4. Which group of acupoints is best suited to treat the underlying condition? 5. The treatment principle in this case is to: 6. All of the following acupoints are suitable to treat the condition EXCEPT: 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))
7. What western medical condition does this resemble? 8. Which acupoint is the best to treat the root condition? 9. Which acupoint is best to treat for symptomatic relief? 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)
10. Which acupoints are most suitable for symptomatic relief of hypochondriac pain? 11. According to Five Element diagnosis, which of the following pathogenesis is most likely? 12. Which of the following acupoints is the best acupoint to treat the root concern? 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)
13. According to Zang Fu theory, what is the most likely diagnosis? 14. Which group of acupoints is best suited to treat this case? 15. Which acupoint can tapping needle (similar to plum blossom without bleeding) method be applied to for chronic dizziness? 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)
16. Which extra acupoint can be used for symptomatic relief? 17. Which channel is affected and causing the headache to reach the eyes? 18. According to Zang Fu theory, what is the most likely diagnosis? 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)
19. Which of the five taxations is correctly matched? 20. According to Chinese medicine, what is the cause of tingling in the bottoms of the patient’s feet? 21. According to Zang Fu theory, what is the most likely diagnosis? 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)
22. All of the following Zang Fu organs are likely affected EXCEPT: 23. According to Zang Fu diagnosis, which of the following pathogenesis is most likely? 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) 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)
25. Which group of acupoints is best suited for this condition? 26. Based on the patient’s condition, what other therapy would be best suited to use? 27. According to Zang-Fu, what is the most likely diagnosis? 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)
28. Which of the following acupoints is best suited to help the patient? 29. Which of the following therapies is not recommended? 30. What is the diagnosis? 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)
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) 32. What is the best acupoint to treat the root condition? 33. According to Zang Fu theory, what is the diagnosis? 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)
34. An acupuncturist administers a treatment of LI 11 (Quchi), SP 9 (Yinlingquan), ST 40 (Fenglong), and ST 44 (Neiting). This would be treating the: 35. The tongue is deviated due to: 36. The best acupoint to treat inability to raise the eyebrow is: 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)
37. Which symptomatic pair is used to treat hot flashes and night sweating? 38. According to Zang-Fu, the most likely diagnosis would be: 39. Another expected sign or symptom you would expect could be: 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)
40. Which symptomatic pair is used to treat constipation? 41. Hot sensation on the soles of feet is a symptom of 42. According to Zang Fu, what is the most likely diagnosis? CASE 15 - The following is for questions 43-45.
A 64-year-old is complaining of pain in the stomach.
Patient Information:
43. Which organ is most likely the root concern? 44. Which channel on the hand is most likely affected? 45. Which acupoint is the best to treat root condition?