Midterm Review Flashcards
A patient has dry cough, hot sensations in the afternoon, and a peeled red tongue. What is the treatment plan? Differentiation (Diagnosis): Principle of treatment: Prescription: Formula:
Differentiation/Diagnosis:
Cough d/t Lung Yin Xu
Principle of treatment:
Nourish LU Yin, clear xu heat, stop cough
Prescription:
LU-9, KD-6, LI-11, SP-6, UB-13, RN-22, RN-17, LU-1
Formula:
Bei mu gua lou san (LU Dry)
Bai he gu jin wan (LU/KD Yin Xu)
Mai men dong tang (LU/ST Yin Xu)
A patient has tongue ulcers, thirst, palpitations and a red tongue. What is the treatment plan? Differentiation (Diagnosis): Principle of treatment: Prescription: Formula:
Differentiation (Diagnosis):
Heart Fire Blazing
Principle of treatment:
Clear heat and drain HT fire, calm shen
Prescription:
HT-8 (ying spring, HT-F), Li-11, RN-14 (FM HT), Shenmen, HT-5 + HT=7 (palpitations),
Formula:
Dao chi san (HT-F pass to SI)
w/ modified
Huan lian e jiao tang (HT-F + HT Xue Xu)
Explanation:
HT opens to the tongue Red tongue= heat Palpitations= rel HT
A patient has loose stools, chilliness, edema, cold limbs, and fatigue. What is the treatment? Differentiation (Diagnosis): Principle of treatment: Prescription: Formula:
Differentiation (Diagnosis):
Spleen yang xu
Principle of treatment:
Tonify SP yang, warm the middle
Prescription:
RN-8 (w/ moxa), RN-6 (Tn SP), SP-3, SP-6 (very good), RN-9 (Sui fen, prom urination to solidify stool), RN-3 (FM UB), ST-28 (Sui Dao- water, passages SP-9 (edema, VIP), UB-22 (BS SJ)
Formula:
Li zhong wan (warm middle)
w/ modified
Wu ling san (promote urination for edema)
May use Wu ling san primarily and modify to include warm interior herbs i.e Gan jiang, Rou gui
Explanation:
Edema rel Org: LU, KD, SP + Fu: SJ, (control water passages) SP= extremities, T/T
A patient has poor appetite, fatigue, and loose stools. What is the treatment? Differentiation (Diagnosis): Principle of treatment: Prescription: Formula:
Differentiation (Diagnosis):
Spleen qi xu
Principle of treatment:
Tonify SP qi
Prescription:
ST-25, SP-3, ST-36, RN-12, UB-20, LR-13
Formula:
Si jun zi tang (ren shen, bai zhu, fu ling, gan cao) or modified Shen ling bai zhu tang (w/ lian zi, huang qi)
A patient has dryness at night, night sweats, backache, and a red tongue without any coating. What is the treatment?
A) RN-4, KD-3, KD-6, SP-6, KD-10
B) LR-8, KD-3, UB-23, UB-18, RN-4
C) RN-4, HT-5, KD-6, SP-6, UB-15
D) HT-6, KD-7, RN-4, SP-6, UB-15
Formula:
A) RN-4, KD-3, KD-6, SP-6, KD-10
RN-4 ( yuan gate- yuan qi),
KD-3 (source KD VIP any KD xu),
KD-6 (calm spirit, night sweats),
SP-6 (san yin jiao, Tn Yin),
KD-10 (He sea, xue xu, night sweat, dry mouth)
DX:
KD Yin xu
Formula:
Liu wei di huang wan
Explanation:
A) RN-4, KD-3, KD-6, SP-6, KD-10
KD Yin Xu
B) LR-8, KD-3, UB-23, UB-18, RN-4
LR Xue Xu/ LR+KD Yin Xu
C) RN-4, HT-5, KD-6, SP-6, UB-15
HT Yin Xu
D) HT-6, KD-7, RN-4, SP-6, UB-15
HT+ KD Yin Xu
The point prescription for hypertension with dizziness, blurred vision, tinnitus, insomnia, palpitations, irritability, numb sensation in the limbs, red tongue w/o coating, and thin pulse is GB-20 (feng chi), LI-11 (qu chi), ST-36 (zu san li), LR-3 (tai chong) combined with:
A) LR-2, GB-34
B) PC-6, ST-40
C) RN-6, RN-4
D) KD-3, HT-7
D) KD-3, HT-7
DX:
HT + KD Disharmony
FX:
Tian wang bu xin dan
(heaven king tonify ht powder)
Explanation:
palpitations d/t HT KD Yin xu can cause blurred vision mixed xu (below) + shi (above)
A patient has palpitations, night sweats, tinnitus, insomnia, and red-peeled tongue w/ a midline crack. What is the treatment?
A) HT-6, KD-7, RN-4, SP-6, UB-15
B) RN-4, KD-3, KD-6, SP-6, KD-10
C) LR-8, KD-3, UB-23, UB18, RN-4
D) DU-4, UB-23, UB-15, SP-9, SP-6
A) HT-6, KD-7, RN-4, SP-6, UB-15
HT-6 (XC HT), KD-7 (Tn yin, night sw), RN-4 (Tn yin), SP-6 (Tn yin), UB-15 (BS HT)
DX:
HT+ KD Disharmony
FX:
Tian wang bu xin dan
Explanation:
KD open to ear = tinnitus
A patient has edema which first started on the feet and then spread over the whole body, sallow complexion, and weak back. The tongue is pale with thin white coating. The pulse is deep and thin. What is the prescription?
