A 72 y/o man with hx of chronic alcoholism and smoking presents to your office with extreme fatigue. Denies any fever or weightloss or nightsweats. Vital signs were normal and physical examination is benign. Laboratory studies reveal CBC with hgb 9.5, wbc 10k with 35% neutrophils, 55% lymphocytes and 9% monocytes, platelets 90k. Basic metabolic panel is within normal limits. A direct coombs test is negative. A peripheral blood smear is shown below.
Most likely cause of this patient’s Anemia :
A) Vitamin B12 deficiency
B) Chronic Myeloid Leukemia
C) Chronic lymphocytic leukemia
E) Autoimmune Hemolysis
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