Persistent Cough and Wheezing Flashcards
Common causes of chronic cough I don’t think about
Vocal cord dysfunction
Non-asthmatic eosinophilic bronchitis
Causes of wheezing that i don’t think about
CHF Foreign body Persistent bronchitis Vocal cord dysfunction PE Upper Airway Cough Syndrome GERD(?)- Reflux can can bronchoconstriction
Length of time needed to dx acute sinusitis
Symptoms present for 7 to 10 days following URI
Length of time needed to dx chronic sinusitis
Symptoms present > 12 weeks
A nonintuitive comorbid condition of asthma
Stress or depression
How many symptoms for chronic sinusitis
Need at least two - Congestion - Mucopurulent drainage - Facial pain, pressure, or fullness - Decreased sense of smell Also require signs of inflammation with imagines or on exam
Severity of Asthma
Freq of symptoms Freq of awakening at night Freq of inhaler use Ability to do normal activity FEV1 value FEV1/FVC ratio
Cells involved in asthma
Mast cell
T lymphs
Macrophages
Eosinophils
Long term changes with asthma
Airway remodeling
Subepi fibrosis
Decreased responsiveness to treatment
Viral vs Bacterial sinusitis
Viral - Less than 10 days - Symptoms should not worsen Bacterial - Greater than 10 days - Symptoms progress
Dx of asthma by PFT
FEV1 Value improves by > 12%
%Predicted FEV1 improves by 10%
Dx of nonasthmatic eosinophilic bronchitis
PFT and chest x-ray will be normal
Requires sputum eosinophilia
Dx of vocal cord dysfunction
Flat inspiratory loop on PFT
No reversible findings
Dx of COPD
Non-reversible obstruction on PFT
Indications fo CT
Further evaluate findings on X-ray
