHEA - QI VACUITY | BOWELS
SP QI VACUITY - loose, not well-formed stools - 1 to 3x daily - gasy/bloaty (T&T) - excessive volume
31
DIARRHEA - DAMP-HEAT | BOWELS
LI DAMP-HEAT - explosive, urgent need to go - foul odor (due to excess heat)
32
ALTERNATING CONSTIPATION + DIARRHEA | BOWELS
MIXED - LV qi stagnation (LV/wood overacting on SP/earth) - LV qi weak: constipation - SP qi weak: diarrhea * diarrhea x constipation
33
FOOD POISONING | BOWELS
TOXIN - rapid onset - pain/cramping - explosive - foul odor * ACUTE
34
URINE | URINE
light yellow (straw/hay color) - 7 to 10x daily - no night urination - odorless - no blood - no pain - no urgency - no cloudiness * exceptions: vitamins, asparagus, morning (darker)
35
POLYURIA | URINE
excess urination - KD qi vac: leaking - KD essence vac: leaking * too many kids cause uterine prolapse * laughing and coughing cause leakage
36
FREQUENT URINATION: KD YANG VACUITY | URINE
KD yang vacuity - clear - copious - frequent - large volumes - BACK PAIN - failure of T&T * yang fails the holding function; also may be due to damp
37
FREQUENT URINATION: KD YIN VACUITY | URINE
KD yin vacuity - darker - cold - frequent but SCANTY - night time - BACK PAIN * also could be SP yang vacuity (immediate need to urinate after drinking)
38
FREQUENT URINATION: HEAT | URINE
typical heat patterns - excess - frequent (heat is irritating) - strong odor - dark colors - usually scanty - possible bleeding from heat * may be burning (UTI) * may be heat in L.JIAO * may be HT heat (HT clears through SI, connects through UB)
39
URINARY INCONTINENCE | URINE
loss of control over urinary functions - more serious, problematic condition * KD essence and yang debility
40
ANURIA EXCESS | URINE
blockage of urine from - damp - damp-cold > damp-heat * lin syndrome: stones
41
ANURIA VACUITY | URINE
KD yang vacuity - pitting edema - absence of urination
42
BEDWETTING CHILDREN | URINE
delayed UB qi developmental issues; not pathological * when older and still unable to control, QI VACUITY
43
QUESTIONS | THIRST/APPETITE/TASTES
quantity - how much frequency - how often processing - how well
44
EXCESS ST HEAT | THIRST/APPETITE/TASTES
SUDDEN BIG HUNGER (spontaneous/ravenous) - eat frequently - bad breath - mouth sores - reflux/GERD, belching - gas (if present, odor) - constipation (heat drying) - diarrhea (heat causing things to move quickly without processing) * ST channel facial acne * big red face, bright red cheeks * (T): red body, thick yellow coat (especially center) * (P): rapid, maybe surging * usually underweight due to fast metabolism
45
DEFICIENT ST HEAT | THIRST/APPETITE/TASTES
CONSTANT HUNGER (grazers; hungry all the time, but nibble; can't take large amounts) - sweet tooth - small/quite burping - small sips with thirst * (T): red body, no coat; peeled center * (P): rapid, forceless, thin
46
LACK OF APPETITE | THIRST/APPETITE/TASTES
DAMP ACCUMULATION (excess over vacuity) - start with underlying SP xu, then internal damp with no T&T - NO DESIRE/APPETITE - can't process well and feel full - eat normal amount or less, but still gain weight - ROTUND BODIES - crave sweets (carbs, alcohol, candy) * (T): pale, swollen (fluid accumulation), wet, greasy * associated with SP deficiency
47
SP QI VACUITY W/O DAMP | THIRST/APPETITE/TASTES
NOT SO MUCH HUNGER - bloating - gas (no odor) - compromised T&T (not processing) - need nap after eating; energy goes into digestion * (T): thin, pale, white coat (on sides)
48
TASTES | THIRST/APPETITE/TASTES
``` LV - sour/bitter SP - sweet/bland LU - spicy/acrid KD - salty HT - bitter ```
49
HEENT
headache dizziness hearing vision
50
EXCESS HEADACHE: BLOOD STASIS | HEENT
STABBING; ICE PICK - can point to exact spot - often from injury, head trauma - debilitating headache * ASK ABOUT HEAD TRAUMA
51
EXCESS HEADACHE: DAMP | HEENT
TIGHT; VICE AROUND HEAD - internal damp gets aggravated with external damp - often associated with food (cold or damp food; good diet will eliminate) * ask about weather patterns
52
EXCESS HEADACHE: LV FIRE | HEENT
