Question

What is NOT true regarding an adult hemophiliac who visits a dentist?

• A. Cryoprecipitate may be needed
• B. The dose of lidocaine required is increased
• C. HIV screening is required
• D. Monitored GA care needs to be given

Hint:

Think about what changes for a hemophiliac at the dentist: factor cover, screening, GA precautions, and injection technique, not the local anesthetic dose itself.

Answer 1

The Correct Option is B

This question asks which statement is NOT true for an adult hemophiliac (a person with a genetic clotting factor deficiency, usually factor VIII or IX) who needs dental treatment. Dental work, even a simple extraction, can cause bleeding that a hemophiliac cannot stop on his own, so each statement needs to be checked against how these patients are actually managed.

1. Cryoprecipitate may be needed: This is true. Cryoprecipitate is rich in factor VIII, and it (or factor VIII concentrate/desmopressin) is given before extractions or block injections to raise clotting factor levels and cut the bleeding risk.
2. The dose of lidocaine required is increased: This is NOT true. Hemophiliacs do not need a higher dose of local anesthetic. The real concern is the injection technique, not the drug dose: a block injection (like an inferior alveolar nerve block) can tear a vessel in a deep tissue plane and cause a hematoma that is hard to control, so infiltration anesthesia is preferred over block anesthesia when possible.
3. HIV screening is required: This is true. Many older hemophiliacs received repeated transfusions of blood products before modern viral screening existed, so they carry a higher risk of blood-borne infections such as HIV and hepatitis. Screening and standard precautions matter before any invasive dental work.
4. Monitored GA care needs to be given: This is true. If general anesthesia is unavoidable, it should be given with careful monitoring and factor replacement cover, since intubation itself can cause bleeding in the airway.

The statement that fails is the one about lidocaine dose, since local anesthetic dosing is not altered in hemophilia; only the injection technique and factor cover are.

Let's summarize:

• Factor replacement (cryoprecipitate or factor concentrate) covers the bleeding risk of dental procedures.
• Infiltration is safer than block anesthesia in hemophiliacs; the anesthetic dose itself is not increased.

So the correct answer is that the dose of lidocaine required is increased, since this is the false statement among the four.