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CCM Clinic entrance exam > Chief Complaint Based Pathology > Flashcards

Chief Complaint Based Pathology Flashcards

1
Q

Common Cold: Wind Cold

Sx
Tx
Pts

A

Sxs: chills, fever, headache, absence of sweating, nasal obstruction, hoarse voice, runny nose, itchy throat, cough, profuse thin sputum, soreness & pain of the limbs. Thin white tongue coat. Pulse floating and tight.

Tx: Disperse wind and cold, relieve the exterior

Points: LU-7, UB-12, GB-20, LI-4, UB-13

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2
Q

Common Cold: Wind Heat
Sx
Tx
Pts

A

Sxs: fever, sweating, headache, dry mouth, sore throat, slight aversion to wind/cold, cough with yellow, thick sputum, nasal obstruction with thick discharge, thirst, weakness of limbs. Thin yellow tongue coat. Floating & rapid pulse.

Tx: Disperse wind, clear, heat, promote lung descending function

Points: DU-14, LI-11, LI-4, LU-10 (ying spring-clear heat), SJ-5, LU-5 (he sea, clear heat)

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3
Q

Common Cold: Summer Damp Heat
Sx
Tx
Pts

A

Sxs: recessive fever, heaviness in the head, sensation of fullness & stuffiness in the chest & epigastrium, aching and weariness of the extremities, scanty, dark urine, thirst, Yellow greasy tongue coat. Pulse is soft and rapid.

Tx: Clear heat, resolve dampness, release the exterior

Points: LI-4, UB-13, UB-12, REN-12, ST-36, SJ-6

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4
Q

Common Cold: Qi Deficiency
Sx
Tx
Pts

A

Sxs: aversion to cold, fever, shortness of breath, unwillingness to speak, headache, fatigue, nasal obstruction, cough with white sputum, spontaneous perspiration, poor appetite.

Tx: Nourish Qi, Relieve the Exterior

Points: GB-20, UB-12, UB-13, ST-36, REN-6, REN-4

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5
Q

Cough: Wind Cold
Sx
Tx
Pts

A

Sxs: harsh cough with dilute whitish sputum, aversion to cold, fever w/o sweating, nasal obstruction w/ clear nasal discharge, itchy throat. Thin white tongue coat. Tight, floating pulse.

Tx: clear wind cold, descend lung qi

Points: UB-13, LU-7, LI-4, SJ-5, UB-12

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6
Q

Cough: Wind Heat
Sx
Tx
Pts

A

Sxs: frequent cough with coarse breathing, sticky yellow sputum with difficult expectoration, dry mouth, thirst, sore throat, itchy throat, feverish sensation with aversion to wind. Thin yellow tongue coat, floating rapid pulse.

Tx: clear wind & heat, descend lung qi

Points: UB-13, LU-7, LI-4, LU-5, DU-14

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7
Q

Cough: Phlegm Dampness
Sx
Tx
Pts

A

Sxs: cough with profuse sputum, fullness sensation in the chest & epigastrium, general lassitude, poor appetite, loose stool. white greasy tongue coat, soft pulse.

Tx: resolve phlegm dampness, descend lung qi

Points: UB-13, LU-7, LI-4, UB-20, SP-3, ST-40

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8
Q

Cough: Liver Fire
Sx
Tx
Pts

A

Sxs: paroxysmal cough, soft pain in the chest & hypochondrium due to cough, bitter taste in the mouth, scanty, sticky sputum, cough in case of qi ascending adversely. Thin yellow tongue coat with less moisture. Wiry, rapid pulse.

Tx: Quench liver fire, descend lung qi

Points: UB-13, LU-7, LI-4, UB-18, LR-3

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9
Q

Asthma: Attack of Wind Cold in the Lung

(excess)

Sx
Tx
Pts

A

Sxs: relatively acute onset, wheezing (since of excess origin, it will be loud), congested chest, dyspnea, cough with thin sputum, aversion to cold, slight fever; tongue with moist, thin, white coat; pulse floating and tight

Tx: Promote dispersing function of the lung and dispel wind and cold

Points: LU-7 (relieve exterior), UB-12 (wind gate), UB-13 (LU shu), Dingchuan (extra pt for asthma sxs-0.5 cun lateral to DU-14 B/L), REN-17 (open chest & regulate qi).

If patient is still having chills and fever you can add LI-4 and GB-20. If bad cough you can add REN-22.

