Ans: D. Folic acid deficiency(Ref Robbins 9/e p631, 648)High MCV, MCH & MCHC - Suggestive of macrocytic, hyperchromic anemia.Typically seen in folic acid deficiency.Folic acid (pteroylmono- glutamic acid) deficiency a results in megaloblastic anemia.Same pathologic features as vitamin B12 deficiency.Interpretation:In question, Hb= 9.5 mg/dL, PCV = 30, RBC count = 2 millions/mm3Hematocrit or PCV = MCV x RBC concentrationMCV PCV/RBC count = 30/0.2 = 150 (increased/Macrocytic)MCH = Hb/ RBC count =9.5/0.2 = 47.5 (increased/Hyperchromic)MCHC = Hb/MCV = 31 (normal)Macrocytic, hyperchromic anemia is typically seen in folic acid deficiency.
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