THROBBING/POUNDING - pure excess headache - clear heat signs (dry, red eyes; flushing) - angry all the time; quick to anger - bitter taste in mouth * PAIN OFTEN TEMPORAL (GB/LV) * PAIN SOMETIMES BEHIND EYES * emotional outburst
53
EXCESS HEADACHE: LV YANG RISING | HEENT
THROBBING/POUNDING - excess over vacuity (yin/blood) - less heat signs - less angry, but easily frustrated - emotional element - dry eyes
54
VACUITY HEADACHE | HEENT
dull/achy better with rest, better with pressure aggravated with exertion
55
VACUITY HEADACHE: QI | HEENT
WHOLE HEAD - worse earlier in the day (more yang than yin) * loose stools * SOB * other qi vacuity symptoms
56
VACUITY HEADACHE: BLOOD | HEENT
TOP OF HEAD - worse later in the evening and afternoon (yin time) * dizzy * poor memory * worse during menses
57
VACUITY HEADACHE: KD ESSENCE | HEENT
IN THE BRAIN - dull and achy brain - worse during sex; can occur after sex (using up essence) EEYORE S/SX - pale - spiritless - premature aging signs - craving salt - lack of energy * need to preserve energy (sleep, fix diet, exercise)
58
DIZZINESS: EXCESS | HEENT
LV fire LV yang rising phlegm: often associated w/ nausea
59
DIZZINESS: VACUITY | HEENT
KD essence/yin/yang - lack of nourishment to the brain BLOOD VACUITY - orthostatic
60
EAR RINGING: KD VACUITY | HEENT
dull, droning | incessant/constant
61
EAR RINGING: LV EXCESS | HEENT
high pitched quick onset; episodic * often emotional component
62
HEARING LOSS: SLOW | HEENT
KD | gradual hearing loss due to aging
63
HEARING LOSS: RAPID | HEENT
RAPID ONSET SJ enters ears congestion/blockage
64
VISION: LV BLOOD VACUITY | HEENT
BLURRY flowery/floaters night blindness
65
VISION: KD VACUITY | HEENT
DIMINISHED EYESIGHT * YIN VAC: dry version macular degeneration * YANG VAC: wet version macular degeneration
66
LOSS OF SMELL: EXCESS | HEENT
FAILURE OF NOURISHMENT DUE TO BLOCKAGE - phlegm - damp accumulation * sinusitis is due to damp-heat
67
LOSS OF SMELL: VACUITY | HEENT
FAILURE OF NOURISHMENT DUE TO INSUFFICIENCY LUNG QI VACUITY - weak pulse (right cun) - regular/recurrent cold (always sick) - possible SOB/asthma/bronchitis
68
GOOD SLEEP | SLEEP
- need 8 to 9 hours - not waking up through the - -- night (urination, nightsweat, restlessness) - 10pm to 6am is most optimal - no dreaming - waking refreshed
69
INSOMNIA | SLEEP
getting 8 hours sleep doesn't mean good sleep * all types will have FATIGUE due to sleep deprivation
70
EXCESS INSOMNIA: LV FIRE | SLEEP
VIVID NIGHTMARES, DISTURBED DREAMS - red eyes; angry - waking up during night mostly because of dreams * (T): red sides, or red all over depending on heat quality * (P): rapid, surging
71
EXCESS INSOMNIA: HT FIRE | SLEEP
VIVID DREAMS OF FLYING - mentally restless/agitated - palpitations; red face - waking up during night; can go back to sleep but not well-rested - bitter taste in mouth * (T): red tip, tongue sores * (P): rapid
72
EXCESS INSOMNIA: PHLEGM HEAT | SLEEP
NIGHTMARISH DREAMS - tossing and turning - fair amount of nausea - low appetite - chest oppression; heaviness; tightness * (T): swollen, red, greasy, yellow coat * (P): rapid, slippery *
73
VACUITY INSOMNIA: HT/SP VACUITY | SLEEP
DIFFICULTY FALLING ASLEEP - anxiety - worriers
74
VACUITY INSOMNIA: KD-HT DISHARMONY | SLEEP
TROUBLE STAYING ASLEEP; TOSS AND TURN - wake up for 20-30min then go back to sleep * KD YIN VACUITY: nightsweats * HT HEAT
75
VACUITY INSOMNIA: LV YIN + BLOOD VACUITY | SLEEP
WAKE UP FREQUENTLY - sleepwalk, sleeptalk - big dreamers * HUN cannot settle, so it wanders
76
VACUITY INSOMNIA: GB VACUITY | SLEEP
wake up at 3am and stay up for hours - light sleepers - easily startled; timid personalities
77
ACUTE SOMNOLENCE | SLEEP
EXTERIOR PATTERN; WEI QI | - fighting pathogens, leading to exhaustion
78
CHRONIC SOMNOLENCE: YANG VACUITY | SLEEP
CHRONIC YANG VACUITY - overweight - may sweat with no exertion - fall asleep pretty much anywhere - not enough yang to stay awake - some element of damp accumulation
79
CHRONIC SOMNOLENCE: DAMP | SLEEP
