15 Clinical Case Studies – Multiple Choice Quiz

You will have 1-hour to complete this quiz. Please use Kenton’s case breakdown method for these cases as they are more straight forward and this method will get you to the correct answer, and fast!

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  • CASE 1 - The following is for questions 1-3.

    A 45-year old patient complains of a headache and alternating chills, fever, and sweating.

    • Fever of 38.5C

    • Aversion to cold

    • Stuffy nose with clear discharge

    • Headache is all over with a heavy sensation

    • Arms and legs feel heavy and achy

    • Appetite is poor

    • Bowel movements have recently been more than once per day and there is undigested food in the stool

    • Tongue: pale with a thick-white coating

    • Pulse: Wiry (Xuan)

  • CASE 2 - The following is for questions 4-6.

    A 26-year-old patient complains of not being able to shake a bad cold for over one month. Patient Information:

    • aversion to wind and cold, feeling cold

    • weak cough with little to no sputum

    • sweating on minor exertion

    • fatigue

    • catches colds and flus easily

    • Tongue: pale with a moist coating

    • Pulse: Floating (Fu)

  • CASE 3 - The following is for questions 7-9.

    A 68-year-old patient complains of a severe, barking cough and problems getting a full breath of air. Patient Information:

    • low-grade fever of 37.5C

    • shortness of breath

    • chest pain

    • wheezing at times

    • thick-yellow phlegm at times

    • Tongue: red with thick-yellow coating

    • Pulse: Rapid (Shuo), Slippery (Hua))

    • CASE 4 - The following is for questions 10-12.

      A 35-year-old patient complains of a sudden bout of coughing since two days ago. Patient Information:

      • thick-yellow phlegm that is sometimes red-tinged

      • hypochondriac pain

      • bitter taste in the mouth

      • recently having a hard time passing stools

      • hot, yellow urine

      • unable to swallow a ball of phlegm in the throat

      • Tongue: red with a thin-yellow coating

      • Pulse: Rapid (Shuo), Wiry (Xuan)

    • CASE 5 - The following is for questions 13-15.

      A 17-year-old patient complains of insomnia and random bouts of dizziness. Patient Information:

      • problems falling asleep

      • heart palpitations

      • not waking up feeling rested

      • fatigue

      • feels more dizzy while standing, better when lying down

      • abdominal distension

      • stools are normal

      • Tongue: slightly red with a geographic coating and teeth marks

      • Pulse: Thready (Xi)

    • CASE 6 - The following is for questions 16-18.

      A 19-year-old patient complains of neck stiffness and pain. Patient Information:

      • patient was in a motor vehicle accident one week ago

      • recently experiencing heart palpitations, especially when in the car

      • problems falling asleep due to replaying the accident over and over

      • neck pain radiates up over the head into the eyes

      • experiencing back pain and right knee pain since the accident

      • bright lights can cause a headache

      • problems staying asleep

      • Tongue: purple petechiae

      • Pulse: Choppy (Se) and Thready (Xi)

    • CASE 7 - The following is for questions 19-21.

      A 55-year-old patient complains of lower back pain after working as a cashier all day. Patient Information:

      • back pain started 6 months into their new job and has been there for two years now

      • there is also some weakness in the knees when walking up stairs

      • sometimes there is a tingling in the bottoms of the feet after long days and their legs often feel heavy

      • pain is worse on cold or cloudy days

      • Tongue: normal with a greasy-white coating

      • Pulse: Deep (Chen), Thready (Xi)

    • CASE 8 - The following is for questions 22-24.

