Cough in Child

Question 1

cough phases

Answer 1

1. inspiratory maneuver
2. activity of expiratory muscles against closed glottis
3. explosive release.

Question 2

acute vs chronic cough

Answer 2

acute <3 weeks, resolves within 3-4 weeks

chronic: 3-12weeks, persists for >8 weeks

Question 3

Common Causes of Acute Cough

Answer 3

• Self limiting infection = URTI several x a yr
• Infection * viral #1 culprit
• Infection bacterial

• Infection “atypical” (mycoplasma), “whooping cough”
(pertussis)

• Asthma
– Is the acute cough truly acute or is it actually chronic
or recurrent? – Rarely without wheeze or breathless ness

• Foreign body aspiration

Question 4

most common strain of infection causing acute cough

Answer 4

viral is #1 culprit

Question 5

whooping cough bug

Answer 5

pertussis

Question 6

acute cough key history

Answer 6

Question 7

symptoms of URTI vs LTRI

Answer 7

Question 8

red flags of acute cough key history

Answer 8

fever, respiratory difficulties, looks unwell.

• tachypnea

Question 9

Tachypnea definition based on age

Answer 9

Question 10

Acue cough scheme

Answer 10

Question 11

Bacterial Tracheitis -rare but life threatening, high fever,
progressive upper airway obstruction need prompt
attention to secure airway and IV antibiotics against __ __, __ ___, and ___

Answer 11

S. Aureus, H. Infl B and Strep

Question 12

4 Ds of epiglotitis

Answer 12

drooling dyspnea dysphagia, dysphonia and
can occur

Epiglottis H Infl B (fever sore throat stridor)
preventable by vaccine, treat with IV fluids, antibiotics
(Ceftriaxone), anti inflammatory corticosteroids look for
the 4 D’s: drooling dyspnea dysphagia, dysphonia and
can occur at any age

Question 13

main bug of epiglotitis

Answer 13

Haemophilus influenza

Question 14

treatment of epiglotitis

Answer 14

preventable by vaccine, treat with IV fluids, antibiotics
(Ceftriaxone), anti inflammatory corticosteroids

Question 15

___ ___ with chronic cough is a red flag

Answer 15

poor growth

Question 16

poor growth+ chronic cough history fingins

Answer 16

• Associated GI symptoms, finger clubbing,
polyps, improvement with antibiotics
• Onset as neonate or in infancy
• Unusual infections, improves with antibiotics
• Associated with meals, choking, neurologic
abnormalities
• Weight loss, fever, night sweats, fatigue,
haemoptosis
• Cough worse at night, with exertion, wheeze

Question 17

poor growth flow chat: do a ___ ___ test to rule out CF.

Answer 17

sweat chlroide test

Question 18

Poor growth flow chart: Abnoraml CXRcauses

Answer 18

structural abnormalities, tumor

Question 19

Poor growth flow chart: CXR nonspecific causes

Answer 19

Question 20

Chronic Cough and Normal Growth Key History:

1. Worse at night, with exertion, triggers, no
   response to antibiotics, wheeze–>. ____
2. Nasal congestion/discharge, sneezing,
   worse morning and upon reclining, throat
   clearing– ___ ___ ___, ___ allergies, chronic ___.
3. Unusual sounding cough, “honking”,
   variable, no cough when asleep–> ___ cough
4. Heartburn, waterbrash (variable in
   children) –> _____ ___

Answer 20

1. Worse at night, with exertion, triggers, no
   response to antibiotics, wheeze–>ASTHMA
2. Nasal congestion/discharge, sneezing,
   worse morning and upon reclining, throat
   clearing– POST NASAL DRIP, NASAL allergies, chronic SINUSITIS.
3. Unusual sounding cough, “honking”,
   variable, no cough when asleep–> HABIT cough
4. Heartburn, waterbrash (variable in
   children) –> GASTROESOPHAGEAL REFLUX

Question 21

T/F habit cough happens at night

Answer 21

false. they will not cough when they are asleep