A 30 year old teacher of a primary school has present with complaint of progressive hornes for last one year the patient is a non smoker and has no history of any respiratory distress. Number one what is the most probable diagnosis number two what is the differential diagnosis of the case number three what are the probable clinical findings number four what are the investigations which you need to do to confirm the diagnosis number five brief in and describe the management of the case according to the marking scheme of 1 + 2 + 4 + 3 + 5.