Review Question - QID 109911

A 65-year-old man presents to his primary care provider complaining of fatigue. He is active in his retirement home’s chess club and enjoys swimming every morning. However, over the past 6 months, he has noticed a significant decrease in his energy level. His wife passed away 9 months ago from breast cancer. Although he remains saddened by her loss, he is comforted by his children and grandchildren who frequently visit him. Since her death, his diet has primarily consisted of fast food. His medical history is notable for hypertension and gout. He takes lisinopril and allopurinol. On examination, he is alert and oriented to person, place, and time. His reflexes, strength, and range of motion are full and symmetric bilaterally in the upper and lower extremities. He walks with a normal gait. Romberg test is negative. His skin is pale and capillary refill is 3 seconds. Hematologic labs are shown below:

Hemoglobin: 10.9 g/dl
Hematocrit: 29%
Leukocyte count: 7,500/mm^3
Platelet count: 180,000/mm^3
Mean corpuscular volume: 103 mm^3

A blood smear is also performed and a notable finding is shown in Figure A. Additional laboratory studies in this patient would most likely reveal which of the following?