I've been waking up feeling like im choking for the past 2/52. Had a cold the week prior to that. It's pretty bad, I wake up and cough and cough and cough until I feel nauseous. I have vomited a few times because of that.
Further Hx: Clear sputum. Denies chills/rigors/wheeze/sweats. Sleeps on 3 pillows. Denies increasing SOBOE. No travel hx. Mild LOW but assoc dieting. Otherwise well no medical history no meds.
Ix: FBE/U&E/CRP normal. CXR clear.
O/E: Stable afebrile. Lying comfortably. Chest clear no added sounds. Pt feels "well" otherwise. Throat looks clear.
What examination is missing? Likely dx?
Possibly asthma but new onset asthma at this age is unlikely. Pt also denies wheeze.
It's most likely Post Nasal Drip / Upper Airway Cough Syndrome. In most people it does not bother them to the point where they will present to hospital but it can be very annoying.
It could be a mass in the neck, so do check for lumps along with cervical lymphadenopathy.
A rare cause of the choking sensation would be a pharyngeal pouch, but the patient has not complained of dysphagia, regurgitation, or halitosis.
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