TCM Question Bank Flashcards
A patient comes in with Shortness of breath, cough and ashtma what diagnosis is this?
A. Heart blood stagnation
B. Lung Qi deficiency
C. Spleen Qi deficiency
D. Stomach fire
B. Lung Qi deficiency
A patient comes in with Poor hearing, Sore/weak back and knees, Leakage of reproductive area/incontinence (urine, ejaculations, miscarriages), what is the Diagnosis?
A. Kidney Qi Deficiency
B. Lung Qi Deficiency
C. Stomach heat
D. heart fire
Kidney Qi deficiency
A patient comes in with weakness especially with exertion, pale face, dizziness, spontaneous sweating, apathy and is worse during the day. What is the diagnosis?
A. Yang Deficiency
B. Yin Deficiency
C. Blood deficiency
D. Qi deficiency
Qi deficiency - as Wei Qi regulates the pores, this is the definition of this
A. Yang Deficiency -Feeling cold/chills (better with warmth), Cold Limbs, Better with pressure, Edema (extra substance/yin)
B. Yin Deficiency - Same as blood but also, Afternoon fever, 5 centre heat, Malar flush, Worse at rest/night (need Yin to rest), Night sweats, Dryness, Increased Thirst, Preference for cold.
C. Blood Deficiency - Although Fatigue, Dizziness, Pale, Weak are similar the difference is that the person is worse with rest (need Yin to rest, this is def.) and Worse at night sugges this
A patient comes in with loose stools, poor appetite, phlegm and a poor appetite, which herbal formula is appropriate for this patient?
A) Lu Jun Zi Tana
B) Si Wu Tang
C) Si Jun Zi Tang
D) Ba Zhen Tang
- Liú Jūn Zǐ Tāng (六君子湯)
Primary Uses:
Tonifies Spleen Qi deficiency.
Transforms Dampness and Phlegm.
Addresses digestive issues such as nausea, vomiting, bloating, poor appetite, and loose stools.
Key Indications: This formula is often used when Spleen Qi deficiency is complicated by Dampness or Phlegm, leading to digestive issues. It strengthens the Spleen’s function of transforming and transporting nutrients while resolving excess moisture. - Sì Wù Tāng (四物湯)
Primary Uses:
Nourishes Blood.
Regulates Liver Blood and moves stagnant Blood.
Key Indications: This formula is commonly used for Blood deficiency, particularly in women, to regulate menstruation, treat irregular periods, anemia, and alleviate fatigue, dizziness, and pale complexion. It also helps with Blood stasis by promoting circulation.
Key Herbs:
Shu Di Huang (Rehmannia): Tonifies blood.
Dang Gui (Angelica): Invigorates and nourishes blood.
Bai Shao (Peony): Nourishes blood and softens the Liver.
Chuan Xiong (Ligusticum): Promotes blood circulation. - Sì Jūn Zǐ Tāng (四君子湯)
Primary Uses:
Tonifies Spleen Qi.
Supports digestion and strengthens the body’s energy.
Key Indications: This formula is used for Spleen Qi deficiency, characterized by symptoms such as poor digestion, fatigue, low energy, weak limbs, poor appetite, and loose stools. It is often considered a foundational formula for general Qi tonification.
Key Herbs:
Ren Shen (Ginseng): Tonifies Qi.
Bai Zhu (Atractylodes): Strengthens the Spleen and dries Dampness.
Fu Ling (Poria): Promotes urination and reduces Dampness.
Zhi Gan Cao (Licorice): Harmonizes the formula and tonifies Qi. - Bā Zhēn Tāng (八珍湯)
Primary Uses:
Tonifies both Qi and Blood.
Key Indications: This formula is used for combined Qi and Blood deficiency. It’s commonly prescribed for patients experiencing fatigue, weakness, pale complexion, dizziness, palpitations, and menstrual issues like irregular or scanty periods. It’s beneficial for recovery after illness, surgery, or in cases of chronic weakness.
Key Herbs: Bā Zhēn Tāng combines Si Jun Zi Tang (for Qi tonification) and Si Wu Tang (for Blood nourishment), making it a powerful formula for treating simultaneous Qi and Blood deficiency.
Summary:
Liú Jūn Zǐ Tāng: Tonifies Spleen Qi, transforms Phlegm, and resolves Dampness.
Sì Wù Tāng: Nourishes Blood and promotes Blood circulation, especially for menstrual and blood deficiency conditions.
Sì Jūn Zǐ Tāng: Strengthens Spleen Qi and aids in digestion, addressing Qi deficiency symptoms.
Bā Zhēn Tāng: Combines the benefits of both Qi and Blood tonification, treating chronic weakness and deficiency after illness or menstruation-related issues.
What does Liú Jūn Zǐ Tāng stand for and what are some other common meanings of other herbs?
- Liú Jūn Zǐ Tāng (六君子湯)
Liú (六): “Six”
Jūn Zǐ (君子): “Gentleman” or “Noble Person”
In TCM, a “junzi” formula often refers to a tonifying formula, specifically one that strengthens Qi. “Noble” ingredients are those that restore balance in a gentle, harmonious way.
Tāng (湯): “Soup” or “Decoction”
Refers to the herbal preparation method where the herbs are boiled and consumed as a decoction.
Liú Jūn Zǐ Tāng literally means “Six Gentlemen Decoction.” This refers to the six primary herbs in the formula, which work together to tonify Spleen Qi and resolve Dampness and Phlegm. - Sì Wù Tāng (四物湯)
Sì (四): “Four”
Wù (物): “Things” or “Substances”
This refers to the four core ingredients of the formula.
Tāng (湯): “Soup” or “Decoction”
Sì Wù Tāng means “Four Substances Decoction.” The name reflects the four key herbs in the formula that work together to nourish Blood and improve circulation, especially for women’s health. - Sì Jūn Zǐ Tāng (四君子湯)
Sì (四): “Four”
Jūn Zǐ (君子): “Gentleman” or “Noble Person”
As mentioned earlier, “junzi” refers to a formula that tonifies in a balanced, harmonious way.
Tāng (湯): “Soup” or “Decoction”
Sì Jūn Zǐ Tāng means “Four Gentlemen Decoction.” The four herbs in this formula are used to tonify Spleen Qi. The name “Four Gentlemen” reflects the balanced and gentle action of the herbs on restoring Qi. - Bā Zhēn Tāng (八珍湯)
Bā (八): “Eight”
Zhēn (珍): “Treasure” or “Precious Things”
Refers to the eight herbs that are considered valuable for nourishing both Qi and Blood.
Tāng (湯): “Soup” or “Decoction”
Bā Zhēn Tāng means “Eight Treasures Decoction.” This name refers to the eight herbs that combine to tonify both Qi (from Sì Jūn Zǐ Tāng) and Blood (from Sì Wù Tāng). It’s considered a valuable or precious formula because it addresses two fundamental deficiencies simultaneously.
Summary:
Liú Jūn Zǐ Tāng: “Six Gentlemen Decoction” – Six herbs that tonify Spleen Qi and resolve Dampness/Phlegm.
Sì Wù Tāng: “Four Substances Decoction” – Four herbs that nourish Blood and regulate Liver Blood.
Sì Jūn Zǐ Tāng: “Four Gentlemen Decoction” – Four herbs that tonify Spleen Qi.
Bā Zhēn Tāng: “Eight Treasures Decoction” – A combination of eight herbs to tonify both Qi and Blood, from the combination of the previous two formulas.
Case 30 Patient Profile:
A 40-year-old female presents with the following symptoms:
Loose stools
Weakness in the limbs
Poor appetite and abdominal distention after eating
Fatigue and tiredness
A pale tongue with teeth marks and a thin, weak pulse
Multiple Choice: TCM Pathologies
Which of the following is the most likely diagnosis for this patient?
A. Spleen Qi Deficiency
B. Liver Qi Stagnation
C. Damp-Heat in the Large Intestine
D. Kidney Yin Deficiency
Acupuncture Point Packs:
Pack 1:
ST36, SP3, UB20, REN12, SP6
Pack 2:
ST36, SP9, UB22, REN9, LI11
Pack 3:
UB18, LV3, GB34, PC6, LV14
Pack 4:
UB13, LU9, K7, SP6, GV14
Case 30: Spleen Qi Deficiency; Pack 1
Explanation of Correct Diagnosis: Symptoms of loose stools, limb weakness, poor appetite, abdominal distention after eating, fatigue, pale tongue with teeth marks, and a weak pulse are classic indicators of Spleen Qi Deficiency. The Spleen is essential for digestion, transforming food into energy, and poor function here results in digestive issues and tiredness.
