Responding To Symptoms 2 Flashcards
What is a cough?
A reflex response to airway irritation
Triggered by stimulation of airway cough receptors in the epithelial layer of the pharynx
What can irritate cough receptors in the pharynx?
Irritants
Perceived foreign bodies
Excessive mucus
Conditions that can cause airway distortion
Impulses are transmitted through the cough centre in the brain (medulla oblingata)
Impulses are sent back via efferent neurons to respiratory muscles in the diaphragm, chest wall and abdomen
These contract causing inspiration and expiration of air, causing a cough
What is the epidemiology of a cough?
Cough occurs in 40 it 50% of upper respiratory tract infections
What are the signs and symptoms of a cough:
It is a common symptom associated with colds and flu as well as may other conditions
It can ofter have a sudden onset
Septum/ phlegm should normally be clear and colourless
Usually lasts 7 to 10 days and sometimes can last 2 weeks
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What does acute mean?
Less that 3 weeks
What does sub-acute mean?
3 to 8 weeks
What does chronic mean?
More than 8 weeks
What are the signs and symptoms of a dry cough?
Thickly cough that doesn’t produce any phlegm (non-productive)
Inflammation and irritation in the pharynx caused by microbes are perceived as foreign objects by the brain
What is a chesty cough?
Phlegm/mucous is produced to help clear the airways (productive)
Large amounts of cohesive mucus are produced in the upper respiratory tract as a defence against invading microbes
What is a wheezy cough?
Bronchial congestion associated with chest tightened and wheezing
Can be productive or non-productive
What causes a cough?
Common causes:
Upper respiratory tract infection (cold/flu)
Acute bronchitis
Exacerbations of asthma or chronic obstructive pulmonary disease (COPD)
Pneumonia
Pertussis (whopping cough)
Cigarette smoke
Angiotensin-converting enzyme (ACE) inhibitor
Post nasal drip syndrome
Gastro-oesophageal reflux disease (GORD)
Less common causes of a cough:
Lung cancer
Lung disease
Pulmonary embolism
Heart failure
What are the symptoms that could lead to differential diagnosis of the following:
Upper respiratory tract infection:
Cough with or without sputum, general malaise, fever
Symptoms may affect nose, ears, throat or sinuses
What are the symptoms that could lead to differential diagnosis of the following:
Asthma
Wheeze, breathlessness, chest tightness, symptoms worse at night
What are the symptoms that could lead to differential diagnosis of the following:
Gastro-oesophageal reflux disease (GORD)
Acid from the stomach reflexes into the oesophagus
Causes heartburn and cough which can be worse at night
What are the symptoms that could lead to differential diagnosis of the following:
Acute bronchitis
Breathlessness, wheeze, general malaise
What are the symptoms that could lead to differential diagnosis of the following:
Chronic bronchitis
Long term productive cough that can be associated with shortness of breath. Caused by chronic irritation of the airways i.e. by tobacco smoke
What are the symptoms that could lead to differential diagnosis of the following:
Lung cancer
Blood in sputum, persistent chest/shoulder pain, weight loss, hoarseness
What are the symptoms that could lead to differential diagnosis of the following:
Croup
A viral upper respiratory tract infection in infants and toddlers. Associated with a harsh barking cough
What are the symptoms that could lead to differential diagnosis of the following:
Pneumonia
Breathlessness, sputum, wheeze, corse crackles
What are the symptoms that could lead to differential diagnosis of the following:
Pertussis (whopping cough)
A bacterial infection which affects babies and children, the cough lasts over 14 days
May vomit after coughing
Can leave a child feeling exhausted after coughing so much, characteristic whooping noise
What are the symptoms that could lead to differential diagnosis of the following:
Tuberculosis
Bacterial infection associated with night sweats, loss of appetite, high fever and extreme tiredness
What are the symptoms that could lead to differential diagnosis of the following:
Adverse drug reaction
ACE inhibitors
NSAIDs
Beta-blockers
What patients presenting with a cough should be referred?
More than three weeks
Severe cough or the cough is getting worse
Coughing up blood/ blood stained sputum
Phlegm which is green/yellow/ rusty coloured
Shortness of breath
Breathing difficulties
Chest pain
Unexplained weight loss
Change in voice
Lump/swelling in neck
Night time cough in children = could indicate asthma
What are the treatment options for a cough?
Cough suppressants (antitussives) Opioids and antihistamines
Expectorants
Demulcents
Decongestants
