NCCAOM Zang-Fu Pattern Differentiation 3 — Questions and Answers
Question 1: The key distinguishing feature of Kidney Yang Deficiency compared to Kidney Qi Deficiency is:
- Frequent urination at night
- Low back weakness
- Cold limbs and strong aversion to cold with a pale swollen wet tongue (Correct answer)
- Fatigue and tinnitus
Correct answer: Cold limbs and strong aversion to cold with a pale swollen wet tongue
Kidney Yang Deficiency includes all Kidney Qi Deficiency signs plus pronounced cold manifestations: cold limbs, aversion to cold, and a pale swollen wet tongue.
Question 2: A 52-year-old woman presents with night sweats, five-center heat, dry mouth at night, dizziness, tinnitus, soreness of the low back and knees, and a red tongue with no coat and a thin rapid pulse. The most likely pattern is:
- Heart Yin Deficiency
- Liver Yin Deficiency
- Kidney Yin Deficiency (Correct answer)
- Lung Yin Deficiency
Correct answer: Kidney Yin Deficiency
Kidney Yin Deficiency features the classic triad of tinnitus, low back weakness, and dizziness combined with night sweats and five-center heat.
Question 3: Kidney Jing Deficiency in an adult is best characterized by:
- Frequent urination alone
- Premature aging, hair loss, weak bones and knees, poor memory, and reproductive disorders (Correct answer)
- Cold limbs and impotence only
- Tinnitus and night sweats alone
Correct answer: Premature aging, hair loss, weak bones and knees, poor memory, and reproductive disorders
Kidney Jing governs growth, reproduction, and aging, so its deficiency manifests as premature aging, hair loss, bone weakness, memory decline, and infertility.
Question 4: Kidney not Grasping Qi is most closely associated with which clinical presentation?
- Urinary incontinence and nocturia
- Dyspnea on exertion with difficulty on inspiration and a weak voice, worse with exertion (Correct answer)
- Chronic dawn diarrhea
- Lower back pain radiating to the leg
Correct answer: Dyspnea on exertion with difficulty on inspiration and a weak voice, worse with exertion
The Kidney's function of grasping Lung Qi means its failure produces shortness of breath worse on exertion with difficulty inhaling rather than exhaling.
Question 5: Combined Liver and Kidney Yin Deficiency typically presents with symptoms from both organ systems, which include:
- Headache, dizziness, dry eyes, tinnitus, night sweats, and five-center heat (Correct answer)
- Cold limbs, poor appetite, and loose stools
- Liver Fire symptoms with Kidney Yang deficiency
- Liver Qi stagnation with urinary symptoms
Correct answer: Headache, dizziness, dry eyes, tinnitus, night sweats, and five-center heat
Liver and Kidney Yin Deficiency combines Liver signs (dry eyes, headache, dizziness) with Kidney Yin signs (tinnitus, night sweats, five-center heat).
Question 6: Heart and Kidney not Communicating (Water and Fire not Harmonizing) is best described as:
- Palpitations in isolation
- Insomnia, palpitations, anxiety, tinnitus, low back weakness, and night sweats (Correct answer)
- Kidney Yang Deficiency causing edema and Heart failure
- Heart Fire causing hematuria
Correct answer: Insomnia, palpitations, anxiety, tinnitus, low back weakness, and night sweats
When Heart Fire fails to descend and Kidney Water fails to ascend, the result is insomnia, palpitations, anxiety (Heart), and tinnitus, low back weakness, night sweats (Kidney).
Question 7: A patient with Kidney Qi not Firm most characteristically presents with:
- Inability to urinate and lower abdominal fullness
- Urinary incontinence, nocturia, premature ejaculation, or excessive leukorrhea (Correct answer)
- Dark scanty burning urine
- Kidney stones and hematuria
Correct answer: Urinary incontinence, nocturia, premature ejaculation, or excessive leukorrhea
Kidney Qi not Firm means the Kidney fails to secure bodily substances, leading to leakage of urine, semen, or vaginal discharge.
NCCAOM Zang-Fu Pattern Differentiation 3
The key distinguishing feature of Kidney Yang Deficiency compared to Kidney Qi Deficiency is: