You are currently viewing Chronic Cough With A Normal Chest Radiograph – Mnemonic

Here is a quick mnemonic “NORMAL CHEST RADIOGRAPH to remember about Chronic Cough With A Normal Chest Radiograph

This can be valuable for patients as well as medical doctors, nurses & students doing their clinical rounds. You can also find it very useful for med exams like USMLE, NExT Medical Step 1&2, MBBS, NEET PG, INI-CET, FMGE,MCAT & NCLEX exams

Chronic Cough With A Normal Chest Radiograph: How To Remember Easily ?

  • N – Not just ACE inhibitors, multiple causes of chronic cough with a normal chest radiograph exist.
  • O – Overlooking alternative explanations can hinder diagnosis.
  • R – Revealing sensitized sensory nerves and afferent pathways, cough hypersensitivity syndrome suggests.
  • M – More common in women, lasting for years, dry or minimally productive cough.
  • A – ACE inhibitors may induce cough due to bradykinin accumulation.
  • L – Look for alternative medications if chronic cough persists.
  • C – Chronic cough may result from postnasal drainage or gastroesophageal reflux.
  • H – Historical clues: postnasal drip, throat clearing, sneezing, rhinorrhea.
  • E – Esophageal reflux may trigger cough; frequency and level require testing.
  • S – Symptoms may vary or be absent despite reflux; glottic inflammation is nonspecific.
  • T – The Cough-variant asthma is common in children; exposure triggers and resolution of cough important.
  • R – Rule out asthma with objective testing (spirometry, bronchoprovocation challenge).
  • A – Again eosinophilic bronchitis causes chronic cough; sputum eosinophilia treated with inhaled glucocorticoids.
  • D – Determine likely cause(s) based on history, examination, and pulmonary function testing.
  • I – Individualized therapy for postnasal drainage, including antihistamines, decongestants, and nasal sprays.
  • O – Options for gastroesophageal reflux treatment include antacids, H2 receptor antagonists, proton pump inhibitors.
  • G – Glucocorticoids and β-agonist bronchodilators effective for cough-variant asthma.
  • R – Reassurance may be given if chest CT, examination, and lung function tests are normal.
  • A – Additional causes of chronic cough may be missed on chest x-ray; consider CT for further evaluation.
  • P – Pulmonary pathology can be ruled out if chest examination, lung function tests, and CT are normal.
  • H – Helpful diagnostic testing and individualized treatment are essential.


Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER (1), (2)working in health department