A400 Chinese Differential Diagnosis

1. Sweat is the fluid of? 2. The root of sweat is? 3. The origin of sweat is? 4. The regulator of sweat is?

1. HT 2. KD 3. SP & ST 4. LU

An irregular pulse is associated with which organ? A. HT B. KD C. LR D. LU

A. HT

Your 85 yr old female patient complains of swelling in the lower extremities. Upon investigation you notice her lower extremities are cool to the touch. The swelling is most noticeable from approximately SP6 down to the web of her toes. It is pitting +3. Which these findings what is the best question to ask next? A. do you feel that you need to dress warmer than others? /How are your bowel movements? B. are your feet numb?/ do you have acid reflux often? C. how is your appetite?/ do you notice hair loss? D. tell me about your stress level?/ do you have anxiety?

A. do you feel that you need to dress warmer than others? /How are your bowel movements?

The three treasures are? A. essence, Qi, and spirit B. xue, Qi, and yin C. kidneys, spleen, and liver D. spirit, fluids, and Qi

A. essence, Qi, and spirit

The Shen is best observed in the? A. face and eyes B. muscle tone C. voice D. nails

A. face and eyes

Damp heat in the lower jiao would make rectal or vaginal excretions smell? A. foul B. sweet C. no smell D. burnt

A. foul

The pulse wave flow of a copy pulse A. it has a rough shape B. arrives strong and recedes weaker C. feels flat D. round like a pearl

A. it has a rough shape

What are the four pillars of diagnostics in TCM? A. looking, listening (and smelling), asking, palpating B. physical exam, asking, listening, smelling C. looking, listening, asking family, orthopedic exams D. looking, tasting, asking, palpating

A. looking, listening (and smelling), asking, palpating

Your patient is a 52-yr old female who has been diagnosed in your clinic with KD yin xu. What would the best choice for a tongue and pulse description? A. pulse rapid and thin; tongue red with no coat B. pulse rapid and thin; tongue red with yellow fur C. pulse slippery; tongue swollen with a white coat D. pulse choppy; tongue swollen with a purple hue

A. pulse rapid and thin; tongue red with no coat

Itchy skin indicates? A. wind B. damp C. Qi xu D. xue xu

A. wind

A floating pulse that is forceless and thin suggests? What are the probable etiological factors in this pulse presentation? A. yin cannot anchor yang B. the defensive yang Qi has mobilized to the exterior C. the yang Qi is trapped and cannot rise to the surface. D. the circulation of Qi and xue is increased in response to the pathogen.

A. yin cannot anchor yang

A 36 yr old female patient complains of irregular periods with painful menstrual cramps. Her periods are often a few days late, lasting 3-4 days with light flow. Pain starting the day before onset and lasting 2-3 days. Pain is slightly relieved by heat. It has been 6 wks since her last period and patient is experiencing mild pain and cramping starting today. patient's complexion is dull and pale, nails are cracked, tongue is thin and pale, pulse is slippery and slightly rapid. The TCM pattern is A. KD yin xu B. LR xue xu C. LR Qi stag D. cold in the lower jiao

B. LR xue xu

All the Zang Fu organs have some direct or indirect connection to the tongue via the channels and collaterals and specific flavors and produced. The Zang Fu that produce a sweet taste in the mouth is? A. HT B. SP C. KD D. LR

B. SP

Which pattern presented below can be responsible for fecal incontinence A. SP & LU Qi xu B. SP & KD Yang xu C. KD Yin xu D. damp heat in the lower burner

B. SP & KD Yang xu

Hypochondriac pain refers to pain under the rib cage margin on one or both sides, or beneath the ribs in the back. This is the "house" of the LR/GB. If the pain in this area is described as severe accompanied by burning and a stifling sensation with a bitter taste in the mouth which of the following LR/GB patterns is most applicable A. LR yin xu B. damp heat in the LR/GB C. xue stag D. LR Qi stag

B. damp heat in the LR/GB

Scaly and dry skin may indicate A. Lu yin xu B. exhaustion of body fluids or xue stag C. interior shi heat D. exterior wind heat attack

B. exhaustion of body fluids or xue stag

When a patient who has been suffering from a along term severe illness suddenly becomes robust with a strong voice and red complexion this is called? A. Yin xu B. false spiritedness C. wind stroke D. wei syndrome

