Kay, a 27-year-old casually employed male of North African origin, walks into the clinic with a mild but persistent cough that has troubled him for over six months. 

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Kay, a 27-year-old casually employed male of North African origin, walks into the clinic with a mild but persistent cough that has troubled him for over six months. He reports associated exertional dyspnoea and gastro-oesophageal reflux.

There is no history of surgery or trauma and no significant past history except for hiatus hernia diagnosed during endoscopy to investigate reflux two years ago.