Mixed Deck — All NCCAOM Topics Flashcards

A patient presents with a sensation of something caught in their throat that they can neither swallow nor expel, a stuffy feeling in the chest, and a moist, white tongue coating with a wiry, slippery pulse. Which of the following formulas is most indicated for this presentation?

Answer: Ban Xia Hou Po Tang

Ban Xia Hou Po Tang is the classic formula for 'Plum-Pit Qi,' which is caused by the stagnation of Qi and Phlegm in the throat. The key symptoms are the subjective sensation of a foreign body in the throat, along with chest stuffiness and a tongue and pulse indicating phlegm and Qi stagnation. Xiao Chai Hu Tang treats Shao Yang syndrome, Su Zi Jiang Qi Tang treats phlegm-cold obstructing the Lungs with Kidney Yang deficiency, and Ju Pi Zhu Ru Tang treats rebellious Stomach Qi due to Stomach deficiency and heat.

Which of the following correctly describes the Sheng (Generating) Cycle of the Five Elements?

Answer: Fire generates Earth, Earth generates Metal, Metal generates Water, Water generates Wood, Wood generates Fire.

The Sheng or Generating Cycle describes the nourishing or promoting relationship between the Five Elements. In this cycle, each element serves as the 'mother' that gives birth to the next element: Wood fuels Fire, Fire's ash creates Earth, Earth bears Metal, Metal can be melted to a liquid state like Water (or collects water), and Water nourishes Wood.

A 35-year-old patient presents with a dry, non-productive cough, dry mouth and throat, and a sensation of heat in the afternoon. They also report a dull epigastric pain, thirst with no desire to drink, and constipation with dry stools. The tongue is red and dry with little coating. This presentation suggests a deficiency of Yin in which two Zang-Fu organs?

Answer: Lung and Stomach

The dry cough, dry throat, and afternoon heat are classic signs of Lung Yin Deficiency. The dull epigastric pain, thirst with no desire to drink, and dry stools point to a lack of fluids in the Stomach, which is Stomach Yin Deficiency. These two patterns often occur together as they are both related to the body's overall fluid balance and the aftermath of febrile diseases.

Chvostek's sign—facial muscle twitching when tapping the facial nerve—indicates deficiency of which electrolyte?

Answer: Calcium

Chvostek's sign is a clinical indicator of hypocalcemia; low calcium increases neuronal excitability, causing spontaneous twitching when the facial nerve is percussed.

When needling ST-9 (Renying), the primary danger to avoid is:

Answer: Puncturing the carotid artery or jugular vein

ST-9 lies directly adjacent to the common carotid artery and internal jugular vein, so needling must be performed carefully to avoid vascular puncture.

Which of the following is the primary buffer system in the blood that maintains pH homeostasis?

Answer: Bicarbonate-carbonic acid buffer system

The bicarbonate-carbonic acid system is the most important extracellular buffer in blood, regulated by both the lungs (CO2) and kidneys (HCO3−).

To locate LU7 (Lieque), a common technique involves crossing the thumbs and index fingers of both hands ('tiger's mouth'). When the index finger of one hand is placed on the styloid process of the radius of the other, where does the point lie?

Answer: In the depression directly under the tip of the index finger.

LU7 (Lieque) is located 1.5 cun proximal to the transverse wrist crease, superior to the styloid process of the radius. The practical location method described, often called the 'shake hands' method, places the tip of the index finger directly in the depression where the point is located.

Which tongue color indicates Blood stagnation in TCM diagnosis?

Answer: Purple or bluish-purple

A purple or bluish-purple tongue indicates Blood stagnation (Blood stasis) due to impaired circulation.

Which of the following is one of Sun Si Miao's 13 Ghost Points, specifically called 'Ghost Heart' (Gui Xin)?

Answer: PC-7 (Daling)

PC-7 (Daling) is called Ghost Heart (Gui Xin) and is the fourth point in Sun Si Miao's Ghost Point sequence.

ST7 (Xiaguan) is located:

Answer: In the depression at the lower border of the zygomatic arch, anterior to the condyloid process of the mandible

ST7 is in the depression at the lower border of the zygomatic arch, anterior to the condyloid process of the mandible, located with the mouth closed.

What does the term 'Xie Qi' refer to in TCM?

Answer: Pathogenic or evil Qi

Xie Qi means pathogenic or evil Qi — any factor that disturbs the body's normal function and causes disease.

A practitioner observes that the tip of a patient's tongue is significantly redder than the rest of the tongue body and has red points. According to TCM tongue diagnosis, this most strongly suggests a pathology in which Zang organ?

Answer: Heart

In TCM tongue diagnosis, different areas of the tongue correspond to different organ systems. The very tip of the tongue corresponds to the Heart. A red color indicates the presence of Heat. Therefore, a red tongue tip is a classic sign of Heart Fire, which may manifest with symptoms like anxiety, insomnia, or palpitations.

Unexplained weight loss of more than 10 pounds over 6 months, without dietary changes, is a major red flag associated with which category of conditions?

Answer: Malignancy, serious infection (e.g., TB, HIV), or endocrine disorders

Unintentional significant weight loss is a classic red flag symptom for underlying malignancy, serious infection, or metabolic disorders requiring biomedical workup.

Which TCM diagnostic principle describes the relationship between the Kidney and Liver in terms of Yin nourishment?

Answer: Liver and Kidney sharing the same source

The concept that 'Liver and Kidney share the same source' (tong yuan) describes how Kidney Yin nourishes Liver Yin and Blood.

GV20 (Baihui) is located:

Answer: On the midline of the head, 5 cun posterior to the anterior hairline

GV20 is on the midline of the vertex, 5 cun posterior to the anterior hairline and 7 cun superior to the posterior hairline.

A patient complains of palpitations, anxiety, insomnia with dream-disturbed sleep, and a persistent bitter taste in the mouth. Examination reveals a red tongue, especially at the tip, with a yellow coating, and a rapid, overflowing pulse. This clinical picture is most characteristic of which pattern?

Answer: Heart Fire Blazing Upwards

The red tongue tip, bitter taste, rapid pulse, and yellow coating are all classic signs of excess heat or fire. When this fire affects the Heart, it disturbs the Shen (spirit), leading to anxiety, palpitations, and insomnia. Mouth and tongue ulcers are also common signs of this pattern.

The Phalen's test, used to diagnose carpal tunnel syndrome, is considered positive when it reproduces symptoms after:

Answer: 60 seconds of wrist flexion

Phalen's test involves maintaining full wrist flexion for 60 seconds; reproduction of numbness or tingling in the median nerve distribution indicates a positive result.

Where is SI3 (Houxi) found?

Answer: At the ulnar end of the distal palmar crease when making a loose fist, at the junction of red and white skin

SI3 is at the ulnar end of the distal palmar crease when a loose fist is made, at the junction of red and white skin.

A patient taking warfarin (INR currently 3.8) presents for acupuncture. The safest approach is:

Answer: Defer treatment and advise the patient to have INR rechecked, as it is above therapeutic range

An INR of 3.8 is above the typical therapeutic range (2–3), indicating excessive anticoagulation and significantly elevated bleeding risk requiring medical consultation.

According to the Nan Jing, He-Sea points are primarily indicated for:

Answer: Counterflow Qi and diarrhea

Nan Jing Chapter 68 states He-Sea points treat counterflow Qi and diarrhea, reflecting their descending and regulating action.