A 60-year-old postmenopausal woman presents with fatigue, mild jaundice, and tingling in the lower extremities. Laboratory studies show elevated serum levels of homocysteine and methylmalonic acid, and mild thrombocytopenia. A peripheral blood smear :

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Macrocytosis. Hypersegmented neutrophil MEGALOBLASTIC ANEMIA

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Megaloblastic (b12 deficiency anemia)

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Megaloblastic

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B12 Folate deficiency Megaloblastic anaemia

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Hypersegmented neutrophils Pathognomonic of B12 deficiency

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vit B12 and folic acid deficiency anaemia.

Vitb12def

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Megaloblastic

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megaloblastic anemia

PBS showing macrocytic blood picture with neurological manifestation and methylmalonic acid Vit B12 deficiency

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