This document outlines the clinical approach to evaluating a patient presenting with cough, including taking a thorough history. Key aspects of the history include determining onset and duration of cough, characterizing the cough, examining sputum production, and identifying aggravating/relieving factors and associated symptoms. A detailed medical history including past illnesses, treatments, and family history is also important. Differential diagnoses that may cause cough include pneumonia, asthma, COPD, bronchiectasis, and lung cancer among others. A targeted history can help identify the underlying cause and guide appropriate management.
4. 2.Character and timing
Short,dry irritating cough with
pain behind jaw or neck:-
Pharyngeal
Harsh,irritative and repetitive
with stridor and cyanosis:-
Laryngeal
14. 6.Aggravating & Relieving factors
Cold,smoke,dust,exertion:-
asthma
Swallowing of liquids:- NM d/s
of oropharynx
Otogenic cough:- impacted wax or
foreign body in ext auditory meatus:
…..subsides with removal of cause
17. Loss of weight:- bronchogenic
carcinoma
Stridor:-FB,Laryngeal nerve
involvment
Hoarseness of voice:-Lary.N invlvmt
Heart burn, regurgitation:- GERD
Erythema nodosum:-Sarcoidosis
18. HISTORY OF PAST ILLNESS
COPD, Asthma, Postnasal drip, GERD
R/c or complicated Pneumonia,
tuberculosis.whooping cough:-
Bronchiectasis
Immunosuppression
Surgery ;bed rest
BCG vaccination
19. Personal history
Loss of appetite, sleep
Smoking
Occupational exposure
Allergy or atopy
20. FAMILY HISTORY
Chronic bronchitis with emphysema,
Respiratory allergy, Asthma, Cystic
fibrosis
TB
21. TREATMENT HISTORY
Angiotensin Converting
Enzyme Inhibitors
Past treatment of d/s like
allergies,asthma,pneumonia,TB,Bron
chitis
Immunosuppressants
22. …DDs
1.Pneumonia:-fever, cough,dyspnoea,
rigor,night sweats
2.Asthma:-episodic wheeze,dyspnea, c/c
dry or productive cough worst at
night,chest tightness
3.COPD:-persistent cough,large amount
sputum,shortness of breath
23. 4.Bronchiectasis:-c/c cough,copious
amount of foul smelling sputum,
hemoptysis,pleuritic chest pain,
dyspnoea,loss of weight,anemia
5.Bronchogenic carcinoma:-new
cough/change in cough,dyspnoea,
hemoptysis,anorexia,loss of weight,
chest pain
24. 6.Tuberculosis:-cough
(dry…purulent
…blood streaks in
sputum),
anorexia,LOW,
night sweats,
evening rise of
temperature