Final Review Flashcards
Case 12 to 20 plus cautions and contraindications
A 39 year old female has been diagnosed with clinical depression. Symptoms include mental depression, chest distress, hypochondriac distention, bleching, poor appetite, and irregular bowel movements. The tongue has a thin-sticky coating. The pulse is string-taut. The acupuncture prescription is UB-18, RN-17, RN-12, ST-36, and LR-3. After several treatments, the patient returns and now reports depression, h/a, chest distress, hypochondriac distention, acid regurgitation, dry mouth, constipation. Her eyes are blood shot. The tongue has a yellow coating. The pulse is string-taut and sl. fast. What is your prescription?
A) ST-44, LI-11, DU-14, ST-25
B) UB-18, GB-20, RN-12, ST-36, KD-6
C) LR-2, GB-43, RN-13, SJ-6, GB-34
D) RN-17, PC-6, LR-3, ST-40 GB-20,
C) LR-2, GB-43, RN-13, SJ-6, GB-34
LR-2 (YS LR)
GB-43 (YS GB, water point, D-H, descend LR yang)
RN-13 (subdue reb ST qi)
SJ-6 (open intestines, cl-H, reg qi, remove obst ch)
GB-34 (prom flow LR qi, subdue reb qi, relax sinew/muscle)
DX:
Original= LR qi OA ST
Now= LR-F causing Reb ST qi
FX:
Long dan xie gan tang (LR-F)
Explanation:
Melancholia pg 450 CAM
d/t Transformation of depressed qi into fire
Main manifestations:
H/a, dryness and bitter taste in mouth, irritability, distress of chest, hypochondriac distention, acid regurgitation, constipation, red eyes, tinnitus, red tongue w/ yellow coating, string-taut rapid pulse
A patient has tongue ulcers, thirst, palpitations and a red tongue. What is the treatment plan?
A) Clear HT-F, resolve P, pacify mind
B) Clear HT, Drain F, pacify mind
C) Open HT, Resolve P
D) Tonify and nourish HT yin, pacify mind
B) Clear HT, Drain F, pacify mind
DX:
HT-F blazing
FX:
Xie xin tang
Prescription:
HT-8, HT-9, RN-15, LI-11, DU-24, SP-6, KD-6 (promote yin to cool F)
A patient has sudden unconsciousness, convulsions, deviation of eye and mouth. What is the treatment plan?
A) Clear heat, disper LR, subdue wind
B) nourish LR yin, subdue LR yang and wind
C) sedate LR, clear fire
D) disperse LR, regulate xue
B) nourish LR yin, subdue LR yang and wind
DX:
LR yin xu –> LR yang rising –> INT LR W
FX:
Shen gan xi feng tang
Prescription:
LR-3 (subdue yang, W)
GB-20 (Int W, subdue yang, clear H, CL brain)
LI-4 (subdue yang)
SJ-5 (subdue LR yang)
DU-19 (int W)
SP-6, LR-8, KD-3 (Tn LR Yin)
Shi xuan (resuscitation)
DU-20 (“”)
DU-16 (expel W, cl mind, benefit brain)
Explanation:
FCM pg 525 LR Wind
CAM pg 401 Windstroke
No F s/s
No sallow complexion therefore no xue xu
No KD yin xu s/s
A) Clear heat, disper LR, subdue wind
LR F–> LR W
B) nourish LR yin, subdue LR yang and wind
LR Yin Xu–> LR yang –> LR W
C) sedate LR, clear fire
LR-F
D) disperse LR, regulate xue
INT W d/t LR Xue xu
Numbness in the extremities, burning pain in the lower limbs, skin feels hot to touch, and yellow greasy tongue coating can indicate:
A) Phlegm-damp obstruction
B) Damp-phlegm stagnation
C) Damp-heat
D) wind-phlegm blocking channels
C) Damp-heat
DX:
D-H in Lower Jiao
FX:
Mod Long dan xie gan tang
Explanation:
numbness d/t D or nonsubstantial P
skin hot to touch= D-H
A) Phlegm-damp obstruction
white greasy tongue coat, er chen tang
B) Damp-phlegm stagnation
er chen tang
C) Damp-heat
long dan xie gan tang
D) wind-phlegm blocking channels
causes convulsions, ban xia bai zhu tian ma tang
A 33 year old woman’s main complaint is constipation, a problem she has had for six years. She has 2-3 BM’s per week. The stools are small and dry. Her breath has a foul odor. The tongue has a normal color w/ a dry yellow coating which is thicker at the root. The pulse is normal. What is the treatment?
