TCM Diagnosis

Diagnosis Mid Cumulative Exam Retake Good Luck! This is one of the hardest parts of Chinese Medicine -- but I know you can ace it! Name___________________________________ MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. In the case that more than one answer may be right, please choose the best of the right answers. 1) Which one of the following conditions could have the same pulse as phlegm and retained fluid? A) Deficiency due to overstrain and stress or deficiency of qi and blood. B) Retention of Food and Excessive Heat C) Stagnation of Qi and Stagnation of Blood D) Traumatic contusions and sprains

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2) A patient presents with sudden unconsciousness, convulsions, deviation of the eye and mouth, hemiplegia, aphasia or difficult speech, and dizziness. Their tongue is red-peeled and deviated and their pulse is floating-empty. Which one of the following is the patient's correct diagnosis? A) Liver Yang Rising Causing Wind B) Extreme Heat Generating Wind C) Damp-Heat in the Liver and Gall Bladder D) Liver Fire Blazing Upwards

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3) What are the key signs and symptoms of Kidney Essence Deficiency? A) Cold in the back, abundant-clear urination, pale tongue and deep pulse. B) Palpitations, Insomnia, night sweating, and a red-peeled tongue with redder tip and midline crack. C) Dry mouth at night, night sweating, and a red-peeled tongue D) Poor bone development, weak knees, falling hair, and weak sexual activity

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4) A patient presents with a cough, breathlessness, splashing sounds in the chest, vomiting of white-watery-frothy sputum, chilliness, cough which may be elicited by a scare. A pale tongue body, with a thick-sticky white coating and a fine and slippery or weak-floating pulse. What is this patient's diagnosis? A) Damp-Phlegm Obstructing the Lungs B) Phlegm-Heat Obstructing the Lungs C) Phlegm-Fluids Obstructing the Lungs D) Invasion of the Lungs by Wind Water

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5) Frequent and urgent urination, burning on urination, difficult urination stopping in the middle of flow, dark-yellow and/or turbid urine, blood in the urine, sand in the urine, fever, and thirst, with a red, thick-sticky yellow coating on the root with red spots, and a rapid, slippery, slightly wiry pulse on the left rear position would best be diagnosed as which one of the following? A) Bladder Deficient and Cold B) Small Intestine Deficient and Cold C) Damp-Heat in the Bladder D) Damp-Cold in the Bladder

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6) Which one of the following tongues indicates syndromes of deficiency type and cold syndromes caused by deficiency of yang qi or insufficiency of qi and blood? A) A deep red tongue. B) A blue purple tongue. C) A tongue that is less red than a normal tongue D) A tongue that is larger than normal.

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7) A patient presents with physical weakness, mental listlessness, phlegm in the throat, breathlessness, dislike to speak, desire to lie down, abdominal distension, poor appetite, aversion to cold, cold limbs, abundant clear or scanty-clear urination, loose stools, diarrhea at dawn, edema of the abdomen and legs, feeling of cold in the back, chronic diarrhea, borborygmi, diarrhea like water, cold abdomen and legs. What do you expect their tongue and pulse to look like? A) A Red-Peeled tongue with the tip redder, crack in the midline reaching the tip and a floating, empty and rapid pulse. B) Pale and swollen tongue with a deep, weak and slow pulse. C) Pale tongue with a weak, tight and deep pulse. D) Red-peeled tongue with two transversal cracks in the Lung area and a floating-empty pulse.

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8) What is the above patient's diagnosis? A) Kidney and Spleen Yang Deficiency B) Kidney and Heart Not Harmonized C) Kidney Yang Deficient with Water Overflowing D) Kidney and Lung Yin Deficiency

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9) Which one of the following conditions could have the same tongue presentation as excessive yang heat bringing the turbid qi in the stomach upwards? A) Syndromes caused by interior heat syndromes or syndromes resulting from cold and damp. B) Syndromes caused by retention of turbid phlegm or retention of food. C) Syndromes caused by consumption of body fluid due to extreme heat. D) Syndromes caused by interior syndromes due to extreme heat or excessive cold.

