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Yr 2 > diagnostics 🩻 > Flashcards

diagnostics 🩻 Flashcards

1
Q

what is the title for the health and safety legislation

A

health and safety at work act 1974

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2
Q

what does this legislation cover

A

both duties of the employer and employee

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3
Q

what the the 3 objectives

A
  1. secure
  2. protect
  3. control
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4
Q

what does the 1st objective do

A

secures health and safety at work

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5
Q

what does the 2nd objective do

A

protects people at risk of health and safety at work

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6
Q

what does the 3rd objective do

A

controls the use/keeping of explosive/highly flammable or other dangerous substances, preventing unlawful acquisition, possession and use of such substances

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7
Q

what must employers do for you ?

A
  • consider who can harm you in your job and take steps to prevent it
  • explain risks and how these are controlled including responsibilities
  • protect you from harm in the workplace
  • provide training
  • provide PPE
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8
Q

what do employees do ?

A
  • takes responsible care of the health and safety ourselves and others that may be affected by what they do or not do
  • cooperate with the employer in health and safety
  • obey local rules on health and safety
  • wear PPE
  • handle store and transport articles/ substances in a safe manner
  • adequately maintain equipment where appropriate to manufactures specification and legislation
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9
Q

what is the title of the control of hazardous substances legislation

A

control of substances hazardous to health regulations 2002

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10
Q

what does the control of hazourdous substances to health 2002 do?

A

controls the exposure of employees to hazardous substances

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11
Q

what are steps to prevent or reduce exposure

A
  • identify the hazard
  • how to prevent haem to health by assessment
  • control measures
  • provide information, instruction and training for employees/ others
  • plan for emergencies
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12
Q

what is the title for the ionising regulation

A

ionising radiation regulations 2017

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13
Q

what does the regulation cover

A

covers all use of radiation and radioactive materials including vet radiology. the regulation identifies hazards, risks and reduction of exposure to employees and others thus leading to the production of local rules.

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14
Q

when were the regulations updated

A

2017

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15
Q

what did the update inlcude

A

inform the health and safety executive of working with ionising radiations, rules for practices to comply to the HSE before carrying out radiography and now a graded approach to work being carried out

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16
Q

what does notify include

A

no cost involved

no expiry date

notification is needed for each practice

lowest risk

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17
Q

what does register include

A

medium risk

to register radiation practice with the health and safety executive HSE

initial cost

must be reviewed every 5 yrs

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18
Q

what does consent include

A

highest risk
consent requires listening or approval

requires additional info

renewal fee

if a vet practice has multiple branches at different locations a consent application is required for each site

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19
Q

are we allowed to manipulate a px when undergoing a diagnostic examination?

A

only if neccessary

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20
Q

can any body parts be placed under the primary beam

A

no

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21
Q

what is radiation

A

energy that moves from one place to another in a form that can be described as waves or particles

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22
Q

additional properties of x-ray mean they can be used to provide an image, what are they

A

penetration- due to high energy
effect of photographic film- produces a latent/ hidden image by processing
energy storage- digital x-ray

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23
Q

what do x-rays produce in relation to tissue

A

biological changes in living tissue, harmful to normal tissue and are a safety hazard

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24
Q

what are the 4 dangers of an x-ray

A
  1. invisible
  2. painless
  3. latent effects- effected that arent on the specific part that you have x-rayed
  4. cumulative- cant see the buildup of radiation
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25
Q

what damages come under biological

A

somatic, carcinogenic, genetic

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26
Q

what does somatic damage include

A

direct changes in the body tissues which can occur soon after exposure

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27
Q

list examples of somatic damage

A
  • skin reddening
  • skin cracking
  • baldness
  • blood disorders
  • cataracts
  • digestive upset
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28
Q

what does carcinogenic include

A

induction of cancer in tissues that have been exposed to radiation. tumour developed in exposed tissues. can last a period of 20-30 yrs of leukaemia

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29
Q

what can carcinogenic damage cause

A

leukaemia
skin cancer

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30
Q

what does genetic damage include

A

effects on the gonads when exposed to radiation i.e the ovaries and testicles

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31
Q

what can genetic damage lead to

A

mutation within the chromosones of the germ cells
inherited abnormalities with offspring

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32
Q

what does stochastic mean

A

occurs by chance relating to any dose rate

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33
Q

what does non-stochastic/ deterministic mean

A

dose specific threshold, with a potential to lead to radiation burns

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34
Q

what are 3 sources of radiation

A

tube head
primary beam
secondary/ scattered radiation

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35
Q

what types of x-rays can you have

A

fixed, mobile and portable

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36
Q

characteristics of a fixed x-ray

A

most powerful- built into x-ray room attached to the flor or wall

expensive

can be linked to a floating tube

output- 1250mA

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37
Q

characteristics of a mobile x-ray

A

larger and more powerful to portable x-rays

can be moved from room to room on wheels

output- 100-500mA

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38
Q

characteristics of a portable x-ray

A

commonly used in general and equine practice

easy to move from site to site carrying case to transport

output- 60mA

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39
Q

how are x-rays produces

A

when electricity from the mains is transformed into a high voltage current, with some of that energy converting into x-rays

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40
Q

what are some physcial features of particles and wave like energy

A

they are thought of as tiny pockets of energy referred to as photons, photons travel in straight lines and can be focused into an area called the primary beam or some photons can be absorbed or scattered and pass through the px. an image is produced by computer manipulation called digital radiography.

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41
Q

what is energy directly proportional too

A

frequency and indirectly proportional to wavelength

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42
Q

what is frequency

A

the number of waves that pass a certain point in a specified amount of time

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43
Q

what is wavelength

A

the distance between any 2 corresponding points on adjacent waves

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44
Q

what does high frequency and shortwave equal

A

high energy

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45
Q

list properties of an x-ray

A

they dont require a medium for transmission

they can pass through a vacuum

they travel in straight lines

they travel at speed in a vacuum

they interact with matter by being absorbed or scattered

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46
Q

how can x rays penetrate

A

due to high energy

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47
Q

what are the effects on a photographic film

A

produces a latent/ hidden image revealed by processing

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48
Q

how can fluorescence occur

A

x-rays cause crystals of certain substances to fluorescence. utilised with digital radiography

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49
Q

what are properties of atoms

A

they are the smallest part of an element

protons have a + charge and they’re located in the nucleus

neutrons have no charge and they are located in the nucleus

electrons have a - charge and they orbit around the nucleus in place

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50
Q

how are x-ray photons created

A

when rapidly moving electrons are slowed down or stopped. when travelling at high speeds they collide with other atoms and lose their kinetic energy. most of this energy is transformed into heat and a small amount is converted into x-ray energy

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51
Q

name the components of a tube head

A

lead lining
glass envelope
focusing cup
vacuum
cooling fins
cooper stem
target
filament
oil
x-ray
filter
earthed metal sheild

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52
Q

what does insulating oil do

A

surrounds the tube and absorbs heat generated during x-ray production to prevent overheating

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53
Q

what does the tube head do

A

a seal which is made of aluminium or leaded glass which produces the x-ray.

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54
Q

what do transformers do

A

alter the voltage of the incoming electric current

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55
Q

what does the aluminium filter do

A

its made of 0.5mm aluminium sheets that absorb most long wavelength radiation.

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56
Q

what does the lead collimator

A

it has a lead plate with a hole in the middle that fits over the metal housing opening where the x-ray beam exits the tube head. the collimator limits the size and shape of the x-ray beam to produce patient exposure to harmful x-rays

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57
Q

what does the target window do

A

a specially designed window on the enclosure where the x-ray is set. its 5cm2 and thinner than the rest of the enclosure to minimalist absroption

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58
Q

what type of electrodes does the tube head contain

A

cathode and anode

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59
Q

what charge does a cathode have

A

negative

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60
Q

what charge does an anode have

A

positive

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61
Q

where are electrons produced

A

the filament

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62
Q

what is the filament made out of

A

coiled wire made out of tungsten

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63
Q

how is thermionic emmison created

A

a small electrical current is applied to the coiled wire filament which is heated and releases a cloud of electrons

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64
Q

what is placed around the filament to ensure the electrons reach the target

A

focusing cup

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65
Q

what is the focusing cup made out of

A

molybdenum

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66
Q

what is good about molybdenum

A

it has a high melting point and is a poor conductor of heat. the

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67
Q

what is the function of the focusing cup

A

stream the electrons in a narrow band towards the anode when an exposure is made. the focusing cup will repel the electrons to the centre and this ensures they flow in a narrow band due to its concave shape and don’t spread.

