Review Question - QID 214693

A 68-year-old man presents to his physician with worsening fatigue, abdominal pain, and a 10-pound unintentional weight loss over the past month. For the past year, he has had abdominal pain associated with constipation, for which he has taken docusate daily. Recently, he developed a feeling of incomplete bladder emptying and decreased urine production. He takes ibuprofen as needed for his chronic low back pain. His mother has a history of rheumatoid arthritis. His temperature is 98.9°F (37.9°C), blood pressure is 150/100 mmHg, pulse is 110/min, and respirations are 22/min. Physical examination reveals pedal edema and conjunctival pallor. There is tenderness to palpation over the lower thoracic vertebrae. Cardiac, abdominal, and digital rectal exams reveal no abnormalities. Laboratory studies demonstrate:

Hemoglobin: 11.2 g/dL
Ca2+: 12.7 mg/dL
BUN: 50 mg/dL
Creatinine: 2.6 mg/dL
Serum protein: 10.1 g/dL
Albumin: 4.2 g/dL

Which of the following other abnormalities would most likely be seen in this patient?