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10) A patient presents with soreness of the back, cold knees, a sensation of cold in the back, aversion to cold, weak legs, bright white complexion, weak knees, impotence, premature ejaculation, lassitude, abundant-clear urination, apathy, edema of the legs, a poor appetite, and loose stool. What kind of tongue and pulse would you expect to see for this patient? A) A pale tongue and a weak, tight, and deep pulse. B) A pale, swollen, and wet tongue with a deep-weak pulse. C) A red-peeled, and cracked tongue with a floating and empty or choppy pulse. D) A red-peeled, cracked, and red tipped tongue and a floating-empty and rapid pulse.

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11) What is the above patient's diagnosis? A) Kidney Yang Deficiency C) Kidney Qi Not Firm

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B) Kidneys Failing to Receive Qi D) Kidney Essence Deficiency

12) Which one of the following pulses would you expect to see if excess heat is retained in the interior and the antipathogenic qi is still strong? A) A rapid and weak pulse B) A broad, large, and forceful pulse like roaring waves which come on powerfully and fade away. C) A rapid and forceful pulse D) A pulse that feels taut, straight and long, giving the feeling of a string of a violin.

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13) A patient presents with stuffiness and fullness of the epigastrium, nausea, no appetite, loose stools, feeling of heaviness, thirst with desire to drink in small amounts, sallow complexion, hypochondriac pain, jaundice, and a bitter taste. What kind of tongue and pulse would you expect to see for this patient? A) Pale tongue and an empty pulse especially on the right side. B) Thick-sticky-yellow tongue coating with a slippery and wiry pulse. C) Sticky-white tongue coating and a slippery and rapid pulse. D) Pale tongue that is paler on the sides and in severe cases the sides could have a slight orange color and a choppy pulse.

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14) What is the above patient's diagnosis? A) Damp-Heat Invading the Spleen B) Spleen and Lung Qi Deficiency C) Spleen and Liver Blood Deficiency D) Obstruction of the Spleen by Dampness with stagnation of Liver Qi

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15) A patient has been presenting with no appetite, abdominal distension after eating, tiredness, lassitude, sallow complexion, weakness of the limbs and loose stool for the past six months. She has now started developing purpura, blood spots under the skin, blood in the urine, menorrhagia, sallow complexion and shortness of breath for the past three weeks. Given her most recently developed signs and symptoms, what tongue and pulse combination will she most likely present? A) A pale tongue with a swollen sides and traversal cracks with an empty pulse. B) A pale, swollen, and wet tongue with a weak, slow and deep pulse. C) A sticky-yellow coating with a slippery rapid pulse. D) Pale tongue and a fine pulse.

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16) What is this patient's current diagnosis? A) Spleen Qi Sinking C) Cold Damp Invading the Spleen

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B) Spleen Qi Deficiency D) Spleen Not Controlling the Blood

17) A patient presents with irritability, distension and pain in the epigastrium and hypochondrium, fullness in the epigastrium, sour regurgitation, belching, nausea, and vomiting. Their tongue is red on the sides and their pulse is weak on the right and wiry on the left. Which one of the following is the patient's correct diagnosis? A) Liver Invading the Stomach B) Liver Invading the Spleen C) Liver Yang Rising D) Liver Qi Stagnation.

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18) A patient presents with cough, fever, aversion to cold, sore throat, stuffed or runny nose with yellow mucus, headache, body aches, slight sweating, thirst, and swollen tonsils. What tongue and pulse combination will they most likely present? A) A thin-white tongue coating with a floating pulse especially in the front position. B) Tongue body red on the sides or tip, the coating is thin and either white or yellow and the pulse is floating rapid. C) A dry tongue with an empty pulse, especially on the right front position. D) A red, peeled tongue with cracks in the Lung area and dry. Their pulse is floating, empty and rapid.

