“My nose has been blocked for months and my cheeks feel pressed.”
Pressure in the face
Months of a blocked nose propped up with spray, in someone who spends the day bent over a treatment table.
- Patient
- Man, 35
- Occupation
- Physiotherapist; long hours bent over the table
- Medication
- Decongestant spray almost daily for months.
- Allergies
- None known
- History
- Deviated septum, never operated.
- Vitals
- BP 126/78 · 36.8 °C
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
Before finishing“«I have never had a fever, and my eye is perfectly fine. What bothers me is not being able to smell coffee.»”
Mark the warning signs present:
What do you do?
7 · The treatment
Principle
Strategy
Points (choose 4)
Case solved
Reasoned solution
Pattern: Damp-Heat in the sinuses (Bi Yuan). Supporting signs: Thick yellow mucus, Pressure that hurts on bending forward, Tenderness on pressing the cheekbones, Yellow greasy coating, Slippery, rapid pulse.
The deciding clue: Thick yellow mucus: Dense and hard to blow out. Deficiency Dampness gives clear runny mucus..
Safety: Chronic sinusitis with no fever, no orbital signs and no waking headache: drain the Dampness and clear the Heat.
Treatment: Clear Damp-Heat, Open the nasal orifices; Drain and open. Points: LI20, GB20, LI4, GB41.
More patients are waiting in the app, with voice, a real timer and a history of your decisions.
See the solution without playing
Pattern: Damp-Heat in the sinuses (Bi Yuan). Supporting signs: Thick yellow mucus, Pressure that hurts on bending forward, Tenderness on pressing the cheekbones, Yellow greasy coating, Slippery, rapid pulse.
The deciding clue: Thick yellow mucus: Dense and hard to blow out. Deficiency Dampness gives clear runny mucus..
Safety: Chronic sinusitis with no fever, no orbital signs and no waking headache: drain the Dampness and clear the Heat.
Treatment: Clear Damp-Heat, Open the nasal orifices; Drain and open. Points: LI20, GB20, LI4, GB41.
Teaching case. Fictional patient for study purposes. If you have real symptoms, consult a healthcare professional.