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68
Q

what does the anode do

A

conducts electrons away from the tube to the generator, provides support for the target and removes excess heat from the tube

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69
Q

which part of the tube head do electrons strike

A

the target

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70
Q

what angle is the target set at

A

20 degrees

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71
Q

why is the target set at an angle

A

so the area being struck by electrons is as large as possible as its the focal spot

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72
Q

what does the glass envelope do

A

a glass vaccum tube that contains the anode and cathode

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73
Q

what is the function of the vaccum

A

allow x-rays to travel in straight lines. in the vacuum, all gases and air are extracted as if 02 were present, the X-rays will bounce off the particles and be misdirected.

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74
Q

what does a soft x-ray mean

A

they don’t have enough power to pass through the px and this can lead to scatter.

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75
Q

how to prevent a soft x-ray

A

an aluminium filter is placed over the window to absorb soft x-rays

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76
Q

what has to be present on every x-ray machine due to legal and safety requirements

A

an aluminium filter

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77
Q

give a summary of x-ray production

A

within the tube head, there is the cathode -ve and the anode +ve. the cathode consitis of a filament made up of tungsten, this filament is heating by an electric current which produces electrons. these electrons are released by thermionic emission. the electrons are directed by a focusing cup to the anode. the electrons then travel at high speeds across the tube from the cathode to the anode. electrons hit the target area and x-rays and heat are produced.

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78
Q

what does absorption depend on

A

it depends on tissue, atomic number, specific gravity and thickness. bone has a higher atomic number than soft tissue so it will absorb more x-ray photons and produce a paler area or radiograph. specific gravity is density or mass per unit volume, bone has a higher specific gravity and has has low specific gravity

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79
Q

what colour will gas show

A

very dark

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80
Q

what colour will fat show

A

dark grey

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81
Q

what colour will soft tissue or fluid show

A

mid grey

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82
Q

what colour will bone show

A

neaely white

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83
Q

what colour will metal show

A

white

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84
Q

can you differentiate between fluid in soft tissues

A

no

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85
Q

what is mA/ mAs

A

milliamperage/ milliamperage time

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86
Q

what does milliamperage measure

A

measures the quantity of electrons crossing the tube during an exposure

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87
Q

what does time measure

A

controls the amount of time that a high voltage is applied for

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88
Q

what is the FFD

A

the distance between the focal spot and the x-ray film/ cassette.

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89
Q

what is the common cm of a FFD

A

75cm

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90
Q

what is the greatest saftey hazard in an x-ray

A

the primary beam

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91
Q

why is the primary beam the greatest safety hazard

A

it has high energy x-rays producing

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92
Q

what does the light beam diaphragm do in visualising

A

it helps to visualise the area of exposure and collimation adjusts the area of exposure.

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93
Q

what is produced in all directions when hitting an object

A

secondary radiation/ scatter

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94
Q

is scatter low energy or high energy

A

low

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95
Q

what is scatter absorbed by

A

PPE

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96
Q

how can scatter be reduced

A

collimation, decreasing exposure and lead tabletops

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97
Q

what animals is scatter not an issue with

A

cats, small dogs, skulls and limbs

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98
Q

what does scatter cause in a image

A

fogging, blackening

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99
Q

what is the name of the guiding principle in radiation safety

A

ALARA

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100
Q

what does ALARA involve

A

avoiding exposure to radiation that doesnt benefit you. ALARA can be achieved by time- limiting the amount of time near to a radioactive source, distance- increasing the distance between the person and the radioactive source and shielding- putting a barrier between the person and the radiation source

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101
Q

what is a controlled area

A

a specific room that has thick walls that are reinforced if necessary.

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102
Q

how far do you stand away from the primary beam

A

2m

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103
Q

true of false
the x-ray should always be connected to a power source even when not in use

A

false
the x-ray should always be DISCONNECTED when not in use

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104
Q

what needs to be outside an x-ray room

A

a light to tell you when the x-ray is in use

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105
Q

does every use of an x-ray need to be logged?

A

yes

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106
Q

what needs to be logged in an x-ray book

A

the date, px identification, what view has been taken, exposure factor, means of restraint, quality of image, depth of tissue, personnel involved, if x-ray warning light went on

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107
Q

list examples of PPE

A

lead aprons
thyroid protector
lead gloves
lead screens
film badge dosimeter

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108
Q

what does a film badge dosimeter measure

A

the exposureof the radiation

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109
Q

how can a dosimeter measure the radiation

A

it has a small piece of film which has small metal filters to assess the type of radiation

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110
Q

list the amount of radiation for an employee/ trainee being of 18yrs or above inc skin, extremities and lens of the eye

A

500mSv 1cm2 for skin
500mSv for extremtities
20mSv for lens of the eye

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111
Q

list the amount of radiation for an trainees being under 18, inc skin, extremities and lens of the eye

A

150mSv 1cm2 for skin
150mSv for extremtities
15mSv for lens of the eye

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112
Q

list the amount of radiation for an any other person/ members of the public and employees under 18yrs of age, inc skin, extremities and lens of the eye

A

50mSv 1cm2 for skin
50mSv for extremtities
15mSv for lens of the eye

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113
Q

list types of positioning aids

A

sandbags
ties
foam wedges
troughs/ cradles

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114
Q

what is the use of sandbags

A

to prevent movement of the px

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115
Q

are sandbags radiopaque or radiolucent

A

radiopaque therefore shouldnt be in primary beam as will show on x-ray

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116
Q

what is the use of ties

A

to prevent limb movement and should only be used when px is under GA

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117
Q

what is the use of foam wedges

A

prevent rotation

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118
Q

are foam wedges radiopaque or radiolucent

A

radiolucent, they can be within the primary beam

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119
Q

what is the use of troughs/ cradles

A

prevents rotation

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120
Q

are troughs/ cradles radiopaque or radiolucent

A

radiopaque

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121
Q

what is a grid

A

a flat plate that is placed between the px and the cassette. they’re are thin plates made of alternating strips of lead and a radiolucent material such as plastic, carbon fibre or aluminium that are placed between a px and an x-ray cassette or film to improve image contrast and reduce scattered radiation.

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122
Q

what is the purpose of lead strips

A

they absorb scatter moving at an angle while undeflected photons pass through the radiolucent material

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123
Q

do grids stop scatter

A

yes

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124
Q

can grids be built into the table or cassette?

A

yes

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125
Q

where are grids placed

A

under the x-ray table or built into the table

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126
Q

list the different types and patterns of a grid

A

parallel grid
potter bucky grid
linear grid
crossed grid
focussed grid
pseudo focussed grid

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127
Q

true or false
you dont have to be perpendicular to the animal when taking an x-ray

A

false. you have to be perpendiculuar to the animal

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128
Q

what is radiographic grid cut off

A

when an x-ray grid absorbs primary x-ray beams prevent the x-rays from reaching the image receptor when it is positioned incorrectly or used upside down.

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129
Q

what is grid ratio

A

the ratio of the height of the lead strips to the distance between them. grid ratio is used to calculate the grid factor. for example- if the height of the lead strip is 6x the width of the interspace that ratio is 6:1

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130
Q

what must you do regarding mAs when using a grid

A

increase the mAs

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131
Q

what is pneumbra

A

the outer shadow formed around an object

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132
Q

what causes pneumbra

A

the focal spot being infintesimally small, blurring, loss of sharpness at the margins / edge

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133
Q

how to prevent pneumbra

A

px as close to the cassette as possible with the smallest focal spot possible

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134
Q

what does collimation aid in

A

radiation safety and improves image quality by reducing scatter

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135
Q

where should collimation be carried out

A

to the area of interest only - only routinely body cavity boundaries

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136
Q

how is collimation performed

A

using variably sized lead shutters within the LBD restricing the area through which x-rays can pass

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137
Q

how can collimation be checked

A

by placing a coin in each edge of the collimation to ensure the coins are seen at the edge of the image

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138
Q

where is centering centred

A

to the area of anatomincal interest

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139
Q

in magnification what is the size of the shadow determined by

A

the distance between the object and the Film focal spot

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140
Q

what makes the imager truer to size

A

the closer the object is to the cassette

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141
Q

what the exposure factors a combination of

A

mAs and kV

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142
Q

when is radiography used in debilitated px

A

RTA
fractures
dislocations
bullets
thorax and abdomen

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143
Q

why is timing important

A

its needed for the information gained and the stress applied to obtain the information. life threatening respiratory and circulatory emergencies or intra-abdominal injuries must be controlled

