ABSTRACT
History A 67-year-old male former coal miner has a long history of early morning productive cough. He presented to his GP feeling generally unwell complaining of lower back pain. He was taking thiazide diuretics to control mild hypertension. His appetite was poor due to dyspepsia, but with no apparent weight loss, and he controlled his dyspepsia with milk and over-the-counter antacids. On direct questioning, he admitted to taking 20 units of alcohol per week and had recently stopped smoking. He had smoked 20 cigarettes per day for 50 years.
