<prompt> A 30 year old female epileptic on phenytoin, developed weakness and fatigue. Blood examination revealed Hb 4.6 gm. MCV 102 fl and MCH 40 pgdl. What is the most probable diagnosisHeart failureIron deficiency anemiaPhenytoin induced agranulocytosisMegalobalstic anemia.  <response>: Ans. is d i.e. Megaloblastic anaemiaNormal valuesMCU- 86 - 98 fLMCH- 28 - 33 pgcellHb female - 12-16 gmdLLab finding in this pt. go in favour of megaloblastic anemia. HO phenytoin intake is also suggestive of same. 