The 18-year-old female patient reports menorrhagia, easy bruising, and epistaxis. Her family history is notable for maternal hypertension, a brother with hemophilia A, and a father who died of stroke at age 48. Which question is most important to ask the patient?

“What was the exact cause of your father’s death?”. The most important question for the female patient with an apparent bleeding disorder whose father had a stroke is to determine the exact cause of the father’s death. A hemorrhagic stroke could indicate the father also had hemophilia A, which could then be passed to the daughter via an abnormal X-chromosome. The patient’s brother has hemophilia A; this indicates the mother is a carrier, so this question is unnecessary. Hormonal contraception pills place the patient at risk for clotting, not bleeding. It may be helpful to learn about other bleeding disorders in the family, but determining the father’s exact cause of death is most helpful.

The 18-year-old female patient reports menorrhagia, easy bruising...

Category: Physiological Adaptation
Difficulty: 9

Topics: Cardiovascular Communication & Documentation Genetics Hematology/Oncology Neurology Sexuality and Reproduction

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