PointsVICaseExercises Flashcards
37 year old male, CC: palpitations. irregular heartbeat heart is racing. oppressive feeling in the chest, yellow sputum in his throat able to expectorate bitter taste in his mouth, dark urine some constipation. Tg: yellow greasy coat Px: slippery and rapid
BianZheng:
Phlegm Fire Disturbs the HT
Tx Principle:
Resolve Phlegm and Tranquilize HT
Acu Rx:
UB15, CV14, HT4 (JR-M),
PC4 (XC), ST40, LU5 (HS)
Points:
Modifications:
ST25 (for constipation)
PC5 (if restless)
Wk1
49 year old female
CC: insomnia.
She goes to lie down at 10pm, but often cannot fall asleep until after 1am.
hot flashes, night sweating, ringing in her ears.
Tg: red tongue, very thin coat with small cracks across
Px: thin, rapid
BianZheng:
Hyperactive Fire from Yin Xu
Tx Principle:
Nourish Yin to Remove Fire and Calm Spirit
Acu Rx:
HT7, PC6 (open chest, yin wei, Luo), UB15, UB17 (diaph Shu), UB23, KD3
Points:
Modifications:
TB3 (for Tinnitus)
PC8 (if Fidget)
Wk1
A 34 year old female
CC: abnormal depressive behavior 3 months,
is accompanied by her mother who has expressed concern for this recent shift.
She is a sensitive and doubtful person,
3 months ago failed to receive an award, causing her to feel angry and sad.
The following three months she cried and screamed often.
In the treatment room her answers are circuitous, murmurs with intermittent bursts of laughter and crying. P: wiry thin bilaterally.
T: dusky body w/greasy coat.
BianZheng:
Phlegm and Damp; Qi and Blood Stasis (heat)
(possible Bl Xu)
BB: Dian Kuang
Tx Principle:
Regulate Qi, Resolve Phlegm,
Tranquilize Mind (calm fire)
Acu Rx:
HT7, PC7, YingTang, CV17 (PC Mu, influence Qi), ST40, SP6 (yin damp; build Blood)
Points:
Modifications:
ST36, ShenTing/Du24
SP10 and UB17 to move Bl stasis (dusky tg)
Wk2
A 68 year old female,
CC: depression for the past year,
began out of the blue w/o any emotional stressor or life-altering event.
Since this began she has growing difficulties in her marriage and will become incredibly angry with him for no reason, despite her reports of him being a supportive partner. Sleep is poor, waking frequently.
P: wiry thin bilaterally
T: thin white coat, pale body
BianZheng:
Blood Xu,
LR Qi stasis?, Disturbed Shen
Tx Principle:
Nourish Blood, Soothe LR,
Tranquilize HT/mind
Acu Rx:
CV14, HT7, SP6,
LR3 (clear heat, nourish yin), ST36
Points:
Modifications:
Wk2
A 39 year old female
CC: frequent tension headaches.
Her headaches tend to come on in the afternoon
and are worse shortly after her period.
She has also noticed difficulty focusing
and has trouble remembering simple lists when she goes to the grocery or her friends’ phone numbers.
She tends to feel better with lying down.
P: thin bilaterally.
T: pale body w/thin white coat.
BianZheng:
Blood Xu
Tx Principle:
Tonify Qi and Bl
Regulate Collaterals, Stop Pn
Acu Rx:
ST36, SP6, UB20,
GV23, GV20
Points:
Modifications:
Wk3
A 70 year old male, CC: vertigo. He is very unsteady on his feet and often uses a shopping cart to steady himself while walking. He has hypertension and occasionally blurred vision. His nails are very dry and withered, and his complexion is dark and his skin dry. Tg: reddish-purple with a thin yellow coat in the center, but no coating elsewhere. His tongue is also stiff and dry. Px: very full and wiry
BianZheng:
LR Yang Overacting
BB: Dizziness (xuan yun)
Tx Principle:
Calm LR Yang
Acu Rx:
GB20, LR2, UB18, GB43, UB23, KD3
Points:
Modifications:
SP6,
Wk3
A 67 year old male
CC: sudden right-sided hemiplegia of the arm.
His speech is slurred
and his right leg is weak.
He attributes his poor walking on his dizziness.
He appears to be oriented to person, time and place with no significant lapses in his mental faculties.
Px: thready
Tg: stiff and deviated to the right with a thin white coat.
BianZheng:
Attack on Jing and Luo
Bl and Qi Stasis
BB: Wind Strike
Tx Principle:
dredge meridians and collaterals
regulate qi and blood
Acu Rx: LI 4, 5, 10, 11 (move qi to head) ST36 and 41 (foot yang ming) GB30 and 34 (infl. tendons, reverse Qi flow) UB62 (YangQiao)
Points:
Modifications:
UB10, GB 12 (one side stiff)
slurred speech?
Wk4
A 23 year old male
CC: long-standing history of muscular dystrophy.
The weakness developed slowly over the past ten years and mostly affects his legs.
He is somewhat ambulatory, but requires a walker.
He also reports low back pain, dizziness on standing,
and overall exhaustion.
He occasionally experiences ringing in his ears.
Px: slightly rapid and thready
Tg: dry with little coat
BianZheng:
LR and KD Yin Xu
and YangMing Dz
BB: Wei Syndrome
Tx Principle:
Nourish KD and LR Yin
Acu Rx:
UB18 (LR shu), UB23 (KD shu)
GB30, 34, 39,
ST31, 34, 36, 41
Points:
Modifications:
Tinnitus:
Wk5
A 48 year old female,
CC: deviation of mouth.
