A 4-year-old boy presents with recurrent bleeding into soft tissue and muscle. Some rib fractures are noted in the child’s chart. At the prior visits, PT, PTT, and TT were tested.All normal results...

A 4-year-old boy presents with recurrent bleeding into soft tissue and muscle. Some rib fractures are noted in the child’s chart. At the prior visits, PT, PTT, and TT were tested.All normal results were reported consistently, except for a transient period as an infant during which PT and PTT were slightly elevated. During this visit the father is concerned since the child’s bruising has continued. The physician identifies symmetric bruising along the child’s midaxillary line. X-ray of the ribs indicates new rib fractures overlaid on healing fractures. His PT, PTT, and TT are currently normal. The next step in working this child’s case up is which of the following?

A. Reorder PT, PTT, and TT.

B. Order a von Willebrand factor count including multimers and ristocetin.

C. Check the platelet count.

D. Check vitamin K levels.

E. Contact Child Protective Services and the team’s social worker on call.