Sampling Methods Flashcards by Tia Brown

examples of diagnostic sampling methods?

FNA
Biopsies
Joint and CSF taps
Thoracocentesis
Pericardiocentesis
Abdominocentesis
BAL

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What equipment do you need for an FNA?

Gloves
Needles
Slides
Slide container
Pencil
Lab form

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where do you normally perform an FNA?

Lymph nodes
Small masses
Internal organs

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what can you diagnose with an FNA?

checks sites for Inflammation and neoplasia

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what are the advantages of an FNA?

Diagnostics

Minimally invasive

Can be done without sedation/GA in most cases

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what are the disadvantages of an FNA?

Haemorrhage - low risk

Introducing infection - low risk

Organ perforation - if internal organs

Introduction of air - lung FNA

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what is the difference between fenestration and aspiration?

two types of FNA techqniues

Fenestration
- uses only a small needle
- good for small areas (eg small masses)
- less blood contamination as no neg pressure from syringe
- less cellular damage as no neg. pressure from syringe
- can’t do on organs as syringe stops air from entering the cavity

Aspiration
- provides negative pressure
- good for firm masses that havent worked with fenetration
- good for painful and sensitive areas
- only need to enter site once

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what stains are used on an FNA sample?

inhouse = diff-quick

external = wright stain

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what is the difference between a biopsy and an FNA?

FNA
- little to no sedation
- non-specific cytology
- results often non-diagnostic

biopsy
- easier to visualise on US
- can do laparoscopic or surgical biopsies
- a diagnosis is quarenteed
- high complications - haemorrhage
- requires sedation/GA - so fasting
- small needles can cause tissue crushing and fragmentation

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what equipment do you need for a biopsy?

Sterile Gloves
Biopsy needle
Formalin pot
Slides
Slide container
Pen
Lab form

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where do you normally perform a biopsy?

Internal organs

Commonly done during surgery

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what can you diagnose with a biopsy?

Inflammation
Infection
Neoplasia

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what are the disadvantages of a biopsy?

Painful
- requires sedation or GA

High risk of haemorrhage
- coagulation testing is vital prior to liver/spleen biopsy

Risk of pneumothorax if lung

Damage to other organs

Vagal response (cats)

Hypertensive crisis – adrenal gland

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what equipment do you need for a thoracocentesis?

gloves
clippers
chloroprep
lidocaine
blade
butterfly needle
syringe
3-way-tap/one way valve
kidney dish
EDTA tube

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what is the site of insertion for a thoracocentesis?

7th-9th intercostal space

avoids liver and heart

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what do different samples from a thoracocentesis suggest?

blood = haemothorax
- neoplastic effusion
- run PCV

puss = pyothorax
- bacterial infection in chest cavity
- run cytology

air = pneumothorax
- lung rupture

pale liquid = chylothorax
- lymph fluid
- thoracic duct damaged
- run biochem

neoplastic
- run cytology

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what are the advantages of a thoracocentesis?

Diagnosis

Therapeutic
- removes fluid or air from lungs
- improves inflation and ventilation

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what are the possible complications of a thoracocentesis?

Can require sedation/GA
- depending on patient compliance

Risk of haemorrhage and pneumothorax

Must be monitored closely after procedure

what equipment do you need for a pericardiocentesis?

gloves
clippers
chloroprep
lidocaine
blade
periocardiococentesis catheter
syringe
3-way-tap/one way valve
kidney dish
EDTA tube

what is the site of insertion for a pericardiocentesis?

3rd-5th intercostal space

ideally right lateral

what can a pericardiocentesis let us diagnose?

often neoplasia

run cytology to confirm

whatchecks should you perform during a pericardiocentesis?

ensure patient is on an ECG
- hit heart = arythmias

check small sample for clotting before draining
- confirms not blood from heart

what are the possible complications of a pericardiocentesis?

Painful

Requires sedation/GA in most cases

Hgh risk of hitting major vessels/perforating ventricle

Haemorrhage

Arrythmias

Pneumothorax

Effusion is very likely

what are the advantages of a pericardiocentesis?

Diagnosis

Therapeutic
- remove fluid from cardiac space
- stop/prevent cardiac tamponade - pressure preventing filling of right ventricle

what equipment is needed for a joint tap?

sterile gloves clippers chloroprep needle syringe slides EDTA and serum tubes

best technique for a joint tap?

Flex joint to open joint capsule

what can a joint tap help us diagnose?

collection of synovial fluid - smear and cytology - EDTA for WBC count - heparin for clot testing - blood culture also helps differentiate: - inflammatory or infectious - traumatic, acute or chronic

crude assessment of synovial fluid? what can it tell us?

colour - normally clear - yellow = bleeding (bilirubin) clarity/apacity - normally clear - more opaque = inflammation viscosity - normally quite thick - if thinned then infection/inflammation

what are the disadvantages of a joint tap?

high risk of intoducing infection some risk of haemmorrhage requires sedation/GA

what equipment do you need for a cerebrospinal fluid tap?

clippers chloroprep sterile gloves spinal needle - no syringe as neg pressure causes damage EDTA tube

where can you perform a CSF tap?

cisternal - preferred lumbar

what can you diagnose with a CFS tap?

should be colourless, ordorless and clear - if not then issue cytology - check bacteria/inflammatory cells protein assessment fungal culture - check toxoplasma/nesopora

what are the disadvantages of CSF taps?

Possible trauma to the spinal cord Introduction of infection Raises intracranial pressure - brain herniation - avoid cisternal if patients already have raised pressure Must be under GA

what equipment do you need for an abdominocentesis?

gloves clippers chloroprep butterfly needle slides if drain then 3-way tap EDTA tube

reasons for ascites?

heart failure uroabdomen - trauma splenic or GI rupture/trauma - haemoabdomen low protein = low albumin FIP infection

where do you perform an abdominocentesis?

centre of linea alba use ultrasound to guide into fluid pockets

what can an abdominocentesis allow us to diagnose?

neoplasia haemorrhage FIP (yellow and straw-like) cytology - bacteria/infection biochemistry - hypoalbuminaemia or urine

what are the advantages of an abdominocentesis?

diagnosis therapeutic - reduces abdominal pressure - improve ventilation - reduce pressure on organs

what are the disadvantages of an abdominocentesisis?

risk of perforating internal organs risk of haemorrhage sedation likely needed

what equipment do you need for a broncho-alveolar lavage?

Intubation equipment EDTA Serum tubes Gloves Syringe Saline Endoscope

where do you perform a BAL?

down ET tube

what can a BAL allow us to diagnose?

Pneumonia Lungworm Asthma

what are the disadvantages of a BAL?

risk of hypoxia - monitoring spO2 is vital bronchospasm post proedure common - especially in cats may worsen respiratory signs - due to inflammation