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Question 4

A 30 year old lady from Madrid is known to be a carrier for haemophilia A.  Her factor VIII level is normally around 15 iU/dL and she has previously had good responses to DDAVP.  
The surgical registrar contacts you because she needs an laparoscopic appendicetomy that evening and you arrange for her to have DDAVP.  
Following the dose of DDAVP her FVIII level rises to 115 iU/dL.  

Unfortunately at 1 am you are called again because she is bleeding into her surgical drain and they are planning to take her back to theatre.  
At this point her blood results are as follows: 

Hb 10.4  WC 13.1  Plts 145

PT 12.1  APTT 59.3  Fibrinogen 4.2

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