Cough Flashcards
Thin and frothy sputum suggests what?
Left ventricular failure.
Thick, mucoid to yellow sputum can suggest what?
Asthma
Mucopurulent sputum is usually caused by what?
Viral infection and does not require referral.
A cough that is worse in the morning may suggest upper airways cough syndrome, bronchiectasis of what?
Chronic bronchitis
URTI cough can linger for more than 3 weeks and is termed ‘postviral cough’. However, coughs lasting longer than 3 weeks should be viewed with caution.
3 days duration = most likely URTI.
3 weeks duration = acute or chronic bronchitis.
3 months duration = ?
Chronic bronchitis, tuberculosis and carcinoma becomes more likely diagnosis at 3 months duration.
What is the most likely cause of cough in the community setting?
Viral infection
What is a likely cause of cough in the community setting?
Upper airways cough syndrome (formerly known as postnasal drip and includes allergies), acute bronchitis.
Unlikely causes of cough in the community setting?
Croup, chronic bronchitis, asthma, pneumonia, ACE inhibitor induced.
Very unlikely causes of cough in the community setting?
Heart failure Bronchiectasis Tuberculosis Cancer Pneumothorax Lung abscess Nocardiasis GORD
Cough duration of longer than 14 days might indicate what?
Post viral cough, or possibly indicate a bacterial secondary infection, but this is clinically difficult to establish without sputum samples being analysed.
Acute bronchitis aetiology
Common in autumn and winter.
Usually lasts for 7-10 days but up to 3 weeks not uncommon.
Dyspnoea and wheeze sometimes seen.
Laryngotracheobronchitis is also known as
Croup.
Occurs in late evening and night, often follows an UTRI.
Infants aged 3 months and 6 years old.
The cough can be violent and bark like.
Majority of children see symptoms improve within 48 hours. Post this:
Treatment is a steriod firstline, dexamethasome liquid, dexol.
Croup age range
Infants aged 3 months to 6 years old.
Croup symptoms
Late evening and night cough that can be violent and bark like.
Croup duration
Most children see improvement within 48 hours.
Croup treatment
Steriod, oral dexamethasome.
Patients with chronic bronchitis often present with what?
A long-standing history of recurrent acute bronchitis in which episodes become increasingly severe and persist for increasing duration until the cough becomes continual.
Asthma defining symptoms
Coughing, wheeze, chest tightness and SoB.
Worse at night and provoked by triggers.
Symptoms of Community acquired pneumonia
Non-productive cough which is painful (24-48 hours), which quickly becomes productive, with sputum being stained red. Cough tends to be worse at night and patient will be unwell, with a high fever, malaise, headache, breathlessness, and experience pleuritic pain (pain in the sides) that worsens on inspiration.
A cough with pleuritic pain (pain in the sides) on inspiration could be
CAP
A number of medicines may cause bronchoconstriction, which presents as cough or wheeze. What is the most common medicine? What about less common causes?
ACEi. most common.
Also NSAIDs and beta-blockers.
Heart failure is one of the unlikely causes of cough seen in the community. What are often the first symptoms a patient will experience?
SoB, orthopnoea (SoB when lying flat) and dyspnoea at night.
Bronchiectasis is another unlikely cause of cough in the community. What is it characterised?
Patient has a chronic cough of very long duration, which produces copious amounts of mucopurulent sputum (green-yellow in colour) that is usually foul smelling.
Cough tends to be worse in the morning and evening.
Gastro-oesophageal reflux disease (GORD) does not usually present with cough but patients with this condition might cough when?
Lying down
