Cough

Question 1

What are 6 categories of chronic cough (>6 months) causes?

Answer 1

Asthma
COPD
Rhinosinusitis
GORD
Laryngeal hypersensitivity
Other

Question 2

Key features of chronic cough in ASTHMA

Answer 2

Worse at night/early morning
Chestiness as child
Personal/family history of atopy
Relief by salbutamol

Question 3

Key features of chronic cough in COPD

Answer 3

Longstanding smoking
Chronic bronchitis (productive cough for at least 3 months, 2 years in a row)

Question 4

Key features of chronic cough in RHINOSINUSITIS

Answer 4

Tickly, irritating
Post-nasal drip
History of sinusitis (frontal headache, nasal discharge)
History of recurrent rhinitis (nasal discharge & blockage)

Question 5

Key features of chronic cough in GORD

Answer 5

Tickly, irritating
Acid reflux symptoms
Responds to PPI

Question 6

Key features of chronic cough in LARYNGEAL HYPERSENSITIVITY

Answer 6

Tickly, irritating
Voice disturbance
Cough precipitated by talking
No nocturnal symptoms
Vigorous cough
Unresponsive to medication

Question 7

What are OTHER causes of chronic cough?

Answer 7

‘Other’ includes lung cancer, bronchiectasis, interstitial lung disease, eosinophilic bronchitis

Question 8

Likely cause of a cough present

Answer 8

URTI (esp. caused by rhinovirus)

Question 9

Likely cause of a cough present for 3 weeks - 3 months

Answer 9

Likely to have non-self-limiting cause, e.g.

• Lung cancer
• Asthma
• COPD
• Rhinosinusitis
• GORD
• Laryngeal hypersensitivity
• Other

Question 10

What is commonly associated with a TICKLY, IRRITATING cough?

Answer 10

URTI’s
Rhinosinusitis
GORD
Laryngeal dysfunction syndrome