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
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.
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