Differentiation (Diagnosis):
Principle of treatment:
Prescription:
Formula:
Differentiation (Diagnosis):
SP + KD Yang xu
Principle of treatment:
Tonify SP + KD yang
Prescription:
KD-3, UB-34, UB-20, UB-22, SP-6, ST-36, RN-4 (yuan qi + KD yang xu), RN-6 (SP-yang xu), RN-9, SP-9, RN-3, DU-4 (KD yang xu, mingmen fire)
Formula:
Jin gui shen qi wan modified w/ increase ze xie, fu ling, add Zhu ling (these three are in wu ling san)
Explanation:
KD edema especially presents on the leg and ankle
SP edema more whole body
A patient has difficulty falling asleep, dreams, palpitations, poor memory, anorexia, and sallow complexion. The tongue is pale w/ thin white coating. The pulse is thin & weak. What is prescription?
A) UB-18, UB-19, GB-12, HT-7, SP-6, An mian
B) HT-7, SP-6, An mian, UB-20, UB-15, SP-1
C) ST-36, HT-7, SP-6, An mian, UB-21
D) An mian, UB-15, UB-23, HT-7, SP-6, KD-3
B) HT-7, SP-6, An mian, UB-20, UB-15, SP-1
DX:
HT Xue & SP Qi Xu (HT + SP Xu)
FX:
Gui pi tang
Explanation:
HT Xue Xu- difficulty fall asleep, dreams, palpitations, poor memory, sallow complexion (either), thin pulse
SP Qi Xu- anorexia, sallow complexion (either), weak pulse
Causes of Insomnia:
HT Xue + SP Qi Xu
HT Xue Xu
LR Xue Xu
A patient has dizziness made worse with stress, irritability, red eyes, dream disturbed sleep, & bitter mouth taste. The tongue red with yellow coating. The pulse is wiry. What is the prescription?
A) UB-23, KD-3, GB-20, UB-18, LR-2
B) DU-20, RN-4, ST-36, SP-6, UB-20
C) UB-20, RN-12, PC-6, ST-40, ST-8
D) Yin tang, ST-8, GB-20, LR-3
A) UB-23, KD-3, GB-20, UB-18, LR-2
LR-2 (expel int-W, subdue rising LR yang)
DX:
LR yang rising d/t KD yin xu
FX:
Tian ma gou teng yin
Explanation:
A) UB-23, KD-3, GB-20, UB-18, LR-2
LR yang rising d/t KD yin xu
B) DU-20, RN-4, ST-36, SP-6, UB-20
SP xu
C) UB-20, RN-12, PC-6, ST-40, ST-8
Phlegm
D) Yin tang, ST-8, GB-20, LR-3
Yangming H/A
CAM: pg 458
FCM: pg 524
DR Cao: LR yang rising d/t LR-Fire
Book says KD yin xu is the root of the LR yang rising so A is best.
Empty H may cause yellow coat bitter taste usually excess condition
A patient has edema in the ankles, palpitations, pale and swollen tongue, and deep-weak pulse. What is the treatment?
A) SP-6, SP-9, UB-22, RN-3, UB-28
B) DU-4, UB-23, UB-15, SP-9, SP-6
C) RN-4, KD-3, KD-6, SP-6, KD-10
D) HT-6, KD-7, RN-4, SP-6, UB-15
B) DU-4, UB-23, UB-15, SP-9, SP-6
DX:
KD yang xu w/ water overflowing to HT
FX:
You gui wan (KD yang xu) w/ Wu ling san
or Mod of Jin gui shen qi san w/ Wu ling san
(little yang xu with more water retention)
Explanation:
Organs and fu control water passages rel edema: LU, SP, KD + SJ FCM pg 601
A patient has hematuria, urgency when feels desire to urinate, burning and hot urine. The tongue has a thin and yellow coating. The pulse is forceful and fast. What is the prescription?
A) SP-9, UB-23, UB-28, RN-3, KD-6
B) UB-28, SP-10, RN-3, SP-9, SP-6
C) LR-2, UB-28, RN-3, SP-9
D) UB-28, RN-3, SP-9, UB-39
B) UB-28, SP-10, RN-3, SP-9, SP-6
DX:
Damp Heat in UB (w/ H in Blood Vessels)
FX:
Mod Ba zheng san (g for pee)
CAM: pg 323
3 Basic points UTI:
UB-28, SP9 or SP-6, RN-3
A patient has acute edema of the face, aversion to wind, and a superficial-slippery pulse. What is the treatment?
A) ST-36, SP-3, UB-20 UB-13, LU-9
B) ST-36, SP-6, SP-9, UB-13, LU-9
C) LU-7, LI-4, LI-6, UB-12, RN-9
D) LU-9, KD-6, RN-4, SP-6, RN-12
C) LU-7, LI-4, LI-6, UB-12, RN-9
LU-7 + LI-4 (wind rel ext together LU luo, LI source)
LI-6 (water passages luo of LI)
UB-12 (wind gate)
RN-9 (water retention)
DX:
Wind-water invading the LU
External W therefore aversion wind & superficial pulse
FX:
Xiao qing long tang
A patient has palpitations, SOB on exertion, sweating, paleness, fatigue, listlessness, pale tongue, and an empty pulse. What is the treatment?
