CASE STUDIES - Final Exam

Question 1

Asthma Cause for Extrinsic, Allergic, Early Onset

Answer 1

WIND

Note: Phlegm is a result not a cause for Allergic Asthma

Question 2

Asthma Cause for Non-Allergic, Late Onset

Answer 2

PHLEGM

Question 3

Facial Paralysis following a Stroke

Answer 3

• From damage to the Central Nervous System
• Above the eye not affected
• D/T Internal Wind

Question 4

Peripheral Facial Paralysis (Bell’s Palsy)

Answer 4

• D/T injury of peripheral nerves
• Only able to move one eyebrow when trying to frown
• D/T External Wind

Question 5

COUGH Diagnosis

Sound

Answer 5

Weak sound = deficiency
Loud sound = excess
Barking cough = heat
Loose/rattling = phlegm

Question 6

COUGH Diagnosis

Time of Day

Answer 6

Worse in late afternoon = Yin deficiency

Worse in the morning = usually phlegm

Question 7

COUGH Diagnosis

Sputum

Answer 7

W/O sputum = deficiency or heat
Abundant = phlegm, Blood = Full or Empty heat
Yellow = heat, White = cold, Greenish = heat
White sticky = prev of dampness or phlegm over cold
White diluted = prevalence of cold over phlegm/damp
White very watery and frothy = phlegm-fluids

Question 8

COUGH Pattern - Acute Ext

Wind-Cold: Sx

Answer 8

cough, sneezing, runny nose with white discharge, aversion to cold, chills, body aches, maybe slight increase in body temp, stiff neck, headache
Tongue: no evident change
Pulse: Floating-Tight

Question 9

COUGH Pattern - Acute Ext

Wind-Cold: Tx

Answer 9

Lu 7- release ext, restores descending of Lung Qi, stops cough
Bl 12- expels exterior Wind, good to use cupping
Bl 13- releases exterior, restores descending of Lung Qi, use cupping
Li 4 & Ki 7- promotes sweating, releases exterior
Lu 6- stops acute cough

Question 10

COUGH Pattern - Acute Ext

Wind-Heat: Sx

Answer 10

Dry cough, aversion to cold, chills, fever, sore throat, slight sweating, body aches, headache, runny nose with yellow discharge, sneezing, slight thirst and slightly dark urine
Tongue: slight Red sides and/or front part
Pulse: Floating-Rapid

Question 11

COUGH Pattern - Acute Ext

Wind-Heat: Tx

Answer 11

Lu 7 – rel ext, expels Wind, restore desc of LU qi & stop cough
Li 4 & Li 11 – expels Wind-Heat
Bl 12 – releases exterior
Lu 11 – expels Wind-Heat, clear Heat from throat.
Du 14 – used if symptoms of Heat are pronounced
Lu 6 – xi-cleft point , stops acute cough

Question 12

COUGH Pattern - Acute Ext

Wind-Dryness: Sx

Answer 12

Dry cough, dry itchy-sore throat, dry lips, dry mouth, soreness of the upper chest
Tongue: slightly red sides and/or front part
Pulse: Floating

Question 13

COUGH Pattern - Acute Ext

Wind-Dryness: Tx

Answer 13

Lu 7 - release ext, expels Wind, restores descending of Lung Qi and stop cough.
Lu 9 – nourishes the Lung’s fluids
Ki 6 – promotes fluids
Sp 6 – promotes fluids

Question 14

COUGH Pattern - Acute Interior

Lung-Heat: Sx

Answer 14

Barking cough, chest pain, breathlessness, fever, thirst, flaring of alae nasi, restlessness and feeling of heat
Tongue: Red with yellow coat
Pulse: Rapid and Overflowing

Question 15

COUGH Pattern - Acute Interior

Lung-Heat: Tx

Answer 15

Lu 5 – clears LU-Heat and restores descending of LU Qi
Lu 1 – clears Lung-Heat, treats acute patterns of the LU
Du 14 & Li 11 - clears Heat
Lu 6 – xi-cleft, treats acute patterns of Lung, stops cough

