<prompt> A 67-year-old woman with a prosthetic aoic valve develops progressive anemia. Examination of a peripheral blood smear reveals reticulocytosis and schistocytes. What is the appropriate diagnosis?AcanthocytosisHenoch-Schonlein purpuraIdiopathic thrombocytopenic purpuraMacroangiopathic hemolytic anemia  <response>: - Given features suggests the diagnosis of Macroangiopathic hemolytic anemia Macroangiopathic hemolytic anemia most commonly results from direct erythrocyte trauma due to abnormal vascular surface e.g., prosthetic hea valve, synthetic vascular graft. Anemia is mild to moderate is accompanied by an appropriate reticulocyte response. Blood smear examination reveals fragmented red blood cells schistocytes and polychromasia. Although microangiopathic hemolytic anemia results in morphologically-similar red blood cells, it reflects changes in small blood vessels. 