<prompt> A 30-year old epileptic female, Kamla on Phenytoin therapy, developed weakness and fatigue. Blood examination revealed Hb 4.6 gm. MCV102 fl and MCH 40 pgdl. What is the most probable diagnosis?Hea failureIron deficiency anemiaPhenytoin induced agranulocytosisMegaloblastic anemia  <response>: Phenytoin can cause folic acid deficiency resulting in megaloblastic anemia. This is confirmed by raised MCV and MCH in the blood examination. REF: KD TRipathi 8th ed. 