A) RN-10, GB-34, LR-3, SP-15, SJ-6
B) ST-25, SP-15, RN-10, ST-44, LI-11, ST-36
C) UB-25, ST-25, ST-36, SP-6, RN-6, UB-13
D) ST-36, SP-6, RN-4, UB-20, UB-23, SP-15
B) ST-25, SP-15, RN-10, ST-44, LI-11, ST-36
ST-25 (FM LI) w/ SP-15 (prom fx LI, Tn SP, reg qi) (combo constipation)
RN-10 (Tn SP, descend ST qi, rel food stag)
ST-44 (YS ST, cl H, reg qi, elim fullness, prom digestion)
LI-11 (cl H)
ST-36 (Tn SP/ST qi, xue, reg intestines, gen fluid)
DX:
Dry heat in LI
FX:
Zhen ye chen qi tang
(mod zhen ye tang + xiao cheng qi tang)
(zyt= gen fluid for constipation d/t yin xu/shi dry)
“boat can’t move w/o water”
Explanation:
CAM pg 429 patient is between xu (yin xu) and shi dry heat therefore pulse is normal yellow coat=dry heat (if yin xu would be scanty/no coat, red body) foul odor- d/t ST food retention/fall descend (ST-44 + RN-10 descend ST)
When concluding the acupuncture needle technique “Setting the Mountain on Fire” you:
A) slowly withdraw the needle and rotate to the left
B) withdraw needle when patient exhales
C) quickly withdraw the needle and press the hole
D) rotate needle fast w/ large amplitude
C) quickly withdraw the needle and press the hole
Explanation:
CAM pg 349
KIM pg 291
In electroacupuncture, pulses which alternate with quick and slow periods are preferable for treating:
A) Pain
B) Paralysis and numbness
C) Spasm
D) Muscle contractions
B) Paralysis and numbness
Explanation:
PG 309 KIM
Regular Frequencies:
- Best for treating pain and spasm
- Drain Shi
Alternate Quick & Slow:
- Tx paralysis
- Strengthen Xu
Chronic and stubborn numbness in the fingers and toes with sensations that are distinguishable between the fingers and toes indicates:
A) Blood xu
B) Wind-phlegm blocking channels
C) Damp-heat blocking channels
D) Damp-phlegm obstruction
D) Damp-phlegm obstruction
Explanation:
A) Blood xu
Sallow complexion, xue xu s/s
B) Wind-phlegm blocking channels
Pulse floating/slippery (d/t Ext W), foamy, white or clear sputum
C) Damp-heat blocking channels
Heat s/s, pulse soggy/rapid/forceful, tongue red w/ yellow greasy coating, thick yellow sputum
D) Damp-phlegm obstruction
nonsubstantial phlegm, may not have any other phlegm s/s
“Strange diseases are due to phlegm”
The needle techniques of “Setting the Mountain on Fire” and “Penetrating Heaven-Coolness” are derived form all of the following techniques EXCEPT:
A) slow and rapid insertion of needle
B) the relation of need tip to flow of qi
C) lifting and thrusting of needle
D) keeping the hole open or closed
B) the relation of need tip to flow of qi
Explanation:
Setting the Mountain on Fire
Tonification
Superficial-Medium-Deep (9x3)
Insertion: slow
Thrust (slow)/Lift(quick): 9x at each level
Withdrawal: Rapid + close hole
Penetrating Heaven Coolness:
Sedation
Superficial-Medium-Deep (6x3)
Insertion: Rapid
Thrust (quick)/Lift (slow): 6x at each level
Withdrawal: Slow + open hole
Kim pg 291
The thumbtack intradermal needle is usually applied to the:
A) Thighs
B) Arms
C) Back
D) Ear
D) Ear
Kim pg 293
The most widely performed bloodletting technique is:
A) Clumping
B) Spot Pricking
C) Dispersing
D) Pecking
B) Spot Pricking
CAM pg 354
Kim pg 293
The dispersing method of bloodletting is done by inducing superficial bleeding in a wide area of the skin. It is primarily used for:
A) Skin diseases such as nerodermatitis
B) Heat stroke
C) Apoplexy
D) Gastronintestinal inflammation
A) Skin diseases such as nerodermatitis
Dr. Cao: bloodletting is for strange diseases such as mental disorders. Can bleed the heal. Also bleed da zhui for skin diseases.
