Asian Med Flashcards by Ali Sherk

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)

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Wood Element

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

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

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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.

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Causes of Liver Qi Stagnation?

Emotional Problems

Pathogenic Attack

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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!)

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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)

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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

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Liver Blood Deficiency Causes?

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

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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

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Causes of Liver Yin Deficiency

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

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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

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Causes of Liver Yang Rising

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

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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

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Causes of Damp Heat in LV/GB

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

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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

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Causes of Stagnation of Cold in the Liver

Exogenous Pathogenic Cold

Liver Qi Stagnation

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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.

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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

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Causes of Liver Blood Stasis

Qi Stagnation
Cold
Heat

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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.

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

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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

Gallbladder Functions

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

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.

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DAMPNESS in the GALBLADDER

Pulse: Wiry + Slipper

OTHER SX
Heavy sensation
Fullness + Distension

Causes
External Dampness
Excess dairy + fried foods.

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……

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Tongue: normal/pale
Pulse: weak

GALLBLADDER DEFICIENT

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

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) ```

Water Element

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

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

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 ```

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. ```

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. ```

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 ```

Functions of UB

Storage + Excretion of Urine

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

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

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

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 ```

Earth Element

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

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

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

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

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)

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.

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

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"

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

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

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

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 ```

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

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

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

Asian Med Flashcards

(51 cards)