Midterm Review Flashcards
(142 cards)
1
Q
A patient has dry cough, hot sensations in the afternoon, and a peeled red tongue. What is the treatment plan? Differentiation (Diagnosis): Principle of treatment: Prescription: Formula:
A
Differentiation/Diagnosis:
Cough d/t Lung Yin Xu
Principle of treatment:
Nourish LU Yin, clear xu heat, stop cough
Prescription:
LU-9, KD-6, LI-11, SP-6, UB-13, RN-22, RN-17, LU-1
Formula:
Bei mu gua lou san (LU Dry)
Bai he gu jin wan (LU/KD Yin Xu)
Mai men dong tang (LU/ST Yin Xu)
2
Q
A patient has tongue ulcers, thirst, palpitations and a red tongue. What is the treatment plan? Differentiation (Diagnosis): Principle of treatment: Prescription: Formula:
A
Differentiation (Diagnosis):
Heart Fire Blazing
Principle of treatment:
Clear heat and drain HT fire, calm shen
Prescription:
HT-8 (ying spring, HT-F), Li-11, RN-14 (FM HT), Shenmen, HT-5 + HT=7 (palpitations),
Formula:
Dao chi san (HT-F pass to SI)
w/ modified
Huan lian e jiao tang (HT-F + HT Xue Xu)
Explanation:
HT opens to the tongue Red tongue= heat Palpitations= rel HT
3
Q
A patient has loose stools, chilliness, edema, cold limbs, and fatigue. What is the treatment? Differentiation (Diagnosis): Principle of treatment: Prescription: Formula:
A
Differentiation (Diagnosis):
Spleen yang xu
Principle of treatment:
Tonify SP yang, warm the middle
Prescription:
RN-8 (w/ moxa), RN-6 (Tn SP), SP-3, SP-6 (very good), RN-9 (Sui fen, prom urination to solidify stool), RN-3 (FM UB), ST-28 (Sui Dao- water, passages SP-9 (edema, VIP), UB-22 (BS SJ)
Formula:
Li zhong wan (warm middle)
w/ modified
Wu ling san (promote urination for edema)
May use Wu ling san primarily and modify to include warm interior herbs i.e Gan jiang, Rou gui
Explanation:
Edema rel Org: LU, KD, SP + Fu: SJ, (control water passages) SP= extremities, T/T
4
Q
A patient has poor appetite, fatigue, and loose stools. What is the treatment? Differentiation (Diagnosis): Principle of treatment: Prescription: Formula:
A
Differentiation (Diagnosis):
Spleen qi xu
Principle of treatment:
Tonify SP qi
Prescription:
ST-25, SP-3, ST-36, RN-12, UB-20, LR-13
Formula:
Si jun zi tang (ren shen, bai zhu, fu ling, gan cao) or modified Shen ling bai zhu tang (w/ lian zi, huang qi)
5
Q
A patient has dryness at night, night sweats, backache, and a red tongue without any coating. What is the treatment?
A) RN-4, KD-3, KD-6, SP-6, KD-10
B) LR-8, KD-3, UB-23, UB-18, RN-4
C) RN-4, HT-5, KD-6, SP-6, UB-15
D) HT-6, KD-7, RN-4, SP-6, UB-15
Formula:
A
A) RN-4, KD-3, KD-6, SP-6, KD-10
RN-4 ( yuan gate- yuan qi),
KD-3 (source KD VIP any KD xu),
KD-6 (calm spirit, night sweats),
SP-6 (san yin jiao, Tn Yin),
KD-10 (He sea, xue xu, night sweat, dry mouth)
DX:
KD Yin xu
Formula:
Liu wei di huang wan
Explanation:
A) RN-4, KD-3, KD-6, SP-6, KD-10
KD Yin Xu
B) LR-8, KD-3, UB-23, UB-18, RN-4
LR Xue Xu/ LR+KD Yin Xu
C) RN-4, HT-5, KD-6, SP-6, UB-15
HT Yin Xu
D) HT-6, KD-7, RN-4, SP-6, UB-15
HT+ KD Yin Xu
6
Q
The point prescription for hypertension with dizziness, blurred vision, tinnitus, insomnia, palpitations, irritability, numb sensation in the limbs, red tongue w/o coating, and thin pulse is GB-20 (feng chi), LI-11 (qu chi), ST-36 (zu san li), LR-3 (tai chong) combined with:
A) LR-2, GB-34
B) PC-6, ST-40
C) RN-6, RN-4
D) KD-3, HT-7
A
D) KD-3, HT-7
DX:
HT + KD Disharmony
FX:
Tian wang bu xin dan
(heaven king tonify ht powder)
Explanation:
palpitations d/t HT KD Yin xu can cause blurred vision mixed xu (below) + shi (above)
7
Q
A patient has palpitations, night sweats, tinnitus, insomnia, and red-peeled tongue w/ a midline crack. What is the treatment?
A) HT-6, KD-7, RN-4, SP-6, UB-15
B) RN-4, KD-3, KD-6, SP-6, KD-10
C) LR-8, KD-3, UB-23, UB18, RN-4
D) DU-4, UB-23, UB-15, SP-9, SP-6
A
A) HT-6, KD-7, RN-4, SP-6, UB-15
HT-6 (XC HT), KD-7 (Tn yin, night sw), RN-4 (Tn yin), SP-6 (Tn yin), UB-15 (BS HT)
DX:
HT+ KD Disharmony
FX:
Tian wang bu xin dan
Explanation:
KD open to ear = tinnitus
8
Q
A patient has edema which first started on the feet and then spread over the whole body, sallow complexion, and weak back. The tongue is pale with thin white coating. The pulse is deep and thin. What is the prescription?
Differentiation (Diagnosis):
Principle of treatment:
Prescription:
Formula:
A
Differentiation (Diagnosis):
SP + KD Yang xu
Principle of treatment:
Tonify SP + KD yang
Prescription:
KD-3, UB-34, UB-20, UB-22, SP-6, ST-36, RN-4 (yuan qi + KD yang xu), RN-6 (SP-yang xu), RN-9, SP-9, RN-3, DU-4 (KD yang xu, mingmen fire)
Formula:
Jin gui shen qi wan modified w/ increase ze xie, fu ling, add Zhu ling (these three are in wu ling san)
Explanation:
KD edema especially presents on the leg and ankle
SP edema more whole body
9
Q
A patient has difficulty falling asleep, dreams, palpitations, poor memory, anorexia, and sallow complexion. The tongue is pale w/ thin white coating. The pulse is thin & weak. What is prescription?
A) UB-18, UB-19, GB-12, HT-7, SP-6, An mian
B) HT-7, SP-6, An mian, UB-20, UB-15, SP-1
C) ST-36, HT-7, SP-6, An mian, UB-21
D) An mian, UB-15, UB-23, HT-7, SP-6, KD-3
A
B) HT-7, SP-6, An mian, UB-20, UB-15, SP-1
DX:
HT Xue & SP Qi Xu (HT + SP Xu)
FX:
Gui pi tang
Explanation:
HT Xue Xu- difficulty fall asleep, dreams, palpitations, poor memory, sallow complexion (either), thin pulse
SP Qi Xu- anorexia, sallow complexion (either), weak pulse
Causes of Insomnia:
HT Xue + SP Qi Xu
HT Xue Xu
LR Xue Xu
10
Q
A patient has dizziness made worse with stress, irritability, red eyes, dream disturbed sleep, & bitter mouth taste. The tongue red with yellow coating. The pulse is wiry. What is the prescription?
A) UB-23, KD-3, GB-20, UB-18, LR-2
B) DU-20, RN-4, ST-36, SP-6, UB-20
C) UB-20, RN-12, PC-6, ST-40, ST-8
D) Yin tang, ST-8, GB-20, LR-3
A
A) UB-23, KD-3, GB-20, UB-18, LR-2
LR-2 (expel int-W, subdue rising LR yang)
DX:
LR yang rising d/t KD yin xu
FX:
Tian ma gou teng yin
Explanation:
A) UB-23, KD-3, GB-20, UB-18, LR-2
LR yang rising d/t KD yin xu
B) DU-20, RN-4, ST-36, SP-6, UB-20
SP xu
C) UB-20, RN-12, PC-6, ST-40, ST-8
Phlegm
D) Yin tang, ST-8, GB-20, LR-3
Yangming H/A
CAM: pg 458
FCM: pg 524
DR Cao: LR yang rising d/t LR-Fire
Book says KD yin xu is the root of the LR yang rising so A is best.
Empty H may cause yellow coat bitter taste usually excess condition
11
Q
A patient has edema in the ankles, palpitations, pale and swollen tongue, and deep-weak pulse. What is the treatment?
A) SP-6, SP-9, UB-22, RN-3, UB-28
B) DU-4, UB-23, UB-15, SP-9, SP-6
C) RN-4, KD-3, KD-6, SP-6, KD-10
D) HT-6, KD-7, RN-4, SP-6, UB-15
A
B) DU-4, UB-23, UB-15, SP-9, SP-6
DX:
KD yang xu w/ water overflowing to HT
FX:
You gui wan (KD yang xu) w/ Wu ling san
or Mod of Jin gui shen qi san w/ Wu ling san
(little yang xu with more water retention)
Explanation:
Organs and fu control water passages rel edema: LU, SP, KD + SJ FCM pg 601
12
Q
A patient has hematuria, urgency when feels desire to urinate, burning and hot urine. The tongue has a thin and yellow coating. The pulse is forceful and fast. What is the prescription?
A) SP-9, UB-23, UB-28, RN-3, KD-6
B) UB-28, SP-10, RN-3, SP-9, SP-6
C) LR-2, UB-28, RN-3, SP-9
D) UB-28, RN-3, SP-9, UB-39
A
B) UB-28, SP-10, RN-3, SP-9, SP-6
DX:
Damp Heat in UB (w/ H in Blood Vessels)
FX:
Mod Ba zheng san (g for pee)
CAM: pg 323
3 Basic points UTI:
UB-28, SP9 or SP-6, RN-3
13
Q
A patient has acute edema of the face, aversion to wind, and a superficial-slippery pulse. What is the treatment?
A) ST-36, SP-3, UB-20 UB-13, LU-9
B) ST-36, SP-6, SP-9, UB-13, LU-9
C) LU-7, LI-4, LI-6, UB-12, RN-9
D) LU-9, KD-6, RN-4, SP-6, RN-12
A
C) LU-7, LI-4, LI-6, UB-12, RN-9
LU-7 + LI-4 (wind rel ext together LU luo, LI source)
LI-6 (water passages luo of LI)
UB-12 (wind gate)
RN-9 (water retention)
DX:
Wind-water invading the LU
External W therefore aversion wind & superficial pulse
FX:
Xiao qing long tang
14
Q
A patient has palpitations, SOB on exertion, sweating, paleness, fatigue, listlessness, pale tongue, and an empty pulse. What is the treatment?
A) HT-5, PC-6, UB-15, RN-17, RN-6, UB-21
B) HT-7, PC-6, RN-15, UB-17, RN-4, UB-20
C) HT-5, PC-6, UB-15, RN-17, RN-6, DU-14
D) HT-7, PC-6, RN-15, RN-4, HT-6, KD-6, KD-7
A
C) HT-5, PC-6, UB-15, RN-17, RN-6, DU-14
HT-5 (tonify HT-qi)
DX:
HT qi xu
FX:
Mod Si jun zi tang or Bao yuan tang
Explanation:
A) HT-5, PC-6, UB-15, RN-17, RN-6, UB-21
HT + ST/SP qi xu
B) HT-7, PC-6, RN-15, UB-17, RN-4, UB-20
HT xue xu- UB-20 (Tn SP to generate xue)
C) HT-5, PC-6, UB-15, RN-17, RN-6, DU-14
HT qi xu -DU-14 (Tn qi)
D) HT-7, PC-6, RN-15, RN-4, HT-6, KD-6, KD-7
KD + HT Disharmony
15
Q
A patient has hypertension with dizziness, flushed face, red eyes, stiff neck, constipation, dry mouth, yellow tongue coating, and strong-wiry pulse. You choose GB-20, LI-11, ST-36, LR-3. What other points would you add to the prescription?
