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TCM Diagnosis 1 Fina
Question | Answer |
---|---|
Chills | feel cold but cannot be relieved by warmth |
cold | feel cold but can be warmed up |
fever | temperature is higher than normal |
warm | feel warm, temperature may be higher than normal or normal |
normal temperature | 98.6 F = 37 C |
Chills accompanied by fever indicates | Exterior (superficial) syndrome, chills are present = exterior syndrome (more chills, more fever) |
Cold without fever indicates | cold syndrome (excess or deficiency) |
Cold evil invasion, abdominal pain, likes warmth, dislikes pressure | Excess cold syndrome |
Loose stool, abdominal pain, likes warmth and pressure, weak pulse | Yang deficiency |
Fever (warm) without cold | heat syndrome (excess or deficiency) |
High fever | > 39 C |
Tidal fever | a fever that occurs or becomes worse at a fixed time of the day, just like the sea waves |
Slight fever | Temp < 38 C |
High fever, profuse sweating, severe thrist, flooding pulse | Excess heat syndrome (Yang ming channel syndrome) The big 4s |
Afternoon fever (between 3-5pm) with constipation and fullness and pain in the abdomen | Excess heat syndrome (Yang ming fu syndrome) "yang ming tidal fever" |
Tidal fever in the afternoon or evening, night sweating, malar flush, red tongue with little coating, rapid and weak pulse | Yin deficiency (yin deficiency tidal fever) |
slight fever, fatigue, poor appetite, weak pulse | qi deficiency |
slight fever, heavy in the head and body, red tongue with a thick coating | heat damp syndrome |
Alternating chills and fever | half exterior and half interior syndrome |
Fever (high fever) that alternates with chills at regular intervals | half exterior and half interior syndrome; malaria |
Fever that alternates with chills at irregular intervals, bitter taste in the mouth, thirst, fullness in the chest and hypochondrium | half exterior and half interior syndrome; Shao yang disease |
Exterior syndrome without sweating | exterior EXCESS syndrome, exterior COLD syndrome (same thing) |
Exterior syndrome with sweating indicates | Exterior deficiency syndrome (Tai yang wind syndrome) |
Controversy: exterior heat syndrome | with sweating and without sweating (so we say both) |
Interior syndrome (3 features) | - Spontaneous sweating - Night sweating - Profuse sweating |
Spontaneous sweating (sweating while awake) that is worse with exertion and accompanied by fatigue indicates | Qi deficiency (without cold symptoms) Yang deficiency (with cold symptoms) |
Night sweating (sweating during sleep, stopping when awake), malar flush, tidal fever or warm indicates | yin deficiency |
profuse sweating, high fever, severe thirst, flooding pulse (big 4s) indicates | excess heat syndrome (Yang ming channel syndrome) |
Profuse cold sweating, pale complexion, cold limbs, feeble pulse that is Barely palpable indicates | yang collapse (exhausted) |
feels distended and painful, often seen in the chest, epigastric, hypochondrial and abdominal regions indicates | qi stagnation |
feels distended and painful in teh head indicates | liver fire or liver yang rising |
Feels heavy and painful and often seen in the head and four limbs indicates | dampness or damp bi |
pain that is unfixed in the joints at the four limbs indicates | wind bi |
pain that moves from place to place with a distended sensation in the chest, hypochondrial or abdominal region indicates | qi stagnation |
a pain that feels like being pricked indicates | blood stasis |
a pain that is very sharp and violent indicates | substantial pathogenic factors obstructing the qi |
Heart attack | chest bi |
a pain with a burning sensation indicates | heat or fire syndrome |
shingles | heat or fire syndrome |
pain with a cold sensation that is relieved by warmth | cold evil invasion; yang deficiency |
a lingering pain that is not severe | deficiency syndrome |
pain with a hollow sensation | qi and blood deficiency |
pain that is aggravated by pressure or dislikes pressure | exterior evils invasion, qi or blood stagnation, substantial pathognieic obstruction (food, stone, etc). |
Pain that is alleviated by pressure and likes pressure | qi, blood, or yang deficiency |
back of the head and neck pain indicates | tai yang channel (UB) |
forehead pain indicates | yang ming channel (ST) |
sides of the head, especially at the temples | shao yang channel (SJ) |
Vertex pain indicates | Jue yin channel (LV) |