A) HT-5, PC-6, UB-15, RN-17, RN-6, UB-21
B) HT-7, PC-6, RN-15, UB-17, RN-4, UB-20
C) HT-5, PC-6, UB-15, RN-17, RN-6, DU-14
D) HT-7, PC-6, RN-15, RN-4, HT-6, KD-6, KD-7
C) HT-5, PC-6, UB-15, RN-17, RN-6, DU-14
HT-5 (tonify HT-qi)
DX:
HT qi xu
FX:
Mod Si jun zi tang or Bao yuan tang
Explanation:
A) HT-5, PC-6, UB-15, RN-17, RN-6, UB-21
HT + ST/SP qi xu
B) HT-7, PC-6, RN-15, UB-17, RN-4, UB-20
HT xue xu- UB-20 (Tn SP to generate xue)
C) HT-5, PC-6, UB-15, RN-17, RN-6, DU-14
HT qi xu -DU-14 (Tn qi)
D) HT-7, PC-6, RN-15, RN-4, HT-6, KD-6, KD-7
KD + HT Disharmony
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 (subdue LR-F)
GB-34 (subdue reb qi, relax sinews and muscles)
DX:
LR-Fire blazing
FX:
Long dan xie gan tang
A patient has dizziness, nervousness, timidity, lack of initiative, startles easily, and sighing, pale tongue, and weak pulse. What is the treatment?
Differentiation (Diagnosis):
Principle of treatment:
Prescription:
Formula:
Differentiation (Diagnosis):
GB xu
Principle of treatment:
Tonify and warm GB, Tonify LR qi
Prescription:
GB-40 (source), UB-19 (BS GB), UB-18 (BS LR), ST-36 (LR qi, xue), LR-3 (source), LR-8 (LR qi + xue), UB-47 (ethereal soul)
Formula:
An shen ding zhi wan
FCM pg 666
A patient has dizziness, nausea, profuse sputum, anorexia, and stuffy head. The tongue has a white and greasy coating. The pulse is slippery. What is the prescription?
A) Yin tang, ST-8, GB-20, SP-9
B) DU-20, RN-4, ST-36, SP-6, UB-20
C) UB-23, KD-3, GB-20, UB-18, LR-2
D) UB-20, RN-12, PC-6, ST-40, ST-8
D) UB-20, RN-12, PC-6, ST-40, ST-8
UB-20 (BS SP)
RN-12 (FM ST, nausea)
PC-6 (nausea, open chest/head)
ST-40 (phlegm)
ST-8 (dizziness)
DX:
Internal damp phlegm (Damp-phlegm in SP/ST)
FX:
Er chen tang
Explanation:
B) DU-20, RN-4, ST-36, SP-6, UB-20
Xu qi + xue –> dizziness
C) UB-23, KD-3, GB-20, UB-18, LR-2
Hyperactivity of LR yang–> dizziness
D) UB-20, RN-12, PC-6, ST-40, ST-8
retention phlegm damp
CAM: pg 449
dizziness d/t internal phlegm damp
A patient has palpitations, sadness, tiredness and an empty pulse. What is the treatment?
A) HT-5, PC-6, UB-15, KD-6, RN-6
B) RN-6, RN-4, DU-20, DU-14, UB-15
C) DU-14, RN-6, HT-5, PC-6, UB-15, RN-17
D) HT-8, HT-7, SP-6, KD-6, RN-15
C) DU-14, RN-6, HT-5, PC-6, UB-15, RN-17
DU-14 (Tn qi)
HT-5 (Tn HT qi)
DX:
HT Qi xu
FX:
Mod Si jun zi tang or Bao yuan tang (tonify HT)
CAM: pg 443 Causes of palpitations
A patient has light red rashes and heavy sensations in the body. The tongue coating is white and sticky. The pulse is floating and slow. What is the pattern and treatment?
A) Heat in Blood
B) Wind-heat
C) Wind-damp
D) Deficient SP Qi with Damp accumulation
C) Wind-Damp
FX:
Xiao Feng San (for skin rashes d/t W-D or W-H)
Prescription:
Bai chong wou (uticaria), SP-9 (damp), DU-14 (Ext W), LI-4 (W), UB-40 (skin diseases)
Explanation:
floating pulse= exterior/wind
sticky/white tongue coat=damp
rash= generally d/t wind
A patient has palpitations, insomnia, mental agitation, poor memory, dizziness, tinnitus, deafness, night sweats, afternoon sensations of heat, nocturnal emission w/ dreams, sore back, and scanty dark urine. What tongue is expected? What is the treatment?