      A 15-year-old patient complains of a constant stuffy nose. Patient Information:

      • history of catching a cold six months ago

      • frequent bloody nose

      • can blow yellow mucous from nose sometimes

      • hungry all the time, but eats only small meals

      • intermittent severe lower abdominal pain which is relieved by flatulence and bowel movements

      • Tongue: red with a greasy-yellow coating, red prickles on either side of tip

      • Pulse: Rapid (Shuo), Full (Hong), and Long (Chang)

    • 24. Organize the pairs of acupoints in order of importance in regards to the case:
      • A. LU 5 (Chize), LU 10 (Yuji)
      • B. LI 4 (Hegu), ST 36 (Zusanli)
      • C. PC 3 (Quze), SP 10 (Xuehai)
      • D. LI 11 (Quchi), ST 44 (Neiting)
      • CASE 9 - The following is for questions 25-27.

        A 50-year-old patient complains of inability to lift their right shoulder. Patient Information:

        • shoulder pain and restricted movement started after falling on ice

        • patient is unable to fully abduct their arm, and when they try to lift it they experience severe pain at the top of the joint

        • shoulder also constantly has stabbing pain

        • patient uses ice on a daily basis to treat the pain

        • Tongue: slightly red with thin-white coating

        • Pulse: Wiry (Xuan)

      • CASE 10 - The following is for questions 28-30.

        A 34-year-old patient complains of pain in both elbows 3 months after starting a job as a draftsperson. Patient Information:

        • elbows feel very hot and painful at both lateral epicondyles both humerus

        • pain is local to the area

        • patient is unable to hold any kitchen utensil or power tool as it makes the elbow pain worse

        • hand extension also is very painful

        • Tongue: pale with a thin-yellow coating

        • Pulse: Wiry (Xuan)

      • CASE 11 - The following is for questions 31-33.

        A 43-year-old patient complains of pain in many of their joints. Patient Information:

        • pain tends to move around between the wrists, ankles, elbows and knees

        • pain in any joint is worse when the weather is cloudy or rainy

        • lower back pain

        • copious pale urine

        • cold limbs

        • Tongue: pale with a moist coating

        • Pulse: Deep (Chen) and Slow (Chi)

      • 31. List the following acupoint pairs from symptomatic to root condition according to this case:
        • A. SP 9 (Yinlingquan), KI 7 (Fuliu)
        • B. LI 11 (Quchi), M-LE-16 (Xiyan)
        • C. GB 20 (Fengchi), GB 31 (Fengshi)
        • D. LI 4 (Hegu), LR 3 (Taichong)
      • CASE 12 - The following is for questions 34-36.

        A 49-year-old patient is complaining of an inability to move half of their face. Patient Information:

        • patient was in and out of air conditioning multiple times in one day

        • cannot raise their left eyebrow

        • cannot close their left eyelid

        • cannot hold a puff of air

        • patient is very obese

        • history of loose stools, and strong-smelling flatulence

        • Tongue: red with a thick-yellow coating, deviated

        • Pulse: Rapid (Shuo), Slippery (Hua)

      • CASE 13 - The following is for questions 37-39.

        A 65-year-old patient is complaining of insomnia. Patient Information:

        • patient had their uterus removed due to a history of heavy menstrual bleeding

        • waking at 1:30am and can’t return to sleep for up to two hours

        • floaters in their eyes

        • restless leg syndrome

        • lower back pain

        • hot flashes and night sweating

        • dry-cracked heels

        • Tongue: red and lusterless without coating

        • Pulse: Choppy (Se)

      • CASE 14 - The following is for questions 40-42.

        A 56-year-old patient is complaining of hot flashes and severe night sweats. Patient Information:

        • easily startled

        • heart palpitations

        • waking up with nightgown soaked

        • experiencing vaginal dryness

        • soles of feet feel like they’re on fire

        • one bowel movement every two days, with the help of a fibre supplement

        • Tongue: red with dry-white coating

        • Pulse: Floating (Fu)

      • CASE 15 - The following is for questions 43-45.

        A 64-year-old is complaining of pain in the stomach. Patient Information:

        • recently diagnosed with Dupuytren’s contracture of the right fourth finger

        • Tongue: slightly re with thin-white coating

        • Pulse: Wiry (Xuan)

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