A 5-day-old exclusively breastfed term baby born at home is brought with oozing from the umbilical stump and blood in the stool. The mother received no antenatal care and the baby received no injections after birth. Prothrombin time and activated partial thromboplastin time are both markedly prolonged; platelet count and fibrinogen are normal.
- A Vitamin K deficiency bleeding of the newborn ✓
- B Hemophilia A
- C Disseminated intravascular coagulation
- D Neonatal immune thrombocytopenia
Correct answer: A. Vitamin K deficiency bleeding of the newborn
Explanation
Classic vitamin K deficiency bleeding occurs between days 2 and 7 in exclusively breastfed infants who did not receive prophylactic vitamin K at birth. Breast milk has low vitamin K content and the sterile neonatal gut synthesizes little menaquinone. Both PT and aPTT are prolonged because factors II, VII, IX and X are affected, while platelet count and fibrinogen remain normal. DIC would show thrombocytopenia and low fibrinogen, and hemophilia presents later with isolated aPTT prolongation.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.