4.Chronic Cough Flashcards
What are some physical exam findings that may help id why you have a chronic cough?
Nasal or ocular discharge
Tracheal massage elicits one
Auscultation over larynx and trachea
Thoracic Auscultation
What may you hear that indicates airway issue?
Stridor, stertor, wheeze, crackle/rale, decreased or abscent lung sound
What can crackles or rales indicate?
Air bubble through fluid
Rapid opening of stiff airway
Where are cough receptors located?
Upper to bronchioles
Larynx, tracheal bifurcation and main bronchi
What are the main anatomical categories to consider a chronic cough?
Airway
Pulmonary parenchyma
Pleural Space
What are differentials for airway?
Post nasal drip
laryngeal paralysis
trahceal collapse
airway FB
Chronic Bronchitis
Broncopneumonia
Neoplasia
Parasite
Eosinophilic bronchopenumopathy
Bronchomalacia
Bronchiectasis
Cronchial compression (heart)
What are differentials for pulmonary parenchymal?
Viral
Bacterial
Protozoa
Fungal
Parasitic
Aspiration
Idiopathic
Pulmonary neoplasia
Pulmonary contusion
Pulmonary thromboembolism
Pulmonary edema
What are some differential for pleural space?
Pleural effusion
Pleural space mass
What does a productive cough indicate?
Material and swallow
Lower airway
How do you rule out nasal disease?
No signs of discharge or sneezing or deformity
How do you rule out pleural space?
No tachypnea
No muffled sounds
How do you rule out laryngeal disease?
No noise like stridor
What is a sign of tracheal disease?
Hoking, goose honk, harsh cough
Panting
Exercise intolerance
Cyanosis
What diagnostics can help distinguish lower air and pulmonary parenchyma?
CBC, Chem, 4Dx, Thoracic rad
What are some differentials for Bronchial disease?
Chronic bronchitis
Eosinophilic bronchopenupathy
parasitic
bronchopneumonia
What are the 3 diagnostic criteria of chronic bronchitis?
- Chronic cough
- Evidence excessive mucus
- Exclusion of other chronic cardiopulmonary disease
Middle to older, small dog
Persistent cough. retch
What is eosinophilic bronchoprumopathy?
Eosinophil in bronchial mucosa
Young dog
Siberian huskie and malamute
cough, gag, retch
What are some parasites of the airway?
Crenosoma vulpis
Oslerus osleri
Euoleus aerophilsu
What is brinchopneumonia?
Bacteria, secondary
Mixed flora
Cough, anorexia, lethargy,fever, inspiratory crackle, tachypnea
What are some diagnostic for lower airway?
Fecal - baerman or zinc sulfate
bronchoalveolar lavage, endotracheal wash
How do you treat chronic bronchitis?
Steroid, cough suppressant
