History: 37-year-old male. Lifelong history of a seizure disorder, treated since age two. At a routine check with his neurologist, he complained of fatigue, exertional dyspnea, and lightheadedness over the past 2-3 months. He appeared pale, but otherwise his physical exam was within normal limits. He was found to have a decreased hemoglobin, and was referred to Hematology Clinic. CBC: RBC – 1.26 x 1012/L; HGB – 5.7 g/dL; HCT – 16.3 %; MCV – 130.0 fL, MCH – 45.2 pg; MCHC – 34.9 g/dL; RDW – 18.1 %; WBC – 6.2 x 109/L (WBC differential: N – 73, L – 21, M – 1, E – 4, B – 1); PLT – 219 x 109/L What alterations are seen in this blood smear field? RBC morphology: