Review Question - QID 220680

A 35-year-old man presents to the emergency room with a 2 day history of frequent nosebleeds. He reports a constant pounding headache over the same timeframe. His wife believes he has seemed “off” lately, frequently forgetting recent events and the names of his friends. His medical history is notable for hypertension and rheumatoid arthritis for which he takes methotrexate. He smokes 1 pack per day and drinks 2-3 beers per day. His temperature is 101.1°F (37.3°C), blood pressure is 145/90 mmHg, pulse is 110/min, and respirations are 18/min. On exam, he appears pale and diaphoretic. Labs are obtained with the following results:
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