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Cough

Version: March 2023
Legacy ID: 18

Rationale

Cough is a common problem for which patients seek medical advice. Assessment of cough is important to distinguish benign from serious causes.

Causal Conditions

(list not exhaustive)

  1. Acute cough
    1. Infectious
    2. Irritant
    3. Other (e.g., initial presentation of a chronic cough etiology)
  2. Subacute cough
    1. Postinfectious
    2. Cough variant asthma
  3. Chronic cough
    1. Upper respiratory tract
    2. Pulmonary
    3. Gastrointestinal (e.g., gastroesophageal reflux)
    4. Cardiac
    5. Other (e.g., medications, work-related exposure)

Key Objectives

Given a patient with a cough, the candidate will diagnose the cause, severity, and complications, and will initiate an appropriate management plan. Particular attention should be paid to differentiating benign causes from more serious causes requiring full investigation and further management.

Enabling Objectives

Given a patient with a cough, the candidate will

  1. list and interpret critical clinical findings, including those derived from an appropriate history and physical examination aimed at
    1. discriminating between acute, subacute, and chronic cough;
    2. differentiating benign from more serious causes; and
    3. identifying triggers and aggravating factors;
  2. list and interpret critical investigations, including
    1. appropriate imaging investigations;
    2. pulmonary function testing; and
    3. allergy testing; and
  3. construct an initial management plan, including
    1. determining if the patient requires specialized care;
    2. prescribing appropriate medication;
    3. counseling and educating the patient (e.g., if there is a need for antibiotics or investigations);
    4. reassuring the patient if they do not require further investigation; and
    5. advising the patient on work-related issues, if necessary.