A patient has hypertension with dizziness, flushed face, red eyes, stiff neck, constipation, dry mouth, yellow tongue coating, and strong-wiry pulse. You choose GB-20, LI-11, ST-36, LR-3. What other points would you add to the prescription?
A) PC-6, ST-40
B) KD-3, HT-7
C) LR-2, GB-34
D) RN-6, RN-4
C) LR-2, GB-34
LR-2 (Ying spring, cl LR F)
GB-34 (HS, Sinews, smooth LR qi, subdue reb qi)
DX:
Liver Fire Blazing
FX:
Long dan xie gan tang
The points RN-22, LI-18, LI-4 symptomatically treat:
A) Asthma
B) Coughing
C) Congested throat
D) Lateral neck pain
C) Congested throat
Explanation:
Asthma or cough involves LU xu + would include LU points @ distal, not LI-4 as in the prescription.
RN-22 doesn’t match lateral neck pain
RN-22: location key, plum pit, sore throat, cough
LI-18: cough, sore throat, neck pain
LI-4: Face/head, neck pain, throat
The points UB-15, HT-7, LR-3 symptomatically treat:
A) Breast distention
B) Sensation of plum pit in the throat
C) Vertex headache
D) Excessive dreaming
D) Excessive dreaming
LR-3 is distal point for shi dreaming
Explanation:
A) Breast distention
Use more LU pts
B) Sensation of plum pit in the throat
Qi stag or phlegm, not tx by HT pts
C) Vertex headache
LR qi stag or LR xue xu- would use LR pts
D) Excessive dreaming
Dream from HT
Which host-guest combination opens and regulates the water passages when pathogenic wind causes symptoms of upper body edema, no sweating, and difficult urination?
A) LI-4, LU-7
B) LU-7, LI-6
C) LU-9, LI-6
D) SP-3, ST-40
C) LU-9, LI-6
Explanation:
Disease location= LU therefore source LU + Luo LI
CAM pg 387
Deadman pg 41-2
SOURCE: LUO:
9 7 7 7 5 6
4 4 4 6 7 5
3 3 3 4 4 5
42 64 40 40 58 37
According to the Yuan-Luo/Host-Guest points which of the following treats Spleen disorders?
A) PC-4, ST-42
B) SP-3, ST-40
C) SP-3, ST-42
D) SP-4, ST-40
B) SP-3, ST-40
A patient has fixed stabbing pain in the hypochondriac area, and pain worse at night. The tongue is purplish. The pulse is choppy. What is the prescription?
A) LR-14, LR-13, GB-26, SJ-6, GB-34
B) UB-18, LR-14, SJ-6, GB-34, UB-17
C) RN-14, LR-3, UB-18, SP-6, ST-36
D) LR-3, LR-14, GB-34, SJ-6, GB-40
B) UB-18, LR-14, SJ-6, GB-34, UB-17
UB-18 (Sooth LR, Tn Xue)
LR-14 (Local pain, move qi)
SJ-6 (reg qi, alleviate pain)
GB-34 (all kinds pain)
UB-17 (all xue disorders)
DX:
LR Xue Stagnation
FX:
Xue Fu Zhu Yu Tang
or
Ge Xia Zhu Yu Tang
Explanation:
pg 458 CAM Pain in Hypochondriac
C= Xue xu
D= LR qi stag
A 32 year old woman has painful periods. She has a short cycle with periods every 21-23 days. She has severe menstrual pain with red blood with small dark clots. She feels cold during her period and has dizziness, and tinnitus. The tongue is pale and swollen. The pulse is slow, choppy, and especially weak in the left rear position. What is the diagnosis?
