Haemophilia A — RACP Adult Medicine MCQ

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ModerateHaematologyHaemophilia ARACP Adult Medicine

A 35-year-old man with known haemophilia A (factor VIII deficiency) presents with an acute haemarthrosis of the right knee. His baseline factor VIII level is <1%. What is the target factor VIII level for treatment of a joint bleed?

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Correct answer: E — 50–80%

For acute haemarthrosis in haemophilia A, the target factor VIII level is 50–80% initially, achieved with factor VIII concentrate. For severe bleeds (intracranial, GI, retroperitoneal), the target is 80–100%. Emicizumab (a bispecific antibody mimicking factor VIII) is now used for prophylaxis in patients with and without inhibitors. The HAVEN trials demonstrated significant reduction in bleed rates. Joint aspiration should be avoided if possible.

Reference: National Blood Authority – 2024 – Haemophilia Management Guidelines; eTG – 2025 – Haematology