Chapter 11, Module 5; Cough Flashcards
Acute-onset, low-grade fever, rhinorrhea, cough especially at night
Nasopharyngitis
Nasal mucosa red and swollen, pharynx mildly red; otherwise normal
Nasopharyngitis
Diagnostic test for Nasopharyngitis?
none
Worsening dyspnea, increased wheezing or coughing, smoker
COPD exacerbation
Purulent sputum, fever, and increased respiratory and heart rates
COPD exacerbation
Diagnostic test for COPD exacerbation?
Chest radiograph, spirometry
Persistent hacking cough; can have inspiratory whoop, vomiting
Pertussis
Fever absent, coryza
Pertussis
Diagnostic test for Pertussis?
Nasopharyngealaspirate abnormal, PCR abnormal, chestradiograph to ruleoutpneumonia
Noisy cough, dyspnea, pleuritic chest pain, sputum production (yellow, green, red color), chills; in children also see poor feeding and irritability
Pneumonia
Fever, tachycardia, tachypnea, inspiratory crackles, asynchronous breathing, tactile fremitus, percussion dull or flat over area of consolidation, bronchophony, egophony
Pneumonia
Diagnostic test for Pneumonia?
Chest radiograph, CBC, sputum and nasal cultures, 02 saturation, blood cultures
Cough, nasal congestion, sore throat, fever, chills, myalgias
Viral URI
Fever, pharyngitis, enlarged anterior cervical lymph nodes, normal TMs, nasal mucosa erythema, normal chest examination
Viral URI
Diagnostic test for Viral URI?
None.Rapid influenza testing during outbreaks
Child or young adult: dry cough, headache, malaise, sore throat
Mycoplasma pneumonia
Fever, rales and rhonchi on auscultation
Mycoplasma pneumonia
Diagnostic test for Mycoplasma pneumonia?
Cold agglutinin, chest radiograph
Paroxysmal staccato cough in infant age 4-12 wk
Chlamydial pneumonia
Afebrile, conjunctivitis in 50% of infants, tachypnea of 40-80 breaths/min, crackles, no wheezing
Chlamydial pneumonia
Diagnostic test for Chlamydial pneumonia?
Radiograph shows hyperexpansion of lungs with diffuse interstitial infiltrates
Grunting, sneezing, cough, anoxia, exposure to passive smoke
Bronchiolitis (RSV)
Fever,wheezingonauscultation,prolongedexpiratory phase,tachypnea of 60-80 breaths/min,tachycardia >200beats/min
Bronchiolitis (RSV)
Diagnostic test for Bronchiolitis (RSV)?
WBC 5000-24,000/mm3 with increased PMNs; chest radiograph shows hyperinflation; infants less than 2 mo, refer; progressive respiratory distress, refer
Duration <3 mo, winter months, URI for 3-4 days; loose, hacking cough that becomes productive, afebrile
Acute bronchitis
Coarse, fine crackles on auscultation; low-grade fever or afebrile
Acute bronchitis
Diagnostic test for Acute bronchitis?
Chest radiograph shows normal findings
History of URI; brassy, barking cough usually at night
Croup (acute laryngotracheo- bronchitis)
Low-grade fever, inspiratory stridor, flaring of nares, prolonged expiratory phase, can see retraction of accessory muscles, breath sounds diminished
Croup (acute laryngotracheo- bronchitis)
Diagnostic test for Croup (acute laryngotracheo- bronchitis)?
None
Cough, sore throat
Postnasal drainage
Mucoidsecretions in posterior pharynx, cobblestone appearanceof posteriorpharynx, tenderness to palpationof sinuses, normal chest examination
Postnasal drainage
Diagnostic test for Postnasal drainage?
Sinus radiographs, sinus CT scan, allergy testing
Dry, hacking cough, especially at night, and with feeding and laughter
Asthma
End-expiratory wheeze, prolonged expiratory phase
Asthma
Diagnostic test for Asthma?