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10
Q

Asthma: Asthma of Heat Syndrome

excess
Sx
Tx
Pts

A

possible sources of heat: external invasion or phlegm heat accumulation and stagnation in the lung (could be from improper diet like over-eating, spicy, or greasy foods)

Sxs: shortness of breath with rapid breathing and wheezing, cough with yellow and sticky sputum, difficult expectoration, fullness in the chest, red tongue with yellow, greasy coating and slippery, rapid pulse. Patient may also be thirsty for cold water and be sweating.

Tx: Clear heat and resolve phlegm to relieve asthma

Points: LU-1, UB-13 (LU shu), LU-5 (he sea-for heat and relieve reverse flow of qi), ST-40 (phlegm), Dingchuan, LI-11 (clear heat), DU-14 (sea of qi and meeting of 6 yang)

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11
Q 
Asthma: Asthma of exterior cold and interior heat
 (excess)
Sx
Tx
Pts
A

seen in pts. with chronic asthma where phlegm heat has accumulated in the body, but acutely they also have wind and cold pathogen invasion. This can also occur in very hot constitution people-when wind and cold invade they can quickly be converted to heat, but the cold is not resolved.

Sxs: relatively acute onset short of breath with wheezing, thick phlegm with difficult expectoration, chills and fever, sweating, thirst with desire for cold drinks, red tongue with thin white or yellow coat; pulse slippery or floating rapid pulse. May also have chest pain from pheglm+external pathogen obstruction.

Tx: Disperse lung qi, clear internal heat

Points: LI-4, UB-12, LU-5, UB-13, Dingchuan, LI-11

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12
Q

Asthma: Stagnation of Phlegm in the Lung

(excess)

Sx
Tx
Pts

A

more related to phlegm from lung or spleen deficiency or improper diet. Often spleen is the source of the phlegm and lung is just the container.

Sxs: short breath with wheezing, cough, full and choking sensation in chest, white thick phlegm with difficult expectoration; tongue with thick white coat; pulse slippery. May be other sxs associate with SP deficiency like bloating or loose stool or obesity.

Tx: resolve phlegm and relieve asthma

Points: PC-6 (open chest), ST-40 (phlegm), UB-20 (SP shu), UB-13 (LU shu), LU-1

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13
Q

Asthma: Deficiency of the Lung

(deficiency)

Sx
Tx
Pts

A

Sxs: shortness of breath with wheezing, weak cough with weak voice, pale complexion, spontaneous sweating, white thin phlegm; tongue with white thin coating; pulse thin, deep, weak or big but empty pulse

Tx: tonify lung qi and relieve asthma

Points: UB-13 (LU shu), UB-43 (strengthen deficiency that disturbs the lung moxa it), LU-9 (earth pt to strengthen metal), REN-17, REN-6 (sea of qi)

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14
Q

Asthma: Deficiency of Spleen

(deficiency)

Sx
Tx
Pts

A

chronic asthma-can be associated with food allergy and improper diet weakening the spleen. Asthma easily triggered by food, which brings up hidden phlegm.

Sxs: shortness of breath with wheezing (with sound of phlegm in the throat), poor appetite, loose stool, chronic cough with lots of phlegm, flabby tongue with thin white coat, pulse soft and weak. Fatigue.

Tx: Tonify spleen qi and resolve phlegm

Points: UB-13 (LU shu), UB-20 (SP shu), ST-36 (nourish SP & mid jiao), REN-17 (sea of qi, open chest), REN-12 (tonifies SP & ST) , ST-40 (phlegm)

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15
Q

Asthma: Deficiency of Kidney

(deficiency)

Sx
Tx
Pts

A

Sxs: shortness of breath with wheezing aggravated by movement, exertion, soreness/weakness of lower back and knees, aversion to cold, cold limbs (yang def), pale or dark complexion. Tongue pale and flabby (yang def) with white coat; pulse deep and weak (yang def) or red with little coat thin rapid, maybe cracked (KD yin def). If yin def pt may be warm at night and have night sweats.

Tx: Tonify the kidney and receive qi

Points: UB-13 (LU shu), KD-3 (yuan source), UB-23 (KD shu), REN-6 (sea of qi, tonifies KD), REN-17 (regulate qi and open chest), Dingchuan (relieve asthma sxs) sometimes these syndromes are mixed in one patient and you have to combine the treatment strategy

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16
Q

Phlegm stagnation in the lung

Sx
Tx
Pts

A

Pathogenesis: The attack by exopathogen or prolonged cough

Sxs: Cough and dyspnea, whitish abundant expectoration which is easily coughed up, or other cold and heat exterior syndromes seen at the same time. Tongue: thin, whitish and greasy fur , Pulse: floating or slippery pulse.