Question 16

COUGH Pattern - Acute Interior

Lung Phlegm Heat: Sx

Answer 16

Barking cough with expectoration of profuse sticky yellow sputum, fever, restlessness, thirst, feeling of heat and sensation of oppression in the chest
Tongue: Red w/sticky yellow coat
Pulse: Rapid and Slippery

Question 17

COUGH Pattern - Acute Interior

Lung Phlegm Heat: Tx

Answer 17

Lu 5 – expels phlegm and clears Heat from Lungs
Lu 1 – front-mu of the Lung, clear LU-Heat, stop cough
Lu 6 – xi-cleft, acute cases, clear LU-Heat, stop cough
Ren 12, Ren 9, Sp 6 & St 40 – resolve phlegm
Du 14 & Li 11 – clear Heat
Sj 6 & Sp 15 – clear Heat, move downward

Question 18

COUGH Pattern
Chronic/Full - Damp Phlegm:
Sx

Answer 18

Repeated attacks of cough, profuse expectoration of white sticky sputum, breathlessness, worse AM and after eating, feeling of oppression in the chest, nausea, poor appetite, tiredness, feeling of heaviness, loose stools
Tongue: Pale or normal, Swollen, sticky/thick white coat
Pulse: Slippery

Question 19

COUGH Pattern
Chronic/Full - Damp Phlegm:
Tx

Answer 19

Lu 5 – res phlegm, restores descending of Lung Qi
Lu 1 – restores descending of Lung Qi
Ren 12, Bl 20 & St 36 – tonify Spleen to resolve Phlegm
Ren 9, St 40 & Sp 6 – resolve Dampness and Phlegm
BL 13 – Back-Shu of Lung, use for chronic patterns, restores descending Lung Qi.

Question 20

COUGH Pattern
Chronic/Full - Phlegm-Heat:
Sx

Answer 20

Repeated attacks of a barking cough with profuse expectoration of yellow or blood-flecked purulent sputum, breathlessness, rattling sound in the throat, feeling of oppression in the chest, red face, feeling of heat, dry mouth, thirst, tiredness, loose stools
Tongue: Red, Swollen with sticky yellow coat
Pulse Slippery and Rapid

Question 21

COUGH Pattern
Chronic/Full - Phlegm-Heat:
Tx

Answer 21

Du 14 & Li 11 – clear Heat
Lu 5 – res phlegm, restores descending of Lung Qi
Lu 1 – restores descending of Lung Qi
Ren 12, Bl 20, & St 36 – tonify Spleen to resolve Phlegm
Ren 9, St 40, & Sp 6 – resolve Dampness and Phlegm
BL 13 – Back-Shu of the Lung, use for chronic patt, restores descending of Lung Qi.

Question 22

COUGH Pattern
Chronic/Full - Phlegm-Fluids:
Sx

Answer 22

Cough with a low sound, expectoration of watery diluted sputum, feeling of cold, feeling of oppression in the chest, tiredness, poor appetite and low spirit
Tongue: Pale, Swollen with sticky white coat
Pulse: Soggy

Question 23

COUGH Pattern
Chronic/Full - Phlegm-Fluids:
Tx

Answer 23

Du 14 & Bl 23 – reinforce with moxa if Kidney Yang deficient
Bl 22 – promote transformj of fluids thus resolve phlegm
Lu 5 – res phlegm, restores descending of Lung Qi
Lu 1 – restores descending of Lung Qi
Ren 12, Bl 20, & St 36 – tonify Spleen to resolve Phlegm
Ren 9, St 40, & Sp 6 – resolve Dampness and Phlegm
BL 13 – Back-Shu of the Lung, use for chronic patt, restores descending of Lung Qi.