A) PC-6, ST-40
B) KD-3, HT-7
C) LR-2, GB-34
D) RN-6, RN-4
A
C) LR-2, GB-34
LR-2 (subdue LR-F)
GB-34 (subdue reb qi, relax sinews and muscles)
DX:
LR-Fire blazing
FX:
Long dan xie gan tang
16
Q
A patient has dizziness, nervousness, timidity, lack of initiative, startles easily, and sighing, pale tongue, and weak pulse. What is the treatment?
Differentiation (Diagnosis):
Principle of treatment:
Prescription:
Formula:
A
Differentiation (Diagnosis):
GB xu
Principle of treatment:
Tonify and warm GB, Tonify LR qi
Prescription:
GB-40 (source), UB-19 (BS GB), UB-18 (BS LR), ST-36 (LR qi, xue), LR-3 (source), LR-8 (LR qi + xue), UB-47 (ethereal soul)
Formula:
An shen ding zhi wan
FCM pg 666
17
Q
A patient has dizziness, nausea, profuse sputum, anorexia, and stuffy head. The tongue has a white and greasy coating. The pulse is slippery. What is the prescription?
A) Yin tang, ST-8, GB-20, SP-9
B) DU-20, RN-4, ST-36, SP-6, UB-20
C) UB-23, KD-3, GB-20, UB-18, LR-2
D) UB-20, RN-12, PC-6, ST-40, ST-8
A
D) UB-20, RN-12, PC-6, ST-40, ST-8
UB-20 (BS SP)
RN-12 (FM ST, nausea)
PC-6 (nausea, open chest/head)
ST-40 (phlegm)
ST-8 (dizziness)
DX:
Internal damp phlegm (Damp-phlegm in SP/ST)
FX:
Er chen tang
Explanation:
B) DU-20, RN-4, ST-36, SP-6, UB-20
Xu qi + xue –> dizziness
C) UB-23, KD-3, GB-20, UB-18, LR-2
Hyperactivity of LR yang–> dizziness
D) UB-20, RN-12, PC-6, ST-40, ST-8
retention phlegm damp
CAM: pg 449
dizziness d/t internal phlegm damp
18
Q
A patient has palpitations, sadness, tiredness and an empty pulse. What is the treatment?
A) HT-5, PC-6, UB-15, KD-6, RN-6
B) RN-6, RN-4, DU-20, DU-14, UB-15
C) DU-14, RN-6, HT-5, PC-6, UB-15, RN-17
D) HT-8, HT-7, SP-6, KD-6, RN-15
A
C) DU-14, RN-6, HT-5, PC-6, UB-15, RN-17
DU-14 (Tn qi)
HT-5 (Tn HT qi)
DX:
HT Qi xu
FX:
Mod Si jun zi tang or Bao yuan tang (tonify HT)
CAM: pg 443 Causes of palpitations
19
Q
A patient has light red rashes and heavy sensations in the body. The tongue coating is white and sticky. The pulse is floating and slow. What is the pattern and treatment?
A) Heat in Blood
B) Wind-heat
C) Wind-damp
D) Deficient SP Qi with Damp accumulation
A
C) Wind-Damp
FX:
Xiao Feng San (for skin rashes d/t W-D or W-H)
Prescription:
Bai chong wou (uticaria), SP-9 (damp), DU-14 (Ext W), LI-4 (W), UB-40 (skin diseases)
Explanation:
floating pulse= exterior/wind
sticky/white tongue coat=damp
rash= generally d/t wind
20
Q
A patient has palpitations, insomnia, mental agitation, poor memory, dizziness, tinnitus, deafness, night sweats, afternoon sensations of heat, nocturnal emission w/ dreams, sore back, and scanty dark urine. What tongue is expected? What is the treatment?
A) Red tongue w/ thin yellow coating
B) Red tongue w/ thin white coating
C) Red and peeled tongue, red tip, cracks in midline
D) Red tongue w/ thick-yellow coating
A
C) Red and peeled tongue, red tip, cracks in midline
DX:
KD + HT Disharmony
FX:
Tian wang bu xin dan
Prescription:
HT-7 (xue), HT-6 (yin), HT-5 (qi), RN-17, RN-15 (FM HT), UB-15 (BS HT), UB-23 (BS KD), DU-24 (emotional disorders), KD-3 (source), KD-6 (KD Yin, xue H), RN-4, SP-6 (Xue, Yin, KD, Calm mind)
Explanation:
Red tongue + whole body w/ no coat= KD
Red tip= HT
Afternoon H + night sweats= Yin xu
HT: mental aggitation, palps, insomnia, controls spirit
KD: tinnitus, deafness, noct. em, sore/weak back (knees)
21
Q
A patient has a red face, thirst, dark urine, stool with foul odor, red tongue w/ yellow moss, and fast, deep pulse. Which of the eight principles apply?
A) Internal, empty, hot
B) external, full, hot
C) internal, full, hot
D) External, empty, hot
A
C) Internal, full, hot
DX:
Damp heat in LI
FX:
Mod Xiao Cheng qi tang (+ D-H clearing herbs)
or
Long dan xie gan tang (for D-H in lower jiao)
Prescription:
ST-37 (LHS LI), LI-11 (H), ST-25 (FM LI), GB-34 (D-H), ST-44 + LR-2 (ST H)
22
Q
A patient has urgent and frequent urination, burning urine, difficult urination which stops midstream, dark colored urine, blood and sand in the urine, feverish sensations, and thirst. What tongue is expected? What is the treatment?
A) white-greasy coating on root
B) pale and wet tongue
C) red tongue w/o coating
D) thick, sticky, yellow coating on root w/ red spots
A
D) thick, sticky, yellow coating on root w/ red spots
DX:
Damp heat in UB (lower jiao)
FX:
Ba zheng san (g for pee)
Treatment:
clear heat, resolve damp, promote urination
Prescription:
UB-28 (BS UB), RN-3 (FM UB), UB-66 (ying spring cl organ H), SP-10 (stop bleeding), SP-9 (damp), SP-6 (cool blood, benefit urination)
Explanation:
A) white-greasy coating on root
C-D UTI
B) pale and wet tongue
Yang xu
C) red tongue w/o coating
Yin xu
D) thick, sticky, yellow coating on root w/ red spots
D-H lower jiao
23
Q
A patient has dry cough with just a small amount of sputum, low-grade fever, hot sensations in the evening, night sweats, red cheeks, and dryness. What tongue is expected? What is the treatment?
A) pale or normal colored tongue
B) red w/o coating
C) dry tongue
D) thin yellow coating
A
B) red w/o coating
DX:
LU yin xu
FX:
Sheng mai san
(LU qi + yin xu w/ sweating)
or
Bei mu gua lou san
Prescription:
LU-9 + ST-40 (xu LU w/ P), RN-22 (cough), RN-4 (yin xu), LU-9 (source), LI-11 (dry heat), SP-6 (yin xu), KD-6 (yin xu, sore throat)
24
Q
A new mother complains of insufficient breast milk. She reports her breasts feel swollen. She has a poor appetite. The points prescribed are ST-18, RN-17, SI-1, ST-36, SP-6. After five treatments there is only slight improvement. What would you prescribe now?
A) ST-18, RN-17, SI-1, ST-36
B) ST-18, RN-17, SI-1, LR-14, LR-3
C) UB-20, RN-6, ST-36, SI-1, ST-18
D) RN-17, PC-6, SI-1, ST-18, LI-4
A
B) ST-18, RN-17, SI-1, LR-14, LR-3
DX:
SP Qi xu w/ LR qi stagnation
FX:
xiao yao san
25
A 35 year old man has had hand tremors. He has been diagnosed with Parkinson's disease. The tremors are worse when reaching for things and disappear while sleeping. He has a sallow complexion. Other symptoms include a weak voice and dry skin. He catches colds easily. The tongue is pale. The pulse is weak. What is the treatment?
A) LI-4, LI-7, GB-20, UB-13, UB-12
B) LR-3, KD-3, LR-8, UB-23, UB-18
C) GB-20, LR-3, UB-17, UB-18, UB-20
D) GB-20, UB-12, DU-16, Si shen cong
**C) GB-20, LR-3, UB-17, UB-18, UB-20**
GB-20 (int W)
LR-3 (Int W, smooth flow LR qi, calm spasm)
UB-17 (Tn xue)
UB-18 (BS LR)
UB-20 (BS SP- Tn SP/qi to generate Xue)
**DX:**
Tremors d/t LR xue xu
**FX:**
Mod Tian ma gou teng yin (tremors d/t LR xue xu)
or Bu gan tang (tonify LR decoction)
**Explanation:**
*Causes LR Wind Agitating Within:*
Extreme heat generating Wind
LR Yin Xu
LR + KD Yin Xu
LR Fire
LR Xue Xu
FCM pg 529
26
A patient has fullness and distention just above the bladder area with pain referring to the genital area, and pain is improved with application of heat, pale wet tongue with white moss, and wiry, deep, and slow pulse. What is the treatment?
A) UB-18, UB-20, UB-17, SP-6, LR-8
B) RN-2, GB-20, Tai yang, GB-13, LI-11
C) GB-34, LR-3, PC-6, SJ-6
D) RN-3, LR-5, LR-1, LR-3
**D) RN-3, LR-5, LR-1, LR-3**
RN-3 (FM UB, local pain)
LR-5 (genitals)
LR-1 (benefit genitals, reg qi)
LR-3 (smooth LR Qi, stop pain)
**DX:**
Cold stagnation in LR channel (D-C obst. LR ch)
**FX:**
Nuan gan jian (warm the LR decoction)
**Explanation:**
Cold stag= better w/ H, slow + deep pulse (cold), wiry (stag d/t C), pale/wet tongue w/ white moss
27
A 27 year-old woman has a problem with sweating. She sweats profusely in the hands and feet with dripping sweat. The condition worsens during her menstrual period and worsens when she gets excited. Other symptoms include palpitations, thirst for cold drinks and irritability. She looks healthy and lively and does not complain of tiredness. The tongue is red. The pulse is fast. You treat the patient with HT-6 + HT-7. There is only slight movement after a few treatments. What would you add to the point prescription?
A) SI-3
B) KD-2, LR-2
C) LI-4, KD-7
D) PC-7, LR-2
**C) LI-4, KD-7**
(VIP pair for sweating or combo HT-6 + KD-7- incl here)
**FX:**
Huang lian e jiao tang
or Xie xin tang (drain HT-F)
28
Deep needling of ST-20 may:
A) penetrate an enlarged stomach
B) penetrate the lung
C) penetrate an enlarged heart
D) penetrate an enlarged liver
**D) penetrate an enlarged liver**
ST-20 5 cun above umbilicus + 2 cun lateral RN-13 (midline)
ST channel 4--\>2 cun @ ST-19
29
Which of the following meridians is connected to the root of the tongue and spreads underneath its surface?
A) Kidney meridian
B) Heart meridian
C) Spleen meridian
D) Liver meridian
**C) Spleen Meridian**
**3 Organs connect to tongue:**
SP: "Penetrates internally to follow the throat up to the root of the tongue, under which it spreads its qi and blood" (pg 130, Kim)
HT:
KD: "Branch continues along the throat and terminates at the root of the tongue" (pg 132 Kim)
Pg. 178 Deadman
30
A patient has urgent and frequent urination, burning urine, difficult urination which stops midstream, dark colored urine, blood and sand in the urine, feverish sensations, and thirst. What tongue is expected?
A) white-greasy coating on root
B) pale and wet tongue
C) red tongue without coating
D) thick, sticky, yellow coating on the root with red spots
**D) thick, sticky, yellow coating on the root with red spots**
**DX:**
Damp heat in UB
**FX:**
Mod Ba Zheng San
**Prescription:**
SP-9 (Damp whole body) or SP-6, UB-22 (BS SJ), UB-28 (BS UB), UB-63 (xi cleft), UB-66 (ying spring), RN-3 (FM UB), RN-9 (water retention, esp mid-upper jiaos), LI-11 (H), ST-28 (local UTI, drain water, promote urination), SP-10 (any blood disorder)
**3 Main UTI points:**
RN-3 SP-9 UB-28
31
A patient has edema more pronounced in the legs and ankles, cold feelings, fullness and distention in abdomen, sore lower back, and scanty and clear urination. What pulse is expected?
A) Deep, weak and slow pulse
B) Floating, empty pulse and rapid pulse
C) Floating and empty pulse or choppy pulse
D) Floating and empty pulse or leather pulse
**A) Deep, weak and slow pulse**
**DX:**
KD yang xu w/ water overflowing
**FX:**
Jin gui shen qi wan (may combo wu lling san)
**Prescription:**
UB-23 (BS KD), UB-22 (BS SJ), DU-4 (Tn KD yang, yuan qi, warm mingmen), SP-6 (Tn KD), SP-9 (water retention), UB-39 (SJ LHS), ST-28 ('water pathway'), RN-3 (FM UB), RN-4 or 6
UB-39 LHS SJ, Tn UB, open water passages in Lower jiao, stimulate transformation and excretion of fluids in lower jiao
ST-28 Open water passages & benefit urination
RN-3 can use moxa
RN-4 yuan qi, KD Jing, yin or yang
RN-6 Qi Hai (qi cave), sea of qi, Tn qi
32
A 49 year old female has been diagnosed with hyperthyroidism. She is being treated with PC-5 & SP-6. She returns in two days. She complains of excess sweating. What would you add to the prescription?
A) KD-7, LI-4
B) HT-6, KD-7
C) HT-6, LI-4
D) RN-4, UB-23
**B) HT-6, KD-7**
HT-6 (XC HT)
KD-7 (all kinds sweating)
**DX:**
HT + KD Disharmony
**FX:**
Tian wang bu xin dan (ht/kd dis)
w/ mu li san (tx sweating)
LI-4 + KD-7 also good for xu or shi sweating w/ appropriate technique
33
A 52 year old man has high blood pressure. Main symptoms include feeling of pressure in the head, stiff neck, throbbing h/a on top of the head, blurred vision, tinnitus, dizziness, waking up frequently during the night with worries and wanting to throw the covers off. The cheeks are slight red and the eyes have no glitter. The tongue is stiff, red with very thin coating. The pulse is wiry and thin. What is the diagnosis?
A) Deficiency KD yin w/ empty fire
B) Deficienty LR yin, LR yang rising
C) LR fire blazing
D) Deficienty KD qi, Deficient HT xue
**B) Deficienty LR yin, LR yang rising**
(LR yin xu w/ LR yang rising)
**FX:**
Tian ma gou teng yin
**Prescription:**
LR-3 (soothe LR, Tn yin)
SP-6 (Tn SP, smooth flow LR qi, Tn xue + yin)
DU-20 (h/a, dizzy, hypertension, expel int W)
ST-36 (Tn xue, qi, brighten vision)
GB-20 (Int/Ext W, Subdue LR yang, eyes)
SJ-5 (any h/a)
LI-4 (w/ LR-3)
**Explanation:**
LR Yin b/c: wiry pulse, blurred/sl red eyes, vertex h/a)
Vs KD Yin xu s/s: low back + knee weak, xu pulse
34
The patient has abnormal uterine bleeding w/ excessive discharge, poor appetite, unformed stools. You choose SP-6, UB-20, UB-18, SP-1. What is missing from your prescription?
A) RN-4, DU-4
B) SP-10, LR-1
C) DU-20
D) ST-25,RN-12
**C) DU-20** (Raise yang)
**DX:**
SP not controlling blood (SP not holding)
**FX:**
Gui pi tang (SP not control xue)
w/ Bu zhong yi qi tang (more SP qi sinking)
35
A 33 year old patient has had painful periods for ten years. The pain occurs during her period. The blood is red and scanty. She generally feels cold during her period. She has a history of miscarriages. Other symptoms include back pain, achy knees, dizziness, tinnitus, poor memory, dry mouth, night sweating, and dribbling urination. The tongue has a normal color. The pulse is overall weak and the left side is thin and empty at the deep level. What is the diagnosis?
A) Deficiency of KD yin w/ false cold
B) Deficiency of KD yin and yang
C) Deficiency of KD yang w/ false heat
D) Deficiency of KD yin w/ excess internal cold
**B) Deficiency of KD yin and yang**
**FX:**
Mod Zuo gui wan (Tn KD yin + yang xu)
+gan jiang or rou gui
or
Gui shen wan (Tn KD yin + yang xu)
You gui wan is too warm for here b/c fu zi
36
A 54 year old woman has had wheezing for 6 years. She is overweight. She has difficulty inhaling, a constant nasal discharge, and phlegm in the throat. She expectorates sticky yellow phlegm. She has a feeling of oppression in the chest and nausea, bad digestion w/ acid reflux and loose stools. She has thirst. The tongue is slight red in color and swollen. The tongue has a crack in the middle with yellow coating. The pulse is generally slippery and weak on the right side. What is the diagnosis?
A) Phlegm obstructing lungs
B) Liver fire insulting lungs, accumulation of phlegm
C) Deficient SP yang w/ accumulation of dampness
D) Phlegm-heat in lungs and ST, SP Qi Xu
**D) Phlegm-heat in lungs and ST, SP Qi Xu**
**FX:**
Qing qi hua tan wan
+bai zhu (Tn SP, Drain D)
Increase fu ling, chen pi
**Prescription:**
SP-3 + ST-40
RN-17 (unbind chest, descend qi)
LU-5 (he sea, Expel phlegm LU)
LU-7 (luo, open LU, open water passages, phlegm + qi stag in LU)
LI-11 (H)
ST-36 + SP-6 (Tn qi, resolve D, clear heat)
37
According to the TCM theory of the five elements, if a patient has a weak pulse in the guan position of the right wrist, which of the following points would you needle?
A) Tonification of LU-9
B) Tonification of SP-2
C) Tonification of SP-3
D) Tonification of LR-2
**B) Tonification of SP-2**
Mother-diseased channel
HT-8 = Horary mother
38
The needling caution from UB-12 all the way to which bladder point carries the risk of pneumothorax with perpendicular or oblique needling away from the spine?
A) UB-21
B) UB-22
C) UB-20
D) UB-23
**A) UB-21** (T-12)
UB-22= puncture KD
UB-23= puncture KD
Many q's on caution + contraindication
39
A patient has amenorrhea with delayed menstrual cycle and gradual decrease of menses, poor appetite, loose stools, dizziness, and sallow complexion. The tongue is pale with little coating. The pulse is weak. What is the pattern?
A) Deficient SP qi w/ damp obstruction
B) Deficient SP + ST qi
C) Deficient Blood
D) Deficient LR Blood
**C) Deficient Blood**
CAM pg 477
Qi is the commander of blood, and blood is the mother of Qi.
Blood is transferred from food through the fxn of t/t of SP, and dyfxn of SP leads to xue xu. Xue xu causes malnutrition of Chong + Ren and voidness of sea of xue... Xue xu fails to nourish muscles, skin & head, bringing sallow complexion, dry skin, vertigo & dizziness & lassitude. Dysfxn of t/t of SP gives rise to poor appetite and loose stools. Pale tongue w/ white coat & slow, weak pulse are signs xue xu. (pg 477)
**FX:**
Tao hong si wu tang
(mod of si wu tang= + tao ren, hong hua)
40
A patient has rash behavior, uncontrollable emotions, incoherent speech and a red tongue w/ a sticky yellow coating. What is the treatment?
A) PC-5, PC-6, UB-15, RN-17, RN-6
B) HT-5, PC-6, UB-15, DU-14, RN-6
C) ST-40, HT-7, HT-5, PC-6, RN-12
D) SP-6, UB-15, PC-5, HT-8, PC-7, ST-40
**D) SP-6, UB-15, PC-5, HT-8, PC-7, ST-40**
SP-6 (resolve D, calm mind, cool xue)
UB-15 (BS HT)
PC-5 (Cl H, Resolve HT P)
HT-8 (Cl HT F, HT-P-F)
PC-7 (Cl H, calm mind)
ST-40 (phlegm)
**DX:**
Phlegm fire harassing HT
**FX:**
Qing qi hua tan wan (Dr. Cao)
or
Huang lian wen dan tang (wen dan tang + huang lian- drain HT F)
41
A patient has palpitations, sadness, tiredness, and an empty pulse. What is the treatment?
A) HT-5, PC-6, UB-15, KD-6, RN-6
B) RN-6, RN-4, DU-20, DU-14, UB-15
C) DU-14, RN-6, HT-5, PC-6, UB-15, RN-17
D) HT-8, HT-7, SP-6, KD-6, RN-15
**C) DU-14, RN-6, HT-5, PC-6, UB-15, RN-17**
**DX:**
HT Qi Xu
**FX:**
Zhi gan cao tang (Fu mai tang)
(for palps d/t HT qi xu)
or
Gui pi tang
(HT Qi + Xue xu causing palps)
**Explanation:**
A) HT-5, PC-6, UB-15, KD-6, RN-6
HT + KD Disharmony
B) RN-6, RN-4, DU-20, DU-14, UB-15
General Qi Xu- not enough HT pts
C) DU-14, RN-6, HT-5, PC-6, UB-15, RN-17
HT Qi Xu
D) HT-8, HT-7, SP-6, KD-6, RN-15
HT Fire
42
A 24 year old man has recently had an appendectomy. After the operation there is abdominal distention w/ no gas being passed. The complexion is dark. He is restless. The mouth is dry but he has no desire to drink. He has a bitter taste in the mouth. The urine is scanty and yellow. He is nauseous and occasionally vomits. The tongue is dark red w/ greasy and yellow coating. The pulse is deep and forceful. What is the diagnosis?
A) Stagnant LR qi invading ST w/ SP damp
B) LR fire w/ damp-heat
C) Damp-heat obstructing intestine qi leading to rebellious ST qi
D) LR and GB damp heat
**C) Damp-heat obstructing intestine qi leading to rebellious ST qi**
**FX:**
Long dan xie gan tang (D-H obst lower jiao)
**Prescription:**
PC-6 + ST-36 (VIP nausea, vomit)
LI-11 (cl H)
LI-4 + LR-3 (Source, D-H obst, move qi)
GB-34 (D-H draining)
ST-37 (LHS LI)
ST-25 (promote BM)
SP-9 (Drain D anywhere)
**Explanation:**
Nausea + vomit= reb ST qi
No desire drink= damp/phlegm
Dark red w/ greasy yellow= heat/phlegm
Bitter taste not only LR/GB (ref acid reflux)
43
A 54 year old man has high fever, irritability, manic behavior, epistaxis, blood urine, dark macules, dark red tongue w/o coating and wiry-fast pulse. What is treatment?
