Second, determine the duration of the cough to narrow the differential diagnosis. See our User Agreement and Privacy Policy. Search pattern for Chest X-ray, How to read CXR systematically? General Examination - OSCE (Y3 Medical Students), No public clipboards found for this slide. Introduce yourself, identify your patient and gain consent to speak with them. Whether the cough is triggered by anything. Allergies. History of any of the following: Cough (worse particularly at night) Recurrent wheeze Recurrent difficulty in breathing Recurrent chest tightness Lingering cough after a cold. The physician should ask about associated symptoms. 1. Ainslie G. Assessment of cough. Further research into potential mechanisms is warranted. Children under four should not have cough medicine. History Taking of Cough. Your electronic clinical medicine handbook. Nevertheless, some people on ACE inhibitors develop a… Respiratory History and Physical Exam . Subjects •How to take a medical history from a patient that presented mainly with cough? You can change your ad preferences anytime. • When do you cough? Exacerbating/alleviating factors: Look for triggers (e.g., only at work or after mowing lawn). Do you have a … Looks like you’ve clipped this slide to already. Protectivemechanism Seeks MEDICAL CARE Discomfort from cough itself Interference with normal lifestyle Concern for cause of cough 3. CLINICAL APPROACHTO A PATIENT WITHCOUGH… HISTORYTAKING 2. Wash your hands and don PPE if appropriate. Target questions. Use the checklists below for history… Whether the cough has been going on for days, weeks, months or years. Does anything make it better or worse? Verify the identity of the patient and her reason for seeking care. Running Time: 16:29. Free medical revision on history taking skills for medical student exams, finals, OSCEs and MRCP PACES. Clinicians should include cough drop use in history taking of patients with persisting cough illnesses. Designed to test clinical reasoning skills, this video provides opportunities to answer questions, practice history taking, and develop an assessment and differential … Communicate the purpose and value of a thorough respiratory history and … ... history-taking skills: Students should be able to obtain, document and present an age-appropriate medical history, that differentiates among … Suggestive of LRTI, COPD exacerbation or bronchiectasis, Suggestive of viral illness, asthma, GI reflux, restrictive lung disease or ACE inhibitors. Continuing Medical Education. For children over four, use caution and read labels … Senior Lecturer Gemma Hurley uses a mock patient to take you through the principles of obtaining a clinical history for www.NurseLedClinics.com. Introduce yourself to the patient including your name and role. Can you tell me more about feeling breathless? … • Do you bring anything up? We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. •Associated symptoms •Timing? •Relieving? In chronic cough and cough with red flag symptoms, thoracic x-ray and pulmonary function testing should be considered at an early stage References: • Have you noticed any blood in your sputum? History Taking Series (12) Analysis of cough Abbas A. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Before we dive into the clinical approach to cough, let us review the respiratory physiolo… Cough is a very common presenting complaint of patients. •Onset? Background Cough is a common indication of respiratory illness and is one of the more common symptoms of children seeking medical attention. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Presenting complaint. Earlier, we discussed how to take Clinical History Taking in medical words, and Respiratory system examination, while in this blog, we will reveal everything that can be asked about Cough to reach the diagnosis. Introduction (WIIPP) Wash your hands; Introduce yourself: give your name and your job (e.g. ; At some point during the encounter, start coughing uncontrollably and observe whether the examinee offers you a drink of water and/or a tissue. First, seek potential alarm features that could represent serious illness. But taking too much of them -- on purpose or by accident -- can make you feel high. 3. Not only does it cause discomfort for the child, cough also elicits stress and sleepless nights for their parents. Analysis of cough Cough When taking a history of a cough, ask the patient: • How long have you been coughing for? Has it improved or worsened? Dr. Loiuse Gooch, ward doctor) Identity: confirm you’re speaking to the correct patient (name and … 2009 Mar 19;27(2):68. Suggestive of upper respiratory tract infection. Note: there is a “thoracic” set of questions you can ask for chest pain, cough, dyspnea. The first step in the treatment of acute cough is to determine if the cause of the cough is one of these serious conditions or an acute upper respirator… Have you had shortness of breath in the past? If you continue browsing the site, you agree to the use of cookies on this website. Exam includes checking weight and height, and listening to heart and lungs. Whether the cough is moist, dry or productive. Moist cough Suggestive of LRTI, COPD exacerbation or bronchiectasis; Dry Cough Suggestive of viral illness, asthma, GI reflux, restrictive lung disease or ACE inhibitors; Long paroxysms of ‘whooping’ Suggestive of pertussis (whooping cough… Listening is at the heart of good history taking. The doctor's agenda, incorporating lists of detailed questions, should not dominate the history taking. ; You are not aware of the meanings of medical terms (e.g., spirometry) and ask for clarification if the examinee uses them. History History of present illness should cover duration and quality of cough (barky, staccato, paroxysmal) and onset (sudden or indolent). Angiotensin-converting enzyme inhibitors (ACE inhibitors) like lisinopril, captopril, and enalapril are antihypertensive medications. Focused History . Act like your cough really annoys you. Character Whether the cough is moist, dry or productive. While cough often suggests pathology of the upper or lower airway, non-respiratory causes should also be considered. History History of present illness should cover duration and quality of cough (barky, staccato, paroxysmal) and onset (sudden or indolent). Characteristic of smoker’s cough (chronic bronchitis). Close history taking and physical examination are sufficient to diagnose the cause of an acute cough without red flag symptoms! Use of steroids (some measure of severity in asthma). What colour is it? ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------. Symptoms and Causative Agent … In its July 9, 2010 Morbidity and Mortality Weekly Report (MMWR), the Centers for Disease Control and Prevention noted that pertussis (whooping cough) cases reported to the California Department of Health between January 1 and June 30 had increased by 418% over those reported during the … What painkillers have you been taking? OSCE 5 presents a clinical encounter of a 45-year-old dispute mediator who presents with a complaint of a cough that has lasted for over 1 week. Abbas A. Suggestive of pneumonia or bronchiectasis, Suggestive of infection, chronic bronchitis, lung cancer or PE, Suggestive of bronchiectasis, lung abscess or necrotizing pneumonia. Dr. Louise Gooch, ward doctor) Identity: confirm you’re speaking to the correct patient (name and date of … •Characteristics? Taking a Respiratory History Every non-emergent assessment should begin by introducing yourself to the patient; provide your name, credentials and your role within the care team. Clipping is a handy way to collect important slides you want to go back to later. Asks about symptoms, smoking, and personal and family history of respiratory disease. Key Symptom Indicators for Considering a Diagnosis of Asthma A. Shawka 2. Provide the patient with enough time to answer and avoid interrupting them. Acute cough is most commonly associated with the common cold, but it also can be associated with life-threatening conditions (e.g., pulmonary embolism, congestive heart failure, pneumonia). Whether the cough is associated with any other symptoms. If you have a cold or the flu, antihistamines may work better than non-prescription cough medicines. Cough . Includes checking fingers, legs, and feet for swelling. Water can help ease your cough - whether you drink it or add it to the air with a steamy shower or vaporizer. History Taking Series (12) Analysis of dyspnea (History Taking) •Site? History of Presenting Complaint. An acute cough lasts less than 3-weeks and the most common causes are the common cold, pneumonia and whooping cough. Initial evaluation of the patient with chronic cough (i.e., of more than eight weeks’ duration) should include a focused history and physical examination, and in most patients, chest radiography. 1. History and physical examination are paramount in the diagnosis of cough. If you continue browsing the site, you agree to the use of cookies on this website. Cough severity in some individuals may be negatively influenced by the amount of menthol consumed via cough drops. The frequency & length of coughing episodes, and whether it varies throughout the day. Character/circumstance: Productive or not, hacking, hemoptysis. Explains risk factors. Cough History Taking 1. The physician should ask about associated symptoms. Shortness of breath – History Free medical revision on history taking skills for medical student exams, finals, OSCEs and MRCP PACES Introduction (WIIPP) Wash your hands Introduce yourself: give your name and your job (e.g. It is also an important presenting symptom for a variety of disorders, some of which are serious and life threatening. A. Shawka. Go through the questions and memorise them, for coughing is one of the most common symptom of disease. Over-the-counter (OTC) cough and cold medicines are safe and effective when they’re used as directed. A good history is one which reveals the patient's ideas, concerns and expectations as well as any accompanying diagnosis. Cough is a non-specific symptom that may occur acutely or be present over a prolonged period of time. Now customize the name of a clipboard to store your clips. Ask about all allergies including, for example, … Past medical history. With a shortness of breath history, you will specifically want to enquire about exercise tolerance, cough, wheeze, chest pain and haemoptysis. A thorough history and physical exam is required to identify other signs and symptoms to lead to a … When evaluating patients with cough, it is important to pay attention to several aspects in the history that involve the duration, quality, severity, and timing of the cough. in this tutorial you will learn how to take a medical history from a patient that presented mainly with cough following simple rules. Use of inhalers (assess compliance and technique). ACE inhibitors are effective at lowering blood pressure and often preferred to other options like beta-blockers (think propanolol). The colour, volume and consistency of the sputum. History taking 1. History of Present Illness . … 2. -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------. See our Privacy Policy and User Agreement for details. Respiratory History Taking Introduction. Patient instructions. Other drugs which may have relevance in respiratory disease - eg, angiotensin-converting enzyme (ACE) inhibitors (cough). Patients with lung disease often complain of the following symptoms: dyspnea/shortness of breath, cough, sputum production, fatigue, exercise intolerance, chest tightness or chest pain. History Taking – Overview. Note the similarities. 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