Review Question - QID 210561

A 67-year-old man presents to his primary care physician for a wellness checkup. The patient has a past medical history of hypertension and diabetes and is currently taking metformin, insulin, and lisinopril. He lives alone, drinks 7 to 10 alcoholic beverages per day, and smokes 3 packs of cigarettes per day. His temperature is 98.6°F (37.0°C), blood pressure is 177/108 mmHg, pulse is 90/min, respirations are 16/min, and oxygen saturation is 99% on room air. Physical exam demonstrates new findings as compared to his appointment 1 month ago, which include a systolic murmur best heard in the right upper sternal area, the findings in Figure A, and an enlarged, soft, and symmetric prostate. Which of the following is associated with the most likely diagnosis?