Review Question - QID 215017

A 48-year-old man comes to the emergency department due to 4 weeks of fatigue and progressive shortness of breath. He also reports diffuse joint pain and joint swelling. He has been having trouble gripping his coffee mug in the morning. He has a history of poorly controlled hypertension, despite compliance with pharmacotherapy with lisinopril, amlodipine, and metoprolol, exercising regularly, and eating a vegetarian diet. He denies any alcohol or drug use, and has no family history of cardiopulmonary disease. His temperature is 99.5°F (37.5°C), blood pressure is 148/90 mmHg, pulse is 84/min, and respirations are 15/min. On examination, he has coarse facial features with prominent frontal and jaw bones. Multiple skin tags are noted on his back. Which of the following is the most appropriate next step in evaluating this patient?