Tx: Ventilating the lung and resolving phlegm.

Points: LU7 (luo pt, ruler of head and neck, master of the REN), LI4 (works with LU-7 to move stagnation), ST40 (phlegm), LU1(helps open lung, mu point). Can also use LU5 if phlegm is yellow (water controls fire)

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17
Q

Mental confusion due to phlegm

Sx
Tx
Pts

A

Pathogenesis: Injury due to seven emotions or the attack by damp and turbid pathogenic factors

Sxs: Coma and depressive psychosis, choking sensation in the chest and precordial pain, fainting and unconsciousness; Tongue: whitish and greasy fur, Pulse: slippery pulse.

Tx: Eliminating phlegm for resuscitation. (open heart orifice)

Points: GV20 (open orifice, clear foggy obstruction), ST40, CV17 (mu of PC, move qi), PC6 (open chest/heart orifice).

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18
Q

Retention of phlegm in the spleen and stomach

Sx
Tx
Pts

A

Pathogenesis: Improper diet or tiredness and anxiety -

Sxs: Fullness in the stomach and poor appetite, nausea and vomiting, tiredness and weakness, heaviness in the body and drowsiness; Tongue: whitish and greasy fur, enlarged tongue, Pulse: soft and floating (due to phlegm, makes deep pulse weak), moderate pulse.

Tx: Strengthening the spleen and reducing phlegm.

Points: CV12 (St mu, Middle jiao mu), ST40, SP9 (dampness and transforms phlegm, yuan, earth on earth channel, diuretic pt). -phlegm is digestion issues and dampness. With nausea - PC-6. Would not want to due moxa on ST40 - may increase phlegm or heat phlegm

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19
Q

Stagnancy of phlegm in the liver

Sx
Tx
Pts

A

Pathogenesis: Stagnation of the liver qi

Sxs: Sensation of something stuck in the throat when swallowing, dull in in the chest and hypochondrium, eructation, susceptibility to anger and depres-sion; Tongue: thin, whitish and greasy fur, Pulse: wiry and slippery pulse.

Tx: Reducing phlegm by alleviation of mental depression.

Points: CV17(influential pt of qi), ST40, LR14 (lr mu, promotes smooth liver qi), CV22(area of obstruction of qi and phlegm).

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20
Q

Stirring of phlegm in the kidney

Sx
Tx
Pts

A

Pathogenesis: Protracted illness damaging the kidney -

Sxs: Dyspnea and shortness of breath, Tongue: pale tongue, Pulse: deep and thready pulse; or dizziness and tinnitus, lassitude in the loins and knees, Tongue: red tongue with little fur, Pulse: thready and rapid pulse.

Tx: Reducing phlegm by warming or nourishing the kidney.

Points: KI7 (for sweating and urination issues, dampness), KI27 (good for chronic asthma), BL23 (kid shu), CV17 (mu PC, influential for qi, open chest), ST40.

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21
Q

Phlegm staying in the joints, meridians and collaterals.

Sx
Tx
Pts

A

Pathogenesis: Phlegm stagnating in the joints, meridians and collaterals

Sxs: Pain and edema in the joints, numbness in the limbs, or hemiplegia, facial paralysis, or scrofula (lymph nodes), goiter, node and lump; Tongue: whitish and greasy fur; Pulse: wiry and slippery pulse.

Tx: Resolving the hard lumps; removing obstruction in the collaterals and reducing phlegm.

Points: ST40, GB34 (ruler of sinews and tendons), TB5 (master - yang wei, luo, moves qi in the channel, dissipates wind, resolves exterior), LI4 (disperses wind, resolve exterior, clear lung heat, commander for mouth and face), LR3. (4 gates) - movement, spreads liver qi, discharges damp in lower jiao, nourishes liver blood and yin, good pt for detox)

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22
Q

Abdominal pain: Damp Cold of the Large Intestine

Sx
Tx
Pts

A

Sxs: clear watery stool, abdominal pain and borborygmus, fullness in the chest, poor appetite, chills, fever, stuffy nose, and headache. Pale tongue with white coat. Pulse is soft & moderate.

