Answer: In this man, because he is symptomatic, the peripheral blood smear is likely to be significantly abnormal. As the hemoglobin concentration of individual red blood cells falls, the cells take on the classic picture of microcytic (small), hypochromic (pale) erythrocytes. There is also apt to be anisocytosis (variation in size) and poikilocytosis (variation in shape), with target cells. The target cells occur because of the relative excess of red cell membrane compared with the amount of
hemoglobin within the cell, leading to "bunching up" of the membrane in the center.