Cough and Hemiptysis ICR Flashcards Preview

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Flashcards in Cough and Hemiptysis ICR Deck (36)
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1

chronic cough

longer than 8 weeks

not an acute infection

2

acute/subacute cough

less than 8 weeks

acute infection or post infectious cause

often self limited

3

paroxysm

sudden "spell"

rapid coughing with increasingly less lung volue

can lead to emesis (vomiting) due to  intensity

4

post-tussive emesis

severe cough that causes vomiting

associtated with pertussis infection

5

PND

post nasal drip

secretions ooze down nasopharynx due to nasal or sinus inflammation from allergies or infection

6

another term for post nasal drip

UACS upper airways cough syndrome

7

GERD

gastric contents can reflux into esophagus and cause cough with or without aspiration into lungs

8

vocal cord erythema may suggest...

GERD

9

eosinophilic bronchitis

eosinophils infiltrate airways and cause cough

can detect in sputum

treat with inhaled steroids

10

how is eosinophilic bronchitis UNLIKE asthma...

no airway hypersensitivity with EB and no abnormal breathing tests

11

medullary cough center

nucleus tractus solitarius

connects afferent impulses to efferent nerves 

12

cough reflex starting in larynx, trachea, bronchi, ear canal, pleura, stomach

vagus nerve --> cough center medulla-->vagus nerve --> larynx and tracheobronchial tree muscles

13

cough reflex starting in nose and paranasal sinus

trigeminal nerve --> medullary cough center --> phrenic/intercostal/lumbar nerves --> diaphragm, intercostal, abdominal, and lumbar muscles

14

cough reflex starting in pharynx

glossopharyngeal nerve --> medullary cough center --> trigeminal, facial, hypoglossal, accessory nerves --> upper airways and accessory muscles

15

cough reflex starting in pericardium, diaphragm

phrenic nerve --> medullary cough center --> trigeminal, facial, hypoglossal, and accessory nerves --> upper airways and accessory muscles 

16

17

in expiration the glottis______

opens

18

equal pressure point theory

pressure is equal inside and outside the airway (high lung volume)--> compression occurs and mucus can be moved

19

irritation of external auditory canal

hurts arnolds nerve - the auricular branch of the vagus nerve

20

what type of drugs can cause cough?

ACE inhibitors

21

treat chronic rhinitis...

nasal steroids and antihistimine-decongestent combo

use first generation antihis. because its more effective than 2nd

22

if patients dont respond to steroids/antihis/decongestant, next?

look for asthma using methacholine challene

23

if it didnt respond to steroids/antihis, and  negative methacholine challenge (isnt asthma, ), thennn?

check for gerd with 24 hr pH probe

treat gerd with proton pump inhibitors (omeprazole or prevacid) at least 8 weeks

24

order of impiric treatment when cough has no appaarent etiology

1) upper airway cough syndrom - treat w nasal steroids and antihistimine/decongestant

2) asthma - using methacholine challenge

3) gerd - proton pump inhibiotors (omeprazole or prevacid)

4) bronchoscopy - --> reevaluate and repeat a previor approach

25

alarm symptoms to check for

hemoptysis

chest pain

short of breath

fevers, night sweats or weightloss

26

what could feversm night sweats, weightloss indicate?

chronic infection (TB) cancer, or chronic inflammatory disease like vasculitis

27

when the xray is normal, a cough is most likely due to

UACs, PND, asthma, or GERD

28

for kids, acute vs chronic times?

less or greater than 2-3 weeks

29

hemoptysis

coughing blood from lower respiratory tract (below vocal cords)

30

hematemesis

vomit blood from GI tract