Review Question - QID 109138

A 45-year-old male presents to the emergency room complaining that he has been coughing up blood-tinged sputum. Since this morning, the patient reports he has coughed up around 1/4 cup of "phlegm" mixed with blood. A review of systems is also notable for fatigue and night sweats that began two nights ago, but he denies any recent changes in weight. His past medical history is significant for hypertension, chronic sinusitis, and childhood asthma. His current medications include metoprolol and amlodipine. He is a smoker with a 20 pack-year history. The patient’s temperature is 99°F (37.2°C), blood pressure is 126/76 mmHg, pulse is 72/min, and respirations are 14/min with an oxygen saturation of 98% O2 on room air. A physical exam is notable for oral ulcers. A chest radiograph is performed and is shown in Figure A. Labs are drawn and are listed below:
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