Ch. 8: Primary Diagnostic Systems Flashcards

1
Q

11yo SF GSD presented with severe chronic progressive hip dysplasia. When she stood on her hind limbs she would sometimes cry/moan, due to suspected pain. Her hips were painful upon extension or deep palpation. She was very stiff and painful in her lumbar area. Her tongue was purple with a red tip and had average moisture. Her pulses were deep and weak. She displayed no temp preference. She was a happy, friendly dog. She wagged her tail, but cried at the same time when her hip/lumbar areas were palpated.

According to the 5 Elements, the patient is which personality type?

A

Fire

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2
Q

11yo SF GSD presented with severe chronic progressive hip dysplasia. When she stood on her hind limbs she would sometimes cry/moan, due to suspected pain. Her hips were painful upon extension or deep palpation. She was very stiff and painful in her lumbar area. Her tongue was purple with a red tip and had average moisture. Her pulses were deep and weak. She displayed no temp preference. She was a happy, friendly dog. She wagged her tail, but cried at the same time when her hip/lumbar areas were palpated.

Based on the 8 principles, which is the patient’s diagnosis? What other pattern does she have?

A

Interior deficiency pattern

Local Qi/Bld stagnation

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3
Q

10yo SF Golden Retriever who presented with 2yr history of severe DJD of L carpus. Referring vet suspected an IMPA. She’d been given pred for the past 2 years. O described her as an easy-going, laid-back dog. Recently she has had great difficulty getting up, and she walked for <1min before she collapsed. She prefers cool places. PE: gen. weakness, hind limb paresis, gen. muscle atrophy, bilat. immature cataracts, small right prescapular mass and reduced flexion of the L carpus. Tongue red/slightly dry; pulse deficient on the L at proximal, middle, and distal positions.

What is her diagnosis based on the 8 principles?

A

Interior deficiency pattern

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4
Q

10yo SF Golden Retriever who presented with 2yr history of severe DJD of L carpus. Referring vet suspected an IMPA. She’d been given pred for the past 2 years. O described her as an easy-going, laid-back dog. Recently she has had great difficulty getting up, and she walked for <1min before she collapsed. She prefers cool places. PE: gen. weakness, hind limb paresis, gen. muscle atrophy, bilat. immature cataracts, small right prescapular mass and reduced flexion of the L carpus. Tongue red/slightly dry; pulse deficient on the L at proximal, middle, and distal positions.

What is her diagnosis based on the Zang-Fu patterns?

A

KID and SP Qi deficiency with KID Yin deficiency

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5
Q

Zack: 10yo NM Pit/Catahoula mix. Presented with moderately differentiated MCT on left lateral thorax. History of unilateral chronic-progressive inflammatory intraocular disease which resulted in glaucoma. He had an ulcerated 2x3cm ovoid mass on his left lateral thora as well as increased respiratory strider with harsh large airway sounds. He had an occasional dry cough. His haircoat was dry. He also showed exercise intolerance and occasionally had loose stool. His tongue was slightly red and dry. Pulse was seak, deep and thready, esp. at right proximal position.

Bsed on the 8 principles, which of the following is Zack’s diagnosis?

A

Interior deficiency pattern

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6
Q

Zack: 10yo NM Pit/Catahoula mix. Presented with moderately differentiated MCT on left lateral thorax. History of unilateral chronic-progressive inflammatory intraocular disease which resulted in glaucoma. He had an ulcerated 2x3cm ovoid mass on his left lateral thora as well as increased respiratory strider with harsh large airway sounds. He had an occasional dry cough. His haircoat was dry. He also showed exercise intolerance and occasionally had loose stool. His tongue was slightly red and dry. Pulse was seak, deep and thready, esp. at right proximal position.

Based on the Zang-Fu patterns, what is Zack’s diagnosis?

