A 20 year old African American male presents with severe acute onset chest pain without an identifiable trigger. It is accompanied by fever, swelling of his joints, nausea, and one episode of vomiting. He's had similar episodes in the past which did not prompt him to see health care; they lasted several days. His past medical history is significant for this as a child:
On exam, he is tachypneic and hypertensive. Laboratory results show a hematocrit of 22 with MCV 95, an unconjugated hyperbilirubinemia, elevated serum LDH, and low serum haptoglobin. An EKG is normal sinus rhythm.
Challenge: What do you expect on peripheral blood smear?
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