Healthcare Questions, Clinical Cases, and Acupuncture Management

This assignment delves into various aspects of healthcare, focusing on acupuncture and clinical case studies. It addresses key questions regarding medical red flags, the importance of medical history and physical examinations, and the four vital signs. The assignment explores specific conditions like appendicitis, cholecystitis, and heart attacks, detailing their clinical characteristics and pathophysiology. It also covers symptoms of migraine, stroke, and deep venous thrombosis (DVT). The second part presents four clinical cases involving patients with high blood pressure, vomiting, shoulder pain, and concussion, prompting diagnostic questions, monitoring tests, and management strategies. The assignment emphasizes the application of acupuncture in treating these conditions and highlights the importance of referring patients to biomedical practitioners when necessary. The solutions provided in this assignment are designed to assist students in understanding and applying healthcare principles in a practical setting.

Health Care Questions

QUESTIONS
Section 1
1.What are medical ‘red flags’? How important are they to you as an acupuncturist?
Red flags in medical can be defined as signs and symptoms found in history and clinical
examination of an individual (Alvim and Ferreira, 2018). They are important for an
acupuncturist to make decision of conducting the process of acupuncture on infected or ills part
of the body to make patient feel relief.
2. It is said that “an effective and profitable Oriental medicine (OM) practice rests on four
foundational pillars”. Briefly discuss these four pillars of a successful OM practice.
Four pillars behind successful OM practice:
 Acupuncture and Moxibustion
 Herbs and nutrition
 Physical manipulation
 Qi Gong (therapeutic breathing exercise)
3. Why are a careful medical history-taking and physical examination considered a powerful
combination whether one practices Western or Oriental medicine?
The care practitioners should focus on careful medical history taking and physical examination
because it is necessary to make decision making of treatment more accurate. It is consider as
powerful combination in Western or Oriental medicine to increase accuracy of conduct treatment
process for wellbeing of patient (Chung and et. al., 2017).
4. What are the four vital signs, which are taken during physical examination? Why are they
called 'vital'?
The vital signs during physical examination consist:
 Body temperature
 Blood pressure
 Pulse (heart rate)
 Respiratory rate (breathing rate)
1

They are called as vital signs because of indicating about status of body’s vital (life-sustaining)
functions. They are important as medical signs to understand about health condition of an
individual.
5. Name two signs or symptoms which may be specific red flags for each of the following organ
systems:
Gastrointestinal: It includes specific red flags like sudden onset abdominal pain, hematemesis,
unexplained weight loss and post coital bleeding.
Neurological: It consist specific red flags such as shaking, concussion, confusion, dizziness,
memory loss and double vision (Hong, 2016).
Cardiovascular: This involves specific red flags including exertional chest pain, heavy, tight &
pressure type chest pain and pain radiating to left arm, right shoulder or both arms.
6. Describe the most common clinical characteristics of pain in appendicitis.
The clinical characteristics of pain in appendicitis are:
 It includes sudden pain started from right side of lower abdomen or around the navel &
often shifts to lower right abdomen.
 The pain worsens of patient cough, walk or make another jarring movement.
 Vomiting and nausea
 Loss of appetite
 Low grade fever which may become complicated of sickness progresses (Koda, 2018).
 Diarrhoea or constipation
 Abdominal bloating and flatulence
7. What is cholecystitis? Show its pathophysiology through a diagram.
Cholecystitis can be described as an inflammation of gallbladder which is caused generally due
to stones which block the tube leading from gallbladder to small intestine.
Pathophysiology
2

Figure 1: Cholecystitis Pathogenesis
(Source: Cholecystitis Pathogenesis, 2020)
8. Relate the clinical manifestations of a heart attack to its pathophysiology. A patient suffering
from a heart attack typically complains of a constricting chest pain. Name, at least, two
other ways pain of a heart attack can clinically manifest.
The clinical manifestations of heart attack are mentioned below.
Pain between shoulder blades and arm
Discomfort or tightness in arm and neck
Pain like a clenched fist in the chest.
9. Aside from chest pain, what other signs and symptoms may lead you to suspect a patient is
having a heart attack?
Other symptoms of indicating about heart attack.
 Nausea, indigestion, heartburn or abdominal pain.
 Shortness of breath
3

