Intro and cough

Question 1

3 timeframes of cough

Answer 1

acute 8wks

Question 2

2 function of cough

Answer 2

1. clear mucous

2. protect airway from inhalation

Question 3

what is pathway of cough

Answer 3

cough receptors>vagus>cough center (medulla)>vagus,phrenic, spinal motor> to cause caugh

Question 4

3 phases of breathing

Answer 4

1. inspiratory
2. compressive
3. expulsive

Question 5

3 causes of 90% of cough

Answer 5

1. upper airway syndrome
2. asthma
3. GERD

Question 6

mech of upper airway syndrome

Answer 6

nasal drips into the back hit the cough receptors

- allergic rhinitis, sinustits, vasomotor

Question 7

Tx of upper airway

Answer 7

1. antihistamines - not long term

2. nasal steroids or ipatropium bromide (vasomotor rhinitis)

Question 8

diagnosis of asthma

Answer 8

• family Hx of atopy or asthma

- need spriometry

Question 9

mech of GERD

Answer 9

regurg hits the cough receptors in the stomach

Question 10

diagnosis of GERD (2)

Answer 10

1. 24hr monitoring - not used

2. treat with PPI and see if it gets better

Question 11

7 other causes of cough

Answer 11

1. infection
2. ACEi
3. chronic bronchitis
4. bonchiectasis
5. CA
6. interstitial lung disease
7. recurrent aspiration

Question 12

what is mech in resp infection

Answer 12

• mostly viral

- can lead to sectretions dripping back

Question 13

Tx of RTI

Answer 13

may help to give ipatropium bromide

- not ABs

Question 14

2 bacterial infections to worry about

Answer 14

1. bortadella pertussis

2. TB

Question 15

what is pertusus

Answer 15

• whooping cough
• inspriatory stridor with cough
• can last months

Question 16

Dx of pertusis

Answer 16

• nasopharyngeal swab

- highest sens. within first few weeks - often too late

Question 17

Tx of pertussis

Answer 17

• only within first few weeks

- macrolide AB

Question 18

mech of ACE cough

Answer 18

block breakdown of bradykinin - stimulate cough receptors

Question 19

what is risk and Dx of chronic bronchitis

Answer 19

• smokers

- PFT

Question 20

what is mech of bronchiectasis

Answer 20

inflammation>small airway damage> airway dilatation and scarring> chronic recurrent infections

Question 21

6 general causes of bronchiectasis

Answer 21

1. post-infectious
2. primary immune
3. CF
4. alpha-1 anti-trypsis def.
5. inflammatory disorders (autoimmune)
6. airway obstuctions

Question 22

what is on imaging of bronchiectasis

Answer 22

dilated thinkened airways

Question 23

Tx of bronciectasis

Answer 23

treat with ABs to prevent worsening

- can do surgery if the area is small

Question 24

what is cough from intestitial lung disease

Answer 24

persistent and non-productive

Question 25

what is recurrent aspiration

Answer 25

• may be diff. swallowing

- ask if related to eating or drinking

Question 26

3 red flags

Answer 26

1. hemoptysis
2. weight loss
3. abnormal CXR