Red Book Questions

Question 1

Enuck is a 13yo MC Husky mix that presents after a history of “not doing well” after an intestinal obstruction surgery six months prior. The owner reports that he has always been very sensitive to recovering from anesthetics. The hair on his abdomen still has not grown back since surgery and he seems weak, collapsing on even short walks. He has always howled with the sound of fire engines and ambulences and now when he does so, his voice sounds weak and he does not howl as long. Despite having an excellent appetite, he has poor body condition and the owner reports that he has lost weight since the surgery. NO vomiting and stools are normal. He has always been a very dominant dog, when he was younger he would catch and eat small animals. Despite having less energy, he still manages to viforously defend his possessions from other dogs in the household. Owner reports that he prefers to sleep on his bed but after a walk he will try to lay on the tile as it tends to get hot in Florida. TCVM exam indicates weak and deep pulses, weaker on the right. His tongue is pale and wt. His body temp is normal and slightly cooler by Bai-hui

What is Enuk’s most dominant personality type?
What is Enuk’s TCVM diagnosis
What is the most likely reason that accelerated the development of this patter in Enuk?

Answer 1

Wood

Qi deficiency

Having had major surgery, being sensitive to anesthetics, and his advanced age further compounds and accelerates the loss of Qi in this dog

Question 2

Sensitivity at LI-18 and PC-1 on palpation or scanning indicates:

A) Stagnation in the shoulder
B) Stag in the sifle
C) Stag in the hock
D) Foot
E) Carpus

Answer 2

D- FOOT

Question 3

Sensitivity at ST-31 and SP-11 indicates:
A) Stagnation in stifle
B)Hock
C)Hind foot
D) Front foot
E) Back

Answer 3

STIFLE

Question 4

Sensitivity at BL-35, BL-39 and GB-27 indicates what stagnation:

Shoulder
Stifle
Hock
Foot
carpus

Answer 4

Hock

Question 5

Sensitivity at BL-53, BL-54, Lu-gu indicates what stagnation”
Shoulder
Carpus
Fetlock
Back
Hip

Answer 5

Hip

Question 6

Sensitiivty at GB-20 indicates what stagnation

opposite shoulder
oppostie hip, stifle, hock
opposite back
opposite front foot
opposite carpus

Answer 6

opposite hip, stifle, hock

Question 7

Maxil, a ten year old Thoroughbred gelding presented with lamitis of both thoracic limbs and fever one week after prosthetic laryngoplasty. 2 grams of bute administered orally twice daily. On exam, gelding’s constitution was Wood. Because of severe pain, he was down in the stall most of the time and his right thoracic limb was was more severely affected. His tongue was dark purple and pulse was wiry. Scanning indicated 5/5 sensitivty to: LI-18, PC-1, BL-13 bilaterally

A) What is the TCVM diagnosis?

B)Which would be the best acupuncture treatment for Maxil?

Answer 7

A) Excess Heat with local Qi-Blood stagnation at the front feet

B) Hemo acupuncture at TH-1, LI-1, SI-1 and electro acupuncture at left shen-shu and right shen-shu, bilateral GB-21 and BL-11, bilateral qian ti men and LI-3, and bilateral PC9 and SI-3

Question 8

A 3 year old Thoroughbred gelding used for racing presented with a 3 month history of poor performance. He would violently buck riders off. REst for 3 months did not help and radiographs showed no abnormalities of the fetlocks, stifles or hocks. On exam the horse had a Wood constitution, a wiry fast pulse and a red tongue. His gums were red and bleeding. THe acupuncture points CV-12, BL-20, BL-21 and ST-7 were extremely sensitive. Endoscopy was recommended based on TCVM findings, which confirmed gastric ulcers

What is the TCVM pattern:

Which acupuncture points would be most helpful
A) TH-1, LI-1, SI-1, BL-67, GB-44, ST-45
B) Bai-hui, LU-7, LU-9, LU-1, CV-17
C) Bai-hui, ST-45, ST-44, BL-67, BL-20, BL-21
D) Shen-shu, BL-17, BL-18, LIV-2, SP-6
E) Shen-shu, LU-5, LU-11, LU-7, KID-3

Answer 8

Stomach heat

C

Question 9

Tendon and ligament problems are typically associated with what TCVM condition?

