Cough Flashcards
What information you want to know about a patient’s cough?
Acute (8 weeks)?
Constant or intermittent?
Productive or dry? (Blood?)
Timing?
Character? (wheeze/bovine/gurgling)
What associated factors would you ask about in a patient with a cough?
Fever, night sweats, weight loss
Breathlessness
Chest pain, particular pleuritic
Wheeze
What are the three most common cause of a chronic cough in a non-smoker
Asthma, post-nasal drip and GORD
Miss Wilson is a 33-year-old nurse who has been referred to the respiratory clinic by her GP with a
3-month history of a dry cough. The GP’s letter notes that she has never smoked and has no previous history of respiratory illness, reflux, or any allergies, but has a high body mass index (BMI). You take a history in which Miss Wilson confirms all of this. She adds that her cough got worse in the spring, but can think of no other exacerbating factors. She says that sometimes she wakes up at night coughing. She has not had a fever, night sweats, or rigors. She has had no chest pain. She does not have a wheeze, is no more breathless than usual on exertion, and is not breathless at rest.
Asthma, post nasal drip or GORD
Mr Hughes is a 48-year-old office worker who comes to his GP complaining of a chronic dry cough. He
has had it for the last few months and thought it was a cold, but has come in as it hasn’t resolved and
is annoying his work colleagues and wife. His coughing spells occur throughout the day and night, with no predictable triggers. On questioning, he comments that he often has heartburn and wakes up with a sore throat.
He is a non-smoker, drinks about 15 pints of lager a week, and has a high body mass index. His past
medical history includes an inguinal hernia repair and childhood asthma, although he has not had to
use an inhaler since he was a teenager. He also suffers from hayfever in the summer but has no other allergies. He has no new pets or other recent changes to his environment (new job or house). He does not have a history of diagnosed GORD despite his heartburn. His only recent travel was to Spain, and he
has had no fevers, night sweats, rigors, or weight loss. His examination is unremarkable and spirometry is normal
GORD
Which lung cancer is most likely if found in the hilium?
Squamous cell carcinoma