Back of the head and neck pain, chills and fever, floating pulse indicate | exterior syndrome (Tai yang disease = UB) |
Chest pain | heart or lung disease |
colic pain in the chest | Chest Bi (heart attack) |
stabbing pain in teh chest | heart blood stasis |
chest pain, night sweating, cough with a little blood in the sputum | lung yin deficiency |
hypochondrial pain | liver or gall bladder disease |
hypochondriac area feels distended with pain moving from place to place, irritability, wiry pulse indicates | liver qi stagnation |
hypochondriac pain, jaundice, thick yellow tongue coating indicates | heat and damp in the liver and gall bladder |
stabbing pain in the hypochondriac region with scaly skin and purplish tongue indicates | liver blood stasis |
burning pain in the hypochondriac region with vesicular skin eruptions indicates | liver fire and damp (shingles) |
Epigastric pain (WAN = middle) | stomach and spleen disease |
distended epigastric pain that is alleviated by belching or flatus indicates | qi stagnation |
a dull, lingering epigastric pain that is alleviated by pressure indicates | deficiency syndrome |
epigastric pain that is alleviated by warmth, refuses pressure indicates | cold invading the stomach |
abdominal pain | spleen, LI, UB B/L lower abdominal pain = LV channel |
dull abdominal pain that is alleviated by warmth and pressure, loose stools, fatigue indicates | spleen yang deficiency |
distended b/l lower abdominal pain indicates | liver qi stagnation |
lumbago | kidney or UB disease or injury |
lower back pain with fatigue indicates | kidney deficiency syndrome |
lower back colic pain that radiates to the perineum, bloody urine indicates | kidney stone stone obstruction and qi stagnation |
fixed pain at the lower back with a history of injury indicates | local qi stagnation and blood stasis |
Limb pain, joint pain | joint pain = bi syndrome |
joint pain that is unfixed in the four limbs | wind bi |
joint pain with a heavy sensation indicates | damp bi |
joint pain that is fixed and severe indicates | cold bi |
joint pain with redness and swelling indicates | heat bi |
thirsty and wants to drink | may be caused by profuse sweating, vomitting, diarrhea, or loss of body fluids |
severe thirst, high fever, profuse sweating, flooding pulse indicates | excess heat syndrome (yang ming channel syndrome) |
thirsty but does not want to drink, with malar flush, tidal fever, night sweating indicates | yin deficiency |
thirst but drinks very little, with a heavy sensation in the head and limbs, red tongue, thick yellow coating indicates | heat and damp syndrome |
thirsty but can only gargle and not swallow, with a purplish tongue, hesitant pulse | blood stasis |
Poor appetite, fatigue, abdominal distention, loose stool, weak pulse indicates | spleen qi deficiency |
Anorexia, jaundice, hypochondriac pain, thick yellow tongue coating | heat damp in the liver and gall bladder |
poor appetite with a heavy sensation in the head and limbs, thick tongue coating indicates | damp invading the spleen |
excessive appetite with mouth odor, red and swollen gums, constipation indicates | stomach fire |
excessive apetite, excessive thierst, excessive urination, emaciation indicates | TCM = xiao ke; WM = dm |
hungry but doesnt want to eat with a burning sensation in teh stomach, red tongue indicates | stomach yin deficiency |
tasteless (can still taste but just doesnt taste good) | spleen qi deficiency |
sweetish taste or stickiness | heat damp syndrome |
sour regurgitation | liver stomach heat |
bitter taste | liver and gb heat |
salty taste | kidney deficiency or cold syndrome |
prefers warm food or drink | cold syndrome |
prefers cold food or drink | heat syndrome |
Insomnia with palpitations, night sweating, red tongue with little coating, rapid and weak pulse indicates: | Heart yin deficiency |
Insomnia with palpitations, lower back soreness, night sweating, red tongue indicates | Disharmony between the heart and kidney |
INsomnia with palpitations, poor appetite, fatigue, pale tongue, weak pulse indicates | Heart and spleen deficiency |
Insomnia with a restless mind, dream disturbed sleep, red tongue tip indicates: | Heart fire hyperactive |
Lethargy with a heavy sensation in the head and limbs, thick coating, slippery pulse indicates | Phlegm damp syndrome |
Sleepiness especially after eating, fatigue, poor appetite indicates | Spleen qi deficiency |
Half asleep with general lassitude, cold limbs indicates | Heart and kidney yang deficiency |