A

LU Yin deficiency with SP Qi deficiency

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7
Q

Lady was a 6yo SF mixed breed dog who presented with a several month history of “allergic skin disease.” Her vet precribed Cephalexin and thyroxine but she showed little improvement. Recently her patchy alopecia and skin flaking were even worse. She had moderate dental calculus and dry flaky skin with hair loss. Tongue: pale/dry. Pulse: weak/thready on left. After 1 acupuncture treatment and a month of daily herbals her overall skin and hair coat became much better and she began to have hair regrowth. Her thyroxine dose was reduced in half.

Can you predict what type of TCVM treatment has been given for Lady?

A

Nourish blood

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8
Q

Bonnie: 10yo SF mixed breed dog who presented with 2yr history of separation anxiety. The O reported her clinical signs were getting worse. She showed excessive panting, drooling, and cloawing when the O was not home. The TCVM examination indicated that she had dry haircoat with dandruff. Her tongue was pale and dry, her pulse deep and weak.

Based on the clinical signs, what is Bonnie’s diagnosis?

A

Shen disturbance due to Heart blood deficiency

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9
Q

Mitzie: 5yo SF Toy Poodle had a nice personality and seemed calm except when her O boarded her for a few days. Recently she developed a bad case of bloody diarrhea when she was boarded. She remained active and all of her BW was normal. Her treatment included antibiotics, a low dose of pred and highly digestible canned dog food. Her diarrhea and hematochezia stopped after a few days. As she was finishing treatment she developed a ‘hot spot’ on the ventral aspect of her chin/neck. Her O claimed she had always been prone to these skin lesions in exactly the same spot. They occurred more often during winter months. The rest of her skin was normal. On PE she appeared healthy and active. Tongue was red color with yellow coating in center (no swelling). Pulse was a little rapid and forceful.

What is your TCVM diagnosis for Mitzie based on Pathogen patterns?

A

Damp heat

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10
Q

16yo SF cat named Kittie has a history of life-long dermatitis. She was obtained from the shelter as a kitten and had a persistent upper respiratory infection. After several weeks of antibiotic treatment, the 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 quite an independent cat, but recently she was more clingly. Kittie had always sought warm places to sleep. For the past year, her KID biochem values had been elevated, and she has been treated with homeopathic remedies. Her O also elected to treat her conjunctival erythema and edema homeopathically. She had a moist dermatitis that started around her ears and eyes and was recently spreading to the underside of her neck, belly and inner thighs. The O asked you to give her cat a TCVM evaluation/treatment. Kittie had severe muscle atrophy and gen. rear weakness, her tongue was red with too miuch saliva and her P was deficient, deep, thin, and easy to compress. She was sensitive at BL-20 and CV-12. Her ears had also been filled with a malodorous wzxy material for months.

What is Kittie’s TCVM diagnosis?

A

LIV/GB damp heat, SP Qi and KID Qi deficiency

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11
Q

An 9yo Quarter horse gelding named Firework presented with a sore back. He was used for barrel racing. About 2 weeks ago he began to show signs of back pain, and it seemed worse recently. For the past 3 days, he had thrown off his rider several times. Normally, he was a nice, easy-going, mellow horse. His Shen was alert. He was very sensitive on the left side from BL-17 - BL-22 upon palpation. His tongue was purple, and his pulse was forceful and wiry. An examination of the saddle revealed that the tree of the left side is broken.

What is your TCVM diagnosis?

A

Qi and blood stagnation

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12
Q

A 17yo Trakehner mare presented with a history of infertility. She was bred the last 2 years 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 her left eye. Her tongue was pale, swollen and wet. Her pulse deep and weak.

What is your TCVM diagnosis?

A

KID Qi deficiency

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13
Q

Max: 7yo NM Basset Hound. Very friendly and happy dog who greets everybody and loves to be petted. Max has a history of chronic impacted anal glands and other illnesses. He was very sick when he was born–at 1 1/2yo he developed temporary lameness of a hind limb. At 2yo he developed high fever, diarrhea and vomiting post-boarding. For over 1mo, Max has shown lethargy, listlessness, and warm-seeking behavior. The O spoon feeds him. His condition has progressed in the past month. Recently, he has been very anorexic and lethargic. He has been drooling and has had some loose stool and vomiting. Max had not eaten at all for 2 days, but he ate a little with some assistance yesterday. He was diagnosed with DCM about 5d ago and was put on enalapril and furosemide. His diet consists of brown rice, meat, and veggies.