Question 24

COUGH Pattern
Chronic/Full -
Liver-Fire insulting Lungs:
Sx

Answer 24

Sudden bouts of cough, red face often elicited by emotional stress, dry throat, a feeling of phlegm in the throat, expectoration on scanty phlegm, hypochondrial pain/distention, pain on coughing, bitter taste, dark urine, dry stools, irritability, and dry mouth
Tongue: Rapid with red sides, dry yellow coat
Pulse: Wiry Rapid

Question 25

COUGH Pattern Chronic/Full - Liver-Fire insulting Lungs: Tx

Answer 25

Liv 2 – drain Liver-Fire Gb 34 – pacifies LV, eliminate stag form hypochondrial Li 11 – clears heat Lu 5 & Lu 1 – clear Lung-Heat, restores desc of Lung Qi Ren 17 – subdues rebel Qi in chest, restores desc of Lu Qi Gb 21 – subdues rebellious Qi and makes Qi descend

Question 26

COUGH Pattern Chronic/Empty - Lung-Qi deficiency: Sx

Answer 26

Slight cough with low sound, no phlegm, spontaneous sweating, easy catch cold, weak voice, tiredness Tongue: Pale Pulse: Empty

Question 27

COUGH Pattern Chronic/Empty - Lung-Qi deficiency: Tx

Answer 27

Lu 9 & Bl 13 – tonify Lung Qi and stop cough Lu 7 – restores the descending Lung Qi Bl 43 – nourishes LU Yin & specific for chronic LU probs Ren 12, St 36 7 Sp 6 – tonify SP and LU (since LU channel starts in Middle Burner)

Question 28

COUGH Pattern Chronic/Empty - Lung-Yin deficiency: Sx

Answer 28

Dry cough in short bursts and low sound, scanty or no phlegm, blood-flecked sputum, dry throat, feeling of heat in evening, night sweats, thin body, extreme tiredness Tongue: No coat, dry, if empty heat then also Red body Pulse: Floating-Empty

Question 29

COUGH Pattern Chronic/Empty - Lung-Yin deficiency: Tx

Answer 29

Lu 9 & Lu 1 – nourish Lung-Yin Lu 10 – clears Lung Empty-Heat Ren 12, St 36 & Sp 6 – tonify Spleen to nourish Lung Lu 7 & Ki 6 – open Ren Mai, benefit throat, nourish Lung-Yin, restores descending of Lung Qi, stop cough from Yin deficiency

Question 30

COUGH Pattern Chronic/Empty - Lung-Dryness: Sx

Answer 30

Dry cough with low sound, dry throat and mouth. Seen in people with predisposition to Lung deficiency who through work have to use voice a lot in this case there could also be Stomach Yin deficiency. Can also occur after invasion of Wind-Heat. Tongue: Dry Pulse: Floating –Empty

Question 31

COUGH Pattern Chronic/Empty - Lung-Dryness: Tx

Answer 31

Lu 9 & Lu 1 – nourish Lung-Yin Lu 10 – clears LU Empty-Heat Ren 12, St 36 & Sp 6 – tonify Spleen to nourish Lung Lu 7 & Ki 6 – open Ren Mai, benefit throat, nourish Lung-Yin, restores descending of Lung Qi, stop cough from Yin deficiency

Question 32

Xiao indicates

Answer 32

a wheezing sound that may resemble that of whistling, snoring or sawing. It is usually accompanied by breathlessness and an inability to breathe when lying down.

Question 33

Xiao/Chuan - Excess Wind Cold Invading the LU Sx

Answer 33

Aversion to cold, shivering, fever, cough, breathlessness, a feeling of oppression of the chest, thin-white mucus, HA, no sweat P: floating and tight

Question 34

Xiao/Chuan - Excess Wind Cold Invading the LU Tx

Answer 34

Lu 7 releases the exterior, expels WC and restores Diffusing and Descending of Lung Qi Lu 6 accumulation pt for acute Lung patterns to stop breathlessness UB 12 and 13 with cupping to release the exterior Dingchuan stops acute breathlessness

Question 35

Xiao/Chuan - Wind-Cold on the Exterior,
 Phlegm fluids in the Interior Sx

Answer 35

Aversion to cold, fever, shivering, HA, no sweat, breathlessness, cough with profuse white-watery sputum, difficulty in lying down, swelling of the limbs. T: sticky, white coat P: floating

