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Cough: Definition and History

by Carlo Raj, MD
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    00:01 We continue our discussion with cough. We’ll do the same thing. Mean to say that with dyspnoea, we walked through why dyspnoea could be perhaps found with standing up, lying down, maybe with exertion.

    00:16 With cough, once again, the characteristics and description of how the patient's presenting with cough becomes incredibly important for you. So, along with dyspnoea, cough is another main way for you to diagnose your respiratory disease. Let's continue.

    00:34 Respiratory causes of cough: asthma, COPD, infection, interstitial lung disease. In the overview section, we talked about how these may then give you, while depending on the site of what kind of cough you might have? Asthma, we talked about 2 different types and we will go into these again, atopic or intrinsic. The most common, would be atopic.

    00:56 That’s the one in which, upon exposure to allergens in the society, we have difficulty with breathing. COPD, more chronic. Infections, we talked about atypical and typical.

    01:09 Other causes: allergy, post-nasal drip or even GERD. Don’t forget this. Think about where you are with GERD, in the GI system. Where are you? At the gastro-oesophageal junction.

    01:20 And now the lower oesophageal sphincter is quite weak and therefore acid is then going to do what? Reflux into the oesophagus. And so much so, that it might actually cause irritation to the respiratory tree. Common causes are bolded, but keep in mind that we will go through all the diseases in great detail. We’re just setting up the foundation of cough. We’ll ask the same question here. For cough, is it acute or chronic? Acute then suggests infection or say that your patient is intubated and if your patient is intubated, there is every possibility that those food particles might then aspirate into your trachea. You’re not able to properly get it into the oesophagus, aspiration pneumonia you’ve heard of, or maybe perhaps acute exacerbation with CHF.

    02:08 Chronic cough, as you can imagine here, just like chronic dyspnoea, will be more of your COPD’s and interstitial lung disease. Is your cough productive? Big time. Ask this question.

    02:18 If it is dry, well, that’s a little bit different. Maybe it’s drug-induced and maybe it’s dry, you’re thinking more along the lines of allergies and such. But, if your cough is productive, then productive cough, if it’s purulent, mean to say that if it’s gold or yellow, something like staph. If it’s rusty, now, understand, with enough coughing, you might then introduce enough damage and injury to the bronchial tree in which at some point, sure, you’re going to have a little bit of blood, that’s rusty.

    02:48 Now, if it’s straight up just blood, then that’s a little bit more concerning and we’ll go through differentials. Maybe it’s cancers or maybe a haemoptysis that you’ve seen with granulomatosis with polyangiitis or Goodpasture's even. If it’s purulent, we’ve talked about green. Things like pyocyanin from pseudomonas, so on and so forth.

    03:07 Dry cough, this is usually interstitial lung disease. ILD stands for interstitial lung disease and by that, we mean that we’re referring to? Atypical pneumonia perhaps or maybe even eosinophilics. We’ll talk more about these eosinophilic conditions when the time is right.


    About the Lecture

    The lecture Cough: Definition and History by Carlo Raj, MD is from the course Introduction to Pulmonary Pathology.


    Included Quiz Questions

    1. GERD
    2. Infection
    3. COPD
    4. Asthma
    5. Interstitial lung disease
    1. Acute
    2. Chronic
    3. Productive
    4. Non-productive
    5. Associated with position

    Author of lecture Cough: Definition and History

     Carlo Raj, MD

    Carlo Raj, MD


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