Macrocytic Anemia : How to Proceed in Investigations - Based on Kaplan USMLE Step 2 Lectures
B12 Deficiency
❖ What is the best intial test?
S Presence of hypersegmented neutrophils and a low B12 level (NOT a Schilling test).
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Folate Deficiency
❖ What is the best initial test?
S Presence of hypersegmented neutrophils and a low folate level.
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Alcohol or other drug toxicity
❖ What is the best initial test?
S Absence of hypersegmented neutrophils and to exclude the B12 and folate deficiency
and look for the drug in the history.