Question 36

Xiao/Chuan - Wind-Cold on the Exterior,
 Phlegm fluids in the Interior Tx

Answer 36

Lu 7 release the exterior Lu 6 and Dingchuan stops breathlessness Lu 5 for phlegm in the lungs Cup UB 12 and 13 to release the exterior P 6 opens the chest St 40 resolves phlegm and opens the chest Ren 22 stimulates the descending of Lung Qi and resolves phlegm

Question 37

Xiao/Chuan - Cold on the Exterior, Heat in the Interior Sx

Answer 37

Breathlessness, distension or pain in the chest, coarse breathing, runny nose, cough, vomiting of sticky phlegm, feeling of heat, cold limbs, irritability, aches, thirst. T: red with a white or yellow coat P: slippery and rapid

Question 38

Xiao/Chuan - Cold on the Exterior, Heat in the Interior Tx

Answer 38

``` Lu 7 restores the descending of Lung Qi Lu 6 relieves breathlessness Lu 10 and Lu 5 clear Lung Heat Lu 1 clears Lu heat and relieves fullness in the chest, stops breathlessness LI 11 clears Heat ```

Question 39

Xiao/Chuan - Phlegm Heat in the Lungs Sx

Answer 39

Cough, breathlessness, pain in the chest, profuse sticky-yellow or blood tinged sputum, irritability, a feeling of oppression in the chest, feeling of heat, sweating, thirst, red face, dry throat, dark urine, constipation. T: red with a sticky yellow coat P: slippery and rapid

Question 40

Xiao/Chuan - Phlegm Heat in the Lungs Tx

Answer 40

``` Lu 5 clears lung heat Lu 1 clears Lung heat and relieves fullness and pain in the chest LI 11 clears heat St 40 resolves phlegm Du 14 clears heat ```

Question 41

Xiao/Chuan - Turbid Phlegm Heat in the Lungs Sx

Answer 41

Breathlessness, difficulty breathing out, a feeling of oppression and fullness of the chest, cough with profuse sticky, white sputum, vomiting or nausea, sticky taste, no thirst T: swollen with thick sticky white coat P: slippery and excess

Question 42

Xiao/Chuan - Turbid Phlegm Heat in the Lungs Tx

Answer 42

Lu 5 and 7 expel damp phlegm from the Lungs and restore the descending of Lung Qi Lu 1 relieves the feeling of oppression of the chest P 6 relieves fullness in the chest St 40, Sp 6, Ren 9 resolve phlegm UB 13 stimulates the descending of Lung Qi UB 20 tonifies the Spleen to resolve Phlegm

Question 43

Xiao/Chuan - Lung Qi Obstructed Sx

Answer 43

Sudden attacks of breathlessness precipitated by emotional problems, no wheezing sounds, feeling of suffocation or constriction in the throat, a feeling of oppression or pain in the chest, palps, restless sleep. T: red sides, P: wiry

Question 44

Xiao/Chuan - Lung Qi Obstructed Tx

Answer 44

Liv 3 and LI 4 soothe the liver and relieve stagnation Liv 14 relieves stagnation in the chest Sp 4 and P6 in combo open the Chong, free the chest and subdue rebellious Qi in the chest Lu 1, Ren 17 and Lu 7 restore the descending of Lung Qi free the chest, and relieves fullness Ht 7 calms the mind St 40 is used to resolve Qi Phlegm

Question 45

Xiao/Chuan - Liver Fire Invading the Lungs Sx

Answer 45

Attacks of breathlessness precipitated by emotional stress, a feeling of oppression of the chest, chest pain, dream disturbed sleep, short temper, thirst, bitter taste, dark urine, constipation, HA, red eyes and face