A) Qi Deficiency
B) Liver Yin and/or blood deficiency
C) SP channel pattern
D) GB damp heat
E) SI and/or LI channel pattern

Answer 9

B

Question 10

electo acupuncture for musculoskeletal conditions is commonly administered at what setting?

A) 250Hz
B)3Hz
C) An oscillation between 5 and 35Hz
D) 20 Hz
E) Electro acupuncture is contraindicated for musculoskeletal conditions

Answer 10

D) 20 Hz

Question 11

When performing a TCVM exam on an equine patient, it is important to:
A) palpate the jing-well points
B) be methodical and apply consistent pressure
C) check for repeatability of findings
D) Exercise good horsemanship as strong patient reactions may be elicited
E) all of the above

Answer 11

E) all of the above

Question 12

In TCVM, stifle pain:
A) is typically associated with Jing deficiency
B) can rarely be treated successfully
C) Is usually associated with the ST channel stagnation
D) Is commonly associated with geriatric problems and kidney deficiency
E) is best treated using only dry needles and Tui-Na techniques

Answer 12

C) is typically associated with the ST channel stagnation

Question 13

The TCVM diagnostic scan may be superior to Western techniques for:
A) longstanding conditions
B) subtle or subclinical conditions
C) neonatal conditions
D) “Splints”
E) A & C

Answer 13

B) subtle or subclinical conditions

Question 14

Back pain in horses:
A) is divided in to 2 types: primary and secondary to limb pain
B) is often treated with BL-11, LIV-13, BL-54
C) has been documented to respond well to acupuncture treatment
D) involves sensitivity along the GV channel
E) typically has an underlying Windy Bi

Answer 14

C) Has been documented to respond well to acupuncture treatment

Question 15

Cinnamon was an 11yo spayed female GSD who presented with severe chronic progressive hip dysplasia. When she stood on her hind limbs, she would cry or moan due to suspect pain. Hips painful upon extension or deep palpation. She was stiff and painful in her lumbar area. Her tongue was purple with a red tip and had average moisture. Pulses deep and weak. Displayed no temp preference. She was happy, friendly. Wagged her tail but cried at the same time when her hip or lumbar areas were palpated

A) What is her constitution

B) What is Cinnamons diagnosis based on the 8 principles?
-Exterior Heat pattern
-Exterior Deficiency Pattern
-Exterior Cold pattern
-Interior deficiency pattern
-interior excess pattern

C) What other pattern might cinnamon have
-Local qi/blood stagnation
-dryness
-phlegm
-damp-heat
-cold-damp

Answer 15

Fire

Interior deficiency pattern

Local Qi/blood stagnation

Question 16

Lady Red is a 10yo SF Golden retriever with 2 yr history of severe degenerative joint disease of the left carpus. rDVM suspected IMPA becuase she had multiple affected joints. She has been on pred for 2 years. she’s explained as an easy going, laid back dog. Has been collapsing after less than one minute walks. Prefers cold places.

Exam showed general weakness, hind limb paresis, muscle atrophy, immature cataracts bilaterally, small right prescapular mass, reduced flexion of left carpus. Tongue was red and slightly dry. Pulse deficient on left at proximal, middle and distal positions

A) What is lady’s diagnosis based on 8 principles?
-Exterior excess
-interior excess
-interior deficiency
-intereior cold
-exterior cold

B) what is lady’s diagnosis based on the zang-fu patterns
-spleen qi deficiency
-kidney yin deficiency
-kidney and spleen yin deficiency
-kidney and spleen qi deficiency with kidney yin deficiency
-kidney qi deficiency with spleen qi deficiency