A) LR-3, DU-16, GB-20, SP-6, KD-3
B) SP-6, SP-10, LI-11, LR-2, HT-9
C) SP-10, LI-11, GB-20, DU-16, LR-2
D) PC-9, PC-8, HT-9, KD-6
**B) SP-6, SP-10, LI-11, LR-2, HT-9**
SP-6 (cool xue)
SP-10 (any xue disorder)
LI-11 (cl H whole body)
LR-2 (YS LR, cool xue)
HT-9 (XC, manic behavior, cl H)
**DX:**
Blood level heat w/ blood moving recklessly
(pg 112 KIM on Wen Bing)
**FX:**
Xi jiao di huang tang (cl xue h, pg. 565 KIM)
epistaxis= bleeding from nose
44
A patient has fever, dark scanty urine, fullness in the chest and hypochondriac area, jaundice, poor appetite and vaginal discharge w/ itching. What is the treatment?
A) LR-14, GB-24, GB-34, DU-9, SP-9, SP-6, LI-11
B) LR-8, LR-3, SP-6, KD-3, GB-20, UB-18
C) LR-8, LR-3, LI-4, SP-6, KD-3, GB-20, DU-20
D) LR-2, GB-20, GB-13, LI-11, Taiyang
A) LR-14, GB-24, GB-34, DU-9, SP-9, SP-6, LI-11
LR-14 (FM LR)
GB-24 (FM GB, resolve D-H, prom fxn LR/GB)
GB-34 (D-H LR/GB)
DU-9 (resolve D-H, reg LR/GB, move qi, open chest)
SP-9 (Damp)
SP-6 (resolve damp)
LI-11 (clear heat)
**DX:**
LR/GB Damp Heat
**FX:**
Long dan xie gan tang
or Mod Yin chen hao tang (basic jaundice fx)
45
You treat a patient for chronic sinusitis. He has red eyes, H/A, and yellow nasal discharge. Your prescription is LI-20, UB-2, UB-7. After several Tx's there is no improvement. What would you add to your prescription?
A) LI-4, LU-7
B) GB-20, LR-2
C) LI-4, UB-1
D) LR-2, Taiyang
**B) GB-20, LR-2**
LR-2 (LR-F- Red eyes, H/A)
GB-20 (tx any facial orifice)
**DX:**
Chronic sinusitis d/t LR F flaring upwards
**Explanation:**
Generally chronic sinusitis not yellow discharge, but more xu s/s. Here more H s/s. Original Tx LI-20, UB-2 + UB-7 only Tx sinusitis. W/ LR-2 + GB-20 cl F + Tx orifice. If pulse were floating therefore W-H invasion.
46
According to TCM 5E theory, if a patient had a strong pulse in the Foot position of the Right wrist, which of the following points would you needle?
A) Tonification of SJ-3
B) Sedation of SJ-10
C) Sedation of GB-38
D) Tonificaiton of GB-43
**B) Sedation of SJ-10**
**Explanation:**
RIGHT FOOT= KD + SJ/Lower jiao
sedate child to clear excess
if was xu therefore tonify mother
**According to Classic of Difficulties:**
CUN= "inch"
GUAN= "gate"
CHI= "foot"
PG 355 FCM
47
A 37 year old professional ice skater has been depressed ever since he fell and broke his leg. He has been worried about being unable to continue his career. He has insomnia, poor memory and inappropriate laughter and crying, is irritable and mentally confused. He looks gloomy and has a pale complexion. Other symptoms include heavy feeling in the head and a rattling sound in the throat. he has poor appetite. There is a sense of distention in the chest and in the hypogastrium. He has palpitations. When he is able to sleep he has nightmares. The tongue is pale with greasy-white coating. The pulse is wiry and thin. You treat the patient with PC-6, HT-7, LR-3, RN-17, ST-36, SP-6. After a course of treatment the patient was able to sleep and appetite improved but there was still a problem w/ uncontrollable laughter and weeping and the nightmares were still occurring. What points would you consider using to modify the prescription?
A) HT-5, ST-40
B) LR-2, HT-8
C) SP-9, RN-9
D) UB-15, UB-18
**A) HT-5, ST-40**
HT-5 (Luo, Tn HT qi, open into tongue, benefit UB, calm Mind)
ST-40 (Luo, resolve D/Ph, cl H, calm asthma, open chest, calm mind)
**DX:**
Phlegm misting HT/Mind w/ LR qi stag + SP qi xu
**FX:**
Di tan tang
(mod of er chen tang + zhi shi, dan nan xing, ren shen, shi chang pu)
or Ban xia bai zhu tian ma tang
(also mod er chen tang, +da zao, tian ma, bai zhu, -wu mei)
48
A patient has palpitations, SOB, shallow breathing, profuse sweating, cold legs & arms, blue lips, bluish-purple tongue, and a hidden-minute pulse. What is the treatment?
A) HT-5, PC-6, UB-15, RN-6, DU-14, moxa RN-17
B) HT-8, HT-7, SP-6, KD-6 moxa, RN-15
C) RN-6, RN-4, DU-4, UB-15, DU-14, moxa RN-8
D) HT-7, PC-6, HT-6, KD-6, KD-7, moxa RN-15, RN-4
**C) RN-6, RN-4, DU-4, UB-15, DU-14, moxa RN-8**
RN-6 (Tn yang + qi, Tn yuan qi)
RN-4 (Tn yang, yuan qi, calm mind)
DU-4 (Expel C, Tn KD yang, nourish yuan qi)
UB-15 (BS HT)
DU-14 (Tn yang, cl mind)
RN-8 (Tn yuan qi, rescue yang)
**DX:**
HT yang collapse
**FX:**
Shen fu tang
**Explanation:**
palpitations, SOB, weak and shallow breathing, profuse sweating, cold limbs, cyanosis of lips, greyish-white complexion, in severe cases coma, very pale/bluish purple tongue, hidden minute knotted pulse
FCM pg 467
49
A patient has retention of urine, distention and dull pain in the lower abdomen after surgical operation. The tongue has purplish spots. The pulse is hesitant and fast. What is the prescription?
A) LR-2, UB-28, RN-3, SP-9
B) UB-28, RN-3, SP-6, UB-39
C) SJ-4, UB-23, RN-4, DU-20, DU-4
D) SP-6, RN-3, ST-28, KD-5
**D) SP-6, RN-3, ST-28, KD-5**
SP-6 (Benefit urine, remove stasis, invig xue)
RN-3 (FM UB)
ST-28 (prom urine, alleviate pain)
KD-5 (XC KD, acute disorders, invig xue)
**DX:**
Damage UB ch qi d/t Surgery w/ xue stasis
**FX:**
Shao fu zhu yu tang (xue stag in lower jiao)
**Explanation:**
PG 437 CAM
Retention of Urine d/t Damage of qi of meridian
Main manifestations: dribbling urination or retention of urine, distention and dull pain in lower abd, purplish spots on tongue, hesitant + rapid pulse (d/t xue stag)
50
A 33 year old nursing mother has an acute case of mastitis. Treatment given was RN-17 + ST-18. After the first initial treatments the condition improved but not totally. What would you add?
A) LR-3
B) LI-4
C) SI-1
D) SJ-5
**C) SI-1 Insufficient lactation**
**FX:**
Wu wei xiao du yin (deep rooted + hard lesions)
or Chuan xin lian w/ lian qiao (cl T-H + reduce masses)
**Explanation:**
Wu wei xiao du yin safe to take while nursing can also pump + throw away milk while infection still present
PG 485 CAM
51
Which xi-cleft point is indicated for blood stasis in the uterus, shan disorder, and lower abdominal pain?
A) SP-8
B) KD-5
C) LR-6
D) KD-8
**C) LR-6**
XC LR, Remove obst ch, promote smooth flow LR qi, stop pain
**FX:**
Mod Shao fu zhu yu tang (xue stag in uterus)
**Explanation:**
LR channel goes to genitalia therefore is best point Shan disorder/Lower abd pain no typical fx- depend on etiology Shan disorder= hernia
52
A 39 year old female has been diagnosed with clinical depression. Symptoms include mental depression, chest distress, hypochondriac distention, bleching, poor appetite, and irregular bowel movements. The tongue has a thin-sticky coating. The pulse is string-taut. The acupuncture prescription is UB-18, RN-17, RN-12, ST-36, and LR-3. After several treatments, the patient returns and now reports depression, h/a, chest distress, hypochondriac distention, acid regurgitation, dry mouth, constipation. Her eyes are blood shot. The tongue has a yellow coating. The pulse is string-taut and sl. fast. What is your prescription?
A) ST-44, LI-11, DU-14, ST-25
B) UB-18, GB-20, RN-12, ST-36, KD-6
C) LR-2, GB-43, RN-13, SJ-6, GB-34
D) RN-17, PC-6, LR-3, ST-40 GB-20,
**C) LR-2, GB-43, RN-13, SJ-6, GB-34**
LR-2 (YS LR)
GB-43 (YS GB, water point, D-H, descend LR yang)
RN-13 (subdue reb ST qi)
SJ-6 (open intestines, cl-H, reg qi, remove obst ch)
GB-34 (prom flow LR qi, subdue reb qi, relax sinew/muscle)
**DX:**
Original= LR qi OA ST
Now= LR-F causing Reb ST qi
**FX:**
Long dan xie gan tang (LR-F)
**Explanation:**
Melancholia pg 450 CAM
d/t Transformation of depressed qi into fire
*Main manifestations:*
H/a, dryness and bitter taste in mouth, irritability, distress of chest, hypochondriac distention, acid regurgitation, constipation, red eyes, tinnitus, red tongue w/ yellow coating, string-taut rapid pulse
53
A patient has tongue ulcers, thirst, palpitations and a red tongue. What is the treatment plan?
A) Clear HT-F, resolve P, pacify mind
B) Clear HT, Drain F, pacify mind
C) Open HT, Resolve P
D) Tonify and nourish HT yin, pacify mind
**B) Clear HT, Drain F, pacify mind**
**DX:**
HT-F blazing
**FX:**
Xie xin tang
**Prescription:**
HT-8, HT-9, RN-15, LI-11, DU-24, SP-6, KD-6 (promote yin to cool F)
54
A patient has sudden unconsciousness, convulsions, deviation of eye and mouth. What is the treatment plan?
A) Clear heat, disper LR, subdue wind
B) nourish LR yin, subdue LR yang and wind
C) sedate LR, clear fire
D) disperse LR, regulate xue
**B) nourish LR yin, subdue LR yang and wind**
**DX:**
LR yin xu --\> LR yang rising --\> INT LR W
**FX:**
Shen gan xi feng tang
**Prescription:**
LR-3 (subdue yang, W)
GB-20 (Int W, subdue yang, clear H, CL brain)
LI-4 (subdue yang)
SJ-5 (subdue LR yang)
DU-19 (int W)
SP-6, LR-8, KD-3 (Tn LR Yin)
Shi xuan (resuscitation)
DU-20 ("")
DU-16 (expel W, cl mind, benefit brain)
**Explanation:**
FCM pg 525 LR Wind
CAM pg 401 Windstroke
No F s/s
No sallow complexion therefore no xue xu
No KD yin xu s/s
A) Clear heat, disper LR, subdue wind
LR F--\> LR W
B) nourish LR yin, subdue LR yang and wind
LR Yin Xu--\> LR yang --\> LR W
C) sedate LR, clear fire
LR-F
D) disperse LR, regulate xue
INT W d/t LR Xue xu
55
Numbness in the extremities, burning pain in the lower limbs, skin feels hot to touch, and yellow greasy tongue coating can indicate:
A) Phlegm-damp obstruction
B) Damp-phlegm stagnation
C) Damp-heat
D) wind-phlegm blocking channels
**C) Damp-heat**
**DX:**
D-H in Lower Jiao
**FX:**
Mod Long dan xie gan tang
**Explanation:**
numbness d/t D or nonsubstantial P
skin hot to touch= D-H
A) Phlegm-damp obstruction
white greasy tongue coat, er chen tang
B) Damp-phlegm stagnation
er chen tang
C) Damp-heat
long dan xie gan tang
D) wind-phlegm blocking channels
causes convulsions, ban xia bai zhu tian ma tang
56
A 33 year old woman's main complaint is constipation, a problem she has had for six years. She has 2-3 BM's per week. The stools are small and dry. Her breath has a foul odor. The tongue has a normal color w/ a dry yellow coating which is thicker at the root. The pulse is normal. What is the treatment?
