a. History: Chronic > 8 weeks

Differential Diagnosis

Allergic rhinitis, Asthma, Bronchiectasis, Chronic Obstructive Pulmonary Disease, Gastroesophgeal Reflux Disease, Laryngopharyngeal Reflux,

Pivotal Assessment	Finding
Further History	Chronic cough with mucus production , repeated lung infections	Family history of asthma	Sneezing, rhinorrhea, nasal obstruction, nasal itching, postnasal drip, cough, irritability, and fatigue
Physical Exam	Wheezing and dyspnea
Direct Laryngoscopy	Arytenoid erythema, edema and pharyngeal inflammation