CARB-TCMPA Acupuncturist Exam cheat sheet

Qi has five cardinal functions: promoting, warming, defending, transforming/transporting, and holding; deficiency produces fatigue, cold limbs, spontaneous sweat, and prolapse patterns.

Blood (xue) is nourished by qi and moves by qi; qi deficiency leads to blood stasis, and blood loss leads to qi deficiency - treat both together in chronic cases.

Yin and yang are relational, not absolute: each contains a seed of the other, so extreme heat may generate cold signs (true heat, false cold) and must be treated by clearing heat.

The five zang (heart, liver, spleen, lung, kidney) store essence and are yin; the six fu (gallbladder, stomach, small intestine, large intestine, bladder, sanjiao) transmit and transform and are yang.

Eight principles - yin/yang, interior/exterior, cold/heat, deficiency/excess - must be resolved before selecting a treatment principle; interior-excess-heat is treated differently from interior-deficiency-heat.

Six excesses: wind, cold, summerheat, damp, dryness, fire; each has a characteristic presentation (wind moves, damp is heavy/turbid, cold contracts, fire rises).

Tongue body color reflects true condition; coating reflects stomach qi and pathogens; a peeled or mirror tongue indicates yin or stomach fluid depletion.

Pulse qualities are combined, not isolated: wiry, slippery, choppy, flooding, thin, and deep pulses are read with position (cun, guan, chi) and pressure level (superficial, middle, deep).

Entry-level scope of practice requires recognizing red flags for referral (sudden severe pain, unexplained weight loss, neurological deficits) before initiating TCM treatment.

The twelve primary channels each connect to a zang-fu organ; the eight extraordinary vessels (including du, ren, chong, dai) do not connect directly to organs and act as reservoirs.

Needling depth is governed by point location and body region: points on the chest and back are shallow (risk of pneumothorax); points on limbs and buttocks may be deeper.

Deqi (arrival of qi) is described as soreness, numbness, distension, or heaviness; it is a clinical endpoint, not a complication.

Absolute contraindications to needling include needling over infected skin, over a full bladder at points like CV3, and needling a pregnant abdomen at points such as LI4 and SP6 without caution.

Moxibustion is indicated for cold and deficiency patterns and contraindicated over the abdomen/lumbosacral region in pregnancy and over impaired sensation.

Cupping creates petechiae by negative pressure; it is avoided over broken skin, on patients on anticoagulants, and over the kidney region in acute nephritis.

Adverse events to monitor: fainting (needle shock) from needle anxiety or empty stomach; pneumothorax from deep needling at BL13, BL14, or ST12; and hematoma from vessel puncture.

Standard precautions: single-use sterile needles, hand hygiene before and after, sharps container immediately at chairside, and gloves when contact with blood or body fluids is likely.

Herbal formulas follow君臣佐使 (chief, deputy, assistant, envoy) structure; the chief treats the main pattern, the envoy harmonizes or directs the formula to the channel.

Eighteen Incompatibilities (十八反) and Nineteen Mutual Antagonisms (十九畏) list herb pairs to avoid; these are memorized safety rules, not optional guidance.

Toxicity safeguards: aconite (fuzi) and pinellia require prolonged decoction or processing; granules and raw herbs differ in dosing; never substitute one form for another without adjustment.

Decoction method matters: aromatic herbs (bohe, muxiang) are added near the end; minerals and shells (muli, longgu) are decocted first; ginseng is decocted separately.

Pregnancy cautions include strong blood movers (taoren, honghua), purgatives (dahuang, mangxiao), and toxic herbs; classify as contraindicated versus use with caution.

Formula modification (加减) is based on the presenting pattern, not the disease name; the same western diagnosis can yield different formulas for different patterns.

Herb-drug interactions to screen: anticoagulant use with blood-invigorating herbs, and immunosuppressants with immune-stimulating herbs.

Documentation must record formula name, individual herb doses, form (raw, granule, patent), duration, and follow-up plan for review of response and adverse effects.