Haematology: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Haematology

Sample item

A 6-year-old boy has recurrent painful swelling of the knee and bleeds after tooth extraction. Platelet count and PT are normal, but aPTT is prolonged and corrects on mixing with normal plasma. Which is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Haemophilia A

Haemophilia A is an X-linked deficiency of factor VIII that causes haemarthroses and deep tissue bleeding, with an isolated prolonged aPTT that corrects on mixing. Diagnosis is confirmed by factor VIII assay. Treatment is factor VIII replacement, and desmopressin is used for mild disease.

Option by option

  • A. Vitamin K deficiency

    Vitamin K deficiency prolongs the PT as well, and is rare in this scenario.

  • B. Haemophilia A (correct)

    Correct. Haemarthrosis in a boy with prolonged aPTT that corrects points to haemophilia A.

  • C. Von Willebrand disease type 1

    Von Willebrand disease type 1 is mild, with mucosal bleeding and a prolonged bleeding time, and haemarthrosis is uncommon.

  • D. Immune thrombocytopenia

    Immune thrombocytopenia causes a low platelet count with mucocutaneous bleeding.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Haemophilia A. Haemophilia A is an X-linked deficiency of factor VIII that causes haemarthroses and deep tissue bleeding, with an isolated prolonged aPTT that corrects on mixing.

Why is "Vitamin K deficiency" not the answer?

Vitamin K deficiency prolongs the PT as well, and is rare in this scenario.

Why is "Von Willebrand disease type 1" not the answer?

Von Willebrand disease type 1 is mild, with mucosal bleeding and a prolonged bleeding time, and haemarthrosis is uncommon.

Why is "Immune thrombocytopenia" not the answer?

Immune thrombocytopenia causes a low platelet count with mucocutaneous bleeding.

What concept does this question test?

It tests Haematology in General Medicine. Diagnosis is confirmed by factor VIII assay. Treatment is factor VIII replacement, and desmopressin is used for mild disease.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematology?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.