This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pathology
Which of the following does not indicate megaloblastic anemia 
Select and explain. 
A. Increased reticulocyte count, B. Raised Bilirubin, C. Mild splenomegaly, D. Nucleated RBC
A: Increased reticulocyte count
Answer: A: Increased reticulocyte count 
Explanation: Ans. a. Increased reticulocyte count Megaloblastic anemia is characterized by hypercellular bone marrow with abnormally large nucleated RBC, raised unconjugated bilirubin and mild splenomegaly Characteristic Features of Megaloblastic Anemia Bone marrow: Hypercellular with a decreased myeloid/erythroid ratio and abundant stainable iron RBC precursors: Abnormally largedeg and have nuclei that appear much less mature than would be expected from the development of the cytoplasm (nuclear-cytoplasmic asynchronydeg). Nuclear chromatin is more dispersed than expected and it condenses in a peculiar fenestrated patterndeg Raised unconjugated bilirubindeg Mild reversible splenomegalydeg (Wintrobes 12/e p1151)