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Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 6-year-old male presents to the emergency department after falling from his scooter. The patient reports that he fell sideways off the scooter as he rounded a curve in the road, and he describes dull, aching pain along his left side where he hit the ground. The patient’s parents report that he has never had any serious injury but that he has always seemed to bruise easily, especially after he started playing youth soccer this fall. His parents deny that he has ever had nosebleeds or bleeding from the gums, and they have never seen blood in his stool or urine. His mother notes that her brother has had similar problems. On physical exam, the patient has extensive bruising of the lateral left thigh and tenderness to palpation. Laboratory tests are performed and reveal the following:

Hemoglobin: 14 g/dL
Hematocrit: 41%
Mean corpuscular volume: 89 µm3
Reticulocyte count: 0.8%
Leukocyte count: 4,700/mm3
Prothrombin time (PT): 13 seconds
Partial thromboplastin time (PTT): 56 seconds
Bleeding time (BT): 4 minutes

Which of the following is the most likely underlying pathophysiology of this patient's presentation?
assistant
Factor VIII deficiency