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33 Cards in this Set
- Front
- Back
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How is an acute cough classified? |
Less than three weeks |
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How is a subacute cough classified? |
3-8 weeks |
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How is a chronic cough classified? |
>8 weeks |
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Where are cough receptors located? |
**Epithelium of the upper and lower respiratory tract -Pericardium, esophagus, stomach, and diaphragm |
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What nerves constitute the afferent cough pathway? |
1. Glossopharyngeal 2. Phrenic 3. Trigeminal |
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Where is the cough center located? |
Medulla |
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What nerves constitute the efferent cough pathway? |
1. Vagus 2. Phrenic 3. Spinal motor nerves |
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What are the MCC of acute cough? |
1. Common cold 2. Acute bacterial sinusitis 3. Pertussis 4. Pneumonia, PE, acute exacerbation of heart failure |
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What are the most common causes of subacute/chronic cough? |
1. Post-nasal drip 2. Asthma 3. GERD 4. Post-infectious cough, pulmonary disease **Usually not infectious |
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What are the ssx of post-nasal drip? |
1. Frequent nasal discharge 2. Sensation in the back of the throat 3. Frequent throat clearing |
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What causes post-nasal drip? |
1. Allergies 2. Non-allergic seasonal 3. Vasomotor rhinitis |
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What is non-asthmatic eosinophilic bronchitis? |
--Atopic patients wtih idiopathic cough and sputum eosinophilia |
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What is the cause of cough in GERD? |
1. Stimulation of upper airway receptors 2. Aspiration of gastric acid 3. Esophageal receptor activation |
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To the development of what disease can GERD contribute? |
Asthma
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What are some complications associated with cough? |
1. Chest pain 2. Abdominal wall soreness 3. Exhaustion 4. Possible syncope 5. Rib fractures |
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What is the first thing you should do for a patient presenting with cough? |
1. Look for usual causes 2. Stop easy stuff first 3. CXR |
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What is the first step of a cough workup? |
1. Administer nasal antihistamine-decongestant combination 2. If partial relief---- add nasal steroid or anticholenergic |
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What should you do if nasal antihistamine/decongestant combo doesn't relive ssx? |
1. Spirometry with methacholine challenge |
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What should be administered if the methacholine challenge test is positive? |
Bronchodilators |
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What is the last-line tx for cough if other steps fail? |
1. PPI for GERD 2. Lifestyle and dietary changes |
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What chronic diseases present with dyspnea? |
1. Asthma 2. COPD 3. Interstitial lung disease 4. Myocardial dysfunction |
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What are the two types of dyspnea? |
1. Respiratory system dyspena 2. Cardiovascular system dyspnea |
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What three components in the body can malfunction to cause dyspnea? |
1. Controller-- brain 2. Ventilator pump 3. Gas exchanger |
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What characterizes a controller problem in dyspnea? |
1. Air hunger and a sense of tightness |
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What characterizes a ventilator pump problem in dyspnea? |
1. Disorders that weaken muscles, change chest wall dynamics, or pleural effusions |
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What characterizes a gas exchanger pump problem in dyspnea? |
1. Any disorder that impairs gas exchange-- pnemonia, PE, aspiration |
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What are some high CO causes of dyspnea? |
1. Anemia 2. R-L shunts 3. Pulmonary HTN 4. Obesity |
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What are some normal CO causes of dyspnea? |
1. Diastolic dysfunction 2. Pericardial disease
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What are some low CO causes of dyspnea?
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Systolic pump failure |
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What types of questions should you ask in evaluation of dyspnea? |
1. H&P 2. "How far can you walk?" 3. "What body position makes this worse?" 4. Note length of sentences |
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What risk factors should you check in dyspnea? |
1. Occupational 2. Family hx 3. Chronic illness |
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What studies can be used to evaluate dyspnea? |
1. CXR 2. Pulmonary fxn testing 3. ECG 4. Echo 5. Labs 6. Cardiac stress |
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How do you tx dyspnea? |
1. Tx underlying condition 2. O2 supplementation if O2 sat below 90 or SpO2 below 60 3. Pulmonary/cardiac rehab |
