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1005 > Responding To Symptoms 2 > Flashcards

Responding To Symptoms 2 Flashcards

1
Q

What is a cough?

A

A reflex response to airway irritation

Triggered by stimulation of airway cough receptors in the epithelial layer of the pharynx

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2
Q

What can irritate cough receptors in the pharynx?

A

Irritants

Perceived foreign bodies

Excessive mucus

Conditions that can cause airway distortion

Impulses are transmitted through the cough centre in the brain (medulla oblingata)

Impulses are sent back via efferent neurons to respiratory muscles in the diaphragm, chest wall and abdomen

These contract causing inspiration and expiration of air, causing a cough

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3
Q

What is the epidemiology of a cough?

A

Cough occurs in 40 it 50% of upper respiratory tract infections

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4
Q

What are the signs and symptoms of a cough:

A

It is a common symptom associated with colds and flu as well as may other conditions

It can ofter have a sudden onset

Septum/ phlegm should normally be clear and colourless

Usually lasts 7 to 10 days and sometimes can last 2 weeks

A

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5
Q

What does acute mean?

A

Less that 3 weeks

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6
Q

What does sub-acute mean?

A

3 to 8 weeks

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7
Q

What does chronic mean?

A

More than 8 weeks

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8
Q

What are the signs and symptoms of a dry cough?

A

Thickly cough that doesn’t produce any phlegm (non-productive)

Inflammation and irritation in the pharynx caused by microbes are perceived as foreign objects by the brain

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9
Q

What is a chesty cough?

A

Phlegm/mucous is produced to help clear the airways (productive)

Large amounts of cohesive mucus are produced in the upper respiratory tract as a defence against invading microbes

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10
Q

What is a wheezy cough?

A

Bronchial congestion associated with chest tightened and wheezing

Can be productive or non-productive

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11
Q

What causes a cough?

A

Common causes:
Upper respiratory tract infection (cold/flu)

Acute bronchitis

Exacerbations of asthma or chronic obstructive pulmonary disease (COPD)

Pneumonia

Pertussis (whopping cough)

Cigarette smoke

Angiotensin-converting enzyme (ACE) inhibitor

Post nasal drip syndrome

Gastro-oesophageal reflux disease (GORD)

Less common causes of a cough:
Lung cancer

Lung disease

Pulmonary embolism

Heart failure

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12
Q

What are the symptoms that could lead to differential diagnosis of the following:

Upper respiratory tract infection:

A

Cough with or without sputum, general malaise, fever

Symptoms may affect nose, ears, throat or sinuses

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13
Q

What are the symptoms that could lead to differential diagnosis of the following:

Asthma

A

Wheeze, breathlessness, chest tightness, symptoms worse at night

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14
Q

What are the symptoms that could lead to differential diagnosis of the following:

Gastro-oesophageal reflux disease (GORD)

A

Acid from the stomach reflexes into the oesophagus

Causes heartburn and cough which can be worse at night

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15
Q

What are the symptoms that could lead to differential diagnosis of the following:

Acute bronchitis

A

Breathlessness, wheeze, general malaise

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16
Q

What are the symptoms that could lead to differential diagnosis of the following:

Chronic bronchitis

A

Long term productive cough that can be associated with shortness of breath. Caused by chronic irritation of the airways i.e. by tobacco smoke

17
Q

What are the symptoms that could lead to differential diagnosis of the following:

Lung cancer

A

Blood in sputum, persistent chest/shoulder pain, weight loss, hoarseness

18
Q

What are the symptoms that could lead to differential diagnosis of the following:

Croup

A

A viral upper respiratory tract infection in infants and toddlers. Associated with a harsh barking cough

19
Q

What are the symptoms that could lead to differential diagnosis of the following:

Pneumonia

A

Breathlessness, sputum, wheeze, corse crackles

20
Q

What are the symptoms that could lead to differential diagnosis of the following:

Pertussis (whopping cough)

A

A bacterial infection which affects babies and children, the cough lasts over 14 days

May vomit after coughing

Can leave a child feeling exhausted after coughing so much, characteristic whooping noise

21
Q

What are the symptoms that could lead to differential diagnosis of the following:

Tuberculosis

A

Bacterial infection associated with night sweats, loss of appetite, high fever and extreme tiredness

22
Q

What are the symptoms that could lead to differential diagnosis of the following:

Adverse drug reaction

A

ACE inhibitors

NSAIDs

Beta-blockers

23
Q

What patients presenting with a cough should be referred?

A

More than three weeks

Severe cough or the cough is getting worse

Coughing up blood/ blood stained sputum

Phlegm which is green/yellow/ rusty coloured

Shortness of breath

Breathing difficulties

Chest pain

Unexplained weight loss

Change in voice

Lump/swelling in neck

Night time cough in children = could indicate asthma

24
Q

What are the treatment options for a cough?

A 
Cough suppressants (antitussives) 
Opioids and antihistamines

Expectorants

Demulcents

Decongestants

25
Q

What do cough suppressants do?

A

Stop a dry tickly cough

26
Q

How can opioid cough suppressants help a cough?

Give some examples

A

They act on the cough centre in the brain and depress the cough reflex

Examples:
Dextromethorphan
Pholcodine
Codeine

Codeine is partly demethylated in the body to morphine which causes the antitussive effect but can also cause side effects such as sedation, respiratory depression and constipation

Pholcodine has less side effects than codine

Dextomethorphan is claimed to be virtually free from side effects

OTC doses of these options have no significant interactions with other medicines

27
Q

How do antihistamines help a cough?

Give some examples

A

Dry up secretions and suppress a dry tickly cough

Examples: 
Diphenhydramine 
Bromepheiramine 
Promethazine 
Triprolidine

All sedating antihistamines

Side effects include:
Sedation, constipation, urinary retention, dry mouth and blurred vision

Should be avoided in people with glaucoma or prostrate problems

28
Q

How do expectorants help a cough?

Give examples

A

Thin the mucus in a chesty cough to help clear the mucus

Guaifensain
Ammonium chloride

In a productive cough, mucus produced in the bronchial passage is moved up to the pharynx by ciliary action and is then expelled by coughing

Should not suppress a chesty cough as the cough is what is helping to keep the airways open

No known interactions with other medicines

1005 (14 decks)

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