Cough

Question 1

Causes of acute cough

Answer 1

URTI
Post nasal drip
COPDE
Asthma
PNA
Sinusitis
PE
PTX

Question 2

Causes of chronic cough

Answer 2

Bronchitis
Post nasal drip
Post infectious
GERD
FB
Meds

Question 3

Symptomatic treatment of cough (wet + dry)

Answer 3

Wet = guaifenesin 200-400mg PO Q4H
Dry = dextromethorphan 15-30mg PO Q4H

Question 4

Causes of acute cough in peds

Answer 4

URTI
Asthma
Croup
Pertussis
FB
GERD
PNA
Bacterial tracheitis

Question 5

Causes of chronic cough of peds

Answer 5

Bronchitis
Post nasal drip
Post infectious
GERD
Asthma
Chronic bronchitis
Primary ciliary dyskinesia
Interstitial lung dz

Question 6

Sx of bacterial tracheitis

Answer 6

Croup like barking cough
Fever
Poor response to epi
Hoarseness
Dysphonia
Resp distress

Question 7

Ix for bacterial tracheitis

Answer 7

AP XR: ragged edge, membrane spanning trachea

Question 8

Rx for bacterial tracheitis

Answer 8

Cefotaxime or ceftriaxone

Question 9

Differences between asthma and COPD

Answer 9

Asthma: onset <20 y/o, variation in sx, worse at night, triggers, lung function normal between episodes, fam hx atopy, seasonal, not worsening over time, responds to dilators, normal lungs on CXR. FEV1 reversibility >12%
COPD: >40 y/o, persistent despite tx, limited relief w/ dilators, daily sx, chronic cough w/o triggers, exposure, hyperinflation. FEV1/FVC <70%

Question 10

covid rx

Answer 10

Remdesivir: quicker recovery in hospital
Steroids: used in severe cases
Tocilizumab: limited evidence

Question 11

What is MIS-C + what is the sx + rx

Answer 11

Rare complication of COVID - multisystem inflammatory syndrome
Sx: hyperinflammation, persistent fever, multisystem organ dysfunction, abdo pain, vomiting, diarrhea, conjunctival hyperemia
Management: high dose IVIG, glucocorticoids

Question 12

Bronchiolitis - cause, RF, sx, Ix, management

Answer 12

LRTI d/t RSV
RF: kids <2, Nov-Jan, daycare, exposure to smoke
Sx: URTI prodrome, wheezy cough, crackles, tachypnea
Ix: not indicated
Management: O2 if sats <90%

Question 13

Croup - cause, RF, sx, Ix + sign on XR, management

Answer 13

Caused by parainfluenza virus
RF: 6mo-3y/o, fall/ winter
Sx: prodrome of URTI, sx worse at night, hoarse barking cough, stridor
Steeple sign on CXR (subglottic tracheal narrowing)
Management:
Dexamethasone 0.6mg/kg PO x1 max 10mg
Nebulised epi in mod/ severe (5ml 1:1000 over 15 mins)

Question 14

FB aspiration sx + ix

Answer 14

Sx: sudden onset resp sx, hx of choking, stridor or monophonic or unilateral wheeze
Ix: CXR

Question 15

Pertussis rx

Answer 15

erythromycin 1g/d BID-QID

Question 16

New name for postnasal drip

Answer 16

Upper airway cough syndrome