Review Question - QID 214370

A 72-year-old woman presents for a well visit. She experienced menarche at age 11 and menopause at age 56. The patient has never been pregnant and has always had negative pap smears. She has never had a sexually transmitted infection, and her only sexual partner has been her husband of 35 years. Her past medical history is significant for obesity with a BMI of 30 kg/m^2, type 2 diabetes mellitus, and breast cancer in her early 50s that was treated with mastectomy and tamoxifen. Her current medications include metformin and topical estrogen. She reports that her period has returned lately and describes episodes of painless, heavy vaginal bleeding over the past few months. The patient denies any previous history of heavy menstrual periods prior to the recent episodes, abnormal bleeding or bruising elsewhere, pain or bleeding with intercourse, and trauma to the area. She denies tobacco and alcohol use. On exam, her abdomen is soft and nontender, her uterus is smooth and non-enlarged, and she has a normal-appearing vagina. Which of the following findings is likely associated with the patient's presentation?