Which of the following is a contraindication to fibrinolytic therapy in a patient presenting with ischemic stroke-like symptoms?

Fibrinolytic therapy, such as the administration of tissue plasminogen activator (tPA), is used in the acute management of ischemic strokes. However, there are specific contraindications to its use that clinicians must consider to ensure patient safety.

The correct answer, "Time," reflects the critical time constraint associated with fibrinolytic therapy. The efficacy of this treatment diminishes significantly after a certain window, typically within 4.5 hours from symptom onset. If therapy is administered outside this timeframe, the risks of complications, particularly hemorrhagic transformation, increase substantially, making it a contraindication to use fibrinolytics.

In terms of the other factors:

• "PMH" (previous medical history) may impact the decision to administer fibrinolytics, such as previous strokes or certain medical conditions, but it does not define a strict timeline constraint.

• "Age" can influence treatment decisions, particularly in very elderly patients, but it is not an absolute contraindication in terms of time parameters.

• "BP" (blood pressure) must be managed prior to administering fibrinolytics, particularly if the systolic is above 185 mmHg or diastolic above 110 mmHg, requiring careful management before considering this