A) RN-10, GB-34, LR-3, SP-15, SJ-6
B) ST-25, SP-15, RN-10, ST-44, LI-11, ST-36
C) UB-25, ST-25, ST-36, SP-6, RN-6, UB-13
D) ST-36, SP-6, RN-4, UB-20, UB-23, SP-15
**B) ST-25, SP-15, RN-10, ST-44, LI-11, ST-36**
ST-25 (FM LI) w/ SP-15 (prom fx LI, Tn SP, reg qi) (combo constipation)
RN-10 (Tn SP, descend ST qi, rel food stag)
ST-44 (YS ST, cl H, reg qi, elim fullness, prom digestion)
LI-11 (cl H)
ST-36 (Tn SP/ST qi, xue, reg intestines, gen fluid)
**DX:**
Dry heat in LI
**FX:**
Zhen ye chen qi tang
(mod zhen ye tang + xiao cheng qi tang)
(zyt= gen fluid for constipation d/t yin xu/shi dry)
"boat can't move w/o water"
**Explanation:**
CAM pg 429 patient is between xu (yin xu) and shi dry heat therefore pulse is normal yellow coat=dry heat (if yin xu would be scanty/no coat, red body) foul odor- d/t ST food retention/fall descend (ST-44 + RN-10 descend ST)
57
When concluding the acupuncture needle technique "Setting the Mountain on Fire" you:
A) slowly withdraw the needle and rotate to the left
B) withdraw needle when patient exhales
C) quickly withdraw the needle and press the hole
D) rotate needle fast w/ large amplitude
**C) quickly withdraw the needle and press the hole**
**Explanation:**
CAM pg 349
KIM pg 291
58
In electroacupuncture, pulses which alternate with quick and slow periods are preferable for treating:
A) Pain
B) Paralysis and numbness
C) Spasm
D) Muscle contractions
**B) Paralysis and numbness**
**Explanation:**
PG 309 KIM
*Regular Frequencies*:
* Best for treating pain and spasm
* Drain Shi
*Alternate Quick & Slow:*
* Tx paralysis
* Strengthen Xu
59
Chronic and stubborn numbness in the fingers and toes with sensations that are distinguishable between the fingers and toes indicates:
A) Blood xu
B) Wind-phlegm blocking channels
C) Damp-heat blocking channels
D) Damp-phlegm obstruction
**D) Damp-phlegm obstruction**
**Explanation**:
*A) Blood xu*
Sallow complexion, xue xu s/s
*B) Wind-phlegm blocking channels*
Pulse floating/slippery (d/t Ext W), foamy, white or clear sputum
*C) Damp-heat blocking channels*
Heat s/s, pulse soggy/rapid/forceful, tongue red w/ yellow greasy coating, thick yellow sputum
*D) Damp-phlegm obstruction*
nonsubstantial phlegm, may not have any other phlegm s/s
"Strange diseases are due to phlegm"
60
The needle techniques of "Setting the Mountain on Fire" and "Penetrating Heaven-Coolness" are derived form all of the following techniques EXCEPT:
A) slow and rapid insertion of needle
B) the relation of need tip to flow of qi
C) lifting and thrusting of needle
D) keeping the hole open or closed
**B) the relation of need tip to flow of qi**
**Explanation**:
*Setting the Mountain on Fire*
Tonification
Superficial-Medium-Deep (9x3)
Insertion: slow
Thrust (slow)/Lift(quick): 9x at each level
Withdrawal: Rapid + close hole
*Penetrating Heaven Coolness*:
Sedation
Superficial-Medium-Deep (6x3)
Insertion: Rapid
Thrust (quick)/Lift (slow): 6x at each level
Withdrawal: Slow + open hole
Kim pg 291
61
The thumbtack intradermal needle is usually applied to the:
A) Thighs
B) Arms
C) Back
D) Ear
**D) Ear**
Kim pg 293
62
The most widely performed bloodletting technique is:
A) Clumping
B) Spot Pricking
C) Dispersing
D) Pecking
**B) Spot Pricking**
CAM pg 354
Kim pg 293
63
The dispersing method of bloodletting is done by inducing superficial bleeding in a wide area of the skin. It is primarily used for:
A) Skin diseases such as nerodermatitis
B) Heat stroke
C) Apoplexy
D) Gastronintestinal inflammation
**A) Skin diseases such as nerodermatitis**
Dr. Cao: bloodletting is for strange diseases such as mental disorders. Can bleed the heal. Also bleed da zhui for skin diseases.
64
A patient has hypertension with dizziness, flushed face, red eyes, stiff neck, constipation, dry mouth, yellow tongue coating, and strong-wiry pulse. You choose GB-20, LI-11, ST-36, LR-3. What other points would you add to the prescription?
A) PC-6, ST-40
B) KD-3, HT-7
C) LR-2, GB-34
D) RN-6, RN-4
**C) LR-2, GB-34**
LR-2 (Ying spring, cl LR F)
GB-34 (HS, Sinews, smooth LR qi, subdue reb qi)
**DX:**
Liver Fire Blazing
**FX:**
Long dan xie gan tang
65
The points RN-22, LI-18, LI-4 symptomatically treat:
A) Asthma
B) Coughing
C) Congested throat
D) Lateral neck pain
C) Congested throat
**Explanation:**
Asthma or cough involves LU xu + would include LU points @ distal, not LI-4 as in the prescription.
RN-22 doesn't match lateral neck pain
RN-22: location key, plum pit, sore throat, cough
LI-18: cough, sore throat, neck pain
LI-4: Face/head, neck pain, throat
66
The points UB-15, HT-7, LR-3 symptomatically treat:
A) Breast distention
B) Sensation of plum pit in the throat
C) Vertex headache
D) Excessive dreaming
**D) Excessive dreaming**
LR-3 is distal point for shi dreaming
**Explanation:**
*A) Breast distention*
Use more LU pts
*B) Sensation of plum pit in the throat*
Qi stag or phlegm, not tx by HT pts
*C) Vertex headache*
LR qi stag or LR xue xu- would use LR pts
*D) Excessive dreaming*
Dream from HT
67
Which host-guest combination opens and regulates the water passages when pathogenic wind causes symptoms of upper body edema, no sweating, and difficult urination?
A) LI-4, LU-7
B) LU-7, LI-6
C) LU-9, LI-6
D) SP-3, ST-40
**C) LU-9, LI-6**
**Explanation**:
Disease location= LU therefore source LU + Luo LI
CAM pg 387
Deadman pg 41-2
68
According to the Yuan-Luo/Host-Guest points which of the following treats Spleen disorders?
A) PC-4, ST-42
B) SP-3, ST-40
C) SP-3, ST-42
D) SP-4, ST-40
**B) SP-3, ST-40**
69
A patient has fixed stabbing pain in the hypochondriac area, and pain worse at night. The tongue is purplish. The pulse is choppy. What is the prescription?
A) LR-14, LR-13, GB-26, SJ-6, GB-34
B) UB-18, LR-14, SJ-6, GB-34, UB-17
C) RN-14, LR-3, UB-18, SP-6, ST-36
D) LR-3, LR-14, GB-34, SJ-6, GB-40
**B) UB-18, LR-14, SJ-6, GB-34, UB-17**
UB-18 (Sooth LR, Tn Xue)
LR-14 (Local pain, move qi)
SJ-6 (reg qi, alleviate pain)
GB-34 (all kinds pain)
UB-17 (all xue disorders)
**DX:**
LR Xue Stagnation
**FX:**
Xue Fu Zhu Yu Tang
or
Ge Xia Zhu Yu Tang
**Explanation:**
pg 458 CAM Pain in Hypochondriac
C= Xue xu
D= LR qi stag
70
A 32 year old woman has painful periods. She has a short cycle with periods every 21-23 days. She has severe menstrual pain with red blood with small dark clots. She feels cold during her period and has dizziness, and tinnitus. The tongue is pale and swollen. The pulse is slow, choppy, and especially weak in the left rear position. What is the diagnosis?
A) Liver Stagnant Blood
B) Liver Yang Rising
C) Deficient Kidney Yang w/ Empty Cold
D) Deficient Liver Blood
**C) Deficient Kidney Yang w/ Empty Cold**
**FX:**
You gui wan
**Prescription:**
RN-8 (w/ moxa- Tx cold pain during period)
KD-3 (Tn KD yin/yang)
DU-4 (Tn yang)
RN-4,6 (Local points)
Zi Gong Xue (local points)
LR-3 (move qi, ch connect uterus)
SP-6 (VIP pain)
**Explanation:**
Dizziness + tinnitus = yang xu
W/ yang xu, KD yin pulse also still xu- look at tongue
CAM pg 475 Dysmenorrhea
71
A 35 year old female patient has had migraines for ten years. The location of the headaches is on top of the head and behind the eyes. They start with a dull pain and proceed to become severe with nausea, vomiting, and diarrhea. The headaches improve with the patient lying down. The headaches occur every day. The tongue is thin and pale and the pulse is weak on the right side and wiry on the left side. What is the treatment?
A) LR-3, DU-20
B) PC-6, SJ-4, ST-36, LR-8, SP-6, LR-3
C) LI-4, LR-3
D) GB-20, SJ-5, LI-4, ST-44, SP-6, KD-3
**B) PC-6, SJ-4, ST-36, LR-8, SP-6, LR-3**
PC-6 (nausea, reg Jueyin)
SJ-4 (H/A)
ST-36 (Tn qi + xue, ST Dx)
LR-8 (LR xue xu + yin)
SP-6 (Tn yin, xue, reg qi, soothe LR)
LR-3 (Anchor yang, Tn LR xue)
**DX:**
LR Yang Rising d/t LR Xue Xu (W/ SP Qi Xu)
**FX:**
Mod Xiao yao san
+Mu li, Gou teng
**Explanation:**
Jueyin H/A
If H/A d/t LR-F + LR-2
72
A patient has flooding at the beginning of her period which then stops. It continues trickling for a longer time after the period proper. The blood is pale and watery. She has a pale face, tiredness, slight dizziness, no appetite. The tongue is pale with teeth-marks. The pulse is weak. What is the pattern?
A) Spleen qi xu
B) KD yang xu
C) Spleen not holding xue
D) Xu qi and xue
**C) Spleen not holding xue**
**FX:**
Gui pi tang
**Prescription:**
RN-12, UB-20, UB-21, UB-17 (Tn xue, stop bleeding), ST-36, SP-3 (source), SP-6 (Tn qi, xue, yin, sooth LR), SP-10, SP-1 (stop bleeding)
**Explanation:**
CAM pg 479 Metorrhagia
73
An 82 year old man has pain in both knees which are swollen and respond with pain to cold weather. He is in general good health. His only other problem is occasional insomnia. The tongue is red without coating and with cracks. The pulse is normal and only a little fine. What is the diagnosis?