Question 46

Xiao/Chuan - Liver Fire Invading the Lungs Tx

Answer 46

Liv 2 drains Liv fire Liver 14 soothes the Liver and relieves stag in the chest Lu 7, Ren 17, and UB 13 restore the descending of Lung Qi Lu 1 relieves fullness and pain in the chest UB 18 drains Liver Fire

Question 47

Xiao/Chuan - Lung Qi Deficiency Sx

Answer 47

SOB, weak lung sounds, slight rattling sound in the throat, sweating, chilliness, pale face, weak voice, expectoration of scanty phlegm T: Pale P: Weak, especially in the front right position

Question 48

Xiao/Chuan - Lung Qi Deficiency Tx

Answer 48

Lu 7 and 9 tonify the Lung UB 13 and Du 12 tonify Lung Qi. Can use moxa Ren 12 and Ren 6 tonify Qi in general. They are also crossing points on the Lu channel St 36 tonifies St and Sp and helps the Lungs according to the principle of strengthening Earth to tonify Metal.

Question 49

Xiao/Chuan - Lung Yin Deficiency Sx

Answer 49

SOB, chronic breathlessness, sweating at night, dry throat, dry cough with scanty sputum, malar flush T: dry with no coat, red body with empty heat P: Floating, deficient, thready; rapid and weak in the right front position.

Question 50

Xiao/Chuan - Lung Yin Deficiency Tx

Answer 50

Lu 9 tonifies Lu yin Lu 7 and K 6 opens the Ren to nourish Yin, descend Lu Qi and benefit the throat UB 43 to nourish Lu Yin esp for chronic disease Ren 4 nourishes Yin and strengthens KD's grasping of Qi UB 13 and Du 12 tonify Lu Qi

Question 51

Xiao/Chuan - Lung & Kidney Deficiency Sx

Answer 51

Chronic breathlessness, attacks brought on by exertion, difficulty inhaling, loss of weight, depression, edema of ankles, cold limbs, LBP, dizziness, weak knees. T: Pale, swollen P: deep, weak, slow

Question 52

Xiao/Chuan - Lung & Kidney Deficiency Tx

Answer 52

UB 23 and K 7 tonify K yang Du 4 tonifies the mingmen fire esp with moxa K 25 local point for fullness chest and breathlessness K 3 source point of Kidneys Lu 7 stimulate the descending of Lung Qi

Question 53

Xiao/Chuan - Lung & Kidney Yin Deficiency Sx

Answer 53

Chronic breathlessness, difficulty breathing in, dry throat, dry cough, night sweats, malar flush T: no coat, cracks in the Lung area, dry, red body with empty heat P: floating, deficient

Question 54

Xiao/Chuan - Lung & Kidney Yin Deficiency Tx

Answer 54

Lu 9 and Ren 17 tonify Lu and promte desc of Lu Qi St 36 and Ren 12 strengthen Earth to reinforce Metal Sp 6 and Ren 4 nourish Yin K 3 nourishes Kidney Lu 7 and K 6 nourish K Yin, restore descending of Lu Qi, and benefit the throat. Opens the Ren which is ideal for this pattern of breathlessness K 25 is local point for stimulating the Kidney’s grasping of Qi in chronic breathlessness from Kidney deficiency

Question 55

Xiao/Chuan - Lung and Kidney Yang deficiency, Fluids overflowing to Heart and Lungs Sx

Answer 55

Chronic breathlessness, cough with expectoration of white-watery sputum, a feeling of oppresion of the chest, palps, edema, scanty urine, chilliness T: Pale, Swollen, Wet P: Deep, weak, slow

Question 56

Xiao/Chuan - Lung and Kidney Yang deficiency, Fluids overflowing to Heart and Lungs Tx

Answer 56

Lu 7, LI 6 and Ren 17 to descend Lu Qi and open the Lung water passages to resolve edema Ren 12, Ren 9, Ren 6 tonify Qi and resolve edema K 7 and Sp 6 to tonify Kidneys and resolve edema St 40 resolves Phlegm P 6 opens the chest, relieves the feeling of oppression of the chest and tonifies Ht Yang UB 20, UB 23 and UB 22 tonify Sp and K Yang, and stimulate the transformation of fluids in the lower jiao to resolve phlegm UB 13 and 15 tonify Lu and Ht Yang