B. false spiritedness

When asking your patient about her sleep habits, your 36yr old female patients states she falls asleep easily but wakes up frequently during the night because she feels hot and sweaty. Her tongue appears red with peeling coat at the tip. Which of the following pulse types do you suspect you will palpate for the 36 yr old female? A. weak and deep B. fast and thready C. floating and fast D. weak and superficial

B. fast and thready

A quivering tongue indicates? A. xue xu B. internal wind C. Qi xu D. yang xu E. yin xu

B. internal wind

A 36 yr old female patient complains of irregular periods with painful menstrual cramps. Her periods are often a few days late, lasting 3-4 days with light flow. Pain starting the day before onset and lasting 2-3 days. Pain is slightly relieved by heat. It has been 6 wks since her last period and patient is experiencing mild pain and cramping starting today. patient's complexion is dull and pale, nails are cracked, tongue is thin and pale, pulse is slippery and slightly rapid. In terms of the 8 principles this is A. internal, xu, hot B. internal, xu, cold C.internal, shi, hot D. internal, shi, cold

B. internal, xu, cold

Your 38 year old patient is seeking treatment for fatigue. She is 8 weeks post Tatum having givin birth to her third child in a span of 5 years. After a complete intake you diagnose her as being xue and qi xu. what is the best choice for a tongue and pulse description you would likely find? A. pulse forceful and rapid; tongue red with yellow fur B. pulse forceless and thin; tongue pale and thin C. pulse floating and forceful; tongue red with a light white coat D. pulse thin and rapid; tongue mirrored

B. pulse forceless and thin; tongue pale and thin

A patient had insomnia, fatigue, cracked fingernails, and a pale lusterless complexion. You would expect their tongue to be? A. swollen B. thin C. purple D. red

B. thin

A patient has insomnia, fatigue, cracked fingernails, and a pale lusterless complexion. You would expect their tongue to be? A. swollen B. thin C. purple D. red

B. thin

When your patient arrives you notice a white dull complexion. what will you investigate due to this observation? A. cold and pain B. xue xu C. heat D. dampness

B. xue xu

Tidal fever occurs or worsens at a fixed hour of the day, just like the regular rise and fall of the tides. It can include a patients subjective sensation of heat, without any measurable increase in body temperature. What is likely indicated by this one finding A. exogenous heat B. yin xu C. exogenous cold D. yang xu

B. yin xu

Define Borborygmi: A. Also call Heart sounds; refers to the sound caused by the heat valves opening and closing as they pump blood. B. Also called lung sounds; refers to the sounds associated with the expansion and retraction of the lungs when breathing. C. Also called bowel sounds or abdominal rumbling; refers to the sounds associated with intestinal movement.

C. Also called bowel sounds or abdominal rumbling; refers to the sounds associated with intestinal movement.

Although the tongue reflects all the Zang Fu it is most closely associated with which organ pair? A. LU/LI B. LR/GB C. SP/ST D. KD/UB

C. SP/ST

Yang edema is characterized by? A. slow onset with symptoms of swelling in the face B. acute onset with symptoms of swelling in the abdomen C. acute onset with symptoms of puffy face and eyelids D. slow onset with swelling in the feet and ankle

C. acute onset with symptoms of puffy face and eyelids

A thick and greasy yellow coat at the back of the tongue indicates? A. LU phlegm fire B. ST fire C. damp heat in the lower jiao D. KD xu

C. damp heat in the lower jiao

Coughing is usually related to LU's ability to properly disperse and descend LU Qi. Of your patient presents with shedding or rattling when coughing it may be? A. dryness in the LU B. an excess pattern C. phlegm in the LU D. heat scorching the fluids

C. phlegm in the LU

Coughing is usually related to lung's ability to properly disperse and descend Lung Qi. if your patient presents with wheezing or rattling when coughing it may be A. Dryness in the LU B. an excess pattern C. phlegm in the LU D. heat scorching the fluids

C. phlegm in the LU

In Autumn the pulse is A. slightly wiry B. slightly surging C. slightly floating D. pulse is deep

C. slightly floating

What is the main factor that contributes to the formation of tongue fur? A. stag. of food B. damp-heat evil attacking the lower burner C. the rising of the Qi of SP and ST D. xu of healthy energy

C. the rising of the Qi of SP and ST

The "chief complaint" is A. the western medical diagnosis B. the TCM diagnostic paradigm or pattern C. the symptom the patient feels with the most severity, usually the main cause for the visit D. lab results

