A child who bleeds from gums and has swollen knee-probably due to-
**Core Concept**
The clinical presentation of gum bleeding and swollen knees in a child suggests a coagulopathy, particularly hemophilia, due to impaired clotting factor activity leading to mucosal and joint hemorrhage. Hemarthrosis (blood in joints) is a hallmark of hemophilia, while gingival bleeding reflects mucosal vulnerability.
**Why the Correct Answer is Right**
Hemophilia A (Factor VIII deficiency) and Hemophilia B (Factor IX deficiency) are X-linked recessive disorders causing prolonged bleeding post-injury or spontaneously. The lack of clotting factors leads to unstable clot formation. Swollen knees result from recurrent hemarthrosis, while gum bleeding occurs due to minor trauma-induced hemorrhage. These symptoms align with the pathophysiology of hemophilia.
**Why Each Wrong Option is Incorrect**
**Option A:** Thrombocytopenia (low platelets) causes petechiae and purpura but not hemarthrosis.
**Option B:** Vitamin C deficiency (scurvy) leads to bleeding gums and joint pain, but swelling is less common, and it’s rare in children without severe malnutrition.
**Option C:** Von Willebrand disease causes mucosal bleeding but minimal joint involvement due to partial clotting factor dysfunction.
**Clinical Pearl / High-Yield Fact**
Remember **“Hemophilia = Hemarthrosis + Hemorrhage”**: Joint swelling (knees, elbows) and mucosal bleeding (gums, nose) are classic. Always consider inherited coagulopathies in children with unexplained bleeding.
**Correct Answer: C. Hemophilia A**