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Year 3 - Medicine and Surgery book > Cough > Flashcards

Flashcards in Cough Deck (20)
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1
Q

What questions about the cough itself should be asked (PC)

A
  1. Acute (<3 weeks) or chronic (>8 weeks). Between this could be due to recovering acute illness or developing chronic illness.
  2. Constant or intermittent? - intermittent cough = extrinsic trigger e.g. allergy. Constant cough = intrinsic cause
  3. Productive or dry? - sputum = inflammation/infection. COPD patients may produce white or clear sputum. Infection = green/yellow sputum.
  4. Blood present? - blood streaked sputum = infection/bronchiectasis. Pink/frothy sputum = pulmonary oedema. Frank blood = TB/lung cancer/pulmonary embolus/bronchiectasis, etc.
  5. Timing - asthma worse at night/early morning. Pulmonary oedema + GORD worse at night.
  6. Character - wheezy cough = airway obstruction due to asthma/COPD. Breathy/bovine cough = vocal cord paralysis. Dry cough = bronchitis/ILD. Gurgling/wet cough = bronchiectasis.
2
Q

What infection causes a whooping cough

A

Pertussis

3
Q

What class of drugs can cause a cough

A

ACEi

4
Q

Why is it very important to ask about travel?

A

May have travelled to area where TB is prevalent

5
Q

3 major ddx of acute dry cough

A

Asthma
Rhinitis/sinusitis with postnasal drip
URTI
(Drug induced)

6
Q

3 major ddx of acute productive cough

A

LRTI
COPD
TB

7
Q

3 major ddx of chronic dry cough

A

Asthma
GORD
Post nasal drip

8
Q

3 major ddx of chronic productive cough

A

Bronchiectasis
TB
Lung cancer

9
Q

Cervical lymphadenopathy in patients with cough suggests infection where

A

URTI

10
Q

How are breath sounds affected in:
Effusion
Pneumonia

A

Breath sounds in effusion = reduced

Breath sounds in pneumonia = bronchial

11
Q

Asterixis is a sign of what in relation to CO2?

A

Increased levels of CO2

12
Q

What blood tests would you do in a patient with cough

A

ABG
FBC - raised WCC in infection, neutrophilia if bacterial
CRP
U&Es - urea indicator of pneumonia severity
Blood cultures - if infection should do a blood test before administering Abx

13
Q

In terms of imaging, CXR and ECG is done. Why ECG?

A

Rule out ischaemia or AF secondary to pneumonia. May see right heart strain in COPD patients

14
Q

What is the CURB-65 score

A

Used to calculate severity of pneumonia and determine need for hospitalisation

Confusion
Urea
Respiratory rate > 30/min
BP 
>65
15
Q

What are the 3 most common causes of chronic cough in a non smoker

A

Asthma
Postnasal drip
GORD

16
Q

Postnasal drip is largely a diagnosis of exclusion. If inhalers don’t work, what might you want to try

A

Antihistamines and or nasal decongestants

17
Q

High BMI and heartburn point to what cause of cough

A

GORD

18
Q

On a CXR, hilar location of consolidation may indicate what type of lung cancer

A

Squamous cell carcinoma

19
Q

What type of pneumonia can have a persistent post infectious cough?

A

Viral pneumonia

Treat with antitussives / inhaled corticosteroids / inhaled ipratropium bromide

20
Q

If someone has blood-streaked sputum and have visited a TB rife country, the likely diagnosis is pulmonary TB. What is the management of this

A

Isolate them in a negative pressure side room until deemed non-infective