A) Deficient channel qi
B) Deficient HT yang
C) Cold and damp bi syndrome
D) WInd-cold invades LU
**C) Cold and damp bi syndrome**
**Prescription**:
Moxa SP-6 + ST-36 (Tn qi, xue, yin, yang)
GB-34 (Tn sinew, bone)
Local: Xi yan, he ding, ST-35, ST-34 (XC, move qi/xue), UB-40, SP-9
KD-3 (Tn KD, Tn sinew/bone)
**FX:**
Du huo ji sheng tang
(chronic C + D Bi d/t LR/KD yin xu)
**Explanation:**
swollen= damp
pain w/ C weather= cold
Main s/s= C-D bi
Rest s/s= d/t age
74
Which of the following acupuncture points can be needled with one hand stretching the skin with the thumb and index finger of one hand and using the other hand to insert the needle?
A) ST-4
B) RN-4
C) Yin tang
D) UB-2
**B) RN-4**
CAM pg 342-4 Insertion
RN-4 stretching skin
ST-4, Yin tang, UB-2 insert by pinching skin
75
In applying gua sha to the sternum, in which direction should it be applied?
A) bottom up to the sternal notch
B) transverse from left to right going up
C) top down to the xyphoid process
D) transverse from right to left going down
**C) top down to the xyphoid process**
76
A patient has pain and numbness in the right leg. Which scalp acupuncture area would you treat?
A) left upper fifth of the sensory line
B) bilateral upper fifth of the sensory line
C) right second and third fifths of the sensory line
D) left second and third fifths of the sensory line
**A) left upper fifth of the sensory line**
Upper 1/5= lower limb + trunk
2nd/3rd 1/5s= upper limb
Lower 2/5= facial
Left to treat right
77
Yellow discharge with pus in the blood in a woman after menopause indicates:
A) Stagnation of LR qi
B) Damp heat in lower burner
C) Damp heat in LR channel
D) Toxic damp heat in uterus
**D) Toxic damp heat in uterus**
Pus + Blood= Toxic damp heat
Post meopause probably cancer- must have biopsy
If pain generally not cancer unless stage 4
78
For which conditions is moxibustion with garlic best used?
A) Scrofula, TB, and early stages of skin ulcer with boils
B) Asthma, chronic diarrhea and indigestion
C) Abdominal pain, vomiting, and prolonged dysentery
D) Impotence, KD yang xu, and premature ejaculation
**A) Scrofula, TB, and early stages of skin ulcer with boils**
**Explanation:**
CAM pg 364- Moxibustion
KIM pg 296 Moxa
A) Scrofula, TB, and early stages of skin ulcer with boils
*Moxa w/ Garlic*
B) Asthma, chronic diarrhea and indigestion
C) Abdominal pain, vomiting, and prolonged dysentery
*Moxa w/ salt*
D) Impotence, KD yang xu, and premature ejaculation
*Moxa w/ Fu zi (monkshood) cake*
79
A patient has stabbing pain in the epigastrium, vomiting dark blood. What is the treatment?
A) LR-14, ST-36, RN-13, UB-21, GB-34
B) RN-13, ST-21, SP-4, PC-6, ST-44
C) ST-36, RN-12, UB-20, UB-21, RN-6
D) SJ-6, ST-21, ST-34, SP-10, UB-17
**D) SJ-6, ST-21, ST-34, SP-10, UB-17**
SJ-6 (Distal tx ST, Subdue Reb ST qi, promote BM)
ST-21 (Local Tx ST, Reg ST, stop vomit, subdue Reb ST qi, stop pain)
ST-34 (XC Acute Dx ST, Subdue Reb ST qi)
SP-10 (All xue Dx)
UB-17 (Stop bleeding, Tn Xue)
**DX:**
ST xue stasis
**FX:**
Yunnan baiyao
(best stop bleeding; San Qi enter LR, ST; esp any kind ST bleeding)
**Explanation:**
Stabbing pain= xue stasis
Wandering pain is d/t qi stagnation
80
Which point combination helps in the treatment of fixed bi syndrome?
A) UB-17, SP-10
B) UB-23, RN-4
C) DU-14, LI-11
D) ST-36, SP-5
**D) ST-36, SP-5**
**Explanation:**
CAM pg 464 Bi Syndrome
A) UB-17, SP-10 *wandering bi*
B) UB-23, RN-4 *painful bi*
C) DU-14, LI-11*heat bi*
D) ST-36, SP-5 *fixed bi*
81
Which point combination helps in the treatment of heat bi syndrome?
A) UB-17, SP-10
B) UB-23, RN-4
C) ST-36, SP-5
D) DU-14, LI-11
**D) DU-14, LI-11**
**FX:**
Mod Xue fu zhu yu tang
+ Mu dan pi, dan shen, shi gao, da huang
**Explanation:**
CAM pg 464 Bi Syndrome
A) UB-17, SP-10 *wandering bi*
B) UB-23, RN-4 *painful bi*
C) ST-36, SP-5*fixed bi*
D) DU-14, LI-11 *heat bi*
82
A patient has irregular menstruation with a shortened cycle, profuse, thin and light red blood, shortness of breath, and fatigue. The tongue is pale with thin coating. The pulse is thin and weak. What is the pattern?
A) Deficient blood
B) Stagnant qi
C) Deficient qi
D) Cold uterus
**C) Deficient qi**
**FX:**
Mod Si jun zi tang
**Prescription:**
DU-14, RN-17, RN-4, RN-6, ST-36 + SP-6, LR-3 + LI-4
**Explanation:**
CAM pg 472 Irregular menstruation
*Causes Irregular Menstruation:*
Xue xu vs. Qi xu
* Xue xu:* Sallow complexion, dizziness, numbness
* Qi xu:* fatigue, SOB
83
A patient has amenorrhea with delayed menstrual cycle and gradual decrease of menses, poor appetite, loose stools, dizziness, and sallow complexion. The tongue is pale with little coating. The pulse is weak. What is the pattern?
A) Deficient SP qi w/ damp obstruction
B) Deficient SP + ST qi
C) Deficient blood
D) Deficient LR blood
**C) Deficient blood**
**FX:**
Tao hong si wu tang
Tao ren + hong hua + si wu tang (shu di, dang gui, bai shao, chuan xiong)
**Prescription:**
SP-6 + ST-36, RN-4 (TN qi to TN xue), ST-29 (abundant qi/xue, local), Zi gong xue (zi=fetus, gong=home), LR-3 (move qi, TN xue)
**Explanation:**
CAM pg 477 Amenorrhea
* 2 Causes:*
1) Xue stagnation
2) Xue xu
Local tx + estim is VIP for gynecology
84
A patient has abnormal uterine bleeding which is continuous and scanty, light red and thin blood, lassitude, and shortness of blood, and poor appetite. The tongue is pale. The pulse is thin and weak. What is the pattern?
A) Deficient blood
B) Deficient qi
C) Deficient yin
D) Internal, deficient, hot
**B) Deficient qi**
**Explanation:**
key: SOB, poor appetite, continuous + scanty light red and thin blood
CAM pg 479 Uterine Bleeding
*2 Causes*: 1) Shi H, 2) Qi xu
85
A pregnant woman has prolonged labor with malposition of the fetus, shap pain in the abdomen, scanty dark and red bleeding, dark complexion. The tongue is dark. The pulse is deep and forceful. What is the pattern?
A) Hot blood and stagnant qi
B) Deficient qi and stagnant qi
C) Deficient blood and stagnant qi
D) Stagnant qi and blood
**D) Stagnant qi and blood**
**Prescription**:
LI-4 + SP-6 (prolonged labor) + moxa on belly to help fetus change position
KEY: Sharp pain, dark tongue, deep + forceful pulse, scanty dark + red bleeding
**FX:**
Chai hu shu gan san (move qi)
**Explanation:**
CAM pg 484 Prolonged labor
*Causes:* 1) Qi + xue stag, 2) QI + xue xu
86
A pregnant woman patient has morning sickness with nausea + vomiting of undigested food right after eating, sleepiness, and lassitude. The tongue is pale with white coating. The pulse is slippery and weak. What is the pattern?
A) Stagnant LR qi invading ST
B) Rebellious ST qi
C) Deficient qi of SP + ST
D) Deficient qi + xue
**C) Deficient qi of SP + ST**
**FX:**
SI jun zi tang + Sheng jiang (subdue reb ST qi, stop nausea + vomit)
**Prescription:**
PC-6, RN-17, RN-12
**Explanation:**
CAM pg 483 Morning Sickness
*2 Causes:* 1) XU SP + ST, 2) Disharmony SP + ST
Slippery pulse d/t pregnancy, weak d/t xu
87
For which of the following conditions can the plum blossom needle be used?
A) Edementous swellings
B) Intercostal neuralgia
C) Infectious disease
D) Acute abdominal disorders
**B) Intercostal neuralgia**
88
Which of the following points can be used for a woman in the second month of pregnancy with morning sickness?
A) SP-6
B) RN-12
C) GB-21
D) UB-60
**B) RN-12**
After 3 mo, can't use RN-12
SP-6, GB-21, UB-60 all induce labor, are contraindicated
LI-4, UB-67 also for induce labor
Below umbilicus and lumbar region
89
The dispersing method of bloodletting is done by inducing superficial bleeding in a wide area of the skin. It is primarily used for:
A) Skin diseases such as neurodermatitis
B) Heat stroke
C) Apoplexy
D) Gastrointestinal inflammation
**A) Skin diseases such as neurodermatitis**
90
When should you test for giving Gua Sha?
A) When the skin feels cold to the touch
B) When there is pain anywhere
C) When the patient asks for it
D) When there is a dark spot on the skin
**A) When the skin feels cold to the touch**
91
As a general guideline, the classics write that during the winter time needling recommendation is to:
A) not needle too deep
B) hav shallow needling
C) needle deep
D) not needle during this time
**C) needle deep**
92
A patient has difficulty falling asleep, dreams, palpitations, poor memory, anorexia, and sallow complexion. The tongue is pale with thin white coating. The pulse is thin and weak. What is the prescription?
A) UB-18, UB-19, GB-12, HT-7, SP-6, An mian
B) HT-7, SP-6, An mian, UB-20, UB-15, SP-1
C) ST-36, HT-7, SP-6, An mian, UB-21
D) An mian, UB-15, UB-23, HT-7, SP-6, KD-3
**B) HT-7, SP-6, An mian, UB-20, UB-15, SP-1**
HT-7 (SS, Source, Tn HT Xue)
SP-6 (San yin jiao, Tn SP, Nourish Xue)
An mian (insomnia, palpitations)
UB-20 (BS SP)
UB-15 (BS HT)
SP-1 (Insomnia)
**DX:**
Palpitations d/t HT blood and SP Qi xu
**FX:**
Gui pi tang
93
A patient has edema more pronounced in the legs and ankles, cold feelings, fullness and distention in abdomen, sore lower back, and scanty and clear urination. What pulse is expected?
A) deep, weak and slow pulse
B) Floating, empty and rapid pulse
C) Floating and empty pulse or choppy pulse
D) Floating and empty pulse or leather pulse
**A) deep, weak and slow pulse**
**DX:**
KD yang xu causing edema
**PTS:**
ST-36 (all xu)
UB-28 (BS UB, prom urine to drain edema)
UB-23 + DU-4 (moxa, Tn KD yang-root)
KD-7 (Tn KD yang, drain pathogenic h2o)
KD-3 (source)
SP-9 (water metab)
RN3 (prom urine)
UB-39 (LHS SJ, prom urine, for edema)
**FX:**
Wu ling san (tx edema)
You gui wan (tx root KD yang xu)
94
A patient has urgent and frequent urination, buring urine, difficult urination which stops midstream, dark colored urine, blood and sand in the urine, feverish sensations, and thirst. What tongue is expected?
