AUBF-Lab-Stool Flashcards by vnlla babe

The third part of the routine urinalysis is the ______ examination of the urinary sediment.

microscopic

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Micro Exam of Urine: Its
purpose is to detect and to identify ______ material present in the urine.

insoluble

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These contributes to the formed elements in urine.

blood
Kidney
lower genitourinary tract external contamination

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Formed elements in the urine consists of (9)

RBCs
WBCs
epithelial cells
casts
bacteria
yeast
parasites
mucus
spermatozoa
crystals
artifacts

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Because some of these components are of no clinical significance and others are
considered normal unless they are present in ______ amount, examination of the urinary sediment
must include both ______ and ______ of the elements present.

increased; identification and quantification

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The ______ microscopic examination is the least standardized and most ______ part of the routine urinalysis.

urine; time consuming

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Identify the Urinary Crystal: Acid
Yellow-brown
Alkali soluble

Uric Acid

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Identify the Urinary Crystal: Acid
Brick-dust or
Yellow-brown
Alkali and heat

Amorphous urates

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Identify the Urinary Crystal: Acid/neutral (alkaline)
Colorless (envelope)
Dilute HCI

Calcium oxalate

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Identify the Urinary Crystal: Alkaline/neutral
White-colorless
Dilute acetic acid

Amorphous phosphates

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Identify the Urinary Crystal: Alkaline/neutral
Colorless
Dilute acetic acid

Calcium phosphates

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Identify the Urinary Crystal: Alkaline
Colorless “Coffin Lids”
Dilute acetic acid

Triple phosphate

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Identify the Urinary Crystal: Alkaline
Yellow-brown “Thorny Apples”
Acetic acid with heat

Ammonium biurate

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Identify the Urinary Crystal: Alkaline
Colorless “dumbbell”
Gas from acetic acid

Calcium carbonate

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Identify the Abnormal Urinary Crystal:
Acid
Colorless
Ammonia, dilute HCI

Cystine

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Identify the Abnormal Urinary Crystal:
Acid
Colorless (notched plates)
Chloroform

Cholesterol

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Identify the Abnormal Urinary Crystal:
Acid/neutral
Yellow
Hot alkali or alcohol

Leucine

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Identify the Abnormal Urinary Crystal:
Acid
Yellow
Acetic acid, HCI, NaOH, Ether,
Chloroform

Bilirubin

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Identify the Abnormal Urinary Crystal:
Acid/neutral
Varied
Acetone

Sulfonamides

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Identify the Abnormal Urinary Crystal:
Acid
Colorless
10% NaOH

Radiographic dye

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Identify the Abnormal Urinary Crystal:
Acid/neutral
Colorless
Refrigeration from bundles

Ampicillin

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What are the NORMAL urinary crystals found in urine? (8)

Uric Acid
Amorphous urates
Calcium oxalate
Amorphous phosphates
Calcium phosphates
Triple phosphate
Ammonium biurate
Calcium carbonate

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What are the ABNORMAL urinary crystals found in the urine? (7)

Cystine
Cholesterol
Leucine
Bilirubin
Sulfonamides
Radiographic dye
Ampicillin

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What are the CASTS seen in urine? (6)

Waxy Casts
Granular Casts
Fatty Casts
Granular WBC Casts
WBC & Renal Epithelial Casts Cells
WBC & RBC Casts

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Microscopic Examination of Urine Procedure

1. Bring pathologic urine samples in the laboratory 2. Fill the test tube with % full of urine **Take note of the color and chemical properties of the specimen by using a dipstick (for correlation only) before centrifuging 3. Centrifuge at high speed for 5-10minutes 4. Decant the supernatant fluid and allow throw tube to stand for some time 5. Focus first under the low power objective and then examine well under the high power objective

Stool examination is often done for evaluation of?

gastrointestinal disorders

Stool examination can be used to diagnose several disorders such as?

Gl obstruction obstructive jaundice parasitic disease dysentery ulcerative colitis increased fat excretion

An adult excretes ______ of fecal matter a day, of which as much as 75% may be _______.

100g to 200g; water

The feces are what remain of the ______ of digested fluid-like material that enters the intestinal tract a day, and oral fluid, saliva, gastric secretion, pancreatic juice and bile add to the formation of feces.