Lethargic stupor, skin with visible macules or papules, deep red tongue, rapid pulse indicates | - Heat invading the pericardium - Blood fen (xue fen) |
Constipation with a high fever, distended abdomen, red tongue with a yellow and dry coating indicates: | excess heat syndrome |
constipation with a pale face, cold limbs, prefers warm drinks, and a deep slow pulse indicates: | cold syndrome |
Constipation or a dry stool with a red tongue with little coating, rapid and thready pulse indicates | yin deficiency |
constipation or a dry stool seen with fatigue in a long term disease or in an elderly patient or postpardum woman indcates | qi and body fluid deficiency |
Loose stool, poor appetite, abdominal distention with a dull pain in the abdomen indicates: | spleen qi deficiency |
diarrhea before dawn, abdominal pain, borborygmus, relieved by defecation, low back soreness, cold in teh limbs indicates: | kidney yang deficiency |
diarrhea with a foul smell, sour vomit with an odor and undigested food, abdominal pain that is relieved by defecation or vomiting indicates | food stagnation |
abdominal pain with diarrhea, relieved by defecation, relating to emotional change | imbalance between the liver and the spleen |
Undigested food in the stool indicates | spleen or kidney deficiency |
alternating constipation and loose stools indicates | imbalance between liver and spleen |
a stool that is dry first, then becomes loose | spleen deficiency |
bloody stool with large mucous and tenesmus with a burning sensation at the anus indicates | large intestine heat damp (dysentery) |
black stool indicates | distal blood |
tenesmus indicates | large intestine heat damp |
heavy sensation at the anus or prolapse of the anus indicates | spleen qi deficiency |
Clear and profuse urine, cold limbs, likes warmth | yang deficiency |
profuse urine, excessive appetite, excessive thirst, emaciation | xiao ke |
yellow urine in small amounts | excess heat syndrome (dehydration) |
small amount of urine with edema | lung, spleen, kidney disease (kidney failure) |
Dark or bloody scanty urine, colic pain in the lower back or abdomen | shi lin (kidney stone) |
Yellow, scanty, frequent, urgent painful urination | UB heat damp (UTI) |
Excessive urine at night indicates | kidney deficiency |
retention or difficult, dribbling urination in an elderly patient indicates | kidney deficiency |
incontinence in an elderly patient indicates | kidney qi deficiency |
Vertigo with fatigue, pale face, and lips, pale tongue, weak pulse | Qi and blood deficiency (deficiency) |
Vertigo with a heavy sensation in the head and limbs, thick coating indicates | damp and phlegm syndrome (exess) |
Vertigo with severe headache, red eyes, and wiry pulse indicates | liver yang hyperactive & wind syndrome or omen of a stroke (mixed excess and deficiency) |
sudden onset, high pitch noise tinnitus that is agravated by pressure indcates | excess syndrome of liver fire |
gradual onset, low pitch tinnitus that is alleviated by pressure indicates | kidney deficiency |
sudden onset deafness indicates | excess syndrome |
gradual onset deafness indicates | deficiency syndrome (commonly seen in the elderly) |
red eyes with blurred vision, headache, tinnitus, lower back soreness indicates | kidney yin deficiency liver yang hyperactive |
dry eyes with decreased vision indicates | liver blood deficiency; liver and kidney yin deficiency |
palpitation + Qi deficiency (big 5) sxs indicate | heart qi deficiency |
palpitation + yang deficiency (big 5 + cold) sxs | heart yang deficiency |
Palpitations + blood deficiency (PPPPP) sxs | heart blood deficiency |
Palpitations + yin deficiency (night sweats, malar flush, etc.) sxs | heart yin deficiency |
Normal menstruation | 21-35 days |
Shortened menstrual cycle | < 21 days |
Lengthened menstrual cycle | > 35 days |
Irregular menses | you never know |
Amenorrhea | no period for 6 months |
Profuse flow with a bright red color, red tongue indicates | heat syndrome |
Profuse flow with a light red color, fatigue, pale tongue, weak pulse indicates | qi deficiency |
scanty amount with a light red color indicates | blood deficiency |
purplish color with cloths, lower abdominal stabbing indicates | blood stasis |
leukorrhea normal | should have no odor |
Condition of the arterial pulse is felt by the finger tips | True |
Pulse formation is associated with __, __, and __ | zang fu, qi and blood |