A) White-greasy coating on root
B) Pale and wet tongue
C) Red tongue without coating
D) Thick, sticky, yellow coating on the root w/ red spots
**D) Thick, sticky, yellow coating on the root w/ red spots**
**DX:**
Damp-Heat in Lower Jiao/UB
**FX:**
Ba zheng san
**PTS:**
RN-3 (FM UB), SP-9 (h2o metab), UB-22 (BS SJ), UB-28 (BS UB), LI-11 (better then UB-63 in practice), SP-6 (benefit urination, cool blood)
95
A patient has abdominal pain, diarrhea with mucous and blood, foul smelling stools, burning anus, fever, sweating does not abate fever, and thirst with no desire to drink. What tongue is expected?
A) Thick-yellow and dry coating
B) Pale or red dry tongue without coating
C) Red tongue, greasy-yellow coating
D) Pale tongue
**C) Red tongue, greasy-yellow coating**
**DX:**
Damp heat in LI
**FX:**
Bai tou weng tang
*severe diarrhea w/ xue/mucous in stools*
**PTS:**
ST-25 (FM LI)
ST-37 (LHS LI)
SP-9 (D-H)
SP-6 (D-H)
UB-25 (BS LI)
LI-11 (All H)
ST-44 (YS, Shi H, CL H, Drain D)
RN-3 + RN-9 (drain water to solidify stool)
**Explanation:**
Thirst=shi H
Thirst w/o desire drink= D-H
Greasy= D, Red= H
Mucous/Xue stool= D-H
Fowl smelling stool= D-H
*Promote urination to solidify stool (esp w/ scanty urination w/ diarrhea)*
96
A 32 year-old overweight woman was diagnosed with viral meningitis two years ago. At that time she had a high fever, rigid neck, and vomiting. After the meningitis was resolved she experienced tiredness, feelings of achiness and heaviness in the limbs, night sweats, and poor concentration. She felt a low-grade fever throughout the day. She had leucorrhea which was a bright yellow color. The tongue body is swollen with sticky-yellow coating. The pulse is slippery. What is the diagnosis?
A) Deficient SP qi w/ accumulation of dampness
B) LR and GB damp-heat
C) Damp-heat invading SP
D) ST heat, xu yin
**C) Damp-heat invading SP**
**FX:**
Mod. Wu ling san (best)
Bai zhu, Fu ling, zhu ling, ze xie
*Add:*
Huang lian (C, drain D-H mid jiao)
Pu gong yin (cl-H, drain D, prom urine)
Hou po (dry D mid jiao, descend qi, sticky taste)
Huo xiang (Drain D midj, descend qi, prom sw)
97
A 37 year-old woman has PMS. It started after she got depressed from giving birth. She gets irritable and cries alot. She has breast distention. Other symptoms include constipation, headaches, insmonia, excess dreaming, and palpitations. The tongue is pale, thin, and red on the sides. The pulse is thin, wiry on the left middle position, and weak on the left front position. What is the treatment plan?
A) Nourish LR and HT Xue, Smooth LR Qi
B) Disperse LR, Smooth Qi, Regulate Xue
C) Disperse LR, Smooth Qi, Nourish HT yin
D) Nourish LR and KD Yin
**A) Nourish LR and HT Xue, Smooth LR Qi**
**DX:**
LR + HT Xue xu w/ LR qi stagnation
**FX:**
Mod Xiao yao san
* + Herbs Tn HT*:
* or*
Ba zhen san
*+ Herbs sooth LR*
(Chai hu, bo he, chen pi, xiang fu)
**PTS:**
UB-15, UB-17, UB-18, UB-20
LR-3, LR-14 (Qi stag/sooth LR)
SP-10 (All Dx xue)
SJ-6 (Prom BM, Tx constipation)
SP-6, RN-17, HT-7
98
In a patient with chest pain which would prompt you to make an immediate emergency referral?
A) Chest pain that burns and is worse lying down
B) Chest pain not worse w/ exertion but worse swallowing very hot or cold substances
C) Chest pain longer than 4 minutes w/ sweating and feeling of dread
D) Chest pain from the breastbone increases w/ deep breaths, movement and touch
**C) Chest pain longer than 4 minutes w/ sweating and feeling of dread**
99
If a patient has an enlarged heart, which of the following needled points can damage the heart muscle?
A) ST-12 + ST-21
B) RN-14 + ST-19
C) RN-15 + RN-16
D) KD-22 + ST-21
**B) RN-14 + ST-19**
ST-12=LU
ST-21= LR, peritoneal cavity
RN-15= contra moxa
RN-16= none
KD-22= HT, LU, LR
100
The pulse can be felt with a gentle touch of the fingers and, on further pressure to the deep level, the pulse becomes forceless and soft. What treatment principle is applicable?
A) nourish the yin
B) tonify the qi
C) tonify the yang
D) drain damp
**A) nourish the yin**
To anchor floating pulse
101
Not being able to fall asleep, but sleeping well after falling asleep indicates:
A) Deficiency of KD-Yin
B) Deficiency of LU Qi
C) Deficiency of HT-Xue
D) Deficiency of GB
**C) Deficiency of HT-Xue**
*KIM Pg 48 Sleep*
**FX:**
Gui pi tang
**PTS:**
Yintang
HT-7 (Tn HT xue) + Du-20
An mian (insomnia)
SP-6 + ST-36
KD-6 + UB-62 (Tx severe insomnia)
*KIM pg 252*
102
The beginning stages of difficulty walking form limb atrophy is often due to:
A) Xu of LR yin
B) Xu of SP + KD yang
C) Xu of LR + KD yin
D) ST-SP qi Xu
**D) ST-SP qi Xu**
* CAM pg 465 Wei Syndrome*
* Def: Wei syndrome= faccidity or atrophy of limbs w/ motor impairment*
LEG (yangming exuberant qi and blood)
ST-34 (xc ST), ST-36, ST-38
ARM ("")
LI-4, LI-11, LI-10
103
A patient has erectile dysfunction, soreness weakness of the legs and hot-dark urination. The tongue is a yellow greasy coating. The pulse is fast. What is the pattern?
A) accumulation of damp-heat in UB
B) decline of mingmen fire
C) damage of the qi of the meridian
D) Xu KD w/ accumulation of dampness
**A) accumulation of damp-heat in UB**
* CAM p438*
* Impotence d/t downward flowing of Damp Heat*
**FX:**
Ba zheng san
**PTs:**
UTI: SP-9, UB-28, RN-3
LI-11 (D-H), ST-28 (prom urine, local pain)
*focus tongue and pulse*
104
A patient has chronic epigastric pain. The pain radiates from the epigastrium to right area. The pain is worse at night and improves after eating. He often belches. The stool is dry. He is tired. The tongue is red on the sides, stiff w/ Sl. rootless coating. The pulse is fine and empty at the deep level on the right mid position, the pulse is empty-floating and sl. wiry. What is your treatment strategy?
A) Each root must eventually be treated
B) first stop pain and move LR qi and then tonify ST yin
**B) first stop pain and move LR qi and then tonify ST yin**
*Urgent case treat branch then treat root*
Branch= pain, qi stagnation
Root= ST Yin
Wiry=qi stag
Fine/Empty @ Deep= xu
Empty/Floating = Yin xu @ Mid= ST
105
In measuring electrical resistance to find ear points which of the following is not true?
A) Repeated probing will make the electrical resistance decline
B) Patient with higher electrical resistance are selected for therapy
C) Cold weather increases electrical resistance in the ear.
D) Some patients (Uterus, UB, Endocrine) normally have lower electrical resistance
**B) Patient with higher electrical resistance are selected for therapy**
* CAM pg 524*
* Detecting electrical changes:*
* Observing changes in electrical resistance, capacity, and potential at auricular points. The most commonly used method is to determine the conductant point of skin resistance by instrument**. Those auricular points w/ low electrical resistance can be displayed on a screen, or by an indicator, or by sound, through the apparatus. This is used for clinical diagnosis.*
106
A patient has SP Qi xu w/ chronic edema, menstrual blood when a patient has one root (ben) which gives rise to different biao. What courses of action should be taken?
A) Simultaneously treat root and biao
B) treat the root
C) Treat the biao
**B) treat the root**
*KIM pg 30*
BEN Only*: When clinical manifestation of* BIAO *are few and mild*
BEN & BIAO: *When* BIAO *produces severe s/s*
BIAO 1st, BEN after: *When* BIAO *s/s are urgent/ acute cases*
MULTIPLE BEN & BIAO:
1) TX each BEN: *Multiple* BEN *giving rise to different* BIAO
2) TX BEN: *One* BEN*giving rise to different* BIAO
3) TX BEN/BIAO: BEN *coincides w/* BIAO (trauma)
107
A patient has bronchial asthma with an upper respiratory tract infection. The selected prescription is extra point ding chuan, RN-22, RN-21, combined w/:
A) DU-14, LI-4
B) ST-40
C) ST-36, RN-4
D) LI-4, ST-36
**A) DU-14, LI-4**
*Cl H + Detoxify, +Rel Ext first, then resolve phlegm*
DU-14
(Expel W, Cl-H, Rel ext, Reg ying/wei, cl mind, Tn qi)
LI-4
(Dispel W, Rel ext, stim descension/dispersion LU)
**FX:**
Mod Qing qi hua tan wan
(LU PH-H causing cough pg 287 Kim mini)
w/
Ding chuan tang
108
Besides the Nutritive-Qi level (ying) which level has delirium, fainting, and a confused mind?
A) Qi level (qi)
B) Only Nutritive-Qi level (ying)
C) Defensive-Qi level (wei)
D) Blood level (xue)
**D) Blood level (xue)**
*Ying Level key s/s:*
fever worse at night, restlessness, delirium, bright red tongue, insomnia
*Xue Level key s/s:* (ying ++)
skin eruptions, rashes, bleeding, dark tongue
(Jean's DOS pg 81-2)
109
Which scalp area is located on the front of the scalp, and begins at the hairline directly above the pupil of the eyes, parallel wit hthe mid line of the head, is 2cm in length and extends posteriorly?
A) reproduction area
B) thoracic cavity
C) speech #2 area
D) stomach area
**D) stomach area**
110
The pulse can be felt with a gentle touch of the fingers and, on further pressure to the deep level, the pulse becomes forceless and soft. What treatment principle is applicable?
A) Tonify the qi
B) Nourish the yin
C) Drain damp
D) Tonify the yang
**B) Nourish the yin**
Floating pulse
* FCM Pg 331*
* 3 Causes Floating Pulse:*
* 1) Exterior Invasion*
* 2) Yin xu causing yang to rise or be unachored*
* 3) Severe qi xu (cancer/anemia)*
111
A patient has abdominal pain, tongue ulcers, and dark-scanty and painful urination. What is the treatment plan?
A) Move Qi in the Lower Jiao, Harmonize the LR
B) Remove Lower Jiao Obstruction, Move SI qi
C) Drain UB Heat, Transform Dampness
D) Drain HT & SI Fire
**D) Drain HT & SI Fire**
**FX:**
Dao chi san
**PTS:**
ST-39 (LHS SI, Cl-H)
HT-8 (HT-F)
LI-11 (H whole body, any)
RN-3 (local UTI, FM UB, prom urine)
ST-28 (local UTI, prom urine, alleviate pain)
Er jian
SP-6 (San yin jiao)
112
A patient has poor appetitie, weak limbs, and tiredness. Two weeks later he also reports symptoms of edema in the legs and leg pain which is worse in basements. What is the root (ben)?
