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Subjects/Medicine/Medicine
Medicine
medium
stethoscope Medicine

All of the following are indications for thrombolysis in a patient with stroke except:

A. Age <18 years
B. Sustained BP >185/110 mm Fig despite treatment
C. On CT scan, edema less than 1/3rd of middle cerebral aery territory
D. Acute ischemic stroke within 3 hours of onset

Explanation

Ans: B. Sustained BP >185/110 mm Fig despite treatment(Ref: Harrison 19/e p759, 1605, 18/e p3273)A sustained BP >185/110 mull Hg despite treatment is a contraindication for thrombolytic therapy as it may lead to hemorrhage. Administration of IV Recombinant Tissue Plasminogen Activator (PA) for Acute Ischemic Stroke:IndicationContraindicationClinical diagnosis of strokeOnset of symptoms to time of drug administration <3 hoursCT scan showing no hemorrhage or edema of >1/3 of the MCA territoryAge > 18 years Sustained BP >185/110 mm Hg despite treatmentPlatelets <100,000; HCT <25%; glucose <50 or>400 mg/dLUse of heparin within 48 hours & prolonged PTT, or elevated INR

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