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19) What is the above patient's diagnosis? A) Invasion of the Lungs by Wind-Heat C) Invasion of the Lungs by Wind-Water

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B) Lung Dryness D) Invasion of the Lungs by Wind-Cold

20) A patient presents with a cough, fever, itchy throat, stuffed nose or runny nose with clear-watery mucus, sneezing, aversion to cold, occipital headache, and body aches. What tongue and pulse combination will they most likely present? A) A dry tongue coating with an empty pulse especially on the right front position. B) A white-slippery tongue coating and a floating-slippery pulse. C) A red tongue body with red on the sides or tip, the coating is thin and is either white or yellow. D) Thin-white tongue coating and a floating pulse especially in the front position.

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21) What is the above patient's diagnosis? A) Invasion of the Lungs by Wind-Cold C) Invasion of the Lungs by Wind-Water

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B) Invasion of the Lungs by Wind-Heat D) Lung Dryness

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22) A patient presents with lower abdominal twisting pain which may extend to the back, abdominal distension, dislike of pressure on the abdomen, borborygmi, flatulence, abdominal pain relieved by emission of wind, and pain in the testes. Their tongue has a white coating and their pulse is deep, wiry, especially on the rear position. Which one of the following is the correct diagnosis? A) Small Intestine Deficient and Cold B) Infestation of Worms in the Small Intestine C) Small Intestine Qi Tied D) Small Intestine Qi Pain

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23) Which one of the following pulses would you expect to see in painful syndromes and disorders due to emotional fear and fright? A) A deep and thready pulse that hits the fingers without strength. B) A slow pulse with irregular missed beats. C) A hurried and rapid pulse with irregularly missed beats. D) A slow and weak pulse with missed beats at regular intervals.

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24) Which one of the following pulses can you expect to see in prolonged endogenous diseases A) A pulse that feels hurried and rapid with irregular missed beats. B) A slow and weak pulse with missed beats at regular intervals. C) A superficial, large and weak pulse. D) A deep and thready pulse that hits the fingers without strength.

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25) All of the following pulses are specifically indicative of phlegm or retained phlegm EXCEPT: A) A pulse that feels slow and weak with missed beats at regular intervals. B) A pulse that feels smooth and flowing like pearls rolling on a dish. C) A pulse that feels hurried and rapid with irregular missed beats. D) A pulse that feels taut, straight and long, giving the feeling of a string of a violin.

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26) Which one of the following pulses would you expect for excessive yang heat, stagnation of qi and blood, and retention of phlegm or food? A) A pulse that feels hurried and rapid with irregular missed beats. B) A pulse that feels like a fine thread but is very distinct and clear. C) A tight and forceful pulse like a stretched rope. D) A pulse that feels smooth and flowing like pearls rolling on a dish.

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27) A patient presents with palpitations, shortness of breath, weak and shallow breathing, profuse sweating, cold limbs, and cyanosis of the lips. Given these signs and symptoms which one of the following tongue and pulse combinations would you most likely expect? A) Pale, wet, and swollen tongue with a deep-weak or knotted pulse. B) Pale, thin, and slightly dry tongue with a choppy or fine pulse. C) Pale or normal colored tongue with an empty pulse. D) Very pale or bluish-purple and short tongue with a hidden-minute-knotted pulse.

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28) What is the above patient's diagnosis? A) Heart Blood Deficiency C) Heart Yang Collapse

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B) Heart Yang Deficiency D) Heart Qi Deficiency

29) Which one of the following syndromes has emaciation, thirst, feeling of a stream of air ascending to the chest region, a hot and painful sensation in the chest, hunger with no desire to eat, cold limbs diarrhea, and vomiting? A) Heat Syndrome of the Shaoyin B) Cold Syndrome of the Shaoyin C) Taiyin Syndrome D) Jueyin Syndrome

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30) If a patient has a diagnosis of Collapse of the Large Intestine what key signs and symptoms should you expect to see? A) Loose stools, cold limbs, and a fine pulse B) Chronic diarrhea and prolapse ani C) Abdominal pain, diarrhea with mucus and blood in the stool D) Sudden abdominal pain, diarrhea and a feeling of cold

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31) All of the following pulses are specifically indicative of pain or painful syndromes EXCEPT: A) A taut, straight, and long pulse giving the feeling of a string of a violin. B) A tight and forceful pulse like a stretched rope. C) A broad, large and forceful pulse like roaring waves which come on powerfully and fade away. D) A slow and weak pulse with missed beats at regular intervals.

