For minor bleeds in hemophilia, which therapy is commonly used?

• A. DDAVP
• B. Vitamin K
• C. Heparin
• D. Warfarin

Answer: (A)

Desmopressin is used for minor bleeds in mild hemophilia because it stimulates the release of stored factor VIII and von Willebrand factor from endothelial cells, temporarily boosting their circulating levels enough to help form a clot. This makes it a practical first-line option for mild factor VIII deficiency (hemophilia A) and some forms of von Willebrand disease, where a modest rise in these factors can stop mild bleeding. It won’t help in hemophilia B, where the missing factor is IX, since desmopressin does not raise factor IX. Vitamin K addresses deficiencies of the vitamin K–dependent factors (II, VII, IX, X) and thus won’t correct factor VIII deficiency. Anticoagulants like heparin or warfarin would worsen bleeding, not treat it. Desmopressin can be given IV or intranasally, with onset in about 30–60 minutes and a duration of several hours, making it a commonly used option for minor bleeds in appropriate patients.