Question 57

Xiao/Chuan - Lung, Heart, and Kidney Yang Deficiency, Fluids overflowing to the Heart Sx

Answer 57

Chronic breathlessness, oppression and pain in the chest, nausea, cyanotic lips, purple face and nails, expectoration of white-watery sputum, difficulty in lying down, edema, chilliness, lower backache, weak knees, scanty but pale urine

Question 58

Xiao/Chuan - Lung, Heart, and Kidney Yang Deficiency, Fluids overflowing to the Heart Tx

Answer 58

Lu 7, LI 6 and Ren 17 stimulate the descending of Lung Qi and open the Lung’s Water passages to resolve edema Ren 12, Ren 9 and Ren 6 tonify Qi and resolve edema K 7 and Sp 6 tonify the Kidneys and resolve edema St 40 resolves Phlegm P 6 opens up the chest and tonifies Ht Yang UB 20, 23 and 22, tonify Sp and K Yang and stimulate the transformj of fluids in the lower Jiao to resolove edema UB 13 and 15 tonify Lu and Ht Yang UB 17 and Sp 10 move blood and eliminate stasis

Question 59

Point for Acute Cough

Answer 59

LU-6

Question 60

Pathogenic Factors involved in | Asthma

Answer 60

In allergic asthma, the bronchospasm is caused by an allergic reaction due to a hypersensitivity called anaphylactic or type 1 reaction. This reaction activates a series of enzymes which lead to the release of certain chemical substances such as histamine, serotonin, prostaglandins among others. These chemicals will provoke acute bronchospasm, and a cascade of other reactions such as inflammation/swelling of the airways which then can cause the production of mucus which further narrows the airways. The mucus in this case is a result rather than the cause of the pathology.

Question 61

Western Drugs to treat Asthma

Answer 61

Antiallergic drugs Bronchodilators Corticosteroids Leukotriene antagonists

Question 62

The 3 main Liver patterns affecting asthma

Answer 62

Liver Qi Stagnant, insulting Lungs Liver Fire insulting the Lungs Liver Yin deficiency

Question 63

Etiology - Atopic/Allergic Asthma

Answer 63

Repeated WC / WH Invasion Irregular Diet Weak Body Constitution

Question 64

Whooping Cough

Answer 64

Whooping cough – occurs in children mostly under 5, starts with ordinary cold with cough then a the characteristic “whoop” appears, cough comes in bouts, worse at night and very distressing, coughing bouts often ends in vomiting, child might get flushed or cyanosed and looks frightened, TCM diagnosis started with Wind-Heat/Wind-Cold then Lung Heat and late stage Stomach and Lung Yin deficiency

Question 65

Pleurisy

Answer 65

Pleurisy – inflammation of pleura, usually appearing after a upper respiratory infection, cough is unproductive and distressingly painful, chest pain and temperature raised, TCM diagnosis Lung Phlegm-Heat at Qi level

Question 66

Pneumonia

Answer 66

Pneumonia – inflammation of the lung alveoli, may begin abruptly with shivering, HA, high temp & breathlessness, at first, cough is short and unproductive, then develops scanty sputum with rust coloured and blood sputum, mostly accompanied by pleurisy giving pain, temperature is high, face flushed pulse and breath rapid, TCM diagnosis Lung Heat at Qi level

Question 67

Carcinoma of the bronchi

Answer 67

Carcinoma of the bronchi – most common cancer of all, most common in men between 40 and 55, dry cough, breathlessness and deep-seated thoracic pain, maybe some scanty blood flecked sputum, patient is weak and lacks appetite, TCM diagnosis Lung Yin deficiency late stage

Question 68

Tuberculosis of the lungs (TB)

Answer 68

Tuberculosis of the lungs (TB) – cough is dry or with scanty, blood flecked sputum, chest pain, SOB and night sweating, patient very tired/debilitated and may have low grade fever in afternoons, TCM diagnosis Lung Yin deficiency with Empty Heat

