This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pathology
[{'content': 'A newborn baby presented with profuse bleeding from the umbilical stump after birth. Rest of the examination and PT, APTT are within normal limits. Most probable diagnosis is - \nSelect and explain. \nA. Factor X deficiency, B. Glanzmann thrombasthenia, C. Von willebrand disease, D. Bernard soulier disease', 'role': 'user'}, {'content': "Answer: B \nExplanation: Normal PT and APTT exclude option a and c because PT is raised in factor X deficiency and APTT is raised in Von Willebrand disease.\nSo we are left with Glanzmann's thrombasthenia and Bernard Soulier syndrome.\nBoth these disorder are platelet function disorders and can result in neonatal bleeding.\nDisorders of platelet function produce defects in the formation of a hemostatic plug and thus results in bleeding.\nBoth are congenital disorders.\nThere is little to differentiate between these two disorders.\nBetween these two, Glanzmann's thrombasthenia can present as bleeding since birth.\n\nGlanzmann's thrombasthenia\n\nGlanzmann's thrombasthenia is a rare autosomal recessive disorder.\nThe disease is characterized by a deficiency of glycoprotein IIb/IIIa which acts as a receptor for fibrinogen.\nThe disease manifests at birth with increased bleeding from the umbilical cord stump.\n\na.\xa0There is a lifelong mucocutaneous bleeding tendency in the form of epistaxis, ecchymoses and bleeding from\xa0the gums.\nb.\xa0Episodes of G.I. bleeding genitourinary bleeding or post surgery/trauma may occur. However, bleeding episodes\xa0decrease with increasing age.\nBernard Soulier syndrome\n\nIt is a rare autosomal disorder characterized by mild thrombocytopenia, giant platelets and defective adhesion.\nThe striking abnormality is giant platelet in peripheral smear.\nThe membrane abnormality is GPIb-IX-V complex in platelets and megakaryocytes.\nBleeding usually begins at an early age.\nThere is moderate bleeding in the form of purpuric rash, bruising epistaxis, gingival bleeding and men.\n\nThe main lab findings are increased in bleeding time without any coagulation abnormality.", 'role': 'assistant'}]