A) Spleen Dampness
B) poor appetite, weak limbs, and tiredness
C) Spleen Qi Xu
D) Leg edema and leg pain
**C) Spleen Qi Xu**
ROOT= SP Qi Xu S/S
Weak d/t SP control muscles
**FX:**
Si Jun Zi Tang (Tn Qi SP/LU)
+
Ze xie, gui zhi, zhu ling (from Wu Ling San)
*If nausea/vomit then Liu Jun Zi Tang (Ph + Qi Xu)*
113
A 35 year old female has had depression and anxiety for 12 years. She is on antidepressants. She had an unhappy childhood and to this day has resentment toward her mother. Her sleep is restless. Other symptoms include headaches w/ stabbing pain on the forehead. She tends to have nasal discharge w/ thick, yellow phlegm. She has a burning sensation in the epigastrium w/ thirst. The tongue is red w/ a purplish tinge and a crack in the center. The coating is greasy and yellow. The pulse is slippery, wiry, and full. What is the treatment plan?
A) Regulate LR, Smooth Qi, Move Blood
B) Disperse LR + GB, Resolve Phlegm, Clear Heat
C) Clear ST- Heat, Descend ST Qi, Resolve Phlegm
D) Resolve Phlegm, Drain Fire, Move Blood, Calm Mind
**D) Resolve Phlegm, Drain Fire, Move Blood, Calm Mind**
*tongue purplish, stabbing pain= xue stag*
**DX:**
Phlegm Fire Misting the Mind w/ Blood Stasis
**FX:**
Gun tan wan (+herbs cool/reg xue)
**PTS:**
RN-12 (Local burning epigastrium)
SP-6 (qi stag, b.s.)
PC-5 (ph/f)
LI-11 (F)
SP-10 (b.s.)
ST-40 (ph)
LR-2 (F)
* If more H: + ST-44*
* Any ST-Dx + ST-36*
**E-STIM:**
* Connect to Pt TX main S/S*
* Ex: ST-Pain: RN-12 + ST-36*
114
A patient has abdominal pain, desire for hot drinks, desire for abdominal pressure and massage, diarrhea, and clear and profuse urinatio, pale tongue with white coating, and deep and slow and weak pulse. What is the Small Intestine Zang-fu pattern?
A) SI Qi pain
B) SI Xu + Cold
C) SI Heat
D) SI Qi Tied
**B) SI Xu + Cold**
* PG 52 KIM Mini:*
* SI XU Cold: Dull abdominal pain alleviated by pressure, a desire for hot drinks, borborygmus, diarrhea, pale and abundant urination, cold limbs, T: pale w/ white coat, P: deep, weak, slow*
**FX:**
Li Zhong Wan
**PTS:**
RN-6, 4 (moxa)
ST-25
ST-39 (LHS SI)
ST-36
UB-27 (BS SI)
UB-20 (BS SP)
DU-4 (moxa= yang xu)
115
Which of the following points are prohibited in infants with unclosed fontanelles?
A) DU-20, Si shen cong
B) DU-15, DU-16
C) Si Feng
D) DU-22, DU-23
**D) DU-22, DU-23**
* KIM pg 241: DU-20-23*
* CAM: DU-21, 22, 23*
116
Which point regulates the intestines and transforms stagnation; clears damp heat and alleviates diarrhea and dysenteric disorder; regulates the spleen and stomach; and activates the channel and alleviates pain?
A) LI-11
B) ST-37
C) ST-38
D) ST-39
**B) ST-37 (LHS LI)**
117
A patient has palpitations, dizziness, insomnia, sleep disturbed by dreams, anxiety, poor memory, startles easily, a dull and pale face, and pale lips. What tongue is expected?
A) Bluish-purple tongue
B) Pale, thin and slightly dry tongue
C) Pale, wet and swollen tongue
D) Pale tongue
**B) Pale, thin and slightly dry tongue**
A) Bluish-purple tongue*=xue stag*
B) Pale, thin and slightly dry tongue*=xue xu*
C) Pale, wet and swollen tongue*=yang xu*
D) Pale tongue*=qi xu*
**DX:**
HT Xue Xu
**FX:**
Gui pi tang
**PTS:**
HT-7, PC-6, RN-14, UB-17, RN-15, SP-6, RN-17 (palps), SP-10 (all xue dx)
118
Which point combination stops lactation?
A) GB-21, SI-1
B) GB-41, GB-37
C) PC-6, RN-17
D) LR-14, PC-6
**B) GB-41, GB-37**
* CAM PG 487*
* Promote lactation: GB-21, RN-17, LR-14, SI-1*
* Inhibit lactation: GB-47, GB-37*
**FX:**
Decoction Mai ya 200g w/ vinegar 5tbsp
(no vinegar if reflux) (3x/day)
Stops in 2 days
119
A patient has a Greater-Yang (tai yang) organ pattern with accumulation of blood. What is the treatment?
A) RN-9, RN-3, ST-28, LU-7
B) RN-3, KD-14, ST-28, SP-10 SP-6
C) RN-4, KD-3, KD-6, SP-6
D) SJ-5, SJ-6, GB-41, DU-13
**B) RN-3, KD-14, ST-28, SP-10 SP-6**
RN-3 (FM UB)
KD-14 (Local invig xue)
ST-28 (Invig xue, prom urine)
SP-10 (All xue dx)
SP-6 (Benefit urine, invig xue)
**DX:**
Blood stasis in Lower jiao or UB
**FX:**
Xue fu zhu yu tang
(cool prop, xue stag anywhere body)
*If UTI + Ba Zheng Tang*
120
A patient has burning urination, difficult urination, and dark urine. What is the treatment plan?
A) Resolve dampness, expel cold, remove obstruction from lower jiao water passages
B) Tonify and warm UB and KD yang
C) Resolves dampness, clear heat, open lower jiao water passages
D) Clear heat, open lower jiao water passages
**C) Resolves dampness, clear heat, open lower jiao water passages**
**DX:**
Damp-Heat in UB/Lower Jiao
**FX:**
Ba zheng san
**PTS:**
RN-3, ST-28, SP-9, LI-11, RN-5
121
A patient has dribbling after urination, back pain, and chronic vaginal discharge or nocturnal emissions without dreams. What is the diagnosis?
A) KD fail to receive qi
B) KD Jing Xu
C) KD qi not firm
D) KD yang xu
**C) KD qi not firm**
**FX:**
Jin suo gu jing wan
* jin suo= golden rock*
* gu jing= stabilize essence*
**PTS:**
KD-3, RN-4, RN-6, UB-23, UB-52, DU-4
122
A patient has chronic diarrhea which tends to occur in the early morning, pain below the navel, and cold extremities. The tongue is pale with white coating. The pulse is deep and weak. What is the pattern?
A) Earth not controlling water
B) Cold-damp
C) Xu KD yang
D) Xu SP yang
**C) Xu KD yang**
**FX:**
*BEST:* Zhen ren yang zhang tang
(SP/KD yang xu)
(chronic diarrhea d/t kd yang xu)
**PTS:**
KD-7 (prom urine to solidify stools)
ST-37 + ST-25 (LHS LI + FM LI to stop diarrhea)
SP-9 + SP-6 (drain D)
UB-23, Du-4, RN-4, RN-6, KD-3, UB-52
MOXA: RN-8 + ST-25
123
A patient has palpitations, shortness of breath on exertion, sweating, paleness, fatigue, listlessness, pale tongue, and an empty pulse. What is the treatment?
A) HT-5, PC-6, UB-15, RN-17, RN-6, UB-21
B) HT-7, PC-6, RN-15, UB-17, RN-4, UB-20
C) HT-7, PC-6, RN-15, RN-4, HT-6, KD-6, KD-7
D) HT-5, PC-6, UB-15, RN-17, RN-6, DU-14
**D) HT-5, PC-6, UB-15, RN-17, RN-6, DU-14**
**DX:**
HT Qi xu
**FX:**
Bao yuan tang
or
Huang qi sheng mai san
(Best HT qi causing palpitations)
124
Which moxa technique treats Tuberculosis?
A) moxa w/ garlic
B) moxa w/ ginger
C) moxa w/ salt
D) moxa w/ monkshood/fu zi
**A) moxa w/ garlic**
*KIM pg 296*
125
A patient has a sore and weak back, clear and frequent urination, weak urinary stream, dribbling after urination, incontinence, urination at night, nocturnal emission without dreams, and premature ejaculation, pale tongue, and deep and weak pulse in the rear position. What is the KD zang-fu pattern?
A) KD yang xu
B) KD fail to receive qi
C) KD qi not firm
D) KD jing xu
**C) KD qi not firm**
**FX:**
Jin suo gu jing wan
**PTS:**
UB-23, DU-4, RN-4, RN-6, KD-3, KD-7, UB-52
* All discharge= KD qi, therefore not firm*
* Can have deep + xu pulse*
126
A 35 year-old woman has had abdominal distention for the past four years. It started during a break up with her boyfriend. She complains of depression and frequently sighs. She has a sallow complexion. She is irritable and quick to get angry. Her appetite is poor and is frequently tired. She has loose stools. The abdominal distention is improved with flatulence. periods are irregular w/ dark red flow. Breasts are distended during menstruation. The tongue is pale. The pulse is thin and wiry. What is the treatment?
A) RN-12, ST-36, ST-25, SP-9, SP-6, LI-4
B) ST-36, RN-4, RN-12, ST-25, UB-25, UB-20
C) ST-25, UB-25, LI-11, SP-9, SJ-6
D) SP-4, PC-6, LR-3, RN-12, RN-6, ST-36
**D) SP-4, PC-6, LR-3, RN-12, RN-6, ST-36**
SP-4 (luo)
PC-6 (reg qi/xue, harmonize ST, reg jueyin)
(remove stag for distention)
LR-3 (VIP qi stag)
RN-12 (FM ST, W/ ST-36 Tn SP qi)
RN-6 (tn qi, local tx)
**DX:**
LR overacting on SP
**FX:**
Xiao yao san
+
Tong xie yao feng
(painful diarrhea d/t qi stag)
**Explanation:**
A) RN-12, ST-36, ST-25, SP-9, SP-6, LI-4
*Diarrhea rel ST dx*
B) ST-36, RN-4, RN-12, ST-25, UB-25, UB-20
*SP/ST Xu--\> diarrhea*
C) ST-25, UB-25, LI-11, SP-9, SJ-6
*D-H LI--\> diarrhea*
D) SP-4, PC-6, LR-3, RN-12, RN-6, ST-36
LR qi stag--\>Sp/ST dx
127
Needling caution KD-11, 12, 13
Caution deep insertion with full bladder
128
Caution pneumothorax which UB points on the back?
UB-12 to 21
129
Needling caution SI-13
Too medial/deep medial puncture lung
130
Needling caution HT-7
Caution ulnary artery and nerve
131
Needling caution ST-20
penetrate enlarged liver
132
Needling caution KD-24, 25, 26?
Deep perpendicular or oblique needling
pneumothorax
133
Needling caution PC-3
Avoid brachial artery and vein
134
Needling caution GB pneumothorax
GB-21-24
135
Needling caution GB-25 + 26
Peritoneal cavity
136
Which UB points caution penetrate KD
UB-22-23, UB 51-52
137
Caution deep needle ST-23
Peritoneal cavity
138
Needling caution ST-19
Deep needle penetrate enlarged
HT- Left, LR-Right
139
Needling caution full bladder Ren channel
RN-2,3,4
140
Needling caution SP-12
Femoral artery, femoral nerve
141
Needling caution LR-12
Femoral vein
142
Needling caution LR-13
enlarged LR or SP
