Which of the following is NOT a typical presenting finding in hemophilia?

• A. Prolonged PTT
• B. Prolonged bleeding time
• C. Normal platelet count
• D. Hemarthrosis

Answer: (B)

In hemophilia, the problem is a deficiency of intrinsic pathway clotting factors (factor VIII or IX), which impairs secondary hemostasis. This leads to a prolonged activated partial thromboplastin time (aPTT) with a normal bleeding time, a normal platelet count, and a tendency for deep tissue bleeding such as hemarthrosis. Bleeding time reflects primary hemostasis—platelet function and vessel wall integrity—not the coagulation cascade. Since platelets and their function are not impaired in classic hemophilia, the bleeding time is typically normal.

So the finding that would not be typical is a prolonged bleeding time. The others—prolonged aPTT, normal platelet count, and hemarthrosis—are consistent with hemophilia.