What would be the likely findings if a bone marrow were performed in a complicated case of iron deficiency
a. Increased myeloid-to-erythroid (M:E) ratio and increased staining with Prussian blue
b. Shaggy polychromatophilic normoblasts and no staining with Prussian blue
c. Polychromatophilic normoblasts with copious pink cytoplasm and no staining with Prussian blue
d. Increased M:E ratio and increased ringed sideroblasts
ANS: B
Shaggy polychromatophilic normoblasts are seen because of the asynchronous maturation of developing red cells, with the cytoplasm lagging behind that of the nucleus. Prussian blue is an iron-specific stain; in iron deficiency anemia, iron stores are absent, and sideroblasts and siderocytes are markedly decreased to absent. The M:E ratio is increased late in iron deficiency because fewer red cell precursors exist in the marrow, but no staining with Prussian blue occurs.
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