A) Liver Stagnant Blood
B) Liver Yang Rising
C) Deficient Kidney Yang w/ Empty Cold
D) Deficient Liver Blood
C) Deficient Kidney Yang w/ Empty Cold
FX:
You gui wan
Prescription:
RN-8 (w/ moxa- Tx cold pain during period)
KD-3 (Tn KD yin/yang)
DU-4 (Tn yang)
RN-4,6 (Local points)
Zi Gong Xue (local points)
LR-3 (move qi, ch connect uterus)
SP-6 (VIP pain)
Explanation:
Dizziness + tinnitus = yang xu
W/ yang xu, KD yin pulse also still xu- look at tongue
CAM pg 475 Dysmenorrhea
A 35 year old female patient has had migraines for ten years. The location of the headaches is on top of the head and behind the eyes. They start with a dull pain and proceed to become severe with nausea, vomiting, and diarrhea. The headaches improve with the patient lying down. The headaches occur every day. The tongue is thin and pale and the pulse is weak on the right side and wiry on the left side. What is the treatment?
A) LR-3, DU-20
B) PC-6, SJ-4, ST-36, LR-8, SP-6, LR-3
C) LI-4, LR-3
D) GB-20, SJ-5, LI-4, ST-44, SP-6, KD-3
B) PC-6, SJ-4, ST-36, LR-8, SP-6, LR-3
PC-6 (nausea, reg Jueyin)
SJ-4 (H/A)
ST-36 (Tn qi + xue, ST Dx)
LR-8 (LR xue xu + yin)
SP-6 (Tn yin, xue, reg qi, soothe LR)
LR-3 (Anchor yang, Tn LR xue)
DX:
LR Yang Rising d/t LR Xue Xu (W/ SP Qi Xu)
FX:
Mod Xiao yao san
+Mu li, Gou teng
Explanation:
Jueyin H/A
If H/A d/t LR-F + LR-2
A patient has flooding at the beginning of her period which then stops. It continues trickling for a longer time after the period proper. The blood is pale and watery. She has a pale face, tiredness, slight dizziness, no appetite. The tongue is pale with teeth-marks. The pulse is weak. What is the pattern?
A) Spleen qi xu
B) KD yang xu
C) Spleen not holding xue
D) Xu qi and xue
C) Spleen not holding xue
FX:
Gui pi tang
Prescription:
RN-12, UB-20, UB-21, UB-17 (Tn xue, stop bleeding), ST-36, SP-3 (source), SP-6 (Tn qi, xue, yin, sooth LR), SP-10, SP-1 (stop bleeding)
Explanation:
CAM pg 479 Metorrhagia
An 82 year old man has pain in both knees which are swollen and respond with pain to cold weather. He is in general good health. His only other problem is occasional insomnia. The tongue is red without coating and with cracks. The pulse is normal and only a little fine. What is the diagnosis?
A) Deficient channel qi
B) Deficient HT yang
C) Cold and damp bi syndrome
D) WInd-cold invades LU
C) Cold and damp bi syndrome
Prescription:
Moxa SP-6 + ST-36 (Tn qi, xue, yin, yang)
GB-34 (Tn sinew, bone)
Local: Xi yan, he ding, ST-35, ST-34 (XC, move qi/xue), UB-40, SP-9
KD-3 (Tn KD, Tn sinew/bone)
FX:
Du huo ji sheng tang
(chronic C + D Bi d/t LR/KD yin xu)
Explanation:
swollen= damp
pain w/ C weather= cold
Main s/s= C-D bi
Rest s/s= d/t age
Which of the following acupuncture points can be needled with one hand stretching the skin with the thumb and index finger of one hand and using the other hand to insert the needle?
