NB: Please DO NOT use this Web site questionnaire for your COBC submission. The real COBC questionnaire is available from the office as part of the COBC pack.
1) What anatomical feature would make deep puncture with an acupuncture needle at CV17 potentially fatal?
One answer only.
Pectus excavatum Pectus carinatum Sternal foramen Dextrocardia
2) What is the prevalence of this feature?
Less than 1 in 100,000 Less than 1 in 100 Greater than 1 in 100
3) Is this feature generally detectable by external examination?
Yes No
4) What anatomical structure is potentially at risk from needling at GB21?
Vertebral Artery Lung / pleura Brachial plexus Subclavian artery
5) What is the main risk associated with needling GB21 or any other point over the rib cage?
Fit Faint Funny turn Pneumothorax
6) What needle angulation should be used at GB21 to minimise risk?
Perpendicular to the skin Vertical Tangential to the rib cage
7) Up to how long after needling over the rib cage can the symptoms of a pneumothorax develop?
2 hours 2 days 2 weeks
8) Which three techniques can be employed when needling over the rib cage to minimise the risk of pneumothorax?
Choose 3 of the following options.
Tangential to the rib cage Superficial Lift and thrust Vigorous twirling Onto a rib Sensing the flow of Chi in the lung meridian Monitoring the "lung" at the radial pulse
9) What is the most important immediate therapeutic action that should be applied to a patient with a tension pneumothorax?
Wrap them up in a warm blanket Relieve the pressure Give them a shot of brandy Take the brandy yourself Rig up a water-seal chest drain with the brandy bottle, some flexible tubing and a bic pen
10) Which of the following medical conditions is an absolute contraindication to the use of indwelling needles?
Cauliflower ear Hypertrophic obstructive cardiomyopathy Ischaemic heart disease Valvular heart disease Mitral valve prolapse Sub-endocardial infarction
11) What is the risk of using indwelling needles in this condition?
Subacute Bacterial Endocarditis Septicaemia Bacteriaemia Uraemia Insomnia
12) Indwelling needles should be used with caution in debilitated patients. What potentially fatal condition are they more at risk of developing?
SBE Septicaemia Bacteriaemia Uraemia Insomnia
13) The use of which type of needle will minimise the risk of blood borne infection?
Reusable Disposable Indwelling
14) Which acupuncture point can be used in any trimester without risk to the pregnancy, and what is the reason for our confidence in its safety?
CV1 because of its convenient anatomical location CV22 because of its safe anatomical location PC6 because of its frequent use in pregnancy GV20 because it is used for everything
15) In which two areas of the body should electroacupuncture be used with particular caution?
Choose 2 of the following options.
Face Cervical spine Anterior triangle of the neck Thoracic spine Across the chest Lumbar spine Abdomen
16) Which two medical conditions might lead you to avoid the use of electroacupuncture?
Diabetes Narcolepsy Epilepsy Cataplexy Valvular heart disease Dysrhythmias controlled with a demand pacemaker Hypnagogic hallucinations Hypnopompic hallucinations
17) If you choose to treat a patient who is taking warfarin, in which two areas of the leg would you avoid vigorous needling, and why?
Into joint spaces because of the increased risk of haemarthrosis The enclosed fascial compartments of the lower leg because of the risk of compartment syndrome Points near the nail beds because of the risk of subungual haematomas GB30 because of the proximity of the sciatic nerve
18) Bleeding diatheses are not an absolute contraindication to acupuncture, but in which one of the following cases should needling be avoided?
Platelet count of 50 x109/l Spontaneous bruising INR of 3.5
19) Which potentially beneficial side effect of acupuncture should you always discuss with a patient at their first session? Why??
Sedation because of the increased risk of an accident occurring on the way home Bruising on the neck because of possible social embarrassment Euphoria because it may result in an unnecessary spending spree
20) Which position should you instruct your patient to assume for their first acupuncture treatment?
Lying or sitting on an examination couch Sitting in an armchair Kneeling among scatter cushions
21) If you leave a patient alone in a treatment room with needles retained, what should always be left within their reach?
A cotton wool ball An alcohol swab An alcoholic drink A warm blanket Some means of attracting your attention Spare needles in case one falls out
22) Name four visible pathological lesions that should be avoided when needling into or through an area of skin?
Choose 4 of the following options.
Ulcers Tumours Depigmented areas Freckles Varicose veins Areas of superficial infection Areas of hyperhidrosis Tattoos