Harr Hematology Practice Test 2025 - Free Hematology Practice Questions and Study Guide

Microangiopathic hemolytic anemia is characterized by the presence of schistocytes and nucleated red blood cells (RBCs). Schistocytes are fragmented red blood cells that typically appear in the blood smear of patients with microangiopathic processes, which can disrupt the normal architecture of red blood cells as they pass through narrowed or obstructed blood vessels. This fragmentation is a direct result of mechanical damage caused by conditions such as thrombocytopenic purpura or disseminated intravascular coagulation.

Nucleated red blood cells indicate a stress response from the bone marrow due to increased demand for erythrocytes in the context of hemolysis. In microangiopathic hemolytic anemia, this rise in immature red blood cells occurs because the bone marrow attempts to compensate for the ongoing destruction of the mature erythrocytes in circulation.

The other options include cellular findings that may be associated with different hematologic disorders rather than microangiopathic hemolytic anemia specifically. For example, target cells and Cabot rings typically indicate other types of anemia or erythrocyte abnormalities unrelated to microangiopathy. Toxic granulation and Döhle bodies are associated with infections or inflammation, while Pappenheimer bodies and basophilic stippling are related