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144
Q

what should be provided prior to imaging

A

pre-radiographic examination
vital signs must be stable
02 therapy
fluid therapy
mild sedation
pain control
ET readily available
anaesthetic emergency box

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145
Q

when would you delay imaging

A

if the animals conditon could be aggravated by the radiographic procedures or the expected benefits of radiology do not exceed the risk

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146
Q

where is the digital / computed radiography image produced onto

A

on a plate or directly into the computer

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147
Q

what are the advantages of digital / computed radiography

A

greater tolerance
wide ranges of tissues
ability to computer- manipulate images
cant loose images

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148
Q

what are the 2 different types of digital radiography

A

computed radiography and direct radiography

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149
Q

what equipment is needed for computed radiography

A

imaging plate, cassette, CR system, reader

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150
Q

how does computed radiography work

A

during exposure, the photostimulate phosphor within the imaging plate stores energy form the x-ray photons in a semi-stable electron trap which creates a latent image. the cassette is labelled electronically with the px details before being inserted into the reader/ digitizer. the phosphor is read by a helium-neon laser within the reader/ digitizer which provides a small amount of energy to the electrons in the trap, allowing them to move back to their resting state and in doing so releasing energy in the form of light. the light produced is collected by a light guide and converted to an analogue electrical signal. this signal is amplified by a photomultiplier and digitized by an analogue converter.

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151
Q

what are some advantages of computed radiography

A

shorter exposure times
more forgiving then film
fewer repeat exposures
faster processing time
no chemicals used

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152
Q

what is direct radiography

A

technology that produces an almost instantaneous image on the display screen without the processing stage.

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153
Q

what do the flat panel decetctors contain in direct radiography

A

a thin film transistor array made of amorphous selenium which is arranged in a matrix

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154
Q

true or false
the image detectors can be wireless only

A

false
the image detectors can be wired or wireless.

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155
Q

list advantages of DR

A

real time image capture
highest quality of digital images
image viewable in seconds
zoom facility allows areas to be magnified
maximum resolution

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156
Q

how many types of DR are there and what are they

A

2
flat panel system
charged coupled device system

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157
Q

what is involved with a flat panel system

A

the detector panel is linked to x-ray equipment
converts x-ray energy to light then a digital signal

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158
Q

what is involved with a charged coupled device system

A

flourescent screen undr x-ray table
computer screen is linked

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159
Q

what is a DR plate

A

a specialised plate that converts light to digital signals directly without requiring a reader. the plates are coated with amorphous. selenium and are similar to a large single computer chip. they cost at least double the price of a CR system.

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160
Q

what are the characteristics of Digital images

A
  • viewed on a monitor
  • images can be manipulated
  • rotation
  • flipping
  • magnification
  • adjustment to density / contrast
  • inversion of black and white
  • annotation
  • compare different images
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161
Q

what are the characteristics of Digital images and communication

A

images produced are stored as DICOM. this allows the images to be stored and viewed across all models of imaging. the image is inbedded with px detaios, owner, species, breed

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162
Q

list ways to store an image

A

computer
usb
DVD
back uos

image is saved as a DICOM or j-pegs

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163
Q

what are the characteristics of picture archiving and communication system

A
  • allows images to be automatically saved/ stored to a secure location
  • stores px ID/ details and the vet practicice/ VS details
  • comes in a variety of sizes, some can store up to 250,000 images
  • images can be viewed throughout the practice, consulting rooms, theatres, newer syetms allows access from anywhere
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164
Q

what are the benefits for PACS

A

recent radiographs can be stored with the previous images and be stored together and PACS enables a continuity of px care and assessment

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165
Q

what are the characteristics of teleradiology

A

the ability to transfer digital files from one location to another. its used in referall or to send to a specialist for interpretation. its quicker and more efficient than sending CDs/ DVDs. a report can then be returned to the practice

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166
Q

what is contrast media

A

contrast media is the method of using x-rays and a special dye to study organs, the dye called a contrast medium helps radiologists to see structures that might not be clear on standard x-rays. radiocontrast agents are substances used to enhance the visibility of internal structures in x-rays based imaging techniques such as CT

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167
Q

why is contrast media used

A

addresses the lack of contrast by selectively absorbing more x-rays photons than the soft tissue- this appears white on the image. it can be introduced into blood vessels, viscera, cavities or joints. information gained from a study - anatomy, integrity and function.

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168
Q

what is positive contrast media

A

contains elements of high atomic number that are radio-opaque ( appear white on x-ray film which are whiter than bone).

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169
Q

what are examples of positive contrast media

A

barium compounds, iodine compounds

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170
Q

what is negative contrast

A

gases which are radiolucent due to their low density and appear black on an x-ray

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171
Q

what are examples of negative contrast

A

02, c02, n20

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172
Q

what is double contrast

A

the use of air and nitrogen plus a contrast agent such as barium

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173
Q

what are advantages and disadvanatges of barium

A

adv-
inert, insoluble

disadv-
may cause a foreign body reaction if leaks

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174
Q

what are the features of lower osmolar ionic media

A
  • hexabrix
  • fewer side effects than those in water soluble iodine
  • better contrast in GIT than in water soluble iodine
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175
Q

what are the features of lower osmolar ionic media

A
  • omnipaque
  • non-ionic
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176
Q

what are the features of ultrasound

A
  • very common
  • non - invasive
  • sound energy at high frequency
  • frequency range is 2.5-15megahertz
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177
Q

what are adv for ultrasound

A
  • real time
  • non-invasive
  • in house
  • quick
  • no ionising radiation
  • differentiates soft tissue to fluid
  • easily repeatable
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178
Q

what are disadv of ultrasound

A

can be expensive
can be hard to interpret if don’t know anatomy
difficult to use for skeleton as cant penetrate bone
not suitable for remote interpretation as frozen images loose value
limited sensitivity

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179
Q

what are some common uses of ultrasound

A

pregnancy
heart images
abdomen
thoracic
blood flow
pregnancy
muscles

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180
Q

what equipment is used in ultrasound

A

control pannel
gel
transducer
printer

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181
Q

what are the features of the control pannel

A

allows changes to the quality, intensity and amplification of the image
it can input px details and more importantly
has a freeze buttonwhat are the features of lower osmolar ionic media

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182
Q

what are the features of the transducer

A

heavily involved with image production
it has a variety of applications depending on area of interest
different types of transducer
contains piezoelectric elements referred to as arrays

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183
Q

what are the 2 main types of transducer

A

array transducer
phased array transducer

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184
Q

what are the features of the array transducer

A

contains crystal elements which are arranged in a line along the surface of the transducer

it has a wide field of view

requires a large contact area between the skin and transducer

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185
Q

what are the uses of an array transducer

A

musculoskeletal system
eyes
body
abdominal organs

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186
Q

what are the features of the phased array transducer

A

semi circle in shape
contains small cyrstals to create a fan shape
allows visualisation of deep structures due to wide field of vision
phased arrays have poor near-field image resolution

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187
Q

what are the uses of phased array transducer

A

deeply located structures of the abdomen
deeply located structures of the thoracic cavity

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188
Q

what are the features of the coupling gel

A

allows sound waves to pass through it easily
helps the transmissions of soundwaves from the transducer to the pxs skin, which produces a clear image
it eliminates air between the skin and transducer as air can cause reflections that create dark areas in the image
it has a smoothing movement

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189
Q

how is an image produced in ultrasound

A

sound waves are produced by vibration of special crystals in the transducer. the transducer is applied to the skin which sends out a beam of sound waves into the body. at interfaces with tissues or different cells some soundwaves are reflected back onto the transducer. the soundwaves virbate the tissues and the crystals within the transducer. the soundwaves are converted back to electrical impulses which are converted into an image.

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190
Q

what does anechoic mean

A

black areas in a ultrasound

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191
Q

what does hypoechoic mean

A

dark areas in an ultrasound

192
Q

what does hyperechoic mean

A

bright areas in an ultrasound which are white in colour

193
Q

what equipment is needed for an ultrasound

A

gel, clippers, stethoscope, cotton wool, swabs, spirit, biopsy needle sample pots, towel, sedation, an extra person for help

194
Q

what should be done pre-procedure with ultrasound

A
  • food withheld for 12hrs
  • can allow drink straight up to procedure
  • allow to defecate and urinate
195
Q

what should be done at the scanning site with ultrasound

A

hair should be removed
apply coupling gel
px should be manually restrained

196
Q

what should be done post-procedure with ultrasound

A

clean the site of gel
allow animal to stretch and move

197
Q

how to care for the equipment for ultrasound

A

clean after use
service annually
check machine for damage
wipe down transducers
wipe down machine

198
Q

what is an endoscopy

A

an optical device which provides a detailed image of inside the body. it is minimally invasive.

