MN568 discussion 2 reply 1

please reply to discussion below using 3 references apa style edition 7

Using the OLDCARTS format to the medical history. The patient is experiencing a dry hacking cough for duration of 3 months. The patient should have been asked the location of his cough, is it an upper airway cough, or lower airway region. In addition, any alleviating factors, and on a scale of 0-10 how bad would you rate your cough? A focused HEENT and respiratory assessment is warranted to assess the patient’s cough. The patient should have a chest X-ray to rule out any lung abnormalities. The guidelines suggest for a cough that has lasted longer than 8 weeks in duration should have a focused history and physical, and chest radiography. The guideline also suggests that patient presenting with a chronic cough that are taking an ACE inhibitor should be switched to another drug class. The most common causes of chronic cough include are upper airway syndrome, asthma, GERD, or combination of all.

Based on the patient physical exam the most probable cause of his cough is from his Lisinipril. The nature of his cough is dry and hacking which suggest a common adverse reaction to ACE inhibitors. An ACE inhibitor can cause a nonproductive cough in 5-20% of patient, affecting women more often than men (Madison & Irwin, 2019). Another differential diagnosis for our patient could be upper airway syndrome, asthma, or GERD. Another test that the be could complete is spirometry; this will help diagnose asthma or any airway obstruction that the patient may be experiencing. The end all treatment for this patient would hopefully be discontinuing his Lisinopril3, which would take the dry hacking cough away. With the patient’s history of seasonal allergies he could be suffering from an upper airway cough syndrome, starting a trial of decongestants, nasal steroids, or antihistamines could alleviate the patients symptoms (Michaudaut & Malaty, 2019).


Benich, J., & Carek, P. (2018). Evaluation of the Patient with Chronic Cough. American Family Medicine , 84(8), 887-892.

Madison, J. M., & Irwin, R. S. (2019). Approach to the patient with chronic cough. Middleton’s Allergy, 1032-1041.

Michaudaut, C., & Malaty, J. (2019). Chronic Cough: Evaluation and Management. American Family Physician, 96(9), 575-580.