Kаtsurа is а 52-year-оld middle schооl science teacher referred by her family physician. She reports progressive hoarseness over the past 6 months, chronic throat clearing, and a “globus” sensation. She drinks 3–4 cups of coffee daily, takes a daily antihistamine for seasonal allergies, and has a history of heartburn. She describes her classroom as “constantly noisy.” Flexible laryngoscopy revealed mild bilateral vocal fold erythema and posterior laryngeal erythema and edema. No structural lesions were noted. Identify at least three distinct etiologic factors contributing to Priya’s dysphonia. Explain what the medical evaluation has established and why this information is essential before proceeding with behavioral voice therapy.