- Good morning sir, I’m Doctor Peacock and I will be the one examining you today.

First things
first, I’d like to review your patient file to make sure our information are up to date, if that’s
okay with you ?
- Sure!
- So first of all, are you indeed Mr. Denali?
- Yes that would be me.
- Can you please confirm your address?
- I live on 81 Maple Way, Seattle.
- Right, and could you tell me about your occupation ?
- I’m a marine biologist.
- Thank you! What about your marital status, is there someone we can contact in case of
emergency ?
- Yes, my wife, Mrs Denali.
- Great! Lastly, what’s your date of birth ?
- I was born on the 19th of July 1996.

- Fantastic. Now let’s move on to your symptoms, what brings you here today ?

- I’ve been bleeding a lot lately and it seems my body has been struggling with healing.

- Alright, do you have any family history with blood diseases?

- Yes I do, my grandfather on my mom’s side has hemophilia and my father has leukemia.

- Has you mother shown any similar symptoms ?

- I don’t believe so.

- Okay. So far, what I’ve gathered from the information you’ve given me is that you’re unlikely
to have hemophilia, as your mother hasn’t displayed symptoms of it. Do you mind delving
deeper into your symptoms ?

- Well the main one is that I’ve been getting frequent and unprovoked nosebleedings. My
gums have also been bleeding a lot when I brush my teeth which I hadn’t noticed before.
Moreover, whenever I hit something I get huge bruises as well, even if I barely grazed my
arm or my leg. And cuts take forever to heal.

- Interesting. Have you been experiencing anything else that you think may not be related to
these symptoms ?

- Yes! I’ve had pretty bad headaches since yesterday. My vision gets blurry at times. I also have
these weird spots on my arms.

- These look like petechiae. Have you been taking any acetaminophen lately ?

- Yes I’ve taken one this morning for the headache.

- I’m going to ask you to stop taking it from now on. I am suspecting thrombocytopenia, which
is a deficiency of platelets in your blood, and is worsened by acetaminophen intake. For now,
I’ll prescribe a blood test to check your platelet count, and some corticosteroids to try to
relieve your symptoms in the meantime. I’m also going to take you upstairs immediately to
have a MRI done as I believe you may be experiencing cerebral bleeding.