In a young woman with heavy menses, which history finding would most strongly suggest von Willebrand disease?

• A. History of bruising
• B. Irregular menses
• C. Family history of colon cancer
• D. Past pregnancy without issues

Answer: (A)

Von Willebrand disease presents as a mucocutaneous bleeding tendency due to a defect in platelet adhesion, often manifesting as easy bruising and menorrhagia. A history of bruising directly points to a platelet adhesion/aggregation problem like vWD, making it the most specific clue among the options. Irregular menses can have many gynecologic causes and isn’t specific for a bleeding disorder. A family history of colon cancer isn’t related to bleeding risk, and a past pregnancy without issues doesn’t negate a mucosal bleeding tendency and isn’t as suggestive as bruising.