Which of the following are clinical manifestations of hemophilia?

Which of the following are clinical manifestations of hemophilia?

• A. Prolonged aPTT, normal bleeding time, excessive bruising, and hemarthrosis
• B. Prolonged bleeding time only
• C. Normal aPTT and abnormal PT
• D. Decreased platelet count

Answer: (A)

Hemophilia classically disrupts the intrinsic pathway of coagulation, so you see bleeding into deep tissues and joints rather than just surface bleeding. This pattern shows up as a prolonged aPTT with a normal PT and a normal bleeding time. Clinically, patients often have excessive bruising and, hallmarkly, hemarthrosis (bleeding into joints). That combination—prolonged aPTT, normal bleeding time, and deep-tissue bleeding like joint bleeds—fits hemophilia best. The other patterns don’t match: prolonged bleeding time suggests a platelet or vessel problem; normal aPTT with abnormal PT points to an extrinsic pathway issue; and a decreased platelet count indicates thrombocytopenia.

Hemophilia classically disrupts the intrinsic pathway of coagulation, so you see bleeding into deep tissues and joints rather than just surface bleeding. This pattern shows up as a prolonged aPTT with a normal PT and a normal bleeding time. Clinically, patients often have excessive bruising and, hallmarkly, hemarthrosis (bleeding into joints). That combination—prolonged aPTT, normal bleeding time, and deep-tissue bleeding like joint bleeds—fits hemophilia best.

The other patterns don’t match: prolonged bleeding time suggests a platelet or vessel problem; normal aPTT with abnormal PT points to an extrinsic pathway issue; and a decreased platelet count indicates thrombocytopenia.