Reply To: Acupuncture Bootcamp
For case study 6 exam
CASE 5
Use the following information to answer questions (17-20):
A 30-year-old patient named Jackson presents with abdominal pain for 11 years that has been worsening for the past 9 months.
Patient Information:
pain is in his entire abdomen and occasionally into the back
his diet was always greasy and rich
pain is heavy and burning, moves around, and is worse after eating
trouble keeping weight on, and in the past has had diarrhea 5-8 times/day
1-2 bowel movements/day which are often small in amount and feel incomplete
occasional mucous in his stool, but denies any blood
cramps and sensations of nausea
occasional front and temporal headaches prior to bowel movements, which is often relieved by defecation
bitter taste in the mouth after meals
in the morning, he often awakes to belching, a bitter liquid in the mouth, and foul The liquid is watery and light green to blackish in colour.
occasional low-pitched and high-pitched ringing in his ears
occasional itchy skin with a mild, red rash
all symptoms are worse with spicy and greasy foods
feels warm overall and is easily frustrated and angered
avoids confrontation at all costs
he has had no big stress over the past year
had an endoscopy 3- months ago which was negative
family history consists of an uncle having a similar condition who died at 50-years-old
diet is bland at this point as it is all he can handle
poor appetite and fatigue
appears thin and malnourished looking
sclerae are slightly red and yellowish, and his eyes are occasionally watery and itchy
currently has a stye on his upper eyelid of his right eye
upon palpation, he is very tender over the left upper and lower quadrants as well as the hypochondriac region on the right side under the 10th rib
Tongue: red body, some greasy, yellow coat, some areas have little coat, red prickles on the sides and tip
Pulse: Wiry (Xuan), Slippery (Hua), and Forceful (You Li) at the surface and Deficient (Xu) below
Question 17: You would diagnose him as having:
The correct answer is Damp Heat in the Liver and Gallbladder; Spleen and Stomach Qi Deficiency.
I found this question hard due to all the information but in the end went with Spleen invaded by Damp Heat with Liver Qi Stagnation because I didnt see much GB signs, and thought that the SP was more effected than the ST. I also thought the spleen must have been weak in the past which has led to it being invaded by damp heat, rather than the LV having damp heat, I though the LV was showing signs of heat but not dampheat.
Can you please explain why the other one is correct?