COUGH/SHORTNESS OF BREATH Flashcards
cough/sob key hx: timing
acute/subacute vs chronic; progression; timing
cough/sob key hx: assoc sxs
sputum presence/description; hemoptysis
constitutional (fever, night sweats, WL, URI, postnasal drip, dyspnea, wheezing, CP, heartburn)
previous episodes
cough/sob key hx: soc hx
smoking hx
cough/sob key hx: med hx
hx of lung dz, posttussive emesis, or heart failure
cough/sob key hx: meds
esp ACEi
cough/sob key PE
VS+-pulse ox
exam nasal mucosa, oropharynx, heart, lungs, LNs, extremities (clubbing, cyanosis, edema)
asthma ddx
GERD
bronchitis
pneumonitis
asthma w/u
CBC
CXR
peak flow measurement
PFTs
COPD – chronic bronchitis ddx
emphysema
bronchiectasis
lung cancer
TB
COPD w/u
CBC sputum gram stain and culture CXR PFTs CT chest quantiferon-TB gold
pneumonia ddx
COPD exacerbation (bronchitis) lung abscess lung cancer TB pericarditis
pneumonia w/u
CBC sputum gram stain and culture CXR CT chest ECG quantiferon-TB gold
atypical pneumonia ddx
asthma
URI-assoc cough (“postinfectious”)
postnasal drip
GERD
atypical pna w/u
CBC induced sputum gram stain and culture CXR IgM detection for Mycoplasma Urine Legionella Ag
lung cancer ddx
TB lung abscess COPD vasculitis (granulomatosis with polyangiitis) interstitial lung dz CHF
lung cancer w/u
CBC sputum gram stain, culture, and cytology CXR CT chest quantiferon-TB gold ANCA bronchoscopy echocardiography
COPD exacerbation ddx
lung cancer
pna
URI
CHF
COPD exacerbation w/u
CBC CXR ABG PFTs sputum gram stain and culture CT chest echocardiography
TB ddx
pna lung abscess vasculitis lymphoma metastatic cancer HIV/AIDS sarcoidosis
TB w/u
CBC PPD/quantiferon-TB gold sputum gram stain, acid fast stain, and culture CXR CT chest bronchoscopy HIV Ab lymph node bx
CHF ddx
cardiac valvular dz GERD pulmonary fibrosis COPD postnasal drip
CHF w/u
CBC CXR ECG echocardiography PFTs BNP CT chest
pulmonary edema ddx
pna CHF mitral valve stenosis arrhythmia asthma
pulmonary edema w/u
CXR ECG CBC ABG PFTs BNP
