Thrombolysis

Question 1

2 drugs?

Answer 1

Streptokinase

Alteplase

Question 2

Streptokinase
Activates ? to form ?, however it is antigenic and the development of streptococcal antibodies thus precludes repeated use.

Answer 2

plasminogen

plasmin

Question 3

Alteplase;
Recombinant tissue type ? activator (t-PA), again leading to increased ? activation and ?.
Not antigenic, but has a slightly higher risk of ? haemorrhage.

Answer 3

plasminogen
plasminogen
fibrinolysis
intracerebral

Question 4

These can be used in ? or ?

Answer 4

MI

Stroke

Question 5

Contra-indications

Active ?.
---o Any sign of ? ? in stroke.
---o Suspected ? ? in ACS.
Recent ? trauma.
Severe ? {>200/120).

Answer 5

bleeding
intracerebral haemorrhage
aortic dissection
head
hypertension

Question 6

Contra-indications

Recent ? (2 months).
? or recent ? {10 days).
Severe ? disease/ oesophageal ?.
Prolonged / traumatic ?.

Answer 6

surgery
preg
delivery
liver
varices
CPR

Question 7

Alteplase is no longer contra-indicated in patients with a history of ? haemorrhage, ? at stroke onset, or bleeding diatheses (e.g. low ? count, on ?/?)

Answer 7

intracerebral
seizure
platelet
warfarin/heparin