FECAL ANALYSIS Flashcards by Anne Cruz

In what part of the digestive track do pancreatic enzymes, and bile salts contribute to digestion

Small intestine

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Where does the absorption of water takes place in the primary digestive process?

Large intestine

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Which of the following test is not performed to detect osmotic diarrhea?

Fecal neutrophils

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The normal composition of feces includes all of the following, except

Blood

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What is the fecal test that requires a three day specimen?

Quantitative fecal fat testing

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Normal brown color of the feces is produced by

Urobilin

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Diarrhea can result from all of the following except

Increased absorption of intestinal, water, and electrolytes

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Stools from persons with steatorrhea will contain excess amounts of

Fat

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Which of the following pairings of stool appearance and cause does not match

Yellow-green barium sulfate

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Stool specimen that appear ribbon like are indicative of what condition

Intestinal constriction

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Black tarry stool is indicative of

Upper G.I. bleeding

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Chemical screening tests performed on feces include all of the following except

Pilocarpine iontophoresis

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Secretory diarrhea is caused by

Vibrio cholerae

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The fecal osmotic gap is elevated in which disorder

Osmotic diarrhea

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Microscopic examination of stools provide preliminary information as to the cause of diarrhea because

Neutrophils are present in conditions that affect the intestinal wall

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True or false

The presence of fecal neutrophils would be expected with diarrhea caused by a rotavirus

False

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Large orange, red droplet seen on direct microscopic examination of stools mixed with Sudan III represent

Neutral fats

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Microscopic examination of stools mixed with sudan III and glacial acetic acid, and then heated will show some more orange red droplets that represents

Fatty acids

Soaps

Neutral fats

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When performing a microscopic stool for muscle fibers the structures that should be counted

Have two dimensional striations

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A value of 85% fat retention would indicate

Steotorrhea

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Which of the following tests would not be indicative of steotorrhea

Fecal occult blood

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The term OCCULT blood describes blood that

Is not visibly apparent in the stool specimen

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What is the recommended number of samples that should be tested to confirm a negative occult blood result

Two samples taken from different parts of three stools

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The immunochemical tests for occult blood

Test for human globulin

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Guaiac test for detecting occult blood rely on the

Pseudoperoxidase activity of hemoglobin

What is the significance of an AP test that remains pink after addition of sodium hydroxide?

Fetal hemoglobin is percent

In the Van de karmer method for quantitative fecal fat determinations, fecal lipids are

Converted to fatty acids prior to titrating with sodium hydroxide

A patient whose stool exhibits increased fats and digested muscle fibers, and the inability to digest gelatin may have

Cystic fibrosis

A stool specimen collected from an infant with diarrhea has a pH of 5.0 the result correlates with a

Positive clinitest

Which of the following tests differentiates a malabsorption cause from a maldigestion cause in steotorrhea

D-xylose test

Human feces is called as

Stool

Feces is plural of Latin term for _____ meaning_____

FAEX RESIDUE

Is the waste residue of indigestible materials of animals digestive tract expelled through the______ during_____

Anus Defecation

Newborn first feces is

Meconium

Study of feces is called

Scatology or coprology

Produces strong odor and flatus Lactose intolerance leads to excessive gas production

Bacterial metabolism

Major site for final breakdown and reabsorption of compounds

Small intestine

4 digestive enzymes

Trypsin Chymotrypsin Lipase Amino peptidase and lipase

increase daily stool in the diarrhea

Above 200 G

Increased liquidity and frequency of more than three times per day

Diarrhea

4 classification of diarrhea

Illness duration Mechanism Severity Stool characteristics

3 major mechanism

Secretory Osmotic Intestinal hypermotility

Bacterial, viral and protozoan infections produce increased secretion of water and electrolytes, which override the absorptive ability of large intestine Stools are characterized as watery and voluminous with no RBC,WBC and mucus

