Last questions answer - Steroid injection.  The patient's diagnosis is osteolysis of the distal clavicle. AC joint injections can be therapeutic for patients with this condition

A 49-year-old female with a past medical history of diabetes and hypertension presents with fatigue and jaundice that started 6 weeks ago and has been gradually progressive in course. On physical examination, mild hepatomegaly is noted. On further investigation, hemoglobin is found to be 9.3 gm/dl and total bilirubin is 2.0 mg/dl. During diagnostic workup, a blood smear is performed which the hematologist reads as having numerous acanthocytes. What does this finding signify?

1.They are extremely large red blood cells
2.Red blood cells have DNA fragments
3.Red blood cells stain with lipids
4.Red blood cells have thorny projections

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