Answer 16

interior deficiency pattern

Kidney and spleen Qi deficiency with Kidney yin deficiency

Question 17

Zack is a 10yo MN Pitty mix. Moderately differentiated mast cell tumor on left lateral thorax. History of unilateral chronic-progressive inflammatory intraocular disease which resulted in glaucoma. Ue had an ulcerated 2x3cm mass on left lateral thorax as well as increased respiratory strider with harsh large airway sounds. He has occasional dry cough. Haircoat dry. Has exercise intolerance and occasional loose stool. Tongue slightly red and dry. Pulse weak and deep and thready especially right proximal position

A) What is Zack’s 8 principles diagnosis?
-Exterior excess
interior excess
interior deficiency
interior cold
exterior cold

B) based on zang fu pattern?
-spleen qi def
-lung yin def
-kidney yin def
-lung yin def with lung qi def
-lung yin def with spleen qi deficiency

Answer 17

Interior deficiency pattern

Lung yin deficiency with spleen qi deficiency

Question 18

Lady was a 6yo SF mixed breed dog who presented with several month history of “allergic skin disease”. Her vet prescribed Cephalexin and Thyroxine but she showed little improvement. Patchy alopecia and skin flaking recently worse. Moderate dental calc and dry flaky skin with hair loss. Tongue pale and dry. Pulse weak and thready on left. After recieving acupuncture and a month of herbals, skin and coat became much better and hair regrew. Thyroxine dose was cut in half.

A) Can you predict what type of TCVM treatment has been given for lady?
-Nourish Yin
-Nourish blood
-Tonify yin
-Tonify Yang
-Calm the Shen

Answer 18

Nourish blood

Question 19

Bonnie is a 10yo SF mixed breed dog who presented with 2yr history of separation anxiety. Owner reported clincical signs getting worse. Showed excessive panting, drooling and clawing when owner not home. TCVM exam showed dry haircoat with dandruff. Tongue pale and dry. Pulse deep and weak.

What is Bonnie’s Diagnosis?
-Liver Qi Stagnation
-Heart Qi stagnation
-Shen Disturbance due to heart fire
-Shen disturbance due to Heart Yin deficiency
-Shen disturbance due to Heart blood deficiency

Answer 19

Shen disturbance due to heart blood deficiency

Question 20

5yo FS toy poodle, Mitzie, had a nice personalitiy and seemed pretty calm except when her owner boarderd her for a few days. Recently developed bloody diarrhea when boarded. Remained active and all bloodwork WNL. Treated with antibiotics, prednisone, GI canned food. Diarrhea dn hematochezia stopped after a few days of therapy. As she was finishing treatment she developed a hot spot on ventral chin and neck. Owner claimed that she had always been prone to skin lesions in this exact same spot. Occurred more often during winter months. Rest of her skin appear normal. She was helathy and active on physical exam. Tongue was red with a yellow coating in the center. No teeth marks or swelling. Pulse was a little rapid and forceful. What is TCVM diganosis based on pathogen patterns?

A) Wind Heat
B) Damp Cold
C) Damp Heat
D) Wind Drynes
E) Summer heat

Answer 20

C) Damp heat

Question 21

16yo SF cat named Kittie has history of life-long dermatitis. Obtained from shelter as a kitten and has had a persistent upper respiratory infection. After several weeks of antibiotic treatment, respiratory infection resolved. As a young cat, she had several dry coughing episodes that were worse in the summer. This resolved following treatment with Pred and homeopathic remedy. Kittie had always been a finicky eater and every 3 weeks she vomits bile. She has been an independent cat but recently has been more clingy. Kitty had always sought warm places to sleep. Kidney values are elevated and she has been treated with homeopathic remedies. Owner elected to treat her conjunctival erythema and edema homeopathically. She had a moist dermatitis that started around her ears and eyes and recently spreading to underside of neck, belly and inner thighs. Owner asked you to give TCVM eval and treatment. Kitty has severe muscle atrophy, general rear weakness, tongue was red with too much saliva and her pulse was deficient, deep, thin and easy to compress. Sensitive upon palpation of BL-20 and CV-12. Ears have been filled with malodorus waxy material for months. WHat is kittie’s diagnosis?

