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Foundation Year - RTS > Cough > Flashcards

Cough Flashcards

1
Q

What are the classifications for cough duration?

A

Acute - 3 to 4 weeks
Subacute - 3 to 8 weeks
Chronic - more than 8 weeks

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2
Q

What are the symptoms of an acute viral cough?

A
  1. Sudden onset and fever
  2. Minimal sputum production
  3. Symptoms worse in the evening
  4. Cold sx for 7 to 10 days
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3
Q

What are the symptoms of upper airways cough syndrome?

A
  1. Sinus or nasal discharge that flows behind the nose and into the throat
  2. Chronic cough
  3. Cough caused by allergies - non productive and worse at night with sneezing, nasal discharge/blockage, conjunctivitis and an itchy oral cavity
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4
Q

What are the symptoms of acute bronchitis?

A
  1. Fever
  2. Cough - usually lasts 7 to 10 days but can last up to 3 weeks
  3. Cold sx
  4. Wheeze
  5. Dyspnoea

Will resolve w/o abx but if systemically unwell refer

Mostly seen in AW

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5
Q

What are the symptoms of croup?

A
  1. Severe violent barking cough late at night
  2. Child may be breathless and struggle to breathe between coughing episodes
  3. Sx improve during the day and and recur at night
  4. Most resolve by 48 hours - if persisting more than 48 hours or strider/distress - med int
  5. Sx triggered by recent infection
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6
Q

What would be the treatment for croup?

A
  1. Nebulised budenoside or PO/IM Dexamethasone

Warm moist air not recommended as no evidence

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7
Q

What are the symptoms of COPD?

A
  1. Chronic cough
  2. Sputum production
  3. Breathlessness on exertion
  4. Wheezing
  5. Recurrent chest infections

Exacerbation of increased breathlessness and reduced activities need referred for abx/steroid therapy

Encourage smoking cessation

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8
Q

What are the symptoms of asthma?

A
  1. Cough - non productive and often worse at night
  2. Wheeze
  3. Chest tightness
  4. SOB

Sx are variable, intermittent, often worse at night and provoked by triggers

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9
Q

What are the symptoms of community acquired pneumonia?

A
  1. Cough that is initially non productive that rapidly becomes productive with red staining - worse at night
  2. Fever
  3. Malaise
  4. Headache
  5. Pleuritic pain
  6. Breathlessness

Refer urgently

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10
Q

What are the symptoms of HF?

A
  1. Fatigue
  2. SOB
  3. Orthopnoea - lying down
  4. Dyspnea
  5. Ankle swelling
  6. Productive frothy cough - pink tinge - worse at night
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11
Q

What are the symptoms of bronchiectasis?

A
  1. Chronic cough caused by irreversible dilation of the bronchi
  2. Sputum production
  3. Wheeze
  4. Chest pain
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12
Q

What are the symptoms of Tb?

A
  1. Fever
  2. Weight loss
  3. Night sweats
  4. Anorexia
  5. Malaise
  6. Chronic cough with sputum and haemoptysis

Slow onset

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13
Q

What are the symptoms of lung carcinoma?

A
  1. Cough with blood streaked sputum
  2. Fatigue
  3. SOB
  4. Chest pain
  5. Weight loss and appetite loss

Over 40 with more than 2 of these symptoms

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14
Q

What are the symptoms of a lung abscess?

A
  1. Cough initially non productive but later produces large amounts of purulent foul smelling sputum
  2. Pleuritic pain
  3. Dyspnoea
  4. Malaise
  5. Fever
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15
Q

What are the symptoms of a collapsed lung?

A

Sharp unilateral pleuritic pain and SOB - most common in young men and smokers - immediate onward referral

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16
Q

What specific question should you ask about a cough?

A
  1. Onset of cough - if worse mane could be UACS, bronchiectasis or chronic bronchitis
  2. Duration - if longer than 3 weeks could be bronchitis, 3 months could be chronic bronchitis, carcinoma
  3. Periodicity - recurrent could be chronic bronchitis
    - recurrent in children could be asthma if fhx of eczema, asthma or hay fever
  4. Age - children most likely URTI but could be asthma or croup
    - adults could be bronchitis, pneumonia and carcinoma
  5. Smoking - prone to recurrent cough that could develop into chronic bronchitis or COPD
  6. Sputum colour - rust = pneumonia
    - pink tinged = left ventricular failure
    - dark red = carcinoma
    - bright red = burst blood vessel
  7. Nature of sputum - thin and frothy = left ventricular failure
    - thick mucoid/yellow = asthma
    - foul smelling = bronchiectasis or lung abscess
17
Q

What cases of cough should be referred?

A
  1. Chest pain/ pain in inspiration
  2. Haemoptysis
  3. Wheeze/SOB
  4. > 3 weeks
  5. Recurrent cough
  6. Persistent nocturnal cough in children
18
Q

What would you give for a chesty cough?

A

Products with guaifenasin

19
Q

What is the dose for guaifenesin products?

A

> 12 = 200mg qid
<12 = 100mg qid

20
Q

Does guaifenesin have any drug interactions?

A

NO cautions, drug interactions or side effects and is okay for pregnant and BF

21
Q

What would you give to suppress a cough (dry cough)?

A

Dextromethorphan

22
Q

Does dextromethorphan have any drug interactions?

A

YES - MAOI, SSRI, tramadol (opioid analgesics), alcohol, anxiolytics and hypnotics - increase sedation as dex is an opioid derivative

Care with asthma as can cause response depression but is fine

Preg - avoid in 3rd trimester

BF - short periods okay but can cause poor feeding or drowsiness in baby

23
Q

Does dextromethorphan have any drug interactions?

A

YES - MAOI, SSRI, tramadol (opioid analgesics), alcohol, anxiolytics and hypnotics - increase sedation as dex is an opioid derivative

Care with asthma as can cause response depression but is fine

Preg - avoid in 3rd trimester

BF - short periods okay but can cause poor feeding or drowsiness in baby

24
Q

What if a patient is struggling to sleep?

A

Antihistamine preps

25
Q

Do antihistamine preps have any interactions?

A

YES - same as for dextro - potentiate sedation

Cause dry mouth, urinary retention, constipation, sedation - avoid in glaucoma and BPH

Preg - okay in preg and bf but check lit

26
Q

What should you give to children, at risk pts, preg, older adults or multiple meds?

A

Demulcents - no interactions

27
Q

What should you advise for children under 6?

A

Increase fluid intake and demulcent

28
Q

What advice should you give to an insulin dependant diabetic?

A

Monitor BG more frequently as insulin requirements increase during acute infection

29
Q

What advice should you give to an insulin dependant diabetic?

A

Monitor BG more frequently as insulin requirements increase during acute infection

Foundation Year - RTS (5 decks)

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