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Flashcards in Asian Med Deck (51)
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1

Liver Functions

Store Blood
Ensure Smooth Flow of Qi (emotion/digestion/bile)
Controls Sinews (Ddx SP - LV will be cramps/contractions SP will be weakness)
Manifests in Nails
Opens into Eyes - allow the eye to see along with the heart + kidney
Houses the HUN - the Ethereal Soul (spirits/demons/yang + a sense of planning/direction)

2

Wood Element

Tears
Anger/Jealousy
Rancid
Sour/Acidic
Shouting
Talking
Vision
Spring
Windy

GB 11pm-1am LV 1am-3am

3

Patient complains of a sensation of a lump in their throat, breast distention before periods and hypochondriac pain with abdominal distention. Patient sighs alot as she admits to being emotionally frustrated with her current relationship which has resulted in anorexia (loss of appetite).

Pulse is wiry but tongue appears normal.

LIVER QI STAGNATION

Tongue variation: slightly purple.



OTHER SX
Lumps or masses along the channel
Migrating pain
Jaundice with a bitter taste in the mouth
PMS with DISTENTION
Irregular menses + amenorrhea (possible infertility - ddx with KD)
Digestion problems that you'd have to ddx with SP = nausea, belching, poor digestion, epigastric pain, distension and loose stools.


4

Causes of Liver Qi Stagnation?

Emotional Problems
Pathogenic Attack

5

45 yo male complains of headache behind the eyes that sometimes radiates to the vertex. You notice his eyes and face are quite red and he has to constantly drink from his water bottle. When you ask about sleep he admits to insomnia with nightmares and says he will also occasionally wake with nosebleeds.
He also admits to drinking approximately 6-10 beers on the average evening.

Pulse is wiry, rapid and full.
Tongue is red with a yellow coating.

LIVER FIRE RISING

OTHER SX:
Bitter tase in mouth
SUDDEN tinnitus/deafness (this must be ddx with KD)
Internal ear pain with purulent d/c (bc of heat)
Irritable/angry personality
Constipation with scany yellow urine (bc of heat!)

6

Causes of Liver Fire Rising?

Long standing emotional problems
Excessive consumption of alcohol, fried foods, meats.
** Dont confuse with LV Yang rising - this one has HEAT in pockets (ears, nose, face)

7

A mother of 4 comes to you concerned with stiffness in her joints, brittle nails and floaters and blurred vision. She finds her muscles feel numb and weak and this interferes with playing with her children. She admits that she often feels dizzy and suffers from insomnia d/t excessive dreams. Her period has also been absent for 3 months with a negative pregnancy test.
Diet - she is a vegetarian.

Diagnosis?
What would expect her Pulse to feel like?

LIVER BLOOD DEFICIENCY

Pulse: wiry, weak, thready
Tongue: small, pale with white coat.

OTHER SX
Tinnitus
Sallow complexion
Night blindness
scant menstruation

8

Liver Blood Deficiency Causes?

Poor Nutrition - low protein
Hemorrhage
LIVER QI STAGNATION
Chronic Dx
Kd Deficiency - Qi, essence or Yin

9

Your regular patient John comes in wondering if he could have diabetes. He notices he has been drinking way more than usual and has been feeling dizzy. Upon further questioning you find that John is drinking more because he feels so dry - especially his eyes, skin and throat. He also says he has been suffering night sweats with hypochondriac pain for the past few weeks around 2am.

You explain to John these are classic signs of...

LIVER YIN DEFICIENCY

Pulse: wiry, thready, rapid
Tongue: dry, red.

OTHER SX:
Flushed face
Tinnitus
Afternoon Fever
5 Centre Heat

10

Causes of Liver Yin Deficiency

Emotional Problems
Liver Qi Stagnation
Liver Blood Deficiency
Febrile Disorders that injure Yin

11

Your patient presents with soreness in the low back and knees as well as tinnitus and poor memory. You think these seem like classic Kidney pathology signs.
But then your patient tells you they always have a headache at the vertex and their eyes are often quite sore; feeling as if there is too much pressure behind them. You realize you are dealing with a case of......

You look at the tongue, Red with No Coat, and your suspicion is confirmed.

