Dental surgical management of the patient with hemophilia

Self-Instruction Exercise No. 388
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Exercise No. 388
Subject Code: 754
Dentistry for the Medically Compromised

The 15 questions for this exercise are based on the article Dental surgical management of the patient with hemophilia on pages 14-17. This exercise was developed by Jean Carlson, DDS, FAGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing the exercise will enable you to:

  • understand the types of hemophilia and bleeding disorders;
  • identify clotting factors administered to patients with hemophilia; and
  • recognize the impact of bleeding disorders on clinical dental procedures.

Answers for this exercise must be received by June 30, 2017.

  1. The most common coagulation disorder is _______________.

    A. true hemophilia
    B. von Willebrand disease
    C. hemophilia B
    D. Christmas disease

  2. The incidence of hemophilia B is estimated to be 1 in __________.

    A. 5,000 females
    B. 5,000 males
    C. 30,000 females
    D. 30,000 males

  3. In case 2, the patient was noted to have an uncorrected factor IX activity level of _____%.

    A. 8.0
    B. 8.2
    C. 8.4
    D. 8.6

  4. Aminocaproic acid was administered to each patient at a dose of _____mg/kg every ___ hours.

    A. 40; 4
    B. 50; 4
    C. 40; 6
    D. 50; 6

  5. The incidence of hemophilia A is 1 in _________ among the male population.

    A. 5,000
    B. 10,000
    C. 15,000
    D. 20,000

  6. Moderate hemophilia exhibits a plasma factor activity range of ________%.

    A. less than 1
    B. 1-5
    C. 6-10
    D. 11-15

  7. Hemophilia types A and B are clinically distinguishable. Hemophilia type A is considered more severe than type B.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  8. Hemophilia A is caused by a deficiency in factor ______, while type B is caused by a deficiency in factor ______.

    A. VIII; IX
    B. VII; VIII
    C. IX; VIII
    D. VII; IX

  9. Primary hemostatic disorders may present as all of the following except one. Which is the exception?

    A. atelectasis
    B. petechiae
    C. epistaxis
    D. surgical hemorrhage

  10. All of the following are common characteristics of hemophilia disorder except one. Which is the exception?

    A. asymptomatic female carriers
    B. genetic dominance
    C. symptomatic males
    D. X-linked

  11. Hemophilia A patients undergoing minor surgery require a plasma factor level of ________% preoperatively.

    A. 10-40
    B. 30-60
    C. 50-80
    D. 70-100

  12. Antifibrinolytic agents prevent postoperative bleeding by inhibiting the formation of ________.

    A. lysine
    B. plasmin
    C. vasopressin
    D. thrombin

  13. Desmopressin acetate mimics __________ in triggering the release of von Willebrand factor and factor VIII in the blood.

    A. oxytocin
    B. isotocin
    C. vasopressin
    D. prolactin

  14. ___________ should be used cautiously for extraction socket hemostasis because its low pH can irritate the socket.

    A. Gelfoam
    C. Tranexamic acid
    D. Surgicel

  15. The form of recombinant factor IX administered to the patient described in case 2 is called _____________.

    A. Advate
    B. BeneFix
    C. Stimate
    D. Amicar


Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent

Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
Did this exercise achieve its objectives? Yes No
Did this article present new information? Yes No
How much time did it take you to complete this exercise? mins

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