Which of the following is listed as a risk factor for vocal fold hemorrhage?

• A. Use of anti-coagulation agents (e.g., aspirin, vitamin E)
• B. Regular hydration
• C. Adequate sleep
• D. Healthy diet

Answer: (A)

Vocal fold hemorrhage happens when delicate blood vessels in the vocal fold mucosa bleed, often after voice use or strain. Systemic factors that affect blood clotting can raise this risk. Using anti-coagulation agents like aspirin or vitamin E increases bleeding tendency, making hemorrhage more likely, so they are listed as a risk factor. In contrast, regular hydration, adequate sleep, and a healthy diet support tissue health and resilience, and don’t increase bleeding risk. They may even help protect the vocal folds, so they are not risk factors for hemorrhage.