A 13-year-old girl is brought to the emergency department by her father because of a severe nosebleed. She takes no medications and has no history of serious medical illness but has had frequent nosebleeds in the past. Physical examination shows brisk bleeding from the right nare and pooled blood in the posterior pharynx. Laboratory studies show:
Hemoglobin 8 g/dL
Platelet count 195,000/mm3
Prothrombin time 12 sec
Partial thromboplastin time 49 sec
Fibrin split products negative
The bleeding time is 11 minutes (N = 2-7). Which of the following is the most appropriate pharmacotherapy?

Question

Quizplus · Accepted Answer

Eductional Objective: Desmopressin stimulates von Willebrand factor (vWF) release from endothelial cells and can be used for the treatment of bleeding due to von Willebrand disease (vWD). Patients with vWD are often asymptomatic; treatment is only required if symptoms such as recurrent epistaxis occur, as seen in this patient. Desmopressin can also be used for the treatment of bleeding due to uremic platelet dysfunction and hemophilia A and is also used for the treatment of diabetes insipidus.

A 13-Year-Old Girl Is Brought to the Emergency Department by Her