Vulvovaginal candidiasis Quiz: Ace Your Exams

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A 45-year-old woman presents to the office with three days of vaginal itching and pain with urination. Today, she noticed a thick white vaginal discharge. She is sexually active with her husband and has recently been working out more than usual. She does not have abdominal or pelvic pain, fever, or chills. Past medical history is significant for diabetes mellitus, high blood pressure and obesity. Temperature is 37.0°C (98.6°F), pulse is 74/min, respirations are 18/min, and blood pressure is 132/82 mmHg. Exam reveals erythema and edema of the vulva with small cracks in the skin bilaterally and a thick, curd-like, white vaginal discharge. There is no cervical motion tenderness. A sample of the vaginal discharge is prepared with potassium hydroxide solution and looked at under the microscope. The wet mount is shown below. Which of the following additional findings would most likely be seen upon further evaluation?    


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