What is Max’s personality type?

A

Fire

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14
Q

Max: 7yo NM Basset Hound. Very friendly and happy dog who greets everybody and loves to be petted. Max has a history of chronic impacted anal glands and other illnesses. He was very sick when he was born–at 1 1/2yo he developed temporary lameness of a hind limb. At 2yo he developed high fever, diarrhea and vomiting post-boarding. For over 1mo, Max has shown lethargy, listlessness, and warm-seeking behavior. The O spoon feeds him. His condition has progressed in the past month. Recently, he has been very anorexic and lethargic. He has been drooling and has had some loose stool and vomiting. Max had not eaten at all for 2 days, but he ate a little with some assistance yesterday. He was diagnosed with DCM about 5d ago and was put on enalapril and furosemide. His diet consists of brown rice, meat, and veggies.

Why does Max have so many illnesses at his young age?

A

KID Jing deficiency

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15
Q

Max: 7yo NM Basset Hound. Very friendly and happy dog who greets everybody and loves to be petted. Max has a history of chronic impacted anal glands and other illnesses. He was very sick when he was born–at 1 1/2yo he developed temporary lameness of a hind limb. At 2yo he developed high fever, diarrhea and vomiting post-boarding. For over 1mo, Max has shown lethargy, listlessness, and warm-seeking behavior. The O spoon feeds him. His condition has progressed in the past month. Recently, he has been very anorexic and lethargic. He has been drooling and has had some loose stool and vomiting. Max had not eaten at all for 2 days, but he ate a little with some assistance yesterday. He was diagnosed with DCM about 5d ago and was put on enalapril and furosemide. His diet consists of brown rice, meat, and veggies.

Which Zang systems are of major concern?

A

SP, HT

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16
Q

Max: 7yo NM Basset Hound. Very friendly and happy dog who greets everybody and loves to be petted. Max has a history of chronic impacted anal glands and other illnesses. He was very sick when he was born–at 1 1/2yo he developed temporary lameness of a hind limb. At 2yo he developed high fever, diarrhea and vomiting post-boarding. For over 1mo, Max has shown lethargy, listlessness, and warm-seeking behavior. The O spoon feeds him. His condition has progressed in the past month. Recently, he has been very anorexic and lethargic. He has been drooling and has had some loose stool and vomiting. Max had not eaten at all for 2 days, but he ate a little with some assistance yesterday. He was diagnosed with DCM about 5d ago and was put on enalapril and furosemide. His diet consists of brown rice, meat, and veggies. PE today reveals Max is lethargic and depressed. Pulse is weaker on the R, tongue is pale purple with white coating. Ears/feet are cold, nose is dry. BL-15,20,21 are sensitive.

What is Max’s TCVM diagnosis?

A

KID Jing deficiency, SP Qi deficiency, HT Yang deficiency

17
Q

Max: 7yo NM Basset Hound. Very friendly and happy dog who greets everybody and loves to be petted. Max has a history of chronic impacted anal glands and other illnesses. He was very sick when he was born–at 1 1/2yo he developed temporary lameness of a hind limb. At 2yo he developed high fever, diarrhea and vomiting post-boarding. For over 1mo, Max has shown lethargy, listlessness, and warm-seeking behavior. The O spoon feeds him. His condition has progressed in the past month. Recently, he has been very anorexic and lethargic. He has been drooling and has had some loose stool and vomiting. Max had not eaten at all for 2 days, but he ate a little with some assistance yesterday. He was diagnosed with DCM about 5d ago and was put on enalapril and furosemide. His diet consists of brown rice, meat, and veggies. PE today reveals Max is lethargic and depressed. Pulse is weaker on the R, tongue is pale purple with white coating. Ears/feet are cold, nose is dry. BL-15,20,21 are sensitive.

Which of Max’s signs correspond to a kidney Jing deficiency?

