Cough Flashcards
Site
Where is you cough coming from?
Quality
What type of cough is it? Do you cough anything up? What colour is the sputum? How thick is the sputum? How much sputum is there? Have you noticed any smell associated with the sputum? Is there any blood in the sputum? Could the blood be from the stomach? How much blood? What colour is the blood?
Severity
How often do you cough?
Is it waking you up at night?
Time course
When did the cough start? Did it start suddenly? How long do you normally cough for? Have there been any changes with the cough? Has this ever happened before
Context
What were you doing when you first got the cough?
When does the cough start?
Is it worse when you lie down?
Do you have asthma?
If you suspect infection, have you travelled anywhere recently?
Relieving Factors
Normal
Aggravating Factors
Normal
Associated Features
Normal
Smoking
Normal
Personal med history
Normal
Family history
Normal
Social history
Normal
Occupational history
Normal
What are the associated features that we might expect?
Dyspnoea Wheeze Haemoptysis Ankle swelling Night sweats (TB) Weight loss (TB, cancer) Anaemia (if coughing blood)
Differential diagnosis
Cardiac Failure – oedema, fatigue, past medical and family history, chest pain
Pulmonary Embolus – sudden onset, chest pain radiating to jaw, shoulder, back, recent immobility, history of clotting disorder, syncope
Asthma – Context, past history, allergies
COPD – smoking history
Cancer – smoking history, past and family history, haemoptysis, fever
Respiratory Infection – fever, productive cough, context, travel + duration (TB?), recent cold
Reflux – chest pain, past history, worse with eating
