Chronic Cough Causes

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Questions and Answers

What is the term for the condition where a cough is triggered by stomach acid flowing back up into the esophagus?

Cough-variant asthma

Upper airway cough syndrome

Chronic bronchitis

Gastroesophageal reflux disease (correct)

What would you recommend to a patient who has a cough and is diagnosed with GERD?

Prescribe an antihistamine

Prescribe an ACE inhibitor

Recommend a bronchodilator

Recommend GER treatment and follow-up (correct)

What is the term for the condition where a cough is the main symptom and is often associated with asthma?

Upper airway cough syndrome

Chronic bronchitis

Gastroesophageal reflux disease

Cough-variant asthma (correct)

What is the term for the condition where the airways produce excess mucus, leading to a chronic cough?

Chronic bronchitis Signup and view all the answers

What is the term for the condition where the air sacs in the lungs are damaged, often leading to a chronic cough?

Emphysema Signup and view all the answers

Which of the following is NOT a symptom of GERD?

Fever Signup and view all the answers

What is a common but under-recognized cause of a chronic cough in adults?

Pertussis Signup and view all the answers

Which of the following is a diagnosis method for chronic cough?

X-rays Signup and view all the answers

What is a type of inflammation in the airways that can cause a chronic cough?

Eosinophilic bronchitis Signup and view all the answers

What is a complication of a viral upper respiratory tract infection that can cause a chronic cough?

Bacterial tracheobronchitis Signup and view all the answers

What is a characteristic of sputum in bacterial tracheobronchitis?

Colored from light yellow to dark green or brown Signup and view all the answers

What is a symptom of bacterial sinusitis that can cause a chronic cough?

Sinus congestion Signup and view all the answers

What is a type of cough that is often misdiagnosed as asthma?

Cough variant asthma Signup and view all the answers

What is a risk factor for lung cancer that can cause a chronic cough?

Smoking Signup and view all the answers

What is the primary distinguishing feature of a chronic cough?

Duration of cough lasting four weeks or longer Signup and view all the answers

What is the significance of a dry cough in a patient with chronic cough?

It is more likely to be associated with GERD Signup and view all the answers

What is the most common cause of chronic cough in adults?

GERD Signup and view all the answers

What is the primary diagnostic feature of eosinophilic bronchitis?

Eosinophilia in sputum or blood Signup and view all the answers

What is the relationship between chronic cough and COPD?

COPD is a common cause of chronic cough, often presenting as a productive cough Signup and view all the answers

What is the significance of a cough that worsens at night?

It is a diagnostic feature of GERD Signup and view all the answers

What is the primary diagnostic feature of chronic bronchitis?

Productive cough lasting three months or longer Signup and view all the answers

What is the relationship between asthma and chronic cough?

Asthma is a common cause of chronic cough, often presenting as a cough variant asthma Signup and view all the answers

What is the primary purpose of Therapeutic Patient Education (TPE)?

To produce a therapeutic effect on patients Signup and view all the answers

What is a barrier against treatment according to the World Health Organization (WHO)?

All of the above Signup and view all the answers

What is the goal of educating patients about their treatment?

All of the above Signup and view all the answers

What is an example of a therapy-related intervention for 'poor adherers'?

Individualized education programs Signup and view all the answers

What is the benefit of self-management education for asthma patients?

All of the above Signup and view all the answers

What is a key aspect of Therapeutic Patient Education (TPE)?

Focus on patient's adaptation process Signup and view all the answers

What is an example of a barrier to treatment adherence?

All of the above Signup and view all the answers

What is the focus of Therapeutic Patient Education (TPE)?

Producing a therapeutic effect Signup and view all the answers

What should you do if you are within the 'orange zone' of the action plan?

Take corticoids orally according to a specified peak-flow value Signup and view all the answers

What should you do if you notice signs or symptoms of a relapse?

Take an additional dose of bronchodilator as soon as signs/symptoms appear and interrupt activity immediately Signup and view all the answers

What is the importance of TPE in chronic disease management?

It is the most important part of chronic disease management Signup and view all the answers

Why is it important to involve patients in the education and treatment plan?

Because patients are more likely to comply with treatment if involved in the plan Signup and view all the answers

What should you do before beginning a physical activity in the 'green zone'?

Take an additional dose of bronchodilator before beginning a physical activity Signup and view all the answers

What should you adjust if necessary, to avoid relapse?

Social activities, exercise, and sports Signup and view all the answers

What is the primary benefit of an individualized education programme on asthma control?

All of the above Signup and view all the answers

What is the focus of a self-management education programme for asthma patients?