Tx: Disperse cold & resolve dampness

Points: REN-12, ST-25, ST-37, SP-9

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23
Q

Abdominal pain: Damp Heat of the Large Intestine

Sx
Tx
Pts

A

Sxs: Loose, urgent, smelly stool with abdominal pain, burning in the abdomen and anus, restlessness, thirst, yellow & scanty urine. Tongue has yellow greasy coat. Pulse is soft & rapid.

Tx: Clear heat and resolve dampness

Points: REN-12, ST-25, ST-37, SP-9, LI-4, LI-11. Bleed UB-40.

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24
Q

Abdominal pain: Food Retention

Sx
Tx
Pts

A

Sxs: abdominal pain relieved by passing stool, borborygmus, fetid stool with undigested food, fullness and distension in the epigastrium, anorexia, belching with odor, acid regurg. Tongue has thick, yellow, greasy coating. Pulse is slippery.

Tx: Promote digestion and relieve food stagnation

Points: SP-4, REN-12, ST-25, ST-36, UB-20, UB-21, UB-25

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25
Q

Abdominal pain: Liver Qi Attacking the Spleen

Sx
Tx
Pts

A

Sxs: recurrent diarrhea and abdominal pain resulting from emotional disturbance or stress, with pain coming first followed by diarrhea. Fullness in the chest and hypochondrium, belching, and poor appetite. Thin red tongue with white or yellow coat. Wiry pulse.

Tx: Soothe liver qi and strengthen the spleen

Points: REN-12, ST-25, ST-36, LR-3, GB-34

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26
Q

Abdominal pain: Deficiency of Spleen & Stomach

Sx
Tx
Pts

A

Sxs: prolonged loose stool with undigested food, decreased appetite, increase in bowel movements after eating oily or greasy food, anorexia, fullness of the abdomen, lassitude and fatigue, sallow complexion. Pale tongue with white coat. Pulse is thready and weak.

Tx: Strengthen the spleen and replenish qi

Points: UB-20, LR-13, REN-12, ST-25, ST-36

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27
Q

Abdominal pain: . Deficiency of Kidney Yang
Sx
Tx
Pts

A

Deficiency of Kidney Yang

28
Q

Dysentery
Sx
Tx
Pts

A

Dysentery is characterized by severe abdominal pain, tenesmus, and stools mixed with blood
and mucous. It frequently occur in summer and fall. It is contagious.

29
Q

Damp Heat Dysentery
Sx
Tx
Pts

A

Sxs: Severe abdominal pain with heavy sensation, tenesmus, loose stool with blood and
mucous (white and red mixed discharge), fever, scanty dark urine, red tongue with
yellow, greasy coat, slippery and rapid.

Tx: Clear heat, eliminate toxins, move Qi and blood

Points: LI4, ST25 (LI mu), ST37 (LI lower h/s), LI11, ST44

30
Q

Fulminant dysentery
Sx
Tx
Pts

A

Sxs: sudden onset, severe abdominal pain, diarrhea with pus and blood, tenesmus, fever,
thirst, dark red tongue with yellow greasy or dry coat, slippery and rapid pulse.

Tx: Clear away heat, cool blood and eliminate toxins

Points: LI4, ST25, ST37, LI11, GV14, Shixuan

31
Q

Cold Dampness Dysentery

Sx
Tx
Pts

A

Sxs: Dysentery with white mucous and less blood, abdominal pain, tenesmus, pale and
scalloped tongue with white greasy tongue coat, soft, and slow pulse

Tx: Warm up the middle jiao, resolve dampness

Points: LI4, ST25, ST37, CV12, CV6

32
Q

Deficient Cold Dysentery
Sx
Tx
Pts

A

Sxs: Diarrhea with white mucous, little blood, persistent dull pain in abdomen, poor
appetite, low energy, pale with white tongue coat, deep, weak pulse,
Tx: Tonify spleen and kidney

Points: BL25 (LI shu), ST25 (LI mu), ST37 (LI lower h.s), BL20 (sp shu),
BL23( kid shu), CV4 (SI mu)

33
Q

Yin Deficient Dysentery

Sx
Tx
Pts

A

Sxs: Dysentery with pus and blood, the blood is bright red and sticky, tenesmus, poor
appetite, thirst, restlessness, dark red tongue with little coat or no coat, thin and rapid
pulse

