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A 74 year old woman has one year of reduced energy. She has stopped going out for her daily walk because she feels breathless when she walks. She has hypertension and takes bendroflumethiazide. She is an ex-smoker with a 50 pack year smoking history.Her pulse is 80 bpm and BP 140/85 mmHg. She has occasional expiratory wheeze and her breath sounds have a prolonged expiratory phase.Which initial investigation is most likely to establish the diagnosis?

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