Addressing both physiological and behavioural health indicators Signup and view all the answers

What is the significance of PEF monitoring in asthma self-management?

It is used to assess asthma control Signup and view all the answers

What is the outcome of a disease management programme on asthma patients?

Significant increase in adherence to asthma medication Signup and view all the answers

What is the goal of a structured step-wise and patient-centered approach to asthma management?

All of the above Signup and view all the answers

What is the outcome of a self-asthma action plan on asthma control?

Improved asthma control Signup and view all the answers

What is the focus of a self-management model of illness behaviour in asthma patients?

Treating asthma with a comprehensive approach Signup and view all the answers

What is the benefit of using a patient-centered approach to asthma management?

All of the above Signup and view all the answers

What is the primary goal of a self-asthma action plan?

To improve asthma control and self-efficacy Signup and view all the answers

What is the outcome of a disease management program on asthma patients?

Improved asthma symptoms and increased adherence to medication Signup and view all the answers

What is the focus of a self-management model of illness behavior in asthma patients?

Both physiological and behavioral health indicators Signup and view all the answers

What is the significance of PEF monitoring in asthma self-management?

It is used to assess asthma control and adjust treatment Signup and view all the answers

What is the benefit of an individualized education program on asthma control?

Improved asthma control and self-efficacy Signup and view all the answers

What is the primary benefit of a structured step-wise and patient-centered approach to asthma management?

Improved asthma control and self-efficacy Signup and view all the answers

What is the outcome of a self-asthma action plan on asthma control?

Improved asthma control and self-efficacy Signup and view all the answers

What is the focus of self-management education for asthma patients?

Both physiological and behavioral health indicators Signup and view all the answers

What is the primary goal of Therapeutic Patient Education (TPE)?

To empower patients to take control of their health Signup and view all the answers

What is the significance of involving patients in the education and treatment plan?

It empowers patients to take control of their health Signup and view all the answers

What type of epithelium is found in the anterior/lingual part of the epiglottis?

Stratified squamous non-keratinized Signup and view all the answers

Which of the following muscles controls the movement of the cartilages in the larynx?

Intrinsic skeletal muscles Signup and view all the answers

What type of cell is responsible for producing mucinogen in the respiratory epithelium?

Goblet cells Signup and view all the answers

What is the characteristic of the submucosa in the trachea?

All of the above Signup and view all the answers

What is the function of the elastic fibers in the trachea?

To allow for the expansion and contraction of the trachea Signup and view all the answers

What is the origin of the trachea?

It begins at the cricoid cartilage of the larynx Signup and view all the answers

What type of cartilage is found in the epiglottis?

Elastic cartilage Signup and view all the answers

What is the function of the basal cells in the respiratory epithelium?

To differentiate into other cell types Signup and view all the answers

What is the characteristic of the adventitia in the trachea?

It anchors the trachea to adjacent structures Signup and view all the answers

What is the structure that separates the mucosa from the submucosa in the trachea?

The bundle of fibers Signup and view all the answers

Study Notes

Chronic Cough

A chronic cough is defined as a cough that lasts 8 weeks or longer in adults, or 4 weeks in children.
It can interrupt sleep, cause exhaustion, and lead to vomiting, lightheadedness, and even rib fractures in severe cases.

Causes of Chronic Cough

Upper airway cough syndrome (UACS)
Cough-variant asthma
Gastroesophageal reflux disease (GERD)
Smoking
Blood pressure drugs (e.g., ACE inhibitors)
Chronic bronchitis
Chronic obstructive pulmonary disease (COPD)
Emphysema

Associated Symptoms

Runny or stuffy nose
Postnasal drip
Frequent throat clearing and sore throat
Hoarseness
Wheezing and shortness of breath
Heartburn or sour taste in mouth
Coughing up blood (rarely)

Less Common Causes

Aspiration (food in adults, foreign bodies in children)
Bronchiectasis (damaged airways)
Bronchiolitis (infections)
Cystic fibrosis
Laryngopharyngeal reflux
Lung cancer
Nonasthmatic eosinophilic bronchitis
Sarcoidosis

Evaluation of Chronic Cough

Medical history and physical examination
Pulmonary function tests (PFTs)
X-rays or chest radiography

Diagnosis and Treatment

GERD treatment (acid blockers) and follow-up
PFTs to rule out asthma or other respiratory conditions
Consideration of other causes, such as bronchiectasis, lung cancer, or eosinophilic bronchitis, based on symptoms and test results

Therapeutic Patient Education (TPE)

