DIAGNOSIS CHECKLIST
for Persistent cough

Why: to establish if truly chronic or persistent i.e. cough that has been present and not improving for more than 4 weeks.

Why: e.g. paroxysmal with whoops suggest whooping cough; painful cough may suggest left ventricular heart failure; weak cough may suggest lung cancer; bovine (no power to cough) suggests vocal cord paralysis.

Why: e.g. cough at night may suggest asthma, left ventricular failure, postnasal drip, chronic bronchitis, whooping cough; cough on waking may suggest bronchiectasis, chronic bronchitis or gastro-esophageal reflux.

Why: e.g. esophageal diverticulum, tracheo-esophageal fistula.

Why: recurrent lung infections from childhood may suggest cystic fibrosis or bronchiectasis.

Why: e.g. ACE inhibitor blood pressure medications are well known to cause a cough.

Why: e.g. asthma; cystic fibrosis; emphysema ( alpha 1- antitrypsin deficiency);anyone in the family had tuberculosis or a persistent cough.

Why: past and present? - increases the risk of emphysema, chronic bronchitis, lung cancer, larynx cancer.

Why: e.g. exposure to asbestos; miners exposure to coal dust or silica; aircraft makers and shipbuilders exposure to berylliosis and asbestosis; farmers exposure to bacteria in hay and causing "farmer's lung"; pigeon breeders exposed to protein from bird feathers and excreta causing "bird fancier's lung".

Why: If there is sputum production, describe it? - e.g. copious amounts with an offensive smell suggests bronchiectasis; yellow-green thick and sticky may suggest asthma; profuse and watery may suggest lung cancer; red-currant jelly may suggest lung cancer; pink and frothy may suggest left ventricular failure with pulmonary edema.

Why: may suggest chronic bronchitis, tuberculosis, bronchiectasis, lung cancer, lung metastasis, foreign body, left ventricular failure and mitral stenosis.

Why: usually suggests asthma but must also consider chronic bronchitis, emphysema, foreign body, lung cancer, congestive heart failure.

Why: more likely to suggest asthma as a cause of chronic cough.

Why: may suggest asthma, pulmonary fibrosis, left ventricular failure, tuberculosis, emphysema and lung cancer.

Why: may suggest gastro-esophageal reflux as a cause of chronic cough.

Why: may suggest lung cancer, laryngeal cancer, tuberculosis, cystic fibrosis.

Why: may suggest left ventricular heart failure.

Why: may suggest whooping cough, foreign body, cancer of the larynx, cancer of the trachea.

Why: may suggest tuberculosis, lung abscess, lung cancer.