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.