Secretory diarrhea

3 causative agent of secretory, diarrhea

Vibrio cholerae Enterotoxigenic Escherichia coli Giardia lamblia

Mechanism of secretory diarrhea Usually caused by an organism that produces a toxin that stimulates______ that leads to____&_____

Adenylase cyclase enzyme Crampy diarrhea & Secretion of intestinal fluid

Mostly caused by bacteria Stool may contain WBC,RBC and specks of mucus and sometimes the organism Destroys the mucosal lining of intestines producing pus, blood and mucus in stool

Invasive diarrhea

Patient with invasive diarrhea is experiencing

Tenesmus

5 causes of invasive diarrhea

Shigella dysenteriae Entamoeba histolytica Enteroinvasive Escherichia coli Campylobacter jejuni Yersinia enterocolitica

Incomplete breakdown of absorption of food represents increased fecal material to large intestine, resulting in retention of water and electrolytes in thr large intestine Usually caused by any efficient absorption of an osmotic substance due to enzyme deficiency Stool samples are watery and gaseous with no WBC,RBC and mucus

Osmotic diarrhea

osmotic diarrhea positive for substances not reabsorbed (4)

Lactose Reducing sugar Fat globules Muscle fibers

2 causes of osmotic diarrhea

Lactose intolerance Pancreatic insufficiency

Osmotic diarrhea pH: Secretory diarrhea pH:

< 5.3 > 5.6

4 tests used in secretory diarrhea

Stool cultures Ova and parasite examination Rotavirus immunoassay Fecal leukocytes

10 tests used in osmotic diarrhea

Microscopic fecal fats Muscle fiber detection Qualitativ fecal fats Trypsin screening Clinitest D-xylose test Lactose tolerance test Fecal electrolytes Stool pH Fecal osmolality

Enchanced motility Can be seen in irritable bowel syndrome 5 causes

Altered motility Cramping Bloating Flatus Diarrhea Constipation

Absence of bile salts that assist pancreatic lipase in breakdown and subsequent reabsorption of triglycerides Increase fat in stool: 3 conditions:

Steatorrhea >6G/day Cystic fibrosis Chronic pancreatitis Carcinoma

Distinguish the steatorrhea in maldigestion and malaabsorption condition Is a shoe guard that does not need to be digested, but does not need to be absorbed to be a present in the urine

D- xylose test

Normal d-xylose test indicates

Pancreatitis

Specimen collection Container must be _____,_____and _____

Clean, nonbreakable, and leakproof container

Specimen collection for fecal occult blood, WBC or qualitative fat only a____ specimen is required

Small

Specimen collection for quantitative fecal fat analysis

72 hours specimen

Technologist must be aware of contaminants such as (3)

Urine Water Paper

3 types of macroscopic examination

Color Consistency Form

Normal stool color is Urobilinogen is converted the urobilin and stercobilin

Brown

Pale color of stool signifies

Biliary obstruction

Color of bleeding stool in upper GIT

Black stools

Color of bleeding stool in lower GIT

Red stools

3 types of stool consistency

Formed Watery Hard

Normal form of stool

Cylindrical

Ribbon like stool (3)

Tumor blockage Malignancy Colon cancer

Small round or scybalous stool (1)

Constipation

Bulky and frothy stool (3)

Bile duct obstruction Pancreatic insufficiency Steatorrhea

Mucoid form of stool (2)

Colitis Constipation

Mucus and blood streaked stool (3)

Amoebic colitis Dysentery Malignancy

Type of stool that separate hard lumps like nuts and hard to pass

Type 1

Type of stool that has sausage shape, but lumpy

Type 2

Type of stool like a sausage, but with cracks on its surface

Type 3

Type of stool like a sausage or snake, smooth and soft

Type 4

Type of stool has soft blobs with clear cut edges and passed easily

Type 5

Type of stool has fluffy pieces with ragged edges and mushy stool

Type 6

Type of stool that is watery, no solid pieces and entirely liquid

Type 7

door is basically depends on the pH of stool and ____ And_____ substances that produce normal odor

