This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Blood, Subject name: Medicine
A 45-year-old woman develops symptoms of shortness of breath on exertion, easy fatigue, and jaundice. On examination she is pale, and there is a palpable spleen, but no lymphadenopathy. Her hemoglobin is 9.0 g/dL, the reticulocyte count 9%, and the direct antibody test (Coombs) is positive. Which of the following bone marrow findings is most likely to be seen in this patient? 
Select and explain. 
A. megaloblastic changes, B. giant metamyelocytes, C. increased erythroid-to-myeloid ratio, D. increased lymphocytes
C: increased erythroid-to-myeloid ratio
Answer: C: increased erythroid-to-myeloid ratio 
Explanation: Bone marrow examination is most likely to show increased erythroid-to-myeloid ratio. Erythroid hyperplasia is common to all hemolytic anemias, and megaloblastic features only develop if they become folate deficient. A left shift only occurs if the bone marrow is under stress, like during a severe infection, and giant metamyelocytes or increased lymphocytes are not feature of an autoimmune hemolytic anemia.