Dr. Zedan
Cough , sputum and hemoptysis
Internal Medicine
1
Cough
Cough is the most frequent symptom of respiratory disease. It is caused by
stimulation of sensory nerves in the mucosa of the :
1-pharynx,
2-larynx,
3- trachea
4-and bronchi.
Patients with chronic cough present more of a diagnostic challenge,
especially those individuals with a normal examination, chest X-ray and lung
function studies:
1- Potnasal drip.
2- cough variant asthma.
3-ACE inhibitors.
Dr. Zedan
Cough , sputum and hemoptysis
Internal Medicine
2
4- Gastroesophageal reflux.
5- Burdetella pertussis.
6- Intrabronchial tumor or foreign body.
Sputum
TYPES:
1- Serous : Clear, watery, frothy and pink.
causes: - Acute pulmonary edema.
- Alveolar cell cancer.
2- mucoid : Clear, grey, white and viscid.
causes: - COPD.
- Asthma.
3- Purulent:
a- yellow: -Acute bronchopulmonary infectoin
-Asthma.
b- Green: long standing infection.
4- Rusty: Rusty red:-pneumococcal pneumonia.
Ask about:
1- Amount.
2- color.
3- Taste or smell
4- Solid material.
HEMOPTYSIS
Coughing up blood, irrespective of the amount, is an alarming symptom and
nearly always brings the patient to the doctor.
Dr. Zedan
Cough , sputum and hemoptysis
Internal Medicine
3
CAUSES OF HAEMOPTYSIS
Bronchial disease
Carcinoma
Bronchiectasis
Acute bronchitis
Bronchial adenoma
Foreign body
Parenchymal disease
Tuberculosis
Suppurative pneumonia
Lung abscess
Parasites (e.g. hydatid disease /flukes)
Trauma
Actinomycosis
Mycetoma
Lung Vascular disease
Pulmonary infection
Polyarteritis nodosa
Goodpasture's syndrome
Idiopathic pulmonary haemosiderosis
Cardiovascular disease
Acute left ventricular failure
Mitral stenosis
aortic aneurysm
blood disorders
Leukaemia
Haemophilia
Anticoagulants