Chronic Cough Quiz

A 55-year-old patient presents with a persistent cough following a viral upper respiratory infection. According to the temporal classification systems used to evaluate cough, what is the minimum duration a cough must be present to be classified as chronic?

• Less than 3 weeks

• Exactly 3 to 8 weeks

• More than 8 weeks

• Exactly 1 to 2 months

• More than 12 months

A 60-year-old non-smoker presents with a chronic cough that has persisted for six months. Physical exam and initial chest radiograph are unremarkable. Which of the following is listed among the three most common causes of chronic cough in adults, alongside postnasal drip and asthma?

• Chronic bronchitis

• Pulmonary embolism

• Gastroesophageal reflux

• Interstitial lung disease

• Chronic refractory and unexplained chronic cough

A 72-year-old male presents with an acute cough and associated dyspnea, fine inspiratory crackles on lung exam, and dependent peripheral edema. Which diagnostic study is specifically suggested for evaluating the likely acute cause of cough in this patient?

• Methacholine challenge

• Sinus CT

• Esophageal manometry

• Brain (B-type) natriuretic peptide level

• Sputum cultures for acid-fast bacilli

A 48-year-old patient develops a dry, persistent nocturnal cough approximately three months after starting a new medication for hypertension. The suggested diagnostic approach for confirming the likely etiology is gauging the clinical response to stopping which class of medication?

• Angiotensin II receptor blockers

• H2 blockers

• Beta-adrenergic agonists

• Angiotensin-converting enzyme (ACE) inhibitors

• Proton pump inhibitors

A 65-year-old female presents with a chronic, non-productive cough. Which of the following associated findings is considered a "red flag" that necessitates immediate testing, including pulse oximetry and chest radiography?

• Cobblestoning of the posterior oropharynx

• Sour taste upon awakening

• Frequent clearing of the throat

• Unintended weight loss

• Cough triggered by cold air or exercise

A patient presents with a chronic cough that has persisted for 4 months. The chest radiograph is unremarkable, and the patient lacks any "red flag" symptoms. Before proceeding to advanced testing (e.g., methacholine challenge or pH probe), many clinicians initiate empiric treatment for which three common underlying conditions?

• Chronic bronchitis, foreign body aspiration, and Tuberculosis

• Airway hyperreactivity, postnasal drip, and gastroesophageal reflux disease

• Pulmonary embolism, pneumonia, and heart failure

• Tumor, interstitial lung disease, and ACE inhibitor use

• Pertussis, rhinosinusitis, and psychogenic cough

A 35-year-old male is recovering from a severe viral upper respiratory tract infection and presents with a dry, non-productive cough that has persisted for six weeks. This clinical picture is most consistent with the most common cause of subacute cough, which is characterized by:

• Chronic bronchitis

• Acute rhinosinusitis

• Chronic refractory cough

• Airway hyperresponsiveness after resolution of a viral or bacterial respiratory infection

• Gastroesophageal reflux

A 52-year-old non-smoker has a chronic cough persisting for 10 months. Empiric therapy for GERD and postnasal drip failed to relieve symptoms, and her chest radiograph is unremarkable. If standard spirometry is also normal, which diagnostic test is specifically recommended in the sequential workup to evaluate for asthma as the underlying cause?

• Sinus CT

• Esophageal pH monitoring

• High-resolution CT of the chest

• Pulmonary function testing with methacholine challenge

• Sputum culture for Pertussis

Which of the following correctly describes the mechanism of action of the common antitussive agent, benzonatate?

• Decreases viscosity and facilitates expectoration of secretions

• Anesthetizes stretch receptors of vagal afferent fibers in bronchi and alveoli

• Stimulates the brainstem respiratory network ("cough center")

• Depresses the medullary cough center (like codeine)

• Acts as a bronchodilator effective for cough after URI

During the physical examination of a patient with a three-month history of cough, the clinician observes "cobblestoning" of the posterior oropharynx and notes that the patient frequently clears their throat. These findings are highly suggestive of which common etiology of chronic cough?

• Chronic bronchitis

• Tuberculosis

• Interstitial lung disease

• Gastroesophageal reflux

• Postnasal drip or upper airway cough syndrome