Full 2L QBank
Medicine General 71b05007

Streptokinase and Urokinase are contraindicated in:

A
Intracranial malignancy
B
Pulmonary Embolism
C
AV fistula
D
Thrombophlebitis
High-Yield Explanation
Answer is A (Intracranial malignancy) Malignant Intracranial Neoplasm is an absolute contraindication for Thrombolysis (Streptokinase / Urokinase). Contraindications and Cautions for Fibrinolytic Use in STEMI: Absolute Contraindications Relative Contraindications * Any prior intracranial hemorrhage * History of chronic severe poorly controlled hypeension * Known structural cerebral vascular lesion * Severe uncontrolled hypeension on presentation (e.g., aeriovenous malformation) (SBP > 180 Hg or DBP > 110 Hg) * Known malignant intracranial neoplasm * History of prior ischemic stroke > 3 months, dementia, or known (primary or metastatic) intracranial pathology not covered in contraindications * Ischemic stroke within 3 months * Traumatic or prolonged (>10 min) CPR or major surgery (<3 wk) (Except acute inschemic stroke within 3 hr.) * Recent (within 2-4 week) internal bleeding * Suspected aoic dissection * Non compressible vascular punctures * Active bleeding diathesis (excluding menses) * For streptokinase/anistreplase: prior exposure (>5 days ago) or * Significant closed head or facial trauma within 3 mo. prior allergic reaction to these agents * Pregnancy * Active peptic, ulcer * Current use of anticoagulants (the higher the INR, the higher the risk of bleeding)

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