PH1122 - ENT Flashcards
what is the time frame from a cough to be classed as being “acute” ?
less than 3 weeks
what is the time frame from a cough to be classed as being “sub-acute” ?
3-8 weeks
what is the time frame from a cough to be classed as being “chronic”
when the cough is present for more than 8 weeks
what is the most likely cause of an acute cough in primary care for all ages ?
viral infection
what is the colour of normal sputum
clear and white (mucoid) - no infection is present
what is the colour of sputum if there is an infection present ?
yellow, green or brown sputum normally indicates infection
- mucopurulent sputum is generally caused by a viral infection and does not require automatic referral.
what is the colour of sputum if the patient has Haemoptysis ?
rust coloured
what is the colour of the sputum if the patient has left ventricular failure ?
pink tinged
what is the colour of sputum if the patient has carcinoma ?
Dark red
would a single time occurrence of sputum with bright red blood be serious
Usuall not. it would normally have been caused by rupturing a blood vessel when coughing to hard.
It does not require automatic referral.
what does thin and frothy sputum suggest ?
left ventricular failure
what does thick mucoid to yellow sputum suggest ?
asthma
what does offensive foul smelling sputum suggest ?
bronchiectasis or lung abscess.
if your cough is worse in the morning what does it suggest ?
may suggest upper airways cough syndrome, bronchiectasis or chronic bronchitis.
how long can it take an acute cough to resolve ?
Acute cough can sometimes take 4 weeks or more to resolve
However, coughs lasting longer than 3 weeks should be viewed with caution – the longer the cough is present, the more likely serious pathology is responsible.
if a Childs family has a history of eczema, asthma, or hay fever and the child has a recurrent cough what does this suggest ?
This might suggest asthma and referral would be required for further investigation.
what may smokers cough lead to ?
Patients who smoke are more prone to chronic and recurrent cough. Over time, this might develop into chronic bronchitis and chronic obstructive pulmonary disease
what are some clinical features of an acute viral cough ?
- present with sudden onset and associated fever.
- Sputum production is minimal, and symptoms are often worse in the evening.
- Associated cold symptoms are also often present; these usually last between 7 and 10 days.
- A duration of longer than 14 days might suggest postviral cough or possibly indicate a bacterial secondary infection
what are likely symptoms of Upper airways cough syndrome
patients describe something stuck in the throat
Allergies are one cause of UACS.
what age does “croup” affect ?
infants aged between 3 months and 6 years
what are some symptoms of croup ?
violent coughing
child may be breathless and may struggle to breathe properly
Typically, symptoms improve during the day and often recur again the following night
if the symptoms occur for longer than 48 hours then medical attention should be seeked.
what are some symptoms of asthma ?
coughing, wheezing, chest tightness, and shortness of breath.
usually the symptoms are worse at night
the symptoms are often bought on by triggers (e.g., allergens, infections, irritant exposure).
what are some symptoms of pneumonia
Initially, the cough is nonproductive and painful (first 24–48 hours),
but it rapidly becomes productive, with sputum being stained red. The intensity of the redness varies, depending on the causative organism.
The cough tends to be worst at night.
The patient will be unwell, with a high fever (> 38 o C), malaise, headache, and breathlessness and experience pleuritic pain
urgent referral is required so the patient can be put on antibiotics
what medication commonly causes a cough
(ACE) inhibitors
NSAIDs
Beta blockers
what is the bacterial infection tuberculosis caused by ?
Mycobacterium tuberculosis that is transmitted primarily by inhalation
When should TB be considered ?
When the patient is at high risk and have symptoms of fever, weight loss, night sweats anorexia or malaise.
sputum production can vary from mild to severe, with associated haemoptysis
A patient with a productive cough for more than 3 weeks and who exhibits one or more of the associated symptoms should be referred for further investigation
what are symptoms of carcinoma
cough, fatigue, shortness of breath, chest pain, weight loss and appetite loss. If a person older than 40 years has two or more of these symptoms, he or she needs to be referred to the GP for a chest x-ray.
The cough produces small amounts of sputum that might be blood-streaked
which is the only expectorant to have any supporting evidence
guafenesin
but not massively effective
out of codeine, pholcodine and dextromethorpran which is most effective for acute coughs ?
all are antitussive (aid cough symptoms) but only dextromethorpran is proven to show significant suppression against acute coughs.
