Review Question - QID 212528

A 64-year-old man comes to his primary care physician complaining of fatigue. He states that over the past month he has noticed that it takes him longer to finish daily chores such as mowing the lawn. He also endorses becoming short of breath when he walks from his basement workshop to the 2nd floor. His medical history is significant for diabetes mellitus and hypertension. He had a prosthetic aortic valve replacement 8 weeks ago for aortic regurgitation. The patient’s temperature is 98°F (36.7°C), blood pressure is 145/79 mmHg, pulse is 88/min, and respirations are 16/min with an oxygen saturation of 96% on room air. On physical examination, a 2/6 systolic ejection murmur is appreciated. Labs reveal elevated lactate dehydrogenase, mild hyperkalemia, and decreased haptoglobin levels. A peripheral smear is obtained. Which of the following images would most likely to be seen on this patient’s peripheral smear?