You are reviewing patients in the medical outpatient clinic. Your next patient has been referred by his general practitioner with the following letter. Please read the letter and then review the patient.

Dear Doctor,

Re: Mr Ibrar Siddique

Age: 42 years

I am very concerned about this Asian gentleman who presented complaining of a long-standing cough and has recently noticed haemoptysis. I am worried that there is sinister underlying pathology. Because of the urgency of this referral I have been unable to organise a chest X-ray. But I would, nonetheless, very much like your advice on the further investigation and management of this chap.

Yours sincerely