Pulse formatinon is controlled to the heart, vessels, zong qi, ying qi, lung spleen, stomach, liver, kidney | True |
__ locations of palpating the TCM pulse | 3 |
Universal palpation | pulse is taken on the head, upper limbs, and lower limbs. Each of those parts are further divided into upper, middle, and lower portions "3 parts and 9 portions" |
Three parts palpation | Renying pulse: carotid pulse Cunkou pulse: radial pulse Fuyang pulse: dorsal pulse |
Renying pulse | carotid pulse |
cunkou pulse | radial pulse (most common) |
fuyang pulse | dorsal pulse |
Cunkou palpitation | Most common - palpating the radial artery on both wrists, divided into 3 parts: cun, guan, chi |
Normal pulse differentiated by: | depth, speed, strength, shape, rhythm |
Normal pulse has 3 characteristics | Stomach qi, vitality (shen) and root at the moderate level, is even and smooth at cun, guan, and chi; has moderate force and regular rhythm , 4-5 beats per breath |
athlete's pulse | slower |
child's pulse | faster |
obese person's pulse | deeper |
thin person's pulse | more superficial |
woman's pulse | softer and slighlty faster |
pregnant woman's pulse | slippery pulse |
spring pulse | wiry |
summer pulse | flooding |
Right hand is stronger than left pulse | baby girl |
left hand is stronger than right pulse | baby boy |
autumn pulse | floating pulse |
winter pulse | sinking pulse |
Pulse can be felt with light palpation but is relatively weak with deep palpation | floating, superficial pulse |
Floating superficial pulse indicates: | exterior (superficial) syndrome or deficiency syndrome (yang qi floating out) |
pulse floating, large and weak pulse - seen in: | prolonged illness and weakened condition |
Pulse is felt only with heavy pressure | sinking, deep pulse |
Sinking, deep pulse is an __ syndrome | interior |
Deep and forceful sinking deep pulse | interior excess syndrome |
Deep and weak sinking deep pulse | interior deficiency syndrome |
slow pulse | the rate is slow with less than 4 beats per breath (< 60 bpm)` |
slow pulse indicates | cold syndrome |
slow and forceful pulse | excess cold syndrome |
slow and weak | deficiency cold syndrome (Yang syndrome) |
The rate is rast, with more than 5 beats per breath (> 90 beats per minute) | rapid pulse |
Rapid pulse indicates | Heat syndrome |
Rapid pulse and forceful | excess heat syndrome |
Rapid pulse and weak | deficiency heat syndrome (Yin deficiency) |
teh rate is very fast with 7-8 beats per breath (140-180 bpm) | swift pulse |
Swift pulse | extreme heat and yin exhausted, approaching qi collapse |
The pulse is felt weak at all 3 levels of pressure | Empty pulse |
Empty pulse, fatigue, spontaneous sweating, light red tongue or with teeth marks indicates | |
Empty pulse, pale face, lips, nails, and tongue indicates | blood deficiency |
Empty and slow pulse, spontaneous sweating, cold limbs, likes warmth, swollen tongue indicates | Yang deficiency |
Empty and rapid pulse, night sweating, malar flush, red tongue with little coating or no coating indicates | Yin deficiency |
The pulse is felt strong and forceful at all 3 levels of pressure | excess, forceful, strong pulse |
Excess cold, excess heat, food stagnation phlem and qi and blood stagnation | excess syndrome |
Excess xie qi and strong zheng qi | excess syndrome |
The pulse is felt smooth and flowing like beads (pearls) rolling on a plate | Slippery, rolling pulse |
Sloppery rolling pulse indicates | phlegm and fluid retention, food stagnation, excess heat, women during pregnancy |
The pulse is felt rough, uneven, unsmooth | Hesitant, choppy, rough pulse |
Hesitant and forceful pulse | Qi or blood stagnation; food stagnation, phlegm retention |
Hesitant and weak pulse | Essence impairment and blood deficiency |
The pulse is broad, large and forceful like roaring waves which come on powerfully and fade away | Flooding, tidal pulse |
Flooding or tidal pulse indicates | excess heat |
Excess heat in the flooding or tidal pulse is seen in | yang ming channel syndrome or Qi Fen Syndrome; also seen in prolonged disease (a weak constitution with a flooding pulse indicates a critical conditions) |
The pulse is broad and large with NO forceful, roaring waves | big, large pulse |
Pulse is big and forceful | excess syndrome |
Pulse is big and weak | deficiency syndrome |
The pulse is felt like a fine thready but is very distinct and clear "as thin as a thread" | thin, thready pulse |
Thin and thready pulse | Qi, blood and yin deficiency OR dam syndrome |
