The Essential cTBNA Bronchoscopist
The Essential Conventional TBNA Bronchoscopist© is the third of six volumes in The Essential Bronchoscopist™ Series. In addition to module-specific competency-oriented learning objectives and post-tests, it contains 30 multiple-choice question/answer sets pertaining to conventional transbronchial needle aspiration (cTBNA). Topics include mediastinal anatomy, proper equipment handling, patient preparation, procedural indications contraindications and complications, bronchoscopic techniques, nodal sampling strategies, lung cancer staging and classification, specimen collection, processing, and expected results for diagnosing malignant and benign mediastinal disorders.
The Essential Conventional TBNA Bronchoscopist© is the third of six volumes in The Essential Bronchoscopist™ Series. In addition to module-specific competency-oriented learning objectives and post-tests, it contains
30 multiple-choice question/answer sets pertaining to conventional transbronchial needle aspiration (cTBNA). Topics include mediastinal anatomy, proper equipment handling, patient preparation, procedural indications contraindications and complications, bronchoscopic techniques, nodal
sampling strategies, lung cancer staging and classification, specimen collection, processing, and expected results for diagnosing malignant and benign mediastinal disorders.
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Question I.10 After performing transbronchial needle aspiration, the needle cannot be
withdrawn into its catheter. You should:
A. Pull the needle completely into the working channel of the scope anyway in order to
remove it.
B. Straighten the bronchoscope. Then remove the needle and the flexible bronchoscope
simultaneously while keeping it in the middle of the airway but without pulling the
needle back into the working channel of the scope.
C. Straighten the bronchoscope. Pull the needle into the working channel so that only the
tip of the needle is visible beyond the tip of the scope. Then remove the needle and the
flexible bronchoscope simultaneously while keeping it in the middle of the airway.
D. Straighten the bronchoscope. Then pull the needle back into the working channel in
order to remove it.
Answer: C
It is safest to straighten the bronchoscope, and while keeping the needle tip in view, to pull the
entire ensemble out. By keeping the scope and needle tip in the middle of the airway, there is no
risk of injury the airway mucosa. The only danger is to scratch pharyngeal or nasal mucosa.
This risk is minimal if the scope is “straight” and without distal flexion or extension, and if only
a small portion of the needle tip is visible beyond the distal tip of the bronchoscope.
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