DAMP (with underlying QI VAC) - difficulty staying awake and alert - lethargy; beyond fatigue - T&T problem
80
BODY/TRUNK QUESTIONS
``` onset isolated event or episodic aggravating factors alleviating factors how it responds to pressure timing of onset: rapid/gradual location: fixed/migratory ```
81
EXCESS PAIN | BODY/TRUNK
RAPID ONSET WORSE WITH PRESSURE stabbing pain wake up at night
82
VACUITY PAIN | BODY/TRUNK
GRADUAL ONSET BETTER WITH PRESSURE, WORSE WITH EXHAUSTION dull, achy pain; need to use heating pads - may be KD vacuity
83
BI SYNDROME PAIN | BODY/TRUNK
EXCESS OVER VACUITY (QI/BLOOD/WEI); always BI is present with underlying vacuity - heat (joint will be hot) - cold - damp (any precipitation; snow/humidity) * with or without WIND * if combined with WIND, pain is migratory * climactic response
84
PAIN LOCATION | BODY/TRUNK
``` ribside: LV/GB LB/back: KD/UB frontside (umbilicus to pubic symphysis): UB/SI chest/thoracic: LU/HT middle: SP/ST shoulder: SI ```
85
GYN/SEXFX
NEED TO KNOW THE ONSET OF - menstrual cycle - fertility - cessation of menses
86
MENSES | GYN/SEXFX
HISTORICALLY 2 x 7 | - but now earlier (10, 11) due to environmental factors
87
NORMAL MENSES | GYN/SEXFX
1. 5-7 days 2. no flooding/spotting 3. healthy red color 4. normal viscosity (not 5. tacky/watery) 6. no significant pain 7. cycle 25-31 days 8. 2x7 9. 6x7 (peri-menopause) 10. 7x7 (menopause)
88
EARLY MENSES, <25 DAYS | GYN/SEXFX
SHORTENED CYCLE HEAT - reckless blood - excess/vacuity - darker red, tacky SP QI VACUITY - failure to hold blood in vessels - pale, watery (poor quality of blood)
89
DELAYED MENSES, >33 DAYS | GYN/SEXFX
LENGTHENED CYCLE COLD - dark, red - clotting due to lack of flow - excess: much more pain, worse with pressure, better with heat - vacuity: dull pain, better with pressure, well with heat BLOOD STASIS - purple color - clotting due to lack of flow; size of clot tells magnitude of stasis - stabbing pain BLOOD VACUITY - rusty quality - discharge-like; scanty QI VACUITY - pale; copious - insufficient energy to move, then CAN'T HOLD
90
IRREGULAR MENSES | GYN/SEXFX
LIVER ISSUE LV QI STAGNATION - emotional stress - dull pain LV QI STAG W/ BLOOD STASIS - even darker w/ deficient clotting - more pain; stabbing * over time, overactive LV affects SP qi SP QI VACUITY - semi-monthly bleeding
91
IRREGULAR MENSES PATTERNS | GYN/SEXFX
spotting: blood vacuity irregular/delayed: stagnation - need to open dai mai any blood vacuity: chong
92
AMENORRHEA | GYN/SEXFX
PRIMARY - taxation, lifestyle, athletes, fatigue SECONDARY - menarche @ 14, then no menses until 17 or 18 (nonpathological)
93
AMENORRHEA: VACUITY | GYN/SEXFX
yin, blood, jing
94
AMENORRHEA: STAGNATION | GYN/SEXFX
generally emotional component; can be combined with - qi, blood - cold, heat - phlegm excess qi vac > stag (cold/heat) > phlegm accumulation
95
BEFORE DYSMENORRHEA | GYN/SEXFX
QI/BLOOD STAGNATION pain goes away when there is movement/period - LV patient - classic PMS s/sx (breast tenderness, ribside pain, emotional, headache/migraine)
96
DURING DYSMENORRHEA | GYN/SEXFX
HOT/COLD PATHOLOGY (often combined with stagnation) - cold: debilitating pain - hot: uterine heat
97
AFTER DYSMENORRHEA | GYN/SEXFX
QI/BLOOD VACUITY - dull, achy pain - fatigue after period finished
98
LEUKORRHEA: COLD-DAMP | GYN/SEXFX
``` profuse discharge (clear/white) fishy odor ```
99
LEUKORRHEA: DAMP-HEAT | GYN/SEXFX
thick/creamy/sticky discharge (white/yellow) | strong foul odor
100
LEUKORRHEA: SP QI VACUITY | GYN/SEXFX
thick/creamy/sticky (white) | NO odor
101
PERI-MENOPAUSE | GYN/SEXFX
DYSREGULATION OF REN AND CHONG KD yin vacuity - irregularity in menstrual flow (flooding, missed, multiple, less predictable per month) - yin vacuity symptoms (hot flash, nightsweats - yang is not anchored so emotional s/sx
102
MENOPAUSE | GYN/SEXFX
SYSTEM IS REBALANCED; 12 CONSECUTIVE MONTHS OF NO PERIOD consists of AGING S/SX - dryness (vagina, eyes, skin) - knee/back pain * supported well with herbs

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