Cough Flashcards
What are the causes of cough in infancy
Infections: URTI, bronchiolitis, pneumonia
Congenital malformations of the airway e.g. laryngomalacia
Viral induce wheeze
Gastro-oesophageal reflux
Cystic fibrosis
What are the causes of cough in pre-school
Infections: URTI, croup, bronchiolitis, pneumonia, pertussis, viral induced wheeze
Foreign body
Asthma
Cystic fibrosis
Passive smoking
What are the causes of cough in school-age to adolescence
Asthma
Infections: URTI, pneumonia
Cigarettes smoking
Postnasal drip
Psychogenic
Cystic fibrosis
What are the red flag symptoms for cough
Productive cough which improves with antibiotics but quickly recurs
Restriction of activity
Failure to thrive
Clubbing
Persistent tachypnoea
What is suggested by a loose, productive cough
Bronchitis, wheezy bronchitis, cystic fibrosis, bronchiectasis
What is suggested by a wheezy cough
Asthma, wheezy bronchitis, viral induced wheeze
What is suggested by a barking cough
Croup
What is suggested by a paroxysmal cough
Cystic fibrosis, pertussis, foreign body, asthma
What is suggested by a nocturnal cough
Asthma, sinusitis
What is suggested by a cough most severe on waking
Cystic fibrosis, bronchiectasis
What is suggested by a cough that occurs with vigorous exercise
Exercise-induced asthma, cystic fibrosis, bronchiectasis
What is suggested by a cough that disappears with sleep
Habit cough
What should be looked for on examination for a cough
General: ?tachpnoea, ?fever
Weight and height: ?FTT
Resp:
- Bronchial breathing / stridor
- Wheeze
- Crackles: course (pneumonia, bronchiectasis), or fine (bronchiolitis)
- Inspiratory whoop
- Reduced chest wall movements unilaterally
- Clear chest
- Use of accessory muscles
What investigations should be done for a cough of unknown cause
Bedside: pernasal swab
Bloods: FBC, blood culture
Other: CXR, CXR and barium swallow, sweat testing, videofluoroscopy and bronchoscopy (foreign body), trial of bronchodilators
What are the red flag symptoms for children with cough
Check on the child regularly, including through the night. Seek help if:
Breathing rate increases
Any episodes of apnoea
Signs of increased effort of breathing
Baby takes <50% of normal feeds
Signs of dehydration: dry mouth, infrequent passage of urine
Baby becomes less responsive or difficult to rouse
Persistent worsening of fever