 Cold sweat
 Fatigue
 Light-headedness or sudden dizziness
10. What is pitting oedema? Where would it be found in the body? Name, at least, two (2)
pathological conditions that are associated with pitting oedema. Support your answer.
Pitting oedema refers to observable swelling of body tissues due to accumulation of fluid which
can be demonstrated through implementing pressure to the swollen area. It may be found on legs,
feet, and ankles often but may occur anywhere on human body (Kumar and et. al., 2016).
However, the pathological condition includes heart valves problems and low protein levels are
associated with pitting oedema.
11. What are the typical symptoms of migraine?
The typical symptoms of migraine involves headache start as dull ache and grows into throbbing
pain, sensitivity towards noise, light & smells, vomiting & nausea, feeling very cold or warm,
belly pain, pale skin, fatigue and dizziness.
12. How would you recognise that a patient has had a stroke?
The stroke conditions of patient can be recognise by evaluating several symptoms such as face
dropping, arm weakness, speech difficulty, numbness or needles sensation in body, severe
headache and dizziness.
13. Describe the patient history and signs and symptoms, which would lead you to suspect a
possible deep venous thrombosis (DVT).
The history of having limb oedema and pain indicate about possibility to occur the problem of
deep venous thrombosis. It is observed that DVT classically develops pain and limb oedema and
its symptoms may present, absent, unilateral or bilateral, or mind or severe. However the
presence of oedema is known to be more specific symptoms of DVT.
Section 2
Clinical case 1
1. What questions will you ask this lady? Why will you ask these questions?
The questions that are required to be ask to the lady with problem of high blood pressure are:
4

 Do you feel weakness or uneasy? It is necessary to analyse the actual symptom to
evaluate the problem for providing proper acupuncture therapy to her.
 Are you experience severe headache of mild one? It is required to examine severity of
entire situation.
2. Name, at least, two investigations/procedures will you perform to assess this patient? Support
your answer.
Physical examination and ECG should be used in order to investigate to assess the condition of
patient. Physical examination is to analyse the blood pressure condition improvements by
providing acupuncture therapy. Meanwhile, the electrocardiogram is necessary to examine the
electrical activity of heart in order to evaluate possible consequences of medical condition of
patient (Pang and et. al., 2019).
3. After your initial assessment how will you manage this patient? Justify your answer.
The management of this patient will be done through using the treatment process of acupuncture
to in order to make patient healthy. It includes the share on Pinterest Electro acupuncture is
known as form of acupuncture which applied low intensity electrical pulses via needles inserted
at specific points on human body. It is favourable to main blood pressure condition and
facilitates to reduce risk of occurring stroke and heart disease for given individual.
4. What medical investigation (or a series of clinical procedures) will you conduct to confirm
that a patient is hypertensive?
The blood pressure is measured consistently > 130 mmHg systolic and >80 mmHg diastolic then
hypertensive condition of patient can be confirned.
Clinical case 2
1. What diagnostic questions will you ask this patient? Justify your answer.
Questions asked:
o How much times you get vomited within last 24 hours? It is required to analyse actual
severity of body condition of patient.
o Are you feeling weakness or gain feel like vomiting? It is necessary to improve accuracy
of treatment decision making.
5

2. What monitoring test(s) will you perform in your clinic? Support your answer.
The monitoring of overall condition of patient includes several activities that are given below.
 It includes physical examination to ensure improvement in symptoms RUQ pain and
other other signs
 Abdominal ultrasound to assess the cause of symptoms shows by patient to provide
appropriate treatment for her wellbeing.
3. Based on your initial assessment, describe how will you manage this patient? What will
prompt you to refer this patient to a biomedical general practitioner?
Management of RUQ pain includes use of acupuncture with specific practices in order to manage
the condition of given patient (Li and Zhang, 2017). It includes the indication of condition of
forming gallstones facilitating occurrence of cholelithiasis which is symptoms the encourage to
refer patient to a biomedical general practitioner for further treatment.
Clinical case 3
1. What diagnostic questions will you ask this patient? Justify your answer.
Diagnostic questions:
 Your shoulder pain is severe or mild one?
 Have you ever feel extreme level of pain in right shoulder?
 Are you feeling weakness or numbness anywhere in whole body?
These questions are required to be asked for gathering more detailed information about
symptoms to provide accurate care services for his better health.
2. What monitoring test(s) will you perform in your clinic? Support your answer.
The monitoring tests includes to carrying out physical examination, PTC examination and
abdominal ultrasound to monitor condition of patient. It is required to ensure effectiveness of
treatment and need of changing medications for his wellness.
3. Based on your initial assessment, describe how will you manage this patient? What will
prompt you to refer this patient to a biomedical general practitioner?
The management includes low at diet to overcome with the problem of symptoms indicated by
old man. It includes using actigall and chenix in order to improve health condition of given
patient. The symptoms indicate towards possibility of cholelithiasis due to which patient should
refer to biomedical general practitioner.
6