Why Other Options are Incorrect:
Liver Qi Stagnation: This would typically present with irritability, mood swings, and hypochondriac pain, none of which are mentioned here.
Damp-Heat in the Large Intestine: Damp-Heat would produce symptoms like diarrhea with foul-smelling stools, abdominal pain, and a yellow tongue coating, which don’t match this case.
Kidney Yin Deficiency: Kidney Yin Deficiency would present with symptoms like night sweats, low back pain, and heat sensations, which are not observed here.
Case 31:
Patient Profile:
A 32-year-old male presents with the following symptoms:
Frequent night sweats
Dry mouth and throat, especially at night
Hot flashes in the afternoon
Tinnitus and low back pain
A red tongue with no coating and a rapid pulse
Multiple Choice: TCM Pathologies
Which of the following is the most likely diagnosis for this patient?
A. Kidney Yin Deficiency
B. Liver Fire Rising
C. Spleen Qi Deficiency
D. Damp-Heat in the Lower Jiao
Acupuncture Point Packs:
Pack 1:
UB23, K3, REN4, UB52, K6
Pack 2:
UB18, LV2, GB43, ST36, SP6
Pack 3:
UB20, SP3, ST36, REN6, UB43
Pack 4:
UB25, ST37, LI11, GB34, REN9
Case 31: Kidney Yin Deficiency; Pack 1
Explanation of Correct Diagnosis: Frequent night sweats, dry mouth and throat at night, hot flashes, tinnitus, low back pain, a red tongue with no coating, and a rapid pulse indicate Kidney Yin Deficiency. Kidney Yin cools and nourishes the body, and its deficiency causes dryness and heat signs, especially in the evening.
Why Other Options are Incorrect:
Liver Fire Rising: While this could cause tinnitus and a rapid pulse, it would typically include anger, headaches, and red eyes, not night sweats or dryness.
Spleen Qi Deficiency: This would cause digestive issues, fatigue, and bloating, but no heat signs or dryness.
Damp-Heat in the Lower Jiao: Damp-Heat would present with symptoms like genital discomfort, burning urination, or diarrhea with a sticky yellow coating on the tongue, which are not observed here.
Case 32:
Patient Profile:
A 45-year-old female presents with the following symptoms:
Insomnia with difficulty falling asleep
Dizziness and blurred vision
Scanty periods and brittle nails
A pale tongue with a thin coating and a thin, wiry pulse
Multiple Choice: TCM Pathologies
Which of the following is the most likely diagnosis for this patient?
A. Liver Blood Deficiency
B. Heart Yin Deficiency
C. Spleen Qi Deficiency
D. Kidney Yang Deficiency
Acupuncture Point Packs:
Pack 1:
LV8, ST36, SP6, UB18, REN4
Pack 2:
LV3, GB34, PC6, LI4, LV14
Pack 3:
HT7, PC6, REN14, SP6, UB15
Pack 4:
UB23, K7, SP6, REN4, UB52
Case 32: Liver Blood Deficiency; Pack 1
Explanation of Correct Diagnosis: Symptoms such as insomnia with difficulty falling asleep, dizziness, blurred vision, scanty periods, brittle nails, a pale tongue with a thin coating, and a thin, wiry pulse point to Liver Blood Deficiency. The Liver stores blood, which nourishes the eyes and regulates menstruation; deficiency here leads to dryness and visual disturbances.
Why Other Options are Incorrect:
Heart Yin Deficiency: This would present with insomnia but would also have symptoms like night sweats, anxiety, and a red tongue, which aren’t present in this case.
Spleen Qi Deficiency: This would lead to digestive symptoms, fatigue, and a pale, swollen tongue, none of which are evident here.
Kidney Yang Deficiency: This would present with coldness, fatigue, and low back pain, not insomnia, dizziness, or brittle nails.
Point Pack:
Explanation of Correct Acupuncture Points:
Pack 1:
LV8: Tonifies Liver Blood.
ST36: Strengthens Qi and Blood production through its action on the Spleen and Stomach.
SP6: Nourishes blood and Yin, especially Liver Blood.
UB18: Back-Shu point of the Liver, regulates and tonifies Liver Blood.
REN4: Tonifies overall Yin and Blood, including Liver Blood.
Why Other Point Packs Are Incorrect:
Pack 2:
Focuses on Liver Qi stagnation or Liver Fire (LV3, GB34), which do not fit this patient’s presentation.
Pack 3:
Targets Heart Yin Deficiency with points like HT7 and REN14, which are not relevant here.
Pack 4:
Primarily addresses Kidney Yang Deficiency, with UB23, K7, and other warming points unrelated to Liver Blood Deficiency.
Case 33:
Patient Profile:
A 50-year-old male presents with the following symptoms:
Sharp epigastric pain
Vomiting blood (hematemesis)
Feeling of warmth in the stomach region
A red tongue with a yellow coating and a rapid pulse
Multiple Choice: TCM Pathologies
Which of the following is the most likely diagnosis for this patient?
A. Stomach Heat
B. Spleen Qi Deficiency
C. Damp-Heat in the Stomach
D. Liver Qi Stagnation
Acupuncture Point Packs:
Pack 1:
ST44, LI11, REN12, ST36, SP15
Pack 2:
UB20, SP6, REN6, ST36, LI11
Pack 3:
UB18, LV3, GB34, PC6, ST36
Pack 4:
UB21, ST44, REN12, SP9, ST25
Case 33: Stomach Heat; Pack 1
Explanation of Correct Diagnosis: Symptoms of sharp epigastric pain, vomiting blood (hematemesis), a sensation of warmth in the stomach region, a red tongue with a yellow coating, and a rapid pulse are indicative of Stomach Heat. Stomach Heat causes intense digestive distress, bleeding, and warmth in the digestive tract.
Sharp pain is indicative of Blood Stagnation or Qi Stagnation, and excess heat can contribute to stagnation by drying fluids and creating obstruction. In this case, the heat is affecting the Stomach region, leading to damage of blood vessels and resulting in vomiting blood (hematemesis).
The red tongue and yellow coating signify heat, while the rapid pulse reflects both excess and heat in TCM.
The feeling of warmth is a hallmark of heat in the middle jiao (Stomach region), confirming the diagnosis of Stomach Heat.
Why Other Options are Incorrect:
Spleen Qi Deficiency: This would cause weak digestion and bloating but not the heat symptoms or hematemesis seen here.
Damp-Heat in the Stomach: While similar, Damp-Heat would present with fullness, bloating, and sticky yellow coating, not necessarily the sharp pain or bleeding here.
Liver Qi Stagnation: This would present with mood-related symptoms and hypochondriac pain, not sharp epigastric pain or bleeding.
Correct Acupuncture Point Pack:
Pack 1:
ST44: Clears heat from the Stomach channel, reduces pain, and is effective for heat-induced vomiting.
LI11: Clears heat and cools the blood.
REN12: Harmonizes the Stomach and calms acute epigastric pain.
ST36: Regulates the Stomach and tonifies Qi to support healing.
SP15: Addresses digestive imbalances and assists with Qi regulation in the middle jiao.
Why Other Packs Are Incorrect:
Pack 2 (UB20, SP6, REN6, ST36, LI11):
This pack focuses on tonifying the Spleen and Qi regulation, which are not relevant to this acute heat and bleeding case.
Pack 3 (UB18, LV3, GB34, PC6, ST36):
This pack targets Liver Qi stagnation and related symptoms, which are unrelated here.
Pack 4 (UB21, ST44, REN12, SP9, ST25):
While UB21 (Stomach back-shu point) and ST44 address Stomach issues, SP9 focuses on Dampness, and ST25 targets diarrhea or abdominal pain rather than acute Stomach Heat with bleeding.
Patient Profile:
A 28-year-old male presents with the following symptoms:
Shortness of breath, especially on exertion
Spontaneous sweating
Fatigue and weak voice
A pale tongue and a weak pulse
Multiple Choice: TCM Pathologies
Which of the following is the most likely diagnosis for this patient?
A. Lung Qi Deficiency
B. Liver Fire Rising
C. Kidney Yang Deficiency
D. Heart Blood Deficiency
Acupuncture Point Packs:
Pack 1:
UB13, LU9, REN6, ST36, SP6
Pack 2:
UB15, HT7, REN14, PC6, SP6
Pack 3:
UB20, SP3, ST36, REN12, SP6
Pack 4:
UB18, LV3, GB34, PC6, ST36
Case 34: Lung Qi Deficiency; Pack 1
Explanation of Correct Diagnosis: Shortness of breath, spontaneous sweating, fatigue, weak voice, pale tongue, and weak pulse are classic indicators of Lung Qi Deficiency. The Lung governs Qi and respiration, so deficiency here causes weakness and susceptibility to fatigue.
