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Diagnostics > Laboratory - Sampling > Flashcards

Laboratory - Sampling Flashcards

1
Q

Why do we carry out an FNA?

A
  • To examine cutaneous masses.
  • Assess cell morphology.
  • Allows examination of any part of the body (including abdomen, thorax and joints).
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2
Q

What is the patient preparation for FNAs? In terms of positioning and chemical restraint.

A
  • Generally done conscious and well tolerated.

- Positioning will depend on location of the lump.

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3
Q

What sized needle would you use for an FNA?

A
  • 21G-25G.
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4
Q

If you had a sample of pleural fluids, where is this from?

A
  • The pleural cavity lining the lungs.
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5
Q

If you had a sample of peritoneal fluids, where would this be from?

A
  • The abdomen.
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6
Q

If you had a sample of synovial fluids, where is this from?

A
  • The joints.
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7
Q

If you had a sample of cerebrospinal fluids, where is this from?

A
  • The spinal cord.
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8
Q

What components make up a transudate?

A
  • A fluid with LOW PROTEINS and LOW WBCs. Moved out of capillaries due to abnormality in pressure. E.g congestive heart failure.
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9
Q

What is an exudate?

A
  • During the inflammation process (i.e wounds, fluid leaks out - capillaries dilate). Lots of protein and WBCs!
  • Can lead to infection and deterioration of wound.
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10
Q

What is a modified transudate?

A
  • Moderate level of protein and WBCs. Fluid build up. Can turn into exudate over time.
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11
Q

what is an effusion?

A
  • An abnormal accumulation of fluid in the body/body cavities discussed earlier.
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12
Q

What might cause an effusion?

A
  • If there’s inflammation it causes an increased volume of fluid.
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13
Q

If the effusion is red what might this mean?

A
  • Blood, signifies trauma or inflammation.
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14
Q

What might it mean if the effusion was a white/cloudy colour?

A
  • WBCs and proteins present. Infection or inflammation.
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15
Q

What is the difference between the turbidity of a normal and abnormal fluid/effusion?

A
  • Normal = not cloudy, clear.

- Abnormal = Cloudy (WBC and protein build up).

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16
Q

What is the specific gravity?

A
  • The density related to water.
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17
Q

What does a higher specific gravity of this fluid signify?

A
  • More WBCs and proteins present. Potential infection.
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18
Q

What is an arthrocentesis?

A
  • The collection of synovial fluid from the joints.
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19
Q

What issues does collecting this sample investigate?

A
  • Synovitis, lameness and arthritis.
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20
Q

Does arthocentesis require flexion or extension of the joint and why?

A
  • Flexion to create better access to the joint cavity.
21
Q

What containers are suitable to put the synovial fluid into?

A
  • Plain tube or EDTA tube.
22
Q

What equipment is needed to carry out an arthrocentesis?

A
  • Sample container, generally EDTA
  • Needle & syringe
  • Clippers
  • Chlorhexadine
  • Pen to label.
23
Q

Why might you take a cerebrospinal fluid sample?

A
  • Collected from a neurological patient or prior to myelography for imagine a spinal cord for possible trauma or neoplasia.
24
Q

What are the 2 methods in which you can acquire this sample?

A
  • Suboccipital puncture.

- Lumbar puncture.

25
Q

Why do we carry out a thoracocentesis?

A
  • To remove air or fluid directly from the thoracic cavity.
26
Q

What 2 ways can we carry this out in terms of chemical restraint?

A
  • GA

- Conscious with local anaesthetic.

27
Q

If there is a pleural effusion, what are 2 things we might need to do?

A
  • Chest drain if lots of fluid to continually drain/

- If emergency for sampling, butterfly catheter.

28
Q

What is the technique for this?

A
  • Clip & surgically prep area.
  • Local anaesthetic administered s/c.
  • Insert drain or catheter into the ventral 3rd of the intercostal space between 7th & 8th rib.
  • For draining fluid - small incision is made with a scalpel and an “over the needle” catheter is used with a 3 way tap connection to avoid causing a pneumothorax.
29
Q

Where are you removing fluid from for a pericardial-centesis?

A
  • The pericardium (the membrane surrounding the heart).
30
Q

What is an accumulation of fluid in the abdomen known as?

A
  • Ascites
31
Q

Why might this build up be there?

A
  • Trauma
  • Viral conditions
  • Heart or liver disease.
  • Infection.
  • Tumours.
  • Can happen from congestive heart failure.
32
Q

Why might you carry out a tracheal wash or bronchoscopy?

A
  • To investigate;
  • Chronic coughing
  • Suspected bacterial or fungal infections.
  • Parasites (lungworm).
  • Antibiotic sensitivity.
33
Q

What equipment do you need to obtain a cerebral spinal fluid sample?

A
  • specialised spinal needle.
  • collection tube
  • sterile gloves
  • sterile drape for equipment
  • sterile equipment.
34
Q

What are the complications of doing a chest drain/catheter for pleural effusions?

A
  • Could puncture a lung.
  • Could introduce air via 3 way tap (pneumothorax).
  • Haemothorax.
35
Q

What machinery should you use to monitor during a pericardial-cenesis and what are you monitoring for?

A
  • ECG.

- Can get arrhythmias during this procedure.

36
Q

What position should the patient be in for a pericardial-centesis?

A
  • Left lateral.
37
Q

If you think you have punctured the heart during a pericardial-centesis, what should you do?

A
  • Check the clotting. Blood will clot but fluid won’t.
38
Q

Why is it good to try and do a tracheal wash with a endoscope?

A
  • so you can see the damage/trauma.
39
Q

How much sterile saline should you flush with for both a tracheal wash and a bronchoscopy?

A
  • Tracheal - 4-6mls

- Bronchoscopy - 10-20mls.

40
Q

What are the 3 different types of tissue biopsy techniques?

A
  • Punch.
  • Wedge.
  • Tru-cut.
41
Q

What is the difference between a punch biopsy and a wedge biopsy?

A
  • Punch, use a little device to punch a hole/chunk out.

- Wedge - Use a blade and manually take a wedge out.

42
Q

What is a tru-cut biopsy and what do you need for it?

A
  • A special needle, looks like a pair of scissors and it’s spring loaded. Takes a slither of tissue. Less trauma.
43
Q

What are tru-cut biopsies used for. Skin or organs?

A
  • Organs.
44
Q

What is the intracapsular technique for obtaining a solid biopsy sample?

A
  • Remove mass along with the capsule it’s contained in.
45
Q

What is the marginal technique for obtaining a solid biopsy sample?

A
  • Describes the area around the mass.
46
Q

What is the wide technique for obtaining a solid biopsy sample?

A
  • Large amount of healthy tissue around the mass.
47
Q

What is the radical technique for obtaining a solid biopsy sample?

A
  • Margin close to the mass.
48
Q

What is the wedge technique for obtaining a solid biopsy sample?

A
  • Take a full thickness slice of the tissue with scalpel blade.

Diagnostics (8 decks)

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