Reference no: EM133675771

Abdominal Distention Homework Case

A 45 year old female presents with abdominal distention of 2 years duration. The condition appeared after a time of extreme emotional stress that resulted in pain and fullness in the subcostal regions. Ultrasonography, barium meal examination and a liver function test revealed nothing remarkable. She turned to Chinese medicine for answers.

TCM exam revealed a markedly distended abdomen which resembled a pregnancy of six months. The abdomen was soft and tympanitic, and no mass was palpable. The patient appeared tired and had a sallow complexion. She complained of depression, and stated that she sighed frequently, was irritable and had a poor temper. She had a poor appetite and experienced frequent belching. The abdominal distention was aggravated by anger and intake of food, but was relieved with upward or downward elimination of gas. Her menstrual periods were irregular and quite painful, with a dark red flow of moderate amount, and her breasts became distended prior to and during menstruation. The tongue was pale with a white coating, and the pulse was thin and wiry.

1. Identify the 8 principles of the case (Interior/Exterior, Excess/Deficient, Hot/Cold, Yin/Yang)

2. List all possible zang fu (organ) patterns for this chief complaint.

3. State your working diagnosis for this case study. Support your choice with at least three elements from the case.

4. State the accepted pathomechanism for the chief complaint.

5. Which channels are likely affected in this case? (Remember to consider luo channels, tendino-muscular channels, divergent channels and extraordinary channels, in addition to main meridians)

6. State your treatment principle (both for zang fu diagnosis & channel diagnosis)

7. Which acupuncture points would you use? (No more than six, and consider the type of needle stimulation indicated)

8. What is the representative herbal formula for the zang fu pattern? Should this formula be modified to better address the chief complaint?

9. What lifestyle advice would you give this patient? Please be specific.

10. Identify the differential diagnosis list for this chief complaint from a biomedical perspective (usually 2-4 diagnoses).

11. Please state the most likely biomedical diagnosis and the ICD code.

12. Which physical exams would be appropriate for this case?

13. Which labs would be appropriate for this case?

14. State the red flags for this chief complaint.

15. State the prognosis for this case.