A) Red tongue w/ thin yellow coating
B) Red tongue w/ thin white coating
C) Red and peeled tongue, red tip, cracks in midline
D) Red tongue w/ thick-yellow coating
C) Red and peeled tongue, red tip, cracks in midline
DX:
KD + HT Disharmony
FX:
Tian wang bu xin dan
Prescription:
HT-7 (xue), HT-6 (yin), HT-5 (qi), RN-17, RN-15 (FM HT), UB-15 (BS HT), UB-23 (BS KD), DU-24 (emotional disorders), KD-3 (source), KD-6 (KD Yin, xue H), RN-4, SP-6 (Xue, Yin, KD, Calm mind)
Explanation:
Red tongue + whole body w/ no coat= KD
Red tip= HT
Afternoon H + night sweats= Yin xu
HT: mental aggitation, palps, insomnia, controls spirit
KD: tinnitus, deafness, noct. em, sore/weak back (knees)
A patient has a red face, thirst, dark urine, stool with foul odor, red tongue w/ yellow moss, and fast, deep pulse. Which of the eight principles apply?
A) Internal, empty, hot
B) external, full, hot
C) internal, full, hot
D) External, empty, hot
C) Internal, full, hot
DX:
Damp heat in LI
FX:
Mod Xiao Cheng qi tang (+ D-H clearing herbs)
or
Long dan xie gan tang (for D-H in lower jiao)
Prescription:
ST-37 (LHS LI), LI-11 (H), ST-25 (FM LI), GB-34 (D-H), ST-44 + LR-2 (ST H)
A patient has urgent and frequent urination, burning urine, difficult urination which stops midstream, dark colored urine, blood and sand in the urine, feverish sensations, and thirst. What tongue is expected? What is the treatment?
A) white-greasy coating on root
B) pale and wet tongue
C) red tongue w/o coating
D) thick, sticky, yellow coating on root w/ red spots
D) thick, sticky, yellow coating on root w/ red spots
DX:
Damp heat in UB (lower jiao)
FX:
Ba zheng san (g for pee)
Treatment:
clear heat, resolve damp, promote urination
Prescription:
UB-28 (BS UB), RN-3 (FM UB), UB-66 (ying spring cl organ H), SP-10 (stop bleeding), SP-9 (damp), SP-6 (cool blood, benefit urination)
Explanation:
A) white-greasy coating on root
C-D UTI
B) pale and wet tongue
Yang xu
C) red tongue w/o coating
Yin xu
D) thick, sticky, yellow coating on root w/ red spots
D-H lower jiao
A patient has dry cough with just a small amount of sputum, low-grade fever, hot sensations in the evening, night sweats, red cheeks, and dryness. What tongue is expected? What is the treatment?
A) pale or normal colored tongue
B) red w/o coating
C) dry tongue
D) thin yellow coating
B) red w/o coating
DX:
LU yin xu
FX:
Sheng mai san
(LU qi + yin xu w/ sweating)
or
Bei mu gua lou san
Prescription:
LU-9 + ST-40 (xu LU w/ P), RN-22 (cough), RN-4 (yin xu), LU-9 (source), LI-11 (dry heat), SP-6 (yin xu), KD-6 (yin xu, sore throat)
A new mother complains of insufficient breast milk. She reports her breasts feel swollen. She has a poor appetite. The points prescribed are ST-18, RN-17, SI-1, ST-36, SP-6. After five treatments there is only slight improvement. What would you prescribe now?
A) ST-18, RN-17, SI-1, ST-36
B) ST-18, RN-17, SI-1, LR-14, LR-3
C) UB-20, RN-6, ST-36, SI-1, ST-18
D) RN-17, PC-6, SI-1, ST-18, LI-4
B) ST-18, RN-17, SI-1, LR-14, LR-3
DX:
SP Qi xu w/ LR qi stagnation
FX:
xiao yao san
A 35 year old man has had hand tremors. He has been diagnosed with Parkinson’s disease. The tremors are worse when reaching for things and disappear while sleeping. He has a sallow complexion. Other symptoms include a weak voice and dry skin. He catches colds easily. The tongue is pale. The pulse is weak. What is the treatment?
A) LI-4, LI-7, GB-20, UB-13, UB-12
B) LR-3, KD-3, LR-8, UB-23, UB-18
C) GB-20, LR-3, UB-17, UB-18, UB-20
D) GB-20, UB-12, DU-16, Si shen cong
C) GB-20, LR-3, UB-17, UB-18, UB-20
GB-20 (int W)
LR-3 (Int W, smooth flow LR qi, calm spasm)
UB-17 (Tn xue)
UB-18 (BS LR)
UB-20 (BS SP- Tn SP/qi to generate Xue)
DX:
Tremors d/t LR xue xu
FX:
Mod Tian ma gou teng yin (tremors d/t LR xue xu)
or Bu gan tang (tonify LR decoction)
Explanation:
Causes LR Wind Agitating Within:
Extreme heat generating Wind
LR Yin Xu
LR + KD Yin Xu
LR Fire
LR Xue Xu
FCM pg 529
A patient has fullness and distention just above the bladder area with pain referring to the genital area, and pain is improved with application of heat, pale wet tongue with white moss, and wiry, deep, and slow pulse. What is the treatment?
A) UB-18, UB-20, UB-17, SP-6, LR-8
B) RN-2, GB-20, Tai yang, GB-13, LI-11
C) GB-34, LR-3, PC-6, SJ-6
D) RN-3, LR-5, LR-1, LR-3
D) RN-3, LR-5, LR-1, LR-3
RN-3 (FM UB, local pain)
LR-5 (genitals)
LR-1 (benefit genitals, reg qi)
LR-3 (smooth LR Qi, stop pain)
DX:
Cold stagnation in LR channel (D-C obst. LR ch)
FX:
Nuan gan jian (warm the LR decoction)
Explanation:
Cold stag= better w/ H, slow + deep pulse (cold), wiry (stag d/t C), pale/wet tongue w/ white moss
A 27 year-old woman has a problem with sweating. She sweats profusely in the hands and feet with dripping sweat. The condition worsens during her menstrual period and worsens when she gets excited. Other symptoms include palpitations, thirst for cold drinks and irritability. She looks healthy and lively and does not complain of tiredness. The tongue is red. The pulse is fast. You treat the patient with HT-6 + HT-7. There is only slight movement after a few treatments. What would you add to the point prescription?
A) SI-3
B) KD-2, LR-2
C) LI-4, KD-7
D) PC-7, LR-2
C) LI-4, KD-7
(VIP pair for sweating or combo HT-6 + KD-7- incl here)
FX:
Huang lian e jiao tang
or Xie xin tang (drain HT-F)
Deep needling of ST-20 may:
A) penetrate an enlarged stomach
B) penetrate the lung
C) penetrate an enlarged heart
D) penetrate an enlarged liver
D) penetrate an enlarged liver
ST-20 5 cun above umbilicus + 2 cun lateral RN-13 (midline)
ST channel 4–>2 cun @ ST-19
Which of the following meridians is connected to the root of the tongue and spreads underneath its surface?
A) Kidney meridian
B) Heart meridian
C) Spleen meridian
D) Liver meridian
C) Spleen Meridian
3 Organs connect to tongue:
SP: “Penetrates internally to follow the throat up to the root of the tongue, under which it spreads its qi and blood” (pg 130, Kim)
HT:
KD: “Branch continues along the throat and terminates at the root of the tongue” (pg 132 Kim)
Pg. 178 Deadman
A patient has urgent and frequent urination, burning urine, difficult urination which stops midstream, dark colored urine, blood and sand in the urine, feverish sensations, and thirst. What tongue is expected?
A) white-greasy coating on root
B) pale and wet tongue
C) red tongue without coating
D) thick, sticky, yellow coating on the root with red spots
D) thick, sticky, yellow coating on the root with red spots
DX:
Damp heat in UB
FX:
Mod Ba Zheng San
Prescription:
SP-9 (Damp whole body) or SP-6, UB-22 (BS SJ), UB-28 (BS UB), UB-63 (xi cleft), UB-66 (ying spring), RN-3 (FM UB), RN-9 (water retention, esp mid-upper jiaos), LI-11 (H), ST-28 (local UTI, drain water, promote urination), SP-10 (any blood disorder)
3 Main UTI points:
RN-3 SP-9 UB-28
A patient has edema more pronounced in the legs and ankles, cold feelings, fullness and distention in abdomen, sore lower back, and scanty and clear urination. What pulse is expected?
A) Deep, weak and slow pulse
B) Floating, empty pulse and rapid pulse
C) Floating and empty pulse or choppy pulse
D) Floating and empty pulse or leather pulse
A) Deep, weak and slow pulse
DX:
KD yang xu w/ water overflowing
FX:
Jin gui shen qi wan (may combo wu lling san)
Prescription:
UB-23 (BS KD), UB-22 (BS SJ), DU-4 (Tn KD yang, yuan qi, warm mingmen), SP-6 (Tn KD), SP-9 (water retention), UB-39 (SJ LHS), ST-28 (‘water pathway’), RN-3 (FM UB), RN-4 or 6
UB-39 LHS SJ, Tn UB, open water passages in Lower jiao, stimulate transformation and excretion of fluids in lower jiao
ST-28 Open water passages & benefit urination
RN-3 can use moxa
RN-4 yuan qi, KD Jing, yin or yang
RN-6 Qi Hai (qi cave), sea of qi, Tn qi
A 49 year old female has been diagnosed with hyperthyroidism. She is being treated with PC-5 & SP-6. She returns in two days. She complains of excess sweating. What would you add to the prescription?
A) KD-7, LI-4
B) HT-6, KD-7
C) HT-6, LI-4
D) RN-4, UB-23
B) HT-6, KD-7
HT-6 (XC HT)
KD-7 (all kinds sweating)
DX:
HT + KD Disharmony
FX:
Tian wang bu xin dan (ht/kd dis)
w/ mu li san (tx sweating)
LI-4 + KD-7 also good for xu or shi sweating w/ appropriate technique
A 52 year old man has high blood pressure. Main symptoms include feeling of pressure in the head, stiff neck, throbbing h/a on top of the head, blurred vision, tinnitus, dizziness, waking up frequently during the night with worries and wanting to throw the covers off. The cheeks are slight red and the eyes have no glitter. The tongue is stiff, red with very thin coating. The pulse is wiry and thin. What is the diagnosis?
