Cough Peds

Pediatrics
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HPI:
ID: Age at birth - TTN, < 3 months - septic work up, < 2year- bronchiolitis , 6 mos -> 3 years croup,
asthmatic
O: sudden, post viral
D:acute or chronic > 8 weeks
F:
Dry/ Productive - pneumonia
Painful/painless
Time of day: asthma
Worse exertion

Post nasal drip: worse in the am, chronic tickle
Bronchiolitis: sick, febrile dyspnea in infant < 2 years old, coryzal prodrome lasting 1 to 3 days,
persistent cough and wob and wheeze/ crackles. Peaks 3-5 days

Pertinent Negatives by Diagnosis
Viral Pharyngitis/ common cold
Strep throat/ bacterial phryngitis: pain, centor score
Asthma: no history of atopy, not worse at night in the cold, with exercise, no wheeze, dyspnea, no puffer
Pneumonia: no fever, purulent sputum, SOB, chest pain or pleurisy,
Sinusitis: No frontal headache, maxillary or frontal sinus pressure, coryza, dental pain, fever
GERD : no heartburn or reflux, unrelated to meals,
Foreign body: no unobserved sudden onset
PE: No hemoptysis, leg pain, or history of immobilization
Cancer: no weight loss, night sweats,
Croup ( viral tracheitis): not peak age 0.5 - 3 years, no coarseness or stridor,
Bacterial Tracheitis:.5- 14 years, like croup but high fever no response to epi
Epiglottitis: drooling, can't swallow saliva

RED Flags
Drooling
Choking,
SOB
Hemoptysis
Exposure to chemical, TB, HIV
Weight loss

Physical exam
VITALS:
HEENT:
RESP:
SKIN:
HPI:
ID: Age at birth - TTN, < 3 months - septic work up, < 2year- bronchiolitis , 6 mos -> 3 years croup,
asthmatic
O: sudden, post viral
D:acute or chronic > 8 weeks
F:
Dry/ Productive - pneumonia
Painful/painless
Time of day: asthma
Worse exertion

Post nasal drip: worse in the am, chronic tickle
Bronchiolitis: sick, febrile dyspnea in infant < 2 years old, coryzal prodrome lasting 1 to 3 days,
persistent cough and wob and wheeze/ crackles. Peaks 3-5 days

Pertinent Negatives by Diagnosis
Viral Pharyngitis/ common cold
Strep throat/ bacterial phryngitis: pain, centor score
Asthma: no history of atopy, not worse at night in the cold, with exercise, no wheeze, dyspnea, no puffer
Pneumonia: no fever, purulent sputum, SOB, chest pain or pleurisy,
Sinusitis: No frontal headache, maxillary or frontal sinus pressure, coryza, dental pain, fever
GERD : no heartburn or reflux, unrelated to meals,
Foreign body: no unobserved sudden onset
PE: No hemoptysis, leg pain, or history of immobilization
Cancer: no weight loss, night sweats,
Croup ( viral tracheitis): not peak age 0.5 - 3 years, no coarseness or stridor,
Bacterial Tracheitis:.5- 14 years, like croup but high fever no response to epi
Epiglottitis: drooling, can't swallow saliva

RED Flags
Drooling
Choking,
SOB
Hemoptysis
Exposure to chemical, TB, HIV
Weight loss

Physical exam
VITALS:
HEENT:
RESP:
SKIN:
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    nasager
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    HPI: ID: Age at birth – TTN, < 3 months – septic work up, < 2year- bronchiolitis , 6 mos -> 3 years croup, asthmatic O: sudden, post viral D:
    [See the full post at: Cough Peds]

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