LIVER YANG RISING

Pulse: Wiry + Strong OR Thready + Rapid

OTHER SX:
Anger + Irritability
Palpitations
Insomnia
Vertigo
Flushed complexion (not RED)
Red eyes

12

Causes of Liver Yang Rising

Water not Nourishing Wood
Liver and Kidney Yin Deficiency (most common)
Anger and Anxiety

13

Anna comes to you for digestive upset. She says she never wants to eat because she always has a heavy feeling and her digestion is horrible. When she does eat she either has nausea + vomiting or some diarrhea or constipation. She admits that her stools have an offensive odour and seem sticky. She has also recently been experiencing vaginal itching with discharge and a darker yellow urine.

DAMP HEAT IN LIVER GALLBLADDER

Pulse: Wiry, rapid, slipper
Tongue: Red body, yellow sticky coat

OTHER SX
Fullness and Distention in chest/hypochondrium
Bitter taste
Sticky mouth
Thirst with no desire
Lassitude
Jaundice
Pain/Redness/Swelling of Testes
Fever

14

Causes of Damp Heat in LV/GB

Spleen Qi Def
Too much greasy/sweet food
Alcohol
Long Term LV Qi Stagnation

15

Dennis complains of pain and a distended feeling in his testes and scrotum. He says sometimes the only thing that helps is applying warmth area. He also says he's had some recent cramps in the lower half of his belly and is concerned because he doesn't want this to interfere with his sex life.

STAGNATION OF COLD IN THE LIVER

Tongue: Pale with a thick white coat
Pulse: Wiry, strong or tight.

Other SX:
Fullness/Distention in Hypogastrium
Straining of testes
Contraction of testes or labia

16

Causes of Stagnation of Cold in the Liver

Exogenous Pathogenic Cold
Liver Qi Stagnation

17

You have been very frustrated with CCNM because exam schedules are hell. You tell your friend you've been nauseous all well and vomited twice. When you're not vomiting your burping like crazy and you have an empty sensation in your epigastric are that doesn't seem to go away. You sigh as you tell her you can't seem to think of a good Asian Med ddx.

She feels your pulse and tells you its WIRY but you're tongue looks normal. She asks if you've had any breast distention because she's thinking you have.......

REBELLIOUS LIVER QI

Causes: Anger, Frustration, Irritability.

18

Eve has come in because she just found out she has endometriosis. Her periods are always irregular, with dark clotted flow and she has not been able to conceive though she's been trying for 2 years. You notice her lips, nails and complexion are of a purplish hue.

Her tongue is also purple along the sides

LIVER BLOOD STASIS

Pulse: Wiry and or Choppy

OTHER SX
Hypochondriac Discomfort
Abdominal Pain
Hematemesis
Epitaxis
Fibroids
Purple petachiae

19

Causes of Liver Blood Stasis

Qi Stagnation
Cold
Heat

20

If a person has a convulsion with neck rigidity (looks like epilepsy). What is most likely asian med cause?

WING AGITATING WITHIN: EXTREME HEAT GENERATING WIND

Pulse: rapid, strong, wiry
Tongue: deep red with a thick yellow coat

Other Sx
High temp
Coma
Limb tremors
Opisthotonos

Heat = contraction = involuntary movement

Causes: exogenous heat or winder entering the blood level.

21

If a patient shows stroke like symptoms (deviation of eye/mouth, hemiplagia and aphasia) what is the most likely asian medicine cause?

WIND AGITATING WITHIN: LIVER YANG RISING GENERATING WIND

Pulse: floating, weak or wiry and rapid
Tongue: peeled, red, deviated.

Other SX
Sudden unconsciousness
Dizziness

Cuases: LV Yin Def, LV Yang Rising


22

Gallbladder Functions

Stores and Secretes Bile
Controls Judgment
Controls Sinews - less nourishing than LV and more Qi distribution.

23

Alex complains of a VERY sticky taste in his mouth and a problem eating rich, fatty foods. He finds he feels nauseous and sometimes vomits with hypochondriac pain after such meals. He tells you he's noticed this only since moving into his basement apartment.

You notice Alex's sclera and skin a both slightly yellow and his tongue has a thick sticky coating on the sides.

DAMPNESS in the GALBLADDER

Pulse: Wiry + Slipper

OTHER SX
Heavy sensation
Fullness + Distension

Causes
External Dampness
Excess dairy + fried foods.

24

Susan brings her 17 yo daughter, Lara, to see you. Lara looks nervous/timid and Susan must do all of the talking. She tells you Lara has been experiencing blurred vision and floaters for the past year. Around the same time she noticed Lara had been increasingly indecisive about college and lost all initiative when it came to homework. Susan thinks that it might have something to do with Lara's restless sleeping patterns.

