<prompt> PNH is associated with all of the following conditions, except :Aplastic anemiaVenous thrombosisIron deficiency anemiaIncreased LAP scores  <response>: Answer is D Increased LAP scores PNH is associated with a decreased Leukocyte Alkaline phosphase LAP score PNH: Paroxysmal Nuctunal haemoglobinuria: Review PNH is an Acquired Q Intracarpuscular -- disorder, acquired at stern cell level - by loss characterised by undue sensitivity of red blood cells membrane to complement -- Common manifestations: PNH : Three common manifestation Hemolytic Anemia Venous Thrombosis Deficient Hematopoesis Probably due to defect at stem cell level Because of increased activation of Activation of complement indirectly PancytopeniaAplastic anemia complement and complement stimulates platelet aggregation and - Granulocytes mediated destruction hypercoagulability thus thrombosis - Thrombocytes thrombocytopenia despite thrombocytopenia HemoglobinemiaQ Hemoglohinuriae HemosiderinuriaQ Elevated LDH Q Why is it called Paroxysmal Nocturnal haemoglobinuria? Basis : Acidification enhances activity of complement During night when one sleeps noctunal -- Relative Hypoxia -- Acidosis -- Enhanced complement activity Paroxysm of Haemoglobinuria identified by -- Complement mediated destruction of red blood cells passage of brown urine in morning. Red Cell Membrane is deficient in two factors which result in increased activation of complement 1. DAF Q :Decay accelerating factor that activates decay of complements 2. MIRL CD 59 : inhibits membrane attack complex 