7. Cough

Question 1

What specific questions should you ask about a cough?

Answer 1

OPTTS
Onset- is it acute or chronic, BTS defines acute as <3 weeks and chronic as >8 weeks
Productive? Ask about blood as well
Timing? Time of day and seasonal variations
Triggers?
Smoking?

Question 2

What triggers may cause a cough?

Answer 2

PATSO

Pets, allergies, travel (areas where TB is prevalent), smoking, occupation

Question 3

What associated symptoms should you ask a person with a wough?

Answer 3

FLAWS- malignancy, TB
Breathlessness
Chest pain
Wheeze

Question 4

How can you classify causes of cough?

Answer 4

Acute/ Chronic

Productive/ Dry

Question 5

What are the main causes of an acute dry cough?

Answer 5

Asthma, rhinit, URTI, drug induced- ACE inhibitors

Question 6

What are the main causes of a chronic dry cough?

Answer 6

Asthma, GORD, post-nasal drip

Question 7

What are the main causes of an acute productive cough?

Answer 7

LRTI, COPD and TB

Question 8

What are the main causes of a chronic productive cough?

Answer 8

Bronchiectasis, TB, Lung cancer

Question 9

What signs are consistent with an infective cause of a cough?

Answer 9

Systemic features- fever, tachycardic
Resp distress
Tender cervical lymphadenopathy
Lungs- reduced chest expansion, abnormal breath sounds
Signs of RHF- due to COPD
Asterixis- CO2 retention in some COPD patients

Question 10

What is the CURB 65 score?

Answer 10

Score used to calculate the severity of pneumonia
Confusion- AMTS= 8
Urea- >7mM
Resp rate >30
Blood pressure <90 systolic and <60 diastolic
>65 years old