A) Deficiency KD yin w/ empty fire
B) Deficienty LR yin, LR yang rising
C) LR fire blazing
D) Deficienty KD qi, Deficient HT xue
B) Deficienty LR yin, LR yang rising
(LR yin xu w/ LR yang rising)
FX:
Tian ma gou teng yin
Prescription:
LR-3 (soothe LR, Tn yin)
SP-6 (Tn SP, smooth flow LR qi, Tn xue + yin)
DU-20 (h/a, dizzy, hypertension, expel int W)
ST-36 (Tn xue, qi, brighten vision)
GB-20 (Int/Ext W, Subdue LR yang, eyes)
SJ-5 (any h/a)
LI-4 (w/ LR-3)
Explanation:
LR Yin b/c: wiry pulse, blurred/sl red eyes, vertex h/a)
Vs KD Yin xu s/s: low back + knee weak, xu pulse
The patient has abnormal uterine bleeding w/ excessive discharge, poor appetite, unformed stools. You choose SP-6, UB-20, UB-18, SP-1. What is missing from your prescription?
A) RN-4, DU-4
B) SP-10, LR-1
C) DU-20
D) ST-25,RN-12
C) DU-20 (Raise yang)
DX:
SP not controlling blood (SP not holding)
FX:
Gui pi tang (SP not control xue)
w/ Bu zhong yi qi tang (more SP qi sinking)
A 33 year old patient has had painful periods for ten years. The pain occurs during her period. The blood is red and scanty. She generally feels cold during her period. She has a history of miscarriages. Other symptoms include back pain, achy knees, dizziness, tinnitus, poor memory, dry mouth, night sweating, and dribbling urination. The tongue has a normal color. The pulse is overall weak and the left side is thin and empty at the deep level. What is the diagnosis?
A) Deficiency of KD yin w/ false cold
B) Deficiency of KD yin and yang
C) Deficiency of KD yang w/ false heat
D) Deficiency of KD yin w/ excess internal cold
B) Deficiency of KD yin and yang
FX:
Mod Zuo gui wan (Tn KD yin + yang xu)
+gan jiang or rou gui
or
Gui shen wan (Tn KD yin + yang xu)
You gui wan is too warm for here b/c fu zi
A 54 year old woman has had wheezing for 6 years. She is overweight. She has difficulty inhaling, a constant nasal discharge, and phlegm in the throat. She expectorates sticky yellow phlegm. She has a feeling of oppression in the chest and nausea, bad digestion w/ acid reflux and loose stools. She has thirst. The tongue is slight red in color and swollen. The tongue has a crack in the middle with yellow coating. The pulse is generally slippery and weak on the right side. What is the diagnosis?
A) Phlegm obstructing lungs
B) Liver fire insulting lungs, accumulation of phlegm
C) Deficient SP yang w/ accumulation of dampness
D) Phlegm-heat in lungs and ST, SP Qi Xu
D) Phlegm-heat in lungs and ST, SP Qi Xu
FX:
Qing qi hua tan wan
+bai zhu (Tn SP, Drain D)
Increase fu ling, chen pi
Prescription:
SP-3 + ST-40
RN-17 (unbind chest, descend qi)
LU-5 (he sea, Expel phlegm LU)
LU-7 (luo, open LU, open water passages, phlegm + qi stag in LU)
LI-11 (H)
ST-36 + SP-6 (Tn qi, resolve D, clear heat)
According to the TCM theory of the five elements, if a patient has a weak pulse in the guan position of the right wrist, which of the following points would you needle?
A) Tonification of LU-9
B) Tonification of SP-2
C) Tonification of SP-3
D) Tonification of LR-2
B) Tonification of SP-2
Mother-diseased channel
HT-8 = Horary mother
The needling caution from UB-12 all the way to which bladder point carries the risk of pneumothorax with perpendicular or oblique needling away from the spine?
A) UB-21
B) UB-22
C) UB-20
D) UB-23
A) UB-21 (T-12)
UB-22= puncture KD
UB-23= puncture KD
Many q’s on caution + contraindication
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
CAM pg 477
Qi is the commander of blood, and blood is the mother of Qi.
Blood is transferred from food through the fxn of t/t of SP, and dyfxn of SP leads to xue xu. Xue xu causes malnutrition of Chong + Ren and voidness of sea of xue… Xue xu fails to nourish muscles, skin & head, bringing sallow complexion, dry skin, vertigo & dizziness & lassitude. Dysfxn of t/t of SP gives rise to poor appetite and loose stools. Pale tongue w/ white coat & slow, weak pulse are signs xue xu. (pg 477)
FX:
Tao hong si wu tang
(mod of si wu tang= + tao ren, hong hua)
A patient has rash behavior, uncontrollable emotions, incoherent speech and a red tongue w/ a sticky yellow coating. What is the treatment?
A) PC-5, PC-6, UB-15, RN-17, RN-6
B) HT-5, PC-6, UB-15, DU-14, RN-6
C) ST-40, HT-7, HT-5, PC-6, RN-12
D) SP-6, UB-15, PC-5, HT-8, PC-7, ST-40
D) SP-6, UB-15, PC-5, HT-8, PC-7, ST-40
SP-6 (resolve D, calm mind, cool xue)
UB-15 (BS HT)
PC-5 (Cl H, Resolve HT P)
HT-8 (Cl HT F, HT-P-F)
PC-7 (Cl H, calm mind)
ST-40 (phlegm)
DX:
Phlegm fire harassing HT
FX:
Qing qi hua tan wan (Dr. Cao)
or
Huang lian wen dan tang (wen dan tang + huang lian- drain HT F)
A patient has palpitations, sadness, tiredness, and an empty pulse. What is the treatment?
