| Feature | Consider: |
| Symptoms present from birth | Cystic fibrosis Structural abnormality Bronchopulmonary dysplasia Primary ciliary dyskinesia |
| Abnormal voice | Acute viral laryngitis Vocal cord nodules Structural abnormalities Inducible laryngeal obstruction |
| Sudden breathlessness at rest | Panic attacks |
| Cough | |
| Acute onset | Inhaled foreign body |
| Dry cough occurring during daytime only | Somatic cough (previously called ‘habit’ cough) |
| Persistent productive cough | Bronchiectasis Cystic fibrosis Primary ciliary dyskinesia Protracted bacterial bronchitis |
| Persistent cough | Post-viral cough Allergic rhinitis Primary ciliary dyskinesia Pertussis |
| 🚩Cough with haemoptysis | Infection Inhaled foreign body Congestive heart disease Vascular abnormality Bronchial mass Cystic fibrosis |
| Upper respiratory tract | |
| Chronic production of sputum | Protracted bacterial bronchitis |
| Nasal polyps | Cystic fibrosis |
| Chest sounds | |
| 🚩 Unilateral wheeze | Inhaled foreign body |
| No variation in wheeze | Structural abnormality |
| Inspiratory wheeze | Inducible laryngeal obstruction |
| Sudden wheeze at rest | Panic attacks |
| Exercise-induced wheeze that stops immediately when exertion ceases | Inducible laryngeal obstruction Anxiety |
| Stridor | Croup Inducible laryngeal obstruction |
| Localised crepitation | Pneumonia |
| Cardiac murmur | Congenital heart disease |
| Skin and integument | |
| Finger clubbing | Cystic fibrosis Primary ciliary dyskinesia Bronchiectasis Immunodeficiency |
| Systemic signs | |
| Weight loss/lack of weight gain | Immunodeficiency |
| Fevers | Chronic infection |
| Growth failure | Cystic fibrosis Immunodeficiency |
| Recurrent or atypical infections | Immunodeficiency |
Additional information
These findings require further investigation or specialist referral. Flag symbol 🚩 indicates urgent referral needed.