Cough is a reflex for clearing the large airways. Productive means bringing things up with the cough ("dry" means the opposite). Haemoptysis is coughing up blood.
- Airways - asthma, COPD (bronchiectasis)
- Infection - pneumonia, TB, URTI
- Cancer - lung cancer, laryngeal cancer
- PE - er, pulmonary embolism
- GI - GORD
- Inheritied - CF
- Foreign body
- Paediatric - bronchiolitis, croup
Clinical and Associated Features
Haemoptysis is a red flag, mainly because it's a symptom of cancer, PE and TB, all of which are serious, and thus it shouldn't be ignored!
- Asthma - non-productive cough, particularly in the evening. SOBOE, wheeze
- COPD - smokers with a productive cough - phlegm is green. Also get breathlessness, wheeze, weight loss, PND, tiredness
- Cancer - haemoptysis, weight loss, smoking, family history of lung cancer
- Pullmonary embolism - haemoptysis, SOB, chest pain
- URTI - fever, infection
- Pneumonia - fever, breathlessness, tiredness, productive cough, dull on percussion, crackles on auscultation, asymmetric chest expansion (reduced on affected side) if severe
- 'TB - as for pneumonia, with haemoptysis, weight loss, from developing world, more long-term.
- 'Reflux - burning sensation in chest, chest pain, worse on eating, worse on lying down
- Cystic fibrosis - failure to thrive, recurrent infection, loose stools, child
- Foreign body - there's a foreign body
- CXR - everybody will need one of these
- FBC - check for infection
- U+E - useful for hydration and important in assessing severity of pneumonia