You would expect Lara's pulse and tongue to be....
This would confirm a diagnosis of......

Tongue: normal/pale
Pulse: weak

GALLBLADDER DEFICIENT

OTHER SX:
Easily startled
Sighing
Waking early in the morning d/t indecision.

25

Kidney Functions

Store Essence + Govern Birth/Repro/Growth
Produce Marrow + Control Bones
Govern Water
Control Reception of Qi
Open into Ears
Manifests in Head Hair
The Gate of Vitality - Ming Men
Houses the Zhi (willpower)

26

Water Element

Urine
Fear
Putrid
Salty
Groaning
Yawning
Hearing
Winter
Cold + Wet
UB 3-5 pm KD 5-7 pm

27

Rick, a newlywed, comes to see you because he has been experiencing insomnia and night sweats. Most nights he says he dreams alot and sometimes notices nocturnal emissions. His major concern is that lately he has been having premature ejaculations. He mentions that his lower back has also been sore but he mostly wants to address the sexual issues because he doesn't want to disappoint his wife.

KIDNEY YIN DEFICIENCY

Pulse: rapid and thready
Tongue: Dry, red with little coat. May be cracked/peeled.

**NOTE - LV Yin Def can lead to KD YIN DEF bc they share a common root**

OTHER SX:
Weak knees
Dizziness/vertigo
TInnitus
Amenorrhea
INCREASED LIBIDO (heat)
5 centre heat
dry mouth and throat (like LV Yin)
Malar Flush

Causes:
Chronic illness
overwork, oversex - depletion of fluids
Misuse of KD yang tonics

28

Sharon tells you her husband wants to come in to see you because he has been having trouble getting an erection and has lost most of his sexual desire. She is worried that something serious might be going on because she has also noticed his ankles have become swollen and he is always waking very early with diarrhea.

Very high on your ddx list would be.....

KIDNEY YANG DEFICIENCY
**KD Yang can't warm Essence therefore sexual energy is not nourished and fluids are not transformed properly***

Pulse: Deep, weak, slow
Tongue: Pale, wet, flabby

OTHER SX:
Sore back
Cold low back + Knees
Dizziness
Lassitude (bc not nourishing brain)
Infertility
Cold uterus
Abd distension
Copious, Clear Urination.

CAUSES:
Chronic illness
Too much sex
Damp retention
Old age

29

Ava comes in with her mother who is concerned because she has been slow to develop both physically and mentally. Ava's mother, Ellen, admits that she struggled throughout school and had a very poor memory. You notice Ellen has prematurely grey and thinning hair.

You feel Ava has inherited this from her parents...

KIDNEY ESSENCE DEFICIENCY

Pulse: thready + weak
Tongue: small

OTHER SX:
Poor intelligence
Late fontanelle closure
INFERTILITY
Amenorrhea
Weak sexual activity
Premature senility
Head Hair loss
Loose teeth
Weak legs

CAUSES:
Congenital
Poor nutrition
Excessive Sex
Prolonged illness
Increased number of pregnancies.

30

Tim has noticed that when he turned 72 he started to become incontinent. He finds he dribbles from time to time and now has to get up from bed to pee at night. You notice during the interview Tim is quite hard of hearing and rubs his knees when he stands up to leave. He admits to still having sex very frequently for his age.

The most likely diagnosis is?

KIDNEY QI INSECURITY

Pulse: Deep + Weak
Tongue: Pale

Other Sx:
Pale face
Sore back
Frequent, clear urination
Nocturnal Emissions/ Premature Ejaculations (ddx with KD Yin Def)
Clearing leukorrhea
MISCARRIAGE

CAUSES:
Old Age
Early lack of KD Qi development
Too Much Sex - most common cause in males (TIM you naughty old bugger)
Prolonged illness.

31

Angie has come in because she has been suffering from asthma for many years. She has all of the common symptoms, SOB, difficult inhalation and cough. You notice her face looks quite oedematous and she is sweating. She tells you she also finds her limbs are quite cold all the time so she is worried about her circulation.

Her tongue shows pale and her pulses are tight, deep and you weak.

You diagnose her with.....

