Cough

Question 1

Jasmine is a 10-year-old girl who is brought to you by the mother after the teacher complained that her coughing was so bad it disrupted the class. . The coughing is harsh and croaky and is not associated with phlegm production. The coughing also frequently stops Jasmine from participating in fitness classes. She does not cough at night. What is the MOST LIKELY cause of Jasmine’s recurrent coughing?

Question 1Select one:

a.
Psychogenic cough

b.
Post-viral cough

c.
Whooping cough syndrome

d.
Cough variant asthma

Answer 1

Psychogenic cough

Question 2

You are referred an 8 year old Indian girl, Arusha, whose family arrived in New Zealand 2-3 months ago. She has a 3 month history of cough with fever and poor eating. Her mother says this runs in the family as she has a chronic cough too. The previous GP has prescribed a beta-agonist inhaler but this appears to have been of minimal benefit. What is the MOST APPROPRIATE FIRST management step?

Question 2Select one:

a.
Chest radiology

b.
Immnoglobulins

c.
Oral antibiotics

d.
CF gene screen

Answer 2

Chest radiology

Question 3

WHICH ONE of the following is NOT typically caused by abnormal function of the cystic fibrosis gene? :

Question 3Select one:

a.
Meconium ileus

b.
Bronchiectasis

c.
Persistent stridor

d.
Chronic sinusitis

Answer 3

Persistent stridor

Question 4

Melissa, a 2-year-old girl, has had coughing bouts during the day and night for 10 weeks. The coughing bouts usually end in her going red in the face and vomiting, and are often triggered by drinking or eating. She has no wheezing and no family history of chest disease. The coughing is MOST LIKELY to be due to:

Question 4Select one:

a.
Cough-variant asthma

b.
Whooping cough syndrome

c.
Psychogenic cough

d.
Gastro-oesophageal reflux

Answer 4

Whooping cough syndrome

Question 5

You are asked to see a 3 year old boy, John, whose mother reports that he has been coughing at night over most of the winter. It gets worse when he has a cold, and is moist for a week or so, but then becomes a dry cough, which persists until he gets another cold. WHICH ONE of the following is the MOST LIKELY cause of John’s coughing?

Question 5Select one:

a.
Pertussis

b.
Psychogenic

c.
Post-viral

d.
Asthma

Answer 5

Post-viral

Question 6

Bradley is a 4 year-old boy who has a history going back to infancy of coughing that the parents describe as moist or rattly. It gets worse when he gets a cold, but is present first thing in the morning and when he is active on most days. He never brings up any phlegm. There are no paroxysmal features to the cough. He is otherwise well and growing well, but does not quite keep up with his friends in active play because of his cough. He coughs occasionally at night but this is not prominent.

What is the most likely diagnosis?

Question 6Select one:

a.
Post-viral cough in wintertime

b.
Protracted bacterial bronchitis

c.
Whooping cough (pertussis)

d.
Chronic preschool asthma

Answer 6

Protracted bacterial bronchitis

Persistent moist cough