Neuromuscular junction disorders Quiz: Ace Your Exams

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A 65-year-old man comes to his outpatient provider because of a chronic cough for the past 3 months. It is occasionally accompanied by flecks of blood-tinged sputum. Review of systems is significant for weakness in the hips and thighs bilaterally and 15 lbs (6.8 kg) weight loss. Past medical history is notable for hypertension. He only takes hydrochlorothiazide. Social history is notable for a 50-pack-year smoking history. In the office, his temperature is 37.0°C (98.6°F), pulse is 76/min and blood pressure is 157/85 mmHg. Pulmonary examination reveals expiratory wheezing on the left side in 5th intercostal space. A chest radiograph is ordered and reveals the following:

A chest X-ray shows diffuse, patchy opacities in both lung fields, with R, AP, and ERECT markers visible in the upper left. The cardiac silhouette is enlarged.
Reproduced from: Radiopaedia.org   

Laboratory testing reveals a creatinine kinase level of 75 U/L (reference range: 25-90 U/L). Which of the following additional examination findings will most likely be present in this patient?  

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