TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 87: Chronic Cough Buttaro: Primary Care: A Collaborative Practice, 6th Edition MULTIPLE CHOICE 1. A patient recovering from a viral infection has a persistent cough 6 weeks after the infection.
What will the provider do? a. Perform chest radiography to assess for secondary infection b. Perform pulmonary function and asthma challenge testing c. Prescribe a second round of azithromycin to treat the persistent infection d. Reassure the patient that this is common after such an infection ANS: D
Postinfection cough is common after a viral infection and may persist up to 8 weeks after the infection; this type of cough generally needs no intervention. It is not necessary to perform chest radiography unless secondary infection is suspected. Antibiotics are not indicated. Unless the cough persists after 8 weeks, asthma testing is not indicated. 2. A nonsmoking adult with a history of cardiovascular disease reports having a chronic cough
without fever or upper airway symptoms. A chest radiograph is normal. What will the provider consider initially as the cause of this patient’s cough? a. ACE inhibitor medication use b. Chronic obstructive pulmonary disease c. Gastroesophageal reflux disease d. Psychogenic cough ANS: A
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About 10% of patients taking ACE inhibitors will develop chronic cough. COPD, GERD, and psychogenic causes are possible, but given this patient’s cardiovascular history, the possibility of ACE inhibitor-induced cough should be investigated initially. 3. A young adult patient develops a cough persisting longer than 2 months. The provider
prescribes pulmonary function tests and a chest radiograph, which are normal. The patient denies abdominal complaints. There are no signs of rhinitis or sinusitis and the patient does not take any medications. What will the provider evaluate next to help determine the cause of this cough? a. 24-hour esophageal pH monitoring b. Methacholine challenge test c. Sputum culture d. Tuberculosis testing ANS: B
Chronic cough without other symptoms may indicate asthma. If PFTs are normal, a methacholine challenge test may be performed. 24-hour esophageal pH monitoring is sometimes performed to evaluate for GERD, but this patient does not have abdominal symptoms and this test is usually not performed because it is inconvenient. Sputum culture is not indicated. TB is less likely.
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