Cough

Question 1

What is a cough?

Answer 1

a mechanical reflex that occurs when cough receptors are activated by a stimulus leading to deep inspiration. The glottis then closes and there is a msucle contraction against it, leading to a release of air from the lungs accompanied by a characteristic sound –> helps to clear the airways of secretions and foreign particles

Question 2

What is the difference between acute and chronic coughs?

Answer 2

Acute –> up to 3 weeks

Chronic –> present for more than 8 weeks

Question 3

What is acute cough commonly caused by?

Answer 3

• viral infections –> common cold, bronchitis or bacterial pneumonia

Question 4

What is chronic cough commonly caused by?

Answer 4

• asthma,
• post-nasal drip
• gastro-oesophageal disease
  etc.

Question 5

What is the difference between a dry and a productive cough?

Answer 5

A productive cough is one that is accompanied by sputum.

Question 6

What is sputum?

Answer 6

Material composed of phlegm or mucus that may also contain blood, pus or bacteria.

Question 7

What is important to know about Sputum?

Answer 7

1. colour
2. volume
3. thickness
4. odour
5. blood? pus? etc.

Question 8

What is haemoptysis?

Answer 8

A person coughing up blood, whether it is in sputum or not.

Question 9

What are important cardinal features associated with cough?

Answer 9

• Quality (cough) and then of sputum
• Severity
• Time course
• Context
• R/A Factors
• Associated features

Question 10

What are some considerations for a cough pertaining to Quality?

Answer 10

• barking/hacking/whooping etc.

- dry/productive

Question 11

What are some considerations for a cough pertainig to severity?

Answer 11

• frequency

- effect of ADLs

Question 12

What are some considerations for a cough pertaining to time course?

Answer 12

• onset
• duration
• changes over time

Question 13

What are some considerations for a cough pertaining to context?

Answer 13

• what caused it?

- occupation

Question 14

What are some considerations for a cough pertaining to relieving factors?

Answer 14

• treatments tried and effect

Question 15

What are some considerations for a cough pertaining to aggravating factors/

Answer 15

• occupational?

- worse at night?

Question 16

What are some considerations for a cough pertaining to associated features?

Answer 16

• dyspnoea
• wheeze
• fever
• haemoptysis
• smoking

Question 17

What are some considerations for a cough pertaining to quality of sputum?

Answer 17

COLOUR chronic bronchitis

• yellow/green –> pulmonary infection/bronchiectasis
• red –> haemoptysis
• black –> smoke, coal dust
• frothy/white/pink –> pulmonary oedema

Question 18

What are rigors?

Answer 18

Shakes…different to shivering

Question 19

What are night sweats?

Answer 19

• You wake up in the middle of the night drenched.

- Characteristic of TB, malignancy or perhaps endocarditis

Question 20

What are some causes of haemoptysis?

Answer 20

• bronchitis, inflammation of the bronchi
• lung cancer
• pneumonia
• pulmonary embolism
• TB

Question 21

What is Haemotemesis?

Answer 21

Vommiting up blood

Question 22

How do you differentiate between haemoptysis and haemotemesis?

Answer 22

Prodrome?
Sputum?
Colour of blood? (red and frothy for haemoptysis; darker for haemotemesis)

Question 23

What are some key features of pneumonia?

Answer 23

Rust coloured sputum

Question 24

What are some key features of Whooping cough?

Answer 24

• caused by borditella pertussis
• coughing repeatedly and then vommiting
• whoop on inspiration

Question 25

What are some key features of croup?

Answer 25

- seal bark of a cough - semi-obstruction of the lung due to inflammation of larynx - use of accessory muscles

Question 26

What is the difference between a wheeze and a stridor?

Answer 26

Wheeze --> LRT & expiration | Stridor --> URT & Inspiration