Hypersegmented neutrophils are seen in -

Ans. is 'c' i.e.. Megaloblastic anemia Findings of megaloblastic anemiaPeripheral bloodo Macrocytosis i.e., megaloblastic RBC - Due to nuclear1 cytoplasmic asynchrony,o Macrocytes lack central pallor of normal RBC.o Anisopoikilocytosis - Marked variation in shape and size,o Majority of RBCs appear as macroovalcytes.o Few tear drop cells.o Low reticulocyte counto Some nucleated RBCs may appear (normally, during maturation of RBC, nucleus disappears),o Hyper-segmented neutrophils - First manifestation of megaloblastic anemia.o Large megakaryocytes with multilobate nuclei.o Evidence of erythropoiesis: - Basophilic stippling, Cabott Ring, Howell-jolly bodies,o As DNA synthesis is impaired in all proliferating ceils, pancytopenia (anemia, leukopenia, thrombocytopenia) may occur.Bone marrowo Hypercellular due to proliferation of erythroid precursors replacing fat - Decreased ration of fat cells to hematopoietic elements (normal is 1 : 1).o Reversal of myeloid to erythroid ratio (normal is 2 to 3 : 1) due to proliferation of erythroid precursors,o Megaloblastic erythropoiesisOtherso t MCV due to macrocytosiso T MCH due to increased hemoglobin content.o Normal MCHC because hemoglobin content in the cell is increased proportiante to increase in the size of RBC.