Peripheral blood smear (1210/1700)

A 51yo man has become increasingly fatigued for the past 10m. PE: no abnormal findings. Labs:
Hgb=9.2, Hct=27.9%, MCV=132fl, plt=242, WBC=7.59. Which of the following morphologic
findings is most likely to be present on examination of his peripheral blood smear?
a. Hypersegmented neutrophils
b. Nucleated RBC
c. Blasts
d. Hypochromic, microcytic RBC
e. Schistocytes


































answer: A

high MCV = macrocytic anemia

DD megaloblastic anemias
B12 deficiency
Folate deficiency


Megaloblastic anaemias are a heterogeneous group of disorders that share common morphological characteristics. Erythrocytes are larger and have higher nuclear-to-cytoplasmic ratios compared to normoblastic cells. Neutrophils can be hypersegmented and megakaryocytes are abnormal.

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