Review Question - QID 210953

A 68-year-old man presents to his primary care physician for pain in his feet. The patient states that it is very painful for him to walk around, and he has significant pain in his right and left toes. The patient has a past medical history of obesity, type 2 diabetes mellitus, anxiety, depression, COPD, and a 30 pack-year smoking history. The patient’s current medications include lisinopril, hydrochlorothiazide, insulin, metformin, fluoxetine, clonazepam, albuterol, home oxygen, varenicline, and fish oil and he is compliant with all medications. His temperature is 98.7°F (37.1°C), blood pressure is 130/75 mmHg, pulse is 90/min, respirations are 12/min, and oxygen saturation is 93% on room air. On physical exam, the patient’s toes appear pale and dirty. When inspecting his toes, shallow wounds with a pale base devoid of granulation tissue can be appreciated. The patient has decreased pinprick sensation in his lower extremities bilaterally. A pulmonary exam is notable for a prolonged expiratory phase. Which of the following findings is most likely to be found in this patient?