Why Other Options are Incorrect:
Liver Fire Rising: This would produce symptoms like anger, headaches, red eyes, and a rapid pulse, none of which are observed here.
Kidney Yang Deficiency: This would cause coldness, fatigue, and low back pain, rather than shortness of breath and weak voice.
Heart Blood Deficiency: This could involve insomnia and palpitations, as well as a pale tongue, but would not typically present with respiratory weakness.
Case 35
Patient Profile: A 28-year-old male presents with the following symptoms:
Fever, sore throat, and cough
Yellow nasal discharge
Thirst
Red tongue with a yellow coating
Rapid pulse
Multiple Choice: TCM Pathologies What is the most likely diagnosis for this patient?
A. Wind Cold
B. Wind Heat
C. Lung Yin Deficiency
D. Heart Fire
Point packs
1. LI 4, LI 11, DU 14, SJ 5, LU 10
2. HT 7, PC 6, REN 14, SP 6, KD 6
3. LV 3, GB 34, PC 6, LI 4, LV 14
4. UB 23, DU 4, REN 4, KD 7, SP 6
Answer: Case 35: Wind Heat; Pack A
Explanation of Correct Diagnosis: Symptoms of fever, sore throat, cough, yellow nasal discharge, thirst, red tongue with yellow coating, and rapid pulse are indicative of Wind Heat, which involves invasion of external heat causing upper respiratory symptoms and thirst.
Why Other Options are Incorrect:
Wind Cold: This would present with chills, clear nasal discharge, and a white tongue coating.
Lung Yin Deficiency: This would present with dry cough, dry throat, and possibly night sweats, not acute fever and yellow discharge.
Heart Fire: Heart Fire would show up with symptoms like irritability, insomnia, and tongue ulcers, not respiratory symptoms.
Explanation: Pack 1 targets the exterior wind and heat symptoms. Options 2, 3, and 4 address issues unrelated to Wind Heat.
Explanation of Correct Point Pack:
Pack 1:
LI 4: Releases the exterior and expels Wind.
LI 11: Clears Heat from the body.
DU 14: Clears Heat, particularly febrile conditions.
SJ 5: Releases the exterior and clears Wind-Heat from the upper body.
LU 10: Clears Heat from the Lungs and relieves sore throat.
Why Other Point Packs Are Incorrect:
Pack 2:
Points like HT 7 and KD 6 are for Heart Yin Deficiency and Yin-tonifying conditions, unrelated to this acute Wind-Heat pattern.
Pack 3:
Points like LV 3 and GB 34 focus on Liver Qi stagnation or Liver Fire conditions, which are unrelated to Wind Heat.
Pack 4:
Points like UB 23 and DU 4 are used for Kidney Yang Deficiency, which presents with cold symptoms, not Heat.
Case 36
Patient Profile: A 42-year-old woman presents with the following symptoms:
Palpitations and insomnia
Night sweats and irritability
Dry mouth and throat at night
Red tongue with no coating
Thin, rapid pulse
Multiple Choice: TCM Pathologies What is the most likely diagnosis for this patient?
A. Heart Blood Deficiency
B. Heart Yin Deficiency
C. Liver Fire
D. Lung Heat
Which point pack is most suitable?
1. UB 23, DU 4, REN 4, KD 3, ST 36
2. HT 7, PC 6, REN 14, SP 6, KD 7
3. LI 4, LI 11, DU 14, SJ 5, LU 10
4. ST 44, LI 11, REN 12, ST 36, SP 6
Answer: Case 36: Heart Yin Deficiency; Pack 2
Explanation of Correct Diagnosis: Symptoms of palpitations, insomnia, night sweats, dry mouth at night, a red tongue without coating, and a thin, rapid pulse suggest Heart Yin Deficiency. This condition involves heat signs and affects the mind and heart.
Why Other Options are Incorrect:
Heart Blood Deficiency: This would present with palpitations and insomnia but would lack heat signs like night sweats and dryness.
Liver Fire: This would involve symptoms like anger, headaches, and red eyes, not palpitations or night sweats.
Lung Heat: Lung Heat would involve cough, chest pain, and possibly fever, not palpitations or insomnia.
Answer: Pack 2
Explanation: Pack 2 nourishes Heart Yin and calms the mind, which is ideal for yin deficiency symptoms. Options 1, 3, and 4 target yang deficiency, wind-heat, and stomach heat, respectively, which are incorrect for this case.
Case 37
Patient Profile: A 55-year-old man complains of the following symptoms:
Weak low back and knees
Cold sensations, especially in the limbs
Frequent urination, especially at night
Pale, swollen tongue
Deep, weak pulse
Multiple Choice: TCM Pathologies What is the most likely diagnosis for this patient?
A. Kidney Yin Deficiency
B. Kidney Yang Deficiency
C. Liver Qi Stagnation
D. Lung Qi Deficiency
Which point pack is most suitable?
1. UB 23, DU 4, REN 4, KD 3, ST 36
2. LV 3, GB 34, PC 6, LI 4, LV 14
3. LI 4, LI 11, DU 14, SJ 5, LU 10
4. HT 7, PC 6, REN 14, SP 6, KD 6
Answer: Case 37: Kidney Yang Deficiency; Pack 1
Explanation of Correct Diagnosis: Weak low back and knees, cold sensations, frequent urination, pale swollen tongue, and a deep, weak pulse indicate Kidney Yang Deficiency. The Kidney Yang is responsible for warming the body, so deficiency here leads to cold sensations and urinary symptoms.
Why Other Options are Incorrect:
Kidney Yin Deficiency: This would cause night sweats, dryness, and hot flashes, rather than cold symptoms.
Liver Qi Stagnation: This would cause symptoms like irritability and hypochondriac pain, not low back weakness or coldness.
Lung Qi Deficiency: Lung Qi Deficiency would include respiratory symptoms like shortness of breath and fatigue but not cold sensations or nocturia.
Answer: Pack 1
Explanation: Pack 1 warms and supports Kidney Yang, which is appropriate for yang deficiency symptoms. The other packs focus on liver qi stagnation, wind heat, and heart yin deficiency.
Case 38
Patient Profile: A 33-year-old female presents with:
Alternating constipation and diarrhea
Abdominal pain that improves after passing gas
Emotional distress and irritability
Thin white tongue coating
Wiry pulse
Multiple Choice: TCM Pathologies What is the most likely diagnosis for this patient?
A. Liver Qi Stagnation
B. Spleen Qi Deficiency
C. Spleen/Stomach Damp Cold
D. Liver Fire
Which point pack is most suitable?
1. ST 44, LI 11, REN 12, ST 36, SP 6
2. LV 3, GB 34, PC 6, LI 4, LV 14
3. UB 23, DU 4, REN 4, KD 3, ST 36
4. HT 7, PC 6, REN 14, SP 6, KD 7
Answer: Case 38: Liver Qi Stagnation; Pack 2
Explanation of Correct Diagnosis: Alternating constipation and diarrhea, abdominal pain that improves after passing gas, emotional distress, and a wiry pulse are signs of Liver Qi Stagnation affecting the digestive system. Liver Qi Stagnation commonly affects digestion and is associated with stress and irritability.
Why Other Options are Incorrect:
Spleen Qi Deficiency: Spleen Qi Deficiency would present with fatigue, bloating, and loose stools without the emotional component.
Spleen/Stomach Damp Cold: Damp Cold would involve a heavy sensation, abdominal pain, and a thick white coating, not alternating bowel habits.
Liver Fire: Liver Fire would present with more intense heat symptoms, such as red eyes and headaches, which are absent here.
Answer: 2
Explanation: Pack 2 helps with the smooth flow of Liver Qi, which is suitable for symptoms of liver qi stagnation. Options 1, 3, and 4 address stomach heat, kidney yang deficiency, and heart yin deficiency, respectively.
Case 39
Patient Profile: A 40-year-old male has:
Bad breath and thirst
Stomach pain that worsens with pressure
Frequent hunger and constipation
Red tongue with a yellow coating
Rapid pulse
Multiple Choice: TCM Pathologies What is the most likely diagnosis for this patient?
A. Lung Heat
B. Stomach Heat
C. Spleen Qi Deficiency
D. Liver Yang Rising
Which point pack is most suitable?
1. ST 44, LI 11, REN 12, ST 36, SP 6
2. UB 23, DU 4, REN 4, KD 7, SP 6
3. LV 3, GB 34, PC 6, LI 4, LV 14
4. HT 7, PC 6, REN 14, SP 6, KD 6
Answer: Case 39: Stomach Heat; Pack 1
Explanation of Correct Diagnosis: Bad breath, thirst, stomach pain, frequent hunger, constipation, a red tongue with yellow coating, and rapid pulse all point to Stomach Heat. Stomach Heat manifests with digestive complaints and a preference for cold drinks.