Pulmonary function testing, chest x-ray, 02 saturation, bronchoprovocation, allergy testing
Cough worse at night, sour taste in mouth, heartburn, history of esophagitis, cigarette smoker, alcohol abuse, overweight; in children 0-18 mo; failure to thrive, dysphagia, cough after eating and lying down, vomiting
GERD
Normal chest examination, normal upper respiratory tract examination, possible epigastric pain with palpation or normal abdominal examination
GERD
Diagnostic test for GERD?
Esophageal pH monitoring, blood count for anemia, radiograph for aspiration pneumonia; endoscopy if no response to therapy; manometry
Cough, mild dyspnea, history of COPD, history of cigarette smoking, yellow sputum
Chronic bronchitis
Hacking, rasping cough; normal breath sounds or rhonchi that clear with coughing; resonant to dull chest, possible barrel chest, prolonged expiration, possible wheezing
Chronic bronchitis
Diagnostic test for Chronic bronchitis?
Chest radiograph, pulmonary function tests
Begins hours to months after starting ACEI; nonproductive, dry cough; scratching sensation in throat
ACEI-induced cough
Normal examination
ACEI-induced cough
Diagnostic test for ACEI-induced cough?
Trial of ACEI
Cough with hemoptysis; history of cigarette smoking, weight loss, shortness of breath
Bronchogenic carcinoma
Enlarged supraclavicular nodes, dull chest percussion over tumor, increased breath sounds distal to tumor
Bronchogenic carcinoma
Diagnostic test for Bronchogenic carcinoma
Chest radiograph, CT scan of chest
Failure to thrive, chronic cough, bulky stools, family history
Cystic fibrosis
Nasal polyps, clubbing of fingernails, sputum
Cystic fibrosis
Diagnostic test for Cystic fibrosis?
Sweat test abnormal findings
Cough
Foreign body in ear canal
Cerumen in ears, hairs in contact with TM or opposite wall of external auditory canal
Foreign body in ear canal
Diagnostic test for Foreign body in ear canal?
None
History of environmental hazard, choking episode
Foreign body aspiration
Asymmetrical physical findings of decreased breath sounds, wheezing
Foreign body aspiration
Diagnostic test for Foreign body aspiration?
Asymmetrical radiograph with forced expiratory view
History of sneezing, cough
Allergic rhinitis
Allergic shiners, allergic salute, rhinorrhea clear and watery
Allergic rhinitis
Diagnostic test for Allergic rhinitis?
Chest radiograph negative, allergy testing positive
Rhinorrhea >7-10 days
Chronic sinusitis
Mucopurulent rhinorrhea
Chronic sinusitis
Diagnostic test for Chronic sinusitis?
Waters radiograph
School-age child, gradual onset, headache, malaise, sore throat, hacking cough
Mycoplasma pneumonia
Reddened pharynx, slightly enlarged lymph nodes, rales often fine and crackling
Mycoplasma pneumonia
Diagnostic test for Mycoplasma pneumonia?
Radiograph shows interstitial pneumonia; cold agglutinins present, ESR elevated, CBC, 02 saturation, sputum cultures, blood cultures
History of exposure, high-risk group, weakness, malaise, weight loss
Tuberculosis
Brassy cough, weight loss, can have fever, night sweats
Tuberculosis
Diagnostic test for Tuberculosis?
Mantoux test, chest radiograph shows abnormalities in apical and hyaline, sputum culture positive for M. tuberculosis
History of smoking or being around a smoker
Smoking (passive/ active)
Yellow teeth, fingers; odor of smoke, productive sputum
Smoking (passive/ active)
Diagnostic test for Smoking (passive/ active)?
Radiograph can have abnormal findings, with interstitial markings
School age or adolescent; dry, hacking cough present only during waking hours
Psychogenic origin
Physical findings of Psychogenic origin?
none
Diagnostic test for Psychogenic origin?
As indicated to rule out other causes