Cough Flashcards
Which body systems can result in a cough?
Respiratory ENT Cardiac CNS GI (GERD)
What are the respiratory differentials for a cough
URTI/LRTI/TB Chronic bronchitis COPD/asthma Lung cancer Obstructive sleep apnoea (cough AM) bronchiectasis/ CF Interstitial lung disease Hypersensitivity pneumonitis Foreign body in airway
Provide an example of an ENT cause of cough
sinusitis
Which medication is typically associated with a cough?
ACEi
Name three associated symptoms with a cough
breathlessness, chest pain, dyspepsia, ankle swelling/ paroxysmal nocturnal dyspneoa/ orthopneoa
Which investigations would you carry out if you have a patient with a chronic/persistent cough?
Routine bloods CXR Spirometry Peak flow diary Bronchoscopy Sputum HRCT ECG Echo (if cardiac failure picture, distinguish between cor pulmonare and left sided HF)
Name three causes of an acute cough
PTE, pneumonia, COVID-19, rhinovirus
Name five causes of a chronic cough
lung cancer COPD GORD smoking heart failure ACEi-induced allergic rhinitis
Which questions could you ask to elucidate asthma in a hx?
Do you ever feel wheezy or tight chested?
Does this happen at a particular time of day or night?
Which questions could you ask to elucidate COPD in a hx?
Have you ever smoked?
Do you regularly bring up green or dirty-coloured sputum?
Do you have recurrent chest infections?
Which questions could you ask to elucidate hypersensitivity pneumonitis in a hx?
Do you have exposure to birds at home or at work? Dust? Mouldy hay?
Which questions could you ask to elucidate TB in a hx?
Have you lost weight or had night sweats?
Do you have a fever that comes and goes?
Have you coughed up blood?
Which questions could you ask to elucidate lung cancer in a hx?
have you ever smoked?
have you lost weight, appetite, or experienced night sweats?
How does bronchiectasis appear on CXR?
dilated bronchi with thickened walls
Thin 40 y/o lady with chronic cough for 20 years. She has recurring chest infections and worsening productive cough over 6/52. Smoked 5 cigarettes/day between 15-20. What are your top differentials?
lung cancer lung abscess asthma COPD TB cystic fibrosis bronchiectasis
which tests are available for cystic fibrosis?
genetic testing
sweat tests
immunoreactive trypsinogen test= screening
Name two classical signs on HRCT that you see in bronchiectasis?
tram track and signet sign
Which vitamins are CF patients most likely to be deficient in?
vit A D E and K (fat soluble)
Chest pain + cough. What are you differentials?
ACS, heart failure, PE, exacerbation of COPD, pneumothorax
How to describe pneumothorax on CXR?
air in r/l pleural space with a visceral pleural line where no lung markings can be seen peripheral to this line
