Which of the following is decreased in megaloblastic anemia? ...

[big1devin]

Which of the following is decreased in megaloblastic anemia?
 
  a. Reticulocyte production index (RPI)
  b. MCV
  c. Lactic dehydrogenase (LD)
  d. Bilirubin

Question 2

Which of the following bone marrow findings would be unexpected in megaloblastic anemia?
 
  a. Nuclear cytoplasmic asynchrony
  b. Giant bands and metas
  c. Hypercellularity
  d. Myeloid-to-erythroid (M:E) ratio of 10:1

[perkiness]

Answer to Question 1

ANS: A
Because ineffective erythropoiesis occurs in the megaloblastic anemias, the RPI is decreased and the MCV is increasedthe anemia is macrocytic. Intramedullary cell death occurs in ineffective erythropoiesis, and this leads to both an increased LD (released from dying cells) and increased bilirubin (increased breakdown of hemoglobin).

Answer to Question 2

ANS: D
A M:E ratio of 10:1 would imply that 10 times as many myeloid cells exist as do erythroid precursors in the marrow. However, erythroid hyperplasia occurs in the marrow, so the M:E ratio is decreased to about 1:1. The marrow is hypercellular, nuclear cytoplasmic asynchrony occurs in maturation because of the defect in DNA synthesis, and giant bands and metas are characteristic.

[big1devin]

Thank you

[perkiness]

No problemo