Question: CASE 5 Patient Is A 28 Year Old School Teacher. She Is Complaining Of Easy Bruising. She Says She Bleed Excessively After Dental Procedures And Has A History Of Menorrhagia. She Is Currently Pregnant With Her First Child Family History Is Significant For Bleeding Problems. Some Family Members, Male And Female, Have Bleeding Tendencies. An Aunt Died …

CASE 5 Patient is a 28 year old school teacher. She is complaining of easy bruising. She says she bleed excessively after dental procedures and has a history of menorrhagia. She is currently pregnant with her first child Family history is significant for bleeding problems. Some family members, male and female, have bleeding tendencies. An aunt died in childbirth from hemorrhage PT 11.2 sec (normal 11.2) aPTT 42 sec (normal 22-34) Factor VIII 55% (normal 50-150%) Von Willebrand factor Antigen decreased Ristocetin cofactor activity decreased Platelet aggregation to Ristocetin – reduced Questions: 1. What is the most likely diagnosis? 2. What testing is used to diagnosis and monitor in these patients? 3. What affects does pregnancy have?