Chronic Cough

Question 1

Function of cough

Answer 1

Protect body by expelling particles, pathogens, foreign bodies, excretions, etc.

Question 2

Function of cough

Answer 2

Protect body by expelling particles, pathogens, foreign bodies, excretions, etc.

Question 3

Physiology of Cough

Answer 3

Afferent signaling through vagus nerves via mechanical rapid or slow stretch receptors or noxious C-fibers.
Efferent signalling produces inspiratory, compressive, expiratory, and relaxation phases

Question 4

Acute, Subacute, and Chronic Cough Durations

Question 5

Causes of Chronic Cough (5)

Answer 5

Upper Airway Cough Syndrome: PND stimulation of cough Rs
Asthma: can be cough-only
GERD: stimulation of cough Rs
Non-asthmatic eosinophilic bronchitis: asthma w/o variable hyper-responsiveness
Neuropathic: low level stimuli cause cough

Question 6

Causes of Chronic Cough (5)

Answer 6

Upper Airway Cough Syndrome: PND stimulation of cough Rs
Asthma: can be cough-only
GERD: stimulation of cough Rs
Non-asthmatic eosinophilic bronchitis: asthma w/o variable hyper-responsiveness
Neuropathic: low level stimuli cause cough

Question 7

Physiology of Cough

Answer 7

Afferent signaling through vagus nerves via mechanical rapid or slow stretch receptors or noxious C-fibers.
Efferent signalling produces inspiratory, compressive, expiratory, and relaxation phases

Question 8

Acute, Subacute, and Chronic Cough Durations

Question 9

Causes of Acute Cough (4)

Answer 9

URI: usually viral
LRI/Acute Bronchitis: usually viral but must exclude PNA
Condition Exacerbation: COPD, asthma, etc.
Environmental: allergens, irritants

Question 10

Causes of Chronic Cough (5)

Answer 10

Upper Airway Cough Syndrome: PND stimulation of cough Rs
Asthma: can be cough-only
GERD: stimulation of cough Rs
Non-asthmatic eosinophilic bronchitis: asthma w/o variable hyper-responsiveness
Neuropathic: low level stimuli cause cough

Question 11

Upper Airway Cough Syndrome: Clinical and treatment

Answer 11

Chronic tickle in throat likely form PND
Cobblstoning and mucus on oropharynx exam
Treat w/ 1st generation anti-histamine and ICS for 2 weeks

Question 12

Asthma: clinical and treatment

Answer 12

Classic asthma symptoms
Maybe wheezing on exam
Treat w/ ICD and LABA for 8 weeks

Question 13

GERD: clinical and treatment

Answer 13

Symptoms of cough w/w/o phlegm, sometimes GI

Treat w/ PPI 2 months

Question 14

NAEB: clinical and treatment

Answer 14

Cough w/o wheezing or dyspnea

Treat with ICS for 4 weeks

Question 15

Cough in Children

Answer 15

Most common acute is viral URI.
Chronic is 4+ weeks, can be asthma, sinusitis, GERD.
Evaluated foreign body and CF