Why Other Options are Incorrect:
Lung Heat: Lung Heat would present with respiratory symptoms like cough and chest pain, not digestive issues.
Spleen Qi Deficiency: This would cause poor appetite and fatigue, rather than frequent hunger or bad breath.
Liver Yang Rising: Liver Yang Rising typically presents with headaches, red eyes, and anger, not digestive symptoms.
Answer: Pack 1
Explanation: Pack 1 clears heat in the stomach, which is ideal for stomach heat symptoms. The other options focus on kidney yang deficiency, liver qi stagnation, and heart yin deficiency, none of which address stomach heat.
Case 40
Patient Profile: A 60-year-old female reports:
Dry skin and mouth
Red eyes and vision issues
Dizziness and frequent sighing
Red, dry tongue
Thin, rapid pulse
Multiple Choice: TCM Pathologies What is the most likely diagnosis for this patient?
A. Liver Blood Deficiency
B. Lung Yin Deficiency
C. Liver Yin Deficiency
D. Spleen Qi Deficiency
Which point pack is most suitable?
1. LI 4, LI 11, DU 14, SJ 5, LU 10
2. UB 23, DU 4, REN 4, KD 7, SP 6
3. LV 8, SP 6, KD 6, REN 4, UB 18
4. ST 44, LI 11, REN 12, ST 36, SP 6
Answer: Case 40: Liver Yin Deficiency; Pack 3
Explanation of Correct Diagnosis: Dry skin, red eyes, vision issues, dizziness, a red, dry tongue, and a thin, rapid pulse indicate Liver Yin Deficiency. Liver Yin Deficiency can cause dryness, especially in the eyes, as well as dizziness and a wiry pulse.
Why Other Options are Incorrect:
Liver Blood Deficiency: This would include similar dryness but would also have pale symptoms, like pale tongue and nails, not red.
Lung Yin Deficiency: Lung Yin Deficiency would manifest with respiratory dryness like a dry cough and dry throat but not eye symptoms.
Spleen Qi Deficiency: This would typically show with fatigue, loose stools, and pale symptoms, not the dryness and redness observed here.
Answer: Pack 3
Explanation: Pack C nourishes Liver Yin, addressing yin deficiency symptoms. Options A, B, and D focus on wind heat, kidney yang deficiency, and stomach heat, respectively, which are unrelated to liver yin deficiency.
Case 41:
Patient: Alex, 45-year-old male
Symptoms: Chronic cough, weak voice, shortness of breath, spontaneous sweating, pale complexion, fatigue.
Diagnosis Options:
A. Lung Qi Deficiency
B. Lung Yin Deficiency
C. Heart Fire
D. Spleen Qi Deficiency
Point Packs:
1. LU 9, ST 36, SP 3, UB 13, REN 6
2. UB 23, KD 3, SP 6, REN 4, DU 4
3. ST 44, LI 11, REN 12, ST 36, SP 6
4. LV 3, GB 34, PC 6, LI 4, LV 14
Correct Diagnosis: Lung Qi Deficiency is characterized by chronic cough, weak voice, shortness of breath, spontaneous sweating, and fatigue, which all relate to weakened lung qi. Pack 1, with LU 9, ST 36, SP 3, UB 13, and REN 6, helps strengthen lung qi and overall vitality.
B. Lung Yin Deficiency - Incorrect because it typically involves dryness, night sweats, and thirst, which are not present here.
C. Heart Fire - Incorrect as heart fire manifests as restlessness, irritability, insomnia, and a red tongue, none of which are seen in this case.
D. Spleen Qi Deficiency - Incorrect because symptoms like loose stools, poor appetite, and abdominal bloating are absent here.
Answer: A. Lung Qi Deficiency - Pack 1
Explanation: LU 9, ST 36, and SP 3 strengthen lung and spleen qi, UB 13 fortifies lung function, and REN 6 boosts overall qi. Other options: B involves yin symptoms, C heart fire signs, and D spleen-specific digestive issues.
Case 42:
Patient: Maya, 32-year-old female
Symptoms: Anxiety, irritability, insomnia, thirst, red face, mouth ulcers, red tongue with a red tip.
Diagnosis Options:
A. Liver Qi Stagnation
B. Heart Fire
C. Lung Heat
D. Heart Blood Deficiency
Point Packs:
1. HT 8, LI 11, REN 15, DU 14, PC 8
2. ST 36, REN 12, SP 6, UB 20, UB 21
3. HT 7, PC 6, REN 14, SP 6, KD 6
4. LV 3, GB 34, PC 6, LI 4, LV 14
Correct Diagnosis: Heart Fire is associated with anxiety, insomnia, thirst, red face, and mouth ulcers, all of which Maya presents. Pack 1, with HT 8, LI 11, REN 15, DU 14, and PC 8, effectively clears heat from the heart and calms the mind.
A. Liver Qi Stagnation - Incorrect, as it often includes irritability, hypochondriac pain, and PMS in women, which are not part of Maya’s symptoms.
C. Lung Heat - Incorrect because Lung Heat includes cough with yellow phlegm, chest pain, and fever, which are not relevant here.
D. Heart Blood Deficiency - Incorrect, as it typically presents with palpitations, poor memory, and pale complexion rather than heat symptoms like ulcers and a red face.
Answer: B. Heart Fire - Pack 1
Explanation: HT 8 and PC 8 clear heart fire, LI 11 and DU 14 clear heat, and REN 15 calms the mind. Other options focus on liver qi issues (A), lung fire (C), and blood deficiency (D).
Case 43:
Patient: Sarah, 28-year-old female
Symptoms: Fever, cough with yellow sputum, chest pain, sore throat, red tongue, rapid pulse.
Diagnosis Options:
A. Lung Yin Deficiency
B. Lung Qi Deficiency
C. Lung Heat/Fire
D. Kidney Yin Deficiency
Point Packs:
1. LU 5, LU 10, LI 11, DU 14, ST 40
2. UB 13, LU 9, ST 36, REN 6, SP 6
3. HT 7, PC 6, REN 14, SP 6, KD 6
4. LV 2, GB 34, LI 4, UB 18, UB 19
Answer: C. Lung Heat/Fire - Pack 1
Explanation: LU 5 and LU 10 clear lung heat, LI 11 clears excess heat, DU 14 clears fire, and ST 40 resolves phlegm. Other options don’t align with heat/fire symptoms (A, B, D).
A. Lung Yin Deficiency - Incorrect as it includes dryness, night sweats, and a thin tongue coating, which are absent here.
B. Lung Qi Deficiency - Incorrect because it typically includes weak voice, shortness of breath, and spontaneous sweating, which are also absent.
D. Kidney Yin Deficiency - Incorrect as it presents with symptoms like lower back pain, night sweats, and tinnitus, none of which are relevant here.
Case 44:
Patient: Ben, 52-year-old male
Symptoms: Dry cough, night sweats, dry mouth, red tongue with little coating, weak, rapid pulse.
Diagnosis Options:
A. Lung Yin Deficiency
B. Lung Qi Deficiency
C. Kidney Yin Deficiency
D. Spleen Qi Deficiency
Point Packs:
1. LU 9, KD 6, SP 6, REN 17, UB 13
2. ST 44, LI 11, REN 12, ST 36, SP 6
3. LV 3, GB 34, PC 6, LI 4, LV 14
4. UB 23, DU 4, REN 4, KD 7, SP 6
Answer: A. Lung Yin Deficiency - Pack 1
Correct Diagnosis: Lung Yin Deficiency presents with dry cough, night sweats, dry mouth, and a red tongue with little coating, matching Ben’s case.
Explanation: LU 9 and KD 6 nourish lung yin, SP 6 and REN 17 support fluid balance, and UB 13 strengthens lung qi. Other options misalign with lung heat and qi deficiency (B, C, D).
B. Lung Qi Deficiency - Incorrect as it generally involves weak voice, shortness of breath, and fatigue, without dryness.
C. Kidney Yin Deficiency - Incorrect since it includes lumbar weakness, tinnitus, and a dry mouth, none of which are seen here.
D. Spleen Qi Deficiency - Incorrect as it often presents with digestive issues like bloating and loose stools, which are irrelevant to Ben’s symptoms.
Case 45:
Patient: Lisa, 40-year-old female
Symptoms: Poor appetite, fatigue, loose stools, abdominal distention, pale complexion.