Clinical case 4
1. Based on the available information and your observation, what is your initial assessment of
this patient's condition? Support your answer.
The consideration of initial assessment by analysing symptoms indicates about health problems
of concussion which has similar symptoms like mental confusion, disorientation and vomiting.
2. What actions will you take to ensure the immediate safety of this patient? Justify your answer.
It includes to provide medication to maintain physical and mental rest of patient. It is favourable
to improve the symptoms of an individual which facilitate to make him feeling relived.
3. Will you refer this patient to the hospital or will you treat with acupuncture? Justify your
answer.
This patient will refer to hospital in order to gain proper medical treatment for symptoms related
to concussion in terms of making patient wellbeing. It is necessary to conduct further clinical
investigation by carrying out neurological examination, cognitive testing, imaging tests and
observation to provide accurate care services for their wellbeing (An and et. al., 2018).
Section 3
1. A 25-year old male patient complains of a general dull abdominal pain with nausea. What will
you be looking for when doing a physical examination of the abdomen. Briefly describe
the relevant procedures that you will perform. Support your answer.
As per their given case scenario, the physical examination consist to focus on pain and
temperature of human body. It includes to conduct physical examination, urinalysis, abdominal
x-ray, white blood cell count, barium anema, ultrasound and CT scan. However, it is favourable
to ensure about actual health problems and its causes to provide appropriate medications because
the symptoms are similar to condition of appendicitis.
2. How will you clinically monitor the response of a patient who is suffering from a CVA
sequelae and who you are treating with acupuncture? Justify your answer.
The procedures for monitoring the condition of patient by with CVA treating by acupuncture by
conducting process of ECG, carotid ultrasound, blood test and EEG. It is favourable to analyse
improvement in condition of patient with acupuncture.
7

3. A 43-year old male patient, complaining of painful urination with associated on and- off back
pain radiating to the groin and who has consulted with biomedical practitioners, comes to
your clinic requesting for an acupuncture treatment. You request the patient for the results
of the laboratory tests that were performed. Name, at least, three (3) tests or procedures
that you will be particularly interested in that has relevance to your acupuncture
management. Support your answer.
The several test are required to be carried for providing more accurate type of acupuncture in
order to improve patient condition of painful urination. It consist to conduct blood tests,
urinalysis, ultrasound and CT scan to conduct accurate treatment of acupuncture for making
individual disease free.
8

REFERENCES
Books and journals
Alvim, D.T. and Ferreira, A.S., 2018. Inter-expert agreement and similarity analysis of
traditional diagnoses and acupuncture prescriptions in textbook-and pragmatic-based
practices. Complementary therapies in clinical practice, 30, pp.38-43.
Chung, K.F. and et. al., 2017. An integrative Chinese-Western diagnostic approach to predict a
positive response to acupuncture. Acupuncture in Medicine, 35(4), pp.306-308.
Hong, H.G., 2016. Electrodermal measurement of acupuncture points may be a diagnostic tool
for respiratory conditions: A retrospective chart review. Medical Acupuncture, 28(3),
pp.137-147.
Koda, E.K., 2018. Fully integrating medical acupuncture into family medicine. The Annals of
Family Medicine, 16(4), pp.367-367.
Kumar, L.D. and et. al., 2016. Advancement in contemporary diagnostic and therapeutic
approaches for rheumatoid arthritis. Biomedicine & Pharmacotherapy, 79, pp.52-61.
Pang, P. and et. al., 2019. Acupuncture methods put to the test for a tinnitus study: a Bayesian
analysis. Complementary therapies in medicine, 42, pp.205-213.
Li, X. and Zhang, S., 2017. Professor LAI Xinsheng's clinical experience in the treatment of
premature ovarian failure with tongyuan acupuncture technique and Chinese herbal
medicine. Zhongguo zhen jiu= Chinese acupuncture & moxibustion, 37(3), pp.303-306.
An, G.H and et. al., 2018. Reporting characteristics of case reports of acupuncture therapy with
CARE guidelines. Chinese journal of integrative medicine, 24(1), pp.56-63.
Online
Cholecystitis Pathogenesis. 2020. [Online]. Available through:<
https://www.vectorstock.com/royalty-free-vector/cholecystitis-pathogenesis-
pathogenesis-vector-15910696>
9