Small, fine pulse | same as thin and thready pulse |
The pulse is felt tight and forceful like a stretched rope | Tight, tense pulse |
Tight and tense pulse indicates | Cold syndrome, pain, or food stagnation |
The pulse rate is 4 beats per breath | Moderate, leisurely pulse |
Indications for a moderate, leisurely pulse | Normal pulse, damp syndrome, spleen and stomach deficiency, qi or blood deficiency, morbid (diseased) moderate = sluggish |
The pulse is long and straight | Long pulse |
Normal pulse [long and gentle], liver yang hyperactive, excess heat syndrome, morbid (diseased) long [long and wiry] | Long pulse |
The pulse is short, only felt distinctly at the guan position | Short pulse |
Pulse is short and forceful | qi stagnation |
Pulse is short and weak | Qi deficiency |
the pulse is felt taut, straight, and long, feels like the "string of a violin" | wiry, stringy pulse |
Wiry, stringy pulse indicates | Liver and gall bladders disease, phlegm and damp retention, pain, and malaria |
The pulse is felt at a superficial and deep level, empty at the middle "feeling like an onion stalk" | Hollow, onion stalk pulse |
Indications for hollow, onion stalk pulse | loss of blood, impairment of yin |
The pulse is felt at the superficial level, large, hollow, and taught "lke feeling the surface of a drum" | Leather, tympanic pulse |
Indications for leather, tympanic pulse | loss of blood, impairment of essence |
The pulse is felt at the deep level, long, taught, and forceful | Confined, fixed, prison pulse |
Indications for confined, fixed, prison pulse | cold accumulation, qi or blood stagnation |
The pulse is felt at the very deepest level (pressing to the bone), thready, feeble, and hardly palpable | Hidden pulse |
Indications for hidden pulse | Pathogens in the interior, jue syndrome (syncope, cold limbs), severe pain |
The pulse has a round shape like a bean, feeling short, slippery, rapid and forceful | Moving, spinning bean pulse |
Indications for a moving, spinning bean pulse | pain and fright |
THe pulse is felt at the superficial level, thready and soft | Soggy, soft pulse |
Indications for the soggy and soft pulse | deficiency syndrome and damp |
The pulse feels extremely thready, feebile, barely palpable | Minute pulse |
Indications for a minute pulse | deficiency syndrome |
The pulse is felt at the deep level, thready, and very soft | Frail, weak pulse |
Indication for a frail and weak pulse | qi and blood deficiency |
The pulse is felt at the superficial level, scattered and uneven | Scattered pulse |
Indication for scattered pulse | Qi is exhausted |
The pulse is rapid with irregularly missed beats | hurried, abrupt pulse |
Indications for hurried and abrupt pulse | excess heat syndrome, qi and blood stagnation, phlegm retention, food stagnation, prostration (CVD) |
The pulse is slow with irregularly missed beats | knotted pulse |
Indications for knotted pulse | Excessive yin, qi stagnation, cold phlegm, blood stagnation |
The pulse is missing beats at regular intervals | intermittent, regularly intermittent pulse |
Indications for an intermittent, regularly intermittent pulse | Zang qi defciency, wind syndrome, pain, emotional fear and fright, injury, CVD |
Floating pulse | exterior syndrome |
sinking pulse | interior syndrome |
Slow pulse | cold syndrome |
rapid pulse | heat syndrome |
Weak pulse | deficiency syndrome |
forceful pulse | excess syndrome |
Prolonged disease, weak condition with a moderate pulse | condition is getting better |
prolonged disease, weak condition with a flooding pulse | critical condition |
Exterior syndrome with a moderate pulse | condition is getting bette |
exteriro syndrome with a rapid pulse | may change to an interior syndrome |
Floating and rapid pulse | exterior (superficial) heat syndrome |
floating tight pulse | exterior (superficial) cold syndrome |
Thready rapid pulse | heat deficiency syndrome (yin deficiency) |
forceful and rapid pulse | excess heat syndrome |
Rapid, slippery, wiry pulse | heat phlegm syndrome |
Cold | cold syndrome |
warm | warm syndrome |
soft and likes pressure | deficiency syndrome |
hard and refuses (dislikes) pressure | excess syndrome |
5 heart heat (heat sensation in the palms, soles, and chest) | yin deficiency syndrome |
local edema | pitting edema |
local qi distention | non-pitting edema |
zheng | ji - pain or a lump with a fixed position indicates blood stagnation |
jia | ju - pain or a lump with an unfixed position indicates qi stagnation |