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
[{'content': 'All are features of Intravascular hemolysis except - \nSelect and explain. \nA. Thrombocytopenia, B. Hemosiderinuria, C. Decreased haptoglobin, D. Raised indirect bilirubin', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Hemolytic anemia\n\nHemolytic anemia is anemia due to hemolysis, i.e. the abnormal breakdown of red blood cells.\nHemolytic anemia has the following features -\n\n\nA shortened red cell lifespan, i.e. premature destruction of red cells.\nElevated erythropoietin level and increased erythropoiesis in the marrow and other sites, to compensate for the loss of red cells→\xa0 characterized by increased reticulocyte count.\nAccumulation of the products of hemoglobin catabolism due to an increased rate of red cell destruction.\n\n\nHemolysis may occur either inside the blood vessels (intravascular hemolysis) or within the mononuclear phagocytic system of spleen, liver or bone marrow (extravascular hemolysis).\n\nIntravascular hemolysis \n\nDue to the destruction of RBC, hemoglobin is released into blood → Hemoglobinemia.\nExcess of hemoglobin may be excreted by kidney → hemoglobinuria.\nSome of the hemoglobin is reabsorbed in kidney and is converted to hemosiderin which is then excreted → hemosiderinuria.\nFree hemoglobin in plasma bound to haptoglobin and this complex is rapidly cleared by mononuclear phagocytic system Decreased haptoglobin.\nWhen haptoglobin is depleted, free hemoglobin is oxidized to methemoglobin → methemoglobinemia.\nExcess heme groups are catabolized to bilirubin within the mononuclear phagocytic system → Increased indirect bilirubin and jaundice.\nLDH is stored in the blood. During hemolysis this enzyme is released in the blood → Increased serum LDH.', 'role': 'assistant'}]