A) HT-5, PC-6, UB-15, KD-6, RN-6
B) RN-6, RN-4, DU-20, DU-14, UB-15
C) DU-14, RN-6, HT-5, PC-6, UB-15, RN-17
D) HT-8, HT-7, SP-6, KD-6, RN-15
C) DU-14, RN-6, HT-5, PC-6, UB-15, RN-17
DX:
HT Qi Xu
FX:
Zhi gan cao tang (Fu mai tang)
(for palps d/t HT qi xu)
or
Gui pi tang
(HT Qi + Xue xu causing palps)
Explanation:
A) HT-5, PC-6, UB-15, KD-6, RN-6
HT + KD Disharmony
B) RN-6, RN-4, DU-20, DU-14, UB-15
General Qi Xu- not enough HT pts
C) DU-14, RN-6, HT-5, PC-6, UB-15, RN-17
HT Qi Xu
D) HT-8, HT-7, SP-6, KD-6, RN-15
HT Fire
A 24 year old man has recently had an appendectomy. After the operation there is abdominal distention w/ no gas being passed. The complexion is dark. He is restless. The mouth is dry but he has no desire to drink. He has a bitter taste in the mouth. The urine is scanty and yellow. He is nauseous and occasionally vomits. The tongue is dark red w/ greasy and yellow coating. The pulse is deep and forceful. What is the diagnosis?
A) Stagnant LR qi invading ST w/ SP damp
B) LR fire w/ damp-heat
C) Damp-heat obstructing intestine qi leading to rebellious ST qi
D) LR and GB damp heat
C) Damp-heat obstructing intestine qi leading to rebellious ST qi
FX:
Long dan xie gan tang (D-H obst lower jiao)
Prescription:
PC-6 + ST-36 (VIP nausea, vomit)
LI-11 (cl H)
LI-4 + LR-3 (Source, D-H obst, move qi)
GB-34 (D-H draining)
ST-37 (LHS LI)
ST-25 (promote BM)
SP-9 (Drain D anywhere)
Explanation:
Nausea + vomit= reb ST qi
No desire drink= damp/phlegm
Dark red w/ greasy yellow= heat/phlegm
Bitter taste not only LR/GB (ref acid reflux)
A 54 year old man has high fever, irritability, manic behavior, epistaxis, blood urine, dark macules, dark red tongue w/o coating and wiry-fast pulse. What is treatment?
A) LR-3, DU-16, GB-20, SP-6, KD-3
B) SP-6, SP-10, LI-11, LR-2, HT-9
C) SP-10, LI-11, GB-20, DU-16, LR-2
D) PC-9, PC-8, HT-9, KD-6
B) SP-6, SP-10, LI-11, LR-2, HT-9
SP-6 (cool xue)
SP-10 (any xue disorder)
LI-11 (cl H whole body)
LR-2 (YS LR, cool xue)
HT-9 (XC, manic behavior, cl H)
DX:
Blood level heat w/ blood moving recklessly
(pg 112 KIM on Wen Bing)
FX:
Xi jiao di huang tang (cl xue h, pg. 565 KIM)
epistaxis= bleeding from nose
A patient has fever, dark scanty urine, fullness in the chest and hypochondriac area, jaundice, poor appetite and vaginal discharge w/ itching. What is the treatment?
A) LR-14, GB-24, GB-34, DU-9, SP-9, SP-6, LI-11
B) LR-8, LR-3, SP-6, KD-3, GB-20, UB-18
C) LR-8, LR-3, LI-4, SP-6, KD-3, GB-20, DU-20
D) LR-2, GB-20, GB-13, LI-11, Taiyang
A) LR-14, GB-24, GB-34, DU-9, SP-9, SP-6, LI-11
LR-14 (FM LR)
GB-24 (FM GB, resolve D-H, prom fxn LR/GB)
GB-34 (D-H LR/GB)
DU-9 (resolve D-H, reg LR/GB, move qi, open chest)
SP-9 (Damp)
SP-6 (resolve damp)
LI-11 (clear heat)
DX:
LR/GB Damp Heat
FX:
Long dan xie gan tang
or Mod Yin chen hao tang (basic jaundice fx)
You treat a patient for chronic sinusitis. He has red eyes, H/A, and yellow nasal discharge. Your prescription is LI-20, UB-2, UB-7. After several Tx’s there is no improvement. What would you add to your prescription?
A) LI-4, LU-7
B) GB-20, LR-2
C) LI-4, UB-1
D) LR-2, Taiyang
B) GB-20, LR-2
LR-2 (LR-F- Red eyes, H/A)
GB-20 (tx any facial orifice)
DX:
Chronic sinusitis d/t LR F flaring upwards
Explanation:
Generally chronic sinusitis not yellow discharge, but more xu s/s. Here more H s/s. Original Tx LI-20, UB-2 + UB-7 only Tx sinusitis. W/ LR-2 + GB-20 cl F + Tx orifice. If pulse were floating therefore W-H invasion.
According to TCM 5E theory, if a patient had a strong pulse in the Foot position of the Right wrist, which of the following points would you needle?
