“I have been exhausted for months and sleep does not fix it.”
Exhausted for months
An exhaustion sleep does not fix, which she has spent months putting down to work.
- Patient
- Woman, 47
- Occupation
- Accountant; quarter-end close last week
- Medication
- None prescribed. Iron two years ago.
- History
- Blood work a year ago, normal except low ferritin.
- Habits
- Eats fast at her desk. No exercise.
- Vitals
- BP 108/68 · afebrile
1 · The consultation
You have 18 minutes. Each question or examination costs 2. Choose carefully what to ask.
Questions
Examination
2 · The tongue
3 · The pulse
Describe the pulse on each axis.
4 · The pattern
5 · Differential diagnosis
You're torn between two patterns. Which is it?
Which finding decides it?
6 · Case twist
Patient update“«Something that may not be relevant: I have lost six kilos since summer without trying, and I sweat at night. I put it down to work.»”
Mark the warning signs present:
What do you do?
7 · The treatment
Principle
Strategy
Points (choose 5)
Case solved
Reasoned solution
Pattern: Spleen Qi deficiency. Supporting signs: Heaviness after eating, Improves with movement, Bloating and loose stools, Pale tongue with tooth marks, Weak pulse in the middle position.
The deciding clue: Crashes after eating: By three in the afternoon she cannot keep her eyes open. Kidney Yang weighs at dawn, not after lunch..
Safety: Six kilos lost without trying plus months of night sweats is the triad you investigate before treating, however clear the Spleen pattern is.
Treatment: Tonify Spleen Qi, Raise the clear Qi; Tonify and raise. Points: ST36, SP3, BL20, CV12, GV20.
More patients are waiting in the app, with voice, a real timer and a history of your decisions.
See the solution without playing
Pattern: Spleen Qi deficiency. Supporting signs: Heaviness after eating, Improves with movement, Bloating and loose stools, Pale tongue with tooth marks, Weak pulse in the middle position.
The deciding clue: Crashes after eating: By three in the afternoon she cannot keep her eyes open. Kidney Yang weighs at dawn, not after lunch..
Safety: Six kilos lost without trying plus months of night sweats is the triad you investigate before treating, however clear the Spleen pattern is.
Treatment: Tonify Spleen Qi, Raise the clear Qi; Tonify and raise. Points: ST36, SP3, BL20, CV12, GV20.
Teaching case. Fictional patient for study purposes. If you have real symptoms, consult a healthcare professional.