Diagnosis Options:
A. Liver Blood Deficiency
B. Heart Blood Deficiency
C. Spleen Qi Deficiency
D. Lung Qi Deficiency
Point Packs:
1. ST 36, SP 3, UB 20, REN 12, SP 6
2. HT 8, LI 11, REN 15, DU 14, PC 8
3. LV 3, GB 34, PC 6, LI 4, LV 14
4. UB 23, KD 3, SP 6, REN 4, DU 4
Case 45: Spleen Qi Deficiency
Answer: C. Spleen Qi Deficiency - Pack 1
Correct Diagnosis: Spleen Qi Deficiency is linked to fatigue, poor appetite, loose stools, and abdominal distention, all of which Lisa experiences. Pack 1, including ST 36, SP 3, UB 20, REN 12, and SP 6, is used to strengthen spleen qi and improve digestion.
A. Liver Blood Deficiency - Incorrect, as it generally includes dizziness, dry eyes, and scanty periods, which are not relevant here.
B. Heart Blood Deficiency - Incorrect since it would present with insomnia, palpitations, and poor memory, none of which Lisa has.
D. Lung Qi Deficiency - Incorrect, as it usually involves respiratory symptoms like shortness of breath and weak voice, which are absent here.
Explanation: ST 36 and SP 3 strengthen spleen qi, UB 20 and REN 12 support digestion, and SP 6 harmonizes qi. Other packs are aimed at non-spleen patterns (A, B, D).
Case 46:
Patient: Mark, 55-year-old male
Symptoms: Cold limbs, fatigue, loose stools, feeling cold, abdominal pain relieved by warmth, pale tongue.
Diagnosis Options:
A. Spleen Qi Deficiency
B. Spleen Yang Deficiency
C. Kidney Yang Deficiency
D. Lung Qi Deficiency
Point Packs:
1. ST 36, SP 6, UB 20, REN 12, REN 6
2. UB 23, DU 4, REN 4, KD 7, SP 6
3. HT 8, LI 11, REN 15, DU 14, PC 8
4. LV 3, GB 34, PC 6, LI 4, LV 14
Answer: B. Spleen Yang Deficiency - Pack 2
Correct Diagnosis: Spleen Yang Deficiency presents with fatigue, loose stools, feeling cold, and abdominal pain relieved by warmth, all of which Mark exhibits. Pack 2, including UB 23, DU 4, REN 4, KD 7, and SP 6, warms the yang and strengthens the spleen.
A. Spleen Qi Deficiency - Incorrect because it includes fatigue and digestive issues but lacks the cold symptoms seen in yang deficiency.
C. Kidney Yang Deficiency - Incorrect as it often presents with lower back pain, cold knees, and impotence, which are absent here.
D. Lung Qi Deficiency - Incorrect since it presents with respiratory symptoms like weak voice and chronic cough, irrelevant to Mark’s symptoms.
Explanation: UB 23 and DU 4 warm yang, REN 4 and KD 7 reinforce kidney and spleen yang, and SP 6 harmonizes. Other options relate to qi deficiency (A, D) and fire signs (C).
Case 47: Liver Fire
Patient: John, 37-year-old male
Symptoms: Irritability, red face, headaches, red eyes, bitter taste, red tongue with yellow coating.
Diagnosis Options:
A. Liver Fire
B. Heart Fire
C. Liver Yin Deficiency
D. Stomach Fire
Point Packs:
1. LV 2, GB 34, LI 4, UB 18, UB 19
2. ST 44, LI 11, REN 12, ST 36, SP 6
3. HT 7, PC 6, REN 14, SP 6, KD 6
4. UB 23, DU 4, REN 4, KD 7, SP 6
Answer: A. Liver Fire - Pack 1
Correct Diagnosis: Liver Fire manifests as irritability, red face, red eyes, and bitter taste, all of which are seen in John’s case. Pack 1, containing LV 2, GB 34, LI 4, UB 18, and UB 19, clears liver fire and harmonizes liver qi.
B. Heart Fire - Incorrect since it includes insomnia, mouth ulcers, and anxiety, none of which are relevant here.
C. Liver Yin Deficiency - Incorrect as it usually includes dryness, dizziness, and scanty menses, none of which are present.
D. Stomach Fire - Incorrect as it often includes symptoms of burning in the epigastrium and thirst for cold drinks, which are absent.
Explanation: LV 2 clears liver fire, GB 34 harmonizes liver qi, and LI 4, UB 18, and UB 19 assist in clearing liver heat. Other packs focus on stomach fire (D), heart fire (B), and yin deficiency (C).
Case 48: Liver/GB Damp Heat
Patient: Sophia, 42-year-old female
Symptoms: Hypochondriac pain, bitter taste, jaundice, nausea, red tongue with greasy yellow coating.
Diagnosis Options:
A. Spleen Dampness
B. Liver Fire
C. Liver/GB Damp Heat
D. Stomach Yin Deficiency
Point Packs:
1. LV 14, GB 24, GB 34, SP 9, UB 19
2. ST 36, SP 6, UB 20, REN 12, SP 3
3. HT 7, PC 6, REN 14, SP 6, KD 6
4. UB 23, DU 4, REN 4, KD 7, SP 6
Answer: C. Liver/GB Damp Heat - Pack 1
Correct Diagnosis: Liver/GB Damp Heat presents with hypochondriac pain, jaundice, and a greasy yellow tongue coating, matching Sophia’s case. Pack 1, with LV 14, GB 24, GB 34, SP 9, and UB 19, clears damp heat from the liver and gallbladder.
A. Spleen Dampness - Incorrect, as it typically presents with bloating, loose stools, and a slippery pulse rather than jaundice.
B. Liver Fire - Incorrect since it often includes irritability and red eyes but lacks the damp signs seen here.
D. Stomach Yin Deficiency - Incorrect as it would present with dry mouth and thirst without a greasy coating or jaundice.
Explanation: LV 14, GB 24, and GB 34 clear liver and GB damp heat, SP 9 addresses dampness, and UB 19 clears liver heat. Other options focus on spleen dampness (A), liver fire (B), and yin deficiency (D).
K.L., a 34-year-old patient, presents with a frontal headache that began 24 hours ago. The headache is accompanied by sinus congestion, runny nose with clear discharge, mild cough, aversion to cold, and no thirst. Upon examination, the pulse is floating and slow, and the tongue is pale with a thin white coating.
Question 1: Diagnosis
Based on K.L.’s presentation, what is the most likely Traditional Chinese Medicine (TCM) diagnosis?
A) Wind Heat
B) Lung Qi Deficiency
C) Lung Heat
D) Wind Cold
Which acupuncture points are most appropriate to treat K.L.’s condition?
A) LI 11, LU 2, LI 4, GB 34
B) LI 4, Yintang, ST 36, LU 7, LI 5
C) LU 9, UB 13, Yintang, LU 2, CV 17
D) LU 10, LI 11, LU 2, LU 5, Anmian
Correct Answer: D) Wind Cold
Rationale:
A) Wind Heat: Incorrect. Wind Heat presents with fever, sore throat, thirst, and yellow nasal discharge, none of which are present.
B) Lung Qi Deficiency: Incorrect. Lung Qi deficiency is marked by symptoms such as shortness of breath, weak voice, and spontaneous sweating, which are not seen here.
C) Lung Heat: Incorrect. Lung Heat is associated with yellow sputum, thirst, and a red tongue with a yellow coating, absent in this case.
D) Wind Cold: Correct. The aversion to cold, clear nasal discharge, pale tongue with a thin white coat, floating and slow pulse, and absence of thirst indicate Wind Cold.
Correct Answer: B) LI 4, Yintang, ST 36, LU 7, LI 5
Rationale:
A) LI 11, LU 2, LI 4, GB 34: Incorrect. LI 11 and GB 34 are used to clear Heat, which is not present in this case.
B) LI 4, Yintang, ST 36, LU 7, LI 5: Correct.
LI 4: Releases exterior Wind and alleviates headache.
Yintang: Relieves sinus congestion and improves frontal headache.
ST 36: Strengthens Qi to support Wei Qi.
LU 7: Releases Wind Cold and regulates the Lungs.
LI 5: Clears nasal passages and relieves symptoms of sinus congestion.
C) LU 9, UB 13, Yintang, LU 2, CV 17: Incorrect. LU 9 and CV 17 are tonification points suitable for deficiency, not for releasing Wind Cold.
D) LU 10, LI 11, LU 2, LU 5, Anmian: Incorrect. LU 10 and LI 11 are used for clearing Heat, not appropriate here.
J.L., a 50-year-old patient, presents with a throbbing headache on the temples, accompanied by dizziness, irritability, red eyes, and blurred vision. The patient feels hot and has difficulty sleeping due to restlessness. The pulse is wiry and rapid, and the tongue is red with a yellow coating.
