Cough

03/11/2013

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A 20-year-old man with a history of asthma complains of two weeks of unrelenting cough.  He denies fever, shortness of breath, myalgias, rhinorrhea, chest pain, and hemoptysis.  His asthma is generally well controlled, but this cough does not appear to be amenable to his bronchodilator.  He became concerned when, after a sudden bout of prolonged coughing, he vomited.

In the ED, you see a well appearing man in no respiratory distress.  His vital signs are normal, and he has trace intermittent end-expiratory wheezing bilaterally with a normal tidal volume and effort.  The remainder of his exam is reassuring.  He states that he feels tired, but relatively well now that he has seen you.

Which of the following is the BEST management approach:

    A.    Penicillin G benzathine (Bicillin) 1.2 million units IM
    B.    Oseltamivir (Tamiflu) 75 mg PO daily for 5 days
    C.    Azithromycin PO for 5 days
    D.    Ondansetron (Zofran) 8 mg PO prn


In the meantime, a quote –


In illness the physician is a father; in convalescence, a friend; when health is restored, he is a guardian.

– Hindu proverb

 


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