When to refer and advanced testing

Rejoice! as our phenomenal guest Dr. Brad Hayward @bradleyjhayward (Weill Cornell Medicine) demystifies chronic cough for the primary care provider. Dr. Hayward, an internist, pulmonologist, intensivist AND palliative care physician sits down with us to discuss common causes for chronic cough, work up pearls and options for treatment. Follow him on Twitter, @BradleyJHayward. Listeners can claim free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). We hope you enjoy learning from this episode as much as we enjoyed producing it!

 

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!

 

Credits

• Written (including CME questions) and Produced by: Cyrus Askin MD
• Infographic by: Cyrus Askin MD
• Cover Art: Kate Grant MBChb, MRCGP
• Hosts: Matthew Watto MD, FACP; Stuart Brigham MD; Paul Williams MD, FACP   
• Editor: Emi Okamoto MD (written materials); Clair Morgan of nodderly.com
• Guest: Brad Hayward MD

 

Sponsors:

Panacea Financial 

This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC

 

 

VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.

  Time Stamps

 

• Sponsor - Panacea Financial panaceafinancial.comSponsor - VCU Health CE curbsiders.vcuhealth.org
• 00:00 Intro, disclaimer, guest bio; Guest one-liner and Pick of the Week*
• 06:23 Sponsor - Panacea Financial panaceafinancial.com
• 07:30 Case of Post Infectious Cough; Basic definitions for cough
• Important aspects of the history
• Empiric therapies for post-viral cough
• 22:50 Case of idiopathic chronic cough; Physical exam
• 29:20 Basic testing and empiric therapy for the common causes of chronic cough
• 41:51 When to refer to pulmonology; Therapy for idiopathic chronic cough; OTC cough meds
• 54:28 Take home message; Outro
• Sponsor - VCU Health CE curbsiders.vcuhealth.org

 

Links*

• 90 Day Fiancé (show)  
• Below Deck Mediterranean (show)
• Mastering Communication with Seriously Ill Patients by  Anthony Back, Robert Arnold & James Tulsky (book) 

 

*The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.

 

Goal

Listeners will develop a pragmatic approach to evaluating subacute and chronic cough in adult patients.

 

Learning objectives

After listening to this episode listeners will be able to…  

1. ... define sub-acute vs chronic cough
2. ... build a repertoire of history questions geared towards identifying the etiology of cough in a patient
3. ... build a toolbox of diagnostic studies / tests that can be used in the evaluation of cough
4. ... marry history, physical and diagnostic studies into a coherent approach to diagnosing subacute and chronic cough through a tiered/logical approach
5. ... understand empiric therapies for cough that may have an advantageous risk-reward profile, even in the absence of diagnosis 
6. ... educate patients on common causes for subacute cough and chronic cough, as well as how to appropriately set expectations regarding symptoms severity and duration

 

Disclosures

Dr. Hayward reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

 

Citation

Askin CA, Hayward B, Williams PN, Brigham SK, Okamoto E, Watto MF. “241: Chronic Cough”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Original Air Date: November 9, 2020.

 

Tags

Cough, dyspnea, asthma, COPD, eosinophil, IL-5, allergy, ENT, allergist, pulmonary, pulmonologist, PFT, spirometry,  post-nasal drip, GERD, reflux, eczema, rash, atopy, mucus, bronchiectasis, lung, antihistamine, CT, X-Ray,  smoking, vaping, birds, dust, cockroaches, steroids, ICS, inhaled, gabapentin,  primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student