By vgreene, 2 October, 2020 GERD sx: Lifestyle change (wt↓ if overwt, elevate bed head, avoid meals
By vgreene, 2 October, 2020 NAEB sx (steroid-responsive cough in nonsmoker w/o airway hyperresponsiveness): ✓blood/sputum eos, FENO, tx w/ inhaled steroids.8 Avoid causal allergens/sensitizers;7 tx w/ inhaled steroids8
By vgreene, 2 October, 2020 If hx chronic obstructive airway dz, consider exacerbation,7 manage as acute exac chronic bronchitis/COPD. If exac of bronchiectasis, incl airway clearance techniques in tx4
By vgreene, 2 October, 2020 Asthma sx (incl cough-variant): ✓spirometry pre/post-BD, methacholine challenge, tx w/ inhaled steroids1,8
By vgreene, 2 October, 2020 UACS/postnasal drip exac: Tx underlying cause (eg, rhinitis, sinusitis, etc); if postviral or no apparent cause, consider empiric 1st-gen antihistamine + decongestant combo7
By vgreene, 2 October, 2020 Consider ongoing infxn (eg, TB, pertussis) before eval for common postinfxn cough:
By vgreene, 2 October, 2020 If acute bronchitis, wet or dry cough (≤6wk, per ACP;5 ≤3wk, per ACCP6): Tests not routine, don’t use abx.5,6 Sx relief guidance varies; ACCP doesn’t recommend antitussives, mucokinetics, NSAIDs;6 ACP suggests weighing risk/benefit5
By vgreene, 2 October, 2020 If hx obstructive airway dz: Consider asthma exac, COPD exac or acute exac chronic bronchitis. If hx bronchiectasis, consider acute exac, tx w/ airway clearance techniques, etc4
By vgreene, 2 October, 2020 If pertussis strongly suspected based on clinical picture (less severe, typical “whoop” less freq in adolescents/adults), strongly consider tx awaiting test results3
By vgreene, 2 October, 2020 If immunocompromise, ✓CXR. Consider TB, esp for HIV pts in hi-prevalence areas, even if NL CXR2