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32) A patient presents with violent abdominal pain, dislike of pressure, borborygmi, flatulence, a thick white tongue coating and a deep, wiry pulse. Which one of the following is their diagnosis? A) Small Intestine Deficient and Cold B) Infestation of Worms in the Small Intestine C) Small Intestine Qi Tied D) Small Intestine Qi Pain

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33) If a patient has a diagnosis of Kidneys Failing to Receive Qi, which one of the following groups of key signs and symptoms can you expect for them to present? A) Breathlessness, asthma, fullness of the hypochondrium, headache, and a wiry pulse. B) Shortness of breath, weak voice, bright-white complexion, and an empty pulse. C) Dribbling after Urination, Nocturnal emissions without Dreams D) Shortness of breath on Exertion, Sweating and Clear Urination

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34) A patient presents with no appetite, fullness and distension of the epigastrium which are relieved by vomiting, nausea, foul breath, sour regurgitation, belching and insomnia. Their tongue has a thick yellow coating and their pulse is full and slippery. What is their diagnosis? A) Retention of Food in the Stomach B) Stomach Qi Rebelling Upwards C) Cold Invading the Stomach D) stases of Blood in the Stomach

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35) A patient presents with an uncomfortable feeling in the epigastrium, no appetite, lack of taste sensation, loose stools, tiredness especially in the morning, and weak limbs. Their tongue is pale and their pulse is empty, especially on the right middle position. Which one of the following is the correct diagnosis? A) Spleen Blood Deficiency B) Spleen Qi Deficiency C) Stomach Deficiency and Cold D) Stomach Qi Deficiency

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36) Which one of the following pulses would you expect to see in an exterior condition? A) A pulse that can be easily felt with gentle touch and feels like a fine thread but is very distinct and clear and hits the fingers without strength B) A pulse that feels tight and forceful like a stretched rope. C) A pulse that is tight and forceful like a stretched rope. D) A pulse that can be easily felt with gentle touch

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37) Which one of the following pulses indicates syndromes of the excess type? A) A forceful pulse felt on the three regions and at the three levels of pressure. B) A pulse that feels rough and uneven. C) A pulse that feels taut, straight, and long, giving the feeling of a string of a violin. D) A pulse that feels fine like a thread but is very distinct and clear.

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38) Which one of the following conditions could have the same pulse as disorders of the liver and gall bladder? A) Painful syndromes, phlegm, and retained fluid B) Damp disorders C) Cold, pain, and retention of food D) Impairment of essence and deficiency of blood.

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39) A patient presents with irritability, propensity to outbursts of anger, tinnitus, deafness, temporal headaches, dizziness, red face and eyes, thirst, bitter taste, dream-disturbed sleep, constipation with dry stools, dark-yellow urine, epistaxis, hematemesis, and hemoptysis. Their tongue had a red body that is redder on the sides with a yellow and dry coating. Their pulse is full, wiry, and rapid. Which one of the followng is the patient's correct diagnosis? A) Damp-Heat in the Liver and Gall Bladder B) Liver Fire Blazing Upwards C) Extreme Heat Generating Wind D) Liver Yang Rising Causing Wind

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40) All of the following are signs and symptoms of Liver Qi Stagnation EXCEPT: A) Feeling of distension of hypochondrium and chest, hypochondriac pain, sighing, and hiccup. B) Epistaxis, painful periods, irregular periods, menstrual blood dark and clotted, abdominal pain, masses in the abdomen, purple nails, purple lips, purple complexion, dry skin, and petechiae. C) Melancholy, depression, moodiness, and fluctuation of mental state. D) Nausea, vomiting, epigastric pain, poor appetite, sour regurgitation, belching, feeling of pulsation in the epigastrium, churning feeling in the stomach, abdominal distension, borborygmi and diarrhea.

