T4 - Cough and SOB Flashcards
what is the tussive reflex and what does it cause?
stimulation of sensory nerves in epithelia of pharynx, larynx, trachea and bronchi that stimulate cough centres in the medulla
- causes contraction of respiratory muscles
what are the respiratory muscles that contract due to the tussive reflex?
internal intercostals, rectus abdominis, ext and int obliques and transversus abdominis
what are the key features of cough duration?
- acute <2 weeks
- persistent 2-8 weeks
- chronic >8 weeks
what does i) bright red blood ii) rusty coloured iii) pink and frothy in sputum indicate?
i) pulmonary infarction or local capillary rupture in pharynx
ii) pneumonia
iii) HF or pulmonary oedema
what are four common causes of haemoptysis?
acute infection, bronchial carcinoma, TB or a pulmonary infarct
what are three occasional causes of haemoptysis?
trauma, vascular abnormalities, bleeding disorders
what are three rare causes of haemoptysis?
lupus, aspergillosis, autoimmune diseases
what are four symptoms of rhinosinusitis?
cough, tickle, nasal congestion, hoarseness
how is rhinosinusitis treated?
with anti-histamines, intranasal corticosteroids or decongestants
what is the most common cause of chronic cough in childhood?
asthma
what is the atopic triad?
eczema, allergies and asthma
what mutation can cause COPD in non smokers?
alpha anti trypsin deficiency
what is bronchiectasis and what causes it?
caused by scarring from previous infections or secondary to other conditions such as CF
- dilation of smaller airways which makes space for mucus pooling and infection
what organism may colonise in bronchiectasis?
pseudomonas
what two cancers are associated with cough?
bronchogenic carcinoma and small cell lung cancer
how is GORD characterised and what is it triggered by?
cough with no respiratory symptoms
- triggered by cough receptors in the oesophagus
what two drugs cause cough (iatrogenic)
ACE inhibitors and beta blockers
is ACE cough dose related?
no
when does an ACE cough typically start?
a few months after taking them
what three things can shortness of breath be associated with?
sputum, cough, chest pain
what is a sudden cause of SOB?
inhaled foreign body, pneumothorax, PE
what may cause SOB over hours?
asthma, HF, pneumonia, diabetic ketoacidosis
what may cause SOB over days?
pneumonia and HF
what may cause SOB over weeks?
pleural effusion and anaemia
