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DDX > Cough > Flashcards

Cough Flashcards

1
Q

What 4 CN requires are required for the cough reflex arc?

A

1) Glossopharyngeal nerve
2) Phrenic Nerve
3) Trigeminal nerve
4) Vagus Nerve

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2
Q

What aspect of the cough reflex arc is the glossopharyngeal nerve responsible for? (1)

A

Pharynx

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3
Q

What aspect of the cough reflex arc is the phrenic nerve responsible for? (2)

A

Pericardium and diaphragm

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4
Q

What aspect of the cough reflex arc is the trigeminal nerve responsible for? (2)

A

Nose and sinuses

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5
Q

What aspect of the cough reflex arc is the Vagus nerve responsible for? (8)

A

1) Ear canals
2) Tympanic membrane
3) Larynx
4) Trachea
5) Bronchi
6) Pleura
7) Esophagus
8) Stomach

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6
Q

Do most patients with a common infectious cough require chest radiographs?

A

No

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7
Q

When do you do a chest radiograph for a cough?

A

Those who have ongoing conditions that put them at a higher risk of developing pneumonia.

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8
Q

Which individuals are more at a risk for developing pneumonia? (7)

A

1) Chronic obstructive pulmonary disease
2) Chronic heart failure
3) Uremia
4) Alcoholic
5) Malnourished
6) Immunosuppressed (Rx prednisone)
7) Elderly

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9
Q

What are some classic signs and symptoms of pneumonia? (8)

A

1) Fever
2) Rigors
3) Pleuritic chest pain
4) Rusty/bloody or colored sputum
5) Tachycardia
6) Tachypnea
7) Consolidation
8) Focal crackles

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10
Q

What is a noninfectious cough?

A

No history of fever or upper respiratory tract infection symptoms

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11
Q

What are some examples of common noninfectious coughs? (3)

A
  • Asthma
  • Aspiration
  • Bronchial irritants
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12
Q

What are some noninfectious coughs that have very sudden onsets of cough? (3)

A
  • Pneumothorax
  • Esophageal rupture
  • Aortic dissection
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13
Q

What are some common causes of a upper respiratory tract related cough? (6)

A

1) Rhinitis
2) Sinusitis
3) Nasal polyps
4) Pharyngitis
5) Tracheolaryngitis
6) Tonsillar hypertrophy

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14
Q

What are some common causes of a lower respiratory tract related cough? (9)

A

1) Bronchitis
2) Asthma
3) Obstructive lung disease
4) Bronchiectasis
5) Pneumonia
6) Tuberculosis
7) Lung cancer
8) Pneumothroax
9) Bronchial irritants

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15
Q

What are some uncommon causes of cough in the upper respiratory tract? (3)

A
  • External otitis
  • Hair or cerumen in ear canal
  • Uvular enlargement
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16
Q

What are some uncommon causes of cough in the lower respiratory tract? (4)

A
  • Aspiration
  • Tracheobronchial foreign body
  • Pulmonary embolism
  • Lung contusion
17
Q

What are some other uncommon causes of cough?(7)

A

1) Subphrenic abscess
2) Ruptured spleen
3) Aortic aneurysm
4) Reflux esophagitis
5) Angina pectoris
6) Psychogenic
7) Cervical spine osteophytosis (phrenic nerve stimulated)

18
Q

What are the signs and symptoms of bacterial pneumonia? (7)

A
  • Usually antecedent upper respiratory tract infection
  • Sudden worsening
  • Shaking chills
  • Pleuritic chest pain
  • Tachycardia/tachypnea
  • Purulent sputum
  • Consolidation on auscultation
19
Q

What is found in the sputum of bacterial pneumonia?

A

• PMNs and predominant organism

20
Q

What is found on the chest radiograph of a bacterial pneumonia?

A

• Lobar/segmental consolidation; may be patchy

21
Q

What is the WBC count for bacterial pneumonia?

A

• 15-25 X 103 with shift to the left

22
Q

What are the common causes of bacterial pneumonia?

A
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Legionella pneumophila
23
Q

What are the signs and symptoms of nonbacterial pneumonia? (6)

A

1) Initial headache, malaise, upper respiratory infection symptoms
2) Gradual worsening, or worsening after initial improvement
3) Uncommon to have rigors
4) Uncommon to have pleuritic chest pain
5) Sputum scant, mucoid or absent
6) Auscultation reveals localized crackles without consolidation

24
Q

What is found in the sputum of nonbacterial pneumonia?

A

• Variable PMNs or mononuclears; no predominant organism

25
Q

What is found on the chest radiograph of a nonbacterial pneumonia?

A

• Unilateral or bilateral interstitial, patchy infiltrates

26
Q

What is the WBC count for nonbacterial pneumonia?

A

Usually Normal

27
Q

What are the common causes of nonbacterial pneumonia?

A

• Mycoplasma pneumoniae
-Cold agglutinins present in 40-60% of patients
• Influenza

28
Q

What are the causes of chronic cough? (7)

A

1) Asthma
2) Post-infectious
3) Postnasal drip
4) Esophageal disorder
5) Psychogenic
6) Cardiogenic
7) Carcinoma

29
Q

What are the causes of hemoptysis? (9)

A

1) Bronchitis
2) Pneumonia
3) Trauma
4) Bleeding gums
5) Epistaxis
6) Lung cancer
7) Pulmonary embolism
8) Bronchiectasis
9) Tuberculosis

DDX (4 decks)

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