NCCAOM Zang-Fu Pattern Differentiation 2 — Questions and Answers
Question 1: A patient has loose stools, fatigue, poor appetite, cold limbs, and a cold sensation in the abdomen relieved by warmth. The tongue is pale and swollen with a white coat; the pulse is deep and weak. Which pattern does this represent?
- Spleen Qi Deficiency
- Spleen Yang Deficiency (Correct answer)
- Kidney Yang Deficiency
- Cold invading the Stomach
Correct answer: Spleen Yang Deficiency
Spleen Yang Deficiency includes all Spleen Qi Deficiency signs plus cold manifestations such as cold limbs and abdominal coldness relieved by warmth.
Question 2: Which tongue and pulse presentation best characterizes Lung Qi Deficiency?
- Red tongue with yellow coat; rapid overflowing pulse
- Pale tongue with thin white coat; weak pulse especially in the Lung position (Correct answer)
- Purple tongue with white coat; wiry pulse
- Red tongue with no coat; thin rapid pulse
Correct answer: Pale tongue with thin white coat; weak pulse especially in the Lung position
Lung Qi Deficiency manifests with a pale tongue reflecting insufficient Qi to nourish, and a weak pulse in the right cun (Lung) position.
Question 3: A patient presents with burning epigastric pain, intense thirst for cold drinks, hunger with no desire to eat, dry stools, bleeding gums, and a red tongue with dry yellow coat. The most accurate pattern is:
- Stomach Cold
- Stomach Qi Deficiency
- Stomach Fire (Correct answer)
- Food Stagnation in the Stomach
Correct answer: Stomach Fire
Stomach Fire is characterized by burning pain, intense thirst for cold drinks, gum issues, and a red tongue with yellow coat.
Question 4: The primary distinguishing feature of the pattern 'Spleen not Controlling Blood' is:
- Blood in stools exclusively
- Spontaneous bleeding from multiple sites accompanied by Spleen Qi deficiency signs (Correct answer)
- Heavy menstruation with Liver signs
- Coughing blood with dry cough
Correct answer: Spontaneous bleeding from multiple sites accompanied by Spleen Qi deficiency signs
Spleen not Controlling Blood involves bleeding from various orifices (uterus, gums, skin) alongside fatigue, pale complexion, and other Spleen Qi deficiency signs.
Question 5: Which presentation most accurately describes Phlegm-Heat obstructing the Lung?
- Clear watery sputum, chills, aversion to cold, white coat
- Yellow sticky profuse sputum, fever, thirst, rapid slippery pulse (Correct answer)
- Dry cough with no sputum, night sweats, red tongue with no coat
- Abundant loose sputum, no fever, white greasy coat
Correct answer: Yellow sticky profuse sputum, fever, thirst, rapid slippery pulse
Phlegm-Heat in the Lung produces yellow sticky sputum, fever, thirst, and a slippery rapid pulse reflecting both phlegm and heat.
Question 6: Which finding primarily differentiates Damp-Heat in the Spleen from simple Spleen Qi Deficiency?
- Fatigue and poor appetite
- Yellow greasy tongue coat with sensation of heaviness and fullness (Correct answer)
- Loose stools
- Limb weakness
Correct answer: Yellow greasy tongue coat with sensation of heaviness and fullness
A yellow greasy tongue coat confirms the heat and dampness component, distinguishing Damp-Heat in the Spleen from pure Spleen Qi Deficiency.
Question 7: A patient has fever, sore throat, slight thirst, headache, floating rapid pulse, and a thin yellow tongue coat. The best pattern diagnosis is:
- Wind-Cold invading the Lung
- Wind-Heat invading the Lung (Correct answer)
- Lung Yin Deficiency
- Lung Phlegm-Fire
Correct answer: Wind-Heat invading the Lung
Wind-Heat invading the Lung presents with fever, sore throat, thirst, a floating rapid pulse, and thin yellow coat rather than the white coat seen with Wind-Cold.
NCCAOM Zang-Fu Pattern Differentiation 2
A patient has loose stools, fatigue, poor appetite, cold limbs, and a cold sensation in the abdomen relieved by warmth.
The tongue is pale and swollen with a white coat; the pulse is deep and weak.
Which pattern does this represent?