History taking of COUGH:
Duration –how long? acute < 3wks
*episodic / intermittent, –asthma or other illness or *persistent ==ILD
*dry or productive (dry —ILD,drug, productive –COPD,TB , brochiectasis )
if productive the following history of sputum should be taken
*Amount –scanty / moderate / profuse
*color –whitish / yellowish
*nature –mucoid , purulent , forthy / serous
*smell—foul-smelling (lung abscess / brochiectasis )
*diurnal variation present or not (for asthma more at early morning
/night )
*seasonal variation present or not
*relation with posture –changing posture increase sputum production
(brochiectasis ))
*triggering factor –pollen cold air , exposure to dander—asthma �does the cough hamper sleep.
*HO atopy or allergy –asthma
family history asthma
*occupation history –animal contact ,asthma, ILD—stone
crashing , ship breaking
is it associate with fever or not –pneumonia , TB , lung
abscess
*chest pain or not –peumonia , ca bronchus
*breathlessness or not –heart failure , bronchial asthma
*Swelling of body –heart failure
*drug history –ACE
*personal history –smoker�
haemoptysis or coughing out of blood
if present then
fresh or clotted blood
mixed with sputum
amount (mild / massive / profuse )
*how many episode
need any hospitalization
HO atopy or allery
family history asthma
*occupation history –animal *contact ,asthma, ILD—stone crashing
, ship breaking
is it associate with fever or not –pneumonia , TB , lung abscess
*chest pain or not –peumonia , ca bronchus
*breathlessness or not –heart failure , bronchial asthma�
*drug history :ACE
*personal history :smoking
*Occupation: contact with animal,
*Stone crashing / ship breaking (ILD)
*Past history TB (bronchiectasis ), atopy
*Family history of asthma
*In case of dry cough
Patient also developed episodic or intermittent dry cough for last 1
month without specific diurnal or seasonal variation or triggering
*
factors and no history of coughing out of blood
in case of persistent cough
Usually in ILD –dry and persistent cough (associated with exertion
breathlessness )
Can present in COPD(more common ) / bronchial asthma in acute
exaggeration –(usually productive)
eg.—patient has history of episodic productive cough for l5 year but for �last 1 month it become persistent.
Just memorize this history ..use every where u got cough to describe it like this
, or better than this
The patient also developed episodic / intermittent cough for same duration or
last 1 months .which initially was dry and later turn into productive ( or the
patient developed episodic productive cough for same duration or for last 1
month) containing………scanty (in case mucoid )/ moderate / profuse(use in
case of purulent ) ………whitish (in case mucoid )/ yellowish (use in case of
purulent )………mucoid / purulent /mucopurulant / frothy sputum which more
marked or aggravated at night/ early morning, exposure to cold / more in
winter and exposure to trigger factor like pollen , dander (or having no diurnal
variation or seasonal variation or any specific triggering factor ). (If case is
brochiectasis then add—sputum production is increased with change of
posture more at left lateral position). He has no history coughing out of blood
(or patient also give history several episodes of coughing out moderate/
profuse/ scanty clotted blood that mixed with sputum or fresh blood). The
cough was not associated with fever, chest pain, breathlessness (if present then
elaborate each complained in next line –). The patient has no history of contac�t with TB patient.
Raiyyan Tahsan. Date:02-02-2025 Sunday Time:-9-12-33 Am
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