The following are typically seen in the peripheral smear in megaloblastic anemia?

Megaloblastic anemia is characterized by ineffective erythropoiesis, primarily due to deficiencies in vitamin B12 or folate. In a peripheral blood smear of a patient with megaloblastic anemia, one can expect to see specific abnormalities.

Oval macrocytes, which are enlarged red blood cells, are a hallmark of megaloblastic anemia. This enlargement occurs due to the impaired DNA synthesis that affects the maturation and division of erythrocyte precursors in the bone marrow. Decreased platelets, or thrombocytopenia, may also be present due to the compromised hematopoietic environment. Furthermore, hypersegmented neutrophils are a significant finding; these neutrophils have more than the typical 5 nuclear lobes, which is indicative of megaloblastic changes related to the ineffective hematopoiesis.

The presence of both oval macrocytes and hypersegmented neutrophils is what strongly supports the diagnosis of megaloblastic anemia, making this choice the most accurate representation of what you would see in the peripheral smear associated with this condition.