**Core Concept**
Streptokinase is a thrombolytic agent that works by activating plasminogen to form plasmin, which then breaks down fibrin clots. This process is essential for dissolving occlusive thrombi in conditions like acute ischemic stroke, pulmonary embolism, and myocardial infarction.

**Why the Correct Answer is Right**
The correct answer is related to the mechanism of action of streptokinase. By activating plasminogen, streptokinase increases the concentration of plasmin in the bloodstream. Plasmin then degrades fibrin clots, leading to their lysis. This process is crucial in the management of acute ischemic strokes, where timely dissolution of occlusive thrombi can significantly improve patient outcomes. The activation of plasminogen by streptokinase involves a complex mechanism involving the formation of a complex between streptokinase and plasminogen, which then activates the plasminogen to plasmin.

**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because it does not relate to the mechanism of action of streptokinase. While streptokinase can cause bleeding as a side effect, this is not the primary mechanism by which it works.
* **Option B:** This option is incorrect because it is unrelated to the pharmacological effects of streptokinase. The increase in plasminogen activator inhibitor (PAI-1) would actually inhibit the action of plasminogen activators like streptokinase.
* **Option C:** This option is incorrect because it is not a direct consequence of streptokinase therapy. While bleeding can occur as a side effect of streptokinase, this is not the primary mechanism by which it works.

**Clinical Pearl / High-Yield Fact**
It's essential to remember that thrombolytic therapy with streptokinase or tissue plasminogen activator (tPA) should only be initiated within a narrow time window after the onset of acute ischemic stroke symptoms, as delayed treatment can lead to poor outcomes. The use of thrombolytic agents also carries a risk of bleeding complications, including intracranial hemorrhage.

**Correct Answer:** D.