Which of the following is elevated in megaloblastic anemia?
a. White blood count
b. Mean cell hemoglobin (MCH)
c. Red blood count
d. Platelet count
ANS: B
Pancytopenia is found in the megaloblastic anemias, because all the blood-forming cells require DNA synthesis to proliferate and replace those cells that die even on a normal basis. Thus the white count, red count, and platelet count are all expected to be decreased. However, because the red cells are macrocytic and normochromic, the MCH is elevated (reflection of fully hemoglobinized large red cells).
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