TPE approach combines subjective and objective aspects of patient care
Considers patient's adaptation process, subjective and objective needs
Reduces long-term care costs for patients and society

Purpose of TPE

Produces therapeutic effects and improves quality of life
Helps patients prevent, manage, or avoid complications and maintain or improve their treatment

Evolution of Patient's Attitude

Acknowledges and copes with their condition
Manages and adapts to their treatment

Effectiveness of TPE for Asthma

Improves medication adherence, reduces emergency visits and hospitalizations
Reviews and studies support its effectiveness in self-management education

Barriers to Treatment Adherence

Social/economic, therapy-related, patient-related, and condition-related barriers
Identified by the World Health Organization

Individualized Education Program

Used for "poor adherers" with three individual sessions
Includes knowledge and skill assessment, demonstration, and objectives

Objectives of the Program

Take action according to environment
Avoid precipitating factors and adjust treatment
Recognize allergies and precipitating factors to avoid relapse

Result of TPE

Improved asthma control, inhaler skills, and health-related quality of life
Sustained effects eight weeks after intervention

Therapeutic Patient Education (TPE)

TPE approach combines subjective and objective aspects of patient care
Considers patient's adaptation process, subjective and objective needs
Reduces long-term care costs for patients and society

Purpose of TPE

Produces therapeutic effects and improves quality of life
Helps patients prevent, manage, or avoid complications and maintain or improve their treatment

Evolution of Patient's Attitude

Acknowledges and copes with their condition
Manages and adapts to their treatment

Effectiveness of TPE for Asthma

Improves medication adherence, reduces emergency visits and hospitalizations
Reviews and studies support its effectiveness in self-management education

Barriers to Treatment Adherence

Social/economic, therapy-related, patient-related, and condition-related barriers
Identified by the World Health Organization

Individualized Education Program

Used for "poor adherers" with three individual sessions
Includes knowledge and skill assessment, demonstration, and objectives

Objectives of the Program

Take action according to environment
Avoid precipitating factors and adjust treatment
Recognize allergies and precipitating factors to avoid relapse

Result of TPE

Improved asthma control, inhaler skills, and health-related quality of life
Sustained effects eight weeks after intervention

Bronchioles

Bronchioles are the 10th to 15th generation of dichotomous branching of the bronchial tree
Less than 1 mm in diameter
Supplies air to a pulmonary lobule
Bronchioles possess no cartilage
The epithelial lining of bronchioles ranges from ciliated simple columnar with occasional goblet cells in larger bronchioles to simple cuboidal (many with cilia) with occasional Clara cells and no goblet cells in smaller bronchioles
The lamina propria of bronchioles has no glands; it is surrounded by a loose meshwork of helically oriented smooth muscle layers

Clara Cells

Clara cells are believed to protect the bronchiolar epithelium by lining it with their secretory product
Produce a surfactant-like material that reduces the surface tension of bronchioles and facilitates the maintenance of their patency
Clara cells divide to regenerate the bronchiolar epithelium

Trachea

The trachea is rounded anteriorly but flattened posteriorly
10 to 12 horse-shoe-shaped hyaline cartilage rings (C-rings) that are connected to each other by smooth muscle
The perichondrium of each C-ring is connected to those of other rings
Provides flexibility and permits elongation during inspiration

Respiratory Epithelium

The respiratory epithelium undergoes reversible alterations (metaplasia) due to chronic exposure to irritants (e.g., cigarette smoke and coal dust)
Increase in the number of goblet cells relative to ciliated cells, producing a thicker layer of mucus to remove irritants
Reduced number of cilia retards the rate of mucus elimination, resulting in congestion

Bronchi

Begins at the bifurcation of the trachea
Composed of airways located outside and inside the lung
Outside: 1° bronchi, extrapulmonary bronchi
Inside: intrapulmonary bronchi, bronchioles, respiratory bronchioles

Cartilages

Elastic cartilages (unpaired epiglottis, paired corniculate and cuneiform cartilages, and superior aspect of the arytenoids) connected to one another by ligaments
Their movements are controlled by intrinsic and extrinsic skeletal muscles

Epiglottis

Flexible flap of tissue, consisting of central elastic cartilage, covered by mucosa on both sides
During swallowing, positioned horizontally, closing off the upper entrance to the larynx
During respiration, stands straight up in the vertical position, permitting the flow of air

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Description

This quiz covers the less common causes of chronic cough, including aspiration, bronchiectasis, bronchiolitis, cystic fibrosis, laryngopharyngeal reflux, lung cancer, nonasthmatic eosinophilic bronchitis, and sarcoidosis.