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Pathology · single question

An 8-year-old boy with hemophilia A has an infection in tooth J (primary upper left canine). What is the BEST next step?

  1. Check INR (International Normalized Ratio)
  2. Obtain informed consent
  3. Have him return in 2 weeks
  4. Consult with the patient's physician
Show answer and explanation

Correct answer: D. Consult with the patient's physician

  • A. INR measures the extrinsic clotting pathway (PT/warfarin monitoring). Hemophilia A is a Factor VIII deficiency affecting the INTRINSIC pathway — INR is not the appropriate test. aPTT (activated partial thromboplastin time) is the correct test for hemophilia A.
  • B. Informed consent is always needed but is not the 'best next step' for managing this complex medical situation.
  • C. Delaying treatment 2 weeks for an active infection in a medically complex child is inappropriate and could lead to serious consequences.
  • D. CONSULTING THE PHYSICIAN (hematologist) is the best next step. The physician needs to advise on Factor VIII replacement therapy before any dental procedure, the appropriate dose and timing of factor replacement, and whether the patient needs hospitalization for treatment. This is essential before any invasive treatment in hemophilia A.

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