How to Answer a Case Study Question
STEP ONE: WHAT IS BEING ASKED?
A 50-year-old male patient has had fatigue, dizziness, and insomnia for two months. Because he is busy at work, he has difficulty falling asleep, wakes up at 2-3 AM, and can’t go back to sleep again. He also suffers from headache on the temples, and tinnitus sometimes. His appetite is reduced, urine and bowel movement are normal. His tongue is red with little fur, the pulse is wiry and small. His face color is red, his BP is 170/98 mmHg. What is your diagnosis?
- Deficiency of yin and yang
- Liver qi stagnation transforming into fire
- Yin deficiency with yang rising
- Phlegm turbidity obstructing the Middle Jiao
This question is asking about a current diagnosis. Pretty standard, nothing tricky
STEP TWO: DON’T READ THE ENTIRE QUESTION–FOCUS ON THE TONGUE AND PULSE? WHAT CAN YOU ELIMINATE?
A 50-year-old male patient has had fatigue, dizziness, and insomnia for two months. Because he is busy at work, he has difficulty falling asleep, wakes up at 2-3 AM, and can’t go back to sleep again. He also suffers from headache on the temples, and tinnitus sometimes. His appetite is reduced, urine and bowel movement are normal. His tongue is red with little fur, the pulse is wiry and small. His face color is red, his BP is 170/98 mmHg. What is your diagnosis?
- Deficiency of yin and yang
- Liver qi stagnation transforming into fire
- Yin deficiency with yang rising
- Phlegm turbidity obstructing the Middle Jiao
The tongue is red with a scanty coat; the pulse is wiry and small. The tongue indicates yin deficiency and the pulse indicates deficiency and Liver involvement. Therefore, you can cross off option #2 (that answer is all Excess) and #4 (if there was phlegm, the tongue would have a greasy coat and the pulse would be slippery).
STEP THREE: READ THE WHOLE QUESTION–WHAT DO THE SIGNS AND SYMPTOMS INDICATE? Underline and label these as you read through the question so you don’t get confused.
A 50-year-old male patient has had fatigue, dizziness, and insomnia for two months. Because he is busy at work, he has difficulty falling asleep, wakes up at 2-3 AM, and can’t go back to sleep again. He also suffers from headache on the temples, and tinnitus sometimes. His appetite is reduced, urine and bowel movement are normal. His tongue is red with little fur, the pulse is wiry and small. His face color is red, his BP is 170/98 mmHg. What is your diagnosis?
- Deficiency of yin and yang
- Liver qi stagnation transforming into fire
- Yin deficiency with yang rising
- Phlegm turbidity obstructing the Middle Jiao
There are no yang deficiency symptoms, so the answer must be option #”3″, which makes sense.