Cough Flashcards
What is a cough?
Cough is a protective response for removing secretions and particulate matter from the airway.
Like fever, it often generates much anxiety in parents but is not a danger per se. It is the cause of cough that must be identified and treated if needed. For these reasons, cough suppressants are not recommended in paediatric practice.
Give differentials for an acute cough
Note: upper airway disease
- Common cold
- Rhinovirus and coronavirus.
- Other infections
- Sinusitis, tonsillitis, laryngitis, croup, viral (influenza and parainfluenza) and bacterial (e.g. GAS)
- Allergic rhinitis and post-nasal drip of secretions
- Especially when supine at night
- Vocal cord dysfunction
Give differentials for an acute cough
Note: lower airway disease
- Asthma
- Infection
- Bronchiolitis
Give differentials for an acute cough
Note: lung parenchymal disease
- Infection
- Viral and bacterial pneumonia and empyema
- Atypical pneumonia
- Mycoplasma pneumoniae infection
How long does a cough have to last for it to be chronic?
A chronic cough is one that has persisted for >8wk.
Give differentials for a chronic cough
Note: long-standing upper airway disease
- Infection
- Chronic sinusitis
- Inflammation
- Persistent GOR
Give differentials for a chronic cough
Note: long-standing lower airway disease
- Congenital abnormalities
- Tetralogy of fallot, cleft larynx and pulmonary artery sling
- Infection
- Post-bronchiolitis symptoms and persistent bacterial bronchitis
- Foreign body
- Bronchiectasis
- Damage to the airway from chronic infection and TB or immunodeficiency
- CF and PCD
Give differentials for a chronic cough
Note: lung parenchymal disease
- Infection
- Atypical pneumonia and empyema
Give differentials for a chronic cough
Note: central causes
- Psychogenic cough
- Tourette disease: with a tic involving throat clearing or cough