Chief Complaint: Persistent bad cough History of Present Illness: A 50-year-old female…

Chief Complaint: Persistent bad cough History of Present Illness: A 50-year-old female presents to the office with a complaint of ongoing dry, non-productive cough for 6 weeks with intermittent harsh coughing episodes, burning chest and SOB. The cough is worse at night or when talking. She is having difficulty doing her job, where she is expected to talk for long periods. For the last week, she has been taking frequent puff on her rescue inhaler (albuterol) she has for her asthma. She states she is fatigued and thinks she is getting worse. Her family complains of the frequent loud and harsh cough. She resides in an area with frequent forest fires and poor air quality and she feels these have contributed to her cough. She states most of the family who lives with her also developed a “cold” around the same time her symptoms began, but they are all doing well now, except her. ROS: Her ROS is positive for harsh, frequent, non-productive cough with intermittent SOB. She denies a history of smoking or other inhalants, but states she grew up with parents who smoked in the home. She had a flu vaccine this season. Her ROS is negative for fever, hemoptysis, wheezing, chest pain, night sweats, poor appetite, body aches, pain, ear pain, nasal congestion, sore throat, history of pneumonia, nausea, vomiting diarrhea, recent travel, exposure to TB or rash. She states her asthma and acid reflux are controlled with routine medication.