Peripheral Smear showing the arrows is diagnostic of
High-Yield Explanation
(C) Megaloblastic anemia# HEMATOLOGICAL FINDINGS OF MEGALOBLASTIC ANEMIA:> The blood film can point towards vitamin deficiency: Decreased Red Blood Cell (RBC) count and hemoglobin levels. Increased mean corpuscular volume (MCV, >95 fl) and Mean Corpuscular Hemoglobin (MCH). Normal mean corpuscular hemoglobin concentration (MCHC, 32-36 g/dL) The reticulocyte count is decreased due to destruction of fragile and abnormal megaloblastic erythroid precursor. The platelet count may be reduced. Neutrophil granulocytes may show multisegmented nuclei ("senile neutrophil"). This is thought to be due to decreased production and a compensatory prolonged lifespan for circulating neutrophils, which increase numbers of nuclear segments with age. Anisocytosis (increased variation in RBC size) and poikilocytosis (abnormally shaped RBCs). Macrocytes (larger than normal RBCs) are present. Ovalocytes (oval-shaped RBCs) are present; Howell-Jolly bodies (chromosomal remnant) also present.