Patient has macroglossia, decreased hemoglobin, vitamin B12 level--, folic acid level. Diagnosis is -

Ans. is 'c' i.e., Megaloblastic anemiao Decreased vitamin Br and folic acid level along with macroglossia suggests megaloblastic anemia.Causes of Macrocytic anemiao Vitamin B,, deficiencyo Folic acid deficiencyo Orotic aciduriao Nitrous oxide inhalationo Liver diseaseo Hypothyroidismo Thiamine deficiencyOral manisfestations of Vitamin B12 :- o Macroglossia (large tongue)o Loss of papilla (Atrophic glossitis)o Red patches on the tongue on red lines (Moeller's glossitis) on the ventrumo Red and inflomed (Sore tongue) tongue,o Angular cheilitiso Oral ulcersPeripheral blood pictureo Macrocytosiso A MCVT MCH, MCHC normalo Anisopoikilocytosiso Macroovalocyteso Tear drop cells and normocyteso Evidence of dyserythropoiesisBasophilic stipplingCaboltringHowell jolly bodieso Reticulocytes are normal or mildly increasedo White cells decreasedHvpersegmented neutrophilso Thrombocytopeniao Pancytopenia