Important topic
What is Cough?
Actually is a defense mechanism against foreign particles and also allows clearance of secretions.
It occurs in 3 phases
1- Deep inspiration
2- Glottis closure for build up of intrathoracic pressure
3- Opening of the glottis with rapid release of pressure
There is more basic stuff about cough,but we are true step1
, if anyone will like to add more to the physiological part be my guest
Now the guy goes and says Doc I have a cough
.
Now what do you do?
You could ask
1-Onset and time of the cough= to determine if is acute or chronic
2-If the patient smokes= is an irritant and also to check for COPD
3-If there is sputum production, if YES then ask
4-what color is it or if there is any blood.
5-Other sign and symptoms like fever, weight loss= you can start thinking about TB, Pneumonia, Cancer, etc.
6- Are there any environmental exposures? dust fumes, animal dander,etc.
Now the differential DX
you can divide it the way I do it
1
- Upper respiratory Infection
-pharyngitis
-Sinusitis
2-
Lower respiratory Infection
-Pneumonia
-bronchitis
3-
Drugs
- ACE Inhibitors
4-
Chronic Inflammatory states
- Asthma
-GERD
-Sarcoidosis= I do not know how for this one
-Chronic Aspiration
5-
Mechanical Irritation= like someone putting something there to stimulate cough.
-Tumor
-Aortic aneurysm
-Pulmonary Edema
-Cerume
The physical examination will be actually trying to rule out this 5 possibles Differential DX.
The TX is to go to the origin of the problem, do not just give antitussive medication if the patient has CF or Chronic Bronchitis you are doing worst to the patient.
So do what I do, if you are in the floor and wants to sleep, give the antitussive so the patient can sleep and also lets you sleep
This last part was a joke
If anyone want to give their 2 cents, correct anything please do, so we all learn from this.
I LOVE YOU TO
IMG SURVIVOR