Review Question - QID 108606

A 41-year-old woman from Ohio presents to her primary care physician with several weeks of fatigue, weight loss, and dry cough. She states that she feels feverish but has not taken her temperature and has also developed mild diffuse joint pain, worst in her fingers and knees. Her past medical history is significant for type 1 diabetes controlled on insulin but no family history of cancer or other inherited diseases. She has smoked one pack per day since the age of 15 when she immigrated from Russia, reports traveling to Arizona and California multiple times in the last 6 months for work, and endorses several new recent sexual partners without consistent barrier protection. Her temperature is 99°F (37.2°C), blood pressure is 122/78 mmHg, pulse is 86/min, and respirations are 16/min. Her CBC with differential is shown below.

Hemoglobin: 12.8 g/dL
Platelets: 160,000/mm^3
Leukocyte count: 14,100/mm^3
Segmented neutrophils: 26%
Eosinophils: 8.7%
Basophils: 0.3%
Lymphocytes: 61%
Monocytes: 4%

Her chest radiograph is shown in Figure A. Which of the following physical exam findings would most likely be seen in this patient?