KIDNEYS FAILING TO RECEIVE QI


OTHER SX:
Rapid + Weak breathing
Thin body
Sore back and Knees


Causes:
Prolonged cough/asthma
Lung deficiency
Kidney damage
Chronic dx

32

Functions of UB

Storage + Excretion of Urine

33

Katie reports that she thinks she has a UTI. She has had dark yellow urine that looks blood tinged. She also reports burning on urination and a feeling of urgency.

Her pulse is rapid and slippery

You treat her for.....

DAMP HEAT IN THE UB

Tongue: Red with sticky yellow coat in the back

Causes:
Pathogenic damp accumulation
Exogenous Damp Heat Invasion
Excessive consumption of hot greasy foods

34

Brent comes in because he has noticed that when he urinates it will stop midstream and when he has to go, " he HAS to go." He also complains that there is a heavy feeling in his abdomen and urethra. When you inquire about the colour of his urine, he denies blood and tells you "there is ALOT of it and its very pale."

You would expect his pulse to be.....
Your diagnosis is....

DAMP COLD IN THE UB

Pulse: slippery, slow, slightly wiry in the chi position
Tongue: White sticky coat in the back

CAUSES:
Pathogenic damp accumulation
Exogenous cold damp invasion

35

Quorra noticed that she has had some unusual white discharge in her underwear and the urge to pee during the night. This is new for her so she wonders if it has something to do with the low back ache she's had for the past few months. You ask about her urination and she says " oh I go all the time, sometimes I'm scared I'll pee myself.......when I do go I feel like I can pee forever." Quorra tells you her pee is clear and she finds it very cold in your office.

DEFICIENT COLD IN THE UB

**Looks similar to KD Qi Insecurity - this one has no knee pain and has WHITE urethral discharge**

Tongue: Wet + Pale
Pulse: Deep, weak, slow

Other Sx
Dizziness
Cold Feeling

CAUSES:
External pathogens
Excessive sex
Excessive physical activity

36

Spleen Functions

Govern Transportation + Transformation
Control Blood
Manifest in the Lips
Houses the Yi (intellect)
Opens into Mouth
Controls Raising the Qi
Controls the muscles (4 limbs)
Foundation of post-natal existence/Root of post natal Qi

37

Earth Element

Saliva
Worry
Fragrant
Sweet
Singing
Swallowing
Taste
LAst 2 weeks of every season
Moist + Thunderous
St 7-9am Sp 9-11am

38

Ali is worried she might fail her ASM202 exam. At this point she feels apathetic and has lost her appetite. She tells her husband she feels exhausted, weak and emaciated. She hasn't had a solid stool in weeks.

Her tongue is pale with a thin white coated and scalloped edges.

Diagnosis?

SP QI DEFICIENCY

Pulses: weak/empty

OTHER SX:
Abd distention

39

Ali's stress increases as her exam schedule intensifies. She begins to notice she is always chilly, oedema and undigested food in her stools. Her friends who have better prepared for the ASM202 exam tell her she has definitely become......

SP YANG DEF

Pulses: Weak, deep, slow
Tongue: Pale, swollen, white/smooth/wet coat.

OTHER SX:
Sallow or Bright white complexion
Cold limbs

40

If Ali began to experience a bearing down sensation in the abdomen or prolaps of an organ what pathology would likely be present?

Tongue would be pale, Pulse would be weak/thin

SP QI SINKING

OTHER SX:
PROLONGED Diarrhea
Frequency of urination/urgency (bc Qi is sinking)
Easily startled
Dull-pale complexion
Pale lips

CAUSES
Standing for prolonged periods
Same as Sp Qi Def

41

Your patient comes in worrying she has a serious disease. Se says she worries about it all night long. She explains that not only does she lack appetite, sweat spontaneously and feel completely fatigued all day. She also bruises extremely easily and has noticed blood in her stools.
When you assess her tongue you notice blood spots on the underside and know exactly what diagnosis you have......

SP FAILING TO CONTROL BLOOD

Other Sx
Hematuria (microscopic tho)
Menorrhagia/Metorrhagia (prolonged or heavy periods)

42

Raychel comes in complaining of abdominal fullness and distention. She says her stools are always loose and her mom complains because they often stain the toilet. She also tells you she has been experiencing some white vaginal discharge and very cloudy urine. Raychel is a vegetarian and admits she eats most meals raw and also hates to drink water.

Without assessing tongue or pulse you already assume Raychel is suffering from.....

COLD DAMP INVADING SPLEEN

Pulse: Slow + Slippery
Tongue: Thick, white, sticky coat.

