Chronic Cough Conditions Flashcards
Physical complications of cough
CV: HPOTN, arrhythmias, syncope GI: reflux, anorexia GU: urinary incontinence M/S Neuro Psychosocial Skin
Dx tests
PFT
CXR only shows certain things: masses, perynchemal abnr - sarcoidosis, fibrosis, CHF, emphysema
Bronchoscopy - if CXR/CT normal/nonlocalizing, Bronch found to not be helpful
Sleep studies
CT
Causes of chronic cough
Upper Airway Cough Synd (UACS) - aka postnasal drip synd
Asthma
GERD
Often multiple causes
Tx
Start tx for 3 major causes of chronic cough
If multple causes, use multiple tx’s simultaneously
Upper Airway Cough Syndrome
Most common cause of chronic cough in nonsmoking, immunocompetent adults c nrml CXR
May have posterior pharynx drainage, throat clearing, nasal discharge, cobblestone appearance of oropharyngeal mucosa, or mucus in oropharynx
None of these sx’s are specific to UACS
Chronic cough DD
Allergic fungal rhinitis Allergic rhinitis Bacterial sinusitis Occupational rhinitis Postinfectious Rhinitis Rhinitis coused by anatomic abnormalities Rhinitis caused by chemical or physical irritants Rhinitis medicamentosis Rhinitis of pregnancy
Plan
Tx - trial of empirical tx
Further tests
F/U
Referral
Classification of cough
Acute < 3wks
Subacute 3-8wks
Chronic >8wks
Postinfectious Cough Workup
Cough that has been present following S&S of acute URI
Judge factors most likely causing cough before considering tx
Possible Factors: Postviral airway inflammation Bronchial hyperresponsiveness Mucus hypersecretion Impaired mucociliary clearance UACS Asthma GERD
Non-postinfectios Subacute Cough Workup
Same as for chronic cough
Most common causes of chronic cough in kids
Asthma
Resp. tract infections
GERD
chronic cough in kids >4wks
Ped Chronic Cough DD
Recurrent viral bronchitis Postinfectious cough Pertussis-like illness cough-variant asthma UACS Psychogenic cough GERD Foreign body aspiration Congenital conditions/abnormalities