199
Q

what are uses of endoscopy

A

otoscopy
rhinoscopy
tracheostomy
vaginoscopy
colonoscopy

200
Q

what are the different types of endoscope

A

rigid and felxible

201
Q

what are the features of a rigid endoscope

A

used to examine non tubular structures
simple design
better image quality and light transmission
larger instrument can be used
easier to clean

202
Q

what are the features of a flexible endoscope

A

used to examine internal tubular structures
poorer light transmission
can only use small intrusments- have to pass down instrument channel
more complex
costly
can only be cleaned by trained team members

203
Q

what does an endoscope comprise of

A

lighting system
visualisation
channels
interface

204
Q

what are the features of the lighting system

A

the light source is external to the endoscope
it illuminates the organ/ area of interest
halogen or xenon bulbs
light is commonly directed by an optical fibre system
can be integrated with insufflation and irrigation

205
Q

what are the features of the interface

A

processor
light source
digital capture device
AIDA- advanced image data archiving system
TELE pack
has air pump

206
Q

what are the features of the cannula

A

can come with or without a trochar which is the pyramidal tip with cutting edges to pierce the body wall

has a lure lock valve- the attachment for insufflation

the cannula has the automatic valve

can also be called an egress cannula

207
Q

what is a rigid endoscope

A

a steel structure that is unable to manoeuvre bends, allowing easier manoeuvrability inside non-tubular structures. within the steel structure, there is a series of rods and lenses arranged in a lineral sequence to maximise light transmission, magnification and resolution. glass fibres surround the rods and lenses transmitting light post to the distal tip of the scope. the image can be viewed directly from the eyepiece or transmitted to a screen by attaching an endoscopic video camera to the eyepiece.

208
Q

what is the function of the sheath

A

protect the scope
passage of instruments through the instrument channel of the sheath
used for cystoscopy, rhinoscopy and otoscopy

209
Q

what are the features of the instrument channel in a rigid scope

A

palpation probes
grasping forceps
biopsy forceps
scissors
needle holder
suture cutter
arthroscopy instruments
arthroscopy stifle set up canine

210
Q

what are general rules for cleaning the rigid endocscope

A

wear gloves
handle with care
have a bath of enzymatic cleaner diluted to Manufacturers guidelines, a bath of instrument disinfection and a bath of rinsing water
place endoscope in cleaning bath
wipe whole endoscope
return endoscope to plastic sleeve
open all taps and using a brush clean them
flush through the ports
wipe down the sheath
brush the jaws
wipe the forceps
repeat all steps in the disinfectent bath
place endoscope, sheath and forceps into distilled water bath
flush through the sheath ports
dry everything
put instruments back in box

211
Q

what are the features of the flexible endoscope

A

has an umbilical cord which plugs into a light source
has a handoiece which is a manual control and working channel port
insertion tube- part that enters the px

212
Q

what can you use a flexible endoscope for

A

respiratory tract
lungs
nasal cavity
abdominal tract]urinary tract

213
Q

what are the 2 types of flexible endoscope

A

fibrescope
videoscope

214
Q

how does a fibrescope work

A

the image is transmitted via a fibreoptic image bundle from the objective lens at the tip of the insertion tube to the ocular lens located in the eyepiece

215
Q

how does a videoscope work

A

the image is transmitted electronically thorugh wires from a sensor located behind the objective lens at the distal tip, along the length of the endoscope to a video processor which produces an image on the screen

216
Q

what is air insufflation

A

inflation
the operator occludes the air/water valve on the control panel. the air travles from the light source, through the universal cord, through the control panel into the insertion tube where air is released from the distal tip at the air/ water nozzle

217
Q

what is suction

A

removal of excess fluid or air
the operator fully depresses the suction valve on the control panel
air/water is sucked in from the distal tip, travels up through the insertion tube, control panel and light guide source. a suction connector will be attached with a cannister to collect fluid/ air.

218
Q

what are the features of the instrument channel in a flexible endoscope

A

located at the distal end of the handpiece
biopsy forceps
cytology brushes
foreign body graspers
instruments should be lubricated after thorough cleaning if reusable
care when passing instruments
suction will not function as strongly

219
Q

how should the practice provide care to endoscopy

A

training and familarity with the equipment
minimal staff requirement - 1 RVN and 1 VS
store ready for use cart in dedicated room
ensure spare equipment is nearby
monitor or tower should be set up on the opposite side of the table for the endoscopist

220
Q

how to clean the flexible endoscope

A

clean immediately
dissemble instruments and place in bath
clean using a enzymatic cleaner
use appropriate brush size
rinse thoroughly
disinfect with disinfectant
rinse
dry with lint free cloth

221
Q

how should flexible endoscops be stored

A

hanging to prevent stress on fibres and remove any residual fluid

222
Q

what are the benefits of the flexible endoscope

A

small wounds so less trauma
reduced post op pain
rapid healing
limited sutures to be removed
reduced surgical operating time

223
Q

what is a zoonotic disease

A

a disease which is transmissible between animals and humans

224
Q

what is blood

A

a connective tissue that circulates around the body in a continuous system of blood vessels

225
Q

what is the % of blood in an animals BW

A

7%

226
Q

what is the normal pH

A

7.35

227
Q

what are the roles of a SNV in a lab practice

A

take bloods
urine samples
facial samples
hair samples
skin samples

228
Q

what nursing skills are vital

A

organised
* preperation with discussion with staff, consider px records, appropriate admission/ consent, px prep, equipment, consent for px
* sampling- knowledge, equipment, restraint, methods, preservation, sample rejection and transportion
* communication with client, vet, staff and external lab staff
* time keeping
* record keeping of clinical and clients records
* communication of results to vet team and client
* understanding findings for limitatiosn of test, relevance or recognition of spurious values
* H&S for vet nurse, other staff, lab staff and clients

229
Q

what should be checked before each test is carried out

A

correct details
* consent
* ensure equipment is working and available
* check with vet what checks need carried out
* clinical history
* safe area to work
* other members of staff are available to collect samples

230
Q

what common tests are carried out in the lab

A
  • biopsy
  • bacterial, fungal, viral
  • culture
  • tissues and body fluids for cytology
  • toxicology
231
Q

what is the right size for a needle for a dog

A

21G

232
Q

what is the correct needle size for a cat

A

23G or 25G

233
Q

what equipment is needed for blood sampling

A

needles with correct G
sterile syringe
collecting tube (the correct tube)
clippers- quiet ones
plaster
restraint aids
antiseptic skin prep solutions/ swabs - but skin needs to be dry before needle
hand wash and gloves
swab for post-venipuncture pressure
bandage materials in case prolonged pressure is required over the venepuncture site
good light source to see vein

234
Q

how should the needle be prepped

A

should be sterile and siposable

235
Q

how should the syringe be prepped

A

should be clean, dry and disposable- ideally new.
never drawback bard on the plunger as this may collapse the vein

236
Q

what should you always do after getting blood from an animal

A

transfer to a collecting tube ASAP to prevent contamination and clotting. normal blood clotts in 10-20secs after contact with tissue, tissue fluids, glass or plastic

237
Q

how do you expel the blood into the tube

A

slowly and gently

238
Q

how can cell damage happen

A

the force of expulsion from the needle

239
Q

how much blood do you collect

A

as much to fill the tube up to the line

240
Q

where can you take a blood sample

A

cephalic, jugular, saphenous and lateral vein

241
Q

where do you take a rabbit blood sample

A

marginal ear vein

242
Q

what is the cephalic vein used for

A

intravenous catheterisation
useful in canine and feline

243
Q

what is beneficial with the cephalic vein

A

its better tolerated than jugular venepuncture in some cases

244
Q

what is a disadvantage of the cephalic vein

A

in small dogs and cat’s the vein can be small and fragile and the vein could collapse

245
Q

why would you choose another vein over the main vein such as the jugular

A

if px is diagnosed with the anticoagulation problem as you don’t want the main vein to keep bleeding

