Cough resident survival guide: Difference between revisions
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*Not postinfectious: Work up same as chronic cough | *Not postinfectious: Work up same as chronic cough | ||
*Shown below is an | *Shown below is an algorithm describing the evaluation of chronic [[cough]] in adults according to the [[American College of Chest Physicians]] guidelines. | ||
{{familytree/start}} | {{familytree/start}} | ||
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{{familytree | | Life-threatening condition | | | | | Consider 4 most common causes: 1)Upper Airway Cough Syndrome (UACS), secondary to rhinosinus diseases, 2)Asthma, 3)Non-asthmatic Eosinophilic Bronchitis 4)Gastroesophageal Reflux Disease (GERD) | | | | | Smoking, ACEI, Sitagliptin |Life-threatening condition=Life-threatening condition|Consider 4 most common causes: 1)Upper Airway Cough Syndrome (UACS), secondary to rhinosinus diseases, 2)Asthma, 3)Non-asthmatic Eosinophilic Bronchitis 4)Gastroesophageal Reflux Disease (GERD)=Consider 4 most common causes: 1)Upper Airway Cough Syndrome (UACS), secondary to rhinosinus diseases, 2)Asthma, 3)Non-asthmatic Eosinophilic Bronchitis 4)Gastroesophageal Reflux Disease (GERD)|Smoking, ACEI, Sitagliptin=Smoking, ACEI, Sitagliptin}} | {{familytree | | Life-threatening condition | | | | | Consider 4 most common causes: 1)Upper Airway Cough Syndrome (UACS), secondary to rhinosinus diseases, 2)Asthma, 3)Non-asthmatic Eosinophilic Bronchitis 4)Gastroesophageal Reflux Disease (GERD) | | | | | Smoking, ACEI, Sitagliptin |Life-threatening condition=Life-threatening condition|Consider 4 most common causes: 1)Upper Airway Cough Syndrome (UACS), secondary to rhinosinus diseases, 2)Asthma, 3)Non-asthmatic Eosinophilic Bronchitis 4)Gastroesophageal Reflux Disease (GERD)=Consider 4 most common causes: 1)Upper Airway Cough Syndrome (UACS), secondary to rhinosinus diseases, 2)Asthma, 3)Non-asthmatic Eosinophilic Bronchitis 4)Gastroesophageal Reflux Disease (GERD)|Smoking, ACEI, Sitagliptin=Smoking, ACEI, Sitagliptin}} | ||
{{familytree | | |!| | | | | | |!| | | | | | |!| }} | {{familytree | | |!| | | | | | |!| | | | | | |!| }} | ||
{{familytree | | Treat based on the cause | | |,|-|-|^|-|-|-|.| | | {{familytree | | Treat based on the cause | | |,|-|-|^|-|-|-|.| | Discontinue for at least 4week | | | ||Treat based on the cause=Treat based on the cause|Discontinue for at least 4week=Discontinue for at least 4week}} | ||
{{familytree | | |!| | | |!| | | | | | |!| | |!| | | | | }} | {{familytree | | |!| | | |!| | | | | | |!| | |!| | | | | }} | ||
{{familytree | | Followup 4-6 weeks if inadequate response| | D02 | | | | | D04 | | Consider 4 most commen causes of cough if No response at4-6 week followup | |Followup 4-6 weeks if inadequate response=Followup 4-6 weeks if inadequate response|D02=D02|D04=D04|Consider 4 most commen causes of cough if No response at4-6 week followup=Consider 4 most commen causes of cough if No response at4-6 week followup}} | {{familytree | | Followup 4-6 weeks if inadequate response| | D02 | | | | | D04 | | Consider 4 most commen causes of cough if No response at4-6 week followup | |Followup 4-6 weeks if inadequate response=Followup 4-6 weeks if inadequate response|D02=D02|D04=D04|Consider 4 most commen causes of cough if No response at4-6 week followup=Consider 4 most commen causes of cough if No response at4-6 week followup}} | ||
Revision as of 23:17, 26 October 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Haddadi, M.D.[2]
| Cough Resident Survival Guide |
|---|
| Overview |
| Causes |
| FIRE |
| Diagnosis |
| Treatment |
| Do's |
| Don'ts |
Overview
Causes
Common Causes
- Allergic Rhinitis
- Asthma
- Bronchiectasis
- Gastroesophageal Reflux Disease (GERD)
- Post-nasal drip
- Medications' side effect
- Bronchitis
- Laryngopharyngeal reflux
- Respiratory tract infection
- Lung cancer
- Nonasthmatic eosinophilic bronchitis
Diagnosis
Shown below is an algorithm summarizing the evaluation of acute cough according to the American College of Chest Physicians guidelines.[1]
| Acute Cough | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| History and physical
examination, ask about environmental and occupational factors and travel exposures ± investigations | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Life-threatening diagnosis | Non-life-threatening diagnosis | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Pneumonia, severe
exacerbation of asthma or COPD, PE, heart failure, other serious disease | Infections | Exacerbation of pre-existing condition | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| LRTI | URTI | Asthma | Bronchiectasis | UACS | COPD | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Evaluate and treat first | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Acute Bronchitis | Pertussis | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Consider TB in
endemic areas or high risk | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
- Shown below is an alogrithm describing the evaluation of subacute cough in adults according to the American College of Chest Physicians guidelines.
| Subacute Cough | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| {{{ History and Physical Exam Ask about red flags,
environmental and occupational factors, travel exposures }}} | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Postinfectious or life-threatening diagnosis | New onset or exacerbation of pre-existing condition | Not postinfectious* | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Pneumonia, severe exacerbation of asthma or COPD, PE, heart failure, other serious disease | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Pertusis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| COPD | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| UACS | Asthma | Bronchitis | GERD | Bronchiectasis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| {{{ }}} | Postinfectious | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| TB | NAEB | AECB/COPD | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
- Not postinfectious: Work up same as chronic cough
- Shown below is an algorithm describing the evaluation of chronic cough in adults according to the American College of Chest Physicians guidelines.
| Chronic Cough | |||||||||||||||||||||||||||||||||||||||||||||||||||
| History, Physical exam and CXR | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Life-threatening condition | Consider 4 most common causes: 1)Upper Airway Cough Syndrome (UACS), secondary to rhinosinus diseases, 2)Asthma, 3)Non-asthmatic Eosinophilic Bronchitis 4)Gastroesophageal Reflux Disease (GERD) | Smoking, ACEI, Sitagliptin | |||||||||||||||||||||||||||||||||||||||||||||||||
| Treat based on the cause | Discontinue for at least 4week | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Followup 4-6 weeks if inadequate response | D02 | D04 | Consider 4 most commen causes of cough if No response at4-6 week followup | ||||||||||||||||||||||||||||||||||||||||||||||||
| E03 | |||||||||||||||||||||||||||||||||||||||||||||||||||
Treatment
Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.
Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.
References
- ↑ Irwin RS, French CL, Chang AB, Altman KW, CHEST Expert Cough Panel* (2018). "Classification of Cough as a Symptom in Adults and Management Algorithms: CHEST Guideline and Expert Panel Report". Chest. 153 (1): 196–209. doi:10.1016/j.chest.2017.10.016. PMC 6689094 Check
|pmc=value (help). PMID 29080708.