OTHER SX:
Lack of appetite
Fullness in epigastrium
Heaviness in head + body
Stickiness in mouth
No thirst
Lassitude

CUASES:
Too much raw/cold food
Wading in the water/caught in the rain
Living in a damp environment.

43

Hannah, a first year college student, comes in because she has noticed a lingering bitter, sticky taste in her mouth. She also says she's experiencing nausea, vomiting, and a heaviness in her body. At first you think this sounds like Damp Heat in the Liver Gallbladder but Hannah mentions she also has this embarrassing burning sensation in her anus and a fullness in the abdomen - she points to the epigastrium (not the hypogastrium as would be expected in liver pathology).

You now know this is a case of.....

DAMP HEAT INVADING THE SPLEEN

Pulse: rapid/slippery
Tongue: yellow, sticky coat

OTHER SX:
Hunger with no desire (ddx with lv/gb- no app)
Thirst with no desire
Loose stool wit offensive odor
Lassitude
Scant, dark yellow urine
Fever

CAUSES
Too much sweet/greasy food
Alcohol drinking

44

Stomach Functions

Rotting + Ripening
Rules Descending
Transportation of Food Essence
Origin of Fluids - dislike dry, enjoys wet
"If there is St Qi there is life, if there is not, there is death"

45

This exam period you have been staying up late and eating irregularly and past 8pm. You have started to notice you want to eat constantly but in small amounts and that you get the hiccups very frequently. You also notice some constipation and your mouth has been dry but you can't seem to drink more than a sip or two of water even though you're quite thirsty.

You remember something from you ASM202 course.....you think you have developed....

STOMACH YIN DEFICIENCY

Pulse: Rapid, thready, thin
Tongue: Dry, red without coating

OTHER SX:
Fever or afternoon fever
dry vomit
uncomfortable sensation in stomach
scanty urine
feeling of fullness after eating

CAUSES
Irregular eating habits
Lat night eating

46

Kara just broke up with her boyfriend and has come in for emotional support. She mentions she's been experiencing heartburn with a sour regurgitation and her gums have been painful and swollen. When you inquire about her diet she tells you she eats small and all throughout the day and tends to consume alot of greasy foods. She only drink cold liquids, she has an aversion to tea or anything hot.

Tongue: Red with thick, dry yellow coat
Pulse: Full, deep and rapid

ST FIRE

OTHER SX
Empty, uncomfortable stomach sensation
Foul breath
Vomit
Constipation
scanty yellow urine

CASUES
Hot/greasy food
Emotional depression

47

Arron complains that he always has the hiccups and burps all day long. Sometimes he hiccups to the point of vomiting.

This is classic......

ST QI REBELLING

But is usually seen alongside LV Qi Stagnation!

Pulse: Tight on R middle position
Tongue: no change

CAUSES
Emotion: anxiety/worry

48

Dalia is frustrated because she cannot consume cold foods without being sick to her stomach. She admits warmth and NO pressure are the only things that makes her stomach feel better and when there is pain it is always in the epigastric area.

You diagnose

ST COLD

Pulse: Deep, slow, tight
Tongue: Thick, white coat

OTHER SX
Sudden pain in epigastrium
Feeling cold
Vomit clear fluid
Prefer warm liquid

49

Kara comes back and is now experiencing loss of appetite, vomiting of undigested foods and insomnia. She has also still noticed the sour regurgitation and foul breath.

You think her heat symptoms cleared from your treatment but her voracious eating habits from the original ST Fire have lead to .....

FOOD RETENTION IN THE ST

Pulse: Full + Slippery
Tongue: Thick coat

OTHER SX:
Fullness in epigastrium
Hesitant Bowel Movement
Belching

CAUSES:
Irregular food intake
Voracious eating
Eating food that is hard to digest

50

Your patient complains of lack of appetite and lack of taste - they also experience loose stools.

ST QI DEF

Pulse: Empty - right guan
Tongue: Pale, no coat

OTHER SX
Epigastric discomfort
Fatigue on waking
Weak limbs

CAUSES:
Eating food hard to digest
Irregular food intake

51

What do these symptoms tell you: Stabbing in epigastrium worse with pressure, vomits blood.

STOMACH BLOOD STAGNATION

Pulse: empty (R guan)
Tongue, pale, no coat

CAUSE:
Qi Stag
Excess cold
Excess heat