A) lung heat with gallbladder heat
B) lung heat with kidney yang deficiency
C) kidney yang deficiency with gallbladder heat
D) liver/gallbladder damp heat, spleen qi and kidney qi deficiency
E) spleen damp-cold with kidney yang deficiency

Answer 21

D

Question 22

8yo Quarter horse gelding presented with sore back. Used for barrel racing. 2 weeks ago showed signs of back pain and seemed to worsen recently. Normally nice, easy going, mellow horse. Shen was alert. Sensitive on left side from BL-17 to BL-22. Tongue purple and pule forceful and wiry. It was found that the saddle tree on the left side was broken.

What is TCVM diagnosis?
A) Qi and blood stagnation
B) blood deficiency
C) heat pattern
D) cold pattern
E) Summer heat pattern

Answer 22

A

Question 23

17yo Trakehner mare presented with history of intertility. She was bred the last 2 yrs and as well as April and May of this year. In June she was still open. She had normal cycles with normal follicles. she had multiple melanomas around her anus and tail and has an apple sized mass caudal to left eye. Tongue pale, swollen and wet. Pulse deep and weak. TCVM diagnosis?

A) spleen qi deficiency
B) kidney qi def
C) kidney yin def
D) spleen yin def
E) spleen qi deficiency with kidney yin def

Answer 23

B) kidney qi deficiency

Question 24

A red tongue indicates:
A) cold
B) heat
C) wind
D) damp
E) dry

Answer 24

B) heat

Question 25

A yellow coating indicates

Answer 25

excess heat

Question 26

A slow pulse indicates

Answer 26

yang deficiency

Question 27

A rapid pulse and red tongue indicate

Answer 27

yin deficiency

Question 28

A malodorus, wet discharge from the ears indicates

Answer 28

damp heat

Question 29

Dandruff indicates

Answer 29

blood deficiency

Question 30

halitosis indicates

Answer 30

excess heat

Question 31

Shuang Fu Mai is
A) An acupuncture point in the horse
B) fast pulse
C) the common carotid artery
D) a sign of excess heat
E) the equine TCVM classic text Yuan Heng LIao Ma Ji

Answer 31

The common carotid artery

Question 32

The fact that lameness in a performance horse is better after exercise indicates

Answer 32

Qi and/or blood stagnation

Question 33

Polydipsia in a geriatric dog usually indicates

A) blood deficiency
B) yang deficiency
C) qi def
D) yin def
E) jing def

Answer 33

D) Yin deficiency

Question 34

Weak coughing usually indicates

Answer 34

Lung Qi def

Question 35

Clear and long urination usually indicates:
A) kidney heat
B) kidney yin def
C) kidney yang def
D) liver heat
E) liver yin def

Answer 35

C) kidney yang def

Question 36

red and inflamed eyes are a sign of:
A) liver heat
B) heart heat
C) stomach heat
D) lung heat
E) bladder damp heat

Answer 36

A) liver heat

Question 37

Si-zhen refers to
A) an abnormal pulse
B) an abnormal tongue
C) an acupuncture point
D) a chinese herbal med
E) the 4 tcvm diagnostic methods

Answer 37

E) the four tcvm diagnostic methods

Question 38

18yo mare, chronic diarrhea. Mellow and laid-back. Appetite poor, weight loss. Pale tongue, weak pulse, low Shen. Appears emaciated. Stool loose without odor or blood. Historyically has had intermittent bouts of watery diarrhea. Dietary changes have not improved diarrhea. What is TCVM diagnosis?
A) heart qi def
B) lung qi def
C) spleen qi def
D) liver qi def
E) kidney qi def

Answer 38

C) spleen qi deficiency