246
Q

what are advantages of the saphenous vein

A

very prominent in greyhounds
can be useful if cephalic/ jugular venipuncture is not possible.
some pxs will tolerate better

247
Q

what is a disadvantage of the saphenous vein

A

in small dogs or cats the vein is small and fragile, the vein could collapse

248
Q

where could you take arterial blood in a RABBIT

A

marginal ear vein

249
Q

why is the lateral ear vein good

A

very useful in rabbits
can be used in canine with large pinnaes such as basset hounds
vein is very superficial
high chance of venous collapse
the central artery can be used for venipuncture but its avoided due to risk of haematoma/ bruising

250
Q

why does the needle need to be bevel up

A

the point part goes into skin first
hurts the animal more if bevel is down

251
Q

what does occluding the vein mean

A

raising the vein

252
Q

what does occluding the vein do

A

it causes pooling of blood and venous engorgement. this makes the vein easier to visualise, feel and assists in making a good volume of sample easier to obtain

253
Q

how do you occlude the vein

A

pressure is applied by the sampler to the thoracic inlet ventral to venipuncture site.

the assistant will apply pressure. their hand is placed behind the pxs elbow and pressure applied to the dorsal aspect of the leg using their thumb, and gently rotating the leg laterally

254
Q

how do you raise the saphenous and ear vein

A

saphenous- apply pressure above the vein, lateral side
ear vein - tip of ear

255
Q

Ollie a 12-year-old Jack Russel has come in through consults requiring a geriatric blood screen biochemistry. This is to be placed in an orange Lith hep tube. You are instructed by the VS to take this sample. Note that Ollie was previously diagnosed with osteoarthritis in his elbows.

Describe the procedure from start to finish:

Which site would you choose and why
Equipment preparation
Preparation of patient
Handling and restraint
Sample collection and storage

A

place ollie so he is sitting or laying down to remove the pressure off his elbows

site choice: saphenous
equipment: gloves, needles, swabs, bandage, syringe,
preparation of px: have him lie down or sit down in a quiet room on a comfy bed as he is old
handling and restraint: have an assistant
sample collection and storage: orange lith hep tube and store in a fridge.

256
Q

what do you do with the blood sample you have just taken

A

take off needle as you dont want to push the blood back through the needle, push the blood out of the syringe into the tube.

257
Q

how do you preserve a blood sample

A

prevent clotting by using anti-coagulent tubes
leaving whole blood- it will clot naturally then serum removed
blood smears

258
Q

what do you use to collect blood

A

vacutainer- tube with a vacuum collected with a double ended needle, more common in large animal. can cause damage to cells. usually come in 20G or 21G

sample tubes- different sizes and types are colour coded depending on the test required blood is usually collected by needle and syringe and then put into tube.

259
Q

what are anti- coagulents

A

a powder/ liquid or solid which allows plasma to form and prevent clotting. mostly always found in the tube. they are spun down shortly after collection and must be in the appropriate anticoagulent for the diagnostic test to be carried out. blood sample must be quickly and gently placed into the correct blood tube and gently mixed.

260
Q

what are the characteristics of no anti-coagulent

A

no anticoagulent in blood tube
serum is formed from clotted sample
serum does not contain clotting factors such as fibrinogen as used forming the blood clot
used for serology and biochemical tests
serum can be extracted.

261
Q

what tubes dont have anti-coagulent

A

brown, white

262
Q

what tubes have anti-coagulent

A

purple, orange, red, yellow, green, black

263
Q

what is EDTA and what is it used for

A

ethylenediamine tetra-acetic acid, used for blood smears, haematology and cell counts

264
Q

what is lithium herapin used for

A

biochemistry

265
Q

what is flouride oxalate used for

A

used for blood glucose

266
Q

what is the fluid part in blood

A

plasma

267
Q

how can you see plasam

A

it separates when in a centrifuge

268
Q

what does plasma look like

A

a clear straw coloured liquid

269
Q

what is plasma

A

the solid part of blood is suspended

270
Q

what does llama contain

A

mineral salts, plasma proteins

271
Q

what are the 3 groups of blood cells

A

eyrthrocytes
leucocytes
thrombocytes

272
Q

what are erythrocytes

A

RBC

273
Q

what are leucocytes

A

WBC

274
Q

thrombocytes

A

platelets

275
Q

what colour will the plasma be when haemolysis has occurred

A

red/pink

276
Q

what colour will the plasma be when jaundice has occurred

A

yellow

277
Q

what colour will the plasma be when lipaemia has occurred

A

white/ milky/ cloudy colour

278
Q

what is the Buffy coat

A

where leucocytes and platelet cells are. its in-between the plasma and blood

279
Q

what can be done to avoid haemolytic when taking a blood sample

A

be gentle
avoid excess suction in syringe
make sure blood passes through needle once
remove needle when transferring blood
use widest needle size the px will allow
dont shake blood
examine as quick as possible

280
Q

what are the 3 ways to preserve a blood sample

A
  1. put sample in fridge, freezer
  2. blood smear
  3. put it into an anticoagulant tube or leave it whole
281
Q

where is a blood analysis taken out

A

tested in practice or in house or its sent to an external lab

282
Q

what does CBC stand for

A

complete blood count

283
Q

what does PCV stand for

A

packed cell volume

284
Q

what does Hb stand for

A

haemoglobin

285
Q

what does HCT stand for

A

haematocrit

286
Q

what does TRBC stand for

A

total red blood cell

287
Q

what does TWBC stand for

A

total white blood cell

288
Q

what does MCV stand for

A

red cell mean corpuscular volume

289
Q

what does MCH stand for

A

mean corpuscular haemoglobin

290
Q

what does MCHC stand for

A

mean corpuscular haemoglobin concentration

291
Q

what does RDW stand for

A

red cell distribution width

292
Q

what is PCV and what does it tell you

A

packed cell volume which is the % of the total blood volume which is made up of RBC’s. it can give you hydration status, degree of anemia and blood loss in an animal

293
Q

what equipment is needed for a PCV

A

ETDA tube (pink/red tube)

centrifuge set to 10000 RPM for 5 mins

294
Q

how to use a ETDA tube

A

gently invert the blood within the tube to mix the sample. place your microhaematocrit tube into the blood and allow the tube to fill to 3/4. once the tube is 3/4 full, place your index finger over the top of the tube to prevent back flow of blood. seal the haematocrit tube using plastocine sealant

295
Q

once spun down how many layers will you see In the blood sample

A

3

296
Q

what are the layers in the blood tube once centrifuged

A

plasma
Buffy coat
RBC

297
Q

what is the PCV range for a dog

A

37-55%

298
Q

what is the PCV range for a cat

A

24-45%

299
Q

what does an increase in PCV indicate

A

dehydration due to reduced plasma levels

300
Q

what does a decrease in PCV indicate

A

anaemia or haemorrhage due to fewer RBCs

301
Q

can PCV be breed specific?

A

yes

302
Q

what is biochemistry

A

Biochemistry isthe study of chemical processes in and around living organisms, and is a sub-discipline of both chemistry and biology.It can be divided into three fields: structural biology, enzymology, and metabolism.

303
Q

what colour tube does EDTA cap have

A

pink

304
Q

what does sodium citrate cap have

A

dark purple

305
Q

what does lithium heparin cap have

A

orange

306
Q

what does sodium fluoride/ potassium oxide cap have

A

yellow

307
Q

what ways can you measure biochemistry parameters

A

in house biochemistry analyser vet test

external lab

commercial test strips- dipstick

hand held analyser

308
Q

what is a biochem pre-anaesthetic profile

A

used to admit their pets for clinical procedure which includes parameters such as urea, creatinine, ALT, ALKP, glucose, total protein

309
Q

what is blood urea nitrogen (BUN)

A

Blood urea nitrogen(BUN) is a waste product formed by the liver and excreted by the kidneys as a result of protein metabolism
Good indicator of both liver and kidney function

310
Q

what is the normal range for blood urea nitrogen for a dog

A

2.5-7mmol/L

311
Q

what is the normal range for blood urea nitrogen for a cat

A

5.0-11.0mmol/L

312
Q

why would there be increased levels of urea

A

Infection or necrosis

High protein diet

Chronic heart failure.
With chronic heart failure there is poor renal perfusion so less urea is taken to the kidneys so there is a greater amount in the blood.