Question 2: Diagnosis and Treatment
What is the most likely diagnosis and the best acupuncture points for J.L.?
A) Diagnosis: Wind Heat
B) Diagnosis: Liver Yang Rising
C) Diagnosis: Qi Deficiency with Damp
D) Diagnosis: Wind Cold
What is the best point selection for J.L. condition?
A) LI 4, GB 20, UB 12, DU 16
B) ST 36, SP 9, REN 12, UB 20
C) LV 3, GB 20, KD 3, SP 6
D) LI 11, GB 20, SJ 5, LU 7
Correct Answer:
Diagnosis: B) Liver Yang Rising
Point Selection: C) LV 3, GB 20, KD 3, SP 6
Rationale:
Diagnosis: Liver Yang Rising (B): Correct. Symptoms like temporal headaches, irritability, dizziness, blurred vision, wiry and rapid pulse, and red tongue with yellow coating strongly indicate Liver Yang Rising due to Yin deficiency failing to anchor Yang.
Points: LV 3, GB 20, KD 3, SP 6 (C):
LV 3: Subdues Liver Yang and calms the mind.
GB 20: Relieves temporal headache and dizziness.
KD 3: Nourishes Kidney Yin to support the Liver.
SP 6: Nourishes Yin and harmonizes the Liver and Spleen.
Incorrect Answers
Diagnosis: Wind Heat (A): Incorrect. While Wind Heat can cause headache and red eyes, it typically presents with fever, sore throat, and floating pulse, which are not present here.
Diagnosis: Qi Deficiency with Damp (C): Incorrect. Symptoms like fatigue, heaviness, pale tongue, and damp signs are not described.
Diagnosis: Wind Cold (D): Incorrect. Occipital headache, aversion to cold, and floating tight pulse are Wind Cold symptoms, which are not present.
Point Selection:
LI 4, GB 20, UB 12, DU 16 (A): Appropriate for Wind Cold, not Liver Yang Rising.
ST 36, SP 9, REN 12, UB 20 (B): Best for Qi Deficiency with Damp, not temporal headaches or Yin deficiency.
LI 11, GB 20, SJ 5, LU 7 (D): Suitable for Wind Heat, not relevant to Liver Yang Rising.
M.H., a 45-year-old patient, presents with a severe, pounding headache located on the vertex. The patient experiences irritability, red eyes, bitter taste in the mouth, and occasional epistaxis (noe bleed). They report feeling hot and flushed, particularly in the face, and they often wake at night feeling restless. The pulse is wiry and rapid, and the tongue is red with a thick, yellow coating.
Question: Diagnosis and Treatment
What is the most likely diagnosis and the best acupuncture points for M.H.?
Diagnosis:
A) Liver Yang Rising
B) Liver Fire
C) Kidney Yin Deficiency
D) Spleen Yang Deficiency
Point Selection:
A) LV 3, GB 20, KD 3, SP 6
B) LV 2, GB 34, LI 11, SP 6
C) KD 6, UB 23, SP 6, LV 8
D) ST 36, SP 3, REN 12, UB 20
Correct Answer:
Diagnosis: B) Liver Fire
Point Selection: B) LV 2, GB 34, LI 11, SP 6
Rationale:
Diagnosis: Liver Fire (B): Correct. Symptoms like severe, pounding vertex headache, red eyes, bitter taste, epistaxis, wiry and rapid pulse, red tongue with a thick yellow coating, and restlessness strongly indicate Liver Fire blazing upward.
Points: LV 2, GB 34, LI 11, SP 6 (B):
LV 2: Clears excess Liver Heat and subdues Fire.
GB 34: Clears heat and regulates the Liver.
LI 11: Clears heat from the entire body.
SP 6: Harmonizes Liver and nourishes Yin to control the Fire.
Incorrect Answers
Diagnosis: Liver Yang Rising (A): Incorrect. Although both Liver Yang Rising and Liver Fire share similar symptoms like headaches and irritability, Liver Yang Rising lacks signs of intense heat, such as bitter taste, epistaxis, and thick yellow tongue coating, which are present here.
Diagnosis: Kidney Yin Deficiency (C): Incorrect. Kidney Yin Deficiency would present with symptoms like dizziness, tinnitus, dry mouth, night sweats, and a red tongue with little or no coating. These signs are absent in this case.
Diagnosis: Spleen Yang Deficiency (D): Incorrect. Symptoms like abdominal bloating, diarrhea, cold limbs, and pale tongue are typical of Spleen Yang Deficiency but are not described here.
Point Selection:
LV 3, GB 20, KD 3, SP 6 (A): Suitable for Liver Yang Rising but does not effectively address the intense heat signs of Liver Fire.
KD 6, UB 23, SP 6, LV 8 (C): Appropriate for Kidney Yin Deficiency but not for symptoms of Liver Fire.
ST 36, SP 3, REN 12, UB 20 (D): Best for Spleen Yang Deficiency, not relevant for Liver Fire.
Case 36:
A 42-year-old female presents with the following symptoms:
Difficulty falling asleep and staying asleep
Dry mouth and throat, especially at night
Hot flashes in the evening
Thin body frame
Red tongue without a coat
Pulse: Rapid and thready
Question:
What is the most likely diagnosis for this patient?
A) Qi Excess
B) Blood Deficiency
C) Yin Deficiency
D) Yang Excess
Correct Answer: C) Yin Deficiency
Explanation of Correct Diagnosis:
Key symptoms: The red tongue without a coat, along with dryness, hot flashes, insomnia, and the rapid, thready pulse, are hallmark signs of Yin Deficiency. The lack of coating on the tongue reflects depleted fluids and Yin, while the red color signals heat due to Yin not anchoring Yang.
Why the Other Options Are Incorrect:
A) Qi Excess:
Symptoms: Qi Excess would typically manifest as distention, fullness, and potentially emotional outbursts or stagnation-related pain.
Tongue: The tongue in Qi Excess is usually red with a thick, greasy coating, reflecting retained heat or stagnation in the body. This patient’s tongue lacks a coat and points to deficiency rather than excess.
B) Blood Deficiency:
Symptoms: Blood Deficiency could explain insomnia and a thin body frame. However, it would also present with a pale tongue due to insufficient Blood to nourish the tissues, as well as symptoms like brittle nails or a dull complexion. The red tongue here suggests heat, not Blood Deficiency.
D) Yang Excess:
Symptoms: Yang Excess would cause significant heat signs, such as irritability, sweating, and intense thirst. It would also likely produce a more forceful and robust pulse rather than a thin, rapid one.
Tongue: The tongue in Yang Excess is typically red with a thick yellow coating, indicating excessive heat, which is inconsistent with this patient’s coating-less tongue.
A 35-year-old female presents with the following symptoms:
Irregular menstrual cycles (delayed and scanty menses)
Dull lower abdominal pain relieved by warmth
Fatigue, low back pain, and weak knees
Pale complexion
A pale tongue with thin coating and a deep, weak pulse
Multiple Choice: TCM Pathologies
Which of the following is the most likely diagnosis for this patient?
A. Liver Blood Deficiency
B. Kidney Yang Deficiency
C. Liver Qi Stagnation
D. Kidney Yin Deficiency
Acupuncture Point Packs
Pack 1:
UB18, LV3, SP6, REN4, ST36
Pack 2:
UB23, REN4, DU4, KD3, SP6
Pack 3:
UB18, UB23, LV8, SP10, ST36
Pack 4:
LV3, GB34, PC6, UB18, REN6
Correct Answer: B. Kidney Yang Deficiency
Why?
This case involves irregular and scanty menses combined with systemic signs of coldness (e.g., dull abdominal pain relieved by warmth, fatigue, low back pain). These symptoms suggest a Yang Deficiency pattern.
Kidney’s Role in Menses:
The Kidney provides the foundation of Essence (Jing) and governs reproductive function.
Kidney Yang is crucial for the warming and activation of menstrual flow. A Yang Deficiency results in delayed and scanty periods due to a lack of warmth and energy to support Blood circulation.
Pulse and Tongue: A deep, weak pulse and pale tongue confirm deficiency (particularly of Yang).
Why Not the Other Options?
A. Liver Blood Deficiency
Liver stores Blood and regulates menstrual flow, but Blood Deficiency often presents with symptoms like dry eyes, dizziness, and pale nails. Abdominal pain is more likely to feel dull rather than cold-relieved, and fatigue would not typically be as prominent as in Kidney Yang Deficiency.
C. Liver Qi Stagnation
Stagnation would manifest with irritability, breast tenderness, and a wiry pulse. Pain would be distending or cramping, not dull and relieved by warmth.
