Review Question - QID 212855

A 67-year-old man arrives to the emergency department complaining of cough and worsening shortness of breath. He states that over the past 6 months he has noticed progressive difficulty breathing along with a persistent dry cough. His medical history includes atrial fibrillation, hypertension, and hyperlipidemia. He takes amiodarone, apixaban, lisinopril, amlodipine, and simvastatin. He is a current tobacco smoker with a 40 pack-year smoking history. He denies other recreational drugs. He is a retired factory worker. The patient’s temperature is 98°F (36.7°C), blood pressure is 145/79 mmHg, pulse is 83/min, and respirations are 16/min with an oxygen saturation of 86% on room air. On physical examination, there is mild digital clubbing, and inspiratory crackles are heard bilaterally. A chest radiograph is obtained, as shown in Figure A. Which of the following may also be found in this patient?