1. B9402033 陳長聖

3.  initiated by the irritation of cough receptors in the epithelium of  upper and lower respiratory tract  Pericardium  Esophagus  Diaphragm  stomach  Chemical receptors  Mechanical receptors

4. Cortical control (?)

5.  Cough can be classified based upon the duration  Acute cough < 3 weeks  3 weeks < Subacute cough < 8 weeks  Chronic cough > 8 weeks

6.  Upper airway cough syndrome  Asthma  Gastroesophageal reflux  ACE inhibitors  Cancer  Chronic granulomatous disease

7. Diagnostic Impression PE Compli- cation History

8.  Caused by postnasal drip rhinitis; acute nasopharyngitis; Sinusitis  PE: the presence of secretions in the nasopharynx

9.  Variable reasons, often allergic  History: often with wheezing and dyspnea may be seasonal may follow an upper respiratory tract infection may worsen upon exposure to cold, dry air, or certain fumes or fragrances

10.  incompetence of the lower esophageal sphincter  Stimulation of receptors in the upper and lower respiratory tracts  Histroy: heartburn or a sour taste Pain with swallowing  Diagnosis: Esophago-gastro-duodeno- scopy

11.  angiotensin converting enzyme (ACE) inhibitors  Bradykinin ( 末梢血管擴張劑 ) may stimulate afferent fibers in the airway  History: After using ACE in., onset can be delayed up to six months

12.  Bronchogenic carcinoma Smoking > 10 pack- year Asbestos, radioactive material Hemoptysis Weight loss Supraclavicular lymphadenopathy  Bronchial adenoma Wheezing Hemoptysis usually no abnormal PE findings

13.  Chronic cough may be the only symptom  Sputum  Hemoptysis  Weight loss  Fever  Night sweats  Sometimes arthritis, erythema nodosum, or skin rash

15.  Night sweats are drenching sweats that require changing bedclothes  The most common reason is:  An overheated room or too many bed coverings (excluded)

16. malignancyinfectionmedications endocrine causes neurologic disease menopause idiopathic hyperhidrosis

17.  Lymphoma Hodgkin lymphoma  fatigue, pruritus, and pain after alcohol consumption  Solid tumors prostate cancer, renal cell cancer, germ cell tumors

18.  Tuberculosis 48 % of patients report night sweat Cough, fatigue, fever, weight loss, anorexia, chest pain, diarrhea, and hemoptysis  Brucellosis  HIV infection  Other bacterial infection

19.  Uptodate: Approach to the patient with night sweats Evaluation of subacute and chronic cough in adults  Wikipedia: Gastroesophageal reflux disease Esophagogastroduodenoscopy Laryngopharyngeal reflux  POMD, 7/E Cough—chronic