🫁 Cough · Acute & Chronic · Diagnostic Decision Tool

Schwartz Clinical Handbook — Chapter 23 · Asthma · Bronchiolitis · Pneumonia · GERD · Post‑nasal drip · Cystic fibrosis · Habit cough

Select cough quality, triggers, associated symptoms, and duration → differentiate asthma, UACS, GERD, pertussis, FB aspiration, or psychogenic cough. Chronic cough ≥4 weeks.
⚠️ Red flags: choking/gagging at onset, hemoptysis, digital clubbing, stridor, failure to thrive, unimmunized infant.

📋 Step 1 — Cough characteristics & context
📌 Diagnostic impressions
📖 Schwartz Ch 23

Select cough quality (barking, staccato, honking, nocturnal), triggers (exercise, feeding, supine), associated wheezing, and age → differential includes asthma, UACS, GERD, pertussis, foreign body, habit cough.

✔️ Barking + stridor → croup.
✔️ Staccato + post‑tussive emesis → pertussis.
✔️ Nocturnal + triggers → asthma.
✔️ Honking, absent during sleep → habit cough.
📘 Schwartz pearls (Chapter 23)
• Chronic cough >4 weeks: CXR, spirometry if age ≥6 years.
• GERD & UACS are common causes of chronic cough.
• Foreign body: unilateral decreased breath sounds, persistent pneumonia.
• Cough suppressants not recommended in children <6 years.