Cough and Cold Pt2 Flashcards
What is tonsillitis
The tonsils are two lymph nodes on the back of your throat and caused by many viruses and bacteria (inflammation of the tonsils)
tonsillitis symptoms
very sore throat, pain swallowing, bad breath, chills/ fever, scratchy sounding voice
- Easily diagnosed and symptoms usually go away within 7-10 days
What is laryngitis
- Inflammation of vocal cords
- Usually not serious and most cases resolve without treatment in about 7 days
Fifth/ sixth disease
- Skin conditions in kids after cold symptoms
- Only know its this when the rash starts
How do Fifth/ sixth disease appear
- Fifth: blush on face
- Sixth: rash like chicken pox on skin (maculopapular)
What is bronchiolitis
- Deeper then bronchitis
- Determined by an MD
- Most cases are mild but 1-2% lead to hospitalization in a child’s 1st year
What is croup
- Younger kids: croup
- Older kids: laryngitis
- Bark like cough and is very dry
- Mainly a viral cause
- It is upper respiratory (in trachea) rather then lower such as pneumonia
When is croup most common
- Winter and early spring
How is croup treated
- Most cases it will clear up on its own within 5-7 days
- Antibiotics are not used (viral not bacteria)
- Can use humidity to try to add moister back into the respiratory system
- Can use otc pain meds for fever
whooping cough (pertussis)
- Bacterial
- Is making a comeback even with a vaccine
- Cold for 2-3 weeks then 100 day cough
- Whoop sound on inhale
- Coughs so much so that you literally run out of air
- There is vaccinations
Prevention and treatment of pertussis
a) Prevention: vaccination
b) Treatment: early is important as it helps prevent the spread to other people
- Usually treated with antibiotics but arent likely to help if the cough has been longer then 2-3 weeks
Mono
- Present like flu or strep throat but with slower onset
- Sore throat, fatigue, fever, swollen neck glands, no coughing
- Have tried the simple things first and then if they have had a “cold” for around a month then can test
Lyme disease
- Caused from an infected tick bite,
- Risk in sask is low but not 0
a) Early symptoms include: - Fever, chills, muscle and joint pain, swollen lymph nodes
- A rash at site of tick bite
- Expanding rash
- Later symptoms: dizziness, weird heartbeat, mental confusion, nervous system disorders
- Risk in sask is low but not 0
Rhinitis of pregnancy (symptoms and treatment)
- Seems like a cold but lasts months , 1/5 pregnant women have (while the cold is still more common at 4/5)
a) Symptoms: sneezing, congestion, runny nose
b) Natural Treatment: saline irrigation, breathe right strips (don’t work really)
Thought process when differential diagnosis of colds and coughs
- Common cold-> bronchitis/ sinusitis-> influenza-> strep throat
- Play the odds
Rule in/out for bronchitis, flu, and strep
- Flu: body aches, sudden fever, dry cough
- Bronchitis: productive cough
- Strep: more pain in throat, swollen glands, exudate at back of throat, no cough
When to refer for a cold (adult, infant, senior)
a) Typical cold in healthy adults almost never refer
b) Infant with cold always refer
c) Senior and cold almost never ( more worried about the drug we will give them)
When to refer children (<1, 1-2, 3-6)
a) <1: always
b) 1-2: be very cautious
c) 3-6: cautious
When to refer for sinusitis (inflammation of sinuses in the face)
- Consider MD referral as the MD may want to give an antibiotic even if it is viral
a) Acute viral cases: <10 days
b) Acute bacterial cases: >10 days- discolored discharge, severe local pain, fever, double sickening
What is double sickening
- Means if you had a bad cold last weak (chest), got better for a bit and then came back.
- Could be another bronchitis but also could be a relapse of sinusitis (almost impossible to tell)
When to refer for coughing
a) How deep does it seem in the chest? We don’t know how deep it really is
b) Productive or dry: dry and raspy is near the top so not deep
c) How long so far: The key
- Comfort zone for about 2 weeks, if its getting better but same severity then we might refer this patient
- If you get nervous then maybe Referral
When to get worried (referral) with infants, kids, adults
a) Infants: always worry <1 year
- They normally cough about 11 days throughout the day
b) Kids
- 1-3: after 1 week
- 4-6 after 2 weeks
c) Adults
- 1/2 of adults with coughs have post cold inflammation (lasts about 3-8 weeks)
- Resolves on its own
Statements that get us worried
- Not my usual
- Its getting worse
- Also have a fever
- It got better and now its back (double sickening)
On average how long do coughs last
- About 18 days
Patients think it should be over in a week and want a prescription (antibiotic)
Some common causes of chronic cough
- Smokers
- Asthma
- PND
- GERD
ACE inhibitors
