Topic Info - BotMed Application

TopicName

Acute Cough

ClinicalTests

Blood culture (bronchitis, pneumonia);
CBC with dif (infections);
BNP (CHF);
Sputum culture (infections: TB);
Consider throat swab;
D-dimer (PE);
Upper GI tests;
Serum/urinary antigen tests for pneumococcal pneumonia and Legionella;

ImagingStudies

Chest x-Ray (pneumonia);
Pulse oximetry;
ABG;
Peak expiratory flow, PEF (Asthma, COPD);
Bronchoscopy (foreign body);
Chest CT (lung cancer, PE);

PhysicalExams

Vitals + puls ox.  – tachycardia, tachypnea, hyper/hypotensive, fever;
General appearance – signs of distress, LOC, sense of doom, restlessness;
HEENT - Exam of nasal mucosa, oropharynx – erythema, lymphadenopathy, examine pharynx;
Heart – JVP distention, murmurs, carotid bruits;
Respiratory – symmetric chest expansion, orthopnea, dullness/ consolidation, hyper resonance, wheeze, stridor, rales, rhonchi, intercostal retraction/ use of secondary respiratory muscles, dry or productive cough;
Peripheral vascular – cyanosis, clubbing, edema;
Wells criterias (PE);

Comment

< 3weeks duration;
1. HIV;
2. Any fever? --> pneumonia.. no fever --> COPD, CKD-->CHF; lung cancer; PE; TB

Respiratory; Cardio; GI; Vascular; 

Acute/subacute vs. chronic, increased frequency of cough if chronic, timing; presence/description of sputum, presence of hemoptysis; associated symptoms (constitutional, URI, postnasal drip, dyspnea, wheezing, chest pain, heartburn); exacerbating and alleviating factors, exposures; smoking history; history of lung disease, posttussive emesis, or heart failure; allergies; medications (especially ACE inhibitors).

WebLink

https://www.aafp.org/afp/2007/0215/p476.html