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Year 3 > Cough (oxford clin cases) > Flashcards

Cough (oxford clin cases) Flashcards

1
Q

What is an acute cough?

A

Less than 3 weeks

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2
Q

What is a chronic cough?

A

More than 8 weeks

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3
Q

What character may a cough be if its been resent for more than 3 weeks but less than 8 weeks?

A

An acute cough in the recovery process

A chronic cough that is developing

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4
Q

What trigger does a constant cough indicate?

A

Intrinsic

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5
Q

What trigger does an intermittent cough indicate?

A

Extrinsic

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6
Q

What pathology does a productive cough indicate?

A

Infection or inflammation

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7
Q

What pathology does a productive cough with white or clear sputum indicate?

A

COPD

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8
Q

What pathology does a productive cough with yellow or green sputum indicate?

A

Infection

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9
Q

What pathology does a productive cough with large volumes of sputum indicate?

A

Bronchiecstasis

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10
Q

What pathology does a productive cough with pink and frothy sputum indicate?

A

Pulmonary oedema

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11
Q

What pathology does a productive cough with blood streaked sputum indicate?

A

Infection or bronchiecstasis

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12
Q

What pathology may a cough be if its worse at night?

A

Asthma
Pulmonary oedema
GORD

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13
Q

What pathology may a wheezy cough be?

A

Asthma or COPD

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14
Q

What pathophysiology underlies a wheezy cough?

A

Airway obstruction

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15
Q

What pathophysiology underlies a bovine cough?

A

Vocal chord paralysis

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16
Q

What type of cough is seen in bronchitis?

A

Dry

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17
Q

What type of cough is seen in interstitial lung disease?

A

Dry

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18
Q

What type of cough is seen in bronchiecstasis?

A

Gurgling or wet

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19
Q

What type of cough is seen in pertussis infection?

A

Whooping cough

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20
Q

What drugs are commonly known to cause a cough?

A

ACE inhibitors

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21
Q

What type of contact is required for the transmission of TB?

A

Prolonged close contact eg family members

22
Q

What pathologies cause cough with breathlessness that is worse on exertion?

A

Asthma
COPD
Pneumonia
Pulmonary oedema

23
Q

What type of breathlessness will malignancy cause?

A

Not worse on exertion

24
Q

What pathology can you suspect with a cough presents with pleuritic chest pain?

A 
Pneumothorax
Pulmonary embolism
Pneumonia
Muscle pull (due to aggressive coughing)
Fractured rib
25
Q

What differentials will cause an acute dry cough?

A

Asthma
Upper resp tract infection
Drugs eg ACE inhibitors
Rhinitis/ sinusitis

26
Q

What differentials will cause an acute productive cough?

A

Lower resp tract infection (pneumonia, bronchitis)

COPD

27
Q

What differentials will cause a chronic dry cough?

A 
Asthma
GORD
Smoking 
Lung cancer
COPD
28
Q

What differentials will cause a chronic productive cough?

A

Bronchiectasis
TB
Lung cancer

29
Q

What is a sign of severe COPD?

A

Intercostal recession

30
Q

What are some symptoms and signs of a cough that is due to infection?

A 
Productive cough, usually green/ yellow in colour
Fever
Tachycardia
High resp rate
Sweating
Tremor/shaking
Cervical lymphadenopathy
Reduced chest expansion
Change in vocal resonance
31
Q

What will be seen on FBC if someone has an infection that is specifically bacterial?

A

Neutrophilia

32
Q

What investigation can indicate the severity of pneumonia?

A

Urea level

33
Q

What investigation should be done on patients with a cough when you suspect pathology is infectious and why?

A

Blood cultures- to identify the causative agent so if first line abx don’t work you can give more specific ones

34
Q

Why should you always do an ECG in someone who has a cough?

A

To rule out ischaemia or atrial fib that may be a result of pneumonia

35
Q

What tool is used to assess those with community acquired pneumonia?

A

CURB-65

36
Q

What is CURB-65

A

A tool that is sued to assess those with community accquired pneumonia and decide if they need to be hospitalised

37
Q

What score on CRUB-65 indicates a need for hosiptalisation?

A

2 or above

38
Q

What does CURB-65 stand for?

A 
C= confusion that is new to the patient
U= urea that is high
R= resp rate that is high (over 30/min)
B= blood pressure (low ie under 90 systolic and under 60 diastolic) 
65= age over 65 yrs old
39
Q

Should you do a sputum analysis when someone has pneumonia? Explain

A

Not needed unless you suspect and abnormal causative organism or unless the first line antibiotics don’t work

40
Q

What happens to blood pressure in pneumothorax?

A

It is reduced, ie hypotension

41
Q

Will someone with pneumothorax have a temperature?

A

No

42
Q

What are the causes of a chronic cough in a non smoker?

A

Asthma

GORD

43
Q

What is FEV1:FVC in those with asthma?

A

Less than 0.7

44
Q

What factors in the history of someone with a chronic cough make a diagnosis of asthma less likely?

A 
Productive cough
Other symptoms like dizziness, chest pain
Lack of breathlessness or wheeze 
Presence of a cold
Significant smoking history
Cardiac history
45
Q

How is asthma most commonly diagnosed?

A

FEV1: FVC

Can also do peak exp flow rate

46
Q

What will accompany a cough in suspected GORD?

A

Heartburn

Overweight

47
Q

How does an ACE inhibitor cause a cough?

A

They lead to a build up of bradykinins in the lungs which causes inflammation and leads to a cough

48
Q

How long does a cough from viral pneumonia last? How is it treated

A

It can continue for a long time after the infectious period has subsided, it can be treated initially with antivirals or antibiotics, and then afterwards with cough suppressants/ inhaled corticosteroids/ antihistamines etc

49
Q

What is it important to remember when administering oxygen to patients with COPD?

A

Do not give them 100% oxygen

50
Q

What device is used to administer oxygen to someone with COPD?

A

Venturi mask

51
Q

If someone has a bovine cough and lung cancer, what can you suspect has happened?

A

Recurrent laryngeal nerve palsy- the tumor has compressed or otherwise compromised the RLN

52
Q

What branch of the recurrent laryngeal nerve is most commonly compromised and why?

A

The right branch- it is longer and loops under the aorta so it can be more affected by chest pathology

Year 3 (104 decks)

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