Bleeding Episodes: Bryson

In the real world, properly diagnosing a patient with hemophilia might also require you to correctly assess a bleeding episode. Let’s look back at Bryson, a patient from the Diagnosing Hemophilia module, to determine what information can help with making a diagnosis.

Remember, Bryson was referred with a history of multiple raised bruises without known trauma. We have his test results, as shown below.

  • Name: Bryson
  • Age: 9 months
  • PT Results: Normal
  • PTT Results: 80
  • Factor VIIIc: 112%
  • Factor IX: 2.5%
Bryson Question 2

Good job! Our assessment has determined that Bryson should be watched for head trauma and mouth, muscle and joint bleeding. What types of signs and symptoms might you tell the parents to look for in these types of bleeds?

Check for:

  • Head trauma
  • Mouth bleeding
  • Muscle bleeding
  • Joint bleeding

The signs and symptoms provided on the Notable Hemorrhages in Hemophilia should be used to assist in determining bleeding sites.

Some suggested responses are

  • Limitation of motion, discoloration, “funny feeling” in joint
  • Swelling, pain, heat, decreased motion, tightness of skin, head trauma
  • Any fall or injury (bump) to the head, with or without a bruise or swelling
  • Signs of intracranial pressure, even without head injury, headache for over 4 hours, irritability, and unequal pupil size with a loss of reactivity to light

Before we go further, here’s a pop quiz to check your understanding of the material. Do your best!

Continue to the next page.