Podcast
Questions and Answers
A patient presents with an acute myocardial infarction. Which mechanism of action explains how thrombolytic medications like streptokinase achieve thrombolysis?
A patient presents with an acute myocardial infarction. Which mechanism of action explains how thrombolytic medications like streptokinase achieve thrombolysis?
- Directly degrading the structural components of atherosclerotic plaques, leading to the dissolution of the thrombus.
- Chelation of calcium ions in the blood, disrupting the coagulation cascade and leading to clot breakdown.
- Activation of plasminogen to plasmin, which then hydrolyzes fibrin, the main protein component of blood clots. (correct)
- Inhibition of platelet aggregation, preventing further clot formation at the site of the infarction.
Following the administration of urokinase for a confirmed pulmonary embolism, a patient develops sudden-onset flank pain and hematuria. Which of the following is the most likely cause of these new clinical findings?
Following the administration of urokinase for a confirmed pulmonary embolism, a patient develops sudden-onset flank pain and hematuria. Which of the following is the most likely cause of these new clinical findings?
- The urokinase is causing a previously undetected renal cell carcinoma to hemorrhage.
- The patient is experiencing an idiosyncratic reaction to urokinase, leading to acute interstitial nephritis.
- Urokinase is causing the formation of new clots within the renal vasculature.
- The thrombolytic activity of urokinase has caused bleeding in the kidneys, resulting in flank pain and hematuria. (correct)
What is the primary reason thrombolytic agents such as streptokinase are contraindicated in patients with a recent history of ischemic stroke?
What is the primary reason thrombolytic agents such as streptokinase are contraindicated in patients with a recent history of ischemic stroke?
- The risk of inducing a hemorrhagic transformation of the original ischemic infarct leading to increased neurological damage. (correct)
- The increased likelihood of precipitating a secondary embolic event due to the disruption of the original thrombus.
- The potential to trigger a systemic inflammatory response that further compromises the blood-brain barrier.
- Thrombolytics may exacerbate neuronal excitotoxicity in the penumbral region, increasing the infarct size.
A patient with a known deep vein thrombosis (DVT) is started on streptokinase. Forty-eight hours later, the patient develops significant hypotension despite aggressive fluid resuscitation. What is the most likely explanation for this patient's hypotension?
A patient with a known deep vein thrombosis (DVT) is started on streptokinase. Forty-eight hours later, the patient develops significant hypotension despite aggressive fluid resuscitation. What is the most likely explanation for this patient's hypotension?
Which of the following best describes the mechanism by which plasmin facilitates the breakdown of blood clots?
Which of the following best describes the mechanism by which plasmin facilitates the breakdown of blood clots?
A patient with a history of hypertension and hyperlipidemia presents to the emergency department with symptoms suggestive of acute myocardial infarction. Lab results reveal elevated troponin levels. However, the patient has a known intracranial neoplasm. Which treatment strategy is most appropriate in this case?
A patient with a history of hypertension and hyperlipidemia presents to the emergency department with symptoms suggestive of acute myocardial infarction. Lab results reveal elevated troponin levels. However, the patient has a known intracranial neoplasm. Which treatment strategy is most appropriate in this case?
A patient is being treated with urokinase for a massive pulmonary embolism. Which laboratory finding would be most indicative of a therapeutic response to the medication?
A patient is being treated with urokinase for a massive pulmonary embolism. Which laboratory finding would be most indicative of a therapeutic response to the medication?
Following thrombolytic therapy with streptokinase, a patient develops an allergic reaction characterized by bronchospasm, urticaria, and angioedema. Which of the following is the most appropriate immediate intervention?
Following thrombolytic therapy with streptokinase, a patient develops an allergic reaction characterized by bronchospasm, urticaria, and angioedema. Which of the following is the most appropriate immediate intervention?
What is the most critical initial step in managing a patient who develops significant bleeding complications after receiving a thrombolytic agent?
What is the most critical initial step in managing a patient who develops significant bleeding complications after receiving a thrombolytic agent?
Which of the following best explains why thrombolytic therapy must be administered within a specific timeframe following the onset of symptoms in acute myocardial infarction or ischemic stroke?
Which of the following best explains why thrombolytic therapy must be administered within a specific timeframe following the onset of symptoms in acute myocardial infarction or ischemic stroke?
Flashcards
Thrombolytics
Thrombolytics
Drugs like streptokinase and urokinase that dissolve existing blood clots.
Streptokinase
Streptokinase
Streptokinase is a thrombolytic drug used to dissolve blood clots.
Urokinase
Urokinase
Urokinase is a thrombolytic drug that dissolves clots by activating plasminogen.
Mechanism of Action of Thrombolytics
Mechanism of Action of Thrombolytics
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Indications for Thrombolytics
Indications for Thrombolytics
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Contraindications for Thrombolytics
Contraindications for Thrombolytics
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Side Effects of Thrombolytics
Side Effects of Thrombolytics
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Study Notes
- Thrombolytics are a class of drugs that includes streptokinase and urokinase
- Thrombolytics are also known as Kinase (SU)
Mechanism of Action
- Thrombolytics dissolve existing clots within blood vessels
- Thrombolytics activate plasminogen, converting it into plasmin
- Plasmin then breaks down fibrin crosslinks, which are essential components of blood clots
Indications
- Used as an anticoagulant
- Used in the treatment of deep vein thrombosis (DVT)
- Used in myocardial infarction (MI)
- Used in pulmonary embolism (PE)
Contraindications
- Active bleeding
- Intracranial neoplasm
- Recent ischemic stroke
Side Effects
- Bleeding
- Kidney damage
- Hypotension
- Allergic reaction
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