Cough

Front 1

acute cough

Back 1

1. < 3 weeks
2. non-productive/small amount of clear or white sputum
3. often worse in the evening

Hint 1

refer if cough lasts longer than 3 weeks

Front 2

subacute cough (usually post infectious cough)

Back 2

1. 3 - 8 weeks
2. persistent non-productive cough

Hint 2

1. inhaled corticosteroid
2. anti-biotics have no role

Front 3

duration of chronic cough

Back 3

1. > 8 weeks

Front 4

croup

Back 4

1. harsh, barking quality
2. difficulty breathing
3. inspiratory stridor

Front 5

pneumonia

Back 5

1. short, dry, painful cough
2. rapidly become productive with red-stain sputum
2. fever
3. malaise, breathlessness, chills and headache

Front 6

upper airway cough syndrome (postnasal drip syndrome)

Back 6

1. result from persistent inflammation of the sinuses
2. frequent clearing throat
3. coughing when laughing or talking for prolonged periods
4. exarcerbation when lying down

Hint 6

is a cause of post infectious cough - subacute cough

Front 7

whopping cough (Bordetella pertussis)

Back 7

fits of coughing with
1. post-tussive vomiting
2. an inspiratory whooping cough
3. or both

Hint 7

is a cause of post infectious cough - subacute cough

Front 8

cough caused by allergic rhinitis

Back 8

1. seasonal, non-productive cough
2. with nasal infammation (discharge, blockage or itching, nocturnal snoring and sneezing)

Front 9

cough caused by asthma

Back 9

1. chest tightness
2. expiratory wheeze
3. exertional breathlessness
4. occur when exposed to triggers or at night

Front 10

cough caused by medications

Back 10

1. ACE inhibitors (irritating, tickling, scratching sensation in the throat)
2. beta-blockers
3. NSAIDs

Front 11

cough caused by chronic rhinosinusitis

Back 11

characterised by chronic nasal or upper airway symptoms:
1. mucopurulent drainage
2. nasal obstruction
3. facial pressure

Front 12

cough caused by medical conditions

Back 12

1. tuberculosis
2. bronchiectasis
3. obstructive sleep apnoea
4. heart failure
5. lung's carcinoma
6. interstitial lung disease
7. psychogenic cough

Front 13

refer when

Back 13

1. chest pain - CV cause
2. persistent fever
3. stridor and other respiratory noises - whopping cough or croup
4. wheeze - asthma
5. shortness of breath - asthma, pulmonary embolism, congestive heart failure
6. recurrent nocturnal cough
7. worse during treatment

Hint 13

8. discoloured or purulent sputum
a. think, yellow or green (bronchiectasis/bronchitis)
b. blood stained (lung cancer/tuberculosis)
c. rust coloured (pneumonia)
d. frothy and pink-red (heart failure)
9. pain on inspiration (pleurisy/pneumothorax)

Front 14

antitussives (cough suppressants)

Back 14

1. pholcodine (of choice) (benadryl)
2. dextromethorphan (max 120mg daily)
3. codeine/dihydrocodeine
4. 2 and 3: limited or no efficacy

Hint 14

avoid in:
1. significant mucus production
2. asthma
3. COPD

Front 15

expetorants (increase secretion of sputum)

Back 15

1. guaifenesin (also antitussive)
2. ammonium salts (contraindication in hepatic and renal impairment)
3. senega

Front 16

combine of antitussive and expetorants

Back 16

not recommended

Front 17

mucolytics

Back 17

bromhexine (bisolvon)

Hint 17

caution in patients with pectic ulcer disease

Front 18

sedating antihistamines

Back 18

1. if the cough associated with postnasal drip/allergic rhinitis
2. avoid in productive cough (risk forming viscid mucus plug)

Front 19

decongestants

Back 19

1. for nasal congestion; otherwise, avoid
2. contraindicated in hypertension, hyperthyroidism, coronary heart disease, diabetes and concurrent MAOI

Front 20

demulcents

Back 20

1. safe for children
2. protect mucous membrane

Hint 20

peadiatric simple linctus is placebo for children