Which of the following are contraindications for giving tPA?

• A. Major surgery within the last 14 days
• B. Thrombocytopenia
• C. Coagulation disorders
• D. All of the above

Answer: (D)

tPA dissolves clots by turning on fibrinolysis throughout the body, which can lead to dangerous bleeding. Any factor that increases bleeding risk is a contraindication. Major surgery within the last 14 days leaves a recent wound site prone to heavy bleeding if clots are dissolved. Thrombocytopenia means there aren’t enough platelets to stop new bleeds. Coagulation disorders indicate impaired clotting factors, making uncontrolled hemorrhage more likely with fibrinolysis. Because each of these conditions raises bleeding risk, all of them are contraindications to tPA, so the correct choice is that all of the above are contraindications.