Cough Flashcards
Chronic cough lasts for ____
Acute cough lasts for ____
> 8 weeks
Drug that causes chronic cough
ACE inhibitors
Top 3 causes of cough
Post Nasal Drip
Asthma
Gastroesophogeal reflux
Combo of PND, Asthma +/or GER: 86% of causes of cough
T/F: 1/3 of patients with cough have >1 cause
False: 1/4
Which of the following statements is false?
A. 5-20% of patients started on ACE inhibitors develop cough
B. Most patients with ACE inhibitor related cough have underlying asthma
C. ACE inhibitor related cough often begins within 1-2 weeks of beginning the medication and resolves within 1 week of stopping it
D. Changing to an angiotensin receptor blocker is common way to resolve the problem.
B
___ and ___ levels increase with ACE inhibition.
Bradykinin
Substance P levels
–> both stimulate airway unmyelinated afferent sensory C-fibers –> bronchoconstriction –> activate cough relex
Which of the following statements is false?
A. Post nasal drainage is perceived by the patient at all times
B. Post nasal drainage is the most common cause of chronic cough
C. Treatment with an intranasal steroid inhaler would be appropriate
A. Can still have PND if not perceived by patient
Pharyngeal cobblestoning is characteristic of ___
Chronic posterior nasal drainage
But not specific or sensitive for diagnosis
Pharyngeal cobblestoning caused by ___
Lymphoid hyperplasia
T/F: 24 hour esophageal pH probe study should be performed 1st to diagnosis of GER
False. Too invasive. Perform only if 8 weeks of gastric acid suppression does not work.
T/F: Absence of improvement in cough after 8 weeks of treatment excludes diagnosis of GER as cause of cough
False. Does NOT exclude.
Crackles of lung suggest ____
Interstitial lung disease
Clubbing often seen in ____ (3)
CHF
Interstitial lung disease
Pulmonary fibrosis
Immunodeficiency syndromes present on CXR with (upper/lower) lobe predominace
lower lobe predominance
vs. Cystic fibrosis has upper lobe predominance
