Cough

Question 1

Definition of cough

Answer 1

Forced expiration against closed glottis. Protective reflex

Question 2

Cough reflex

Answer 2

Afferent - vagus nerve
Cough center- medulla
Efferent- intercostal and phrenic

Question 3

Things to ask

Answer 3

Duration
Dry/ wet
Variation
Special character

Question 4

Mechanism of cough
Ace- icatibant
Beta blockers
Amiodarone
Cancer drugs

Answer 4

Accumulation of bradykinin
Bronchospasm
Fibrosis
Fibrosis

Question 5

Postural variTion

Answer 5

Gerd
Bronchiectasis
Abcess
Edema

Question 6

Diurnal variation

Answer 6

Early morning- asthma , bronchiectasis , chronic bronchitis
Night- gerd , edema , tpe

Question 7

Character
Epiglottitis
Bovine
Smokers
Ace inhibitors
Nagging cough
Pertussis
Laryngotracheobtonchitis

Answer 7

Barking
Carcinoma larynx. Rln palsy
Hacking cough
Dry brassy
Tef
Whooping
Croup

Question 8

What is paroxysmal cough

Answer 8

Cough for more than one hour like in fb

Question 9

Things to ask in sputum

Answer 9

Amount
Consistency
Colour
Smell
Blood

Question 10

How do you measure sputum

Answer 10

Teaspoon 5ml
Table spoon 10ml
Teacup 200 ml

Question 11

Bronchorrhea

Answer 11

1 litre
Seen in bac

Question 12

Colour of sputum
Green
Red currant jelly
Rusty
Black
Yellow

Answer 12

Pseudomonas
Klebsiella
Streptococcus
Cwp , aspergillus, Smokers
Actinomycoses

Question 13

Serous sputum-white
Mucoid- white
Mucopurulent- whitush yellow
Purulent

Answer 13

Bac
Asthma
Lrti

Question 14

Smell of sputum
Foul - why?

Answer 14

Due to short chain fatty acid
Butyric acid

Question 15

Common respiratory anaerobic organisms

Answer 15

Pepto streptococcus
Prevotella
Fusobacterium

Question 16

Causes of acute couhg

Answer 16

Pe
Pneumothorax
Chf
Allergies
Exacerbation
FB.
PNEUMONIA
CHF

Question 17

Chronic cough causes

Answer 17

Ild
Tb
Copd
Cancer
GERD
PND
SMOKER
BRONCHIECTASIS
Uacs
Allergy

Question 18

Cough with wheeze

Answer 18

Copd.
Asthma
Fb
Cough variant asthma
Mass lesion pressing mediastinum
Cep
Churgstrauss
Resp bronchiolitis

Question 19

Mechanism of cough in pnd

Answer 19

Acute and chronic laryngitis and bronchitis due to pnd
Direct chemical and physical stimulation of cough receptors in the larynx and trachea

Question 20

Mechanism of cough in gerd

Answer 20

Vagal stimulation

Question 21

Causes of dry cough

Answer 21

Cough variant asthma
Atopic
Ace
Gerd
Eosinophilic bronchitis
Allergy
Ild
Tumors- both

Question 22

Atopic cough criteria

Answer 22

Dry cough for 3 weeks without wheeze
No resp to bd
Findings s/o atopic predisposition/ sputum eosinophilia
Relief woth antihistamines steroids

Question 23

Investigation

Answer 23

Stain
Cultures
Blood tests
Imaging - chest / sinus
Ag test
bronchoscopy
Feno 24hr ph
Psychological

Question 24

Causes of impaired cough

Answer 24

Muscle strength
Cw deformity
Tracheomalacia
Tracheostomy
Central depression

Question 25

Causes of cough Airway Parenchymal Tumors Fb Middle ear pathology Cvs Drugs

Answer 25

Airway - asthma , copd , eosinophilic bronchitis, cough variant asthma , pnd Paren- ild / emphysema / sarcoidosis

Question 26

Cough with hemoptysis

Answer 26

Malignancy, pe , tb. Abcess , pneumonia. Ectasis

Question 27

Nocturnal cough

Answer 27

Lvf Ba Aspiration Pnd Tpe

Question 28

Supine

Answer 28

Chf Gerd Post nasal drip Ectasis Acute bronchitis

Question 29

Dry cough

Answer 29

Pleura Ild Atypical pneumonia Mediastinum

Question 30

Cough in tef

Answer 30

Spluttering

Question 31

Chronic bronchitis

Answer 31

More than 3 mknths for 2 years

Question 32

Cough variant asthma

Answer 32

8 weeks without wheezing No h/o asthma No uri in last 8 weeks Inc Airway responsiveness Response to bd No Inc in cough sens Normal chest xray

Question 33

Cough with wheeze

Answer 33

Asthma Copd Fb Tumor compressing trachea Cep Churgstrauss Resp bronchiolitis

Question 34

Wet

Answer 34

Tb Infection Fb Bronchitis Ectasis

Question 35

Dry

Answer 35

Cv astma Eosiniphilic Ace Gerd Allergy Ild Psychogenic Tumor

Question 36

Atopic cough

Answer 36

Dry cough 3 weeks without wheeze No bd responsiveness Finding s/o atopy/ induced sputum eosiniphilia Relief with anti histamines