Urethral obstruction and rupture of the bladder

Renal failure

Dehydration- causes apparent raised urea levels

Other systemic and metabolic conditions

Corticosteroid therapy -steroids

313
Q

what would cause decreased levels of Urea

A

low protein diet

anabolic steroids

liver failure

portosystemic shunts

314
Q

what is portosystemic shunts

A

portosystemic shunt can be used to refer to any pathology where blood from the splanchnic venous circulation is shunted to an alternate venous drainage pathway without passing through the hepatic sinusoids. - blood doesn’t pass through the hepatic circulation which means urea is not taken up by the blood for excretion by the kidneys.

315
Q

what is creatinine

A

a waste product in the blood formed from creatine, which is found is skeletal muscle. it comes from muscle wear and tear.

316
Q

what does the quantity of creatinine depend on

A

depends on diet and muscle mass

317
Q

how does creatinine diffuse

A

out of muscle and into bodily fluids including blood. when muscle cells are damaged.

318
Q

how is creatinine filtered

A

filtered through the glomeruli in the kidney and eliminated in urine, so determines the kidney function

319
Q

what is the range for creatinine for dogs

A

40-130umol/L

320
Q

what is the range for creatinine for cats

A

40-130umol/L

321
Q

what causes an increase creatinine

A

Muscle disorders in small animals caused by exertional hyperthermia

Hypothyroidism

Heart disease

Selenium/vitamin E deficiencies

Trauma to muscles

322
Q

what is ALT ( alanine aminotransferase

A

an enzyme

323
Q

what is the normal range for aLT for a dog

A

10-125IU/L

324
Q

what is the normal range for a cat

A

12-130IU/L

325
Q

what causes an increase in ALT

A

liver disease

,uncle damage

feline hyperthyroidism

326
Q

what is ALKP/ALP

A

alkaline phosphatase

a liver enzyme

327
Q

what is the normal range for ALKP for dogs

A

0-80IU/L

328
Q

what is the normal range for ALKP for cats

A

15-96IU/L

329
Q

is ALKP higher in young animals or old animals?

A

young animal because large quantities are found in bone (Osteoblasts), so because young animals are still growing, the levels will be higher.

330
Q

what is glucose

A

cell energy source

331
Q

what Is the normal range of glucose for a dog and cats- important

A

3.3-6mmol/L

332
Q

what are glucose levels an indication of

A

carbohydrate metabolism and endocrine pancreatic function

333
Q

wha can cause an elevated signs of glucose

A

diabetes mellitus, hyperadrenocorticism, corticosteroid therapy, stress
pancreatitis
post feeding samples

334
Q

what can cause a decreased levels of glucose

A

hepatic insufficiency
hypoadrenocorticism
neoplasia
malabsorption
starvation
insulin treatment

335
Q

what are the normal ranges for TP for a dog

A

54-71g/L

336
Q

what are the normal ranges of TP for a cat

A

54-78g/L

337
Q

what causes an increased levels of TP

A

dehydration, chronic and immune- mediated disease, lactation, infection and neoplasia

338
Q

what causes an decrease in TP

A

renal disease, malnutrition, malabsorption, haemorrhage, hepatic and pancreatic insufficiency

339
Q

what does blood lactate measure

A

the amount of lactic acid or lactate in the blood

340
Q

what are the normal ranges of blood lactate for cats and dogs

A

less than 2.5mmol/L

341
Q

what causes an increase in lactate levels

A

hypoxia
reduced circulation

342
Q

what are the electrolytes

A

sodium, potassium, chloride, phosphorus

343
Q

what is albumin

A

a protein in the blood

344
Q

what is the normal range of albumin in dogs

A

25-40g/L

345
Q

what is the normal range of albumin in cats

A

25-40g/L

346
Q

why is albumin caused

A

caused of depressed levels of chronic liver disease, ascites, tissue oedema, heart failure and renal failure

347
Q

what is amylase

A

water soluble enzyme secreted by the pancreas

348
Q

what is the normal range for amylase for cats and dogs

A

400-2000units/L

349
Q

what is the normal range of calcium in dogs

A

2-3mmol/L

350
Q

what is the normal range of calcium in cats

A

1.8-3mmol/L

351
Q

what causes elevated levels of calcium

A

dehydration, neoplasia, hyperparathyroidism, renal disease

352
Q

what causes a decreased level of calcium

A

hypoparathyroidism, eclampsia, pregnancy, acute pancreatitis

353
Q

what is the normal range for cholesterol in dogs

A

2.5-8mmol/L

354
Q

what is the normal range for cholesterol in cats

A

2-6.5mmol/L

355
Q

what causes an increased level of cholesterol

A

diabetes mellitus hypothyroidism, hyperadrenocorticism, liver disease, renal disease

356
Q

what causes a decreased level of cholesterol

A

maldigestion, malabsoprtion, sever hepatic insufficiency

357
Q

what is the normal range for phosphorus in dogs

A

0.8-1.6mmol/L

358
Q

what is the normal range for phosphorus in cats

A

1.3-2.6mmol/L

359
Q

what causes an increased level of phosphorus

A

underachieve parathyroid gland and kidney disease

360
Q

what causes a decreased level of phosphorus

A

overactive parathyroid gland, malnutrition, malabsoprtion

361
Q

what does PCV measure

A

% of rbc in blood and is used to assess anaemia/ haemorrhage or dehydration.

362
Q

what does an increase of PCV indicate

A

dehydration as the plasma levels are reduced, but it may also mean endotoxic shock or splenic problems.

363
Q

what does a decrease of PCV indicate

A

a decreased number of rbc’s and anaemia/haemorrhage.

364
Q

what 2 colours of haemltocrit tubes can you get

A

red and blue

365
Q

why do you use a red haematocrit tube

A

If you are taking blood from patient and putting straight into a tube it should be heparinized as it prevents clotting RED micro haematocrit tube

366
Q

why would you use a blue haematocrit tube

A

If you are taking blood from an EDTA sample, it should be into a plain tube –BLUE micro haematocrit tube

367
Q

what is the normal PCV range for dogs- important

A

37-55%

368
Q

what is the normal PCV range for cats- important

A

24-45%

369
Q

what is the speed for a PCV

A

10000 for 10mins

370
Q

what is the purpose of a blood smear

A

The purpose of performing a blood smear is to examine the red and white blood cells. Their size, shape, colour.

371
Q

how to use the diff-quick stain

A

Prepare a small pot of each solution – deep enough to dip a slide completely.
Dip the dried blood smear slide into solution A (Blue) for 5 x 1seconds. Then shake off the excess.
Repeat for solutions B (Red) and C (Purple)
Carefully rinse off the excess solution 3 with distilled water.
Air dry vertically.

372
Q

what do you look at on the blood smear

A

RBC – look at their,
size
shape
colour
intracellular inclusions

May see the nucleus in very immature rbc
Some rbc have some intracellular material – reticulocytes (blue)
May see some intracellular parasites
Differential WBC count is the proportion of each of the different wbc per 100 wbcs seen

373
Q

describe the characteristics of RBC

A

Nucleated red blood cells (NRBC)
The cytoplasm of these is pink. They also become smaller and are called;
Normoblasts
Here, the small nucleus is extruded and the cell is called;
Reticulocyte

A cell with a reticular structure (small pieces of blue staining within the cytoplasm). These cells have no nucleus and enter the blood stream.

374
Q

what are the 3 forms of WBC

A

polymorphonucelur granulocytes
monocytes
lymphocytes

375
Q

describe the characteristics of PMNL

A

These cells have a single lobular nucleus with a granular cytoplasm. By staining they can be divided into;

neutrophil
eosinophil
basophil

376
Q

describe the characteristics of neutrophils

A

Found in the bloodstream at the acute stages of inflammation
They are 10-12 цm in diameter
The nucleus stains purple/violet
The cytoplasm is pale blue/grey
The granules are violet

377
Q

describe the characteristics of eosinophils

A

Crucial part on killing endoparasites contain a toxic based protein
The granules stain orange/red
The shape of the granules varies with species.
The nucleus is bi-lobed or segmented

378
Q

describe the characteristics of basophils

A

Release histamine in response to an
inflammatory response
Similar in size to neutrophils, or slightly larger
The nucleus is a kidney bean shape
The cytoplasm is a mass of deep purple granules (may obscure nucleus)
Granules contain histamine and heparin and they are released at the site of inflammation.
These cells are rarely seen in the normal animal – seen when chronic tissue damage or myeloid leukaemia

379
Q

describe the characteristics of monocytes

A

These are large cells, 15-20 µm in diameter
They are involved in the repair of damaged blood vessels
They attach to the damaged area and plug the leak.
They are then involved in the clotting process to produce fibrin

