NCCAOM Zang-Fu Pattern Differentiation Questions and Answers

Question 1

A patient presents with irritability, hypochondriac distention, alternating constipation and diarrhea, and flatulence that provides temporary relief from abdominal discomfort. The pulse is wiry. Which Zang-Fu pattern is the most likely diagnosis?

Accepted Answer

Liver Qi Stagnation overacting on the Spleen

Answer

The irritability, hypochondriac distention, and wiry pulse are classic signs of Liver Qi Stagnation. The digestive symptoms, such as alternating bowel movements and bloating relieved by gas, indicate that the Spleen's function of transformation and transportation is being disrupted by the stagnant Liver Qi. This is a classic presentation of the Wood element overacting on the Earth element.

Question 2

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?

Accepted Answer

Heart Fire Blazing Upwards

Answer

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.

Question 3

Which of the following sets of symptoms is most indicative of a Kidney Yang Deficiency pattern?

Accepted Answer

Low back pain, feeling of cold in the knees and back, copious clear urination, and a deep, weak pulse.

Answer

Kidney Yang is the root of all Yang in the body and provides warmth. Its deficiency leads to a lack of warmth, manifesting as cold sensations, especially in the lower back and knees (the domain of the Kidneys). The inability to transform fluids leads to copious clear urination, and the pulse is deep and weak, reflecting the deficiency and interior nature of the condition.

Question 4

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?

Accepted Answer

Lung and Stomach

Answer

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.

Question 5

Jaundice with a bright yellow color, fever, dark scanty urine, hypochondriac pain, and a bitter taste in the mouth are key signs of which Fu organ pattern?

Accepted Answer

Damp-Heat in the Gallbladder

Answer

Damp-Heat in the Gallbladder obstructs the flow of bile, causing it to 'overflow' and lead to jaundice. The bright 'yang' yellow color, fever, and dark urine are characteristic of the heat component, while the heaviness and greasy tongue coating (often present) are signs of dampness. This pattern is often associated with conditions like cholecystitis or gallstones in biomedicine.

(NCCAOM) National Certification Commission for Acupuncture and Oriental Medicine Practice Test

(NCCAOM) National Certification Commission for Acupuncture and Oriental Medicine Practice Test

NCCAOM Zang-Fu Pattern Differentiation Questions and Answers