USMLE Forum Archives - USMLE Step 2 CK - differential d-s of chronic cough
differential d-s of chronic cough
ysemak - 01-25-10 08:32
A 13 y/o boy has come to see you for the evaluation of a chronic cough. He states that his cough began over 1 month ago and has continued since without change. There is no diurnal variation that he or his family have noticed. He denies wheezing or dyspnea. He has been treated with 2 courses of antibiotics for sinusitis without any effect. His 7 year-old sibling has developed similar symptoms over the past week but seems to be responding somewhat to an OTC cough suppressant. He has no past medical history. His height and weight are in the 75th percentile for his age and sex. His physical examination is notable only for minimal erythema and cobblestoning of his posterior pharynx. He has a dry ‘barking’ cough.
Which of the following is unlikely in the differential diagnosis of chronic cough in this teen?
ysemak - 01-25-10 08:32
A 13 y/o boy has come to see you for the evaluation of a chronic cough. He states that his cough began over 1 month ago and has continued since without change. There is no diurnal variation that he or his family have noticed. He denies wheezing or dyspnea. He has been treated with 2 courses of antibiotics for sinusitis without any effect. His 7 year-old sibling has developed similar symptoms over the past week but seems to be responding somewhat to an OTC cough suppressant. He has no past medical history. His height and weight are in the 75th percentile for his age and sex. His physical examination is notable only for minimal erythema and cobblestoning of his posterior pharynx. He has a dry ‘barking’ cough.
Which of the following is unlikely in the differential diagnosis of chronic cough in this teen?
The correct answer and explanation will be available after you answer.
Page 1
#3
Re: differential d-s of chronic cough olaoluodunaike - 01-25-10 20:34 My answer is: d.
History of chronic cough, not associated with duirnal variation, or allergy, history of barking cough, and cobblestones.
#7
Re: differential d-s of chronic cough conym5 - 01-27-10 22:51 My answer is: e.
Throat clearing and a “cobblestone” posterior pharynx are features that suggest the presence of postnasal drip syndrome, but these features also occur in other conditions. Furthermore, even when suggestive features are lacking (“silent” postnasal drip syndrome), a patient still may respond to appropriate treatment.
#10
Re: differential d-s of chronic cough brianberto - 01-29-10 11:32 My answer is: a.
Well this patient's cough lacks diurnal variation. additionally there is now wheezing or shortness of breathing. The dry "barking" pattern points more towards pertussis, which is of course infectious (his younger sibling developing the same symptoms)
#14
Re: differential d-s of chronic cough ammulufy - 03-21-10 19:02 But it was said that ptnt didnt hav any wheezing or sob which defines asthma!!!!!
Page 1