D. Kidney Yin Deficiency
Kidney Yin Deficiency would present with heat signs like night sweats, a red tongue with little coating, and scanty menses with dry symptoms. There are no signs of heat in this case.
Acupuncture Pack Explanation
Pack 2 is correct for Kidney Yang Deficiency:
UB23: Tonifies Kidney Yang.
REN4: Nourishes Kidney Essence and strengthens Yang.
DU4: Strengthens the Ming Men fire, which is essential for Yang.
KD3: Tonifies Kidney Yin and Yang.
SP6: Nourishes Blood and supports the Kidney’s role in reproduction.
A 42-year-old female presents with the following symptoms:
Scanty menstrual flow, with cycles that are regular but light in volume
Dull lower back pain and soreness
Insomnia with frequent waking at night
Hot flashes and night sweats
Dry throat and mouth, especially at night
A red tongue with little to no coating and a thin, rapid pulse
Multiple Choice: TCM Pathologies
Which of the following is the most likely diagnosis for this patient?
A. Liver Qi Stagnation
B. Kidney Yang Deficiency
C. Kidney Yin Deficiency
D. Liver Blood Deficiency
Acupuncture Point Packs
Pack 1:
UB23, KD3, KD6, SP6, REN4
Pack 2:
UB18, LV3, PC6, GB34, REN6
Pack 3:
UB23, DU4, REN4, SP6, ST36
Pack 4:
SP10, UB20, LV8, SP6, REN4
C. Kidney Yin Deficiency
Correct: The patient’s symptoms—scanty menstrual flow, dull lower back pain, insomnia, night sweats, dry throat, red tongue with little coating, and a thin, rapid pulse—are classic for Kidney Yin Deficiency.
A. Liver Qi Stagnation
Wrong: While Liver Qi Stagnation can cause menstrual irregularities, the hallmark signs here (night sweats, hot flashes, dry mouth) indicate a deficiency of Yin rather than Qi stagnation.
B. Kidney Yang Deficiency
Wrong: Kidney Yang Deficiency presents with cold signs such as a pale, swollen tongue, cold limbs, and frequent urination, which are not observed here.
D. Liver Blood Deficiency
Wrong: Liver Blood Deficiency causes scanty or delayed menses, pale complexion, and dizziness. However, it does not account for the heat signs like night sweats and red tongue.
Acupuncture Point Pack Answers:
Pack 1:
Correct: These points tonify Kidney Yin (UB23, KD3, KD6) and nourish Yin (SP6, REN4).
Pack 2:
Wrong: These points focus on Liver Qi and general Qi stagnation, which are not the main issue.
Pack 3:
Wrong: While UB23, REN4, and SP6 support Kidney Yin, DU4 and ST36 are better for Kidney Yang and general Qi, not Yin.
Pack 4:
Wrong: These points address Blood deficiency (SP10, LV8) but do not target Kidney Yin Deficiency.
A 29-year-old female presents with the following symptoms:
Irregular menstrual cycles, often delayed
Distending pain in the lower abdomen before the onset of her period
Irritability, mood swings, and frequent sighing
Tenderness and swelling in the breasts before menstruation
A wiry pulse and a slightly purple tongue with thin white coating
Multiple Choice: TCM Pathologies
Which of the following is the most likely diagnosis for this patient?
A. Liver Blood Deficiency
B. Liver Qi Stagnation
C. Kidney Yin Deficiency
D. Spleen Qi Deficiency
Acupuncture Point Packs
Pack 1:
LV3, GB34, PC6, REN6, UB18
Pack 2:
SP6, ST36, UB20, REN12, SP9
Pack 3:
UB23, KD3, KD6, REN4, DU4
Pack 4:
LV8, SP10, UB18, SP6, REN4
A. Liver Blood Deficiency
Wrong: Liver Blood Deficiency causes pale symptoms (e.g., complexion, tongue) and does not explain the mood swings, breast tenderness, or distending pain before menstruation.
B. Liver Qi Stagnation
Correct: Irregular periods, distending abdominal pain before menses, irritability, and breast tenderness are hallmark signs. The wiry pulse and purple tongue confirm Liver Qi stagnation with possible mild Blood stagnation.
C. Kidney Yin Deficiency
Wrong: While Kidney Yin Deficiency can cause irregular cycles, it does not typically present with premenstrual irritability or breast tenderness.
D. Spleen Qi Deficiency
Wrong: Spleen Qi Deficiency leads to heavy or prolonged menses, fatigue, and bloating, which are absent here.
Acupuncture Point Pack Answers:
Pack 1:
Correct: LV3 and GB34 move Liver Qi, PC6 calms the mind, REN6 supports Qi flow, and UB18 nourishes the Liver.
Pack 2:
Wrong: These points tonify Spleen Qi and resolve dampness, which do not address Liver Qi Stagnation.
Pack 3:
Wrong: These points target Kidney Yin (UB23, KD3, KD6, REN4, DU4), not Liver Qi Stagnation.
Pack 4:
Wrong: These points primarily nourish Blood and Yin (LV8, SP10, UB18, SP6) rather than resolving Liver Qi Stagnation.
A 32-year-old female presents with the following symptoms:
Severe cramping during menstruation, relieved slightly after passing clots
Dark menstrual blood with clots
Breast tenderness and mood swings before menstruation
A purple tongue with thin white coating and wiry pulse
Multiple Choice: TCM Pathologies
Which of the following is the most likely diagnosis for this patient?
A. Liver Qi Stagnation
B. Liver Qi Stagnation with Blood Stasis
C. Spleen Qi Deficiency
D. Kidney Yin Deficiency
Acupuncture Point Packs:
Pack 1: LV3, SP6, REN6, UB18, ST36
Pack 2: SP10, UB17, SP6, REN3, LV2
Pack 3: LV14, PC6, GB34, ST25, SP15
Pack 4: REN4, UB23, SP8, LV8, KD3
Correct Answer: B. Liver Qi Stagnation with Blood Stasis
B. Liver Qi Stagnation with Blood Stasis: Correct. The severe cramping relieved after passing clots, dark menstrual blood, purple tongue, and wiry pulse all indicate Blood Stasis secondary to Liver Qi Stagnation.
Explanations:
A. Liver Qi Stagnation: Partially correct. While Liver Qi Stagnation is likely involved, it does not explain the blood clots. The clots and purple tongue indicate that Liver Qi Stagnation has progressed to Blood Stasis.
C. Spleen Qi Deficiency: Incorrect. Spleen Qi Deficiency may cause heavy menstrual bleeding, but it is associated with pale blood and fatigue, not dark clots or pain relieved by clot passage.
D. Kidney Yin Deficiency: Incorrect. Kidney Yin Deficiency is associated with scanty menstrual flow, hot flashes, and a red tongue, none of which match this case.
Correct Answer: Pack 3: UB18, LV3, GB34, PC6, SP10
Explanation:
UB18 (Liver Back Shu): Regulates Liver Qi and supports smooth flow of blood. Essential for addressing Liver Qi Stagnation and Blood Stasis.
LV3 (Liver Yuan-Source Point): Moves Liver Qi and resolves stagnation, key in both Liver Qi Stagnation and Blood Stasis.
GB34 (He-Sea Point of Gallbladder): Relieves hypochondriac pain and moves Qi in the Liver/Gallbladder channels.
PC6 (Luo-Connecting Point): Regulates blood flow and calms emotional stress, often associated with Liver Qi issues.
SP10 (Sea of Blood): Clears Blood Stasis and invigorates blood circulation, addressing the clots and pain.
Why Other Packs Are Incorrect:
Pack 1: ST44, LI11, REN12, ST36, SP15
Focused on clearing heat and regulating digestion, not appropriate for Blood Stasis.
Pack 2: UB20, SP6, REN6, ST36, LI11
More suitable for Qi Deficiency with digestive and systemic symptoms, not stagnation and clots.
Pack 4: UB21, ST44, REN12, SP9, ST25
Focused on dampness and digestive issues rather than resolving Blood Stasis.
Male with Prostatitis
Patient Profile:
A 50-year-old male presents with the following symptoms:
Difficulty urinating with a weak, hesitant stream
Lower abdominal distension and pain
Fatigue and feeling cold in the lower back
A pale, swollen tongue with a white coating and a deep, weak pulse
Multiple Choice: TCM Pathologies
Which of the following is the most likely diagnosis for this patient?