380
Q

describe the characteristics of lymphocytes

A

There are two types;
Small – nucleus is round (7 – 10 um)
stains deep purple
cytoplasm pale blue
The cell is filled mostly by the nucleus
This is the most common lymphocyte
Large – the nucleus stains lighter (12 – 20 um)
It also has a more light blue cytoplasm

Role – These cells have a protective role. They are associated with;
a. Antibody production
b. Recognition of foreign substances
c. Body itself – auto immune conditions

381
Q

what are some abnormalities of RBC

A

size
shape
colour
inclusions
immaturity

382
Q

what is the name given to large RBC

A

macrocytes

383
Q

what is the name given to small RBC

A

microcyte

384
Q

what is crenation

A

spiky appearance of a RBC.

seen in haemolytic anaemia

385
Q

what is schistocyte

A

red blood cell fragments

386
Q

what is spherocyte

A

spherical

387
Q

what is rouleaux

A

normal shape but cells ae stacked to form chains

388
Q

what is hypochromasia

A

pale in colour

389
Q

what is polychromatic

A

larger bluer cells

390
Q

what are example of cytology samples

A

hair
faecal
skin
lumps
abscess
lungs
heart
joint
nose
mouth
genitals

391
Q

what to prep for a px for cytology samples

A

temperament
condition being investigated
prep of site
invasive procedure?
withhold food
drug treatments?

392
Q

what is centesis

A

a needle within the body cavity or organ to collect fluid

393
Q

what is the prep for cerebrospinal fluid

A

STRICT ASEPSIS during sampling –
Sterile gloves used for procedure
Clip hair
Disinfect skin
Use sterile consumable and equipment
Patient anaesthetised and placed in lateral recumbency
Head and neck are flexed and held in position
VS uses 20-22G spinal needle, into subarachnoid space
Fluid allowed to drip into collection tube(EDTA or plain tubes) (1ml per 5Kg BW)
VS removes need slowly
Adhesive dressing placed over point of insertion

394
Q

what does polyuria mean

A

increased amount of urine

395
Q

what does oliguria mean

A

decreased amount of urine

396
Q

what does straguria mean

A

painful, slow, difficult urination

397
Q

what does anuria mean

A

no production of urine

398
Q

what does dysuria mean

A

difficulty urinating

399
Q

why do we test urine

A
  • test for hormones
  • test for blood present
  • test for glucose
  • test for SG
  • test for protein
  • test for urinary crystals
  • very easy
400
Q

why is urine testing good

A

Non invasive
Simple and quick method to determine health status of patients- Can help us diagnose many conditions of the urinary system and conditions in other body systems.
Often a slight change on urinalysis can lead us to carry out more invasive tests- ie. Bloods, ultrasound, radiography
Conditions that may cause abnormal urine production
Feline lower urinary tract disease (FLUTD)
Diabetes mellitus
Renal disease/failure
Dehydration
Bladder rupture

401
Q

what is the normal output for dogs and cats

A

1-2ml/kg/hr

or

24-48ml/lg/day

402
Q

what equipment is needed do collect a sample

A
  • sample/ collection clean pot
  • cleanable item
  • if owners asked to collect urine sample- recommend PPE
  • feline / canine
  • lead
  • favourite urination area/ good smelling area/ privacy, quiet area for feline pxs
  • steady hand
  • needle and syringe
  • clippers and skin prep for needle extraction , ultrasound gel
  • catheter and serile lube or suture to maintain in place
403
Q

what time should you collect urine and why

A

morning

it will be more concentrated and examine in an hour of collection

404
Q

what are the methods of urine collection

A

free flow

manual expression of the bladder

urethral catheter

cystocentesis

405
Q

explain free flow

A

When urine is collected during normal micturition (urination) the best sample to collect is mid-flow because first flow often contains skin cells and debris from other parts of the urogenital system which may contaminate the sample. If possible, vulva or prepuce should be cleaned to avoid bacterial contamination

406
Q

explain manual expression

A

Done by veterinary surgeon or nurse, gently and steadily palpating the bladder. Patient normally in lateral recumbency. Should never be used in patients with suspected urethra obstruction. Vulva and prepuce should be cleaned before procedure starts.

407
Q

explain urethral catheter

A

This method will provide a more sterile sample involves placing a polypropylene or rubber catheter within the bladder via the urethra. Variety of different catheters available for sex and species. A sterile method should be used to for the procedure, sterile catheter and gloves used.

408
Q

explain cystocentesis

A

This involves passing a sterile needle (22-20g 1-1.5inch) through the abdominal wall into the bladder. Strict asepsis must be adhered to (patient must be clipped and the area cleaned with a skin detergent and surgical spirit.) It is a relatively quick method of obtaining a sterile sample. The patient -rarely needs anaesthetised or sedated as they tolerate this quite well. There must be sufficient urine in the bladder for this to be effective, but it can result in blood contamination of the sample.

409
Q

how do you store urine

A

Morning urine sample ideal
Once a sample has been obtained ideally should be examined within 60minutes.
If a sample is left at room temperature for an extended period cells, casts may degenerate, crystals dissolve or precipate, and some chemical levels within the urine reduce(glucose, bilirubin & ketones), bacteria multiply, increased pH due to bacterial breakdown of urea to ammonia.

Store urine sample in fridge until ready to be tested or sent to lab
Bring urine sample to room temperature before testing.

410
Q

how do you preserve urine samples

A

refrigerate urine sample - recommended for up to 24hrs post collection

boric acid- 0.1-0.2%. this holds the urine sample steady for 48-96hrs post collection.

411
Q

what are some things you might want to analyse in an urinalysis

A

pH
SG
proteins, nitrates, ketones
blood
bilirubin
mucus
urobilinogen
glucose
yeast/ fungus
bacterial cells

412
Q

what are some physical characteristics of urine

A

odour
turbidity
colour
SG

413
Q

what does a pear drop smelling urine indicating

A

diabetes mellitus

414
Q

what does a foul odour of urine indicate

A

excess protein

415
Q

what does viscid urine indicate (sticky)

A

inflammation in the urinary tract

416
Q

what does each colour of urine indicate

A

Clear urine – usually dilute and indicates poldipsia/polyuria
Dark yellow/orange/brown urine – usually more concentrated and indicates dehydration.
Green/yellow. If, on shaking, there is a greenish foam on the surface this indicates biliverdin (oxidation of bilirubin)
Brown/red/black urine – indicates haematuria or certain drugs have been used.
Blue/green urine .Some drugs alter the colour of urine as does beetroot.

417
Q

why will urine go cloudy when left alone

A

due to the microorganisms decomposing urea to ammonia which causes a rise in pH so phosphate is precipitated

418
Q

what may abnormal turbidity be due to

A

RBC
crystals or casts
epithelial cells
bacteria
yeast
fungi
pus- WBC
phosphate precipitation
prostate or vaginal secretions

419
Q

what is SG

A

indication of the weight compared to distilled water

420
Q

what does SG depend on

A

number and molecular weight of solutes dissolved in the urine

421
Q

what is the normal SG for a dog

A

1.015-1.045

422
Q

what is the normal SG for the cat

A

1.020-1.040

423
Q

what is SG an estimation of

A

concentrating ability of the kidney

424
Q

what may cause a decrease of SG

A

polydipsia
chronic renal failure
diabetes insipidus
IV fluid therapy
pyometra
corticosteroid treatment

425
Q

what may cause an increase in SG

A

dehydration
acute renal failure
diabetes mellitus
shock
crystals
haemorrhage

426
Q

what are 2 ways to measure SG

A

dip stick

refractometer

427
Q

what are the characteristics of measuring SG with a refractometer

A

used to measure conc. of protein in serum and the change in the refractive index of a fluid due to substances dissolved in it

more concentrated the fluid, higher the SG, the greater the refractive index.

