Cough and its causes and examination.

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Cough
Dr. Kamal Kishore
M.D. (Ayu)

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Introduction :-
Forced explosive maneuver against an initially
closed glottis.
 Acute <3 weeks
 Chronic > 8 weeks
 Most common cause :-
 Acute - URT viral infections
 Chronic – Smoker, BA , GOERD, Sinus disease.

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Types of cough :-
BOVINE COUGH / FEEBLE NON
EXPLOSIVE COUGH WITH
HOARSENESS
• Lung CA causing recurrent
laryngeal nerve palsy.
• Neuromuscular disorders
leading to Respiratory muscle
weakness.
BARKING COUGH WITH
HOARSENESS/ RASPING OR
CROAKING SOUND
• Laryngitis, epiglottitis
MOIST COUGH
• Acute – Bronchitis /
Bronchiectasis
• Chronic – Bronchitis / smokers
cough
WHOOPING COUGH • Pertussis
DRY COUGH
• Pneumonia, ILD, Pulmonary
Fibrosis, Asthma, Ace inhibitors

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Sputum
 It is mucous produced from respiratory tract.
 Normal is 100ml.
Serous Clear, watery, frothy,
pink
Acute pulmonary
oedema
Alveolar cell cancer
Mucoid Clear, white Chronic Bronchitis,
COPD,
Purulent Yellow
Green
Acute bronchitis,
Asthma
Lung abscess
Bronchiectasis
Pneumonia
Rusty Red Pneumococcal
Pneumonia

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Large volumes of Sputum
 Pulmonary oedema
 Alveolar cell cancer
 Bronchiectasis, Lung abscess, Emphysema
Foul Smell Sputum
 Bronchiectasis
 Lung abscess
 Empyema

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Sputum with Blood
Malignancy
Infection TB
Lung abscess
Bronchiectasis
Vascular Pulmonary infarction
Pulmonary thromboembolism
Chest trauma
Cardiac diseases e.g LVF
Anticoagulant use
Blood dyscrasias e.g haemophilia
Vasculitis

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Red flags of Cough
Haemoptysis
Breathlessness
Fever
Chest pain
Weight loss

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X-ray in Cough
Normal
Chest X-ray
Abnormal
Chest X- ray
Acute cough
(<3 weeks)
Bronchitis (URI)
Inhaled irritants dusts
or fumes
Pneumonia
Engulped foreign body
Chronic cough
(>8 weeks)
Asthma
GOERD
Rhinitis/Sinusitis
Smoking
Ace inhibitors
Lung Tumor
Tuberculosis
ILD
Bronchiectasis

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