A few of the lymphocytes were of larger size with an eccentrically placed nucleus and a single prominent nucleolus. Platelets appeared decreased. Make a problem list. Construct an initial plan of workup. She has also noticed occasional palpitations and headaches.
Family history is noncontributory.
WDWN female in no acute distress who appears stated age. Abdomen negative, no LKS palpable. Skin, extremities and neurologic normal. Peripheral blood smear reveals marked aniso and poikilocytosis with several macrocytes, some microcytes, and moderate basophilic stippling. Some large agranular platelets are observed.