It began gradually over the course of several days after a severe purulent ear infection. She is unable to smile or frown on the right side.
You notice that her right eye is not as open as her left and does not fully close when she blinks.
Px: slippery and rapid
Tg: red with a sticky coat.
BianZheng:
Damp heat attack upward
Tx Principle:
Clear heat and resolve damp heat
Acu Rx: Base for all Facial Paralysis
LI4, ST4, ST6, ST7, GB20, GB14
TB17, TB5, SI18
More Rx: for damp heat
SP9, GB34, LI11, ST44
Points:
Modifications:
Difficulty in frowning and raising the eyebrow: BL2, TB23
Incomplete closing of the eye: BL2, BL1, GB1, Yuyao, TB23
Ear Pain: GB2, TB3
Wk5
A 67 year old female
CC: joint pain.
She began experiencing pain seven years ago,
first emerging with shoulder pain.
Currently the pain moves from the shoulders to knees, hips, and wrists.
She describes the pain as a soreness and extending into the muscles.
When you check her range of motion, it is limited in abduction of the shoulder and flexion of the knee.
Both the shoulders and knees are swollen.
She reports alternating sensations of cold and heat
with a general aversion to wind.
T: thin white coat
P: floating and wiry
BianZheng:
Wind, Cold, & Damp in Collaterals… obstructing Qi & Blood
BB: Wandering Bi
Tx Principle:
Dispel wind & cold, remove damp, dredge collaterals
Acu Rx:
BL17, SP10 - move blood
GB20, BL12, LR3
Points:
Modifications: active local points for shoulder - TB14, LI15, SI10 hips - GB30, 29, 39 knees - ST35, GB34, LR8, UB40, SP9 wrists - TB5, 4, LI5, SI4
Wk6
A 16 year old male
CC: 2 weeks history of low back pain.
The pain began after a recent fall from his BMX bike.
When asked to isolate his pain, he points to the left side of L2-L3.
He describes the pain as stabbing and tender to palpation.
His active range of motion is limited in rotation and lateral flexion to the left.
T: normal tongue body with some purple dots
P: choppy
BianZheng:
Blood Stasis
BB: Lumbago (Yao Tong)
Tx Principle:
activate blood to remove blood stasis, dredge collaterals to relieve pain
Acu Rx:
BL23, BL40, Ashi; SP10, BL17;
Distal (insert and have them move): GV26, YaoTong, LI10
Points:
Modifications:
DU26 if really stiff/immobile
Wk7
A 30 year old female presents to clinic for help regarding recurring cystitis.
She reports that she has been suffering from recurring bladder infections for the past year.
During the attacks she experiences frequent and scanty urination, with a burning pain.
She notices that the urine is darker than usual. In the past, she had been prescribed antibiotics, which have helped temporarily until her symptoms return.
When the attacks first began, she had lost her father and felt very sad
T: slightly red, with a markedly redder tip, yellow coat in the root with red spots
P: slightly rapid and wiry
BianZheng:
Heat stranguria (Bing)
Damp Heat Low Jiao
Tx Principle:
Clear heat, drain damp,
promote urination
Acu Rx:
UB28 (shu), CV3 (UB Mu), SP9
SP6, TB5
Points:
Modifications:
Wk8
A 32 year old female,
CC: delayed menses.
Her menses have been long for the past two years, ever since beginning as a student at medical school.
Cycles can last up to 50 days and when she bleeds the blood is light in color and very thin.
She states that she has been fatigued since starting school.
She has also noted occasional palpitations when she lays down to rest.
On inspection you note that her complexion appears sallow, she is slight of frame and her skin lacks luster.
T: Pale body, thin white coat
P: Weak and thready
BianZheng:
Blood Xu Syndrome
Tx Principle:
Warm meridians to regulate blood. Tonify Qi and Blood
Acu Rx:
CV6 (QiHai),
KD13 (KD and Chong), SP6
Points:
Modifications:
ST36, BL17,
BL20 source of qi/bl, infl bl
Wk9
A 52 year old female
CC: irregular menses.
She wants to be through menopause and is frustrated that she still gets menstrual bleeding at intermittent intervals.
She occasionally gets hot flashes, though she does not seem to be bothered by them too much.
Her digestion is poor,
with bloating and occasional nausea.
She appears overweight
and clears her throat often during your interview.
Px: slippery
Tg: greasy coat.
BianZheng:
Phlegm and Qi Stasis
Tx Principle:
Regulate qi and resolve phlegm
Acu Rx:
CV17, CV12, CV6, PC6, ST40, SP6
Points:
Modifications:
GV20, KD3
Wk10
43 y.o mlae
CC: sudden onest paralysis;
woke ok, but noticed lopsided in mirror;
speech was muffled (ht orifice) b/c impaired movement of right side;
his affect seems blunted (d/t paralysis);
unable to smile or frown on right side ;
right eye can’t open completely and left not fully close when blinks..
P: superficial + tight
T: thin white coat
BB: facial paralysis
BZ: Damp Cold & Wind Attack
Tx Principle: expel wind and cold, dredge meridians & collaterals
Acu Rx: Basic for all facial paralysis
LI4, ST4, ST6, ST7
GB20, GB14, TB17, TB5, SI18
More: for wind cold
UB12, GV12, TaiYang
Modifications:
Incomplete closing of eye:
UB2, UB1, GB1, YuYao, TB23
Difficulty frowning &/or raising eyebrow: UB2, TB23
WK5 (example from previous year’s class notes)
