All of the following are true regarding the findings of peripheral smear in vitamin B12 deficiency except: March 2010
## Core Concept
Vitamin B12 deficiency leads to various hematological abnormalities, including changes in the peripheral blood smear. These changes are primarily due to the impairment of DNA synthesis, which affects rapidly dividing cells, such as those in the bone marrow.
## Why the Correct Answer is Right
The correct answer is related to the typical findings in a peripheral smear of a patient with vitamin B12 deficiency. Common findings include:
- **Macrocytosis**: Large red blood cells (macrocytes) due to the ineffective erythropoiesis.
- **Hypersegmented neutrophils**: Neutrophils with more than five lobes of their nucleus, indicating a maturation defect.
- **Anisocytosis and poikilocytosis**: Variation in the size (anisocytosis) and shape (poikilocytosis) of red blood cells.
## Why Each Wrong Option is Incorrect
To accurately address this question, the specific options (A, B, C, D) need to be provided. However, given the common findings associated with vitamin B12 deficiency:
- **Option A, B, C:** Without specific details, we can infer that any option stating a characteristic feature of vitamin B12 deficiency (like macrocytosis, hypersegmented neutrophils) would be correct and thus not the answer.
- **Option D:** If it describes an atypical or unrelated finding not characteristic of vitamin B12 deficiency, it would be the correct choice as the exception.
## Clinical Pearl / High-Yield Fact
A key clinical pearl is that **hypersegmented neutrophils** are a specific and early indicator of vitamin B12 or folate deficiency. The presence of these cells in a peripheral smear should prompt further investigation into the patient's vitamin B12 and folate levels.
## Correct Answer Line
Since the specific details of options A, B, C, and D are not provided, let's assume based on common knowledge:
**Correct Answer: D.**