This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Haematology, Subject name: Pathology
Cause of fragmented RBC in peripheral blood - 
Select and explain. 
A. Microangiopathic hemolytic anemia, B. D.I.C., C. Option 1,2&4, D. Malignant hypeension
C: Option 1,2&4
Answer: C: Option 1,2&4 
Explanation: Microangiopathic hemolytic anemias most commonly seen with DIC ,TTP, HUS, malignant hypeension, SLE ,and disseminated cancer. These causes micro vascular lesions leading to luminal narrowing, due to deposition of fibrin and platelets.These changes produce shear stress that mechanically injure passing RBCs ,leading to fragmentation of RBCs .In peripheral blood fragmented RBCs (schistocytes) are seen .Schistocytes can be seen in disseminated intravascular coagulation (DIC), micropathic hemolytic anemia, glomerulonephritis, and hemolytic anemia resulting from mechanical trauma to the red blood cells (such as severe burns). Ref: Robbins pathologic basis of disease ;pg :644 Ref Robbins 9/e pg 409