8 to 10L

The ________ (3) of the stool should be noted.

quantity form consistency color

Large amounts of mushy, frothy, foul smelling stool are characteristic of?

steatorrhea

Feces have a characteristic odor that varies with the _____ and _____ of the stool.

diet and pH

The first indication of gastrointestinal disturbances can often be provided by changes in the ______ and ______of the normal stool.

brown color and formed consistency

The brown color or normal feces is probably due to _______, a bile pigment derivative.

stercobilin (urobilin)

What Color of Stool will be caused by the ff? Upper gastrointestinal bleeding Iron Therapy Charcoal Bismuths (Antacids)

Black

What Color of Stool will be caused by the ff? Lower Gastrointestinal Bleeding Beets and food coloring Rifampin

Red

What Color of Stool will be caused by the ff? Bile-duct obstruction Barium sulfate

Pale, Yellow, White, Gray

What Color of Stool will be caused by the ff? Biliverdin/Oral Antibiotics Green vegetables

Green

What Color of Stool will be caused by the ff? Bile-duct obstruction Pancreatic disorders

Bulky/Frothy

What Color of Stool will be caused by the ff? Intestinal constriction

Ribbon-like

What Color of Stool will be caused by the ff? Colitis Dysentery Malignancy Constipation

Mucus/Blood streaked mucus

STOOL CONSISTENCY (5)

FORMED SEMI-FORMED SOFT WATERY MUCOID

The most frequently performed fecal analysis is chemical screening for the detection of ________.

occult (hidden) blood

Bleeding in the upper GI tract may produce a ______, ______ stool.

black, tarry

Bleeding in the lower GI tract may result in an overtly ______ stool.

bloody

_______ testing is also controversial owing to many false-positive and false-negative results.

Occult blood

**Patients must be on a ______ diet for ______ prior to the test to avoid false positive reaction. Salmons, sardines, and mutton also produce positive blood test.

meat-free; 4 days;

What foods can cause positive result in occult blood testing?

Salmons, sardines, and mutton

What are the tests for testing of occult blood?

Benzidine Test Guaiac Test

Procedure for Benzidine Test:

1. Take a piece of stool about a size of a pea and place on the spot plate 2. Add few drops of unsaturated solution of benzidine in glacial acetic acid and mix with feces using an applicator 3. Add a few drops of 3% hydrogen peroxide is produced

Positive Result of Benzidine Test

A blue to green color is produced

Procedure of Guaiac Test

1. Take a piece of feces the size of a pea and place on a spot plate 2. Add 2 drops of glacial acetic acid and mix with the feces, using an application stick 3. Add a few drops of the Guaiac reagent. Mix.

Positive result of Guaiac Test

A blue to green color is produced

Increased destruction of red blood cells, as in hemolytic anemia, increases the amount of _______ excreted.

urobilinogen

Liver disease, in general, reduces the flow of ______ to the intestine and thereby decreases the fecal excretion of urobilinogen.

bilirubin

In addition, complete ______ of the bile duct reduces urobilinogen to very low levels.

obstruction

DETECTION OF FECAL UROBILIN: This test investigates ______ and _____ conditions.

hemolytic diseases and hepatic obstructive

is an estimation of the total excretion of bile pigments, which are breakdown products of hemoglobin.

Determination of stool urobilinogen

Reference Values or Stool Urobilin in adult? in newborns-6months

50-300 mg/24hourss or 100-400 Erlich units/100g Newborns - 6 months: Negative

Principle of Schmidt's Test

Hydrobilirubin unites with mercury compounds to form a red hydrobilirubin -mercury

Procedure of Schmidt's Test

1. Place a few grams of fresh feces in a mortar and add an equal quantity of 10% mercuric chloride solution. 2. Mix well with pestle 3. Transfer to a shallow evaporating dish and allow to stand 6-24 hours

Positive result of Schmidt's Test: Urobilin which is normally present will give a _____ color Bile which is not normally present in feces will give a _____ color

red; green

Positive result of Schmidt's Test: Urobilin which is normally present will give a _____ color Bile which is not normally present in feces will give a _____ color

red; green

Microscopic screening of fecal smears is performed to detect the presence of_____ associated with microbial diarrhea and undigested muscle fibers and fats associated with steatorrhea.

leukocytes

Fecal leukocytes primarily _______, are seen in the feces in conditions that affect the intestinal mucosa, such as _____ and _____.

neutrophils; ulcerative colitis and bacterial dysentery

______ can be helpful in the diagnosis and monitoring of patients with pancreatic insufficiency, such as in cases of cystic fibrosis.

Undigested striated muscle fibers

Procedure of Direct Fecal Smear Method

1. Emulsify a minute amount of the most suspicious portion of the stool with an applicator stick and NSS solution. 2. Place a cover slip 3. Examine the preparation under the microscope

Direct Fecal Smear Method: *This method permits the examination of motile stages of fresh stools. In the case of cyst, the addition of a drop dilute ______ solution will help in bringing about details in these structure.

Lugol's