Chronic Cough Flashcards
When do we say someone has chronic cough?
Greater than 8 weeks
Top 6 causes of chronic cough?
Upper airway cough syndrome, asthma, GERD, bronchiectasis, ace inhibitors, chronic bronchitis because of smoking
What should all chronic cough patients undergo and what two things are advised?
Chest X-ray.
Stop smoking and stop ace inhibitors for additional work up.
What 3 conditions account for 90% of chronic cough in patients who don’t smoke, CXR normal, and are not taking an ace?
Asthma, UACS, and GERD
Explain what UACS is?
Mucus from the nose drains into the throat and sets off cough receptors
When is the diagnosis of UACS confirmed?
When drug therapy takes our the discharge an mucus.
4 associated symptoms with UACS?
Nasal drainage, postnasal drainage, throat clearing, cobblestone appearance.
What should be initial treatment of chronic cough when the cause is unknown?
Nonsedatin antihsitamine-decongestant combo
What 1 thing suggests cough variant asthma and what 1 thing confirms it?
Airway hyperresponsiveness
Cough resolves with asthma meds
What is the best test to see if a chronic cough is because of GERD?
24 hour esophageal pH monitoring with with PPI trial first
What are we thinking if patient has normal CXR, normal spirometry, and negative methacholine test?
NAEB
What is the hallmark symptom of Chronic Bronchitis?
Productive cough
What are the two hallmarks of bronchiectasis?
Chronic cough and tons of sputum production. Much more than chronic bronchitis.
What are the two most common causes of coughing up blood?
Infection and malignancy
All patients with hemoptysis should undergo what?
CXR