A) ST-4
B) RN-4
C) Yin tang
D) UB-2
B) RN-4
CAM pg 342-4 Insertion
RN-4 stretching skin
ST-4, Yin tang, UB-2 insert by pinching skin
In applying gua sha to the sternum, in which direction should it be applied?
A) bottom up to the sternal notch
B) transverse from left to right going up
C) top down to the xyphoid process
D) transverse from right to left going down
C) top down to the xyphoid process
A patient has pain and numbness in the right leg. Which scalp acupuncture area would you treat?
A) left upper fifth of the sensory line
B) bilateral upper fifth of the sensory line
C) right second and third fifths of the sensory line
D) left second and third fifths of the sensory line
A) left upper fifth of the sensory line
Upper 1/5= lower limb + trunk
2nd/3rd 1/5s= upper limb
Lower 2/5= facial
Left to treat right
Yellow discharge with pus in the blood in a woman after menopause indicates:
A) Stagnation of LR qi
B) Damp heat in lower burner
C) Damp heat in LR channel
D) Toxic damp heat in uterus
D) Toxic damp heat in uterus
Pus + Blood= Toxic damp heat
Post meopause probably cancer- must have biopsy
If pain generally not cancer unless stage 4
For which conditions is moxibustion with garlic best used?
A) Scrofula, TB, and early stages of skin ulcer with boils
B) Asthma, chronic diarrhea and indigestion
C) Abdominal pain, vomiting, and prolonged dysentery
D) Impotence, KD yang xu, and premature ejaculation
A) Scrofula, TB, and early stages of skin ulcer with boils
Explanation:
CAM pg 364- Moxibustion
KIM pg 296 Moxa
A) Scrofula, TB, and early stages of skin ulcer with boils
Moxa w/ Garlic
B) Asthma, chronic diarrhea and indigestion
C) Abdominal pain, vomiting, and prolonged dysentery
Moxa w/ salt
D) Impotence, KD yang xu, and premature ejaculation
Moxa w/ Fu zi (monkshood) cake
A patient has stabbing pain in the epigastrium, vomiting dark blood. What is the treatment?
A) LR-14, ST-36, RN-13, UB-21, GB-34
B) RN-13, ST-21, SP-4, PC-6, ST-44
C) ST-36, RN-12, UB-20, UB-21, RN-6
D) SJ-6, ST-21, ST-34, SP-10, UB-17
D) SJ-6, ST-21, ST-34, SP-10, UB-17
SJ-6 (Distal tx ST, Subdue Reb ST qi, promote BM)
ST-21 (Local Tx ST, Reg ST, stop vomit, subdue Reb ST qi, stop pain)
ST-34 (XC Acute Dx ST, Subdue Reb ST qi)
SP-10 (All xue Dx)
UB-17 (Stop bleeding, Tn Xue)
DX:
ST xue stasis
FX:
Yunnan baiyao
(best stop bleeding; San Qi enter LR, ST; esp any kind ST bleeding)
Explanation:
Stabbing pain= xue stasis
Wandering pain is d/t qi stagnation
Which point combination helps in the treatment of fixed bi syndrome?
A) UB-17, SP-10
B) UB-23, RN-4
C) DU-14, LI-11
D) ST-36, SP-5
D) ST-36, SP-5
Explanation:
CAM pg 464 Bi Syndrome
A) UB-17, SP-10 wandering bi
B) UB-23, RN-4 painful bi
C) DU-14, LI-11heat bi
D) ST-36, SP-5 fixed bi
Which point combination helps in the treatment of heat bi syndrome?
A) UB-17, SP-10
B) UB-23, RN-4
C) ST-36, SP-5
D) DU-14, LI-11
D) DU-14, LI-11
FX:
Mod Xue fu zhu yu tang
+ Mu dan pi, dan shen, shi gao, da huang
Explanation:
CAM pg 464 Bi Syndrome
A) UB-17, SP-10 wandering bi
B) UB-23, RN-4 painful bi
C) ST-36, SP-5fixed bi
D) DU-14, LI-11 heat bi
A patient has irregular menstruation with a shortened cycle, profuse, thin and light red blood, shortness of breath, and fatigue. The tongue is pale with thin coating. The pulse is thin and weak. What is the pattern?