Question 69

Bronchiectasis

Answer 69

Bronchiectasis – permanent dilation of bronchi and bronchioles, alveoli become distended and filled with mucus, cough occurs more in morning with productive profuse purulent sputum with fruity odour, breath is offensive after bout of coughing, during acute episodes temperature increases, TCM diagnosis Turbid Phlegm in Lungs

Question 70

Tai Yang (1)

Answer 70

SI, UB More Blood, Less Qi Invasion of WC or WH P: Floating & Rapid OR Floating & Tight OR Deep, Rapid & Thready OR Floating & Slow

Question 71

Yang Ming (2)

Answer 71

ST, LI More Blood, More Qi High Fever P: Flooding & Rapid OR Deep, Full, Slippery & Rapid

Question 72

Tai Yin (4)

Answer 72

LU, SP More Qi, Less Blood SP Qi Deficiency P: Deep, Weak, Slow

Question 73

Shao Yin (5)

Answer 73

KD, HT More Qi, Less Blood Cold Transformation (Yang Def) - P: Deep, Week, Slow Heat Transformation (Yin Def) - P: Rapid & Thready

Question 74

Jue Yin (6)

Answer 74

LV, PC Less Qi, More Blood Yin/Yang Not Communicating (Heat above, Cold Below) P: Wiry

Question 75

Shao Yang (3)

Answer 75

SJ, GB Alt. Fever/Chills, Bitter Taste P: Wiry, Thin

Question 76

INFLUENTIAL POINTS ZANG SINEW FU VESSELS QI BONES BLOOD MARROW

Answer 76

``` ZANG: LV-13 FU: REN-12 QI: REN-17 BLOOD: BL-17 SINEW: GB-34 VESSELS: LU-9 BONES: BL-11 MARROW: GB-39 ```

Question 77

COMMAND POINTS

Answer 77

``` LU-7: Head & Nape LI-4: Face & Mouth PC-6: Chest & Lateral Costal Region ST-36: Abdomen BL-40: Back & Lumbar Region DU-26: Resuscitation ```

Question 78

FX OF REN-12

Answer 78

1. Transforming & Distributing the Essence of Food & Drink throughout the Body 2. Tonify ST Qi, ST Yin & SP Qi to Resolve Phlegm

Question 79

``` Identification of Pattern according to 4 levels - WEI LEVEL (Defensive Qi) ```

Answer 79

Wind Heat Summer Heat Dry Heat Damp Heat

Question 80

EFP at YING Level

Answer 80

Chronic conditions at this level People start to waste away, disease consumes weight and Body Fluids Low-grade fever, Yin has contained Heat a little so that it isn’t as exuberant Fever usually comes and goes Herbs must be used

Question 81

EFP at Blood Level

Answer 81

``` General fever, Reckless Blood Extreme restlessness; irritability Insomnia, Stuttering Very dark skin eruptions Tremors; convulsions; seizures Less fluids allow Wind to enter vessels ```