428
Q

what is glucose in the urine called

A

glucosuria

429
Q

why may increased levels of glucose in the urine occur

A

stress
excitement
hyperthyroidism
diabetes mellitus
cushings
after high doses of cortisol
after saline infusions

430
Q

what is haematuria

A

blood in urine

431
Q

what is bilirubin

A

presence of jaundice and bilirubin in the urine

432
Q

what do ketones show

A

an abnormal and excessive breakdown of fat

433
Q

what is protein in the urine called

A

proteinuria

434
Q

what is urobilinogen

A

bilirubin that has been broken down by intestinal bacteria

435
Q

should bile salts be present in urine

A

no

436
Q

what is pruritis

A

itchy skin

437
Q

what tests are run for skin

A

gross examination- visual (flea dirt)

microscopy- parasites

staining and microscopy- yeasts

culture and sensitivity - pustuls

histology- neoplasia

438
Q

how to collect skin samples

A

collection of coat brushings

tape collection techniques

collection of plucked hair

superficial/ deep skin scrape techniques

squash, smear or swabbing techniques

biopsy

439
Q

what equipment is needed for skin and hair collection

A

PPE
brush, comb, toothbrush
tape
forceps
paper
biopsy ouch
swabs liquid paraffin
microscope slides
scalpel blades

440
Q

explain the coat brushing technique

A

Using a small brush or toothbrush, brush the coat in small areas at a time in one direction. Tap the brush onto a Petri dish, or onto a microscope slide with liquid paraffin and a cover slip, and examine under the microscope. The animal may be allowed to stand over a large piece of paper and the coat brushings poured off or the flea dirt test performed directly on the paper.

The flea dirt test involves dampening the debris brushed out of the coat. In the case of flea faeces being present, the paper will stain a reddish colour as the ingested blood in the flea faeces dissolves in the water.

441
Q

explain the tape technique

A

The animal’s hair is either parted or lightly clipped to expose the skin underneath. A length of sticky tape is then gently pressed down onto the skin and hair. When looking for ectoparasites, the tape is merely stuck directly onto the microscope slide and examined – this technique is extremely useful in diagnosing Cheyletiella infestations in rabbits.

To investigate the presence of yeast infections of the skin, the tape impression is submitted to a staining technique which will illustrate the yeast. For such investigations Scotch tape is recommended and Diff-Quick is a rapid and easy to use stain.
The yeast commonly investigated in practice using this technique is called Malassezia pachydermatitis which causes a greasy and often pruritic skin infection.

442
Q

explain the plucked hair technique

A

Using tweezers or forceps, individual hairs are plucked and submitted for examination.
It is important that the hair root is plucked out.
If there are lesions present, then the hair should be taken from the edge of a lesion.
This technique is used in examination for a fungal infection of the skin and hair, generally ringworm
infection.

443
Q

explain the process of skin scraping

A

Involves using a scalpel blade to scrape the surface of the skin. The depth of the scrapping will depend on the parasite in question but it should result in capillary ooze. Scrapings should be placed onto liquid paraffin or 10% potassium hydroxide. The scrapings can be placed onto a microscope slide for examination under the microscope. The microscope should be viewed immediately

444
Q

what does the examination of faeces provide

A

The examination of faeces provides information on the health of the gastrointestinal tract and how well it is functioning.

445
Q

what are the collection methods for faeces collection

A

direct from ground
direct from rectum

446
Q

what equipment Is needed for faeces collection

A

PPE
collection pot
scoop
paper towel
poo bags

447
Q

how many grams of faeces should be collected

A

5g

448
Q

when should the sample be examined

A

within 2 hrs or stored in fridge

449
Q

what do you look for in faeces samples

A

undigested food
ingested materials that shouldn’t be there

life stage of parasites

450
Q

how do you examine faeces

A

gross examination- look, smell, consistency

microscope examination - direct smears

concentration method- floatations

451
Q

what should you observe in faeces examination

A

colour
smell
consistency
fatty or mucous
identifiable objects
parasitic evidence

452
Q

what does black poo indicate

A

bleeding from SI

453
Q

what does red poo indicate

A

bleeding from LI

454
Q

what does yellow poo indicate

A

malsboprtion of nutrients

455
Q

what does white poo indicate

A

increased fat in diet or eating bone

456
Q

what does fatty or mucoid

A

exocrine pancreatic insufficiency or colitis

457
Q

how do you take a direct smear of faeces

A
  1. Take a microscope slide and place a drop of saline in the middle.
  2. Add an equal volume of faeces.
  3. Add stain; a. Lugols iodine - starch shows blue/black
    b. Methylene Blue - shows undigested meat fibres
    c. Sudan IV - shows fat globules - red
  4. Mix well -make a thin smear and add a cover slip.
  5. Low power look for worm eggs
  6. High power look for protozoa
458
Q

what is the conc. method

A

used to concentrate parasitic material in faeces

used by flotation or sediment

459
Q

what does flotation rely on

A

relies on weight of certain debris and the use of liquids wit different SG

460
Q

what is the method of faecal flotation

A

Standard flotation
1. Mix faeces and solution thoroughly (3 – 4g in 50ml of water)
2. Put mixture through a fine sieve
3. Put the filtrate in a test tube and leave for 5 minutes.
4. Pour off the supernatant then add the flotation solution.
5. Fill a test tube to the top - with a meniscus on top.
6. Place a cover slip on top and leave for 10 – 20 minutes.
7. Lift cover slip off vertically and place it on a slide.
8. Look under low power x 25

Centrifugal flotation
More commonly used than standard
Spin the tubes at 1000 – 1500 rpm for 3-5 minutes
The top fluid meniscus is examined.

461
Q

what is faecal sedimentation

A

this allows parasitic eggs, oocysts and other parasitic material to sink to the bottom of a liquid usually being water

462
Q

what is the method of faecal sedimentation

A

Method
1. Mix 2g of faeces with tap water and then strain
2. Half fill a centrifuge tube with the filtrate
3. Spin at 1500 rpm for 5 minutes
4. Pour off the supernatant
5. Put some sediment, using a Pasteur pipette onto a slide and use a cover slip.
6. Lugols Iodine can be mixed with the sediment before examination under low power

The above method concentrates the eggs by centrifugation.
The disadvantage is that it can be difficult to see the eggs in all the faecal debris.

463
Q

what is the modified McMaster technique

A

this determines the no. of eggs per g of faeces

464
Q

where is occupy blood seen

A

ulcers
neoplasia
parasitism

465
Q

what is a parasite

A

an organism that is dependent both physically and metabolically to another ( the host). they exploit the host for one or multiple life cycles to ensure development and survival

Multicellular ie worms and arthropods
Single-celled ie protozoa
In some cases two or more parasites can effect one host ie fleas and tape worm
This is known as poly or hyperpasrasistism
Hosts in these cases are known as co-infected hosts

466
Q

what are ecto-parasites

A

external parasites
feed on hosts: blood, skin, hair, feathers

joined legs
invertebrates
hard external skeleton
most are arthropods - fleas, lice and flies

body divided into head, thorax and abdomen with 3 main pairs of legs
most are wingless

arachnida- ticks and mites
head, thorax, and abdomen fused. wingless. larvae- 3 pairs, adult 4 legs

467
Q

what are endoparasites

A

internal parasites
live inside a host
live in organs, gut and tissue

468
Q

what are obligatory parasites

A

require a host to complete life cycle
may use more than one host to do this
patasites affecting one host for the duration, direct life cycle such as hook worms
indirect lifecycle = use of multiple hosts to complete cycle in tick
intermediate or secondary hosts are exploited for short periods
final or primary hosts are whir parasites are able to mature and reproduce

469
Q

what are facultative parasites

A

able to live freely
can complete their life cycle without a host
only entering a host under certain conditions
there are opportunistic and produce infection

470
Q

what is the RVN responsibility re parasites

A

advise owners and public on preventative measures and treatment options
client
staff
hygiene
identification of parasites- treat and prescribe
suitable knowledge for protection of yourselves and colleagues.
understand the CS of potential zoonotic conditions.
informing clients about potential parasitics zoonosis risk and advise on suitable precautions

471
Q

what do you look for in faecal examinations

A

signs of undigested food or ingested materials
parasites- particular life stages- eggs, oocysts, larvae, segments, adults
blood

472
Q

how do you examine faecal samples

A

gross examination- oberservations
microscope examination- direct smears
concentration methods

473
Q

what is the latin name for tapeworms

A

cestodes

474
Q

what is the latin name for roundworms

A

nematodes

475
Q

what are examples of roundworms

A

Ascarids:
Toxocara canis (Dogs) & Toxocara cati (cats)
Toxascaris leonina (both)
Hookworms:
Uncinaria stenocephala
Lungworm
Angiostrongylus vasorum
Whipworm
Trihuris vulpis
Folarioides
Dirofilaria imitis

476
Q

what are examples of tapeworms

A

Dipylidium caninum
Echinococcus granulosus
Taenia spp

477
Q
A

Yr 2 (5 decks)

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