Lower respiratory tract diseases - CHRONIC COUGH

Question 1

what is chronic cough?

Answer 1

a cough that lasts longer than 8 weeks

Question 2

what are the 2 mechanisms that chronic cough can result from?

Answer 2

1) stimulation of sensory nerves in the epithelium (e.g. by secretions, foreign bodies, cigarette smoke, tumours)
2) sensitisation of cough reflex with abnormal increase in the sensitivity of cough receptors

Question 3

what does it present clinically as?

Answer 3

a persistent tickling sensation in the throat.

Question 4

what is it found in association with

Answer 4

• viral infections
• oesophageal reflux
• postnatal drip
• cough variant asthma
• angiotensin converting enzymes

Question 5

in the absence of chest X-rays, what other investigations could be done?

Answer 5

• ENT examination
• lung function test
• ambulatory oesophageal pH monitoring
• fibreoptic bronchoscopy for inhaled foreign body or tumour
  ECG, echocardiography and exercise testing and impedance for cardiac causes
• hyper-ventillation testing
• psychiatric appraisal