A

History of serious disease at an early age

18
Q

Max: 7yo NM Basset Hound. Very friendly and happy dog who greets everybody and loves to be petted. Max has a history of chronic impacted anal glands and other illnesses. He was very sick when he was born–at 1 1/2yo he developed temporary lameness of a hind limb. At 2yo he developed high fever, diarrhea and vomiting post-boarding. For over 1mo, Max has shown lethargy, listlessness, and warm-seeking behavior. The O spoon feeds him. His condition has progressed in the past month. Recently, he has been very anorexic and lethargic. He has been drooling and has had some loose stool and vomiting. Max had not eaten at all for 2 days, but he ate a little with some assistance yesterday. He was diagnosed with DCM about 5d ago and was put on enalapril and furosemide. His diet consists of brown rice, meat, and veggies. PE today reveals Max is lethargic and depressed. Pulse is weaker on the R, tongue is pale purple with white coating. Ears/feet are cold, nose is dry. BL-15,20,21 are sensitive.

Which of Max’s signs correspond to a heart Yang deficiency?

A

Cold ears/feet, warm-seeking behavior, fire personality, DCM and pale purple tongue

19
Q

Max: 7yo NM Basset Hound. Very friendly and happy dog who greets everybody and loves to be petted. Max has a history of chronic impacted anal glands and other illnesses. He was very sick when he was born–at 1 1/2yo he developed temporary lameness of a hind limb. At 2yo he developed high fever, diarrhea and vomiting post-boarding. For over 1mo, Max has shown lethargy, listlessness, and warm-seeking behavior. The O spoon feeds him. His condition has progressed in the past month. Recently, he has been very anorexic and lethargic. He has been drooling and has had some loose stool and vomiting. Max had not eaten at all for 2 days, but he ate a little with some assistance yesterday. He was diagnosed with DCM about 5d ago and was put on enalapril and furosemide. His diet consists of brown rice, meat, and veggies. PE today reveals Max is lethargic and depressed. Pulse is weaker on the R, tongue is pale purple with white coating. Ears/feet are cold, nose is dry. BL-15,20,21 are sensitive.

Which of Max’s signs correspond to a SP Qi deficiency?

A

Anorexia, lethargy, vomiting and drooling, weak pulse on the right side

20
Q

For a diagnosis including KID Jing deficiency, HT Yang deficiency, and SP Qi deficiency, what are your main treatment strategies?

A

Tonify SP Qi and HT Yang first, then tonify KID Jing

21
Q

Max: 7yo NM Basset Hound. Very friendly and happy dog who greets everybody and loves to be petted. Max has a history of chronic impacted anal glands and other illnesses. He was very sick when he was born–at 1 1/2yo he developed temporary lameness of a hind limb. At 2yo he developed high fever, diarrhea and vomiting post-boarding. For over 1mo, Max has shown lethargy, listlessness, and warm-seeking behavior. The O spoon feeds him. His condition has progressed in the past month. Recently, he has been very anorexic and lethargic. He has been drooling and has had some loose stool and vomiting. Max had not eaten at all for 2 days, but he ate a little with some assistance yesterday. He was diagnosed with DCM about 5d ago and was put on enalapril and furosemide. His diet consists of brown rice, meat, and veggies. PE today reveals Max is lethargic and depressed. Pulse is weaker on the R, tongue is pale purple with white coating. Ears/feet are cold, nose is dry. BL-15,20,21 are sensitive.

Which of the following acupoint formulas is best for Max today?

  1. Shan-gen, BH, BL-20, ST-36, LI-10, HT-7, BL-15
  2. Shan-gen, BH, BL-20, ST-36, GV-1, Wei-jian
  3. Shan-gen, BH, GV-3, GV-4, CV-4, BL-23, KID-3, KID-7
  4. KID-3, KID-10, KID-7, BL-23, Shen-shu, BH
  5. HT-7, HT-9, BL-14, BL-15, BH, CV-17
A

Shan-gen, BH, BL-20, ST-36, LI-10, HT-7, BL-15