1.
A child presents with attacks of Otitis Media which occur when the child is exhausted or run down, or when the child catches a cough or cold (which happens frequently). The glands in the neck are palpable, soft and spongy, and the eardrum is pale and swollen. The child is tired and uninterested. Which syndrome do you suspect?
Correct Answer
C. Spleen (and Lung) Qi Xu with LPF
Explanation
The symptoms described in the question, such as attacks of Otitis Media occurring when the child is exhausted or run down, glands in the neck being palpable, soft and spongy, and the eardrum being pale and swollen, suggest a deficiency in Spleen (and Lung) Qi with Lingering Pathogenic Factor (LPF). This syndrome is characterized by a weakened Spleen and Lung Qi, making the child more susceptible to infections and unable to properly clear pathogens from the body. Additionally, the child's tiredness and lack of interest further support the diagnosis of Spleen (and Lung) Qi deficiency.
2.
A 1 1/2 year old presents with recurrent attacks of otitis media with ear pain, poor sleep, restless mood and crying, insomnia and general grumpiness. Attacks come and go, especially when the child is teething. On inspection the child has a swollen and bloated abdomen, red cheeks, and green around the mouth. Bowels are foul smelling, especially during a bout of earache, which can last several days. Which syndrome do you suspect?
Correct Answer
A. Accumulation/Ji
Explanation
The symptoms described in the question, such as recurrent ear infections, ear pain, poor sleep, restless mood, crying, insomnia, grumpiness, swollen and bloated abdomen, red cheeks, green around the mouth, foul-smelling bowels, and the association with teething, suggest the presence of Accumulation/Ji syndrome. This syndrome is characterized by the accumulation of pathogenic factors in the body, leading to various symptoms and signs.
3.
A 6 year old presents with chronic Otitis Media - a continuous feeling of pressure in the ear which comes and goes, along with feeling genearl off colour, tired and out of sorts. On palpation the glands in the neck are hard and rubbery. The child also presents with chronic nasal congestion and cattarh, and bouts of abdominal pain that are unrelated to eating. The child is spaced out, detached and dreamy. Which syndrome do you suspect?
Correct Answer
B. Lingering Pathogenic Factor
Explanation
Based on the symptoms described, including chronic otitis media, hard and rubbery glands in the neck, chronic nasal congestion and catarrh, bouts of abdominal pain unrelated to eating, and a spaced out, detached, and dreamy demeanor, the most likely syndrome is Lingering Pathogenic Factor. This syndrome is characterized by the persistence of a pathogen within the body, causing various symptoms and impairing the normal functioning of the organs involved.
4.
Glue Ear is caused by a combination of the following (tick all that apply):
Correct Answer(s)
B. pHlegm
C. Deficiency (of Lung and Spleen Qi)
Explanation
Glue Ear is caused by the accumulation of fluid in the middle ear, resulting in hearing loss and discomfort. Phlegm can contribute to the development of Glue Ear as it can block the Eustachian tube, preventing proper drainage of fluid from the middle ear. Deficiency of Lung and Spleen Qi can also play a role in Glue Ear as it weakens the body's immune system and ability to fight off infections, which can lead to the accumulation of fluid in the middle ear.
5.
Chronic Otitis Media with pain is caused by a combination of the following (tick all that apply):
Correct Answer(s)
A. Stagnation
B. pHlegm
C. Deficiency (of Lung and Spleen Qi)
Explanation
Chronic Otitis Media with pain can be caused by a combination of stagnation, phlegm, and deficiency of Lung and Spleen Qi. Stagnation refers to the blockage or congestion in the ear, which can lead to pain. Phlegm accumulation in the ear can also contribute to the development of chronic otitis media. Additionally, a deficiency of Lung and Spleen Qi weakens the immune system and makes the ear more susceptible to infections and inflammation. Liver Fire, however, is not mentioned as a cause in this case.
6.
In an attack of Otitis Media the eardrum bursts in 2% cases, often with a reduction in pain and some blood stained discharge from the ear. This problem nearly always repairs itself in 6-8 weeks, and is not usually a cause for concern.
Correct Answer
A. True
Explanation
In an attack of Otitis Media, the eardrum bursting occurs in 2% of cases. This is often accompanied by a decrease in pain and some discharge from the ear that may contain blood. However, this problem typically resolves on its own within 6-8 weeks and does not usually require medical intervention. Therefore, the statement is true.
7.
The Lungs (and Spleen) govern the middle ear, whereas the Kidney opens to, and governs, the inner ear.
Correct Answer
A. True
Explanation
The statement is true because in Traditional Chinese Medicine, the Lungs and Spleen are believed to govern the middle ear, while the Kidney is believed to open to and govern the inner ear. This means that the health and functioning of the middle ear are influenced by the Lungs and Spleen, while the inner ear is influenced by the Kidney.
8.
Si Feng (found on the distal interphalangeal crease of the palmar aspect of the finges) is a useful point for Sp Qi Deficiency with resulting Accumulation Disorder
Correct Answer
B. False
Explanation
Si Feng is used to treat Accumulation Disorder by strongly clearing, and is not used for deficiency. It is found on the palmar surface on the hand, at the midpoints of the transverse creases of the proximal interphalangeal joints of the four fingers (there are four points on each hand). If there are two creases, use the one that is most prominent on moving the finger.
9.
The most important channels involved with Otitis Media are (choose 2 of the following):
Correct Answer(s)
A. Gall-Bladder
D. San Jiao - Triple Burner
Explanation
The correct answer is Gall-Bladder and San Jiao - Triple Burner. Otitis Media is an inflammation or infection of the middle ear. The Gall-Bladder channel runs through the side of the head and can be affected by middle ear issues. The San Jiao - Triple Burner channel also passes through the ear and can be involved in ear infections. The Bladder and Large Intestine channels are not directly related to the ear and are not commonly associated with Otitis Media.
10.
Chronic Otitis Media is a relatively deep lingering pathogenic factor, compared to one that may cause asthma, ezcema or recurrent bladder infections?
Correct Answer
B. False
Explanation
It is a relatively superficial lingering pathogenic factor, and therefore easier to treat.
11.
A Shaoyang level disorder represents an intermediary stage between an external and internal disease where pathogens can easily become chronically lodged, at the level of the ‘Membranes’ (MoYuan) – typical symptoms include: cyclical, recurrent and sub-acute symptoms; alternating chills and fever; bitter taste; blurred vision; fullness/distension of hypochondrium/chest; no desire to eat or drink, vomiting, nausea; irritability; TC: one side only or half white, half black or grey; P: wiry/fine. The Channels involved with this level of disorder are:
Correct Answer
C. Gall-Bladder and SanJiao (Triple Burner)
Explanation
A Shaoyang level disorder represents an intermediary stage between an external and internal disease where pathogens can easily become chronically lodged, at the level of the 'Membranes' (MoYuan). Typical symptoms include cyclical, recurrent and sub-acute symptoms, alternating chills and fever, bitter taste, blurred vision, fullness/distension of hypochondrium/chest, no desire to eat or drink, vomiting, nausea, irritability. The tongue coating is one side only or half white, half black or grey, and the pulse is wiry/fine. The channels involved with this level of disorder are the Gall-Bladder and SanJiao (Triple Burner).
12.
Chronic Supporative Otitis Media is associated with a persistent discharge of pus from the middle ear infection (2 weeks or more) with a perforated ear-drum that is unable to heal. This condition is mild and self limiting and doesnt need treatment or intervention.
Correct Answer
B. False
Explanation
This condition needs to be treated or it can result in permanent hearing damage, or other complications.