C. the symptom the patient feels with the most severity, usually the main cause for the visit

A red tongue tip indicates? A. LR fire B. KD yin xu C. ST fire D. HT fire

D. HT fire. Red indicated heat, the tip of the tongue relates to the HT.

Upon beginning intake you note your patients voice is very soft and forceless. How do you likely proceed with your initial investigation with this only finding? A. I will investigate probable wind pathogenic factors with this pattern B. I will investigate a probable external pathogenic influence with this patient C.I will investigate a probable excess pattern with this patient D. I will investigate a probable pattern of deficiency with this patient

D. I will investigate a probable pattern of deficiency with this patient

A 45 yr old male patient complains of cluster headaches 2-3 times per week, with pressure in the head. He states that he eats spicy and greasy food and drinks alcohol. When attacks happen he paces rapidly, shouts and curses. His face is bright red and his pulse is slippery and rapid. The TCM pattern in the above case is? A. HT yin xu B. wind heat C. SP damp heat D. LR fire

D. LR fire

A tongue that is red and rough on the sides indicates? A. ST fire B. HT fire C. KD/LR yin xu D. LR/GB fire

D. LR/GB fire. Red indicated heat, rough indicates excessive, the sides of the tongue relate to the LR and GB.

Your asthmatic patient arrives at your office anxious sad and distressed. You can hear and see rapid breathing and hear his shortness of breath. He complains of tightness and constriction in his chest. You can hear him gasp for breath and observe his nostrils flaring and his shoulders rising with each breath. Which organs are likely involved and what to you do next? A. LU/HT; lay your patient down B. LU/LR; cup your patient C. LU/KD; needle your patient D. LU/KD; dial 911

D. LU/KD; dial 911

Emotional shock can cause a stirring pulse. Choose the best description of a stirring pulse A. Slow, relaxed, stagnant; not smoothly flowing. Like a knife scraping bamboo. B. Floating, soft, large body, but empty in the center. Like the stem of a green onion. C. Difficult to feel, under the sinews, not obvious, requires heat pressure to obtain. D. Without heat to tail; a bean, short and trembles under the fingers.

D. Without heat to tail; a bean, short and trembles under the fingers.

Venule examination in children under the age of two is demonstrated by examining the small vessel which extends towards the tip of the index finger. The creases in the joints of the index fingers are called gates. The wind gate extends to the first crease at the mcp articulation. The qi gate extends to the second, and the life gate to the third. If the vessel appears deep red and extends to the life gate position this may indicate? A. Mild disease B. an internal illiness C. a cold condition D. a life threatening condition

D. a life threatening condition

which of the following etiological factors may contribute to insomnia? A. nutritive and defensive Qi disharmony B. imbalance of yin and yang C. shen disturbance D. all of the above

D. all of the above

A thin crimson body and shrunken tongue indicates? A. cold damp due to exuberant pathogen B. turbid phlegm harassing the upper body C. SP qi xu D. damage to yin yeh (yin humor) from exuberant heat E. fulminant yang qi desertion

D. damage to yin yeh (yin humor) from exuberant heat

Leukorrhea or vaginal discharge, is a normal fluid that begins during a female puberty. It is described as a clear, thin mucus, which is odorless, and occurs in small amounts. A vaginal discharge that is described as thick, foul smelling and yellowish in color would likely have what diagnosis A. xu cold syndrome B. dampness invading the SP C. KD xu D. damp heat

D. damp heat

Which of the following is lease likely to indicate true vitality? (true spiritedness) A. firm muscles B. glittering eyes C. a clear mind D. flushed cheeks as the malaria region

D. flushed cheeks as the malaria region

Your unresponsive patients extremities feel cold but their abdominal temp feels warm and almost hot. Your suspicion is A. KD yang xu B. exterior cold C. yang xu D. true heat, false cold

D. true heat, false cold

The cun position of the right hand relates to which organ

Lung

Information about the state of an organ's health as well as the state of the Qi, Blood, Yin, and Yang can be gathered from

Pulse diagnosis

The pulse rhythm reflects

The state of the HT's yang Qi

A deep pulse indicates

interior disease

An empty pulse lacks force, it feels empty with pressure. If your patient's pulse feels empty and thready, one indication would be:

yin or xue xu