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The page below is a sample from the LabCE course Red Cell Disorders: Peripheral Blood Clues to Nonneoplastic Conditions. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Macrocytosis-associated conditions: Case Study One
A complete blood count (CBC) was ordered for a patient recently admitted to the emergency department. The MCV on the count was 115 femtoliters (fL) (normal range 80 - 100 fL). A peripheral blood smear was reviewed; a representative field from the smear is shown on the right.
Which of the following conditions could immediately be ruled out, based on the MCV and appearance of the RBCs on the peripheral blood smear?

Please select the single best answer