Tx: Nourish Yin, clear heat

Points: BL25, ST25, ST37, PC6, SP6,

34
Q

Constipation: Qi stagnation:

Sx
Tx
Pts

A

Sx: is related to emotional changes and includes these symptoms: constipation, difficult defecation, but stool is not dry, belching, flatulence, fullness in the chest and hypochondrium, distention and pain in the abdomen, reduced appetite, alternating diarrhea and constipation, like IBS. Bitter taste in the mouth. The pulse is wiry and the tongue is red with thin white coat

Tx: soothe liver & regulate qi

Points: ST-25, ST-37, ST-36, REN-6, LR-2, GB-34, UB-25, TB6 + CV12

35
Q

Constipation: QI & Blood deficiency
Sx
Tx
Pts

A

Sx: constant urge to have a BM, but unable to, stools are not dry but passing them occurs with difficulty, sweating, shortness of breath, tiredness after the BM, pale face, low energy. The tongue looks tender with a thin white coat, the pulse is weak.

Tx: tonify qi & nourish blood

Points: ST-25, ST-37, ST-36, UB-20, UB-21, UB-25, REN-4, SP-6, TB6

36
Q

Constipation: heat
Sx
Tx
Pts

A

Sx: constipation with dry stool, fullness and distension in the abdomen, abdomen is tender, may also be fever, flushed face, foul breath, restlessness, dry mouth, and scanty yellow urine. Tongue has a dry, yellow coat. Pulse is rapid & slippery.

Tx: clear heat & moisten the intestines

Points: ST-25, ST-37, ST-36, LI-4, LI-11, ST-44, TB6, UB25

37
Q

Constipation: cold
Sx
Tx
Pts

A

Sx: difficult to pass, dry, and impacted stool, prolapse of rectum in severe cases, occasional cold pain in the abdomen, soreness of the waist, cold limbs, desire for warmth, clear or frequent urination. Tongue has thick white coat. Pulse is deep and slow.

Tx: yang deficiency

Points: ST-25, ST-37, ST-36, REN-6, REN-4, UB-23, TB6, CV8

38
Q

Xiong Bi (chest bi)

Sx
Tx
Pts

A

chest yang obstruction, failure of meridian qi and blood being warmed, manifested as fullness and pain in the chest, radiating to the arm. It may be accompanied by SOB, palpitation, and intermittent pulse, or coughing and edema.

39
Q

Xiong Bi: Etiology & Pathogenesis:

Sx
Tx
Pts

A
  1. Invasion of pathogenic cold–>coagulates yang qi –> chest obstruction –>pain
  2. Improper Diet –> spleen damaged –> phlegm accumulates –> obstructs heart collaterals –> pain
  3. Emotional Disturbance –>Qi Stagnation –> Blood stasis in chest/heart –> Pain
  4. Kidney Yang Deficiency –> fails to warm the heart –> chest obstruction → pain
  5. Kidney Yin Deficiency –> fails to nourish heart –> chest obstruction –> pain
40
Q

Xiong Bi: Cold Coagulation

Sx
Tx
Pts

A

Sxs: severe pain in the chest, aggravated by cold, cold extremities, pale complexion, white and wet tongue coating, deep and tight pulse.

Tx: disperse cold, open chest yang

Points: UB-15 (HT shu), UB-14 (PC shu), PC-6, HT-5. REN-17 could be helpful

41
Q

Xiong Bi: Turbid Phlegm

Sx
Tx
Pts

A

Sxs: stuffiness in the chest, dull heavy pain, SOB, tongue has white greasy tongue coating, slippery pulse. Patient may also have some nausea, phlegm in throat, vertigo. May be an overweight patient. Patient may have overall feeling of body heaviness.

Tx: Resolve phlegm, activate yang qi

Points: REN-14 (HT Mu), REN-17 (PC Mu), ST-40 (phlegm), SP-9 (phlegm), PC-4 (xi-cleft for acute)

42
Q

Xiong Bi: Heart Blood Stasis

Sx
Tx
Pts

A

Sxs: stabbing/pricking pain in the chest, purplish spots on the tongue, thin and choppy pulse or knotty pulse. Complexion may be dusky/purple

Tx: activate blood circulation, resolve blood stasis

Points: UB-15 (HT shu), UB-17 (diaphragm shu-opens chest, meeting pt/sea of qi), REN-17 (PC Mu, Qi movement), HT-6 (xi-cleft)

