An anemic young man is found to have a macrocytosis of 90%. The most likely cause is? a. Zieve’s syndrome

The key is E. Folate deficiency. 

[Zieve's syndrome is an acute metabolic condition that can occur during withdrawal from prolonged alcohol abuse. It is defined by hemolytic anemia (with spur cells and acanthocytes), hyperlipoproteinaemia (excessive blood lipoprotein), jaundice, and abdominal pain. The underlying cause is liver delipidization].