Pediatrics Flash Cards - Case 13 - 6yo chronic cough
ddx chronic cough infant/toddler?
infants are more likely to have anatomic malformations (e.g., congenital vocal cord dysfunction, laryngotracheomalacia, vascular ring, laryngeal web, tracheal stenosis or tracheoesophageal fistula). toddlers: foreign body aspiration,too
def of acute vs chronic cough?
chronic is >4 wks
If cough worsens at night think?
asthma, sinusitis
If cought disappears at night think?
habitual cough
If dry cough think?
environmental irritant, asthma, fungal infection
If barking cough think?
croup, subglottic disease or foreign body
Brassy or honking cough think?
habitual cough, tracheitis
If paroxysmal cough think?
pertussis, Chlamydia, mycoplasma, foreign body
Cough associated w/ gagging or choking think?
gastroesophageal reflux
Most common etiologic agents in atypical pneumonia in school aged child?
influenza, adenovirus, and mycoplasma
Three “cold” presentations that tip the scale towards bacterial sinusitis?
Persistence of bilateral nasal d/c of any quality or daytime cough, or both, lasting > 10 days w/p signif improvement (unilateral = foreign body), OR Worsening after initial improvement (“double-sickening”) OR High fever and purulent nasal d/c > 3 days.
Commonest bugs causing bacterial sinusitis?
S. pneumo, H. flu, and M. catarrhalis (same as AOM). S. aureus: rare cause of sinusitis although often found in complications of acute sinusitis
normal I:E ratio?
normally 1:2 or 1:3
At what point should a kiddo with a cough of unknown origin get a CXR?
at 3 weeks (chronic cough)
Mild persistent asthma sx burden
symptoms occur 3–6 days/week and 3–4 nights/month