43
Q

Xiong Bi: Yin Deficiency of both Heart and Kidney

Sx
Tx
Pts

A

Sxs: dull pain in chest, palpitations, night sweating, soreness of lower back, weak knee joints, tinnitus, red tongue, with little coat, thin and rapid or choppy pulse. -

Tx: Nourish Yin and open the chest

Points: UB-15, HT-7 (yuan source for nourishment), SP-6 (nourish yin), KD-6 (nourish yin, yin qiao)

44
Q

Xiong Bi: Deficiency of Qi and Yin

Sx
Tx
Pts

A

Sxs: chest pain and stuffiness (b/c qi def. cannot promote movement), general lassitude, SOB, palpitations, pale complexion, night sweating, red tip, tender and scalloped tongue, thin and weak, intermittent pulse (irregularly irregular probably). Patient probably sweats easily because Qi cannot protect yin & keep it in.

Tx: Tonify Qi and Nourish Yin, open the chest

Points: UB-15 (HT shu), HT-7 (nourish), REN-17 (sea of qi), REN-6 (sea of qi), SP-6 (nourish yin)

45
Q

Xiong Bi: Deficiency of Heart Yang

Sx
Tx
Pts

A

Sxs: stuffiness or pain in the chest, spontaneous sweating, intolerance of cold, cold extremities, low energy, pale tongue, deep, weak pulse

Tx: Warm up yang qi. Invigorate blood circulation.

Points: UB-15, UB-14, REN-4, DU-4

46
Q

Insomnia: Deficiency of Heart & Spleen

Pathogenesis
Sx
Tx
Pts

A

Pathogeneis: due to anxiety and overwork damaging the heart & spleen → qi & blood deficiency

Sxs: difficulty going to sleep, easy to wake with excessive dreams during sleep. Palpitations, amnesia, sweating, lusterless complexion, fatigue, weakness, abdominal distension, loose stool. Pale tongue with thin white coat. Pulse thready and weak.

Tx: strengthen qi and nourish blood

Points: UB-20, UB-15, HT-7, SP-6

47
Q

Insomnia: Hyperactivity of Fire due to Yin Deficiency, Disharmony of Heart & Kidney

Pathgenesis
Sx
Tx
Pts

A

Pathogenesis: Kidney yin damage from excessive sexuality, chronic diseases, or weak constitution → yin not containing heart fire → fire invades the mind → irritability & insomnia

Sxs: Insomnia, restlessness, or easy to wake after a short sleep. Hot sensation in palms & soles, severe palpitations, night sweating, a dry mouth & throat, tinnitus, amnesia, seminal emission, soreness and weakness of the lumbar region & knees. Red tongue. Thready, rapid pulse.

Tx: Nourish yin to balance pathogenic fire

Points: UB-23, UB-15, KD-3 (nourish KD yin), PC-7 (dec heart fire), LR-3 (calm liver yang), HT-7 (calm the shen)

48
Q

Insomnia: Disorder of Stomach Qi

Pathgenesis
Sx
Tx
Pts

A

Pathogenesis:-improper diet → food retention → phlegm heat in middle jiao → flares up → insomnia

Sxs: Vexation with a full sensation in the heart, gastric distension, belching, dizziness, even vomiting with phlegm. Tongue has a yellow, greasy coat. Pulse is slippery or wiry.

Tx: Resolve phlegm to resolve normal stomach function

Points: REN-12, ST-40, ST-25, PC-6 (to soothe chest oppression)

49
Q

Insomnia: Hyperactivity of Liver Yang Disturbing the Heart

Pathgenesis
Sx
Tx
Pts

A

Pathogenesis: mental depression → liver dysfunction → hyperactive liver yang → flares up to heart & brain -liver yin deficiency → hyperactive liver yang → flares up to heart & brain

Sxs: sleeplessness with dizziness and headache, irritability, easily frightened, redness of the eyes, tinnitus, bitter taste in the mouth, hypochondriac pain. Red tongue with thin yellowish coat. Pulse is wiry and rapid.

Tx: Calm liver yang and descend liver fire

Points: UB-18, UB-19, LR-2 (fire pt), GB-44 (bleed ying spring pt)

50
Q

Palpitations:Qi Deficiency

Sx
Tx
Pts

A

Sxs: palpitations, SOB, easily frightened, restlessness, sweating of the palms. Pale tongue with thin white coat. Weak or intermittent pulse.

