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Questions and Answers
What is the most likely diagnosis for the patient with a left upper lobe cavitary lesion?
What is the most likely diagnosis for the patient with a left upper lobe cavitary lesion?
Which of the following symptoms is most likely associated with the patient experiencing increasing dyspnea and cough?
Which of the following symptoms is most likely associated with the patient experiencing increasing dyspnea and cough?
What is the next best test to assess the cause of the left pleural effusion in the 80-year-old male patient?
What is the next best test to assess the cause of the left pleural effusion in the 80-year-old male patient?
Which of the following findings would be least expected in a patient with a normal CBC and electrolytes in the context of recent respiratory symptoms?
Which of the following findings would be least expected in a patient with a normal CBC and electrolytes in the context of recent respiratory symptoms?
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What is a significant risk factor noted for the patient with a 50 pack-year smoking history?
What is a significant risk factor noted for the patient with a 50 pack-year smoking history?
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What condition is suggested by a patient experiencing a prolonged dry cough following a respiratory infection with no other symptomatic resolution?
What condition is suggested by a patient experiencing a prolonged dry cough following a respiratory infection with no other symptomatic resolution?
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What might be a likely treatment for a patient diagnosed with cough hypersensitivity syndrome?
What might be a likely treatment for a patient diagnosed with cough hypersensitivity syndrome?
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Which of the following is NOT considered a treatable trait in cough management?
Which of the following is NOT considered a treatable trait in cough management?
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Which of these symptoms would likely prompt further investigation in a patient with a chronic cough?
Which of these symptoms would likely prompt further investigation in a patient with a chronic cough?
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What management approach is recommended for patients with chronic cough caused by COPD?
What management approach is recommended for patients with chronic cough caused by COPD?
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A 70-year-old male with productive cough shows yellow to green phlegm. What is the next most appropriate step in management?
A 70-year-old male with productive cough shows yellow to green phlegm. What is the next most appropriate step in management?
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What psychological impact may result from chronic cough in patients?
What psychological impact may result from chronic cough in patients?
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In the context of cough management, which of the following medications should be stopped if the patient is experiencing a cough?
In the context of cough management, which of the following medications should be stopped if the patient is experiencing a cough?
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What is the most likely cause of the cough and wheezing in the patient with a 40 pack-year smoking history?
What is the most likely cause of the cough and wheezing in the patient with a 40 pack-year smoking history?
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Which vital sign finding suggests that the patient with COPD may be experiencing respiratory distress?
Which vital sign finding suggests that the patient with COPD may be experiencing respiratory distress?
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What is indicated by the arterial blood gas (ABG) results of 7.33/45/63/27?
What is indicated by the arterial blood gas (ABG) results of 7.33/45/63/27?
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Which treatment should be considered for the patient upon discharge following their COPD exacerbation?
Which treatment should be considered for the patient upon discharge following their COPD exacerbation?
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What symptom, in the otherwise healthy 21-year-old female, is most concerning for a serious underlying condition?
What symptom, in the otherwise healthy 21-year-old female, is most concerning for a serious underlying condition?
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What finding on the chest exam of the young female suggests localized lung pathology?
What finding on the chest exam of the young female suggests localized lung pathology?
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Given her presentation, which condition should be considered in the differential diagnosis for the young female patient?
Given her presentation, which condition should be considered in the differential diagnosis for the young female patient?
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What is an important counseling point for the patient with COPD regarding lifestyle choices?
What is an important counseling point for the patient with COPD regarding lifestyle choices?
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Study Notes
Cough Hypersensitivity Syndrome
- Cough hypersensitivity syndrome is a diagnosis for chronic cough that is associated with a history of upper respiratory tract infection.
- It can worsen with talking, laughing, and exercising
- Symptoms may persist after an upper respiratory tract infection
- It can be associated with social embarrassment and isolation, stress incontinence, vomiting, syncope, exhaustion, quality of life impairment, and economic burden
Cough Causes
- Asthma – treated with inhaled corticosteroids (ICS) or ICS/long-acting beta-agonist (LABA)
- Gastroesophageal reflux - treated with proton pump inhibitor (PPI), which may only improve acidity.
- Obstructive sleep apnea - treated with continuous positive airway pressure (CPAP)
- Post- nasal drip - treated with sinus rinses or nasal sprays
- ACE inhibitor-induced cough - stopping ACE inhibitors may resolve the cough
- Smoking - quitting smoking can help
- Pulmonary disease (ie. Chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), bronchiectasis) - treated with medication directly targeting the condition.
- Cardiac disease (ie. Heart failure) - treated with medication directly targeting the condition
COPD Exacerbation
- COPD exacerbations can cause shortness of breath and productive cough
- They can present with yellow or green sputum
- COPD exacerbations require urgent medical attention
- Patients can be hospitalized due to their severity
- Exacerbations can be more frequent in patients who smoke
COPD Pharmacotherapy
- Inhaled corticosteroids
- Long-acting Beta2-agonists
- Long-acting muscarinic antagonists
- Phosphodiesterase 4 inhibitors
- Combination inhaled therapies
Pulmonary Rehabilitation
- Pulmonary rehabilitation helps to improve exercise capacity
- It can help patients manage COPD
- Pulmonary rehabilitation can reduce hospital admissions
- It can improve quality of life
Tuberculosis
- Tuberculosis (TB) is a serious infectious disease
- It can cause fever, night sweats, weight loss, and cough
- Tuberculosis can be diagnosed with a chest x-ray and blood tests
- Treatment typically involves a multidrug regimen
Pleural Effusion
- Pleural effusions are fluid collections within the pleural space
- The most likely cause of a pleural effusion is infection
- They can be diagnosed with a chest x-ray
- Often, a thoracentesis is needed to drain the fluid and be analyzed
- The fluid is examined to determine the cause
- Diagnosis and treatment depend on the cause
Thoracentesis
- A thoracentesis is a procedure to drain fluid from the pleural space
- It involves inserting a needle into the chest
- The fluid is collected in a syringe
- The fluid is then analyzed to determine the cause of the pleural effusion
Light's Criteria
- Light's criteria are used to classify pleural effusions as transudative or exudative.
- They are based on the protein content and the lactate dehydrogenase (LDH) level of the pleural fluid
- Transudative effusions are usually caused by systemic conditions like heart failure, cirrhosis, or nephrotic syndrome.
- Exudative effusions are typically caused by infection, malignancy, or trauma.
Important Notes:
- Smoking cessation counseling is crucial for patients with chronic cough and lung disease.
- Patients with chronic cough should be referred to specialists for further evaluation and management.
- Inhaled corticosteroids can be effectively used to treat cough associated with eosinophilic inflammation.
- It is important to assess the patient's clinical presentation and risk factors to determine the most appropriate management approach.
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Description
This quiz explores Cough Hypersensitivity Syndrome, its symptoms, and causes. Learn about the impact of this condition on quality of life and the various treatments available. Test your knowledge on the management of chronic cough associated with respiratory issues.
