Medical MCQ - A 45-year-old woman develops symptoms of shortness of breath on exertion, easy fatigue, and jaundice. On examination she is pale, and there is a palpable spleen, but no lymphadenopathy. Her hemoglobin is 9.0 g/dL, the reticulocyte count 9%, and the direct antibody test (Coombs) is positive. Which of the following bone marrow findings is most likely to be seen in this patient?

A 45-year-old woman develops symptoms of shortness of breath on exertion, easy fatigue, and jaundice. On examination she is pale, and there is a palpable spleen, but no lymphadenopathy. Her hemoglobin is 9.0 g/dL, the reticulocyte count 9%, and the direct antibody test (Coombs) is positive. Which of the following bone marrow findings is most likely to be seen in this patient?

megaloblastic changes

giant metamyelocytes

increased erythroid-to-myeloid ratio

increased lymphocytes

Question Category:

Medicine

Correct Answer:

increased erythroid-to-myeloid ratio

Description:

Bone marrow examination is most likely to show increased erythroid-to-myeloid ratio. Erythroid hyperplasia is common to all hemolytic anemias, and megaloblastic features only develop if they become folate deficient. A left shift only occurs if the bone marrow is under stress, like during a severe infection, and giant metamyelocytes or increased lymphocytes are not feature of an autoimmune hemolytic anemia.

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