Question 82

Identification of Pattern according to 4 levels - | QI LEVEL

Answer 82

``` Lung Heat (Heat in Chest and Diaphragm) Stomach Heat Intestines Dry Heat Gall Bladder Heat Damp Heat in Stomach and Spleen ```

Question 83

Identification of Pattern according to 4 levels - | YING (NUTRITIVE) LEVEL

Answer 83

Heat in the Nutritive Qi Level | Heat in the Pericardium

Question 84

PULSE according to 4 LEVELS

Answer 84

Wei = floating, Rapid Qi = Rapid, Full Ying = Thin, Rapid Blood (Heat) = Wiry, Rapid Blood (Collapse of Yin/Empty Wind) = Rapid, Thready Blood (Collapse of Yang) = Hidden, Slow, Scattered

Question 85

TX (points) for WC & WH

Answer 85

WC: LU-6 LU-7, UB-12 WH: LI-4, LI-11, SJ-5

Question 86

CHRONIC LBP - DISTAL POINTS | Men vs. Women

Answer 86

In MEN, needle SI-3 on LEFT and UB-62 on right. In WOMEN, needle SI-3 on the RIGHT and UB-62 on the left and the REN channel points: Lu-7 on the left and K-6 on the right. Remove needles in reverse order.

Question 87

CHRONIC LBP - DISTAL POINTS

Answer 87

SI-3, BL-40, BL-58, BL-59, BL-62

Question 88

PULSES according to Wei Levels

Answer 88

Wind Heat = Floating & Rapid Summer Heat = Soggy & Rapid Damp Heat = Soggy & Slow Dry Heat = Floating & Rapid

Question 89

3 Organs involved in Xiao Pattern

Answer 89

Spleen Lung Stomach

Question 90

Tx for LV Yang Rising - | Reduce &/or Tonify?

Answer 90

Reduce AND Tonify | b/c it is excess and deficiency

Question 91

Tai Yang Pattern Sx

Answer 91

Aversion to Cold, Occipital HA, Neck ache | P: Floating, Tight

Question 92

Wind Cold enters through... | Wind Heat enter through...

Answer 92

``` WC = Skin WH = Nose, Mouth ```

Question 93

Chuan - dyspnea or breathlessness | Sounds

Answer 93

``` Excess = breath in shallow/long, exhale is quick w/loud wheezing sounds, possible cough, P: Slippery or Tight/Full Deficient = breathing is short & rapid, quick inhale w/low noise (labored breathing and cannot lie flat, mouth breathing), P: Weak ```

Question 94

Chuan - dyspnea or breathlessness | Etiology, Pathology, Patterns, Western Differentiation

Answer 94

Etiology: EPF, Diet, Emotions, Overwork, Chronic Illness Pathology: SP, LU, K xu Patterns: Excess & Deficiency West Diff: LU cause Asthma, CB, emph, bronchial carcinoma, HT cause left HT failure, general anemia

Question 95

Xiao - wheeze | Sounds

Answer 95

Momphonic: wheezing composed of single sounds each time with it's own pitch Polyphonic: wheezing with different sounds with different pitches all starting and stopping at same time (short rapid wheezing respiration)

Question 96

Xiao - wheeze | Onset, Etiology, Pathology, Patterns, Western Differentiation

Answer 96

Onset: Late or intrinsic or non atopic bronchial hyperactivity Etiology: EPT, Diet, Weak Constitution Pathology: Hidden phlegm propelled by rebellious qi narrows the airways and causes wheezing Patterns: Acute-CP, HP...Chronic-SP, LU, K xu West Diff: Acute, chronic bronchitis, asthma

Question 97

Atopic or Allergic Asthma | Sounds

Answer 97

Momphonic: wheezing composed of single sounds each time with its own pitch Polyphonic: wheezing with different sounds with different pitches all starting and stopping at same time (short rapid wheezing respiration)

Question 98

Atopic or Allergic Asthma | Onset, Etiology, Pathology, Patterns, Western Differentiation

Answer 98

Onset: Early or Extrinsic Etiology: Atopy-Allergens or "Wind", EPF not always the case, Weak Body Constitution Pathology: LU & KD Wei Qi systems deficiency Patterns: During attack - WC no sweat, WC sweat, WH...In btw attacks - LU & KD Wei Qi system xu

Question 99

Pathology for Allergic Asthma

Answer 99

LU & KD Wei Qi systems deficiency

Question 100

HA Better or Worse with or w/o activity & B4 Menses

Answer 100

Worse B4 Menses - LV Yang Rising or LV Qi Stag Worse w/activity- Def Qi or Blood Better w/activity-LV Yang Rising or Phlegm Better w/rest or lying down- Def Qi or Blood Worse lying down- Dampness or Phlegm

Question 101

Hoarseness may be from WC or WH...T/F?

Answer 101

TRUE...related obstruction of Lung’s Wei Qi portion by Wind