Tx: Nourish Qi, Calm the shen

Points: PC-5, HT-7, UB-15, REN-14

51
Q

Palpitations: Blood Deficiency

Pathgenesis
Sx
Tx
Pts

A

Pathogenesis: prolonged illness, weak constitution, excessive worrying, or excessive blood loss → blood fails to nourish the heart → shen is not contained → palpitations

Sxs: palpitations, vertigo, dizziness, lustreless complexion, restlessness, and heat in the heart, insomnia, and excessive dreams. Pale or red tip of the tongue. Pulse thready and rapid.

Tx: Nourish blood, calm the shen

Points: UB-17, HT-5, UB-20, ST-36

52
Q

Palpitations: Phlegm Fire

Pathgenesis
Sx
Tx
Pts

A

Pathogenesis: Improper diet or excessive worry → spleen deficiency → damp phlegm accumulation → transforms into heat & fire → Phlegm fire mists the heart→palpitations

Sxs: Alternate palpitations, fullness in the chest, bitter taste in the mouth, yellowish profuse sputum with cough, darkish urine, difficulty defecating. A yellow, greasy tongue coating. Slippery & rapid pulse.

Tx: Clear heat, transform phlegm, calm shen

Points: LU-5, LU-10, ST-40, HT-4, PC-4

53
Q

Palpitations: Blood Stasis
Sx
Tx
Pts

A

Sxs: palpitations and restlessness, alternate heart pain in some severe cases, fullness and uneasy sensation in the chest, purple lips and nails. A dark and purple tongue, with petechiae. Choppy or intermittent pulse.

Tx: promote blood circulation and tonify the heart

Points: PC-3, HT-3, REN-6, SP-10

54
Q

Depression pathogenesis

A
  1. Emotional depression → liver dysfunction → spleen deficiency → qi & blood deficiency → heart not nourished
  2. Depression of qi → pathogenic fire → depletion of yin and KD essence → hyperactivity of fire → restlessness, fullness in chest, hysteria
55
Q

sx of depression

A

mental depression, low spirits, emotional unrest, constant cries of grief and sorrow breaking out due to emotional stimulation. thin tongue coat, wiry pulse.

deficiency of both heart and spleen, there may be abdominal distension, poor appetite, palpitations, insomnia, lassitude and pale complexion. Pale tongue with slow, thready pulse.

deficiency of heart and kidney, there may be dizziness, tinnitus, reddish complexion, fever and sweating in the palms and soles, sore lumbar, poor memory, restlessness and insomnia. Red tongue, less coat, and thready, rapid pulse.

56
Q

tx + Pts for depression

A

strengthen qi, tonify yin, nourish heart, calm shen

Points: UB-17, UB-23, UB-15, PC-6, SP-6

57
Q

Blood stasis

Pathogenesis
Sx
Tx
Pts

A

Pathogenesis: fixed, stabbing pain

Sxs: dusky/purple tongue, with petechiae, sublingual stasis. Choppy pulse.

Tx: nodules, masses, fixed pain, pale complexion

Points: SP-10 (sea of blood, dispels stasis), UB-17 (meeting pt of blood, dispels stasis), SP-6 (3 leg yin, invigorates blood)

58
Q

FOUR-STEP TREATMENT STRATEGY FOR BLEEDING

A
  1. Harmonize blood: stop bleeding, eliminate stasis, calm the blood, nourish blood
  2. Treat root cause of bleeding:
    - Heat or Fire (may be external pathogen or generated by improper diet or extreme emotions turning to heat or chronic illness damage yin so def heat flares up): forcing
    blood to rush out of the vessels or damaging the vessels→ extravasation –> hemorrhage
  • Qi Deficiency: failure of blood being controlled & kept in vessels by qi –> hemorrhage
  • failure of qi to promote blood movement –> blood stasis blocks vessel→ hemorrhage from side of vessel.
  1. Astringe
  2. Treat Qi: relieve deficiency or stasis
59
Q 
LIN SYNDROME (URINARY STRANGURY)
\: western med correspondence
A

Acute or chronic UTI to (cystitis, urethritis)
Prostatitis
Urinary renal calculi
Neoplasms of the bladder, prostate, and urethra

60
Q

LIN SYNDROME (URINARY STRANGURY): pathogenesis

A

Damp Heat in the Urinary Bladder:
- overeating greasy or spicy food or alcohol indulgence → damp heataccumulation descends to bladder → stranguria