A) Tonification of SJ-3
B) Sedation of SJ-10
C) Sedation of GB-38
D) Tonificaiton of GB-43
B) Sedation of SJ-10
Explanation:
RIGHT FOOT= KD + SJ/Lower jiao
sedate child to clear excess
if was xu therefore tonify mother
According to Classic of Difficulties:
CUN= “inch”
GUAN= “gate”
CHI= “foot”
PG 355 FCM
A 37 year old professional ice skater has been depressed ever since he fell and broke his leg. He has been worried about being unable to continue his career. He has insomnia, poor memory and inappropriate laughter and crying, is irritable and mentally confused. He looks gloomy and has a pale complexion. Other symptoms include heavy feeling in the head and a rattling sound in the throat. he has poor appetite. There is a sense of distention in the chest and in the hypogastrium. He has palpitations. When he is able to sleep he has nightmares. The tongue is pale with greasy-white coating. The pulse is wiry and thin. You treat the patient with PC-6, HT-7, LR-3, RN-17, ST-36, SP-6. After a course of treatment the patient was able to sleep and appetite improved but there was still a problem w/ uncontrollable laughter and weeping and the nightmares were still occurring. What points would you consider using to modify the prescription?
A) HT-5, ST-40
B) LR-2, HT-8
C) SP-9, RN-9
D) UB-15, UB-18
A) HT-5, ST-40
HT-5 (Luo, Tn HT qi, open into tongue, benefit UB, calm Mind)
ST-40 (Luo, resolve D/Ph, cl H, calm asthma, open chest, calm mind)
DX:
Phlegm misting HT/Mind w/ LR qi stag + SP qi xu
FX:
Di tan tang
(mod of er chen tang + zhi shi, dan nan xing, ren shen, shi chang pu)
or Ban xia bai zhu tian ma tang
(also mod er chen tang, +da zao, tian ma, bai zhu, -wu mei)
A patient has palpitations, SOB, shallow breathing, profuse sweating, cold legs & arms, blue lips, bluish-purple tongue, and a hidden-minute pulse. What is the treatment?
A) HT-5, PC-6, UB-15, RN-6, DU-14, moxa RN-17
B) HT-8, HT-7, SP-6, KD-6 moxa, RN-15
C) RN-6, RN-4, DU-4, UB-15, DU-14, moxa RN-8
D) HT-7, PC-6, HT-6, KD-6, KD-7, moxa RN-15, RN-4
C) RN-6, RN-4, DU-4, UB-15, DU-14, moxa RN-8
RN-6 (Tn yang + qi, Tn yuan qi)
RN-4 (Tn yang, yuan qi, calm mind)
DU-4 (Expel C, Tn KD yang, nourish yuan qi)
UB-15 (BS HT)
DU-14 (Tn yang, cl mind)
RN-8 (Tn yuan qi, rescue yang)
DX:
HT yang collapse
FX:
Shen fu tang
Explanation:
palpitations, SOB, weak and shallow breathing, profuse sweating, cold limbs, cyanosis of lips, greyish-white complexion, in severe cases coma, very pale/bluish purple tongue, hidden minute knotted pulse
FCM pg 467
A patient has retention of urine, distention and dull pain in the lower abdomen after surgical operation. The tongue has purplish spots. The pulse is hesitant and fast. What is the prescription?
A) LR-2, UB-28, RN-3, SP-9
B) UB-28, RN-3, SP-6, UB-39
C) SJ-4, UB-23, RN-4, DU-20, DU-4
D) SP-6, RN-3, ST-28, KD-5
D) SP-6, RN-3, ST-28, KD-5
SP-6 (Benefit urine, remove stasis, invig xue)
RN-3 (FM UB)
ST-28 (prom urine, alleviate pain)
KD-5 (XC KD, acute disorders, invig xue)
DX:
Damage UB ch qi d/t Surgery w/ xue stasis
FX:
Shao fu zhu yu tang (xue stag in lower jiao)
Explanation:
PG 437 CAM
Retention of Urine d/t Damage of qi of meridian
Main manifestations: dribbling urination or retention of urine, distention and dull pain in lower abd, purplish spots on tongue, hesitant + rapid pulse (d/t xue stag)
A 33 year old nursing mother has an acute case of mastitis. Treatment given was RN-17 + ST-18. After the first initial treatments the condition improved but not totally. What would you add?
A) LR-3
B) LI-4
C) SI-1
D) SJ-5
C) SI-1 Insufficient lactation
FX:
Wu wei xiao du yin (deep rooted + hard lesions)
or Chuan xin lian w/ lian qiao (cl T-H + reduce masses)
Explanation:
Wu wei xiao du yin safe to take while nursing can also pump + throw away milk while infection still present
PG 485 CAM
Which xi-cleft point is indicated for blood stasis in the uterus, shan disorder, and lower abdominal pain?
A) SP-8
B) KD-5
C) LR-6
D) KD-8
C) LR-6
XC LR, Remove obst ch, promote smooth flow LR qi, stop pain
FX:
Mod Shao fu zhu yu tang (xue stag in uterus)
Explanation:
LR channel goes to genitalia therefore is best point Shan disorder/Lower abd pain no typical fx- depend on etiology Shan disorder= hernia
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
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
