RBC lysis is observed in all of the following except__________?
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Answer: C. Obstructive jaundice
Explanation
Obstructive jaundice causes conjugated hyperbilirubinemia and lipid abnormalities without triggering widespread red blood cell lysis. Bile duct obstruction impairs bilirubin excretion into the intestine, leading to jaundice rather than hemolytic destruction. Red blood cell lifespan remains largely normal in obstructive jaundice, distinguishing it clearly from hemolytic anemias. Obstructive jaundice typically results from gallstones or tumors blocking the extrahepatic biliary tree ducts. Accumulated bile salts in the circulation cause pruritus and liver function test abnormalities without hemolysis. Hemolytic conditions feature accelerated destruction of erythrocytes, releasing excessive unconjugated bilirubin into the blood.
Clinicians differentiate obstructive jaundice from hemolytic disorders using fractionated bilirubin and reticulocyte count panels. Patients with biliary obstruction present with dark urine, pale clay-colored stools, and yellowing sclera. Prompt surgical or endoscopic decompression is required to relieve the obstruction and prevent secondary liver damage. Thalassemia involves defective globin chain synthesis that leads to premature destruction of red blood cells. Methotrexate therapy can cause bone marrow suppression and megaloblastic anemia with associated red cell lysis. Sickle cell anemia features abnormal hemoglobin polymerization causing rigid crescent cells and severe hemolytic crises.
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