A. Kidney Yang Deficiency
B. Liver Qi Stagnation
C. Damp-Heat in the Lower Jiao
D. Blood Stasis in the Lower Jiao
Acupuncture Point Packs:
Pack 1: UB23, DU4, REN4, KD7, SP6
Pack 2: LV3, GB34, SP6, REN3, UB28
Pack 3: SP9, REN3, UB28, ST28, LV5
Pack 4: UB17, SP10, REN6, LV8, KD3
Correct Answer: A. Kidney Yang Deficiency
Explanations:
A. Kidney Yang Deficiency: Correct. Difficulty urinating with a weak stream, feeling cold in the lower back, and a pale, swollen tongue with a deep, weak pulse strongly indicate Kidney Yang Deficiency.
B. Liver Qi Stagnation: Incorrect. Liver Qi Stagnation would present with emotional stress, irritability, and hypochondriac pain, not a weak stream or cold symptoms.
C. Damp-Heat in the Lower Jiao: Incorrect. Damp-Heat would present with burning urination, yellow tongue coating, and a rapid pulse, none of which are present here.
D. Blood Stasis in the Lower Jiao: Incorrect. Blood Stasis would present with sharp, fixed lower abdominal pain and dark purple tongue, which are absent in this case.
Correct Answer: Pack 4: UB23, KD3, REN4, UB28, SP6
Explanation:
UB23 (Kidney Back Shu): Tonifies Kidney Yang, addressing the weak urination and cold symptoms.
KD3 (Kidney Yuan-Source Point): Strengthens Kidney Yang and supports urinary function.
REN4 (Gate of Origin): Warms Kidney Yang and benefits the lower jiao.
UB28 (Bladder Back Shu): Regulates the urinary system, critical for addressing prostatitis symptoms.
SP6 (Meeting Point of Three Yin): Strengthens Spleen and Kidney function while moving Qi and clearing stagnation.
Why Other Packs Are Incorrect:
Pack 1: ST44, LI11, REN12, ST36, SP15
Focused on clearing heat and supporting digestion, not urinary or Kidney issues.
Pack 2: UB20, SP6, REN6, ST36, LI11
While SP6 is relevant, this pack is primarily for Qi Deficiency and digestion, not Kidney Yang Deficiency or prostatitis.
Pack 3: UB18, LV3, GB34, PC6, SP10
Targets Liver Qi and Blood Stasis but does not address the urinary symptoms or cold nature of the case.
Patient Profile:
A 40-year-old male presents with the following symptoms:
Intermittent epigastric pain worsened by stress
Belching and a feeling of fullness in the chest
Irritability and frequent sighing
A wiry pulse and a normal-colored tongue with a thin white coating
Multiple Choice: TCM Pathologies
Which of the following is the most likely diagnosis for this patient?
A. Liver Qi Stagnation Invading the Stomach
B. Spleen Qi Deficiency
C. Stomach Yin Deficiency
D. Damp-Heat in the Middle Jiao
Acupuncture Point Packs:
Pack 1: REN12, PC6, LV3, ST36, SP4
Pack 2: UB20, UB21, REN6, SP9, LV14
Pack 3: LV2, GB34, PC7, REN17, ST25
Pack 4: REN3, UB28, KD6, SP6, ST44
Correct Answer: A. Liver Qi Stagnation Invading the Stomach
Explanations:
A. Liver Qi Stagnation Invading the Stomach: Correct. Stress-related epigastric pain, belching, and fullness in the chest, along with a wiry pulse, indicate Liver Qi Stagnation disrupting Stomach function.
B. Spleen Qi Deficiency: Incorrect. This would present with bloating, loose stools, and fatigue, which are not mentioned.
C. Stomach Yin Deficiency: Incorrect. Stomach Yin Deficiency would present with dry mouth, hunger without desire to eat, and a red, peeled tongue, none of which are present here.
D. Damp-Heat in the Middle Jiao: Incorrect. Damp-Heat would present with a thick, greasy tongue coating, abdominal distension, and a rapid pulse, none of which match this case.
Correct Answer: Pack 3: UB18, LV3, GB34, PC6, ST36
Explanation:
UB18 (Liver Back Shu): Regulates Liver Qi, addressing emotional stress and digestive issues from Liver overacting on the Spleen.
LV3 (Liver Yuan-Source Point): Moves stagnant Liver Qi and calms stress.
GB34 (He-Sea Point of Gallbladder): Resolves Qi stagnation in the Liver and Gallbladder channels, alleviating the chest fullness and hypochondriac discomfort.
PC6 (Luo-Connecting Point): Calms the spirit and harmonizes the middle jiao, relieving emotional and digestive symptoms.
ST36 (He-Sea Point of Stomach): Strengthens the Stomach and Spleen to support digestion and address epigastric pain.
Why Other Packs Are Incorrect:
Pack 1: ST44, LI11, REN12, ST36, SP15
Partially useful for digestive complaints, but it does not address Liver Qi Stagnation or emotional stress.
Pack 2: UB20, SP6, REN6, ST36, LI11
Focused on general Qi Deficiency, not Qi stagnation or digestive disturbance from Liver overacting on the Stomach.Correct Answer: Pack 3: UB15, PC6, REN17, SP10, UB17
Explanation:
UB15 (Heart Back Shu): Invigorates blood and addresses chest pain related to the Heart.
PC6 (Luo-Connecting Point): Opens the chest, regulates blood, and calms the spirit.
REN17 (Sea of Qi): Opens the chest, promotes Qi and blood flow, and relieves pain.
SP10 (Sea of Blood): Clears Blood Stasis and invigorates circulation.
UB17 (Influential Point of Blood): Resolves Blood Stasis and promotes healthy blood circulation, particularly for Heart-related issues.
Why Other Packs Are Incorrect:
Pack 1: ST44, LI11, REN12, ST36, SP15
Focused on clearing heat and supporting digestion, not addressing Blood Stasis or Heart symptoms.
Pack 2: UB20, SP6, REN6, ST36, LI11
Targets Qi Deficiency, not Blood Stasis or chest pain.
Pack 4: UB21, ST44, REN12, SP9, ST25
Focused on dampness and digestive symptoms, not Blood Stasis or Heart pain.
Pack 4: UB21, ST44, REN12, SP9, ST25
More relevant for dampness and heat in the digestive system, not Liver Qi Stagnation.
Male Patient with Emotional Stress and Digestive Issues
Patient Profile:
A 60-year-old male presents with the following symptoms:
Chest pain that radiates to the shoulder
Purple lips and nail beds
Palpitations and shortness of breath
A purple tongue with petechiae and a choppy pulse
Multiple Choice: TCM Pathologies
Which of the following is the most likely diagnosis for this patient?
A. Blood Stasis in the Heart
B. Phlegm Obstructing the Heart
C. Liver Qi Stagnation
D. Spleen Qi Deficiency
Acupuncture Point Packs:
Pack 1: UB15, REN17, UB17, SP10, PC6
Pack 2: LV3, GB34, SP9, PC7, REN12
Pack 3: ST36, SP6, REN6, UB20, DU20
Pack 4: UB18, UB19, GB40, REN4, SP4
Correct Answer: A. Blood Stasis in the Heart
Explanations:
A. Blood Stasis in the Heart: Correct. Chest pain radiating to the shoulder, purple lips and nail beds, and a purple tongue with a choppy pulse are hallmark signs of Blood Stasis in the Heart.
B. Phlegm Obstructing the Heart: Incorrect. Phlegm Obstruction would present with mental confusion, dizziness, and a greasy tongue coating, none of which are mentioned here.
C. Liver Qi Stagnation: Incorrect. Liver Qi Stagnation does not explain the chest pain, purple tongue, or choppy pulse.
D. Spleen Qi Deficiency: Incorrect. Spleen Qi Deficiency would present with fatigue, loose stools, and pale features, which do not match this case.
Correct Answer: Pack 3: UB15, PC6, REN17, SP10, UB17
Explanation:
UB15 (Heart Back Shu): Invigorates blood and addresses chest pain related to the Heart.
PC6 (Luo-Connecting Point): Opens the chest, regulates blood, and calms the spirit.
REN17 (Sea of Qi): Opens the chest, promotes Qi and blood flow, and relieves pain.
SP10 (Sea of Blood): Clears Blood Stasis and invigorates circulation.
UB17 (Influential Point of Blood): Resolves Blood Stasis and promotes healthy blood circulation, particularly for Heart-related issues.
Why Other Packs Are Incorrect:
Pack 1: ST44, LI11, REN12, ST36, SP15
Focused on clearing heat and supporting digestion, not addressing Blood Stasis or Heart symptoms.
Pack 2: UB20, SP6, REN6, ST36, LI11
Targets Qi Deficiency, not Blood Stasis or chest pain.
Pack 4: UB21, ST44, REN12, SP9, ST25
Focused on dampness and digestive symptoms, not Blood Stasis or Heart pain.
