.Snapshot A 25-year-old woman presents to the emergency room with prolonged bleeding after a dental procedure early that day. She has gone through several gauze packing with no success. Her past medical history includes heavy and prolonged menses. As a child, she had several episodes of unexplained nosebleeds. Labs show normal PT, PTT, and platelet count. Introduction unknown Inherited mixed platelet and coagulation disorder from deficiency in von Willebrand factor (vWF) Genetics login to view 1 more bullet Epidemiology login to view 2 more bullets Pathogenesis login to view 5 more bullets Presentation Symptoms login to view 7 more bullets Evaluation Normal or ↑ PTT (like hemophilia) Normal PT ↑ bleeding time (unlike hemophilia) CBC login to view 2 more bullets Diagnosis by ristocetin cofactor assay login to view 2 more bullets Differential Diagnosis Bernard-Soulier syndrome Glanzmann thrombasthenia Hemophilia Treatment DDAVP (desmopressin acetate) login to view 1 more bullet Factor VIII replacement if refractory to DDAVP login to view 1 more bullet Prognosis, Prevention, and Complications Prognosis login to view 1 more bullet Prevention login to view 1 more bullet Complications login to view 1 more bullet