  • unclean genitals → tubid pathogenic factors → stranguria

Deficiency of both Spleen & Kidney:

  • prolonged stranguria → consumes vital qi → excess syndrome becomes deficiency
  • weak constitution, old person, or overindulgence in sex → def of SP & KD → SP fails to raise the clear qi and KD fails to control the urine

Stagnation of Liver Qi:
- Anger → stagnates LR qi → transforms into fire → fire accumulates in lower jiao→ stranguria

61
Q

Damp Heat in the Urinary Bladder

Sx
Tx
Pts

A

Sxs: frequent and scanty urination with burning and stabbing pain, dark yellow urine, distending sensation and pain in the lower abdomen, aversion to cold, fever, bitter taste in the mouth, vomiting nausea, lumbar pain, tenderness, and constipation possible. Yellow, greasy tongue coating. Soft & rapid pulse.

Tx: clear heat, resolve dampness

Points: UB-28, REN-3, SP-9, LR-2, KD-2

62
Q

Stranguria caused by urinary stones

Sx
Tx
Pts

A

Sxs: difficult urination with occasional sandy substances in the urine. May be pain or colic in the lower abdomen, lumbar, and urethra, yellow, turbid urine, or hematuria. Red tongue with thin, yellow coat. In prolonged cases, there may be lusterless complexion, mental fatigue, SOB, and soreness of the lower back. a pale tongue with teeth marks and a weak pulse, or a red tongue with little coating and a rapid pulse.

Tx: clear heat, resolve dampness, and promote urination

Points: UB-28, REN-3, SP-9, LR-2, KD-2. If progresses to qi deficiency, add ST-36, SP-6, UB-23, UB-20, REN-4

63
Q

Stranguria caused by disorder of Qi

Sx
Tx
Pts

A

Pathogenesis: Melancholy or other strong emotion → liver qi stagnation → affects bladder b/c of liver channel passes over bladder. -Spleen qi deficiency → qi fails to control urine → dribbling

Sxs:

  • Excess: difficult and painful urination and distending pain in the lower abdomen. There may be fullness in the chest and distension in the hypochondriac region and restlessness. in cases of deficiency. Thin, white tongue coat and a deep, wiry pulse.
  • Deficient: may be dribbling urination with drops, distending sensation in the lower abdomen, and a pale complexion in cases of deficiency. There may be poor appetite and general lassitude. pale tongue and a weak, rapid pulse

Tx: Soothe liver qi. If deficient, strengthen spleen qi.
*Points: UB-28, REN-3, SP-9, LR-2, KD-2, GB-34, SJ-6, LR-14

64
Q

Stranguria complicated with hematuria

Sx
Tx
Pts

A

Sxs:
- Excess: may be dark yellow urine with stabbing and burning pain. may be severe heat pain, dark purplish clots, and irritability. Yellow tongue coating with slippery, rapid pulse

  • Deficiency: there may be pink urine with mild pain. may be soreness and weakness in the lumbar & knees, and lassitude. Pale, red tongue with thready and rapid pulse.

Tx: Clear heat, resolve dampness. If deficient, nourish SP & KD

Points: UB-28, REN-3, SP-9, LR-2, KD-2. If deficient, add UB-20, UB-23, ST-36, SP-6

65
Q

Stranguria marked by Chyluria

Sx
Tx
Pts

A

Sxs:

  • Excess: turbid, milky urine with sediment at the bottom and fatty, oily substance at the top. poss. burning sensation, pain, and blood in the urine. Red tongue with yellow, greasy coat and soft, rapid pulse.
  • Deficient: repeated attacks and turbid fatty, oily substances in the urine. Gradual emaciation, dizziness, lassitude, and soreness in the lumbar & knees. Pale tongue with greasy coating and thready, weak pulse.

Tx: Clear heat, resolve dampness. If deficient, nourish SP & KD

Points: UB-28, REN-3, SP-9, LR-2, KD-2. If deficient, add UB-20, UB-23, ST-36, SP-6

66
Q

Stranguria induced by overstrain

Sx
Tx
Pts

A

Sxs: reddish urine with mild pain, repeated attacks, aggravated by overstrain. Soreness in the lumbar and knees, with lassitude. Pale tongue with rapid, weak pulse.

Tx: Nourish SP & KD, clear heat, promote urination

Points: UB-28, REN-3, ST-36, SP-6, UB-23, UB-20, DU-4, REN-4

CCM Clinic entrance exam (6 decks)

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