Reply To: Herbal Bootcamp
Thanks so much Kylie! I have a couple more questions from the practice exams.
In R.TCMP practice exam – clinical case study #2, case 14 question 48:
I didn’t guess the correct answer, so I was just wondering if you could please explain this case and what the TCM diagnosis would be 🙂 thank you!
A 25-year-old come to your clinic with three primary concerns: nausea, dizziness, and insomnia.
Patient Information:
* several times throughout the day he looses his balance due to extreme dizziness that sometimes feels like vertigo
* he has troubles falling asleep and when he does he wakes up from disturbing dreams which causes him difficulty in falling back asleep
* his epigastrium has the feeling of gnawing hunger but when he does eat it results in nausea that sometimes results in vomiting when he is emotionally upset
* he is slightly thirsty and when he drinks he prefers cold drinks and tries to use the drink to rinse out the bitter taste he has in his mouth
* he feels quite anxious but cannot tell if that is resulting from the disturbing dreams but notices the anxiety come on more when he has recently had heart palpitations which he experiences a few times per day
Question 48: Which of the following is the most likely tongue and pulse presentation for this patient?
Options are:
* Red tongue with a dry yellow coating and a Rapid (Shuo) and Thready (Xi) pulse)
* Red tongue with a redder tip and a peeled coating and a Rapid (Shuo) and Floating (Fu) pulse)
* Greasy yellow tongue coating and a Rapid (Shuo) and Slippery (Hua) pulse) (correct answer)
* Thick, greasy white tongue coating with a Rapid (Shuo) and Wiry (Xuan) pulse
In Practice Exam – Clinical Case Study #5, Case 8, Question 15
I guessed Cold Fluid blocking the middle jiao, and I’m just having trouble seeing where the spleen and kidney yang deficiency are coming in. I would have expected to see a deep pulse and loose stools or something along those lines as well. I was just wondering if you could point out the Yang Deficiency signs that would point me towards selecting that answer vs just the cold fluid blocking the middle jiao. I picked up on the low back pain but I didn’t want to diagnose based on one symptom. Thank you! 🙂
Case info:
A 40-year-old man has suffered from stomachache for 5 years.
Patient Information:
* distention and pain of the stomach often radiated to the lower back
* frequent nausea with occasional vomiting
* belching
* fatigue
* internal vexation
* palpitations in the abdomen
* cold
* Tongue: white coat, wet, puffy
* Pulse: Big (Da), Wiry (Xuan) and Tight (Jin) especially in Chi position
Which is the best TCM diagnosis?
options:
Spleen and Stomach Yang Deficiency, Damp blocking the middle jiao
Spleen and Kidney Yang Deficiency, Cold fluid blocking the middle jiao (correct answer)
Liver and Stomach Yang Deficiency
Liver and Stomach Qi Stagnation
Cold fluid blocking the middle jiao