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41) Which one of the following conditions could have the same tongue presentation as invasion of the pericardium by heat? A) Yang deficiency of the Spleen and Kidney B) Retention of turbid phlegm in the interior or excessive pathogenic heat consuming body fluid. C) Accumulation of pathogenic heat in the interior. D) Interior heat syndromes or syndromes resulting from cold and damp.

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42) Which one of the following conditions could have the same pulse as retention of cold phlegm? A) Cold, pain and retention of food B) Excessive Yin and Accumulation of Qi C) Excessive Yang heat and stagnation of qi and blood D) Deficiency of both Qi and Blood

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43) A patient presents with mental confusion, unconsciousness, lethargic stupor, vomiting, rattling sound in the throat and aphasia. Their tongue has a thick-sticky- slippery coating and a midline crack reaching the tip with prickles in it. The tongue body is swollen. Which one of the following options is the patient's diagnosis? A) Damp-Heat in the Heart B) Phlegm Fire Harassing the Heart C) Phlegm Misting the Mind D) Heart Fire Blazing

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44) A patient presents with fever, mild aversion to wind and cold, headache, cough, absence of sweating or slight sweating, mild thirst, swelling and pain of the throat. Given these signs and symptoms which one of the following tongue and pulse combinations would you most likely expect? A) Dry and yellow tongue coating and a superficial, large and forceful pulse B) Red tongue tip and borders, thin and white tongue coating, and a superficial and rapid pulse. C) Red tongue with a yellow coating and a rapid pulse. D) Dry and yellow tongue coating, and a rapid and rolling pulse.

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45) What is the above patient's diagnosis? A) Syndromes of the Wei Stage C) Syndromes of the Qi Stage

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B) Syndromes of the Xue Stage. D) Syndromes of the Ying Stage

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46) A patient presents with feverishness of the body which is more pronounced in the afternoon, constipation, fullness and pain in the abdomen aggravated by pressure, restless, and delirium. Given these signs and symptoms which one of the following tongue and pulse combinations would you most likely expect? A) A pale tongue with white coating and a deep feeble and thready pulse. B) A pale tongue with a white coating and a slow or slowing-down pulse. C) Burnt-yellow coating with thorns on the tongue and a deep and forceful pulse of the excess type. D) A dry yellow tongue coating and a superficial and forceful pulse.

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47) What is the correct diagnosis for the above patient? A) Taiyin Syndrome C) Syndrome of the Yangming Meridian

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B) The Heat Syndrome of Shaoyin D) Syndrome of the Yangming Fu Organ

48) A patient exhibits aversion to cold, lying in a curled up position, listlessness with desire to sleep, cold limbs, diarrhea with undigested food, absence of thirst or preference for hot drinks, and profuse clear urine. Given these signs and symptoms which one of the following tongue and pulse combinations would you most likely expect? A) A pale tongue with a white coating and a slow or slowing-down pulse. B) A pale tongue with white coating and a deep feeble thready pulse. C) A dry tongue with no coating or little coating and a thready and rapid pulse. D) A red or deep-red tongue and a rapid and thready pulse.

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49) What is the above patient's diagnosis? A) Taiyin Syndrome C) Jueyin syndrome

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B) Syndrome of the Yangming Meridian D) Cold Syndrome of Shaoyin

50) Which one of the following pulses is specific to damp disorders? A) A superficial and thready pulse that hits the fingers without strength. B) A slow and weak pulse with missed beats at regular intervals. C) A pulse that feels rough and uneven. D) A tight and forceful pulse like a stretched rope.

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