DSA Approach to Cough Flashcards
An acute cough lasts how long?subacute? chronic?
a. less then 3 weeks b. 3-8 weeks c. greater than 8 weeks
Where are cough receptors located? what causes a cough in rhinitis, rhino sinusitis, and pharyngitis
a. larynx, trachea, bronchi b. reflex stimulation from postnasal drainage or throat clearing
What is the most common cause of an acute cough?
viral URI *pneumonia is the third most common cause, but most serious
What viruses are most associated with a cough?
those that produce primarily lower respiratory tract disease (ie, influenza A and B, parainfluenza virus, respiratory syncytial virus) as well as viruses that produce upper respiratory tract symptoms (ie, coronavirus, adenovirus, rhinovirus).
clinicians should limit treatment for suspected pertussis to adult patients with a high probability of pertussis (cough lasting _____ without an apparent cause associated with one of the following symptoms: ____, ____ or ____ or cough ≥2 weeks during a ____, known close contact to a confirmed case of _____
clinicians should limit treatment for suspected pertussis to adult patients with a high probability of pertussis (cough lasting ≥2 weeks without an apparent cause associated with one of the following symptoms: paroxysms of coughing, inspiratory whoop or posttussive emesis or cough ≥2 weeks during a documented outbreak of B. pertussis, known close contact to a confirmed case of pertussis)
What three bacteria are known to cause a cough?
- Bordetella pertussis - Mycoplasma pneumoniae - Chlamydophila pneumoniae
What do you check to rule out pneumonia in someone with an acute cough?
combined absence of abnormalities in vital signs (ie, heart rate ≥100/min, RR ≥28/min, oral temperature ≥37.8°C [100.0°F], or on chest examination (ie, crackles, diminished breath sounds) sufficiently reduces the likelihood of pneumonia to the point where further diagnostic testing is unnecessary.
Treatment of an acute cough includes:
- antitussive agents, - expectorants - mucolytic agents - antihistamines - nasal anticholinergic agents.
What are the main indicators for therapy in an acute cough?
sleep disruption, painful cough, and debilitating cough
What are some AEs of antitussive medications?
confusion, nausea, and constipation, particularly in elderly adults
All chronic cough patients should get what? what must happen before further testing?
a. CXR b. smoking cessation, and discontinuation of ACE inhibitors for 4 weeks
Chronic cough is caused by what in most patients?
more than one condition
What three conditions cause 90% of chronic coughs in nonsmokers with a normal CXR who are not taking an ACE I?
Upper airway cough syndrome, GERD, asthma
What is Upper airway cough syndrome? what are the sx? tx?
a. recurrent cough that occurs when mucus from the nose drains down the oropharynx and triggers cough receptors b.postnasal drainage, frequent throat clearing, nasal discharge, cobblestone appearance of the oropharyngeal mucosa, or mucus dripping down the oropharynx. c. Nonsedating antihistamines + a decongestant
How does GERD cause a cough?
by aspiration, but the most common mechanism is a vagally mediated distal esophageal- tracheobronchial reflex