A) Deficient blood
B) Stagnant qi
C) Deficient qi
D) Cold uterus
C) Deficient qi
FX:
Mod Si jun zi tang
Prescription:
DU-14, RN-17, RN-4, RN-6, ST-36 + SP-6, LR-3 + LI-4
Explanation:
CAM pg 472 Irregular menstruation
Causes Irregular Menstruation:
Xue xu vs. Qi xu
- Xue xu:* Sallow complexion, dizziness, numbness
- Qi xu:* fatigue, SOB
A patient has amenorrhea with delayed menstrual cycle and gradual decrease of menses, poor appetite, loose stools, dizziness, and sallow complexion. The tongue is pale with little coating. The pulse is weak. What is the pattern?
A) Deficient SP qi w/ damp obstruction
B) Deficient SP + ST qi
C) Deficient blood
D) Deficient LR blood
C) Deficient blood
FX:
Tao hong si wu tang
Tao ren + hong hua + si wu tang (shu di, dang gui, bai shao, chuan xiong)
Prescription:
SP-6 + ST-36, RN-4 (TN qi to TN xue), ST-29 (abundant qi/xue, local), Zi gong xue (zi=fetus, gong=home), LR-3 (move qi, TN xue)
Explanation:
CAM pg 477 Amenorrhea
- 2 Causes:*
1) Xue stagnation
2) Xue xu
Local tx + estim is VIP for gynecology
A patient has abnormal uterine bleeding which is continuous and scanty, light red and thin blood, lassitude, and shortness of breath, and poor appetite. The tongue is pale. The pulse is thin and weak. What is the pattern?
A) Deficient blood
B) Deficient qi
C) Deficient yin
D) Internal, deficient, hot
B) Deficient qi
Explanation:
key: SOB, poor appetite, continuous + scanty light red and thin blood
CAM pg 479 Uterine Bleeding
2 Causes: 1) Shi H, 2) Qi xu
A pregnant woman has prolonged labor with malposition of the fetus, shap pain in the abdomen, scanty dark and red bleeding, dark complexion. The tongue is dark. The pulse is deep and forceful. What is the pattern?
A) Hot blood and stagnant qi
B) Deficient qi and stagnant qi
C) Deficient blood and stagnant qi
D) Stagnant qi and blood
D) Stagnant qi and blood
Prescription:
LI-4 + SP-6 (prolonged labor) + moxa on belly to help fetus change position
KEY: Sharp pain, dark tongue, deep + forceful pulse, scanty dark + red bleeding
FX:
Chai hu shu gan san (move qi)
Explanation:
CAM pg 484 Prolonged labor
Causes: 1) Qi + xue stag, 2) QI + xue xu
A pregnant woman patient has morning sickness with nausea + vomiting of undigested food right after eating, sleepiness, and lassitude. The tongue is pale with white coating. The pulse is slippery and weak. What is the pattern?
A) Stagnant LR qi invading ST
B) Rebellious ST qi
C) Deficient qi of SP + ST
D) Deficient qi + xue
C) Deficient qi of SP + ST
FX:
SI jun zi tang + Sheng jiang (subdue reb ST qi, stop nausea + vomit)
Prescription:
PC-6, RN-17, RN-12
Explanation:
CAM pg 483 Morning Sickness
2 Causes: 1) XU SP + ST, 2) Disharmony SP + ST
Slippery pulse d/t pregnancy, weak d/t xu
For which of the following conditions can the plum blossom needle be used?
A) Edementous swellings
B) Intercostal neuralgia
C) Infectious disease
D) Acute abdominal disorders
B) Intercostal neuralgia
Which scalp area is located on the front of the scalp, and begins at the hairline directly above the pupil of the eyes, parallel wit hthe mid line of the head, is 2cm in length and extends posteriorly?
A) reproduction area
B) thoracic cavity
C) speech #2 area
D) stomach area
D) stomach area