Indole Skatole

Foul order is caused by degradation of

Undigested protein excessive carbohydrate intake

Sickly sweet odor is produced by

Undigested lactose

Based on the pseudoperoxidase activity of hemoglobin molecule reacting with the______ Screening test for colorectal cancer and GIT bleeding ___or____ of stool is significant

Fecal occult blood Chromogen 2.5 mL or 150 grams

Commonly used in fecal occult blood because it is not too sensitive and avoids high false positive

Gum guiac

Most sensitive chromogen

Benzidine

Positive result of fecal occult blood

Blue chromogen

Substances that may also exhibit pseudoperoxidase activity or reaction (4)

Hemoglobin Myoglobin Vegetables Fruits

Dietary restrictions 3 days before the examination (6)

Red meat Horse radish Melons Raw Broccoli Turnip Vitamin C and iron

Specific for globin portion of human hemoglobin and uses anti human hemoglobin antibodies Does not require dietary or drug restrictions More sensitive to lower G.I. bleeding could be an indicator of colon cancer Can be used for patients who are taking aspirin and other anti-inflammatory medications

Immunochemical fecal occult blood test

Offers a porphyrin based FOBT fluorometric test for hemoglobin based on conversion of heme to fluorescent porphyrins Measures both intact hemoglobin and hemoglobin in that has been converted to porohyrins

Hemoquant Or Porphyrin-based fecal occult blood

Determine if infants, stool or vomitus is feral or maternal in origin Fetal blood resist, alkaline degeneration remains pink while maternal blood is sensitive to alkaline degeneration turns yellow brown

APT test

APT test procedure Specimen in emulsified with____,____ then added with______

Water Centrifuged 1% sodium hydroxide

Result of APT test Maternal blood is denature: Fetal blood is unchanged:

Yellowish brown Pink

Confirmatory test for steatorrhea Collection of 3 days fecal specimen Method: Rapid test:

Quantitative fecal fat testing Van de kamer titration (gold standard) Acid steatocrit

3 types of microscopic examination

WBC Increased fecal fat Meat or muscle fibers

Seen in bacterial dysentery and ulcerative colitis Invasive organisms are positive Toxin producing organism are negative Wet preparation with methylene blue gram’s stain or wright’s stain __/hpf is significant

Fecal WBC 3 WBC

Detects fecal WBC, even on frozen specimen

Lactoferrin latex agglutination test

Infection or inflammatory intestine mucosal wall 5 bacteria in fecal WBC/neutrophils: Five clinical significance in fecal wbc:

Neutrophils Salmonella Shigella Campylobacter Yersinia E. coli Ulcerative colitis Dysentery Ulcerative diverticulitis Intestinal TB Abscess

Signifies pancreatic insufficiency Associated with bulky frothy stool with lots of fecal fat Abnormal connection of stomach and intestine_____ Digested meat fibers has no striations Partially digested fiber has___striation Undigested fiber has___striation

Muscle fiber Gastrocolic fistula 1 2

Procedure of muscle fiber Stool with____ Exam slides for___ Count the_____

10% eosin 5 minutes Striated muscle fibers

Done in cases of steatorrhea and malabsorption syndromes 4 types of fats: 3 Stains used:

Qualitative fecal fat Neutral fat Fatty acid salts or soaps Fatty acid Cholesterol Sudan 3 (most commonly used) Sudan 4 Oil red O

Neutral fat stain procedure Mixed tool with____ Count the______ ___/HPF IS SIGNIFICANT

Sudan 3 Large orange-red droplets > 60 droplets

Split fat stain measures total fat fat procedure Mix stool with____ and___ it measures____ and_____ Count and take note of______ Normal is ______ ______ Is significant

Acetic acid and heat Soap and fatty acid Size of droplets 100 small droplets ; < 4 um 6 to 75 um

Cholesterol fecal fat procedure Stool Is mixed with____ then heated Allow to cool and then look for______

Sudan 3 Cholesterol crystals

FECAL ANALYSIS Flashcards

(106 cards)